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Zheng Y, Wang X, Wang J, Yang J, Wang T, Li Q, Zhu W, Wang Y, Sui J, Qiang W, Guo H, Wang Y, Shi B, He M. Effects of time-restricted eating and low-carbohydrate diet on psychosocial health and appetite in individuals with metabolic syndrome: A secondary analysis of a randomized controlled trial. Clin Nutr 2024; 43:2316-2324. [PMID: 39226719 DOI: 10.1016/j.clnu.2024.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 07/18/2024] [Accepted: 08/26/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND & AIMS Time-restricted eating (TRE) and low-carbohydrate diet (LCD) can improve multiple cardiometabolic parameters in patients with metabolic syndrome (MetS), but their effects on psychosocial health and satiety are unclear. In this study, we aimed to evaluate the effects of TRE, LCD, and their combination (TRE + LCD) on quality of life (QoL), sleep, mood, appetite, and metabolic hormones in patients with MetS. METHODS This is a secondary analysis of a single-center, 3-month, open-label, randomized clinical trial investigating the effects of TRE, LCD, and TRE + LCD on weight and cardiometabolic parameters in individuals with MetS. This secondary analysis examined QoL, sleep, mood, and appetite using the Rand 36-Item Short Form (SF-36); Pittsburgh Sleep Quality Index (PSQI); Depression, Anxiety, and Stress Scale; and Eating Behavior Rating Scale, respectively, as well as measured levels of metabolic hormones including leptin, amylin, glucose-dependent insulinotropic polypeptide, glucagon-like peptide-1 (GLP-1), pancreatic polypeptide (PP), and peptide YY. Between-group comparisons were conducted via one-way ANOVAs and post hoc LSD tests for normally distributed variables or Kruskal‒Wallis H tests and the Nemenyi test for abnormally distributed variables. P < 0.017 was considered significant in multiple comparisons following Bonferroni adjustment. RESULTS A total of 162 participants (mean [SD] age, 41.2 [9.9] years; mean [SD] body mass index, 29.3 [3.4] kg/m2; 102 [63%] men) who started the intervention were analyzed. After 3 months, only the TRE group decreased GLP-1 levels (-0.9 [IQR, -1.9 to -0.3] pg/mL; P = 0.002), increased PP levels (8.9 [IQR, -7.6 to 71.8] pg/mL; P = 0.011), physical functioning in the SF-36 (5.2 [95% CI, 1.9 to 8.5]; P = 0.001), social functioning in the SF-36 (9.1 [95% CI, 2.5 to 15.6]; P = 0.005), role-physical in the SF-36 (24.1 [95% CI, 11.8 to 36.4]; P < 0.001), role-emotional in the SF-36 (22.4 [95% CI, 12.6 to 32.2]; P < 0.001), and sleep efficiency in the PSQI (0.29 [95% CI, 0.03 to 0.55]; P = 0.021). Compared with changes in LCD, TRE further increased general health in the SF-36 (9.7 [95% CI, 3.3 to 16.0]; P = 0.006). Relative to the changes of TRE + LCD, TRE significantly increased role-emotional in the SF-36 (19.9 [95% CI 4.9 to 34.8]; P = 0.006). Changes in sleep quality, mood status, appetite, and metabolic hormones did not differ among three groups. Greater weight loss was associated with decreased leptin levels (r = 0.538), decreased amylin levels (r = 0.294), reduced total appetite scores (r = 0.220), and improved general health (r = -0.253) (all P ≤ 0.01). CONCLUSIONS TRE, LCD, and TRE + LCD all could improve psychosocial health and reduce appetite. Notably, TRE yielded greater benefits in QoL compared with LCD or TRE + LCD in individuals with MetS. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04475822.
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Affiliation(s)
- Yixuan Zheng
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Xin Wang
- Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Jingya Wang
- Department of Gastroenterology, Xi'an Children's Hospital, Shaanxi Research Institute for Pediatric Diseases, The Affiliated Children's Hospital of Xi'an JiaoTong University and National Regional Medical Center for Children (Northwest), No 69, Xiju Yuan Lane, Xi'an, Shaanxi 710003, PR China
| | - Jing Yang
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China; Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Ting Wang
- Department of Cardiovascular Medicine, Shaanxi Provincial People's Hospital, 256 Youyi West Road, Beilin District, Xi'an, Shaanxi 710068, PR China
| | - Qian Li
- Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Wenzhi Zhu
- Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Yue Wang
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Jing Sui
- Department of Endocrinology and International Medical Center, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Wei Qiang
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Hui Guo
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Yanan Wang
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China; Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Bingyin Shi
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Mingqian He
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China; Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China.
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Xiang Y, Shen L, Xue Y, Wang Z, Zhou R, Cao Y, Zhu Z, Xu P, Yu X, Fang P, Shang W. Efficacy and safety of diacerein monotherapy in adults with obesity: A randomized, double-blind, placebo-controlled trial. Diabetes Obes Metab 2024. [PMID: 39192530 DOI: 10.1111/dom.15881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/29/2024] [Accepted: 08/01/2024] [Indexed: 08/29/2024]
Abstract
AIM To assess the efficacy and safety of diacerein monotherapy in adults with obesity. METHODS Forty-two adults with obesity participated in the study and were randomly assigned to receive diacerein or placebo in addition to lifestyle modification for 14 weeks, in a double-blinded fashion. Differences in changes in body weight, body composition, metabolic variables, fatty liver-related indicators, cardiovascular system variables, lifestyle score and metabolic factors were compared. RESULTS Post-treatment weight loss percentage from baseline was -6.56% (-8.71%, -4.41%) in the diacerein group and -0.59% (-2.74%, 1.56%) in the placebo group. Compared with the placebo group, the diacerein group showed significant improvements in body composition, metabolic variables and indicators related to fatty liver. In addition, after 14 weeks of treatment, diacerein led to a significant reduction in serum visfatin concentration versus the placebo group. The reductions in total body fat mass and visceral fat area mediated the weight loss induced by diacerein. No significant differences were found between the groups in the number of adverse events and safety variables. CONCLUSIONS For adults with obesity, diacerein led to a clinically meaningful weight loss and provided multiple metabolic benefits with acceptable safety. These results support that diacerein is a promising candidate medicine to be developed for obesity management.
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Affiliation(s)
- Yingying Xiang
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory for Metabolic Diseases in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Lixuan Shen
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory for Metabolic Diseases in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yingying Xue
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory for Metabolic Diseases in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ziwei Wang
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory for Metabolic Diseases in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ruonan Zhou
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory for Metabolic Diseases in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yue Cao
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory for Metabolic Diseases in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ziwei Zhu
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory for Metabolic Diseases in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Pingyuan Xu
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory for Metabolic Diseases in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xizhong Yu
- Key Laboratory for Metabolic Diseases in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Penghua Fang
- Key Laboratory for Metabolic Diseases in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenbin Shang
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory for Metabolic Diseases in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
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Gatica-Saavedra M, Nazar G, Rubí P, Bustos C. Adaptation and validation of the Weight Efficacy Lifestyle Questionnaire (WEL) in a Chilean sample. PLoS One 2024; 19:e0293658. [PMID: 38295143 PMCID: PMC10829987 DOI: 10.1371/journal.pone.0293658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 10/18/2023] [Indexed: 02/02/2024] Open
Abstract
Self-efficacy is a cognitive-emotional factor that is consistently associated with behavioral change and, in particular, with changes in health behavior. Eating self-efficacy, understood as adopting and maintaining behaviors such as controlling one's weight and trusting in one's ability to control one's eating behavior, has been proposed for managing obesity. This study aimed to validate the Chilean version of the Weight Efficacy Lifestyle Questionnaire (WEL) in a sample of adults from the general population. Four hundred sixty-nine individuals (69.08% women, mean age = 38.02; SD = 10.31) participated in the study. An instrumental design was used geared toward developing tests and psychometric instruments, including adapting existing ones. Exploratory and confirmatory factor analyses were performed. The instrument version validated in Spain was applied in the study. The analysis obtained an instrument of 11 items with adequate psychometric properties allowing its use in clinical and research settings. It can help assess eating self-efficacy in the general population.
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Affiliation(s)
- Mariela Gatica-Saavedra
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Concepción, Concepción, Chile
| | - Gabriela Nazar
- Department of Psychology, Faculty of Social Sciences, Universidad de Concepción, Concepción, Chile
| | - Patricia Rubí
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Concepción, Concepción, Chile
| | - Claudio Bustos
- Department of Psychology, Faculty of Social Sciences, Universidad de Concepción, Concepción, Chile
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Rastmanesh R. Inadequate Hydration Status of Test Subjects Can Affect Bioavailability Studies. ACS Pharmacol Transl Sci 2023; 6:1104-1106. [PMID: 37470021 PMCID: PMC10353055 DOI: 10.1021/acsptsci.3c00089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Indexed: 07/21/2023]
Abstract
This Viewpoint identifies some of the pitfalls in the bioavailability of water-soluble drugs and introduces a novel bias we term the "hypohydration bias". We suggest that future bioavailability studies take some important neglected confounding factors into account, and we propose that, to avoid such a bias, some relevant variables such as serum and urine osmolality, dry weight adjustment, fluid balance, semi-nude body mass, saliva osmolality, saliva total protein concentration, and urine specific gravity should be controlled to increase the precision of the bioavailability measurements. We suggest that a new definition of hydration status is needed, and that systematic protocols of bioavailability studies should be revisited.
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Affiliation(s)
- Reza Rastmanesh
- American
Physical Society, College Park, Maryland 20740, USA
- The
Nutrition Society, London W6 7NJ, U.K.
- Independent
researcher, #6, Physicians
Building, Sarshar Alley, Vali-Asr, Tajrish, Tehran 1961835555, Iran
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Marzola E, Martini M, Longo P, Toppino F, Bevione F, Delsedime N, Abbate-Daga G, Preti A. Psychometric properties of the Italian body shape questionnaire: an investigation of its reliability, factorial, concurrent, and criterion validity. Eat Weight Disord 2022; 27:3637-3648. [PMID: 36352341 PMCID: PMC9803762 DOI: 10.1007/s40519-022-01503-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
PURPOSE This study was set up to investigate the reliability, factorial, concurrent, and criterion validity of the Italian version of the 34-item Body Shape Questionnaire (BSQ) and its shorter versions. METHODS The study included 231 patients diagnosed with an eating disorder and 58 putatively healthy people (comparison sample). The Italian BSQ-34 was administered to participants together with the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale. Information on body mass index, caloric intake at baseline, and the number of episodes of self-vomiting per week was also acquired. RESULTS Cronbach's alpha of BSQ-34 was 0.971 (95% confidence interval [CI] 0.965-0.976) in patients and 0.960 (0.944-0.974) in controls. Test-retest stability in patients (n = 69), measured with intraclass correlation coefficient, was 0.987 (0.983-0.991). Confirmatory factor analysis of the single-factor model yielded acceptable fit for all versions of the BSQ. On all BSQ versions, patients scored higher than controls with a large effect size when calculated as Cliff's delta. BMI and mean caloric intake at baseline had a stronger association with BSQ-34 than levels of anxiety and depression. The analysis with the receiver operating characteristics (ROC) curve showed that the BSQ-34 distinguished patients with an eating disorder from controls with good accuracy (Area Under the Curve = 86.5; 95% CI 82.2-90.7). CONCLUSION The Italian version of the BSQ possesses good psychometric properties, in both the long and the shortened versions, and it can be applied to measure body dissatisfaction for both clinical and research purposes. LEVEL OF EVIDENCE Level III, Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Enrica Marzola
- Eating Disorders Unit, Department of Neuroscience, University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Matteo Martini
- Eating Disorders Unit, Department of Neuroscience, University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Paola Longo
- Eating Disorders Unit, Department of Neuroscience, University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Federica Toppino
- Eating Disorders Unit, Department of Neuroscience, University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Francesco Bevione
- Eating Disorders Unit, Department of Neuroscience, University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Nadia Delsedime
- Eating Disorders Unit, Department of Neuroscience, University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Giovanni Abbate-Daga
- Eating Disorders Unit, Department of Neuroscience, University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Antonio Preti
- Eating Disorders Unit, Department of Neuroscience, University of Turin, Via Cherasco 15, 10126, Turin, Italy.
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