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de Souza DM, Cavalcante HC, Dos Santos Lima M, Alves AF, da Veiga Dutra ML, D'Oliveira AB, Vasconcelos de Araújo AN, Gomes Dutra LM, Batista KS, de Souza Aquino J. Intermittent fasting associated with coconut oil (Cocos nucifera L.) alters gut-liver axis parameters in diet-induced obese rats. Nutrition 2024; 121:112370. [PMID: 38401196 DOI: 10.1016/j.nut.2024.112370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/15/2023] [Accepted: 01/24/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVE The aim of this article is to investigate the effect of intermittent fasting, associated or not with coconut oil intake, on the gut-liver axis of obese rats. METHODS A total of 50 rats were divided into five groups: control, obese, obese with intermittent fasting, obese with intermittent fasting plus coconut oil, and obese with caloric restriction. The rats were induced to obesity with a high-sugar diet for 17 wk. The respective interventions were carried out in the last 4 wk. RESULTS The groups with intermittent fasting protocols had reduced total cholesterol (on average 54.31%), low-density lipoprotein (on average 53.39%), and triacylglycerols (on average 23.94%) versus the obese group; and the obese with intermittent fasting plus coconut oil group had the highest high-density lipoprotein compared with all groups. The obese with intermittent fasting plus coconut oil and obese with caloric restriction groups had lower metabolic load compared with the other groups. The obese group had high citric and succinic acid concentrations, which affected the hepatic tricarboxylic acid cycle, while all the interventions had reduced concentrations of these acids. No histologic changes were observed in the intestine or liver of the groups. CONCLUSION Intermittent fasting, especially when associated with coconut oil, had effects comparable with caloric restriction in modulating the parameters of the gut-liver axis.
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Affiliation(s)
- Danielle Melo de Souza
- Laboratory of Experimental Nutrition, Department of Nutrition, Federal University of Paraíba, João Pessoa, Brazil; Postgraduate Program in Nutrition Sciences, Federal University of Paraíba, João Pessoa, Brazil
| | - Hassler Clementino Cavalcante
- Laboratory of Experimental Nutrition, Department of Nutrition, Federal University of Paraíba, João Pessoa, Brazil; Postgraduate Program in Nutrition Sciences, Federal University of Paraíba, João Pessoa, Brazil
| | - Marcos Dos Santos Lima
- Postgraduate Program in Food Science and Technology, Federal University of Paraíba, João Pessoa, Brazil; Food and Beverage Analysis Laboratory, Department of Food Technology, Instituto Federal do Sertão Pernambucano, Petrolina, Brazil
| | - Adriano Francisco Alves
- Pathology Laboratory, Department of Physiology and Pathology, Federal University of Paraíba, João Pessoa, Brazil
| | - Maria Letícia da Veiga Dutra
- Laboratory of Experimental Nutrition, Department of Nutrition, Federal University of Paraíba, João Pessoa, Brazil; Postgraduate Program in Nutrition Sciences, Federal University of Paraíba, João Pessoa, Brazil
| | - Aline Barbosa D'Oliveira
- Laboratory of Experimental Nutrition, Department of Nutrition, Federal University of Paraíba, João Pessoa, Brazil
| | - Alana Natalícia Vasconcelos de Araújo
- Laboratory of Experimental Nutrition, Department of Nutrition, Federal University of Paraíba, João Pessoa, Brazil; Postgraduate Program in Nutrition Sciences, Federal University of Paraíba, João Pessoa, Brazil
| | - Larissa Maria Gomes Dutra
- Postgraduate Program in Food Science and Technology, Federal University of Paraíba, João Pessoa, Brazil
| | - Kamila Sabino Batista
- Semiarid National Institute (Instituto Nacional do Semiárido - INSA), Campina Grande, Brazil
| | - Jailane de Souza Aquino
- Laboratory of Experimental Nutrition, Department of Nutrition, Federal University of Paraíba, João Pessoa, Brazil; Postgraduate Program in Nutrition Sciences, Federal University of Paraíba, João Pessoa, Brazil; Postgraduate Program in Food Science and Technology, Federal University of Paraíba, João Pessoa, Brazil.
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Li W, Wang D, Chen H, Liu Y, Dong S, Sun M, Chen W. The relationship between psychological distress and weight maintenance in weight cycling: mediating role of eating behavior. BMC Public Health 2024; 24:894. [PMID: 38532390 PMCID: PMC10964590 DOI: 10.1186/s12889-024-18349-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 03/13/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Obesity is a global public health concern. The goal of this study was to see if eating habits could mediate the relationship between psychological distress and weight maintenance in a population with a history of weight cycling. METHODS A 3-month outpatient intervention consisting of a diet and exercise program was provided to 153 participants. Psychological distress, appetite, and behavior were assessed at the beginning and end of the study. Anthropometric measurements were taken at baseline and six months. RESULTS After the structural equation model was developed, it was discovered that the psychological status of people with obesity and weight cycling histories correlated with the weight loss outcome effect (three and six months). This effect was mediated by factors related to eating behavior. Associative psychological factors had a direct effect on eating behavior (three months: β = 0.181, 95% CI: 0.055-0.310; six months: β = 0.182, 95% CI: 0.039-0.332) and appetite had a direct effect on eating behavior (three months: β = 0.600, 95% CI: 0.514-0.717; six months: β = 0.581, 95% CI: 0.457-0.713), both of which were significant (p < 0.01). At three months, psychological distress has a more substantial positive impact on weight change, with eating behavior acting as a partial mediator. At six months, there was no support for appetite's moderating role in eating behavior. CONCLUSIONS The findings suggest that psychological interventions should be strengthened to improve weight loss effectiveness, particularly in participants with a history of weight cycling, making weight loss more complicated and prone to rebound. CLINICAL TRIAL REGISTRATION The study has been registered in Clinical Trials (NCT05311462).
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Affiliation(s)
- Wanyang Li
- Department of Clinical Nutrition, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China
| | - Dan Wang
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, 19 Xinjiekou Wai Street, 100875, Beijing, China
| | - Hongyu Chen
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Yan Liu
- Department of Clinical Nutrition, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China
| | - Shuyao Dong
- Shandong Institute of Prevention and Control for Endemic Disease, 250014, Jinan, China
| | - Mingyao Sun
- Department of Clinical Nutrition, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China
| | - Wei Chen
- Department of Clinical Nutrition, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China.
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Dague P, Muller L, Paulevé L, Irigoin-Guichandut M. Towards a qualitative theory of the interruption of eating behavior change. J Theor Biol 2024; 581:111731. [PMID: 38211891 DOI: 10.1016/j.jtbi.2024.111731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 12/18/2023] [Accepted: 01/06/2024] [Indexed: 01/13/2024]
Abstract
The poor maintenance of eating behavior change is one of the main obstacles to minimizing weight regain after weight loss during diets for non-surgical care of obese or overweight patients. We start with a known informal explanation of interruption in eating behavior change during severe restriction and formalize it as a causal network involving psychological variables, which we extend with energetic variables governed by principles of thermodynamics. The three core phenomena of dietary behavior change, i.e., non-initiation, initiation followed by discontinuation and initiation followed by non-discontinuation, are expressed in terms of the value of the key variable representing mood or psychological energy, the fluctuation of which is the result of three causal relationships. Based on our experimental knowledge of the time evolution profile of the three causal input variables, we then proceed to a qualitative analysis of the resulting theory, i.e., we consider an over-approximation of it which, after discretization, can be expressed in the form of a finite integer-based model. Using Answer Set Programming, we show that our formal model faithfully reproduces the three phenomena and, under a certain assumption, is minimal. We generalize this result by providing all the minimal models reproducing these phenomena when the possible causal relationships exerted on mood are extended to all the other variables (not just those assumed in the informal explanation), with arbitrary causality signs. Finally, by a direct analytical resolution of an under-approximation of our theory, obtained by assuming linear causalities, as a system of linear ODEs, we find exactly the same minimal models, proving that they are also equal to the actual minimal models of our theory since these are framed below and above by the models of the under-approximation and the over-approximation. We determine which parameters need to be person-specific and which can be considered invariant, i.e., we explain inter-individual variability. Our approach could pave the way for universally accepted theories in the field of behavior change and, more broadly, in other areas of psychology.
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Affiliation(s)
- Philippe Dague
- Université Paris-Saclay, CNRS, ENS Paris-Saclay, Laboratoire Méthodes Formelles, 4 avenue des Sciences, 91190, Gif-sur-Yvette, France.
| | - Laurent Muller
- Université de Lorraine, APEMAC, Ile du Saulcy, 57045, Metz, France.
| | - Loïc Paulevé
- Université de Bordeaux, CNRS, Bordeaux INP, LaBRI, 351 cours de la Libération, 33405, Talence, France.
| | - Marc Irigoin-Guichandut
- Assistance Publique Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, 47-83 Bd de l'Hôpital, 75013, Paris, France.
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4
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Lopez TD, Hernandez D, Bode S, Ledoux T. A complex relationship between intuitive eating and diet quality among university students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2751-2757. [PMID: 34788570 DOI: 10.1080/07448481.2021.1996368] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 09/01/2021] [Accepted: 10/17/2021] [Indexed: 06/13/2023]
Abstract
Intuitive Eating (IE) theory posits eating in response to internal hunger, and satiety cues minimize impulses to over-consume foods. To assess this relationship, 758 university students (55% male) completed the Intuitive Eating Scale 2 (IES-2) and the Diet History Questionnaire II (DHQ). The IES-2 includes a total score and four subscale scores; unconditional permission to eat (UPE), reliance on hunger and satiety cues (RHSC), eating for physical rather than emotional reasons (EPR), and body food choice congruence (BFCC). Using multiple regression analysis, IE total was not related to diet quality. EPR (ß =0.10, p ≤ .01) and BFCC (ß =0.29, p ≤ .001) were positively related to diet quality. UPE (ß = -0.15, p ≤ .001) and RHSC (ß = -0.08, p ≤ .05) were negatively related to diet quality. This study found an antipodal relationship between the subscales of IE and diet quality among university students.
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Affiliation(s)
- Tabbetha D Lopez
- Family and Consumer Science, Sam Houston State University, Huntsville, Texas, USA
| | - Daphne Hernandez
- University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, Texas, USA
| | - Sharon Bode
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA
| | - Tracey Ledoux
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA
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Graybeal AJ, Brandner CF, Henderson A, Aultman RA, Vallecillo-Bustos A, Newsome TA, Stanfield D, Stavres J. Associations between eating behaviors and metabolic syndrome severity in young adults. Eat Behav 2023; 51:101821. [PMID: 37866123 DOI: 10.1016/j.eatbeh.2023.101821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 10/24/2023]
Abstract
Metabolic syndrome (MetS), a precursor to cardiovascular disease and type II diabetes, is rapidly increasing in young adults. Accordingly, earlier interventions aimed at combating the onset of MetS in young adults are required. However, current behavioral interventions have failed to consider the eating behaviors that precede disease development, likely contributing to the consistently high failure rates of these interventions. The purpose of this cross-sectional study was to evaluate the associations between eating behaviors and MetS severity (MetSindex) in a sample of young adults. A sample of 104 (non-Hispanic White: 45; non-Hispanic Black: 49; Hispanic White: 5; Asian: 5) young adult (age: 23.1 ± 4.4) males and females (F:61, M:43) completed anthropometric, blood pressure, blood glucose, and blood lipid assessments; each of which were used to calculate a continuous MetSindex score. Participants also completed the revised version of the 18-item Three-factor Eating Questionnaire to measure emotional eating (EmE), uncontrolled eating (UE), and cognitive restraint (CR). EmE was positively associated with MetSindex for young adult females (p = 0.033) and non-Hispanic Black participants (p = 0.050), but not male (p = 0.506) or non-Hispanic White participants (p = 0.558). Additionally, MetSindex was greater in the highest EmE tertile compared to the lowest EmE tertile for the total sample (p = 0.037) and young adult females (p = 0.015). UE and CR were not associated with MetSindex. These data suggest a potential link between EmE and MetS severity in young adults, and that behavioral interventions aimed at MetS prevention should focus on treating the underlying EmE behaviors common in young adults, particularly for young female and Black adults at the greatest risk.
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Affiliation(s)
- Austin J Graybeal
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA.
| | - Caleb F Brandner
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Alex Henderson
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Ryan A Aultman
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | | | - Ta'Quoris A Newsome
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Diavion Stanfield
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Jon Stavres
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
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Geurts KAM, Ozcan B, van Hoek M, van de Laar R, van Teeffelen J, van Rosmalen J, van Rossum EFC, Berk KA. The (cost) effectiveness of a very low-energy diet intervention with the use of eHealth in patients with type 2 diabetes and obesity: study protocol for a randomised controlled non-inferiority trial (E-diet trial). Trials 2023; 24:642. [PMID: 37798620 PMCID: PMC10557281 DOI: 10.1186/s13063-023-07620-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 09/04/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Despite preventive measures, the number of people with type 2 diabetes and obesity is increasing. Obesity increases morbidity and mortality in people with type 2 diabetes, making weight loss a cornerstone of treatment. We previously developed a very low energy diet (VLED) intervention that effectively reduced weight in people with type 2 diabetes in the long term. However, this intervention requires considerable time and manpower, which reduces the number of people who can benefit from it. eHealth offers more efficient solutions but has proven to be less effective than face-to-face interventions. Therefore, we want to investigate whether a blended version of our VLED intervention (in which face-to-face contact is partly replaced by an eHealth (mobile) application (E-VLED)) would be more cost-effective than the current face-to-face intervention. METHODS We will conduct a randomised, controlled trial with non-inferiority design in patients with type 2 diabetes and obesity (BMI > 30 kg/m2), aged 18-75 years. The control group will receive the usual care VLED intervention, while the intervention group will receive the E-VLED intervention for 1 year, where face-to-face contact will be partly replaced by an eHealth (mobile) application. The main study endpoint is the difference in weight (% change) between the control and intervention group after 1 year, plus the difference between the total costs (euro) of the treatment in the control and intervention groups. The secondary aims are to investigate the effectiveness of the E-VLED diet intervention regarding cardiovascular risk factors, quality of life, patient satisfaction, compliance, and to study whether there is a difference in effectiveness in pre-specified subgroups. General linear models for repeated measurements will be applied for the statistical analysis of the data. DISCUSSION We hypothesise that the E-VLED intervention will be equally effective compared to the usual care VLED but lower in costs due to less time invested by the dietician. This will enable to help more people with type 2 diabetes and obesity to effectively lose weight and improve their health-related quality of life. TRIAL REGISTRATION Netherlands Trial Register, NL7832, registered on 26 June 2019.
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Affiliation(s)
- Karlijn A M Geurts
- Department of Internal Medicine, Division of Dietetics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Behiye Ozcan
- Department of Internal Medicine, Division of Diabetology and Division of Vascular Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Mandy van Hoek
- Department of Internal Medicine, Division of Diabetology and Division of Vascular Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Roel van de Laar
- Department of Internal Medicine, Ikazia Hospital, Montessoriweg 1, 3083 AN, Rotterdam, The Netherlands
| | - Jolande van Teeffelen
- Dietician Practice Health Risk Control, Henk Speksnijderstraat 27, 3067 AC, Rotterdam, The Netherlands
| | - Joost van Rosmalen
- Department of Biostatistics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Division of Endocrinology, Obesity Center CGG, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Kirsten A Berk
- Department of Internal Medicine, Division of Dietetics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
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Adeola OL, Agudosi GM, Akueme NT, Okobi OE, Akinyemi FB, Ononiwu UO, Akunne HS, Akinboro MK, Ogbeifun OE, Okeaya-Inneh M. The Effectiveness of Nutritional Strategies in the Treatment and Management of Obesity: A Systematic Review. Cureus 2023; 15:e45518. [PMID: 37868473 PMCID: PMC10585414 DOI: 10.7759/cureus.45518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Obesity, a condition primarily resulting from positive energy balance, has become a significant global health concern. Numerous studies have demonstrated that obesity is a major risk factor for various illnesses, including different types of cancer, coronary heart disease, sleep apnea, CV stroke, type II diabetes mellitus, etc. To effectively address this issue, prevention and treatment approaches to manage body weight are crucial. There are several evidence-based approaches available for the treatment and management of obesity, taking into account factors such as body mass index classification, individual weight history, and existing comorbidities. To facilitate successful obesity treatment and management, there are pragmatic approaches and tools available, including the reduction of energy density, portion control, and diet quality enhancement. These approaches encompass the use of medications, lifestyle interventions, bariatric surgery, and formula diets. Regardless of the specific method employed, behavior change, reduction of energy intake, and increased energy expenditure are integral components for successful treatment and management of obesity. These measures allow patients to personalize and customize their dietary patterns, leading to effective and sustainable weight reduction. Incorporating physical activities and self-monitoring of individual diets are effective techniques for promoting behavior change in obesity and weight management. The main objective of this systematic review is to evaluate the effectiveness of dietary/nutritional interventions in the treatment and management of obesity through provision of valuable insights into the effectiveness of such nutritional strategies. To attain this, a comprehensive analysis of various dietary approaches and their impacts on weight will be conducted.
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Affiliation(s)
| | | | - Ngozi T Akueme
- Dermatology, University of Medical Sciences (UNIMED), Ondo, NGA
| | - Okelue E Okobi
- Family Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
- Family Medicine, Medficient Health Systems, Laurel, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
| | | | - Uchechi O Ononiwu
- Family Medicine, Imo State University College of Medicine, Alberta, CAN
| | | | - Micheal K Akinboro
- Epidemiology and Biostatistics, Texas A&M Health School of Public Health, College Station, USA
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Pepe RB, Lottenberg AM, Fujiwara CTH, Beyruti M, Cintra DE, Machado RM, Rodrigues A, Jensen NSO, Caldas APS, Fernandes AE, Rossoni C, Mattos F, Motarelli JHF, Bressan J, Saldanha J, Beda LMM, Lavrador MSF, Del Bosco M, Cruz P, Correia PE, Maximino P, Pereira S, Faria SL, Piovacari SMF. Position statement on nutrition therapy for overweight and obesity: nutrition department of the Brazilian association for the study of obesity and metabolic syndrome (ABESO-2022). Diabetol Metab Syndr 2023; 15:124. [PMID: 37296485 DOI: 10.1186/s13098-023-01037-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 03/23/2023] [Indexed: 06/12/2023] Open
Abstract
Obesity is a chronic disease resulting from multifactorial causes mainly related to lifestyle (sedentary lifestyle, inadequate eating habits) and to other conditions such as genetic, hereditary, psychological, cultural, and ethnic factors. The weight loss process is slow and complex, and involves lifestyle changes with an emphasis on nutritional therapy, physical activity practice, psychological interventions, and pharmacological or surgical treatment. Because the management of obesity is a long-term process, it is essential that the nutritional treatment contributes to the maintenance of the individual's global health. The main diet-related causes associated with excess weight are the high consumption of ultraprocessed foods, which are high in fats, sugars, and have high energy density; increased portion sizes; and low intake of fruits, vegetables, and grains. In addition, some situations negatively interfere with the weight loss process, such as fad diets that involve the belief in superfoods, the use of teas and phytotherapics, or even the avoidance of certain food groups, as has currently been the case for foods that are sources of carbohydrates. Individuals with obesity are often exposed to fad diets and, on a recurring basis, adhere to proposals with promises of quick solutions, which are not supported by the scientific literature. The adoption of a dietary pattern combining foods such as grains, lean meats, low-fat dairy, fruits, and vegetables, associated with an energy deficit, is the nutritional treatment recommended by the main international guidelines. Moreover, an emphasis on behavioral aspects including motivational interviewing and the encouragement for the individual to develop skills will contribute to achieve and maintain a healthy weight. Therefore, this Position Statement was prepared based on the analysis of the main randomized controlled studies and meta-analyses that tested different nutrition interventions for weight loss. Topics in the frontier of knowledge such as gut microbiota, inflammation, and nutritional genomics, as well as the processes involved in weight regain, were included in this document. This Position Statement was prepared by the Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), with the collaboration of dietitians from research and clinical fields with an emphasis on strategies for weight loss.
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Affiliation(s)
- Renata Bressan Pepe
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Ana Maria Lottenberg
- Laboratório de Lipides (LIM10), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
- Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), Rua Mato Grosso 306 - cj 1711, Sao Paulo, SP, 01239-040, Brazil.
| | - Clarissa Tamie Hiwatashi Fujiwara
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Mônica Beyruti
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP, Brazil
| | - Dennys Esper Cintra
- Centro de Estudos em Lipídios e Nutrigenômica - CELN - University of Campinas, Campinas, SP, Brazil
| | - Roberta Marcondes Machado
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Alessandra Rodrigues
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP, Brazil
| | - Natália Sanchez Oliveira Jensen
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | | | - Ariana Ester Fernandes
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Carina Rossoni
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Fernanda Mattos
- Programa de Obesidade e Cirurgia Bariátrica do Hospital Universitário Clementino Fraga Filho da UFRJ, Rio de Janeiro, RJ, Brazil
| | - João Henrique Fabiano Motarelli
- Núcleo de Estudos e Extensão em Comportamento Alimentar e Obesidade (NEPOCA) da Universidade de São Paulo - FMRP/USP, Ribeirão Preto, Brazil
| | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, MG, Brazil
| | | | - Lis Mie Masuzawa Beda
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP, Brazil
| | - Maria Sílvia Ferrari Lavrador
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Mariana Del Bosco
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP, Brazil
| | - Patrícia Cruz
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | | | - Priscila Maximino
- Instituto PENSI - Fundação José Luiz Egydio Setúbal, Instituto Pensi, Fundação José Luiz Egydio Setúbal, Hospital Infantil Sabará, São Paulo, SP, Brazil
| | - Silvia Pereira
- Núcleo de Saúde Alimentar da Sociedade Brasileira de Cirurgia Bariátrica e Metabólica, São Paulo, Brazil
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Oikarinen N, Jokelainen T, Heikkilä L, Nurkkala M, Hukkanen J, Salonurmi T, Savolainen MJ, Teeriniemi AM. Low eating self-efficacy is associated with unfavorable eating behavior tendencies among individuals with overweight and obesity. Sci Rep 2023; 13:7730. [PMID: 37173366 PMCID: PMC10182077 DOI: 10.1038/s41598-023-34513-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
Success in long-term weight management depends partly on psychological and behavioral aspects. Understanding the links between psychological factors and eating behavior tendencies is needed to develop more effective weight management methods. This population-based cross-sectional study examined whether eating self-efficacy (ESE) is associated with cognitive restraint (CR), uncontrolled eating (UE), emotional eating (EE), and binge eating (BE). The hypothesis was that individuals with low ESE have more unfavorable eating behavior tendencies than individuals with high ESE. Participants were classified as low ESE and high ESE by the Weight-Related Self-Efficacy questionnaire (WEL) median cut-off point. Eating behavior tendencies were assessed with Three Factor Eating Questionnaire R-18 and Binge Eating Scale, and additionally, by the number of difficulties in weight management. The difficulties were low CR, high UE, high EE, and moderate or severe BE. Five hundred and thirty-two volunteers with overweight and obesity were included in the study. Participants with low ESE had lower CR (p < 0.03) and higher UE, EE, and BE (p < 0.001) than participants with high ESE. Thirty-nine percent of men with low ESE had at least two difficulties in successful weight control while this percentage was only 8% in men with high ESE. In women, the corresponding figures were 56% and 10%. The risk of low ESE was increased by high UE [OR 5.37 (95% CI 1.99-14.51)], high EE [OR 6.05 (95% CI 2.07-17.66)], or moderate or severe BE [OR 12.31 (95% CI 1.52-99.84)] in men, and by low CR [OR 5.19 (95% CI 2.22-12.18)], high UE [OR 7.20 (95% CI 2.41-19.22)], or high EE [OR 23.66 (95% CI 4.79-116.77)] in women. Low ESE was associated with unfavorable eating behavior tendencies and multiple concomitant difficulties in successful weight loss promotion. These eating behavior tendencies should be considered when counseling patients with overweight and obesity.
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Affiliation(s)
- Noora Oikarinen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
| | | | - Laura Heikkilä
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Marjukka Nurkkala
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Janne Hukkanen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
| | - Tuire Salonurmi
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Markku J Savolainen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Department of Medicine, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anna-Maria Teeriniemi
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland.
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10
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Cai Z, Yang X, Huang Z, Wang X, Chen Z, Cai Z, Zhao W, Wu W, Wu S, Chen Y. Age-dependent changes in the risk of weight gain in Chinese adults: results from the Kailuan cohort study. Public Health 2023; 218:139-145. [PMID: 37030271 DOI: 10.1016/j.puhe.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/12/2023] [Accepted: 03/03/2023] [Indexed: 04/10/2023]
Abstract
OBJECTIVES Over the past decades, China has seen a dramatic epidemic of overweight and obesity. However, the optimal period for interventions to prevent overweight/obesity in adulthood remains unclear, and little is known regarding the joint effect of sociodemographic factors on weight gain. We aimed to investigate the associations of weight gain with sociodemographic factors, including age, sex, educational level, and income. STUDY DESIGN This was a longitudinal cohort study. METHODS This study included 121,865 participants aged 18-74 years from the Kailuan study who attended health examinations over the period 2006-2019. Multivariate logistic regression and restricted cubic spline were used to evaluate the associations of sociodemographic factors with body mass index (BMI) category transitions over two, six, and 10 years. RESULTS In the analysis of 10-year BMI changes, the youngest age group had the highest risks of shifting to higher BMI categories, with odds ratio of 2.42 (95% confidence interval 2.12-2.77) for a transition from underweight or normal weight to overweight or obesity and 2.85 (95% confidence interval 2.17-3.75) for a transition from overweight to obesity. Compared with baseline age, education level was less related to these changes, whereas gender and income were not significantly associated with these transitions. Restricted cubic spline analyses suggested reverse J-shaped associations of age with these transitions. CONCLUSIONS The risk of weight gain in Chinese adults is age dependent, and clear public healthcare messaging is needed for young adults who are at the highest risk of weight gain.
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Affiliation(s)
- Zhiwei Cai
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Xu Yang
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Zegui Huang
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Xianxuan Wang
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Zekai Chen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Zefeng Cai
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Wenliu Zhao
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Weiqiang Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China.
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China.
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11
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Young IE, Crino N, Steinbeck KS, Parker HM. Eating Patterns of Young Women (18–25 y) with Overweight and Obesity: A Preliminary Investigation. Nutrients 2023; 15:nu15071652. [PMID: 37049493 PMCID: PMC10096735 DOI: 10.3390/nu15071652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023] Open
Abstract
Overweight and obesity impact up to 40% of young women in Australia; however, young women are challenging to recruit to research and are rarely the focus of weight loss interventions. This study aimed to examine dietary patterns in young women (18–25 years; BMI > 25 kg/m2). An analysis of participants’ (mean age: 22.6 year; BMI: 32.2 kg/m2) 3-day food records found young women with overweight/obesity consumed a diet characterised by total energy intake of 9174 (2526) kJ/day, with the first meal at 9:12 am (range: 4:30 am–12:40 pm), the last at 10:43 pm (range: 2:40 pm–2:00 am), and an average eating window of 11.5 h. Young women had poor quality diets, which did not meet dietary recommendations for most core food groups, and high intake of refined carbohydrates. They also reported consuming at least one takeaway meal per day and >30% of total energy intake was from discretionary items. The findings showed that young women with overweight or obesity consume most of their energy intake in the afternoons and late into the evenings and have poor-quality diets with high-discretionary intake, each of which have been shown in previous work to be associated with increased weight and risk of metabolic comorbidities. While these findings require further examination in larger groups with both qualitative and longitudinal data collection to verify the impact of these eating patterns on weight maintenance, the eating behaviours identified here may present a suitable target for novel weight loss interventions in young women, who are an understudied population group in need of tailored weight management solutions.
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Affiliation(s)
- Isabel E. Young
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
- Correspondence: ; Tel.: +61-2-9351-9309
| | - Natalie Crino
- Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia
| | - Katharine S. Steinbeck
- Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia
- Discipline of Child and Adolescent Health, Department of Adolescent Medicine, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Helen M. Parker
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia
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12
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Tham KW, Abdul Ghani R, Cua SC, Deerochanawong C, Fojas M, Hocking S, Lee J, Nam TQ, Pathan F, Saboo B, Soegondo S, Somasundaram N, Yong AML, Ashkenas J, Webster N, Oldfield B. Obesity in South and Southeast Asia-A new consensus on care and management. Obes Rev 2023; 24:e13520. [PMID: 36453081 PMCID: PMC10078503 DOI: 10.1111/obr.13520] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 12/03/2022]
Abstract
Obesity is a chronic disease in which the abnormal or excessive accumulation of body fat leads to impaired health and increased risk of mortality and chronic health complications. Prevalence of obesity is rising rapidly in South and Southeast Asia, with potentially serious consequences for local economies, healthcare systems, and quality of life. Our group of obesity specialists from Bangladesh, Brunei Darussalam, India, Indonesia, Malaysia, Philippines, Singapore, Sri Lanka, Thailand, and Viet Nam undertook to develop consensus recommendations for management and care of adults and children with obesity in South and Southeast Asia. To this end, we identified and researched 12 clinical questions related to obesity. These questions address the optimal approaches for identifying and staging obesity, treatment (lifestyle, behavioral, pharmacologic, and surgical options) and maintenance of reduced weight, as well as issues related to weight stigma and patient engagement in the clinical setting. We achieved consensus on 42 clinical recommendations that address these questions. An algorithm describing obesity care is presented, keyed to the various consensus recommendations.
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Affiliation(s)
- Kwang Wei Tham
- Singapore Association for the Study of Obesity, Singapore
| | | | - Sioksoan C Cua
- Division of Pediatric Endocrinology, Philippine General Hospital, Metro Manila, Philippines.,Department of Pediatrics, Chinese General Hospital, Cardinal Santos Medical Center, Manila Doctors Hospital, Metro Manila, Philippines
| | | | - Mia Fojas
- Department of Biochemistry and Molecular Biology, University of the Philippines College of Medicine, Manila, Philippines
| | - Samantha Hocking
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, Australia.,Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Boden Initiative, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - June Lee
- Upper Gastrointestinal and Bariatric Surgery, Department of Surgery, Changi General Hospital, Singapore
| | - Tran Quang Nam
- Department of Endocrinology, Ho Chi Minh City University Medical Center, Ho Chi Minh City, Vietnam
| | - Faruque Pathan
- Department of Endocrinology, Ibrahim Memorial Diabetes Center, Dhaka, Bangladesh
| | - Banshi Saboo
- Dia Care Diabetes Care and Hormone Clinic, Ahmedabad, Gujarat, India
| | - Sidartawan Soegondo
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.,Diabetes Connection and Care, Eka Hospitals, Jakarta, Indonesia
| | | | - Alice M L Yong
- Department of Internal Medicine, RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam
| | | | | | - Brian Oldfield
- Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, Australia
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13
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Putnoky S, Serban DM, Banu AM, Ursoniu S, Serban CL. Reliability and Validity of the Emotional Eater Questionnaire in Romanian Adults. Nutrients 2022; 15:nu15010026. [PMID: 36615682 PMCID: PMC9823580 DOI: 10.3390/nu15010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Negative emotions and chronic stress trigger abnormal compensatory behaviors known as emotional eating (EE). EE is a well-known mediator for increased body mass index and weight gain. Our aim was to analyze the factor structure and validity and reliability of the Emotional Eater Questionnaire (EEQ) in a sample of 200 Romanian adults with excess weight. Principal component analysis (PCA) was used to assess the construct validity. The mindful eating questionnaire (MEQ) was used to test concurrent validity. Cronbach’s alpha and Spearman correlations were used to analyze internal and external reliability. The socio-demographic characteristics were used as factors for convergent validity. PCA revealed the existence of three major factors, disinhibition, type of food, and guilt, which accounted for 64.9% of the variance. Concurrent validity showed medium to large associations with MEQ (r = 0.650; p < 0.001) and a large association with the emotional subscale of MEQ (r = 0.732; p < 0.001). Reliability was adequate with Cronbach’s alfa = 0.841 and ICC = 0.775. In a multivariate model, the highest contribution to the EE score was the age (beta = −0.327), followed by feminine gender (beta = 0.321), high levels of perceived stress (beta = 0.215), BMI (beta = 0.184) and lower perceived health status (beta = 0.184). The Romanian version of the EEQ is a reliable and valid tool for measuring emotional eating in adults with excess weight.
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Affiliation(s)
- Salomeia Putnoky
- Department of Microbiology, Discipline of Hygiene, Centre for Studies in Preventive Medicine, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
| | - Denis Mihai Serban
- Department of Obstetrics-Gynaecology, Discipline of Obstetrics-Gynaecology II, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
- Correspondence: ; Tel.: +40256-204400
| | - Ancuta Mioara Banu
- Department 2, Discipline of Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
| | - Sorin Ursoniu
- Department of Functional Sciences, Discipline of Public Health, Center for Translational Research and Systems Medicine, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
| | - Costela Lacrimioara Serban
- Department of Functional Sciences, Discipline of Public Health, Center for Translational Research and Systems Medicine, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
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14
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Silventoinen K, Li W, Jelenkovic A, Sund R, Yokoyama Y, Aaltonen S, Piirtola M, Sugawara M, Tanaka M, Matsumoto S, Baker LA, Tuvblad C, Tynelius P, Rasmussen F, Craig JM, Saffery R, Willemsen G, Bartels M, van Beijsterveldt CEM, Martin NG, Medland SE, Montgomery GW, Lichtenstein P, Krueger RF, McGue M, Pahlen S, Christensen K, Skytthe A, Kyvik KO, Saudino KJ, Dubois L, Boivin M, Brendgen M, Dionne G, Vitaro F, Ullemar V, Almqvist C, Magnusson PKE, Corley RP, Huibregtse BM, Knafo-Noam A, Mankuta D, Abramson L, Haworth CMA, Plomin R, Bjerregaard-Andersen M, Beck-Nielsen H, Sodemann M, Duncan GE, Buchwald D, Burt SA, Klump KL, Llewellyn CH, Fisher A, Boomsma DI, Sørensen TIA, Kaprio J. Changing genetic architecture of body mass index from infancy to early adulthood: an individual based pooled analysis of 25 twin cohorts. Int J Obes (Lond) 2022; 46:1901-1909. [PMID: 35945263 PMCID: PMC9492534 DOI: 10.1038/s41366-022-01202-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 11/09/2022]
Abstract
Background Body mass index (BMI) shows strong continuity over childhood and adolescence and high childhood BMI is the strongest predictor of adult obesity. Genetic factors strongly contribute to this continuity, but it is still poorly known how their contribution changes over childhood and adolescence. Thus, we used the genetic twin design to estimate the genetic correlations of BMI from infancy to adulthood and compared them to the genetic correlations of height. Methods We pooled individual level data from 25 longitudinal twin cohorts including 38,530 complete twin pairs and having 283,766 longitudinal height and weight measures. The data were analyzed using Cholesky decomposition offering genetic and environmental correlations of BMI and height between all age combinations from 1 to 19 years of age. Results The genetic correlations of BMI and height were stronger than the trait correlations. For BMI, we found that genetic correlations decreased as the age between the assessments increased, a trend that was especially visible from early to middle childhood. In contrast, for height, the genetic correlations were strong between all ages. Age-to-age correlations between environmental factors shared by co-twins were found for BMI in early childhood but disappeared altogether by middle childhood. For height, shared environmental correlations persisted from infancy to adulthood. Conclusions Our results suggest that the genes affecting BMI change over childhood and adolescence leading to decreasing age-to-age genetic correlations. This change is especially visible from early to middle childhood indicating that new genetic factors start to affect BMI in middle childhood. Identifying mediating pathways of these genetic factors can open possibilities for interventions, especially for those children with high genetic predisposition to adult obesity.
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Affiliation(s)
- Karri Silventoinen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland. .,Center for Twin Research, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Weilong Li
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Aline Jelenkovic
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Spain.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Reijo Sund
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Yoshie Yokoyama
- Department of Public Health Nursing, Osaka Metropolitan University, Osaka, Japan
| | - Sari Aaltonen
- Institute for Molecular Medicine Finland FIMM, Helsinki, Finland
| | - Maarit Piirtola
- Institute for Molecular Medicine Finland FIMM, Helsinki, Finland.,UKK Institute - Centre for Health Promotion Research, Tampere, Finland
| | - Masumi Sugawara
- Faculty of Human Studies, Shirayuri University, Tokyo, Japan
| | - Mami Tanaka
- Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Satoko Matsumoto
- Institute for Education and Human Development, Ochanomizu University, Tokyo, Japan
| | - Laura A Baker
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Catherine Tuvblad
- Department of Psychology, University of Southern California, Los Angeles, CA, USA.,School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Per Tynelius
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Finn Rasmussen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Jeffrey M Craig
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University School of Medicine, Geelong, Australia.,Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Richard Saffery
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Gonneke Willemsen
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, Amsterdam, Netherlands
| | - Meike Bartels
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, Amsterdam, Netherlands
| | | | - Nicholas G Martin
- Genetic Epidemiology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Sarah E Medland
- Genetic Epidemiology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Grant W Montgomery
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Matt McGue
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Shandell Pahlen
- Department of Psychology, University of California, Riverside, Riverside, CA, 92521, USA
| | - Kaare Christensen
- The Danish Twin Registry, Department of Public Health, Epidemiology, Biostatistics & Biodemography, University of Southern Denmark Odense, Odense, Denmark.,Department of Clinical Biochemistry and Pharmacology and Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Axel Skytthe
- The Danish Twin Registry, Department of Public Health, Epidemiology, Biostatistics & Biodemography, University of Southern Denmark Odense, Odense, Denmark
| | - Kirsten O Kyvik
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Kimberly J Saudino
- Boston University, Department of Psychological and Brain Sciencies, Boston, MA, USA
| | - Lise Dubois
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Michel Boivin
- École de psychologie, Université Laval, Québec, Canada
| | - Mara Brendgen
- Département de psychologie, Université du Québec à Montréal, Montréal, Québec, Canada
| | | | - Frank Vitaro
- École de psychoéducation, Université de Montréal, Montréal, Québec, Canada
| | - Vilhelmina Ullemar
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Theme Women's Health, Karolinska University Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado, Boulder, Colorado, USA
| | - Brooke M Huibregtse
- Department of Psychology and Neuroscience, University of Colorado, Boulder, Colorado, USA
| | | | - David Mankuta
- Hadassah Hospital Obstetrics and Gynecology Department, Hebrew University Medical School, Jerusalem, Israel
| | - Lior Abramson
- The Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Robert Plomin
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Morten Bjerregaard-Andersen
- Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau.,Department of Endocrinology, Hospital of Southwest Jutland, Esbjerg, Denmark.,Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | | | - Morten Sodemann
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
| | - Glen E Duncan
- Washington State Twin Registry, Washington State University - Health Sciences Spokane, Spokane, WA, USA
| | - Dedra Buchwald
- Washington State Twin Registry, Washington State University - Health Sciences Spokane, Spokane, WA, USA
| | - S Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Clare H Llewellyn
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Abigail Fisher
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Dorret I Boomsma
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, Amsterdam, Netherlands
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Public Health (Section of Epidemiology), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Institute for Molecular Medicine Finland FIMM, Helsinki, Finland
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15
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Mauldin K, May M, Clifford D. The consequences of a weight-centric approach to healthcare: A case for a paradigm shift in how clinicians address body weight. Nutr Clin Pract 2022; 37:1291-1306. [PMID: 35819360 DOI: 10.1002/ncp.10885] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/27/2022] [Accepted: 05/14/2022] [Indexed: 11/10/2022] Open
Abstract
Current healthcare is weight-centric, equating weight and health. This approach to healthcare has negative consequences on patient well-being. The aim of this article is to make a case for a paradigm shift in how clinicians view and address body weight. In this review, we (1) address common flawed assumptions in the weight-centric approach to healthcare, (2) review the weight science literature and provide evidence for the negative consequences of promoting dieting and weight loss, and (3) provide practice recommendations for weight-inclusive care.
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Affiliation(s)
- Kasuen Mauldin
- Department of Nutrition, Food Science, and Packaging, San José State University, San José, California, USA.,Department of Clinical Nutrition, Stanford Health Care, Stanford, California, USA
| | - Michelle May
- Am I Hungry? Mindful Eating Programs and Training, USA.,Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Dawn Clifford
- Department of Health Sciences, Northern Arizona University, Flagstaff, Arizona, USA
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16
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Jiskoot G, Dietz de Loos A, Timman R, Beerthuizen A, Laven J, Busschbach J. Lifestyle treatment in women with polycystic ovary syndrome: predictors of weight loss and dropout. Brain Behav 2022; 12:e2621. [PMID: 35652323 PMCID: PMC9304828 DOI: 10.1002/brb3.2621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) affects 5%-10% of women in their reproductive years. Most women with PCOS struggle with obesity during their entire life. Knowing which determinants contribute to a successful lifestyle change is important to optimize treatment options for women with PCOS. OBJECTIVE This analysis of secondary outcome measures aimed to determine factors of ≥5% weight loss and dropout in all arms of the study and separately in the lifestyle intervention (LI) and control (care as usual [CAU]) groups. STUDY DESIGN Women diagnosed with PCOS (N = 183) and a Body Mass Index (BMI) above 25 kg/m2 were included. Participants were assigned to (1) 20 lifestyle sessions involving cognitive behavioral therapy (CBT), (2) 20 lifestyle sessions involving CBT with additional short message service (SMS), or (3) to control (CAU). A generalized linear regression was performed to identify determinants of ≥5% weight loss. Logistic regression was performed to identify determinants of dropout. All models were corrected by including baseline weight as a covariate. RESULTS LI (OR 4.906, p = .001) was associated with ≥5% weight loss, while higher depression scores (OR 0.549, p = .013) had a negative association. Restraint eating was a positive factor for ≥5% weight loss in LI but a negative in CAU. Higher baseline weight (OR 1.033, p = .006), LI with SMS (OR 4.424, p = .002), and higher levels of androstenedione (OR 1.167, p = .026) were associated with dropout. CONCLUSIONS Depression and eating behavior were associated with ≥5% weight loss. Women with PCOS should be screened for depression and eating behavior before a LI.
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Affiliation(s)
- Geranne Jiskoot
- Division of Reproductive Endocrinology and InfertilityDepartment of Obstetrics and GynecologyErasmus MCRotterdamThe Netherlands
- Department of PsychiatrySection Medical Psychology and PsychotherapyErasmus MCRotterdamThe Netherlands
| | - Alexandra Dietz de Loos
- Division of Reproductive Endocrinology and InfertilityDepartment of Obstetrics and GynecologyErasmus MCRotterdamThe Netherlands
| | - Reinier Timman
- Department of PsychiatrySection Medical Psychology and PsychotherapyErasmus MCRotterdamThe Netherlands
| | - Annemerle Beerthuizen
- Department of PsychiatrySection Medical Psychology and PsychotherapyErasmus MCRotterdamThe Netherlands
| | - Joop Laven
- Division of Reproductive Endocrinology and InfertilityDepartment of Obstetrics and GynecologyErasmus MCRotterdamThe Netherlands
| | - Jan Busschbach
- Department of PsychiatrySection Medical Psychology and PsychotherapyErasmus MCRotterdamThe Netherlands
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Jiskoot G, de Loos AD, Timman R, Beerthuizen A, Laven J, Busschbach J. Changes in eating behavior through lifestyle treatment in women with polycystic ovary syndrome (PCOS): a randomized controlled trial. J Eat Disord 2022; 10:69. [PMID: 35581616 PMCID: PMC9116037 DOI: 10.1186/s40337-022-00593-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eating behaviors like emotional eating, external eating and restrained eating play an important role in weight gain and weight loss in the general population. Improvements in eating behavior are important for long-term weight. This has not yet been studied in women with Polycystic Ovary Syndrome (PCOS). The aim of this study is to examine if a three-component lifestyle intervention (LI) is effective for improving disordered eating behavior in women with PCOS. METHODS Women diagnosed with PCOS (N = 183), with a body mass index (BMI) > 25 kg/m2 and trying to achieve a pregnancy were either assigned to 1 year of 20 group sessions of cognitive behavioral therapy (CBT) combined with nutritional advice and exercise with or without additional feedback through Short Message Service (SMS) or Care As Usual (CAU), which includes the advice to lose weight using publicly available services. RESULTS The Eating Disorder Examination Questionnaire (EDEQ) scores worsened in CAU (47.5%) and improved in the LI (4.2%) at 12 months. The difference between the LI and CAU was significant (P = 0.007) and resulted in a medium to large effect size (Cohen's d: - 0.72). No significant differences were observed in EDEQ scores between LI with SMS compared to LI without SMS (Cohen's d: 0.28; P = 0.399). Also, weight loss did not mediate the changes in eating behavior. An overall completion rate of 67/183 (36.6%) was observed. CONCLUSIONS A three-component CBT lifestyle program resulted in significant improvements in disordered eating behavior compared to CAU. Changes in disordered eating behavior are important for long-term weight loss and mental health. TRIAL REGISTRATION NTR, NTR2450. Registered 2 August 2010, https://www.trialregister.nl/trial/2344.
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Affiliation(s)
- Geranne Jiskoot
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Alexandra Dietz de Loos
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Reinier Timman
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Annemerle Beerthuizen
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Joop Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jan Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
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Hasan FO, Hamilton KP, Angadi SS, Kranz S. Effects of Vinegar/Acetic Acid Intake on Appetite Measures and Energy Consumption: Systematic Review. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022. [DOI: 10.1249/tjx.0000000000000205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Jayne JM, Karl JP, McGraw SM, O'Connor K, DiChiara AJ, Cole RE. Eating Behaviors Are Associated With Physical Fitness and Body Composition Among US Army Soldiers. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:480-488. [PMID: 33674236 DOI: 10.1016/j.jneb.2021.01.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Examine associations between soldiers' eating behaviors, compliance with body composition and fitness standards, and physical performance. DESIGN Cross-sectional study. SETTING Eight Army installations. PARTICIPANTS US Army Soldiers (n = 1,591; 84% male). MAIN OUTCOME MEASURES Characteristics, eating behaviors, compliance with body composition and physical fitness standards, and fitness level were assessed via questionnaire. ANALYSIS Bivariate and multivariable logistic regression. RESULTS Eating mostly at a dining facility was associated with lower odds of body composition failure (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.26-0.73); whereas, eating at a fast rate (OR, 1.51; 95% CI, 1.05-2.17) or often/always ignoring satiety cues (OR, 2.12; 95% CI, 1.06-4.27) was associated with higher odds of body composition failure. Eating mostly fast-food/convenience meals (OR, 1.75; 95% CI, 1.19-2.59) and eating at a fast rate (OR, 1.42; 95% CI, 1.04-1.93) was associated with higher odds of physical fitness failure. Skipping breakfast was associated with lower odds of high physical performance (OR, 0.41; 95% CI, 0.23-0.74); whereas, nutrition education was associated with higher odds of high physical performance (OR, 1.02; 95% CI, 1.01-1.04). CONCLUSIONS AND IMPLICATIONS As eating behaviors are modifiable, findings suggest opportunities for improving the specificity of Army health promotion and education programs.
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Affiliation(s)
- Julianna M Jayne
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA.
| | - J Philip Karl
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Susan M McGraw
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Kristie O'Connor
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Adam J DiChiara
- Combat Capabilities Development Command Soldier Center, US Army Soldier Systems Center, Natick, MA
| | - Renee E Cole
- US Military-Baylor University Graduate Program in Nutrition, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX
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20
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Katsarou AL, Katsilambros NL, Koliaki CC. Intermittent Energy Restriction, Weight Loss and Cardiometabolic Risk: A Critical Appraisal of Evidence in Humans. Healthcare (Basel) 2021; 9:495. [PMID: 33922103 PMCID: PMC8143449 DOI: 10.3390/healthcare9050495] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 11/17/2022] Open
Abstract
Dietary patterns with intermittent energy restriction (IER) have been proposed as an attractive alternative to continuous energy restriction (CER) for the management of obesity and its associated comorbidities. The most widely studied regimens of IER comprise energy restriction on two days per week (5:2), alternate-day energy restriction by 60-70% (ADF), and timely restriction of energy intake during a specific time window within the day (TRF; time-restricted feeding). Although there is some evidence to suggest that IER can exert beneficial effects on human cardiometabolic health, yet is apparently not superior compared to CER, there are still some critical issues/questions that warrant further investigation: (i) high-quality robust scientific evidence regarding the long-term effects of IER (safety, efficacy, compliance) is limited since the vast majority of intervention studies had a duration of less than 6 months; (ii) whether the positive effects of IER are independent of or actually mediated by weight loss remains elusive; (iii) it remains unknown whether IER protocols are a safe recommendation for the general population; (iv) data concerning the impact of IER on ectopic fat stores, fat-free mass, insulin resistance and metabolic flexibility are inconclusive; (v) the cost-effectiveness of IER dietary regimens has not been adequately addressed; (vi) direct head-to-head studies comparing different IER patterns with variable macronutrient composition in terms of safety and efficacy are scarce; and (vii) evidence is limited with regard to the efficacy of IER in specific populations, including males, the elderly and patients with morbid obesity and diabetes mellitus. Until more solid evidence is available, individualization and critical perspective are definitely warranted to determine which patients might benefit the most from an IER intervention, depending on their personality traits and most importantly comorbid health conditions.
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Affiliation(s)
| | - Nicholas L. Katsilambros
- Research Laboratory Christeas Hall, Medical Faculty, National Kapodistrian University of Athens, 11527 Athens, Greece;
- First Propaedeutic Department of Internal Medicine and Diabetes Center, Laiko University Hospital, National Kapodistrian University of Athens, 11527 Athens, Greece
| | - Chrysi C. Koliaki
- First Propaedeutic Department of Internal Medicine and Diabetes Center, Laiko University Hospital, National Kapodistrian University of Athens, 11527 Athens, Greece
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Silventoinen K, Konttinen H. Obesity and eating behavior from the perspective of twin and genetic research. Neurosci Biobehav Rev 2021; 109:150-165. [PMID: 31959301 DOI: 10.1016/j.neubiorev.2019.12.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/11/2019] [Accepted: 12/09/2019] [Indexed: 12/21/2022]
Abstract
Obesity has dramatically increased during the last decades and is currently one of the most serious global health problems. We present a hypothesis that obesity is a neuro-behavioral disease having a strong genetic background mediated largely by eating behavior and is sensitive to the macro-environment; we study this hypothesis from the perspective of genetic research. Genetic family and genome-wide-association studies have shown well that body mass index (BMI, kg/m2) is a highly heritable and polygenic trait. New genetic variation of BMI emerges after early childhood. Candidate genes of BMI notably express in brain tissue, supporting that this new variation is related to behavior. Obesogenic environments at both childhood family and societal levels reinforce the genetic susceptibility to obesity. Genetic factors have a clear influence on macro-nutrient intake and appetite-related eating behavior traits. Results on the gene-by-diet interactions in obesity are mixed, but emerging evidence suggests that eating behavior traits partly mediate the effect of genes on BMI. However, more rigorous prospective study designs controlling for measurement bias are still needed.
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Affiliation(s)
- Karri Silventoinen
- Department of Social Research, University of Helsinki, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland.
| | - Hanna Konttinen
- Department of Social Research, University of Helsinki, Helsinki, Finland
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22
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Hwalla N, Jaafar Z. Dietary Management of Obesity: A Review of the Evidence. Diagnostics (Basel) 2020; 11:diagnostics11010024. [PMID: 33375554 PMCID: PMC7823549 DOI: 10.3390/diagnostics11010024] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/08/2020] [Accepted: 12/08/2020] [Indexed: 01/29/2023] Open
Abstract
Obesity is a multi-factorial disease and its prevention and management require knowledge of the complex interactions underlying it and adopting a whole system approach that addresses obesogenic environments within country specific contexts. The pathophysiology behind obesity involves a myriad of genetic, epigenetic, physiological, and macroenvironmental factors that drive food intake and appetite and increase the obesity risk for susceptible individuals. Metabolically, food intake and appetite are regulated via intricate processes and feedback systems between the brain, gastrointestinal system, adipose and endocrine tissues that aim to maintain body weight and energy homeostasis but are also responsive to environmental cues that may trigger overconsumption of food beyond homeostatic needs. Under restricted caloric intake conditions such as dieting, these processes elicit compensatory metabolic mechanisms that promote energy intake and weight regain, posing great challenges to diet adherence and weight loss attempts. To mitigate these responses and enhance diet adherence and weight loss, different dietary strategies have been suggested in the literature based on their differential effects on satiety and metabolism. In this review article, we offer an overview of the literature on obesity and its underlying pathological mechanisms, and we present an evidence based comparative analysis of the effects of different popular dietary strategies on weight loss, metabolic responses and diet adherence in obesity.
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23
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Järvelä-Reijonen E, Puttonen S, Karhunen L, Sairanen E, Laitinen J, Kolehmainen M, Pihlajamäki J, Kujala UM, Korpela R, Ermes M, Lappalainen R, Kolehmainen M. The Effects of Acceptance and Commitment Therapy (ACT) Intervention on Inflammation and Stress Biomarkers: a Randomized Controlled Trial. Int J Behav Med 2020; 27:539-555. [PMID: 32394219 PMCID: PMC7497453 DOI: 10.1007/s12529-020-09891-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Psychological processes can be manifested in physiological health. We investigated whether acceptance and commitment therapy (ACT), targeted on psychological flexibility (PF), influences inflammation and stress biomarkers among working-age adults with psychological distress and overweight/obesity. METHOD Participants were randomized into three parallel groups: (1) ACT-based face-to-face (n = 65; six group sessions led by a psychologist), (2) ACT-based mobile (n = 73; one group session and mobile app), and (3) control (n = 66; only the measurements). Systemic inflammation and stress markers were analyzed at baseline, at 10 weeks after the baseline (post-intervention), and at 36 weeks after the baseline (follow-up). General PF and weight-related PF were measured with questionnaires (Acceptance and Action Questionnaire, Acceptance and Action Questionnaire for Weight-Related Difficulties). RESULTS A group × time interaction (p = .012) was detected in the high-sensitivity C-reactive protein (hsCRP) level but not in other inflammation and stress biomarkers. hsCRP decreased significantly in the face-to-face group from week 0 to week 36, and at week 36, hsCRP was lower among the participants in the face-to-face group than in the mobile group (p = .035, post hoc test). Age and sex were stronger predictors of biomarker levels at follow-up than the post-intervention PF. CONCLUSION The results suggest that ACT delivered in group sessions may exert beneficial effects on low-grade systemic inflammation. More research is needed on how to best apply psychological interventions for the health of both mind and body among people with overweight/obesity and psychological distress. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01738256, Registered 17 August, 2012.
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Affiliation(s)
- Elina Järvelä-Reijonen
- Institute of Public Health and Clinical Nutrition, Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
| | - Sampsa Puttonen
- Finnish Institute of Occupational Health, P.O. Box 40, FI-00251 Helsinki, Finland
| | - Leila Karhunen
- Institute of Public Health and Clinical Nutrition, Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
- Institute of Clinical Medicine and Clinical Nutrition, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS Kuopio, Finland
| | - Essi Sairanen
- Department of Psychology, University of Jyväskylä, P.O. Box 35, FI-40014 Jyväskylä, Finland
- Department of Social and Psychological Studies, Karlstad University, SE-651 88 Karlstad, Sweden
| | - Jaana Laitinen
- Finnish Institute of Occupational Health, P.O. Box 40, FI-00251 Helsinki, Finland
| | - Mikko Kolehmainen
- Department of Environmental and Biological Sciences, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
| | - Jussi Pihlajamäki
- Institute of Public Health and Clinical Nutrition, Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
- Institute of Clinical Medicine and Clinical Nutrition, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS Kuopio, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - Riitta Korpela
- Medical Faculty, Pharmacology, Medical Nutrition Physiology and Human Microbe Research Program, University of Helsinki, P.O. Box 63, FI-00014 Helsinki, Finland
| | - Miikka Ermes
- Institute of Public Health and Clinical Nutrition, Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
- VTT Technical Research Centre of Finland, P.O. Box 1300, FI-33101 Tampere, Finland
| | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - Marjukka Kolehmainen
- Institute of Public Health and Clinical Nutrition, Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
- Institute of Clinical Medicine and Clinical Nutrition, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS Kuopio, Finland
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Effect of a chronotype-adjusted diet on weight loss effectiveness: A randomized clinical trial. Clin Nutr 2020; 39:1041-1048. [DOI: 10.1016/j.clnu.2019.05.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 04/10/2019] [Accepted: 05/10/2019] [Indexed: 11/22/2022]
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Effect of the EndoBarrier Device: a 4-Year Follow-up of a Multicenter Randomized Clinical Trial. Obes Surg 2020; 29:1117-1121. [PMID: 30627989 DOI: 10.1007/s11695-018-03659-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To evaluate the long-term effect of the duodenal-jejunal bypass liner (DJBL) on weight loss and glycemic control. BACKGROUND Data on the long-term effect of DJBL treatment is still missing. METHODS From 2010 to 2012, 29 patients were treated with the DJBL at center A and center B, as part of a multicenter randomized controlled trial. Prior to implantation and after removal of the DJBL, all patients underwent standardized physical examination and blood sampling. Four years after removal of the DJBL, included patients underwent standardized physical examination and blood sampling as previously performed during the initial study. RESULTS Out of the 29 patients, 15 patients were eligible for follow-up with a median duration of 42 months. Five patients had successfully received additional bariatric surgery. Four years after explantation of the DJBL, median weight in these 15 patients was 102.0 kg (IQR 94.0-124.6), which was not statistically significantly different from the 106.1 kg at baseline (IQR 99.0-128.4). Median BMI changed from 33.1 kg/m2 (IQR 32.3-38.5) at baseline to 33.7 kg/m2 (IQR 31.2-36.9) after follow-up. Patients had a TWL of 2.2% (IQR - 1.3-5.6) compared to baseline weight. None of the parameters were significantly different after follow-up compared to baseline. CONCLUSIONS The effect of weight reduction of initial DJBL treatment seems to be diminished after 4 years of follow-up. However, larger prospective studies with long-term follow-up need to be conducted in the future.
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Mediation of emotional and external eating between dieting and food intake or BMI gain in women. Appetite 2020; 145:104493. [DOI: 10.1016/j.appet.2019.104493] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/16/2019] [Accepted: 10/13/2019] [Indexed: 12/15/2022]
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Dugmore JA, Winten CG, Niven HE, Bauer J. Effects of weight-neutral approaches compared with traditional weight-loss approaches on behavioral, physical, and psychological health outcomes: a systematic review and meta-analysis. Nutr Rev 2019; 78:39-55. [DOI: 10.1093/nutrit/nuz020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Abstract
Context
Weight-neutral approaches for health are emerging therapeutic alternatives to traditional weight-loss approaches. The existing literature base comparing these approaches has not yet been systematically evaluated by a meta-analysis.
Objective
This review aims to determine if weight-neutral approaches are valid alternatives to weight-loss approaches for improving physical, psychological, and behavioral health outcomes.
Data Sources
Embase, Scopus, PsycINFO, PubMed, CINAHL, and the University of Queensland Library databases were searched.
Study Selection
Peer-reviewed, experimental, or quasi-experimental studies that included weight-neutral and weight-loss arms and reported physical, psychological, or behavioral outcomes were eligible. A total of 525 studies were identified through initial database searches, with 10 included in the final analysis after exclusion criteria were applied.
Data Extraction
Screening and eligibility assessment of studies followed the PRISMA protocol. The following outcomes were extracted: weight, body mass index, lipid and glucose variables, blood pressure, eating behavior, self-esteem, depression, quality of life, physical activity, and diet quality.
Data Analysis
Studies were graded per the National Health and Medical Research Council (NHMRC) level-of-evidence tool and the Academy of Nutrition and Dietetics quality-evaluation tool. Effect sizes were examined as a meta-analysis of standardized and mean differences using a random-effects inverse-variance model with 95%CIs. Practice recommendations for each outcome were graded per NHMRC body-of-evidence guidelines.
Conclusions
Weight-neutral approaches resulted in greater improvement in bulimia (P = 0.02), but no significant differences were observed for any other outcome. Weight-neutral approaches may be as effective as weight-loss methods for improving physical, psychological, and behavioral outcomes. Limitations include inconsistent definitions of both approaches and variable time frames of follow-up.
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Affiliation(s)
- Jaslyn A Dugmore
- J.A. Dugmore, C.G. Winten, H.E. Niven, and J. Bauer are with the School of Human Movement and Nutrition Science, The University of Queensland, Brisbane, Australia
| | - Copeland G Winten
- J.A. Dugmore, C.G. Winten, H.E. Niven, and J. Bauer are with the School of Human Movement and Nutrition Science, The University of Queensland, Brisbane, Australia
| | - Hannah E Niven
- J.A. Dugmore, C.G. Winten, H.E. Niven, and J. Bauer are with the School of Human Movement and Nutrition Science, The University of Queensland, Brisbane, Australia
| | - Judy Bauer
- J.A. Dugmore, C.G. Winten, H.E. Niven, and J. Bauer are with the School of Human Movement and Nutrition Science, The University of Queensland, Brisbane, Australia
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Aspiration therapy for the treatment of obesity: 4-year results of a multicenter randomized controlled trial. Surg Obes Relat Dis 2019; 15:1348-1354. [PMID: 31302000 DOI: 10.1016/j.soard.2019.04.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 04/01/2019] [Accepted: 04/26/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND The AspireAssist is the first Food and Drug Administration-approved endoluminal device indicated for treatment of class II and III obesity. OBJECTIVES We earlier reported 1-year results of the PATHWAY study. Here, we report 4-year outcomes. SETTING United States-based, 10-center, randomized controlled trial involving 171 participants with the treatment arm receiving Aspiration Therapy (AT) plus Lifestyle Therapy and the control arm receiving Lifestyle Therapy (2:1 randomization). METHODS AT participants were permitted to continue in the study for an additional year up to a maximum of 5 years providing they maintained at least 10% total weight loss (TWL) from baseline at each year end. For AT participants who continued the study, 5 medical monitoring visits were provided at weeks 60, 68, 76, 90, and 104 and thereafter once every 13 weeks up to week 260. Exclusion criteria were a history of eating disorder or evidence of eating disorder on a validated questionnaire. Follow-up weight, quality of life, and co-morbidities were compared with the baseline levels. In addition, rates of serious adverse event, persistent fistula, withdrawal, and A-tube replacement were reported. All analyses were performed using a per-protocol analysis. RESULTS Of the 82 AT participants who completed 1 year, 58 continued to this phase of the trial. Mean baseline body mass index of these 58 patients was 41.6 ± 4.5 kg/m2. At the end of first year (at the beginning of the follow-up study), these 58 patients had a body mass index of 34.1 ± 5.4 kg/m2 and had achieved an 18.3 ± 8.0% TWL. On a per protocol basis, patients experienced 14.2%, 15.3%, 16.6%, and 18.7% TWL at 1, 2, 3, and 4 years, respectively (P < .01 for all). Forty of 58 patients (69%) achieved at least 10% TWL at 4 years or at time of study withdrawal. Improvements in quality of life scores and select cardiometabolic parameters were also maintained through 4 years. There were 2 serious adverse events reported in the second through fourth years, both of which resolved with removal or replacement of the A tube. Two persistent fistulas required surgical repair, representing approximately 2% of all tube removals. There were no clinically significant metabolic or electrolytes disorders observed, nor any evidence for development of any eating disorders. CONCLUSIONS The results of this midterm study have shown that AT is a safe, effective, and durable weight loss alternative for people with class II and III obesity and who are willing to commit to using the therapy and adhere to adjustments in eating behavior.
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Bergen M, Mollen D. Teaching Sizeism: Integrating Size into Multicultural Education and Clinical Training. WOMEN & THERAPY 2019. [DOI: 10.1080/02703149.2018.1524065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Martha Bergen
- Counseling and Psychological Services, Texas Woman’s University, Denton, Texas
| | - Debra Mollen
- Department of Psychology and Philosophy, Texas Woman’s University, Denton, Texas
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Calogero RM, Tylka TL, Mensinger JL, Meadows A, Daníelsdóttir S. Recognizing the Fundamental Right to be Fat: A Weight-Inclusive Approach to Size Acceptance and Healing From Sizeism. WOMEN & THERAPY 2018. [DOI: 10.1080/02703149.2018.1524067] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
| | - Tracy L. Tylka
- Department of Psychology, The Ohio State University, Columbus, Ohio
| | - Janell L. Mensinger
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
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Koliaki C, Spinos T, Spinou Μ, Brinia ΜE, Mitsopoulou D, Katsilambros N. Defining the Optimal Dietary Approach for Safe, Effective and Sustainable Weight Loss in Overweight and Obese Adults. Healthcare (Basel) 2018; 6:healthcare6030073. [PMID: 29958395 PMCID: PMC6163457 DOI: 10.3390/healthcare6030073] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/25/2018] [Accepted: 06/26/2018] [Indexed: 01/06/2023] Open
Abstract
Various dietary approaches with different caloric content and macronutrient composition have been recommended to treat obesity in adults. Although their safety and efficacy profile has been assessed in numerous randomized clinical trials, reviews and meta-analyses, the characteristics of the optimal dietary weight loss strategy remain controversial. This mini-review will provide general principles and practical recommendations for the dietary management of obesity and will further explore the components of the optimal dietary intervention. To this end, various dietary plans are critically discussed, including low-fat diets, low-carbohydrate diets, high-protein diets, very low-calorie diets with meal replacements, Mediterranean diet, and diets with intermittent energy restriction. As a general principle, the optimal diet to treat obesity should be safe, efficacious, healthy and nutritionally adequate, culturally acceptable and economically affordable, and should ensure long-term compliance and maintenance of weight loss. Setting realistic goals for weight loss and pursuing a balanced dietary plan tailored to individual needs, preferences, and medical conditions, are the key principles to facilitate weight loss in obese patients and most importantly reduce their overall cardiometabolic risk and other obesity-related comorbidities.
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Affiliation(s)
- Chrysi Koliaki
- First Department of Propaedeutic Medicine, National Kapodistrian University of Athens, Laiko University Hospital, Athens 11527, Greece.
| | - Theodoros Spinos
- Medical School, National Kapodistrian University of Athens, Athens 11527, Greece.
| | - Μarianna Spinou
- Medical School, National Kapodistrian University of Athens, Athens 11527, Greece.
| | - Μaria-Eugenia Brinia
- Medical School, National Kapodistrian University of Athens, Athens 11527, Greece.
| | - Dimitra Mitsopoulou
- Medical School, National Kapodistrian University of Athens, Athens 11527, Greece.
| | - Nicholas Katsilambros
- First Department of Propaedeutic Medicine, National Kapodistrian University of Athens, Laiko University Hospital, Athens 11527, Greece.
- Research Laboratory Christeas Hall, Medical School, National Kapodistrian University of Athens, Athens 11527, Greece.
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Abstract
PURPOSE OF THE REVIEW Eating in response to negative emotions (EE) may be an explanatory factor of the weight regain of many dieters. This narrative review presents evidence on possible causes of EE and the association of EE with depression and obesity and discusses implications of these findings for the treatment of obesity. RECENT FINDINGS Possible causes of EE are high dietary restraint, poor interoceptive awareness, alexithymia, emotion dysregulation and a reversed hypothalamic pituitary adrenal (HPA) stress axis. EE may be the outcome of inadequate parenting or depressive feelings in interaction with genetic susceptibility. There is also robust evidence that EE is a mediator between depression and obesity. The association of EE with depression and poor emotion regulation skills suggests that the treatment of obese people with high EE should not focus on calorie-restricted diets but on emotion regulation skills. The DEBQ (Dutch Eating Behavior Questionnaire) enables such a matched treatment of obesity.
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Affiliation(s)
- Tatjana van Strien
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
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33
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Impact of a non-restrictive satiating diet on anthropometrics, satiety responsiveness and eating behaviour traits in obese men displaying a high or a low satiety phenotype. Br J Nutr 2017; 118:750-760. [DOI: 10.1017/s0007114517002549] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AbstractThe aim of this study was to evaluate the impact of a non-restrictive satiating diet in men displaying various degrees of satiety efficiency. In all, sixty-nine obese men aged 41·5 (sd5·7) years were randomly assigned to a control (10–15, 55–60 and 30 % energy as protein, carbohydrate and lipid, respectively;n34) or satiating (20–25, 45–50 and 30–35 % energy as protein, carbohydrate and lipid, respectively;n35) diet for 16 weeks, and were classified as having a low (LSP) or high (HSP) satiety phenotype. Both diets were consumedad libitum. Changes in body weight, BMI, percent fat mass, waist circumference, satiety responsiveness and eating behaviour traits were assessed following the intervention. Dropout rates were higher in the control diet (44·1 %) compared with the satiating diet (8·6 %). Decreases in body weight, BMI and waist circumference were significant in both groups, yet HSP individuals lost more body weight than LSP individuals (P=0·048). Decreases in % fat mass were greater in the satiating diet (LSP: −2·1 (sd2·1) %;P<0·01 and HSP: −3·0 (sd2·5) %;P<0·001) compared with the control diet (LSP: −1·1 (sd2·5) % and HSP: −1·3 (sd2·6) %) (P=0·034). Satiety responsiveness was markedly improved in the satiating diet, whereas no significant changes were observed in the control group. Changes in dietary restraint (+3·3 (sd2·9) to +7·2 (sd5·5)), flexible control (+0·9 (sd1·4) to +2·3 (sd2·7)), rigid control (+2·2 (sd1·5) to +2·5 (sd2·8)), disinhibition (−2·8 (sd3·7) to −3·2 (sd2·6)) and susceptibility to hunger (−2·7 (sd4·1) to −4·6 (sd3·9)) were similar between the diets. Compared with the control diet, the satiating diet favoured adherence, decreased % fat mass and improved satiety responsiveness in both HSP and LSP individuals.
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Trans -10, cis -12 conjugated linoleic acid ( t 10- c 12 CLA) treatment and caloric restriction differentially affect adipocyte cell turnover in obese and lean mice. J Nutr Biochem 2017; 49:123-132. [DOI: 10.1016/j.jnutbio.2017.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 07/14/2017] [Accepted: 08/07/2017] [Indexed: 11/21/2022]
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35
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Abstract
Body weight regain often causes failure of obesity therapies while the underlying mechanism remains largely unknown. In this study, we report that immune cells, especially CD4+ T cells, mediate the ‘memory’ of previous obese status. In a weight gain-loss-regain model, we found that C57BL/6J mice with an obesity history showed a much faster rate of body weight regain. This obesity memory could last for at least 2 months after previously obese mice were kept at the same body weight as non-obese mice. Surprisingly, such obesity memory was abrogated by dexamethasone treatment, whereas immunodeficient Rag1−/− and H2A−/− mice failed to establish such memory. Rag1−/− mice repossessed the obesity memory when immune cells or CD4+ T cells isolated from previously obese mice were transferred. Furthermore, depletion of CD4+ T cells led to obesity memory ablation. Taken together, we conclude that CD4+ T cells mediate obesity memory and promote weight regain.
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36
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Weight stigmatization and disordered eating in obese women: The mediating effects of self-esteem and fear of negative appearance evaluation. EUROPEAN REVIEW OF APPLIED PSYCHOLOGY-REVUE EUROPEENNE DE PSYCHOLOGIE APPLIQUEE 2017. [DOI: 10.1016/j.erap.2017.02.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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37
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Percutaneous Gastrostomy Device for the Treatment of Class II and Class III Obesity: Results of a Randomized Controlled Trial. Am J Gastroenterol 2017; 112:447-457. [PMID: 27922026 PMCID: PMC5350543 DOI: 10.1038/ajg.2016.500] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 09/26/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The AspireAssist System (AspireAssist) is an endoscopic weight loss device that is comprised of an endoscopically placed percutaneous gastrostomy tube and an external device to facilitate drainage of about 30% of the calories consumed in a meal, in conjunction with lifestyle (diet and exercise) counseling. METHODS In this 52-week clinical trial, 207 participants with a body-mass index (BMI) of 35.0-55.0 kg/m2 were randomly assigned in a 2:1 ratio to treatment with AspireAssist plus Lifestyle Counseling (n=137; mean BMI was 42.2±5.1 kg/m2) or Lifestyle Counseling alone (n=70; mean BMI was 40.9±3.9 kg/m2). The co-primary end points were mean percent excess weight loss and the proportion of participants who achieved at least a 25% excess weight loss. RESULTS At 52 weeks, participants in the AspireAssist group, on a modified intent-to-treat basis, had lost a mean (±s.d.) of 31.5±26.7% of their excess body weight (12.1±9.6% total body weight), whereas those in the Lifestyle Counseling group had lost a mean of 9.8±15.5% of their excess body weight (3.5±6.0% total body weight) (P<0.001). A total of 58.6% of participants in the AspireAssist group and 15.3% of participants in the Lifestyle Counseling group lost at least 25% of their excess body weight (P<0.001). The most frequently reported adverse events were abdominal pain and discomfort in the perioperative period and peristomal granulation tissue and peristomal irritation in the postoperative period. Serious adverse events were reported in 3.6% of participants in the AspireAssist group. CONCLUSIONS The AspireAssist System was associated with greater weight loss than Lifestyle Counseling alone.
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Ferrario CR, Labouèbe G, Liu S, Nieh EH, Routh VH, Xu S, O'Connor EC. Homeostasis Meets Motivation in the Battle to Control Food Intake. J Neurosci 2016; 36:11469-11481. [PMID: 27911750 PMCID: PMC5125214 DOI: 10.1523/jneurosci.2338-16.2016] [Citation(s) in RCA: 163] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 08/30/2016] [Accepted: 09/05/2016] [Indexed: 01/09/2023] Open
Abstract
Signals of energy homeostasis interact closely with neural circuits of motivation to control food intake. An emerging hypothesis is that the transition to maladaptive feeding behavior seen in eating disorders or obesity may arise from dysregulation of these interactions. Focusing on key brain regions involved in the control of food intake (ventral tegmental area, striatum, hypothalamus, and thalamus), we describe how activity of specific cell types embedded within these regions can influence distinct components of motivated feeding behavior. We review how signals of energy homeostasis interact with these regions to influence motivated behavioral output and present evidence that experience-dependent neural adaptations in key feeding circuits may represent cellular correlates of impaired food intake control. Future research into mechanisms that restore the balance of control between signals of homeostasis and motivated feeding behavior may inspire new treatment options for eating disorders and obesity.
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Affiliation(s)
- Carrie R Ferrario
- University of Michigan Medical School, Department of Pharmacology, Ann Arbor, Michigan 48109-5632
| | - Gwenaël Labouèbe
- University of Lausanne, Center for Integrative Genomics, Lausanne, CH1015, Switzerland
| | - Shuai Liu
- University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Edward H Nieh
- Picower Institute for Learning and Memory, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139
| | | | - Shengjin Xu
- Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, Virginia 20147, and
| | - Eoin C O'Connor
- University of Geneva, Department of Basic Neuroscience, Geneva, CH1211, Switzerland
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39
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Demark-Wahnefried W. The rural women connecting for better health trial-A landmark study that establishes several "firsts". Obesity (Silver Spring) 2016; 24:2031. [PMID: 27589365 DOI: 10.1002/oby.21640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 07/27/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Wendy Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA.
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40
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Bravo-Sagua R, Mattar P, Díaz X, Lavandero S, Cifuentes M. Calcium Sensing Receptor as a Novel Mediator of Adipose Tissue Dysfunction: Mechanisms and Potential Clinical Implications. Front Physiol 2016; 7:395. [PMID: 27660614 PMCID: PMC5014866 DOI: 10.3389/fphys.2016.00395] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 08/24/2016] [Indexed: 01/09/2023] Open
Abstract
Obesity is currently a serious worldwide public health problem, reaching pandemic levels. For decades, dietary and behavioral approaches have failed to prevent this disease from expanding, and health authorities are challenged by the elevated prevalence of co-morbid conditions. Understanding how obesity-associated diseases develop from a basic science approach is recognized as an urgent task to face this growing problem. White adipose tissue (WAT) is an active endocrine organ, with a crucial influence on whole-body homeostasis. WAT dysfunction plays a key role linking obesity with its associated diseases such as type 2 diabetes mellitus, cardiovascular disease, and some cancers. Among the regulators of WAT physiology, the calcium-sensing receptor (CaSR) has arisen as a potential mediator of WAT dysfunction. Expression of the receptor has been described in human preadipocytes, adipocytes, and the human adipose cell lines LS14 and SW872. The evidence suggests that CaSR activation in the visceral (i.e., unhealthy) WAT is associated with an increased proliferation of adipose progenitor cells and elevated adipocyte differentiation. In addition, exposure of adipose cells to CaSR activators in vitro elevates proinflammatory cytokine expression and secretion. An increased proinflammatory environment in WAT plays a key role in the development of WAT dysfunction that leads to peripheral organ fat deposition and insulin resistance, among other consequences. We propose that CaSR may be one relevant therapeutic target in the struggle to confront the health consequences of the current worldwide obesity pandemic.
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Affiliation(s)
- Roberto Bravo-Sagua
- Institute of Nutrition and Food Technology, University of ChileSantiago, Chile; Faculty of Chemical and Pharmaceutical Sciences and Faculty of Medicine, Advanced Center for Chronic Diseases and Center for Molecular Studies of the Cell, University of ChileSantiago, Chile
| | - Pamela Mattar
- Institute of Nutrition and Food Technology, University of ChileSantiago, Chile; Faculty of Chemical and Pharmaceutical Sciences and Faculty of Medicine, Advanced Center for Chronic Diseases and Center for Molecular Studies of the Cell, University of ChileSantiago, Chile
| | - Ximena Díaz
- Institute of Nutrition and Food Technology, University of Chile Santiago, Chile
| | - Sergio Lavandero
- Faculty of Chemical and Pharmaceutical Sciences and Faculty of Medicine, Advanced Center for Chronic Diseases and Center for Molecular Studies of the Cell, University of ChileSantiago, Chile; Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical CenterDallas, TX, USA
| | - Mariana Cifuentes
- Institute of Nutrition and Food Technology, University of Chile Santiago, Chile
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Long-term Effect of Percutaneous Electrical Neurostimulation of Dermatome T6 for Appetite Reduction and Weight Loss in Obese Patients. Surg Laparosc Endosc Percutan Tech 2016; 26:212-5. [DOI: 10.1097/sle.0000000000000271] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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