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Long-term interdisciplinary therapy reduces endotoxin level and insulin resistance in obese adolescents

Fábio S Lira15*, Jose C Rosa1, Gustavo D Pimentel1, Ronaldo V Santos2, June Carnier1, Priscila L Sanches1, Aline de Piano1, Claudio T de Souza5, Lian Tock1, Sergio Tufik3, Marco T de Mello13, Marília Seelaender4, Claudia M Oller do Nascimento1, Lila M Oyama12* and Ana R Dâmaso12*

Author Affiliations

1 Departamento de Fisiologia, Rua Botucatu nº 862 Vila Clementino, São Paulo, Brazil

2 Departamento de Biociências, Rua Marselhesa n Vila Clementino, São Paulo, Brazil

3 Departamento de Psicobiologia, Rua Marselhesa n Vila Clementino, São Paulo, Brazil

4 Da Universidade Federal de São Paulo–UNIFESP, São Paulo. Grupo de Metabolismo e Câncer, ICB-Universidade de São Paulo–USP, São Paulo, Brazil

5 Laboratory of Exercise Biochemistry and Physiology, Health Sciences Unit, University of Southern Santa Catarina, Criciúma, SC, Brazil

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Nutrition Journal 2012, 11:74  doi:10.1186/1475-2891-11-74

Published: 18 September 2012



The purpose of the present study was to assess the dietary fat intake, glucose, insulin, Homeostasis model assessment for insulin resistance HOMA-IR, and endotoxin levels and correlate them with adipokine serum concentrations in obese adolescents who had been admitted to long-term interdisciplinary weight-loss therapy.


The present study was a longitudinal clinical intervention of interdisciplinary therapy. Adolescents (n = 18, aged 15–19 y) with a body mass index > 95th percentile were admitted and evaluated at baseline and again after 1 year of interdisciplinary therapy. We collected blood samples, and IL-6, adiponectin, and endotoxin concentrations were measured by ELISA. Food intake was measured using 3-day diet records. In addition, we assessed glucose and insulin levels as well as the homeostasis model assessment for insulin resistance (HOMA-IR).


The most important finding from the present investigation was that the long-term interdisciplinary lifestyle therapy decreased dietary fat intake and endotoxin levels and improved HOMA-IR. We observed positive correlations between dietary fat intake and endotoxin levels, insulin levels, and the HOMA-IR. In addition, endotoxin levels showed positive correlations with IL-6 levels, insulin levels and the HOMA-IR. Interestingly, we observed a negative correlation between serum adiponectin and both dietary fat intake and endotoxin levels.


The present results indicate an association between dietary fat intake and endotoxin level, which was highly correlated with a decreased pro-inflammatory state and an improvement in HOMA-IR. In addition, this benefits effect may be associated with an increased adiponectin level, which suggests that the interdisciplinary therapy was effective in improving inflammatory pathways.

Obesity; Cytokines; Endotoxin; Insulin resistance; Interdisciplinary therapy