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Martins TDCP, Duarte TC, Mosca ERT, Pinheiro CDF, Marçola MA, De-Souza DA. Severe protein malnutrition in a morbidly obese patient after bariatric surgery. Nutrition 2014; 31:535-8. [PMID: 25701346 DOI: 10.1016/j.nut.2014.10.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Revised: 10/15/2014] [Accepted: 10/21/2014] [Indexed: 12/14/2022]
Abstract
The aim of this study was to describe the clinical course of a morbidly obese patient who underwent Roux-en-Y gastric bypass (RYGB) surgery and, in the late postoperative period, presented the expected loss of weight, but also presented severe protein malnutrition (PM). A patient with morbid obesity, who in March 2012, presented PM (serum albumin = 2.4 g/dL) 2 y after the completion of RYGB surgery (loss of 52.7% of usual body weight). During the hospitalization, the patient received partial volumes of commercial semi-elemental, high-protein, low-fat diet by tube feeding with gastric positioning, associated with an oral low-fat, low-sodium, and bland-consistency diet. The patient presented a temporary clinical improvement, however, outpatient monitoring identified the need for subsequent hospitalizations due to the recurrence of severe hypoalbuminemia (e.g., 1.39 g/dL), anasarca (increase of 15 kg in 79 d), and normocytic and normochromic anemia (e.g., hemoglobin 9.2 g/dL). In July 2013 the RYGB partial reversal technique was performed with a reduction of 100 cm in the Roux-en-Y arm. Seventy days after surgery, the patient was asymptomatic (albumin 3.7 g/dL), however, she presented rapid and progressive recovery of the body weight (increase of 10.3 kg in 60 d, without edema). The effective treatment of morbid obesity is still a major challenge in clinical practice. Restrictive, malabsorptive bariatric techniques are associated with nutritional deficiencies. Severe PM is rarely reported as a late postoperative complication of RYGB, however, due to the serious consequences associated with this, it requires early diagnosis and treatment.
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Affiliation(s)
- Tatiana de Castro Pereira Martins
- Faculty of Medicine, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil; Multidisciplinary Residency Program in Clinical Nutrition, Multidisciplinary Residency in Health, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Thaís Castro Duarte
- Faculty of Medicine, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil; Multidisciplinary Residency Program in Clinical Nutrition, Multidisciplinary Residency in Health, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil; Postgraduate Program in Health Sciences, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Etelvina Rocha Tolentino Mosca
- Faculty of Medicine, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil; Multidisciplinary Residency Program in Clinical Nutrition, Multidisciplinary Residency in Health, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Conceição de Fátima Pinheiro
- Department of Surgery, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil; Clinical Hospital, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Maria Alzira Marçola
- Multidisciplinary Residency Program in Clinical Nutrition, Multidisciplinary Residency in Health, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil; Clinical Hospital, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Daurea Abadia De-Souza
- Faculty of Medicine, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil; Multidisciplinary Residency Program in Clinical Nutrition, Multidisciplinary Residency in Health, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil; Postgraduate Program in Health Sciences, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil; Department of Internal Medicine, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
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252
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Simon JJ, Skunde M, Hamze Sinno M, Brockmeyer T, Herpertz SC, Bendszus M, Herzog W, Friederich HC. Impaired Cross-Talk between Mesolimbic Food Reward Processing and Metabolic Signaling Predicts Body Mass Index. Front Behav Neurosci 2014; 8:359. [PMID: 25368558 PMCID: PMC4201102 DOI: 10.3389/fnbeh.2014.00359] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 09/27/2014] [Indexed: 12/20/2022] Open
Abstract
The anticipation of the pleasure derived from food intake drives the motivation to eat, and hence facilitate overconsumption of food, which ultimately results in obesity. Brain imaging studies provide evidence that mesolimbic brain regions underlie both general as well as food-related anticipatory reward processing. In light of this knowledge, the present study examined the neural responsiveness of the ventral striatum (VS) in participants with a broad BMI spectrum. The study differentiated between general (i.e., monetary) and food-related anticipatory reward processing. We recruited a sample of volunteers with greatly varying body weights, ranging from a low BMI (below 20 kg/m(2)) over a normal (20-25 kg/m(2)) and overweight (25-30 kg/m(2)) BMI, to class I (30-35 kg/m(2)) and class II (35-40 kg/m(2)) obesity. A total of 24 participants underwent functional magnetic resonance imaging while performing both a food and monetary incentive delay task, which allows to measure neural activation during the anticipation of rewards. After the presentation of a cue indicating the amount of food or money to be won, participants had to react correctly in order to earn "snack points" or "money coins," which could then be exchanged for real food or money, respectively, at the end of the experiment. During the anticipation of both types of rewards, participants displayed activity in the VS, a region that plays a pivotal role in the anticipation of rewards. Additionally, we observed that specifically anticipatory food reward processing predicted the individual BMI (current and maximum lifetime). This relation was found to be mediated by impaired hormonal satiety signaling, i.e., increased leptin levels and insulin resistance. These findings suggest that heightened food reward motivation contributes to obesity through impaired metabolic signaling.
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Affiliation(s)
- Joe J Simon
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg , Heidelberg , Germany
| | - Mandy Skunde
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg , Heidelberg , Germany
| | - Maria Hamze Sinno
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg , Heidelberg , Germany
| | - Timo Brockmeyer
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg , Heidelberg , Germany
| | - Sabine C Herpertz
- Department of General Adult Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg , Heidelberg , Germany
| | - Martin Bendszus
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg , Heidelberg , Germany
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg , Heidelberg , Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg , Heidelberg , Germany
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253
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Grey M, Schulman-Green D, Knafl K, Reynolds NR. A revised Self- and Family Management Framework. Nurs Outlook 2014; 63:162-70. [PMID: 25771190 DOI: 10.1016/j.outlook.2014.10.003] [Citation(s) in RCA: 151] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 09/25/2014] [Accepted: 10/05/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Research on self- and family management of chronic conditions has advanced over the past 6 years, but the use of simple frameworks has hampered the understanding of the complexities involved. PURPOSE We sought to update our previously published model with new empirical, synthetic, and theoretical work. METHODS We used synthesis of previous studies to update the framework. DISCUSSION We propose a revised framework that clarifies facilitators and barriers, processes, proximal outcomes, and distal outcomes of self- and family management and their relationships. CONCLUSIONS We offer the revised framework as a model that can be used in studies aimed at advancing self- and family management science. The use of the framework to guide studies would allow for the design of studies that can address more clearly how self-management interventions work and under what conditions.
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Affiliation(s)
| | | | - Kathleen Knafl
- University of North Carolina at Chapel Hill, Chapel Hill, NC
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254
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Rönn M, Lind L, Örberg J, Kullberg J, Söderberg S, Larsson A, Johansson L, Ahlström H, Lind PM. Bisphenol A is related to circulating levels of adiponectin, leptin and ghrelin, but not to fat mass or fat distribution in humans. CHEMOSPHERE 2014; 112:42-48. [PMID: 25048886 DOI: 10.1016/j.chemosphere.2014.03.042] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 03/04/2014] [Accepted: 03/07/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Since bisphenol A (BPA) has been shown to induce obesity in experimental studies, we explored the associations between BPA and fat mass, fat distribution and circulating levels of adiponectin, leptin and ghrelin in humans. METHODS In the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS), fat mass and fat distribution were determined in 70-year-old men and women (n=890) by dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI) (n=287). Serum levels of BPA were analyzed using isotope liquid chromatography/tandem mass spectrometer (API4000LC-MS/MS). Hormone levels were analyzed with radioimmunoassays (RIA) or enzyme-linked immunosorbent assay (ELISA). Imaging was performed approximately two years following collection of other data. RESULTS Serum concentrations of BPA were not related to adipose tissue measurements by DXA or MRI. BPA associated positively with adiponectin and leptin, but negatively with ghrelin, following adjustments for sex, height, fat mass, lean mass, smoking, alcohol consumption, physical activity, energy intake, and educational levels (p<0.001, p=0.009, p<0.001, respectively). The relationship between BPA and ghrelin was stronger in women than in men. CONCLUSION Although no relationships between BPA levels and measures of fat mass were seen, BPA associated strongly with the adipokines adiponectin and leptin and with the gut-hormone ghrelin suggesting that BPA may interfere with hormonal control of hunger and satiety.
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Affiliation(s)
- Monika Rönn
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Lars Lind
- Department of Medical Sciences, Cardiovascular epidemiology, Uppsala University, Uppsala, Sweden
| | - Jan Örberg
- Department of Organismal Biology, Environmental Toxicology, Uppsala University, Uppsala, Sweden
| | - Joel Kullberg
- Department of Radiology, Oncology, and Radiation Science, Uppsala University, Uppsala, Sweden
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, and Heart Centre, Umeå University, Umeå, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Cardiovascular epidemiology, Uppsala University, Uppsala, Sweden
| | - Lars Johansson
- Department of Radiology, Oncology, and Radiation Science, Uppsala University, Uppsala, Sweden
| | - Håkan Ahlström
- Department of Radiology, Oncology, and Radiation Science, Uppsala University, Uppsala, Sweden
| | - P Monica Lind
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
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255
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Pappou I, Virani NA, Clark R, Cottrell BJ, Frankle MA. Outcomes and Costs of Reverse Shoulder Arthroplasty in the Morbidly Obese: A Case Control Study. J Bone Joint Surg Am 2014; 96:1169-1176. [PMID: 25031371 DOI: 10.2106/jbjs.m.00735] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The rising number of morbidly obese patients has important consequences for the health-care system. We investigated the effect of morbid obesity on outcomes, complications, discharge disposition, and costs in patients undergoing reverse shoulder arthroplasty. METHODS Our joint registry was searched for all patients who had undergone primary reverse shoulder arthroplasty for a reason other than fracture from 2003 to 2010 and had a minimum of twenty-four months of follow-up. Twenty-one patients with a body mass index (BMI) of ≥40 kg/m2 were identified (follow-up, 45 ± 16 months; sex, seventeen female and four male; age, 69 ± 7 years) and were compared with sixty-three matched control patients with a BMI of <30 kg/m2 (follow-up, 48 ± 20 months; sex, fifty female and thirteen male; age, 71 ± 6 years) after an a priori sample size calculation. Outcome instrument data were obtained preoperatively and postoperatively. The Charlson-Deyo comorbidity index (CDI) score, total comorbidities, operative time, blood loss, duration of hospital stay, discharge disposition, costs, and complications were recorded. RESULTS Compared with nonobese patients, morbidly obese patients had similar improvements in functional outcomes (e.g., American Shoulder and Elbow Surgeons score, 32 to 69 compared with 40 to 78) and in shoulder motion (e.g., forward flexion, 61° to 140° compared with 74° to 153°); all improvements were significant (p < 0.05). Morbidly obese patients had a similar rate of scapular notching (odds ratio [OR] = 0.58, p = 0.63), more total comorbidities excluding obesity (six compared with four, p = 0.001), a higher CDI (2 compared with 1, p = 0.025), and a higher rate of obstructive sleep apnea (OR = 27.7, p = 0.0001). Their operative time was thirteen minutes longer (p = 0.014) and their blood loss was 40 mL greater (p = 0.008). Morbidly obese patients had a similar duration of stay (3.1 compared with 2.6 days, p = 0.823) and hospital readmission rate (OR = 16.3, p = 0.08) but a sixfold higher rate of discharge to rehabilitation facilities rather than to home (OR = 8, p < 0.0001). Hospital costs were higher by $2974 (p = 0.009). The rates of major complications (n = 4 compared with 8, p = 0.479) and of minor complications (n = 3 compared with 14, p = 0.440) were similar. No intraoperative complications or mechanical device failures were noted in either group. CONCLUSIONS Reverse shoulder arthroplasty appears to be as safe and effective in morbidly obese patients, although it has an increased cost and patients have a lower rate of discharge to home and greater care needs after discharge. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Ioannis Pappou
- Shoulder and Elbow Division, Florida Orthopaedic Institute, 13020 North Telecom Parkway, Tampa, FL 33637. E-mail address for M.A. Frankle:
| | - Nazeem A Virani
- Clinical Research Department, Foundation for Orthopaedic Research and Education, 13020 North Telecom Parkway, Tampa, FL 33637
| | - Rachel Clark
- Clinical Research Department, Foundation for Orthopaedic Research and Education, 13020 North Telecom Parkway, Tampa, FL 33637
| | - Benjamin J Cottrell
- Clinical Research Department, Foundation for Orthopaedic Research and Education, 13020 North Telecom Parkway, Tampa, FL 33637
| | - Mark A Frankle
- Shoulder and Elbow Division, Florida Orthopaedic Institute, 13020 North Telecom Parkway, Tampa, FL 33637. E-mail address for M.A. Frankle:
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256
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Cruz Y, Hernandez-Lane ME, Cohello JI, Bautista CT. The effectiveness of a community health program in improving diabetes knowledge in the Hispanic population: Salud y Bienestar (Health and Wellness). J Community Health 2014; 38:1124-31. [PMID: 23913103 DOI: 10.1007/s10900-013-9722-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We evaluated the effectiveness of the Salud y Bienestar program to deliver diabetes education in the Hispanic population in the United States. This program uses a community outreach model where community health promoters are trained and then they deliver education to other community members regarding diabetes disease, risk factors, and ways to prevent and control disease. This intervention applies a one-group pre- and post-test design to improve diabetes knowledge. The intervention carried out in the states of California, Texas, and Washington DC. A total of 1,413 participants were enrolled. Of these, 73% were females, 46% were 65 years or older, 59% were Mexican, 64% had at least elementary education, 56% had lived in the US for more than 20 years, and 38% participants were self-reported diabetic. Among diabetic participants, a significant improvement was observed on diabetes knowledge when comparing pre- and post-test scores (13.7 vs. 18.6, P < 0.001; Cohen's d = 1.2). Among non-diabetic participants, diabetes knowledge also increased significantly after one-single training session (12.9 vs. 18.2, P < 0.001; Cohen's d = 1.2). The Salud y Bienestar program conducted by community health workers was effective approach to improving diabetes knowledge in the Hispanic population.
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Affiliation(s)
- Yanira Cruz
- National Hispanic Council on Aging, 734 15th Street NW Suite 1050, Washington, DC, 20005, USA
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257
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Júdice PB, Silva AM, Magalhães JP, Matias CN, Sardinha LB. Sedentary behaviour and adiposity in elite athletes. J Sports Sci 2014; 32:1760-7. [PMID: 24915288 DOI: 10.1080/02640414.2014.926382] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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258
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Pei Z, Flexeder C, Fuertes E, Standl M, Buyken A, Berdel D, von Berg A, Lehmann I, Schaaf B, Heinrich J. Food intake and overweight in school-aged children in Germany: Results of the GINIplus and LISAplus studies. ANNALS OF NUTRITION AND METABOLISM 2014; 64:60-70. [PMID: 24862842 DOI: 10.1159/000362694] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 04/07/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate the cross-sectional association between food intake and overweight in children. METHODS Height and weight were measured in 2,565 school-aged children. Intakes of 11 food groups were categorized (low, medium and high) using specific tertile cutoffs. Multivariate energy partition models were applied. Adjustment included energy intake from other food groups, city, family income, parental education and 'screen' time. Possible underreporters were identified and used in sensitivity analyses. RESULTS Compared to low intake, high intakes of meat, fish, beverages and bakery products were associated with greater BMI z-scores [β (95% CI) = 0.32 (0.21, 0.42), 0.13 (0.03, 0.24), 0.23 (0.11, 0.35) and 0.10 (-0.01, 0.20)] and increased risk of being overweight [odds ratio (OR) (95% CI) = 2.08 (1.58, 2.73), 1.39 (1.08, 1.80), 1.36 (1.01, 1.84) and 1.62 (1.24, 2.11)]. Conversely, medium and high intakes of confectionery were associated with smaller BMI z-scores [β = -0.18 (-0.28, -0.07) and -0.22 (-0.33, -0.12)] and decreased risk of being overweight [OR = 0.64 (0.50, 0.83) and 0.53 (0.40, 0.68)]. These associations were robust to sensitivity analyses. CONCLUSIONS Intakes of meat, fish, beverages and bakery products correlate with body weight status.
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Affiliation(s)
- Zhengcun Pei
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
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259
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Brondani LA, Assmann TS, de Souza BM, Bouças AP, Canani LH, Crispim D. Meta-analysis reveals the association of common variants in the uncoupling protein (UCP) 1-3 genes with body mass index variability. PLoS One 2014; 9:e96411. [PMID: 24804925 PMCID: PMC4013025 DOI: 10.1371/journal.pone.0096411] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 04/05/2014] [Indexed: 12/19/2022] Open
Abstract
Background The relationship between uncoupling protein (UCP) 1–3 polymorphisms and susceptibility to obesity has been investigated in several genetic studies. However, the impact of these polymorphisms on obesity is still under debate, with contradictory results being reported. Until this date, no meta-analysis evaluated the association of UCP polymorphisms with body mass index (BMI) variability. Thus, this paper describe a meta-analysis conducted to evaluate if the -3826A/G (UCP1); -866G/A, Ala55Val and Ins/Del (UCP2) and -55C/T (UCP3) polymorphisms are associated with BMI changes. Methods A literature search was run to identify all studies that investigated associations between UCP1-3 polymorphisms and BMI. Weighted mean differences (WMD) were calculated for different inheritance models. Results Fifty-six studies were eligible for inclusion in the meta-analysis. Meta-analysis results showed that UCP2 55Val/Val genotype was associated with increased BMI in Europeans [Random Effect Model (REM) WMD 0.81, 95% CI 0.20, 1.41]. Moreover, the UCP2 Ins allele and UCP3-55T/T genotype were associated with increased BMI in Asians [REM WMD 0.46, 95% CI 0.09, 0.83 and Fixed Effect Model (FEM) WMD 1.63, 95% CI 0.25, 3.01]. However, a decreased BMI mean was observed for the UCP2-866 A allele in Europeans under a dominant model of inheritance (REM WMD −0.18, 95% CI −0.35, −0.01). There was no significant association of the UCP1-3826A/G polymorphism with BMI mean differences. Conclusions The meta-analysis detected a significant association between the UCP2-866G/A, Ins/Del, Ala55Val and UCP3-55C/T polymorphisms and BMI mean differences.
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Affiliation(s)
- Letícia A. Brondani
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Postgraduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Tais S. Assmann
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Postgraduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Bianca M. de Souza
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Postgraduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ana P. Bouças
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Postgraduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luis H. Canani
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Postgraduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Daisy Crispim
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Postgraduate Program in Medical Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- * E-mail:
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260
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A weight loss program in a chiropractic practice: a retrospective analysis. Complement Ther Clin Pract 2014; 20:125-9. [PMID: 24767958 DOI: 10.1016/j.ctcp.2013.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Revised: 11/17/2013] [Accepted: 11/19/2013] [Indexed: 11/20/2022]
Abstract
CONTEXT Obesity is a global problem and places individuals at risk for developing chronic metabolic disorders. The need for investigating simple, effective and sustaining approaches to weight loss cannot be overstated. METHODS We performed a retrospective file analysis of patient files attending a 13-week weight loss program. Inclusion for analysis were files of adults (i.e., >18 years) completing the program consisting of chiropractic adjustments/spinal manipulative therapy augmented with diet/nutritional intervention, exercise and one-on-one counseling. RESULTS Sixteen of 30 people (i.e., 53.33%) completed the program. Statistically and clinically significant changes were noted in weight and BMI measures based on pre-treatment (average weight = 190.46 lbs. and BMI = 30.94 kg/m(2)) and comparative measurements (average weight = 174.94 lbs. and BMI = 28.50 kg/m(2)). CONCLUSION A cohort of patients under enrolled in a weight loss program was described. This provides supporting evidence on the effectiveness of a multi-modal approach to weight loss implemented in a chiropractic clinic.
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261
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Durrant LM, Khorram O, Buchholz JN, Pearce WJ. Maternal food restriction modulates cerebrovascular structure and contractility in adult rat offspring: effects of metyrapone. Am J Physiol Regul Integr Comp Physiol 2014; 306:R401-10. [PMID: 24477541 DOI: 10.1152/ajpregu.00436.2013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Although the effects of prenatal undernutrition on adult cardiovascular health have been well studied, its effects on the cerebrovascular structure and function remain unknown. We used a pair-fed rat model of 50% caloric restriction from day 11 of gestation to term, with ad libitum feeding after birth. We validated that maternal food restriction (MFR) stress is mediated by glucocorticoids by administering metyrapone, a corticosterone synthesis inhibitor, to MFR mothers at day 11 of gestation. At age 8 mo, offspring from Control, MFR, and MFR + Metyrapone groups were killed, and middle cerebral artery (MCA) segments were studied using vessel-bath myography and confocal microscopy. Colocalization of smooth muscle α-actin (SMαA) with nonmuscle (NM), SM1 and SM2 myosin heavy-chain (MHC) isoforms was used to assess smooth muscle phenotype. Our results indicate that artery stiffness and wall thickness were increased, pressure-evoked myogenic reactivity was depressed, and myofilament Ca(2+) sensitivity was decreased in offspring of MFR compared with Control rats. MCA from MFR offspring exhibited a significantly greater SMαA/NM colocalization, suggesting that the smooth muscle cells had been altered toward a noncontractile phenotype. MET significantly reversed the effects of MFR on stiffness but not myogenic reactivity, lowered SMαA/NM colocalization, and increased SMαA/SM2 colocalization. Together, our data suggest that MFR alters cerebrovascular contractility via both glucocorticoid-dependent and glucocorticoid-independent mechanisms.
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Affiliation(s)
- Lara M Durrant
- Center for Perinatal Biology, Divisions of Physiology and Pharmacology, School of Medicine, Loma Linda University, Loma Linda, California; and
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Coplan JD, Fathy HM, Abdallah CG, Ragab SA, Kral JG, Mao X, Shungu DC, Mathew SJ. Reduced hippocampal N-acetyl-aspartate (NAA) as a biomarker for overweight. NEUROIMAGE-CLINICAL 2014; 4:326-35. [PMID: 24501701 PMCID: PMC3913836 DOI: 10.1016/j.nicl.2013.12.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 12/22/2013] [Accepted: 12/23/2013] [Indexed: 12/11/2022]
Abstract
OBJECTIVE We previously demonstrated an inverse relationship between both dentate gyrus neurogenesis - a form of neuroplasticity - and expression of the antiapoptotic gene marker, BCL-2 and adult macaque body weight. We therefore explored whether a similar inverse correlation existed in humans between body mass index (BMI) and hippocampal N-acetyl-aspartate (NAA), a marker of neuronal integrity and putatively, neuroplasticity. We also studied the relationship of a potentially neurotoxic process, worry, to hippocampal NAA in patients with generalized anxiety disorder (GAD) and control subjects (CS). METHODS We combined two previously studied cohorts of GAD and control subjects. Using proton magnetic resonance spectroscopy imaging ((1)H MRSI) in medication-free patients with GAD (n = 29) and a matched healthy control group (n = 22), we determined hippocampal concentrations of (1) NAA (2) choline containing compounds (CHO), and (3) Creatine + phosphocreatine (CR). Data were combined from 1.5 T and 3 T scans by converting values from each cohort to z-scores. Overweight and GAD diagnosis were used as categorical variables while the Penn State Worry Questionnaire (PSWQ) and Anxiety Sensitivity Index (ASI) were used as dependent variables. RESULTS Overweight subjects (BMI ≥ 25) exhibited lower NAA levels in the hippocampus than normal-weight subjects (BMI < 25) (partial Eta-squared = 0.14) controlling for age, sex and psychiatric diagnosis, and the effect was significant for the right hippocampus in both GAD patients and control subjects. An inverse linear correlation was noted in all subjects between right hippocampal NAA and BMI. High scores on the PSWQ predicted low hippocampal NAA and CR. Both BMI and worry were independent inverse predictors of hippocampal NAA. CONCLUSION Overweight was associated with reduced NAA concentrations in the hippocampus with a strong effect size. Future mechanistic studies are warranted.
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Affiliation(s)
- Jeremy D Coplan
- Department of Psychiatry, Division of Neuropsychopharmacology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Hassan M Fathy
- Department of Psychiatry, Division of Neuropsychopharmacology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Chadi G Abdallah
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Sherif A Ragab
- Department of Psychiatry, Division of Neuropsychopharmacology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - John G Kral
- Department of Surgery and Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Xiangling Mao
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA ; Department of Psychiatry, Weill Medical College of Cornell University, New York, NY, USA ; Department of Biophysics, Weill Medical College of Cornell University, New York, NY, USA
| | - Dikoma C Shungu
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA ; Department of Psychiatry, Weill Medical College of Cornell University, New York, NY, USA ; Department of Biophysics, Weill Medical College of Cornell University, New York, NY, USA
| | - Sanjay J Mathew
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
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263
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Naghshizadian R, Rahnemai-Azar AA, Kella K, Weber MM, Calin ML, Bibi S, Farkas DT. Patient perception of ideal body weight and the effect of body mass index. J Obes 2014; 2014:491280. [PMID: 25614830 PMCID: PMC4295128 DOI: 10.1155/2014/491280] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 12/17/2014] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Despite much effort, obesity remains a significant public health problem. One of the main contributing factors is patients' perception of their target ideal body weight. This study aimed to assess this perception. METHODS The study took place in an urban area, with the majority of participants in the study being Hispanic (65.7%) or African-American (28.0%). Patients presented to an outpatient clinic were surveyed regarding their ideal body weight and their ideal BMI calculated. Subsequently they were classified into different categories based on their actual measured BMI. Their responses for ideal BMI were compared. RESULTS In 254 surveys, mean measured BMI was 31.71 ± 8.01. Responses to ideal BMI had a range of 18.89-38.15 with a mean of 25.96 ± 3.25. Mean (±SD) ideal BMI for patients with a measured BMI of <18.5, 18.5-24.9, 25-29.9, and ≥30 was 20.14 ± 1.46, 23.11 ± 1.68, 25.69 ± 2.19, and 27.22 ± 3.31, respectively. These differences were highly significant (P < 0.001, ANOVA). CONCLUSIONS Most patients had an inflated sense of their target ideal body weight. Patients with higher measured BMI had higher target numbers for their ideal BMI. Better education of patients is critical for obesity prevention programs.
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Affiliation(s)
- Rozhin Naghshizadian
- Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, 1650 Selwyn Avenue, Suite 4E, Bronx, NY 10457, USA
| | - Amir A. Rahnemai-Azar
- Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, 1650 Selwyn Avenue, Suite 4E, Bronx, NY 10457, USA
| | - Kruthi Kella
- Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, 1650 Selwyn Avenue, Suite 4E, Bronx, NY 10457, USA
| | - Michael M. Weber
- Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, 1650 Selwyn Avenue, Suite 4E, Bronx, NY 10457, USA
| | - Marius L. Calin
- Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, 1650 Selwyn Avenue, Suite 4E, Bronx, NY 10457, USA
| | - Shahida Bibi
- Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, 1650 Selwyn Avenue, Suite 4E, Bronx, NY 10457, USA
| | - Daniel T. Farkas
- Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, 1650 Selwyn Avenue, Suite 4E, Bronx, NY 10457, USA
- *Daniel T. Farkas:
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264
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Ramage S, Farmer A, Eccles KA, McCargar L. Healthy strategies for successful weight loss and weight maintenance: a systematic review. Appl Physiol Nutr Metab 2013; 39:1-20. [PMID: 24383502 DOI: 10.1139/apnm-2013-0026] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The rates of overweight and obesity are rising in Canada and worldwide, and there is a need for effective methods for weight loss and weight maintenance to empower individuals to make changes. The purpose of this systematic review was to examine the evidence available for successful diet strategies for weight loss and weight maintenance among adults. A search was conducted of the following databases: CAB Abstracts, Central Register of Controlled Trials, EMBASE, MEDLINE, Food Science and Technology Abstracts, and Web of Knowledge. The studies investigated had participants who were overweight or obese and between 18 and 65 years of age. A successful study was defined as one that reported an intervention that created ≥5% weight loss from baseline and a maintenance phase during which the ≥5% weight loss was maintained from baseline to 12 months. After exclusions, the search resulted in 67 papers. Overall, for significant safe weight loss, an energy deficit was required, which was commonly achieved by reduced fat intake. Increased dietary fibre was also a component of 21% of successful interventions. Physical activity was included in 88% of successful interventions, and behaviour training such as self-monitoring was part of 92% of successful interventions. The same combination of energy and fat restriction, regular physical activity, and behavioural strategies was also required for successful weight maintenance. This review confirmed previous knowledge about weight loss and weight maintenance in adults. A comprehensive approach, including reduced dietary intake, regular physical activity, and behavioural strategies, is warranted and is supported by the research evidence.
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Affiliation(s)
- Stephanie Ramage
- a Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2P5, Canada
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Satiety responsiveness and eating behavior among Chilean adolescents and the role of breastfeeding. Int J Obes (Lond) 2013; 38:552-7. [PMID: 24145926 PMCID: PMC3981889 DOI: 10.1038/ijo.2013.191] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 08/29/2013] [Accepted: 09/24/2013] [Indexed: 11/25/2022]
Abstract
Objective To determine patterns of satiety responsiveness and its relationship to eating in the absence of hunger (EAH), in a cohort of adolescents. We also assessed whether sex, BMI and duration of breastfeeding, during infancy, predicted satiety responsiveness and eating behavior at 16 years. Methods Adolescents (n=576) from a longitudinal cohort, that began as an iron deficiency anemia preventive trial, participated in an unlimited breakfast after an overnight fast, and reported satiety response on a visual analogue scale after the meal, followed by an EAH procedure. Height, weight and body composition were measured before breakfast. Latent profile analysis generated profiles that captured individual differences in satiety responsiveness. Multivariable regressions, adjusted for potential confounders, evaluated the association between: 1) satiety responsiveness and EAH, and 2) breastfeeding in infancy, satiety responsiveness and EAH in adolescence. Results Participants were on average 16.7-years-old, 48% female, 37% overweight/obese and 76% were breastfed as the sole source of milk for < 6 months. We found three latent profiles of satiety responsiveness: 1. “responsive” (49%); 2. “not responsive” (41%); 3. “still hungry” (10%). Participants in the “not responsive” or “still hungry” profile were more likely to eat during the EAH procedure (OR=2.5, 95%CI 1.8–3.6). Being breastfed for < 6 months was related to higher odds of being in the “not responsive” or “still hungry” profile (OR 1.8, 95%CI 1.2–2.6) and EAH (OR=2.2, 95% CI 1.4–3.3). Satiety responsiveness was not influenced by sex and overweight/obesity. Conclusion After an ad libitum meal, we found varied satiety responses, which related to EAH. Furthermore, shorter breastfeeding duration was associated with poorer satiety response and higher consumption during an EAH procedure. Understanding if breastfeeding influences the development of satiety responsiveness and eating behavior may be important in an era characterized by abundant calorie-dense foods and a plethora of environmental cues promoting consumption.
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266
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Abu-Farha M, Tiss A, Abubaker J, Khadir A, Al-Ghimlas F, Al-Khairi I, Baturcam E, Cherian P, Elkum N, Hammad M, John J, Kavalakatt S, Warsame S, Behbehani K, Dermime S, Dehbi M. Proteomics analysis of human obesity reveals the epigenetic factor HDAC4 as a potential target for obesity. PLoS One 2013; 8:e75342. [PMID: 24086512 PMCID: PMC3782461 DOI: 10.1371/journal.pone.0075342] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 08/13/2013] [Indexed: 02/07/2023] Open
Abstract
Sedentary lifestyle and excessive energy intake are prominent contributors to obesity; a major risk factors for the development of insulin resistance, type 2 diabetes and cardiovascular diseases. Elucidating the molecular mechanisms underlying these chronic conditions is of relevant importance as it might lead to the identification of novel anti-obesity targets. The purpose of the current study is to investigate differentially expressed proteins between lean and obese subjects through a shot-gun quantitative proteomics approach using peripheral blood mononuclear cells (PBMCs) extracts as well as potential modulation of those proteins by physical exercise. Using this approach, a total of 47 proteins showed at least 1.5 fold change between lean and obese subjects. In obese, the proteomic profiling before and after 3 months of physical exercise showed differential expression of 38 proteins. Thrombospondin 1 (TSP1) was among the proteins that were upregulated in obese subjects and then decreased by physical exercise. Conversely, the histone deacetylase 4 (HDAC4) was downregulated in obese subjects and then induced by physical exercise. The proteomic data was further validated by qRT-PCR, Western blot and immunohistochemistry in both PBMCs and adipose tissue. We also showed that HDAC4 levels correlated positively with maximum oxygen consumption (VO2 Max) but negatively with body mass index, percent body fat, and the inflammatory chemokine RANTES. In functional assays, our data indicated that ectopic expression of HDAC4 significantly impaired TNF-α-dependent activation of NF-κB, establishing thus a link between HDAC4 and regulation of the immune system. Together, the expression pattern of HDAC4 in obese subjects before and after physical exercise, its correlation with various physical, clinical and metabolic parameters along with its inhibitory effect on NF-κB are suggestive of a protective role of HDAC4 against obesity. HDAC4 could therefore represent a potential therapeutic target for the control and management of obesity and presumably insulin resistance.
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Affiliation(s)
- Mohamed Abu-Farha
- Department of Biomedical Research, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Ali Tiss
- Department of Biomedical Research, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Jehad Abubaker
- Department of Biomedical Research, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Abdelkrim Khadir
- Department of Biomedical Research, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Fahad Al-Ghimlas
- Fitness and Rehabilitation Centre, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Irina Al-Khairi
- Department of Biomedical Research, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Engin Baturcam
- Department of Biomedical Research, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Preethi Cherian
- Department of Biomedical Research, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Naser Elkum
- Department of Biostatistics & Epidemiology, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Maha Hammad
- Department of Biomedical Research, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Jeena John
- Department of Biomedical Research, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Sina Kavalakatt
- Department of Biomedical Research, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Samia Warsame
- Department of Biomedical Research, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Kazem Behbehani
- Department of Biomedical Research, Dasman Diabetes Institute, Kuwait, Kuwait
- Fitness and Rehabilitation Centre, Dasman Diabetes Institute, Kuwait, Kuwait
- Department of Biostatistics & Epidemiology, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Said Dermime
- Biomedical Research Facility, King Fahad Specialist Hospital Dammam, Dammam, Kingdom of Saudi Arabia
| | - Mohammed Dehbi
- Department of Biomedical Research, Dasman Diabetes Institute, Kuwait, Kuwait
- Genomic Medicine and Systems Biology Research Center, Qatar Biomedical Research Institute, Education City, Doha, Qatar
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267
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Ho KM, Bertenshaw C, Same S, Schneider M, Williams KA, Godsell L, Hird K. Differential Associations between Body Mass Index and Outcomes after Elective Adult Cardiac Surgery: A Linked Data Cohort Study. Anaesth Intensive Care 2013; 41:573-583. [DOI: 10.1177/0310057x1304100502] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- K. M. Ho
- Intensive Care Unit, Mount Hospital, Perth, Western Australia, Australia
- Department of Intensive Care, Royal Perth Hospital, School of Population Health, University of Western Australia
| | - C. Bertenshaw
- Intensive Care Unit, Mount Hospital, Perth, Western Australia, Australia
- University of Notre Dame
| | - S. Same
- Intensive Care Unit, Mount Hospital, Perth, Western Australia, Australia
| | - M. Schneider
- Intensive Care Unit, Mount Hospital, Perth, Western Australia, Australia
| | - K. A. Williams
- Intensive Care Unit, Mount Hospital, Perth, Western Australia, Australia
| | - L. Godsell
- Intensive Care Unit, Mount Hospital, Perth, Western Australia, Australia
- Mount Hospital
| | - K. Hird
- Intensive Care Unit, Mount Hospital, Perth, Western Australia, Australia
- University of Notre Dame
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268
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Berstein LM. Cancer and heterogeneity of obesity: a potential contribution of brown fat. Future Oncol 2013; 8:1537-48. [PMID: 23231516 DOI: 10.2217/fon.12.150] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Obesity has lately been drawing additional attention as a potential cancer risk and, with some exceptions as a prognostic factor. As obesity is a complex issue characterized by different variants, mechanisms and manifestations, its role in cancer development is also a complex problem exceeding the basic fact of the fat content rising above certain limits. Therefore, in the present paper obesity is viewed as a heterogeneous entity, which has distinct connections with cancer pathogenesis. Among other issues, emphasis is made on the state of white and brown adipose tissue, in particular the association of specific brown fat features and the so-called white fat browning with the functions of normal and mutated tumor suppressor genes, such as PTEN and BRCA1. These connections are considered from the viewpoint implying the existence of two types of hormonal carcinogenesis and of hormonal mediation of the genetic predisposition to tumor development, and should be accounted for in prevention and treatment of both obesity and cancer.
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Affiliation(s)
- Lev M Berstein
- Laboratory of Oncoendocrinology, N.N. Petrov Research Institute of Oncology, St. Petersburg 197758, Russia.
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269
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Salinardi TC, Batra P, Roberts SB, Urban LE, Robinson LM, Pittas AG, Lichtenstein AH, Deckersbach T, Saltzman E, Das SK. Lifestyle intervention reduces body weight and improves cardiometabolic risk factors in worksites. Am J Clin Nutr 2013; 97:667-76. [PMID: 23426035 PMCID: PMC3607649 DOI: 10.3945/ajcn.112.046995] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Worksites are potentially effective locations for obesity control because they provide opportunities for group intervention and social support. Studies are needed to identify effective interventions in these settings. OBJECTIVE We examined the effects of a multicomponent lifestyle intervention on weight loss and prevention of regain in 4 worksites (2 intervention and 2 control sites). DESIGN Overweight and obese employees (n = 133) enrolled in this pilot worksite-randomized controlled trial with a 0-6-mo weight-loss phase and a 6-12-mo structured weight-maintenance phase. The intervention combined recommendations to consume a reduced-energy, low-glycemic load, high-fiber diet with behavioral change education. Outcome measurements included changes in body weight and cardiometabolic risk factors. RESULTS The mean ± SEM weight loss was substantial in intervention participants, whereas control subjects gained weight (-8.0 ± 0.7 compared with +0.9 ± 0.5 kg, respectively; P < 0.001), and 89% of participants completed the weight-loss phase. Intervention effects were not significant at the 0.05 level but would have been at the 0.10 level (P = 0.08) in a mixed model in which the worksite nested within group was a random factor. There were also significant improvements in cardiometabolic risk factors in intervention compared with control subjects regarding fasting total cholesterol, glucose, systolic blood pressure, and diastolic blood pressure (P ≤ 0.02 for each). No significant weight regain was observed in participants who enrolled in the structured weight-maintenance program (0.5 ± 0.7 kg; P = 0.65), and overweight and obese employees in intervention worksites who were not enrolled in the weight-loss program lost weight compared with subjects in control worksites (-1.3 ± 0.5 compared with +0.7 ± 0.2 kg, respectively; P = 0.02). CONCLUSION Worksites can be effective for achieving clinically important reductions in body weight and improved cardiometabolic risk factors. This trial was registered at clinicaltrials.gov as NCT01470222.
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Affiliation(s)
- Taylor C Salinardi
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA
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Foster RG, Peirson SN, Wulff K, Winnebeck E, Vetter C, Roenneberg T. Sleep and Circadian Rhythm Disruption in Social Jetlag and Mental Illness. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2013; 119:325-46. [DOI: 10.1016/b978-0-12-396971-2.00011-7] [Citation(s) in RCA: 136] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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271
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Novelle MG, Contreras C, Romero-Picó A, López M, Diéguez C. Irisin, two years later. Int J Endocrinol 2013; 2013:746281. [PMID: 24298283 PMCID: PMC3835481 DOI: 10.1155/2013/746281] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 10/01/2013] [Indexed: 12/16/2022] Open
Abstract
In January 2012, Boström and colleagues identified a new muscle tissue secreted peptide, which they named irisin, to highlight its role as a messenger that comes from skeletal muscle to other parts of the body. Irisin is a cleaved and secreted fragment of FNDC5 (also known as FRCP2 and PeP), a member of fibronectin type III repeat containing gene family. Major interest in this protein arose because of its great therapeutic potential in diabetes and perhaps also therapy for obesity. Here we review the most important aspects of irisin's action and discuss its involvement in energy and metabolic homeostasis and whether the beneficial effects of exercise in these disease states could be mediated by this protein. In addition the effects of irisin at the central nervous system (CNS) are highlighted. It is concluded that although current and upcoming research on irisin is very promising it is still necessary to deepen in several aspects in order to clarify its full potential as a meaningful drug target in human disease states.
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Affiliation(s)
- Marta G. Novelle
- Department of Physiology, CIMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria (IDIS), 15782 Santiago de Compostela, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), 15706 Santiago de Compostela, Spain
- *Marta G. Novelle: and
| | - Cristina Contreras
- Department of Physiology, CIMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria (IDIS), 15782 Santiago de Compostela, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), 15706 Santiago de Compostela, Spain
| | - Amparo Romero-Picó
- Department of Physiology, CIMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria (IDIS), 15782 Santiago de Compostela, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), 15706 Santiago de Compostela, Spain
| | - Miguel López
- Department of Physiology, CIMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria (IDIS), 15782 Santiago de Compostela, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), 15706 Santiago de Compostela, Spain
| | - Carlos Diéguez
- Department of Physiology, CIMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria (IDIS), 15782 Santiago de Compostela, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), 15706 Santiago de Compostela, Spain
- *Carlos Diéguez:
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Abstract
Metagenomic studies have truly revolutionised biology and medicine, and changed the way we study genomics. As genome sequencing becomes cheaper it is being applied to study complex metagenomes. 'Metagenome' is the genetic material recovered directly from an environmental sample or niche. By delivering fast, cheap, and large volumes of data Next Generation Sequencing (NGS) platforms have facilitated a deeper understanding of the fundamentals of genomes, gene functions and regulation. Metagenomics, also referred to as environmental or community genomics, has brought about radical changes in our ability to analyse complex microbial communities by direct sampling of their natural habitat paving the way for the creation of innovative new areas for biomedical research. Many metagenomic studies involving the 'human microbiome'have been undertaken to date. Samples from of a number of diverse habitats including different human body sites have been subject to metagenomic examinations. Huge national and international projects with the purpose of elucidating the biogeography of microbial communities living within and on the human body, are well underway. The analysis of human microbiome data has brought about a paradigm shift in our understanding of the role of resident microflora in human health and disease and brings non-traditional areas such as gut ecology to the forefront of personalised medicine. In this chapter we present an overview of the state-of-the-art in current literature and projects pertaining to human microbiome studies.
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Affiliation(s)
- Ramana Madupu
- Genomic Medicine group at the J. Craig Venter Institute, USA
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273
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Krug I, Villarejo C, Jiménez-Murcia S, Perpiñá C, Vilarrasa N, Granero R, Cebolla A, Botella C, Montserrat-Gil de Bernabe M, Penelo E, Casella S, Islam M, Orekhova E, Casanueva F, Karwautz A, Menchón J, Treasure J, Fernández-Aranda F. Eating-related Environmental Factors in Underweight Eating Disorders and Obesity: Are There Common Vulnerabilities During Childhood and Early Adolescence? EUROPEAN EATING DISORDERS REVIEW 2012; 21:202-8. [DOI: 10.1002/erv.2204] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - C. Villarejo
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona; Spain
| | | | | | - N. Vilarrasa
- Endocrinology and Clinical Nutrition Department; University Hospital of Bellvitge-IDIBELL and CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM); Barcelona; Spain
| | | | | | | | | | - E. Penelo
- Laboratori d'Estadística Aplicada, Departament de Psicobiologia i Metodologia; Universitat Autònoma de Barcelona; Spain
| | - S. Casella
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona; Spain
| | - M. A. Islam
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona; Spain
| | - E. Orekhova
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona; Spain
| | | | - A. Karwautz
- Department of Child and Adolescent Psychiatry; Medical University of Vienna; Vienna; Austria
| | | | - J. Treasure
- Psychological Medicine, Institute of Psychiatry; King's College London; UK
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Lau B, Kim H, Haigh PI, Tejirian T. Obesity Increases the Odds of Acquiring and Incarcerating Noninguinal Abdominal Wall Hernias. Am Surg 2012. [DOI: 10.1177/000313481207801024] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The current data available describing the relationship of obesity and abdominal wall hernias is sparse. The objective of this study was to investigate the current prevalence of noninguinal abdominal wall hernias and their correlation with body mass index (BMI) and other demographic risk factors. Patients with umbilical, incisional, ventral, epigastric, or Spigelian hernias with or without incarceration were identified using the regional database for 14 hospitals over a 3-year period. Patients were stratified based on their BMI. Univariate and multivariate analyses were performed to distinguish other significant risk factors associated with the hernias. Of 2,807,414 patients, 26,268 (0.9%) had one of the specified diagnoses. Average age of the patients was 52 years and 61 per cent were male. The majority of patients had nonincarcerated umbilical hernias (74%). Average BMI was 32 kg/m2. Compared with patients with a normal BMI, the odds of having a hernia increased with BMI: BMI of 25 to 29.9 kg/m2 odds ratio (OR) 1.63, BMI of 30 to 39.9 kg/m2 OR 2.62, BMI 40 to 49.9 kg/m2 OR 3.91, BMI 50 to 59.9 kg/m2 OR 4.85, and BMI greater than 60 kg/m2 OR 5.17 ( P < 0.0001). Age older than 50 years was associated with a higher risk for having a hernia (OR, 2.12; 95% [CI], 2.07 to 2.17), whereas female gender was associated with a lower risk (OR, 0.53; 95% CI, 0.52 to 0.55). Those with incarcerated hernias had a higher average BMI (32 kg/m2 vs 35 kg/m2; P < 0.0001). Overall, BMI greater than 40 kg/m2 showed an increased chance of incarceration, and a BMI greater than 60 kg/m2 had the highest chance of incarceration, OR 12.7 ( P < 0.0001). Age older than 50 years and female gender were also associated with a higher risk of incarceration (OR, 1.28; 95% CI, 1.02 to 1.59 and OR, 1.80; CI, 1.45 to 2.24). Increasing BMI and increasing age are associated with a higher prevalence and an increased risk of incarceration of noninguinal abdominal wall hernias.
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Affiliation(s)
- Briana Lau
- Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
| | - Hanjoo Kim
- Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
| | - Philip I. Haigh
- Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
| | - Talar Tejirian
- Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
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275
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Maternal obesity, lipotoxicity and cardiovascular diseases in offspring. J Mol Cell Cardiol 2012; 55:111-6. [PMID: 22982026 DOI: 10.1016/j.yjmcc.2012.08.023] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2012] [Revised: 08/28/2012] [Accepted: 08/28/2012] [Indexed: 02/02/2023]
Abstract
Maternal obesity has risen dramatically over the past 20 years, by nearly 42% in African-Americans and 29% in Caucasians. Maternal obesity is afflicted with many maternal obstetric complications in the offspring including high blood pressure, obesity, gestational diabetes and increased perinatal morbidity. Maternal nutritional environment plays a rather important role in the programming of the health set-points in the offspring such as glucose and insulin metabolism, energy balance and predisposition to metabolic disorders. In particular, maternal obesity is associated with elevated prevalence of cardiovascular diseases in the offspring. Evidence from human and experimental studies including rodents and nonhuman primates has indicated that maternal obesity or overnutrition programs offspring for an increased risk of adult obesity. Maternal obesity or fat diet exposure predisposes the onset and development of obesity, insulin resistance, cardiac hypertrophy and myocardial contractile anomalies in the offspring. A number of mechanisms including elevated hormones (leptin, insulin), nutrients (fatty acids, triglycerides and glucose) and inflammatory cytokines have been postulated to play a key role in maternal obesity-induced postnatal cardiovascular sequelae. In addition, lipotoxicity (accumulation of lipid metabolites) resulting from maternal obesity is capable of activating a number of stress signaling cascades including pro-inflammatory cytokines and oxidative stress to exacerbate maternal obesity-induced cardiovascular complications later on in adult life. This mini-review summarizes the recent knowledge with regard to the role of lipotoxicity in maternal obesity-induced change in cardiovascular function in the offspring. This article is part of a Special Issue entitled "Focus on Cardiac Metabolism".
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276
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James AW, Zara JN, Corselli M, Askarinam A, Zhou AM, Hourfar A, Nguyen A, Megerdichian S, Asatrian G, Pang S, Stoker D, Zhang X, Wu B, Ting K, Péault B, Soo C. An abundant perivascular source of stem cells for bone tissue engineering. Stem Cells Transl Med 2012. [PMID: 23197874 DOI: 10.5966/sctm.2012-0053] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Adipose tissue is an ideal mesenchymal stem cell (MSC) source, as it is dispensable and accessible with minimal morbidity. However, the stromal vascular fraction (SVF) of adipose tissue is a heterogeneous cell population, which has disadvantages for tissue regeneration. In the present study, we prospectively purified human perivascular stem cells (PSCs) from n = 60 samples of human lipoaspirate and documented their frequency, viability, and variation with patient demographics. PSCs are a fluorescence-activated cell sorting-sorted population composed of pericytes (CD45-, CD146+, CD34-) and adventitial cells (CD45-, CD146-, CD34+), each of which we have previously reported to have properties of MSCs. Here, we found that PSCs make up, on average, 43.2% of SVF from human lipoaspirate (19.5% pericytes and 23.8% adventitial cells). These numbers were minimally changed by age, gender, or body mass index of the patient or by length of refrigerated storage time between liposuction and processing. In a previous publication, we observed that human PSCs (hPSCs) formed significantly more bone in vivo in comparison with unsorted human SVF (hSVF) in an intramuscular implantation model. We now extend this finding to a bone injury model, observing that purified hPSCs led to significantly greater healing of mouse critical-size calvarial defects than hSVF (60.9% healing as opposed to 15.4% healing at 2 weeks postoperative by microcomputed tomography analysis). These studies suggest that adipose-derived hPSCs are a new cell source for future efforts in skeletal regenerative medicine. Moreover, hPSCs are a stem cell-based therapeutic that is readily approvable by the U.S. Food and Drug Administration, with potentially increased safety, purity, identity, potency, and efficacy.
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Affiliation(s)
- Aaron W James
- Dental and Craniofacial Research Institute, UCLA, Los Angeles, CA, USA
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277
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Gesundheit N. Filling the treatment gap in the weight management of overweight and obese patients. INTERNATIONAL JOURNAL OF OBESITY SUPPLEMENTS 2012; 2:S39-S42. [PMID: 25018869 PMCID: PMC4089698 DOI: 10.1038/ijosup.2012.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Approximately two out of three adult Americans are overweight or obese. Despite widespread recognition of this disorder, there has been little progress in the past 20 years in finding effective noninvasive treatments for weight loss. The consequences of obesity are increasingly well recognized and include increases in blood pressure, plasma lipids, the onset of type 2 diabetes, sleep apnea, asthma, osteoarthritis and a variety of cancers. Obesity can increase the rate of pregnancy complications and fetal malformations in normoglycemic women. Current medical approaches to obesity, including intensive lifestyle interventions and drug therapies, have been successful in achieving modest weight loss of 4-7%, less than the 1998 NIH Guidelines target of 10%. Surgical approaches, including laparoscopic adjustable gastric banding, vertical banded gastroplasty and Roux-en-Y gastric bypass, are much more successful, achieving weight loss of 15-50%. A treatment gap therefore exists in the management of obese and overweight patients, because many patients desire and would receive great health benefits by achieving weight loss of 7-15%. This review will discuss the dilemma of the treatment gap and explore possible ways by which it may be filled in the future by the use of innovative approaches.
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Affiliation(s)
- N Gesundheit
- Division of Endocrinology, Gerontology and Metabolism, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA
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278
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279
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Social Jetlag and Obesity. Curr Biol 2012; 22:939-43. [PMID: 22578422 DOI: 10.1016/j.cub.2012.03.038] [Citation(s) in RCA: 891] [Impact Index Per Article: 74.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 01/27/2012] [Accepted: 03/20/2012] [Indexed: 11/20/2022]
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280
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Affenito SG, Franko DL, Striegel-Moore RH, Thompson D. Behavioral determinants of obesity: research findings and policy implications. J Obes 2012; 2012:150732. [PMID: 22957214 PMCID: PMC3431098 DOI: 10.1155/2012/150732] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 06/18/2012] [Indexed: 11/30/2022] Open
Affiliation(s)
- Sandra G. Affenito
- School of Health and Natural Sciences, University of Saint Joseph, West Hartford, CT 06117, USA
- *Sandra G. Affenito:
| | - Debra L. Franko
- Department of Counseling and Applied Educational Psychology, Northeastern University, Boston, MA 02115-5000, USA
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