Al-zhar University, Egypt
Bifid bacterium represent one of the major genera of the intestinal tract of human and animals used as probiotics in dairy and nondairy foods for restore the intestinal micro flora which confers a health benefit. The identification of bifid bacterium by phenotypic features is commonly unreliable, time, money, and effort consuming. We sought to improve the Bifid bacterium identification method based on molecular level to identify probiotic bacteria in complex microbial communities. The application of 16S-23S rRNA Oligonucleotides primers is the best and most reliable, rapid, and precise species and sub species identification approach. The ribosomal antigenic spacer region (ISR) located between the highly conserved 16S rRNA and 23S rRNA shows a high degree of variation in length and sequence and potential for intra species discrimination and providing the phylogenetic Relationship of the Genus Bifid bacterium spp. Results showed that one of the two primer sets Bflac2-Bflac5 species specific gives positive results differentiating between B. animal is ssp. Lactic isolated from breast fed infants milk of human and that isolated from feces of breast fed infant and detecting reference strain for B. animal is ssp. Lactic DSM10140. DNA sequences of the two strains were submitted to the Genbank NCBI under accession number (KT758845) named as B. animal is ssp. Lactic Egm1 (Egyptian milk) and accession number (KT758846) named as Egf1 Egyptian feces while the second primer give false positive result. Also, we aim to obtain patent protection under Intellectual property rights (IPRs) for B. animal is ssp. Lact is which was isolated from Egyptian resources to be used for a better and healthier food and dairy products.
Aalborg university, Denmark
Background: To measure the probability of 10-year cardiovascular disease (CVD) risk based on Framingham risk scores (FRS) and to explore the latterʼs association with, sitting time, central obesity and physical activity among Saudi adults.
Methods: In a cross-sectional survey, 2997 Saudi adults were selected from 18 primary health care centers and 24 private institutions situated in Riyadh.
Results: The FRS scores revealed that 33% (n=320) males and 17% (n=346) females had intermediate/high 10-year probability for developing CVD. The multiple logistic regression model for males and females revealed that >6.0 hours sitting time [males OR 1.4 (95%CI 1.0,2.0; females. OR 1.6 (95%CI 1.2,2.0)]; central obesity [males OR 1.8 (95%CI 1.2, 2.7) females OR 1.6 (95%CI 1.0, 3.0)]; ; high central obesity [males OR 2.6 (95%CI 1.8,3.9) females OR 3.3 (95%CI 1.9, 5.5) and low physical activity [ males 2.0 (95%CI 1.0, 4.0) females OR 1.3 (95%CI 1.0, 1.8)] were associated with intermediate/high CVD risk.
Conclusions: Modifiable risk factors of central obesity, prolonged sitting time, and low physical activity have high implications for primary care prevention that can change the risk profile for CVD of Saudi population.
Spanish National Research Council (CSIC), Spain
Obesity is well-known to involve alterations in the metabolism damaging thus the immune systemwhich causes a higher risk to suffer from infections and allergies. More recently, there is scientific evidence about the important role that microbiota can play in the prevention and development of obesity and other chronic diseases, especially as a result of an energy unbalance. Probiotics have been defined as food supplements containing live bacteria (Bifid bacteria, Lactobacillus, Streptococcus and non-pathogenic strains of Escherichia coli). The adequate administration of probiotics can exert health benefits due to their potential effectiveness both in preventing and treating immunological disorders. Nowadays, probiotics are considered as a useful tool to healthily modulate intestinal microbiota. This is the reason why the use of potential therapies including probiotics alone or together with prebiotics (symbiotic) has been suggested as a new approach to manage obesity, diabetes type 2 and other chronic diseases that promote a distorted immune system and unbalanced microbiota. In particular, several bacteria strains have been shown to act as obesity prevention both in animal models and in humans. Recently a new usefulness of probiotics has been discovered to tackle obesity-related alterations, such as osteoporosis, adipose tissue accumulation, allergy symptomatology, gut mucosa lesions and hypercholesterolemia. In conclusion, although most of the studies to evaluate the effectiveness of probiotics on obesity have been performed on animal models, the results are very promising, especially those related to changes in microbiota and the improvement of the immune function in obese subjects.
Department of Studies in Food Science & Nutrition, University of Mysore, India
Menopause is the strongest biological transitory phase in a womenʼs life. Natural menopause is associated with CVD risk, which may be related to hormonal and metabolic changes.. The prevalence of the metabolic syndrome increases with menopause and may partially explain the apparent acceleration in CVD after menopause. The transition from pre- to post-menopause is associated with the emergence of many features of the metabolic syndrome, including viz., increased central (intra-abdominal) body fat, a shift toward a more atherogenic lipid profile, with increased low density lipoprotein and triglycerides levels, reduced high density lipoprotein, and small, dense low density lipoprotein particles and increased glucose and insulin levels. It is unclear whether the transition to menopause increases CVD risk in all women or only those who develop features of the metabolic syndrome. The study reports the prevalence of Metabolic Syndrome in an apparently healthy population of employed pre and post menopausal women in Mysore city, India. 150 subjects without previous history of diabetes, dyslipidemia, hypertension or cardiac event, with a family history of one or more CVD risk factor were randomly drawn from a sample of 443 subjects belonging to an age group of 30 – 60years and grouped according to their menopausal status. They were evaluated for the presence of metabolic syndrome using NCEP criteria. It was observed that irrespective of menopausal status a higher percentage of women exhibited features of metabolic syndrome, 50% had FBS ≥ 110mg/dl and HDL <50mg/dl while; > 50% had waist circumference ≥ 85cm. The observations indicate the prevalence of metabolic syndrome in apparently healthy women employees irrespective of their menopausal status. It is recommended that women aged 35 years and above, especially with a family history of CVD risk factors or cardiac event need to undergo cardiac evaluation annually or as required. Awareness programs for lifestyle changes should be organized by the institutions in association with health care sectors. A better understanding of these metabolic changes with menopause will aid in the recognition and treatment of women at risk for future CVD, leading to appropriate interventions.
Departement of Biology, University of Tlemcen, Algeria
Maternal obesity is associated with increased adiposity and alter depression of genes in the adipose tissue of the fetus, including increased expression of LPLThese findings, suggestive of the protective effects of marine food sources against heart disease, have prompted the study of mechanisms for the hypotriacylglyceridaemic action of w3 fatty acid . The aim of the present study was to determine the time course of changes LPL adipose tissue in cafeteria-diet-fed and cafeteria diet supplemented green microalgae dams during gestation, lactation and pups at weaning. The study focuses on four groups of pregnant rats and offspring consuming the control diet or cafeteria diet supplemented or not by marine unicellular algae, LPL white adipose tissue was measurement, tissue homogenates were prepared by homogenizing 100 mg of tissue for 1 min in 4 ml of 50 mM NH4Cl/aq. Our results shown that the cafeteria plan provide an obese phenotype with alterations mainly causing an increase in TG, VLDL-TG and LPL. The supplementation of 10% of marine microalgae reduced TG, VLDL-TG and higher LPL in obese pregnant rats-algae and off spring. In conclusion, maternal over nutrition has long term metabolic consequences. The supplementation of 10% marine microalgae can reduce this disorder by a significant increaseLCPUFAn-3.
Keywords: Adipose tissue, w3, LPL, obesity.
Trauma, abuse and neglect in childhood are correlated with many adult issues including food and body image issues. Newer research shows that childhood maltreatment has a direct impact on two very important developmental issues – the healthy development of the brain and itʼs nervous system connections and healthy attachment. Both attachment issues and dysfunction of brain development can lead to difficulties in emotional regulation, impulse control, the capacity for healthy relationships and social interactions, attention and the ability to responses to stress – all of which have a direct impact on food and body image issues. This workshop will present a 4-point approach from integrative medicine to 1) address brain recovery, 2) offer the SIMPLE™ eating plan, 3) uncover hidden causes of obesity and 4) stop cravings, emotional and stress eating.
1. At the end of this workshop, participants will be able to list the adverse childhood experiences that correlate with the development of food and body image issues.
2. At the end of this workshop, participants will be able to name specific therapies to help with brain recovery.
3. At the end of this workshop, participants will be able to list the hidden causes of obesity.
4. At the end of this workshop, participants will be able to develop a treatment plan based on the 4-point program for food and body image issues.
Keywords: Obesity, weight loss, body image, childhood trauma, attachment disorders, amino acids, dietary supplements
Q and A
1. Adverse childhood experiences are strongly associated with the development of food and body image issues. (True)
2. Amino acid therapies have not been shown to have any impact on food and body image issues. (False)
3. Attachment disorders have not been shown to be a contributing factor in the development of food and body image issues. (False)
4. Adapt gens are herbal therapies for stress. (True)
5. Childhood trauma can cause changes in the way the brain develops. (True)
6. Thyroid disease does not cause obesity. (False)
7. A personʼs reaction to stress can be one reason why they may overeat. (True)
8. Many people with obesity are missing very important vitamins and minerals that affect their mood and digestion. (True)
9. Obesity is caused by lack of willpower, not by genetics. (False)
10. A personʼs body image can be affected by bullying by their peers or by family members. (True)
Dr. Carolyn Coker Ross is an internationally known author, speaker, expert and pioneer in the use of Integrative Medicine for the treatment of Eating Disorders, Obesity and Addictions. She is a graduate of Andrew Weilʼs Fellowship Program in Integrative Medicine. She is the former head of the eating disorder program at internationally renowned Sierra Tucson. Dr. Ross is a consultant for treatment centers around the US. She is the author of three books including one of the first books on Binge Eating Disorder: The Binge Eating and Compulsive Overeating Workbookand her recent book, The Emotional Eating Workbook. Her newest book, The Food Addiction Recovery Workbookwill be released on September 1, 2017. Dr. Ross currently has a private practice in Denver and San Diego specializing in Integrative Medicine for treating eating disorders, addictions, mood and anxiety disorders and obesity.
Department of Food and Nutrition, School of Food Engineering, UNICAMP, Brazil
Background: The prevalence of obesity has been growing worldwide in all age groups, including adolescents. Inadequate eating behavior and sedentary lifestyle are factors that contribute to the nutritional transition from underweight to obesity. In this sense, the analysis of eating behavior such as craving for sweets is fundamental to better understand the factors that contribute to inadequate eating habits and overweight in adolescence.
Objective: To show the association of craving for sweets and overweight among teenagers.
Methods: Cross-sectional study was carried out with 132 adolescents, 64 males and 68 females, aged 15-19 years, from a public school located in the state of Minas Gerais, Brazil. The Taste Attitude Scale was applied to analyze craving for sweets. The anthropometric and body composition measurements evaluated were weight, height, BMI, skinfold thicknesses and body fat percentage. Statistical analyzes were performed by PASW 17.0 software, with significance level 5%. The study was approved by the Research Ethics Committee of the State University of Campinas, Brazil, protocol number 48065215.3.0000.5404.
Results: Craving for sweets was associated with overweight, adiposity and physical inactivity (P<0.05). Triceps (18.33±5.48 vs 12.47±5.57), biceps (9.88±5.27 vs 7.43±4.93), subscapular (14.81±6.05 vs 11.32±5.40), supra-iliac (18.52±6.96 vs 13.34±8.30) and abdominal skinfold thicknesses (20.22±5.98 vs 15.13±7.81) and BF% (25.33±6.60 vs 15.14±7.47) were higher among females than males (P<0.05). Females also had higher craving for sweets score (22.88±4.77 vs 18.89±5.81) and higher frequency of physical inactivity (64.7% vs 25%) than males (P<0.05).
Conclusion: Craving for sweets was associated with overweight and physical inactivity in adolescence. These findings allow for the proposition of nutritional education directed at motivating healthier eating and lifestyle habits among teenagers.
Helena Previato is Nutritionist, Master in Health and Nutrition and PhD candidate in Food and Nutrition by University of Campinas (UNICAMP), Brazil. She works as researcher in the area of teenagersʼ food behavior (food neophobia, craving for sweets and nutrition) in Department of Food and Nutrition, School of Food Engineering, UNICAMP, Brazil. She is member of the Evaluation Commission of Residence in Health, Education Ministry, Brazil. She is Invited Professor in the Postgraduate course in Nutrition, School of Nutrition UNIS, Brazil. She is member of the Editorial Board of several International Scientific Journals in the field of nutrition and food science.
1University of Worcester, England
2Worcestershire Health and Care NHS Trust, England
Physical health problems are common in young people with psychosis who experience poor health and a significant reduction in life expectancy. mainly due to premature cardiovascular disease (CVD), underpinned by metabolic disorders like diabetes, and tobacco smoking. Moreover, the mortality gap compared to non-psychotic peers is widening. NICE (2014) developed 8 quality standards for the care of adults with psychosis and schizophrenia which included 2 physical health standards requiring services to complete a comprehensive physical health assessment and offer combined healthy eating and exercise programmes as well as help to stop smoking. This presentation will describe one of the first UK ‘real worldʼ service evaluations of a bespoke EI physical health monitoring and intervention programme for young people with early psychosis called SHAPE. SHAPE offers a co-ordinated, multi-professional, 12 week wellbeing and exercise programme in a youth focused, socially inclusive setting. Anthropometric data are measured at baseline, 12 weeks and 12 months post-intervention. Mean baseline data revealed participants were at an increased health risk with elevated values in mean BMI (70% overweight/obese), waist circumference, resting heart rate, and triglycerides. Over 50% reported smoking daily and 52% of participants were prescribed highly obesogenic antipsychotic medications (Clozapine, Olanzepine). At 12 weeks and 12 months, no changes were observed in mean BMI, waist circumference or any other clinical variable (p > 0.05). Positive impacts on lifestyle behaviours included 7 participants eating ~400g of fruit/vegetables daily, 2 ceased substance use, 2 ceased alcohol use, 4 ceased smoking and 5 were less sedentary. SHAPE supported participants to attenuate their physical health risk following a 12-week intervention which was sustained at 12 months follow up. Participants also made positive lifestyle behaviour changes contributing to weight maintenance and physical health.
Professor Jo Smith is a Professor in Early Intervention in Psychosis (EIP) at University of Worcester, Worcester, UK. Jo is a member of the International First Episode Physical Health Group (iphYs) promoting the physical health needs of young people with Psychosis in relation to their increased cardiovascular and diabetes risk. Jo is Project Lead of a physical health monitoring and intervention programme for young people with early psychosis called ‘SHAPEʼ funded through a Health Foundation (UK) SHINE Award 2014. ‘SHAPEʼ has been a finalist for several national awards including a National Institute for Clinical Excellence (NICE 2017) ‘Shared Learningʼ Award.
KarolinskaInstitutet and Capio St Goranʼs Hospital, Sweden
Background: Hyper insulinemic hypoglycemia (HH) is a post-operative complication after Roux-en-Ygastric bypass (RYGBP). Dietary intake and lifestyle a choice affect the symptoms but is not well-studied neither are the metabolic parameters.
Methods: Food intake of ten patients with HH and nine controls was registered, during seven days. Meals per day, energy distribution, carbohydrate quality and nutrient content were compared between the groups and to the dietary recommendations. Furthermore, all patients wore a blinded continuous blood glucose monitor (CGM, a Dexcom-4) during the study and metabolic parameters were assessed.
Results: Meals per day and energy distribution complied with the dietary recommendations in both groups, but fiber intake was lower. The maximum dietary recommendation for added sugar (10% of total energy intake) was exceeded by both groups; those with HH (14.6% of total energy intake) and the control group (11.4% of total energy intake) but the difference was not statistically significant (p = 0.327). The HH group had a lower intake of vitamin B12 (3.4±1.5 μg vs 5.5±2.3 μg, p<0.05) and calcium (680±193 mg vs 866±184 mg, p<0.05) compared to the control group. The proportion of subjects (with no difference between the two groups) that actually complied with the dietary recommendations was only 16% for vitamin A, 53% for vitamin D, and 26% for iron. The metabolic parameters will also be presented but are now processed.
Conclusion: There were no statistically significant differences in compliance to the dietary recommendations between the HH group compared to healthy controls apart from lower intake of B12 and calcium in the HH group. However, there are trends towards higher intake of sugar, iepoor carbohydrate quality and lower micronutrient content in the HH group. The study shows that the overall intake of dietary micronutrients after RYGBP is inadequate. The metabolic results will also be added to this presentation.
Joanna Uddén Hemmingsson is a senior consultant in the Endocrinology department and in charge of the Medical Obesity Unit at St Goranʼs Hospital in Stockholm, Sweden. Dr Uddén Hemmingsson is also an affiliated researcher at the Department of Medicine in the Karolinska Institute at Karolinska University Hospital in Huddinge.
Her research interests include diabetes and metabolic implications of weight regulation. She is engaged in several associations within both steering and organizing committees for obesity and diabetes research as well as education, and also chairperson of the Swedish Organization for the Study of Obesity.
She has published in several international medical journals in the areas of bariatric surgery, but also about endocrine and stress aspects of abdominal fat accumulation, as well as on the impact of behavioral changes and metabolic risk factors.
ICAR-Central Institute of Fisheries Technology (CIFT), India
Fish oil considered as a perfect diet because of its high digestibility and bioactivity. It contains high amount of polyunsaturated n-3 fatty acids such as EPA and DHA. However, it can undergo oxidation easily resulting in the formation of toxic off flavor compounds such as peroxides and hydro peroxides. These compounds adversely affect the nutritional quality and reverse any cardiovascular benefits. By using microencapsulation with various biopolymers we can solve this problem. This encapsulated PUFA rich oil will possess numerous health benefits. The current study aimed to investigate the possible protective effect of encapsulated PUFA against doxorubicin-induced cardiotoxicity and the underlying mechanisms. In vitro cytotoxicity evaluation was conducted using H9c2 cardiomyocytes. MTT assay revealed that effective cytoprotective effect was induced by a sample concentration of 12.5μg/mL. Results of apoptosis by double fluorescent staining with acridine orange/ethidium bromide and Caspase-3 evaluation by ELISA substantiated the above findings. Further, flowcytometric determination of membrane potential, relative expression of NF-κB by PCR, and ROS determination using DCFH-DA also confirmed the protective effect of encapsulated sardine oil against doxorubicin induced cardiotoxicity. NF-κB expression was down-regulated nearly by 50% on cells treated with encapsulated fish oil. Altogether the results revealed that these microparticles demonstrated cell protection against doxorubicin-induced oxidative stress.
Keywords: PUFA; Cardio toxicity; Doxorubicin. Microencapsulated fish oil.
Vishnu K. V. Expertise in Microencapsulation of marine lipids and its health benefits. He has multiple years of experience in research in the field of Biochemistry and Molecular biology. He is currently working on stabilization of nutritionally important marine lipids by microencapsulation with polysaccharide-protein complex.
Johns Hopkins Bloomberg School of Public Health, USA
Obesity is a multi factorial disease at the intersection of environment, genetics, lifestyle, government policy, food availability, and socioeconomic factors. The healthcare cost of obesity has drawn attention and resources to addressing this disease, but this focus on obesity has distracted the community from considering the root causes of this disorder. The messages that have been sent by the healthcare professionals to overweight patients are frequently resulting in no change in behavior due to low awareness of the primary care physicians of the underlyng causes of obesity and lack of training required to counsel patients to change lifestyle. Moreover, the prevailing emphasis on counting calories and macronutrient composition of the meals has not resulted in drops in obesity rates, and, in fact, quite the opposite became the norm. We are making the arguments that the reason for the failure of this approach is lack of recognition of the underlying eating disorders. We argue that a more effective approach could be developed if the emphasis be put on learning about the psychology of eating disorders and considering obesity as part of that spectrum. We propose steps to integration of trained dieticians nutritionists into the healthcare and adopting evidence-based practice in weight management that embraces both sides of the spectrum eating disorders: anorexia/bulimia and obesity, that will lead to recognizing the early symptoms of this spectrum disorder and developing effective treatments using multi-disciplinary approach. Case studies of successful management of lifestyle modification and use of technology to learn about and manage lifestyle of patients will be presented.
Dr. Tsaioun is a scientist and entrepreneur with focus on commercialization of technological innovations in safety assessment and translation of science innovations into public policy. She got her PhD in Nutritional Biochemistry at Tufts University Friedman School of Nutrition Science and Policy. Her research was on the role of vitamin K-dependent protein in the aging nervous system. She spent most of her career developing and implementing safety assessment tools for pharmaceutical industry. Dr. Tsaioun serves on the scientific review and advisory boards of a few technology companies and NIH. Her main research interests are in public health, knowledge translation and evidence-based methods in healthcare.
Department of Epidemiology, Tulane University, USA
Obesity has become epidemic worldwide. Diet interventions have been widely accepted in prevention and treatment of obesity; however, considerable individual variability has long been noted in response to diet interventions, which is likely due to modifications of genetic susceptibility. In large prospective studies, we have identified dietary intakes of sugar sweetened beverage and fried amplified genetic effects on body weight and obesity. In randomized clinical trials, we demonstrated that genetic variants related to obesity, insulin resistance and obesity significantly interacted with diet interventions in relation to long-term weight loss, and changes in cardiometabolic risk factors. In addtion, we found that gentic variations determining preference to macronutrients modified effects of carbohydrate intakes on weight loss. Our data provide supportive evidence for precision obesity management through diet modifications.
Dr. Qi obtained a medical degree in China and PhD at Tufts University in the United States. He is now HCA Regents Distinguished Chair and Professor in Tulane University and Adjunct Professor at Harvard T.H Chan School of Public Health. He has published more than 250 scientific publications and edited a textbook.
Alliance Health Medical Clinic, Canada
Background: According to Statistics Canada, the number of adults that are overweight or obese rises every year in Canada. After extensive community consultation, the Healthy Weights Initiative (HWI) started in Moose Jaw and expanded to Regina, Saskatchewan, Canada.
Objectives: To determine adherence, factors impacting adherence, and impact on various health outcomes
Methods: From January 2014 to March 2015, 229 participants started the comprehensive six-month HWI program. Given that having a “buddy” and signing social support contracts with family members or friends were important to program adherence, both went from being recommended to becoming mandatory.
From April 2015 to August 2016, 771 additional participants started the program – allowing evaluation of the two new policies. As well, HWI participant adherence was compared to 1000 YMCA new members.
Results: Among the first 229 HWI participants, 79.9% completed the six-month program. After the two new policy changes among 771 participants, 96.1% completed the HWI program (RR = 1.20; 95% CI = 1.01-1.49). In comparison, among new YMCA regular members without supervision or assistance, 14.0% were adhering to their fitness program after six months (RR = 6.85; 95% CI = 3.88 - 12.10). After logistic regression, the only variable with an independent effect for not completing the HWI program was not having a spouse/partner supporting the program (OR = 2.31; 95% CI = 1.13 – 3.67).
Although weight loss reductions were obtained (mean 9.5 pounds), the more significant benefits observed were numerous benefits to various health outcomes. For example, the prevalence of depressed mood reduced from 44.0% to 16.4% (p = 0.000).
Conclusions: With two new policy changes including a mandatory “buddy” and a signed social support contract, the HWI has become more successful at promoting program adherence. As well, numerous positive health outcomes have been obtained during this free, community based initiative.
Dr. Mark Lemstra is the owner of Alliance Health multi-disciplinary medical clinics in the province of Saskatchewan, Canada. He has eight university degrees including doctorates in epidemiology, public health and psychiatry.
Kwame Nkrumah University of Science and Technology, Ghana
Background: Dyslipidemia is a major risk factor of cardiovascular diseases, which in turn contribute 68% of mortality among type 2 diabetes. Conversely, intakes ofantioxidant micronutrients can delay or prevent diabetic complications such as cardiovascular diseases. The study aimed to assess antioxidant micronutrient status and risk of CVDs among Type 2 Diabetic Outpatients.
Methods: A cross sectional study was conducted on type 2 diabetics.. Dietary intakes of antioxidant micronutrients were assessed using 24-hour dietary recall. Anthropometrics including Body Mass Index, waist circumference, and biochemical indices, includingglycatedhaemoglobin (HbA1c), fasting blood glucose (FBG), coronary risk, atherosclerosis risk, serum zinc and lipids profile were measured in 152 participants. Data were analyzed using SPSS version 23.
Results: Thirty-seven (24.3%) were males and 115 (75.7%) were females. Also, 74.3% of type 2 diabetes patients had high FBG and 64.6% had high HbA1c. The prevalence of single dyslipidemia, combined dyslipidemia and mixed dyslipidemia were 63.8%, 15.8%, and 1.3% respectively. Also, 35.3% of subjects had high coronary risk and 5.3% had high atherosclerosis risk. The mean intakes of zinc (5.04±2.76 mg/day), vitamin E (5.16±2.60 mg/day) and vitamin C (82.72±38.76 mg/day) were lowered among type 2 diabetes patients. When controlling for age and gender, inadequate vitamin E was directly associated with HbA1c, (r=0.220, p=0.033), Total Cholesterol (TC), (r= 0.260, p=0.011), Low density lipoprotein Cholesterol (LDL-C) (r= 0.267, 0.009) and coronary disease risk (r=0.217, p=0.036). Coronary risk was strongly associated with TC (r=0.690, p< 0.0001) and LDL-C, (r=0.783, p< 0.0001), while atherosclerotic risk correlated with serum Triglycerides (TG), (r=0.817, p< 0.0001) and VLDL-C, (r=0.817, p< 0.0001). Serum zinc was reduced among participants and had inverse relationship with glycated haemoglobin (r= -0.206, p=0.05) and fasting blood glucose (r = -0.227, p value = 0.033 Regression analyses revealed that a point increase in TC was associated with 2.6-folds increased odds of coronary disease risk (OR= 2.6, 95% CI=1.9-3.7, p< 0.0001), TG was associated with 2-folds higher coronary risk (OR= 2.5, 95% CI= 1.3-4.8, p=0.004), and LDL-C was associated with 5-folds higher coronary disease risk (OR= 4.9, 95% CI=2.9-8.1, p< 0.0001) among participants.
Conclusion and Recommendation: Uncontrolled blood glucose and atherogenicdyslipidemia was common among these diabetics, were significantly associated with high coronary disease risk, and atherosclerotic risk. Management of diabetes in Ghana needs a critical look at to increase effectiveness and reduce the burden of the disease.
OdeafoAsamoah-Boakye is a graduate research student in Nutrition and Dietetics at Kwame Nkrumah University of Science and Technology. He is also attended 4 international conferences in Ghana, and made one oral presentation. He is a young scientist who has to my credit 2 publications and 4 manuscripts under review. He is highly motivated research and has engaed in PhD research volunteer in my institution. His research areas have been diabetes, obesity and cardiovascular diseases.
University of Arkansas, Fayetteville, USA
Recent studies have shown the influence of paid advertisements on individualʼs dietary habits. With the social networking advertisement industry growing rapidly, individuals are being subjected to images of relatively unhealthy food from restaurants, fast food establishments, etc. Recent studies also show an increase in media usage has an increased impact on physical activity and sleep disorders and therefore, obesity. With the rising popularity of social media, there is a need to determine if social media is associated with obesity. This study seeks to understand how social media influences dietary habits. A pilot study is underway at the University of [College]. Student (N=25) social media images are being observed to determine what college students post about food. Face book, Twitter, Instagram and Snapchat are currently being utilized to collect the data. A preliminary ocular (visual) analysis indicates that posted food images are relatively more unhealthy than healthy. With this information, it is then necessary to investigate portion sizes, nutrient density and food preparation techniques. The My Plate recommendations from USDA will be used to analyze portion sizes and nutrient density in food images. The surroundings of the food images will be used to analyze food preparation techniques. Implications and recommendation will be developed for an array of audiences. Understanding the relationship between social media and obesity is key to overcoming this global epidemic.
Sara Maples is a graduate of Mississippi State University with a B.S in Agricultural Education, Leadership and Communications. She is a secondyear graduate student at the University of Arkansas. She is pursuing a masterʼs of science in Agricultural and Extension Education with a concentration on Agricultural Communications. Her thesis research is on food literacy. She has presented and attended conferences in U.S including the National Health Outreach Conference in May 2017 and Association of Leadership Educators in July 2016.
Zhejiang University School of Medicine, China
Objectives: The present study examines gender differences of individual and regional variants in overweight and obesity between men and women.
Methods: Participants were 11,942 college students identified through a multistage survey sampling process conducted in 50 universities in China. The data collection instrument was a self-administered questionnaire. Multilevel logistic regression models were used to examine individual and regional influences on overweight and Obesity.
Results: The prevalence of overweight and obesity was 9.5% (95% CI: 7.7%, 11.3%) in the overall study sample, was double higher in males (13.9% <95% CI: 11.5%, 16.7%>) in males and (6.1% <95% CI: 4.1%, 8.1%>) in females, respectively. The final multiple level logistic model showed that higher family income and original GDP, higher perceived life stress and regional unemployment were associated with higher overweight and obesity in males. However, unlike male students, only regional unemployment was associated with overweight and obesity in the opposite direction among females.
Conclusion: Our research underscores males were more sensitive to overweight and obesity, which were influenced by more environmental variants in males than in females. This information should be considered in formulating policy and designing and implementing effective interventions in overweight and obesity among male young adults.
Triphase Pharmaceutical Pvt. Ltd., India
Fenugreek is one of the popular spices in West and South Asia. It is also found in Northern Africa, North and South America, parts of Europe, Australia. Fenugreekʼs recognition as a medicinal plant with various health benefits makes it more important. Scientific evidences have proven thatfenugreek can be used for diabetes and obesity management. Diosgenin, 4-hydroxy-isoleucine, trigonelline, galactomannan are the major active constituents which confers fenugreek its metabolic syndrome managing potentiality [Das et al. 2016]. In order to manufacture soluble fenugreek fibre, fenugreek seeds were wet, grinded and processed through anenzymatic hydrolysis ofglycosidic linkages between insoluble fibres [a patented method by Triphase]. This solution was spray dried into final product in powder form. The optimum condition for spray drying was found to be: 150°C inlet temperature, 60 Nm3/h aspirator flow rate, feed flow rate 4ml/min, total dissolved solid: approx. 4.5% in feed.
Keywords: diabetes, obesity, blood sugar, fenugreek, soluble fibre, spray drying Reference: DasS, Dhananjaya BL, Desiraju S. 2016. “Trigonellafoenum-graecum (Fenugreek) for Management of Diabetes” in special edition of ‘Metabolic Disordersʼ vol-2 in ‘Recent Progress in Medicinal Plantsʼ, Eds. Dr. J.N. Govil; Studium Press LLC. (In press)
US Patent Application No. 15115446; Indian Patent Application No. 4978/CHE2014― Desiraju A, Desiraju S, Sharieff I, Abhilash P. 2015.
State University of New York College, USA
Childhood obesity is a growing concern worldwide. It has becoming a problem in every country where there is data. Children who are born preterm or Small for Gestational Age (SGA) are at higher risk for developing childhood obesity than their peers who are born on time and of normal weight. This presentation will discuss the impact that the development of obesity has not only on the more commonly known long term health consequences such as diabetes, hypertension and cardiovascular disease, but it will also discuss itʼs impact on the development of food allergies and other inflammatory diseases. The eating habits during the perinatal period and breastfeeding and their impact on the development of obesity will also be described. We will explore the impactindividual nutrition counseling has on childhood obesity compared to group counseling and virtual counseling. Finally evidenced based strategies to prevent the onset of obesity during pregnancy, breastfeeding and childhood will be presented.
Dr. Loomis received her B.S from the University of Rhode Island and her M.S. and Doctorate of Clinical Nutrition from the University of Medicine and Dentistry of New Jersey. She is a Registered Dietitian (RD) with 16 years of experience in pediatric nutrition. Dr. Loomis has conducted presentations on a local and national level on a number of areas including the impact of Registered Dietitians in the Neonatal Intensive Care Unit (NICU), Combating Childhood obesity and Pediatric Food Allergies and Treating Picky Eating. Her doctoral work looked at the impact of standardized feeding guidelines for low birth weight infants, which was recently published in the Journal of Pediatric Gastroenterology and Nutrition. Dr. Loomisʼ current research looks at the impact of nutrition counseling on childhood obesity, and the eating habits of picky eaters as well as the impact of role modeling on the eating habits and weight status of college students. Dr. Loomis is an Assistant Professor at SUNY Oneonta and is the Director of the Masters Program and Dietetics Internship. She also works as a pediatric dietitian in a pediatricianʼs office counseling children who struggle with obesity and has owned her own private practice since 2010.
University of Yaounde, Cameroon
Aim of Study: Obesity is a leading preventable cause of death worldwide, with increasing rates in adults and children. Nowadays, the number of fat and obese people is increasing in Cameroon and many of them in all likelihood develop various diseases, particularly heart diseases, type 2 diabetes, certain types of cancer and osteoarthritis. Fat or obese people present an abnormal accumulation or excess body fat that may have a negative effect on health, leading to reduce life hope and/or increased health problems. This disorder is most commonly caused by a combination of excessive energetic food intake, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes, endocrine disorders, medication and/or psychiatric diseases. People are considered obese when their body mass index (BMI), a measurement obtained by dividing a subjectʼs weight by the square of the personʼs height, exceeds 30 kg/m2, and fat when their BMI is equal or superior
Methods: In the present study, we carried out an ethno pharmacological survey of anti-obesity plants in Cameroon. Recorded herbal medicines were detailed described and the standardization of dosages were investigated. We also did a systematic review about their safety and efficacy in the management of obesity in human by searching bibliographic data bases such as, Google Scholar, Pub Med, Scopus and Web of Science, for studies reported between April 2012 to February 2014 on human or animals, investigating the beneficial and harmful effects of herbal medicine to treat obesity in Cameroon.
Results: A total of twenty anti-obesity plants were recorded. Flavonoids extracted from the fruits of Solanum melongena (Cheucheu in Bamileke tribe) at a dose of 1mg/100g BW/day showed significant hypolipidemic effect in normal and cholesterol fed rats. Studies reported on Irvingia gabonensis and I. wombolu (two species of West and Central Africa, African bush mangoes) showed significant decreases in body weight. African mangoes seeds seem to have satisfactory anti obesity effects. The effect magnitude of each of recorded medicinal plants is a critical point that should be considered for interpretation. While there was no report for side effect in these species, we believe that safety of these plants still remains to be elucidated by further literature researches or longterm studies for their better exploitations.
Keywords: Herbal medicine, Obesity, Cameroon, Systematic review, efficacy, safety
Acknowledgements: The authors acknowledge the respondents (traditional healers and obese people) for their contribution during the ethnopharmaceutical prospection. The authors appreciate the collaboration of Jean Paul Ghogue of the Cameroon National Herbarium for validating plant identification.
Memorial Hospital of Sun Yat-sen University, China
Background and Objective: We have previously found that chloride channel/antiporter ClC-3 gene knockout alleviates lipid and glucose disorders in mice model with type 2 diabetes. The present study was designed to verify the role of ClC-3 in adipocyte hypertrophy and adipose tissue macrophage (ATM) inflammation during obesity.
Methods: We measured the ClC-3 expression and fat cell size in omental fat tissues from Chinese women with body mass index (BMI) from 16.0 to 28.4 kg/m2. The adipocyte cell size, ATM-mediated inflammatory phenotype switch and TLR-4/NFκB inflammatory signaling pathway was examined in visceral adipose tissue from ClC-3-/- and wild-type mice fed with high-fat diet (HFD) using micro-CT, histological, cellular, and biochemical molecular approaches.
Results: The expression of ClC-3 mRNA and protein upregulated in omental fat tissues of obese women and has a strong positive correlation with BMI and adipose cell size. In HFD-induced obese mice, ClC-3 protein significantly increased as early as 4 weeks after HFD initiation. ClC-3-/- mice exhibited a dramatic decrease in HFD-induced body weight gain; VAT accumulation, adipocyte size enlargement or increased percentage of large adipocytes in VAT, as well as an improvement of obesity-induced metabolic disorders. ClC-3 deficiency also reduced obesity-induced ATM recruitment and accumulation, M1-like macrophage polarization and expression of pro-inflammatory cytokines through the TLR-4/NF-κB signaling pathway. In THP-1 differentiated cells in vitro, ClC-3 knockdown dramatically reduced LPS-induced NF-κB activation and TLR-4 expression, while overexpression of ClC-3 did the opposite.
Conclusion: The upregulation of ClC-3 gene may contribute to obesity-induced adipose tissue dysfunction by promoting adipocyte hypertrophy and ATM inflammation, suggesting a therapeutic potential of inhibiting ClC-3 for obesity-related metabolic disorders.
Xiaomiao Zhao, MD., Ph.D., an associate professor and associate chief physician of reproductive endocrine and advisor of Ph.D candidate, the vice president of Youth Committee of the Chinese OB/GT Committee of International Health Care Exchange and Promotive society. She has completed her M.D. at the age of 24 years and Ph.D at 30 years from Sun Yat-Sen University in Guangzhou, China and postdoctoral studies from Cedars-Sinai medical center, USA. Her research interest is in the field of reproductive endocrinology, mainly in polycystic ovary syndrome, androgen excess, insulin resistance, IVF, poor responder for ovary stimulation. Until now, Dr. Zhao has grown up to be the outstanding person of the field of reproductive endocrinology and leads the PCOS study group to the innovative science research, and has great performance of the clinical practice in IVF center. She has published more than 53 papers, among which, over 24 papers in reputed English journals (e.g. Fertility and Sterility, Clinical Endocrinology, International of Caner, and International Journal of Cardiology, etc.) and serving as a reviewer of International Journal of Cancer, JCEM and endocrinology. She takes charge of 11 research grants as a PI in China.
Cyberjaya University, College of Medical Sciences, Malaysia
Anxiety, phobias and stress are the main mental health problems among the Malaysian population, with global prevalence varying from 8% to 18%. Even so, less than 30% who suffer these disturbances seek treatment.
The objective of this study is to evaluate and compare the anxiolytic effects of Aconitum napellus and Homeopathic complex Vita-C 15 in the acutely stressed C57BL6 mice by using the fecal and serum corticoid test and open field test (OFT).
Methodology: A double blinded randomized controlled study was conducted at SPF animal facility of Brain Research Institute Monash Sunway (BRIMS) - Jeffrey Cheah School of Medicine and Health Sciences of Sunway University Malaysia. All the animals were acclimatized to constant laboratory conditions for 14 days before starting the experiments. The treatments were carried out over 7 days. 48 male C57BL6 mice (n=6), 4-5 weeks of age were used. They were randomly selected and divided into two groups. Group I was the healthy control group of mice which were not exposed to acute stress. Group II (stress group); comprise of mice expose to acute restraint stress. Prior to restraint stress, the treatments given were Aconitum napellus 30 cH, Homeopathic complex Vita-C 15, Diazepam, and placebo. Then the results were evaluated by fecal and serum CORT test and open field test by comparing the anxiolytics effects between pre-test and post-test.
Results: The results showed higher levels of serum CORT and a significant increase in FCM than CON animals in acutely stressed animals on Day 7 (p<0.05). Acutely stressed animals demonstrated treated mice spent more time in the center had more entries into the center of the open field (p<0.001) and more active as measured in distance traveled in the center and traveled greater distance overall (p<0.001). Thus research into prevention and supportive therapies is necessary and beneficial for this disorder.
Charis Liew Siaw Min has her expertise in the research on anxiety, depression and stress under the treatment and management of Traditional and Complementary Medicine (Homeopathy) and evaluation and passion in improving the mental health and wellbeing. She is currently doing on postgraduate study of Master in Medical Science (M.Sc.) on the comparison of homeopathic and conventional intervention on anxiety and stress.
Buckingham University, UK
Background: Laparoscopic gastric banding procedure (LAGB) is decreasing worldwide in favour of other bariatric procedures. Common reasons for the removal of the gastric band arethe dissatisfaction of the patients or the late complications. We observed what happened to 1800gastric band patients after long time follow up (FU).
Methods: Between 2001-2015. We have performed 1800 LAGB-operations. 1460 patients (77%) were available for follow up. We collected our data prospectively. Recorded data preoperatively included age, sex, comorbidity, body mass index (BMI), Postoperatively recorded data included, intra and post operative morbidity and mortality, percentage of excess weight loss (%EWL), at 3,6 and 12-months and then annually up to 15years postoperatively and the removal or conversion rate of the gastric bands.
Results: 1460 patients had follow up between1- 15 years or more (81%), of these 570 patients (39%) of them had their band removed or converted to other bariatric procedure. Reason for removal was discomfort and not sufficient weight loss in 302 (53%) cases, band slippage in 180 (31.5%) cases, band intolerance 32 (5.6%) cases, band erosion in 26 (1.75%) cases, private reasons in 30 (5.2%)cases. These Incidence has increased with longer follow up.
Mean BMI decreased mostly with more satisfaction in the first 5years postop. Only 48% of the patient achieved excess weight loss >50% with FU 10years or more.
Conclusions: Laparoscopic adjustable gastric banding seems to be an effective treatment for morbid obesity in the early years postoperatively with increasing removal rate and dissatisfaction after that.
Buckingham University, UK
Background: Laparoscopic sleeve gastrectomy is increasing world in the last years.
We see more cases in the last years who need conversions for different reasons. Common reasons are dissatisfaction of the patients or complications. We observed the reasons of conversion in our clinical practice
Methods: Between 2002-2016. we have performed 1220 operations. 990(81%)patients were available for follow up. We collected our data prospectively. Recorded data preoperatively included age, sex, comorbidity, body mass index (BMI), Postoperatively recorded data included, intra and post operative morbidity and mortality, percentage of excess weight loss (%EWL), re-interventions and conversion to other procedure, patients who had the primary sleeve operation by other surgeons and came for second procedure were included in the converted group.
Results: We had 122 redo or conversion operations. 24 of them from my clinic and 98 from other clinics. Indication of conversion or redo was insufficient weight loss in 47(38.5%), severe reflux disease in 48,(39%), gastric stricture in 23(18.8%), fistula and leakage 4(0.3%).
Procedures performedlaparoscopically were re-sleeving in 18 cases, omega bypass in 89 cases, Roux en Y gastric bypass in 14 cases biliopancreatic diversion in 2 cases.
Satisfaction of the re-operated cases was achieved in 90% of the cases in longer than one year follow up.
Conclusions: Insufficient weight loss and gastroesophageal reflux disease are the common indications for sleeve gastrectomy conversion and different options are available. The majority of the patients are satisfied with conversion results.
Bnei Zion Medical Center, Israel
Purpose: The effect of weight on paraoxonase activity was determined in 39 ischemic heart disease patients, 14 of whom with BMI 30 who underwent a 12week aerobic exercise training program.
Background: Paraoxonases have been found to perform a number of biological functions, though the primary role of this group of enzymes is still a topic of speculation. Some of the observed roles have revealed activities of anti-inflammatory, anti-oxidative, antiatherogenic, anti-diabetic, anti-microbial and organophosphate-hydrolyzing properties
Methods: Paraoxonase activity was measured by its arylesterase activity Spectrophotometrically, at 250 degrees C, wavelength 270 nm.
Results: A 15.9 increase in paraoxonase activity was found following the 12week exercise program. In addition, there was a significant BMI (body mass index) effect with higher mean paraoxonase levels among women during both pre-exercise 16.8 and post-exercise 19.5.2 training, p<0.05.
Conclusions: Aerobic exercise training was found to be an effective means in inducing plasma levels elevation of the antioxidative, antiatherogenicparaoxonase in patients with coronary artery disease, and particularly in obese patients.
Department of Food Science and Nutrition, S.N.D.T. Womenʼs University, Iran
Objective: The prevalence of overweight and obesity in Iranian children has increased considerably in the last decades. Obesity in children is a major concern. Higher variety score of die may cause obesity are overweight among urban schoolchildren. The objective of this study was to measure dietary diversity score and obesity in child from Iran.
Methods: The present study examined Dietary Diversity Score(DDS) and weight status by calculating Body Mass Index (BMI) and the World Health Organization‘s (WHO) anthropometric indices of weight-for-age (WA) and weight-for-height. A cross-sectional study was performed on 2234 Iranian aged 6-9 years, attending primary schools residing in urban area from low and middle income categories. Dietary diversity scores were assessed based on frequency of consumption of individual food items categorized into 11 individual food groups.
Results: Overweight children showed the highest mean score for cereals (F=2.209, P=0.005), vegetables (F=5.234, P=0.001), non-vegetarian foods (F=12.3920, P=0.000), mixed dishes (F=9.899, P=0.000), beverages (F=9.654, P=0.000), sweets and sugar (F=5.122, P=0.002) and fats(F=10.263, P=0.000). Mean scores for vegetables, sweets, beverages and fat consumption increased with increasing weight. High scores for pulses and legumes consumption were observed in obese children. Scores for vegetable consumption were higher among overweight children.
Conclusion: Overweight and obese school children had high diversity scores in their diet.
Dr. Sahar Hooshmand is an academician and researcher in the field of epidemiological child nutrition. She had a practice career graduating from S.N.D.T. Womenʼs University of Mumbai, India. She published and presented several papers in some congress and journals. she has written three educational nutrition books. She is participated as lecturers at department of food science and nutrition in Iran and as trainer in Family education courses conducted by education and training organization. She is honored to get awards for child nutrition and dietary diversity papers by University of hohenheim, Germany (2012) and International nutrition foundation (INF), USA (2013).
Mansoura University, Egypt
Background: Laparoscopic gastric plication (LGP) is one of the restrictive bariatric procedures. It seemed attractive to both morbidly obese patients and bariatric surgeons due to two main factors; safety and low cost. Moreover, many studies documented its efficacy in terms of weight loss and resolution of comorbidities. This study tests the mid-term outcome of LGP in morbidly obese patients.
Patients and Methods: The data of morbidly obese patients who underwent LGP were analyzed. LGP was offered to obese patients with BMI > 40 kg/m2 or > 35 kg/m2 with one or more comorbidities. Superobese patients (BMI > 60 kg/m2) and those who have previous bariatric surgeries were excluded. The technique of LGP was standardized. After gastric mobilization the stomach was plicated in two rows of extramucosal non-absorbable sutures over 36 Fr calibrating tube. Perioperative and in-hospital data were recorded. Postoperative follow up visits was scheduled at 1, 3, 6, 12 months then annually. Patients were followed for complications, weight loss and resolution/improvement of comorbidities.
Results: Eighty eight consecutive morbidly obese patients had been operated by the standardized technique of LGP between March 2010 and September 2014. There were 19 men and 69 women, with a mean age of 24.2 years and a mean BMI of 38.7 kg/m2 (range 35–51 kg/m2). Type 2 diabetes, hypertension, dyslipidemia, obstructive sleep apnea, and back pain were reported in 4, 10, 12, 4, 6 patients respectively. There were no significant intraoperative complications and no conversion to laparotomy. The most frequently reported complication was prolonged early postoperative nausea/vomiting and occurred in 5 of 88 (5.7 %) patients and were treated with conservative means. Early leak occurred in 3/88 (3.4%) patients and it was managed by conversion to laparoscopic sleeve gastrectomy (LSG) in two patients (one of them died of sepsis) and suture repair with undoing plication in the last patient. Postoperative follow-up period ranged from 6 to 42 months with a mean of 25 months. %EWL was 27.2 %, 35.0 %, and 41.1 % at 3, 6, and 12 months, respectively. Weight regain had been reported in 10 (11.4%) patients at a mean follow up period of 9.5 months. It was treated by laparoscopic replication (n=2), conversion to LSG (n=1), laparoscopic minigastric bypass (MGB) (n=1). One of replicated patients had inadequate weight loss and was converted to laparoscopic MGB. Resolution/improvement of comorbidities was documented in 5/36 (13.9%) patients only.
Conclusions: Inadequate weight loss, prolonged hospital stay, inadequate resolution/improvement of comorbidities plus risk of leak forced us to stop LGP. However, more studies on a larger number of patients with longer follow up is required.
Keywords: Laparoscopic gastric placation, bariatric surgery, leak, weight regain, morbid obesity
FERTIPAQ Shanghai, Shanghai, China
The human gastrointestinal (GI) tract contains a trillions number of microorganisms. Although this tract is relatively dominated by a highly diverse number of Probiotics at subspecies levels, there appears to be microbial disparity at some of the divisions of the GI tract. The genome size of the stable microbial structure, collectively termed as microbiome, may provide humans with metabolic and genetic attributes pertinent to the maintenance of holistic homeostasis. These days, accumulating evidence reveals that gut microbiota in the humanʼs body may play a significant role in the development of obesity, metabolic syndromes such as diabetes, cardiovascular disease, andmany other current critical endocrinal or metabolic disorders. In this paper, the mechanisms of actions by which the gut microbiota take part in the holistic activities within the host are explained. The results indicated that balanced probiotics mighthave a positive impact on the development of diabetes, together withlow-grade inflammations, lipid metabolism, energy harvesting, bowel function of the intestinal barrier, as well as bile acid metabolism. Thus, balanced probiotics at each division of GI tract and total gut microbiota in the host could be a natural biological factor to modulate diabetes if scientifically synchronized.
Keywords: Gut microbiota; Probiotics; Diabetes; Obesity; Metabolism
Nditange Shigwedha is a Senior R&D Scientist at FERTIPAQ Shanghai. He studied BSc. Agriculture at the University of Namibia; both MSc. Food Science and PhD. Environmental Engineering at Jiangnan University. From 2007-2013, he has taught as a Senior Lecturer at the University of Namibia and afterward sabbatical for his Postdoctoral research in a Food microbiology laboratory at Harbin Institute of Technology. In 2016, he has held to the position of a Head of the R&D department at CPS China in Suzhou. Formerly also served as HOD: Food Science & Technology and occasionally acted as a Faculty Dean of Agriculture & Natural Resources at the University of Namibia 2008-2012.