Day 2 :
Keynote Forum
Alper Celik
Turkish Metabolic Surgery Foundation, Turkey
Keynote: Basic concepts and rationale of metabolic surgery
Time : 10:00-10:40
Biography:
Alper Celik graduated from Ankara University School of Medicine in 1999 and started his training in the fi eld of General Surgery in 2000. Following the invitation of\\\\r\\\\nProfessor Fumio Konishi, he worked as a clinical and research fellow at Saitama Medical Center of Jichi Medical University during 2007 in Japan. He also worked\\\\r\\\\nwith Dr Ricardo Cohen and Dr Louis Berti in Brazil and Dr Muffazal Lakdawala and Dr Suren Ugale in India. What shaped his career in the fi eld of Metabolic Surgery\\\\r\\\\nwas the BPD (Biliopancreatic Diversion) technique training he received in Italy from Nicola Scopinaro. He set up Metabolic Surgery Clinic in 2011. He received\\\\r\\\\nSurgeon of Excellence in 2013 by Surgical Review Corporation. He is the Founder and President of both Turkish Metabolic Surgery Foundation and Metabolic\\\\r\\\\nSurgery Association
Abstract:
Metabolic Syndrome and two of its most important components, obesity and Type 2 diabetes have reached pandemic\\\\r\\\\nproportions threatening the entire world. Initial treatment options indicating life style changes including diet and exercise\\\\r\\\\nhave failed to achieve desired results for an important proportion of patients and eventually considerable numbers of patients\\\\r\\\\nbecame worse than the pre-treatment status because of reactional weight regain. Currently, the most eff ective treatment for\\\\r\\\\nobesity and Type 2 diabetes is without a doubt, surgical procedures. Th ere is no treatment option that can achieve remission for\\\\r\\\\nthe entire compounds of Metabolic Syndrome with over 90% effi ciency. However, it should be known that there are numerous\\\\r\\\\nmethods used for the surgical treatment of metabolic syndrome and all of these methods have advantages, disadvantages,\\\\r\\\\nrestrictions and effi ciency of their own.\\\\r\\\\nCurrently the most widespread procedures in obesity surgery are gastric bypass and sleeve gastrectomy. Unfortunately\\\\r\\\\nthe third most widespread procedures in terms of frequency are revision operations. Sadly, the word “revision’’ represents\\\\r\\\\nthe disability and ineffi ciency of the operations we perform. Surgical community is focusing on performing tighter sleeves,\\\\r\\\\nnarrower anastomoses, and surgeons are trying to revise failed restrictions with further restriction. As is valid for any restriction\\\\r\\\\ndone on human beings throughout the history with thousands of examples, mechanical restriction and restrictive operations\\\\r\\\\ndone for obese individuals will fail in the end. Anthropometric data also suggests a digestive adaptation based on our feeding\\\\r\\\\nbehavior. Th e success in terms of bariatric and metabolic control relies on the activation of distal intestinal hormones like GLP-\\\\r\\\\n1, Peptide YY and oxyntomodulin which provide an insulin mimetic and anorexiogenic eff ect.\\\\r\\\\nIn the light of all this knowledge and while keeping universal digestive adaptations mechanisms in mind, Metabolic Surgery\\\\r\\\\naims to activate ileum based hormones without causing severe malabsorption. Ileal Transposition and Transit Bipartition\\\\r\\\\nprocedures, two surgical techniques devised with this purpose, will be explained in detail during presentations
Keynote Forum
Hillel Mazansky
Corporate Keynote Speaker at Gianinc, USA
Keynote: The Management of moderate -morbid obesity using Virtual Lap Band Hypnosis in conjunction with diet and exercise
Time : 11:00-11:40
Biography:
Hillel Mazansky is Corporate Keynote Speaker in GIANINC since January 1977 – Present He is also a Physician & CEO. He is an Expert international healthcare\\r\\nkeynote speaker Motivational. He is a very knowledgeable, patient, empathic professional with a great mind. He is a passionate and knowledgeable resource to\\r\\nanyone looking to improve their health and lifestyle. He has membership in the Royal College of General Practitioners, American psychology and medical hypnosis\\r\\nassociation. He is the president and owner of Gianinc, the premier fi rm dedicated to teaching employers and employees of Fortune 500, as well as Mid-Sized\\r\\nto Small businesses how to live longer, healthier lives through the use of Guided Imagery, nutrition and exercise. He is the only physician in the entire world that\\r\\nspecializes in medical hypnosis and hypnotherapy, guided imagery(visualization/meditation) nutrition and exercise. For the second consecutive year, I am pleased\\r\\nto announce that Guided Imagery and Nutrition, Inc. has been selected for the 2012 San Diego Award in the Guided Imagery Specialist category by the US\\r\\nCommerce Association (USCA)
Abstract:
Four modalities comprising medical hypnosis and hypnotherapy, guided\\r\\nimagery (visualization/meditation), nutrition and exercise are utilized in\\r\\ntreating moderate to severely obese patients. I have practiced this type\\r\\nof medicine since 2011. Previously I was a family physician with over\\r\\n45 years of experience, and am thus able to render a more effective\\r\\ntreatment result for patients as opposed to hypnosis alone.The causes and\\r\\nsequelae of obesity will be discussed.\\r\\nFrom 1970 - 1973 while practicing family medicine in South Africa I was\\r\\nprincipal investigator in a three year study of obese patients, publishing the\\r\\nfindings of the study in the South African Medical Journal. Subsequently\\r\\nI spoke at the first International Society of Obesity held in London in 1973.\\r\\nMy book, titled “Empower Yourself with Medical Hypnosisâ€, published in\\r\\n2014 offers chapters on medical hypnosis, guided imagery, nutrition and\\r\\nexercise. My website is DrMedicalHypnosis.com, and my YouTube channel\\r\\nis MrGianinc.
- Track 3: Weight Management Strategies
Track 4: Surgical Procedures for Weight Loss
Track 5: Child hood Obesity- Causes and Risk Factors
Location: Liberty-4
Chair
Alper Celik
Turkish Metabolic Surgery Foundation, Turkey
Co-Chair
Stacy D Hunter
Pure Action Inc., USA
Session Introduction
Marvin A Sackner
University of Miami, USA
Title: If you choose to stay seated “Don’t sit stillTMâ€
Time : 11:40-12:10
Biography:
Marvin A Sackner has completed his MD from University of Zurich, he was born in 1932, educated at Jefferson Medical College from 1953-1957, trained in Medicine and Cardiology at Philadelphia General Hospital until 1961 and was a Research Fellow in Physiology at University of Pennsylvania from 1961-1964. He has been in Miami ever since as Chief of Pulmonary Diseases and Medicine, Mt. Sinai Medical Center as well as Professor of Medicine, University of Miami. He was President of the American Thoracic Society and Chairman, American Subspecialty Board of Pulmonary Disease. He has authored 225 scientifi c publications and 3 books and holds 34 American patents
Abstract:
FDA has exempted from regulation, low-risk general wellness devices used in conjunction with a healthy lifestyle to help reduce risk or help living well with heart disease, high blood pressure and Type-2 diabetes. A sedentary lifestyle is unhealthy viz., an average adult spends 50 to 70% of waking hours sitting at a computer screen in a car or watching television; 80% of Americans do not exercise. To mitigate excessive sitting, several low-risk wellness devices have become available that include sitting-standing, treadmill and cycling desks and step counting with accelerometers. All require active participation not readily accepted or complied with on a long-term basis by the general population. We fabricated a passive device, the“Gentle JoggerTM†in which a seated subject places feet upon two motorized pedals that are reciprocally moved at jogging speed to fl ex and extend the ankle with soles tapping against a rigid surface. Applications of 15 to 30 minutes between or aft er meals are recommended. Seated, “jogging†permits single tasking while operating a computer, reading, conversing or watching television. It operates through an off -on switch, is portable weighing 5 kg or 11 lb., and fi ts within a roller bag. It has an LED display of step counts that can be logged for consumer feedback with options for monitoring of pulse rate, blood pressure and glucose on an iPhone or iPad before, during and aft er a treatment. On cessation of treatment, the subject oft en perceives a temporary, pleasant, tingling, sensation in the legs that may migrate to the body
Stacy D Hunter
Pure Action, Inc. USA
Title: Hot yoga and obesity-related metabolic dysfunction
Time : 12:10-12:40
Biography:
Stacy Hunter is the Research Director for Pure Action, Inc. a nonprofi t organization devoted to funding yoga research and providing yoga to underserved populations. She is also an affi liate of the University of Texas at Austin where she received her PhD in Clinical Exercise Physiology studying the effects of yoga on vascular function in the Cardiovascular Aging Research Laboratory. She has published several studies on the impact of various styles of yoga on vascular function and glucose tolerance and traveled the US and abroad presenting her fi ndings
Abstract:
Insulin resistance is associated with obesity and advancing age. Although much evidence supports a positive role of traditional exercise in improving metabolic function, only a few studies have employed yoga as an interventional strategy. Yoga may present a feasible alternative exercise for obese adults due to the low-impact nature and moderate-intensity of this activity. As indirect evidence has shown benefi cial eff ects of stretching and thermal therapy on glucose metabolism, we investigated the eff ect of 8 weeks of hot yoga, a combination of thermal therapy and fl exibility training on glucose tolerance in both lean and obese adults. Although no changes in anthropometric measures occurred in lean adults, body mass and body mass index signifi cantly declined in obese subjects as a result of the hot yoga intervention. Glucose tolerance also improved in obese but not in lean adults. Bikram yoga may be an eff ective alternate therapy for the treatment of obesity-related metabolic dysfunction.
Brandy E Strahan
University of Florida, USA
Title: The effect of video-game playing on overweight/obese adolescents with autism spectrum disorders
Time : 13:40-14:10
Biography:
Brandy Strahan is working on completing her PhD at the University of Florida, College of Nursing and completed her MSN at Florida State University in Nursing Education. She is an assistant professor at the University of West Florida, Department of Nursing, teaching pediatric nursing as well as community and public health nursing. She is a member of Sigma Theta Tau International and has served as treasurer
Abstract:
Obesity is a problem of epidemic proportions for children, and children with developmental disorders, specifically autism spectrum disorder (ASD), are at higher risk (30.4%) than the general population (23.6%). Although numerous studies have addressed adolescent obesity in the typically developing population, none exists for adolescents with ASD. The ongoing dissertation research incorporates physical activity through video gaming that should appeal to the adolescent. A single subject, multiple baseline design will be used to determine if inactive and active video gaming has an effect on weight, BMI, waist-to-neck ratio, and triceps skinfold as well as self-reported stress and anxiety. Parental satisfaction will assessed to help determine the social validity of the intervention for improving health outcomes
Sjaak Pouwels
Catharina Hospital, The Netherlands
Title: Effects of bariatric surgery on inspiratory muscle strength
Time : 14:10-14:40
Biography:
Sjaak Pouwels, MD, recently finished Medical School (Radboud University Medical Centre Nijmegen, the Netherlands) and is currently working on his PhD thesis called ‘Exercise and physiology in Abdominal and Bariatric surgery’ at the Catharina Hospital Eindhoven, the Netherlands. He is currently working in the Catharina Hospital Eindhoven in the Netherlands, at both the general surgery department and the bariatric centre. His main research interests are perioperative physiology and exercise in the broadest way possible
Abstract:
Introduction The respiratory function is affected by obesity due to an increased deposition of fat on the chest wall. Objectives The objective of this study was to investigate the strength of the inspiratory respiratory muscles of obese individuals and the possible influence of bariatric surgery. Methods Of the patients referred to our bariatric centre between the 3rd of October 2011 and the 3rd of May 2012 the Maximum Inspiratory Pressure (MIP) was measured at screening and 3, 6 and 9 months postoperative. Results The mean age of the 124 included patients was 42.9 ± 11.0 years and mean BMI was 43.1 ± 5.2 kg/m2. The mean predicted MIP preoperatively was 127 ± 31 in cm H2O and the mean measured MIP was 102 ± 24 in cm H2O. Three patients (2.4%) received training. Three months after surgery the MIP was 76 ± 26 cm H2O, after 6 months 82 ± 28 cm H2O and after 9 months 86 ± 28 cm H2O. All postoperative measurements were significant lower than preoperatively (P<0.05). No significant difference was found between patients who had a sleeve gastrectomy compared to a gastric bypass (P=0.06, P=0.165 and P=0.124 after 3, 6 and 9 months respectively). The only influencing factor for the preoperative MIP was age (p=0.014). Conclusion The preoperative MIP values were significantly lower than the predicted MIP values and a significant decrease in inspiratory pressures was found at 3, 6 and 9 months after bariatric surgery
May N Al-Muammar
King Saud University, Saudi Arabia
Title: Predictors of physicians’ practices related to nutritional counseling and management in Riyadh City
Time : 14:40-15:10
Biography:
May N Al - Muammar is an associate professor of Nutrition at King Saud University. She completed her PhD on 2003 from King Saud University and her masters on 1992 from Iowa State University. She is the dean of the college of Applied medical sciences in King Saud University, Riyadh, for the last two years till present. She has published more than 25 papers in reputed journals and is a member of various scientifi c associations including Saudi Dietetic association, American School Health Association and Sheikh Ali Bin Sulaiman Alshehri Chair for Research and Treatment of Obesity
Abstract:
Background: A growing interest has become increasing in the role of physicians as eff ective resources for the promotion of good nutritional practices, however, the factors that impede their Nutritional Counseling & Management practice (NC&M) are not clearly understood in Saudi Arabia. Objectives: Th e objectives of the study were to investigate physicians’ practices concerning NC&M and to explore some determinants that predict such practices. Results: Data of 266 physicians working in big hospitals in Riyadh showed that only 7.9% of the respondents reported that they were practicing all aspects of NC&M; including nutritional assessment, therapy, and education. Th ose who practiced any one of these aspects ranged between 13.9–40.2%, meanwhile, 28% frankly reported that they did not practice NC&M. Physicians attitude and perceived effi cacy towards NC&M was moderately high as the mean scores were greater than their midpoint. Th eir perceived barriers of NC&M were considerably moderate; as the mean total score was found to be near the midpoint of that scale. Among the seven independent variables entered the binary logistic regression of physicians practice of NC&M, only the knowledge, attitude, and selfeffi cacy scores were signifi cantly associated with their NC&M practice. Th ese three predictors contributed by 23.5% of the variation of physician practice of NC&M. Conclusions: Physicians knowledge, self-effi cacy, attitudes and other factors should be stressed in any intervention warranted to improve their nutritional practices
Abdeslam Hamrani
Lodz University of Technology, Poland
Title: Prevalence of metabolic syndrome and its individual components among Moroccan adolescents: The role of overweight-obesity and excess body fat
Time : 15:10-15:40
Biography:
Abdeslam Hamrani has completed his PhD at the age of 27 from Ibn Tofaïl University, Morocco and started his Postdoctoral studies in the Framework of the Erasmus Mundus Project at the Lodz University, Poland. He worked as a Trainer for PhD students in Applied Statistics and as an Assistant Professor. He has published 10 papers in reputed journals, he serves as a reviewer at three journals (Journal of the American Society for Nutrition, USA; Journal of Metabolic Syndrome, OMICS Group, USA; Net Journal of Social Sciences, UK) and he is an Author of two books
Abstract:
The prevalence of obesity and related diseases such as Metabolic Syndrome (MetS) are increasing in young populations over the world, especially in developing countries. Th is study aimed to estimate the prevalence of MetS and its individual components and to assess their association with both overweight-obesity and excess body fat. Th is study included 192 adolescents (77 boys and 115 girls) aged 11 to 17 years. Blood pressure, anthropometric measurements, glucose and lipids levels from fasting blood samples were determined. Percent body fat was estimated using deuterium oxide. MetSwas defi ned according to international diabetes federation criteria. Th e prevalence of MetS among overweight-obese adolescents was 18.6% while it was not observed in their normal weight counterparts. Th e most common abnormality found in the study population was reduced HDL-cholesterol (26.6%) followed by elevated fasting blood glucose (22.4%) and high waist circumference (19.3%). Among overweight-obese groups, the rates of individuals with raised TG and reduced HDL-cholesterol were signifi cantly higher in boys than girls. Overweight-obese subjects had higher odds of having at least two MetS components (OR=5.37) or at least three MetS components (OR=11.80). Excess body fat showed similar degrees of association with clustering MetS components. In conclusion, the prevalence of MetS and its individual components was quite high among the study population particularly among overweight-obese adolescents. MetS components were strongly associated with both overweight-obesity and excess body fat. MetS and its components might be best predicted by obesity indexes determined according to age and body mass index in adolescents than accurate percent body fat
Rajajeyakumar Manivel
Chennai Medical College Hospital and Research Centre, India
Title: Effect of yoga type of breathing on R-R interval variability and sympatho-vagal balance: Early interventions to prevent the future risk of obesity related complications
Time : 15:40-16:10
Biography:
Rajajeya Kumar Manivel has completed his MD Physiology (2006-2009) at JIPMER-An Institution of National Importance under the Ministry of Health & Family Welfare, Govt. of India. He worked as Research Assistant (2009-2012) in Advanced Centre for Yoga Therapy, Education and Research Lab, JIPMER. He did MSc Yoga in Annamalai University and completed ISAK Level 1 and 2 (2010-11). He has published more than 20 papers in reputed national & international journals. He is serving as an expert reviewer (>14) and Editorial Board Member (>15) for many national and international journals.
Abstract:
The prevalence and severity of obesity are increasing worldwide, especially in India and other South Asian countries. Obesity increases cardiovascular morbidity and mortality risk through insulin resistance, dyslipidemia, hypertension, metabolic syndrome, diabetes etc. In recent years, Heart Rate Variability (HRV) is a simple method to evaluate the sympathovagal balance at the Sino-atrial level. Th e balance was changed in favor of sympathetic activity and vagal activity was decreased in obesity. Low HRV is associated withan increased risk of coronary heart disease and sudden cardiac death. Time domain analysis of HRV uses statistical methods to quantify the diff erences between successive R-R intervals. Frequency domain analysis of HRV calculates the respiratory dependent High Frequency (HF) and the Low Frequency (LF) powers. High frequency power is mediated by vagal activity while low frequency power has been suggested to represent both sympathetic and parasympathetic activity but predominantly sympathetic modulation. Where as LF/HF ratios refl ect the mirror images of sympathovagal balance.Yoga is an ancient discipline designed to bring balance and health to the physical, mental, emotional and spiritual dimensions of the individual. Th ese techniques act through down-regulation of the Hypothalamic–Pituitary–Adrenal (HPA) axis and the Sympathetic Nervous System (SNS). Early detection and management by weight reduction and regular exercise can reduced the risk and increase HRV. Th is analysis can detect changes even before clinical signs appear. Th us regular assessment of HRV measures can be used asa biomarker for early detection and subsequent management of cardiovascular diseases in obese individuals