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van Baak MA, Mariman ECM. Obesity-induced and weight-loss-induced physiological factors affecting weight regain. Nat Rev Endocrinol 2023; 19:655-670. [PMID: 37696920 DOI: 10.1038/s41574-023-00887-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 09/13/2023]
Abstract
Weight regain after successful weight loss resulting from lifestyle interventions is a major challenge in the management of overweight and obesity. Knowledge of the causal mechanisms for weight regain can help researchers and clinicians to find effective strategies to tackle weight regain and reduce obesity-associated metabolic and cardiovascular complications. This Review summarizes the current understanding of a number of potential physiological mechanisms underlying weight regain after weight loss, including: the role of adipose tissue immune cells; hormonal and neuronal factors affecting hunger, satiety and reward; resting energy expenditure and adaptive thermogenesis; and lipid metabolism (lipolysis and lipid oxidation). We describe and discuss obesity-associated changes in these mechanisms, their persistence during weight loss and weight regain and their association with weight regain. Interventions to prevent or limit weight regain based on these factors, such as diet, exercise, pharmacotherapy and biomedical strategies, and current knowledge on the effectiveness of these interventions are also reviewed.
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Affiliation(s)
- Marleen A van Baak
- NUTRIM School for Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University, Maastricht, Netherlands.
| | - Edwin C M Mariman
- NUTRIM School for Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University, Maastricht, Netherlands
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2
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Rosenbaum M, Foster G. Differential mechanisms affecting weight loss and weight loss maintenance. Nat Metab 2023; 5:1266-1274. [PMID: 37612402 DOI: 10.1038/s42255-023-00864-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 07/13/2023] [Indexed: 08/25/2023]
Abstract
In most lifestyle, pharmacological and surgical interventions, weight loss occurs over an approximately 6- to 9-month period and is followed by a weight plateau and then weight regain. Overall, only about 15% of individuals can sustain a 10% or greater non-surgical, non-pharmacological, weight loss. A key question is the degree to which the genotypes, phenotypes and environmental correlates of success in weight loss and weight loss maintenance are continuous or dichotomous. This Perspective is a comparison of the interactions of weight loss and maintenance with genetic, behavioural, physiological and environmental homeostatic systems and a discussion of the implications of these findings for research in, and treatment of, obesity. Data suggest that weight loss and weight loss maintenance are physiologically and psychologically different in many ways. Consequently, individuals may require different interventions designed for temporarily sustaining a negative energy balance during weight loss versus permanently maintaining energy balance after weight loss.
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Affiliation(s)
- Michael Rosenbaum
- Columbia University Irving Medical Center, Departments of Pediatrics and Medicine, Division of Molecular Genetics and the Irving Center for Clinical and Translational Research (MR), New York, NY, USA.
| | - Gary Foster
- WW International, Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Weight and Eating Disorders Program (GF), New York, NY, USA
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Susanto A, Burk J, Hocking S, Markovic T, Gill T. Differences in weight loss outcomes for males and females on a low-carbohydrate diet: A systematic review. Obes Res Clin Pract 2022; 16:447-456. [PMID: 36244957 DOI: 10.1016/j.orcp.2022.09.006] [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: 01/24/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 12/05/2022]
Abstract
It has been widely demonstrated that there are a broad range of individual responses to all weight management regimens, often masked by reports of the mean. Identifying features of responders and non-responders to weight loss regimens enables a more tailored approach to the provision of weight management advice. Low-carbohydrate diets are currently popular, and anecdote suggests that males are more successful at losing weight using this approach. This is feasible given the physiological and socio-psychological differences between the genders. We analysed the extent and variation in weight change for males and females separately through a systematic search for all low-carbohydrate diet trials published since 1985. Very few studies compared weight loss outcomes by gender and, of those that did, most lacked supporting data. The majority of studies reported no gender difference but when a gender difference was found, males were more frequently reported as losing more weight than females on a low-carbohydrate diet. The lack of gender stratification in weight loss trials is concerning, as there are a range of gender-based factors that affect weight loss outcomes. This study highlights the importance of examining weight change for males and females separately, since as failure to do so may mask any potential differences, which, if detected, could assist with better weight loss outcomes.
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Affiliation(s)
- Alyssa Susanto
- Boden Group, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia.
| | - Jessica Burk
- Boden Group, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia
| | - Samantha Hocking
- Boden Group, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia; Metabolism & Obesity Service, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Tania Markovic
- Boden Group, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia; Metabolism & Obesity Service, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Tim Gill
- Boden Group, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia
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Magkos F, Rasmussen SI, Hjorth MF, Asping S, Rosenkrans MI, Sjödin AM, Astrup AV, Geiker NRW. Unprocessed red meat in the dietary treatment of obesity: a randomized controlled trial of beef supplementation during weight maintenance after successful weight loss. Am J Clin Nutr 2022; 116:1820-1830. [PMID: 36307956 PMCID: PMC9761757 DOI: 10.1093/ajcn/nqac152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 05/24/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Consumption of unprocessed red meat in randomized trials has no adverse effects on cardiovascular risk factors and body weight, but its physiological effects during weight loss maintenance are not known. OBJECTIVES We sought to investigate the effects of healthy diets that include small or large amounts of red meat on the maintenance of lost weight after successful weight loss, and secondarily on body composition (DXA), resting energy expenditure (REE; indirect calorimetry), and cardiometabolic risk factors. METHODS In this 5-mo parallel randomized intervention trial, 108 adults with BMI 28-40 kg/m2 (45 males/63 females) underwent an 8-wk rapid weight loss period, and those who lost ≥8% body weight (n = 80) continued to ad libitum weight maintenance diets for 12 wk: a moderate-protein diet with 25 g beef/d (B25, n = 45) or a high-protein diet with 150 g beef/d (B150, n = 35). RESULTS In per protocol analysis (n = 69), mean body weight (-1.2 kg; 95% CI: -2.1, -0.3 kg), mean fat mass (-2.7 kg; 95% CI: -3.4, -2.0 kg), and mean body fat content (-2.6%; 95% CI: -3.1, -2.1%) decreased during the maintenance phase, whereas mean lean mass (1.5 kg; 95% CI: 1.0, 2.0 kg) and mean REE (51 kcal/d; 95% CI: 15, 86 kcal/d) increased, with no differences between groups (all P > 0.05). Results were similar in intention-to-treat analysis with multiple imputation for dropouts (20 from B150 compared with 19 from B25, P = 0.929). Changes in cardiometabolic risk factors were not different between groups, the general pattern being a decrease during weight loss and a return to baseline during weight maintenance (and despite the additional mild reduction in weight and fat mass). CONCLUSIONS Healthy diets consumed ad libitum that contain a little or a lot of unprocessed beef have similar effects on body weight, energy metabolism, and cardiovascular risk factors during the first 3 mo after clinically significant rapid weight loss.
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Affiliation(s)
| | - Sidse I Rasmussen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | | | - Sarah Asping
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Maria I Rosenkrans
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Anders M Sjödin
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | | | - Nina R W Geiker
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Fogarasi A, Gonzalez K, Dalamaga M, Magkos F. The Impact of the Rate of Weight Loss on Body Composition and Metabolism. Curr Obes Rep 2022; 11:33-44. [PMID: 35133628 DOI: 10.1007/s13679-022-00470-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Weight loss has multiple beneficial effects on body composition and metabolism, but whether these depend on the rate at which body weight is lost is not clear. We analyzed data from studies in which the same amount of weight loss was induced rapidly or gradually. RECENT FINDINGS Thirteen studies were included in which the same percentage weight loss was achieved at slow or fast rates (range: 0.2 to 3.2 kg/week) by means of dietary calorie restriction, exercise, and bariatric surgery. Faster rates of weight loss may result in more fat-free mass and less fat mass being lost during the dynamic phase of weight reduction compared with slower rates of weight loss, in conjunction with greater declines in resting energy expenditure. However, these differences are attenuated after 2-4 weeks of stabilization at the new, lower body weight, and do not affect the rate and amount of weight regain 9-33 months later (nor the tissue composition of regained weight). Differences in waist circumference, visceral and liver fat contents, resting blood pressure, fasting blood lipid profile, and insulin and adipokine concentrations in response to different rates of weight loss are trivial. The decline in fasting glucose concentration and the improvement in insulin sensitivity after 6-11% weight loss are both greater with rapid than gradual weight loss, but not different after 18-20% weight loss. Changes in body composition and metabolism after losing the same amount of body weight at different rates are largely similar, and occasional differences are likely not meaningful clinically for the long-term management of obesity and cardiometabolic diseases.
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Affiliation(s)
- Adam Fogarasi
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - Katherine Gonzalez
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - Maria Dalamaga
- Department of Biological Chemistry, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark.
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Eik-Nes TT, Tokatlian A, Raman J, Spirou D, Kvaløy K. Depression, anxiety, and psychosocial stressors across BMI classes: A Norwegian population study - The HUNT Study. Front Endocrinol (Lausanne) 2022; 13:886148. [PMID: 36034441 PMCID: PMC9399822 DOI: 10.3389/fendo.2022.886148] [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: 02/28/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Obesity is a global issue with detrimental health impacts. Recent research has highlighted the complexity of obesity due to its psychological correlates. The purpose of the present study was to explore the relationship between body mass index (BMI) and depression, anxiety, and psychosocial stress. METHODS Data, including demographic, height, and weight information from 23 557 adult participants was obtained from the fourth survey of the Norwegian population based Trøndelag Health Study (HUNT4, 2017-2019). The Hospital Anxiety and Depression Scale (HADS) was used to measure self-reported depression and anxiety. We also collected data on 10 domains of psychosocial stress (violence, mental violence, unwanted sex, cyber bullying, school bullying, history of own life-threatening disease, life-threatening disease in family, relationship problems, divorce, and sudden family death), which were aggregated into a cumulative measure of psychosocial stress. RESULTS Multinomial logistic regression was utilized for statistical analysis. In the full model, the relationship between depression, anxiety, and psychosocial stress were explored controlling for age, sex, income, marital status, and educational attainment. After adjustments, a significant relationship was found between depression and obesity I (OR = 1.05, 95% CI 1.03-1.06, p <.001) and II and III (OR = 1.10, 95% CI 1.06-1.14, p <.001). After the same adjustments, significant relationship between anxiety and overweight and obesity class I was found among elderly participants (≥65 years old). Psychosocial stress significantly and positively related to all levels of BMI, with or without considering anxiety and depression, after controlling for sex, age, educational attainment, marital status, and income in all age groups. CONCLUSIONS Obesity is a multifaceted health problem, significantly related to psychological factors including depression and psychosocial stress, which supports the need for a multifaceted, targeted approach to obesity treatment.
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Affiliation(s)
- Trine Tetlie Eik-Nes
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU),, Trondheim, Norway
- Stjørdal Community Mental Health Centre, Department of Psychiatry, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- *Correspondence: Trine Tetlie Eik-Nes,
| | - Audrey Tokatlian
- Discipline of Psychological Science, Australian College of Applied Professions, Sydney, NSW, Australia
| | - Jayanthi Raman
- School of Psychological Sciences, University of Newcastle, Sydney, NSW, Australia
| | - Dean Spirou
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
- Department of Endocrinology and Diabetes, Blacktown Hospital, Sydney, NSW, Australia
- School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Kirsti Kvaløy
- Department of Research and Development, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Health Study of Trøndelag (HUNT) Research Centre Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Levanger, Norway
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, Arctic University of Norway (UiT), Tromsø, Norway
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A protein-supplemented very-low-calorie diet does not mitigate reductions in lean mass and resting metabolic rate in subjects with overweight or obesity: A randomized controlled trial. Clin Nutr 2021; 40:5726-5733. [PMID: 34749132 DOI: 10.1016/j.clnu.2021.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/21/2021] [Accepted: 10/06/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND & AIMS The European Food Safety Authority recently recommended an increase in the protein content of total diet replacement (TDR) products from 50 to 75 g/day. The rationale was to minimize reductions in lean mass (LM) and resting metabolic rate (RMR) that occur with weight loss, and thereby facilitate maintenance of lost weight. We sought to directly compare the efficacy of TDR regimens with the new vs the current protein requirement. METHODS We randomized 108 adults with overweight or obesity (body mass index 28-40 kg/m2) to very-low-calorie diets (VLCD) with either 52 or 77 g/day protein for 8 weeks (total energy intake of 600 or 700 kcal/day, respectively). LM was determined by dual energy X-ray absorptiometry and RMR by indirect calorimetry. RESULTS Attrition rate was 22% in both groups. Both VLCDs decreased body weight, fat mass, LM, and RMR (all P < 0.05). Significant time-by-group interactions were detected for weight and fat mass (both P < 0.05), with corresponding reductions being smaller in the higher-protein than the standard-protein VLCD, likely because of the added calories. On the other hand, reductions in LM (6% from baseline) and RMR (9-10% from baseline) did not differ between groups (P = 0.155 and P = 0.389, respectively), and the contribution of LM to total weight loss was identical (27 ± 2% of lost weight, P = 0.973). CONCLUSIONS Our results indicate that the proposed increase in the protein content of TDR products does not attenuate reductions in LM and RMR in individuals with overweight and obesity who are treated with <800 kcal/day VLCDs for 2 months. CLINICAL TRIAL REGISTRY ClinicalTrials.gov # NCT04156165.
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Myers A, Camidge D, Croden F, Gibbons C, Stubbs RJ, Blundell J, Finlayson G, Buckland N. Free-Living Energy Balance Behaviors Are Associated With Greater Weight Loss During a Weight Loss Program. Front Nutr 2021; 8:688295. [PMID: 34595197 PMCID: PMC8478016 DOI: 10.3389/fnut.2021.688295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/28/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Free-living movement (physical activity [PA] and sedentary behavior [SB]) and eating behaviors (energy intake [EI] and food choice) affect energy balance and therefore have the potential to influence weight loss (WL). This study explored whether free-living movement and/or eating behaviors measured early (week 3) in a 14-week WL programme or their change during the intervention are associated with WL in women. Methods: In the study, 80 women (M ± SD age: 42.0 ± 12.4 years) with overweight or obesity [body mass index (BMI): 34.08 ± 3.62 kg/m2] completed a 14 week WL program focused primarily on diet (commercial or self-led). Body mass (BM) was measured at baseline, and again during week 2 and 14 along with body composition. Free-living movement (SenseWear Armband) and eating behavior (weighed food diaries) were measured for 1 week during week 3 and 12. Hierarchical multiple regression analyses examined whether early and early-late change in free-living movement and eating behavior were associated with WL. The differences in behavior between clinically significant weight losers (CWL; ≥5% WL) and non-clinically significant weight losers (NWL; ≤ 3% WL) were compared. Results: The energy density of food consumed [β = 0.45, p < 0.001] and vigorous PA [β = -0.30, p < 0.001] early in the intervention (regression model 1) and early-late change in light PA [β = -0.81 p < 0.001], moderate PA [β = -1.17 p < 0.001], vigorous PA [β = -0.49, p < 0.001], total energy expenditure (EE) [β = 1.84, p < 0.001], and energy density of food consumed [β = 0.27, p = 0.01] (regression model 2) significantly predicted percentage change in BM. Early in the intervention, CWL consumed less energy dense foods than NWL [p = 0.03]. CWL showed a small but significant increase in vigorous PA, whereas NWL showed a slight decrease in PA [p = 0.04]. Conclusion: Both early and early-late change in free-living movement and eating behaviors during a 14 week WL program are predictors of WL. These findings demonstrate that specific behaviors that contribute to greater EE (e.g., vigorous PA) and lower EI (e.g., less energy-dense foods) are related to greater WL outcomes. Interventions targeting these behaviors can be expected to increase the effectiveness of WL programs.
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Affiliation(s)
- Anna Myers
- Sport and Physical Activity Research Center, College of Health, Wellbeing, and Life Sciences, Sheffield Hallam University, Sheffield, United Kingdom
| | - Diana Camidge
- Faculty of Medicine and Health, Appetite Control and Energy Balance Research, School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Fiona Croden
- Faculty of Medicine and Health, Appetite Control and Energy Balance Research, School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Catherine Gibbons
- Faculty of Medicine and Health, Appetite Control and Energy Balance Research, School of Psychology, University of Leeds, Leeds, United Kingdom
| | - R James Stubbs
- Faculty of Medicine and Health, Appetite Control and Energy Balance Research, School of Psychology, University of Leeds, Leeds, United Kingdom
| | - John Blundell
- Faculty of Medicine and Health, Appetite Control and Energy Balance Research, School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Graham Finlayson
- Faculty of Medicine and Health, Appetite Control and Energy Balance Research, School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Nicola Buckland
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
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Brzęk P, Gębczyński A, Selewestruk P, Książek A, Sadowska J, Konarzewski M. Significance of variation in basal metabolic rate in laboratory mice for translational experiments. J Comp Physiol B 2021; 192:161-169. [PMID: 34595579 PMCID: PMC8816319 DOI: 10.1007/s00360-021-01410-9] [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: 06/20/2021] [Revised: 08/24/2021] [Accepted: 09/20/2021] [Indexed: 12/03/2022]
Abstract
The basal metabolic rate (BMR) accounts for 60–70% of the daily energy expenditure (DEE) in sedentary humans and at least 50% of the DEE in laboratory mice in the thermoneutral zone. Surprisingly, however, the significance of the variation in the BMR is largely overlooked in translational research using such indices as physical activity level (PAL), i.e., the ratio of DEE/BMR. In particular, it is unclear whether emulation of human PAL in mouse models should be carried out within or below the thermoneutral zone. It is also unclear whether physical activity within the thermoneutral zone is limited by the capacity to dissipate heat generated by exercise and obligatory metabolic processes contributing to BMR. We measured PAL and spontaneous physical activity (SPA) in laboratory mice from two lines, divergently selected towards either high or low level of BMR, and acclimated to 30 °C (i.e., the thermoneutral zone), 23 or 4 °C. The mean PAL did not differ between both lines in the mice acclimated to 30 °C but became significantly higher in the low BMR mouse line at the lower ambient temperatures. Acclimation to 30 °C reduced the mean locomotor activity but did not affect the significant difference observed between the selected lines. We conclude that carrying out experiments within the thermoneutral zone can increase the consistency of translational studies aimed at the emulation of human energetics, without affecting the variation in physical activity correlated with BMR.
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Affiliation(s)
- Paweł Brzęk
- Faculty of Biology, University of Białystok, Ciołkowskiego 1J, 15-245, Białystok, Poland.
| | - Andrzej Gębczyński
- Faculty of Biology, University of Białystok, Ciołkowskiego 1J, 15-245, Białystok, Poland
| | - Piotr Selewestruk
- Faculty of Biology, University of Białystok, Ciołkowskiego 1J, 15-245, Białystok, Poland
| | - Aneta Książek
- Faculty of Biology, University of Białystok, Ciołkowskiego 1J, 15-245, Białystok, Poland
| | - Julita Sadowska
- Faculty of Biology, University of Białystok, Ciołkowskiego 1J, 15-245, Białystok, Poland
| | - Marek Konarzewski
- Faculty of Biology, University of Białystok, Ciołkowskiego 1J, 15-245, Białystok, Poland
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10
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Altree TJ, Bartlett DJ, Marshall NS, Hoyos CM, Phillips CL, Birks C, Kanagaratnam A, Mullins A, Serinel Y, Wong KKH, Yee BJ, Grunstein RR, Cayanan EA. Predictors of weight loss in obese patients with obstructive sleep apnea. Sleep Breath 2021; 26:753-762. [PMID: 34357505 DOI: 10.1007/s11325-021-02455-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/07/2021] [Accepted: 07/28/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Consistent predictors of weight loss outcomes with very low-energy diets (VLEDs) in obstructive sleep apnea (OSA) have not been identified. This study aimed to identify variables predictive of weight loss success in obese patients with OSA undertaking an intensive weight loss programme. METHODS We analysed biological, psychological, and behavioural variables as potential predictors of weight loss in obese patients with OSA after a 2-month VLED followed by one of two 10-month weight loss maintenance diets. Actigraphy, in-lab polysomnography, urinary catecholamines, and various psychological and behavioural variables were measured at baseline, 2, and 12 months. Spearman's correlations analysed baseline variables with 2-month weight loss, and 2-month variables with 2-12 month-weight change. RESULTS Forty-two patients completed the VLED and thirty-eight completed the maintenance diets. Actigraphy data revealed that late bedtime (rs = - 0.45, p = < 0.01) was correlated with 2-month weight loss. The change in the time that participants got out of bed (rise-time) from baseline to two months was also correlated with 2-month weight loss (rs = 0.36, p = 0.03). The Impact of Weight on Quality of Life-Lite questionnaire (IWQOL) Public Distress domain (rs = - 0.54, p = < 0.01) and total (rs = - 0.38, p = 0.02) scores were correlated with weight loss maintenance from 2 to 12 months. CONCLUSIONS Results from this small patient sample reveal correlations between actigraphy characteristics and weight loss in obese patients with OSA. We suggest the IWQOL may also be a useful clinical tool to identify OSA patients at risk of weight regain after initial weight loss. CLINICAL TRIAL REGISTRATION This clinical trial was prospectively registered on 18/02/2013 with the Australia and New Zealand Clinical Trials Registry (ACTRN12613000191796). PUBLIC REGISTRY TITLE Sleep, Lifestyle, Energy, Eating, Exercise Program for the management of sleep apnea patients indicated for weight loss treatment: A randomised, controlled pilot study. URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363680.
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Affiliation(s)
- Thomas J Altree
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia.
- Adelaide Institute for Sleep Health, Flinders University, Level 2, Mark Oliphant Building, 5 Laffer Drive, Bedford Park, South Australia, 5049, Australia.
| | - Delwyn J Bartlett
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Nathaniel S Marshall
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
- NeuroSleep, National Health and Medical Research Council Centre of Research Excellence, Sydney, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, Australia
| | - Camilla M Hoyos
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
- NeuroSleep, National Health and Medical Research Council Centre of Research Excellence, Sydney, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, Australia
- Healthy Brain Ageing Program, Brain and Mind Centre, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Craig L Phillips
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, Australia
- Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia
| | - Callum Birks
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, Australia
| | - Aran Kanagaratnam
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Anna Mullins
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine, New York, NY, USA
| | - Yasmina Serinel
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
- Department of Respiratory and Sleep Medicine, Nepean Hospital, Kingswood, Australia
| | - Keith K H Wong
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Brendon J Yee
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Ronald R Grunstein
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, Australia
- NeuroSleep, National Health and Medical Research Council Centre of Research Excellence, Sydney, Australia
| | - Elizabeth A Cayanan
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
- NeuroSleep, National Health and Medical Research Council Centre of Research Excellence, Sydney, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, Australia
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11
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Bates S, Norman P, Breeze P, Brennan A, Ahern AL. Mechanisms of Action in a Behavioral Weight-Management Program: Latent Growth Curve Analysis. Ann Behav Med 2021; 56:64-77. [PMID: 33821937 PMCID: PMC8691398 DOI: 10.1093/abm/kaab019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background A greater understanding of the mechanisms of action of weight-management interventions is needed to inform the design of effective interventions. Purpose To investigate whether dietary restraint, habit strength, or diet self-regulation mediated the impact of a behavioral weight-management intervention on weight loss and weight loss maintenance. Methods Latent growth curve analysis (LGCA) was conducted on trial data in which adults (N = 1,267) with a body mass index (BMI) ≥28 kg/m2 were randomized to either a brief intervention (booklet on losing weight), a 12 week weight-management program or the same program for 52 weeks. LGCA estimated the trajectory of the variables over four time points (baseline and 3, 12 and 24 months) to assess whether potential mechanisms of action mediated the impact of the weight-management program on BMI. Results Participants randomized to the 12 and 52 week programs had a significantly greater decrease in BMI than the brief intervention. This direct effect became nonsignificant when dietary restraint, habit strength, and autonomous diet self-regulation were controlled for. The total indirect effect was significant for both the 12 (estimate = −1.33, standard error [SE] = 0.41, p = .001) and 52 week (estimate = −2.13, SE = 0.52, p < .001) program. Only the individual indirect effect for dietary restraint was significant for the 12 week intervention, whereas all three indirect effects were significant for the 52 week intervention. Conclusions Behavior change techniques that target dietary restraint, habit strength, and autonomous diet self-regulation should be considered when designing weight loss and weight loss maintenance interventions. Longer interventions may need to target both deliberative and automatic control processes to support successful weight management.
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Affiliation(s)
- Sarah Bates
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Paul Norman
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Penny Breeze
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Amy L Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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12
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Aronne LJ, Hall KD, Jakicic JM, Leibel RL, Lowe MR, Rosenbaum M, Klein S. Describing the Weight-Reduced State: Physiology, Behavior, and Interventions. Obesity (Silver Spring) 2021; 29 Suppl 1:S9-S24. [PMID: 33759395 PMCID: PMC9022199 DOI: 10.1002/oby.23086] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/26/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022]
Abstract
Although many persons with obesity can lose weight by lifestyle (diet and physical activity) therapy, successful long-term weight loss is difficult to achieve, and most people who lose weight regain their lost weight over time. The neurohormonal, physiological, and behavioral factors that promote weight recidivism are unclear and complex. The National Institute of Diabetes and Digestive and Kidney Diseases convened a workshop in June 2019, titled "The Physiology of the Weight-Reduced State," to explore the mechanisms and integrative physiology of adaptations in appetite, energy expenditure, and thermogenesis that occur in the weight-reduced state and that may oppose weight-loss maintenance. The proceedings from the first session of this workshop are presented here. Drs. Michael Rosenbaum, Kevin Hall, and Rudolph Leibel discussed the physiological factors that contribute to weight regain; Dr. Michael Lowe discussed the biobehavioral issues involved in weight-loss maintenance; Dr. John Jakicic discussed the influence of physical activity on long-term weight-loss maintenance; and Dr. Louis Aronne discussed the ability of drug therapy to maintain weight loss.
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Affiliation(s)
- Louis J. Aronne
- Weill Cornell Medicine Comprehensive Weight Control Center, New York, New York, USA
| | - Kevin D. Hall
- Laboratory of Biological Modeling, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - John M. Jakicic
- Healthy Lifestyle Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rudolph L. Leibel
- Departments of Pediatrics and Medicine, Division of Molecular Genetics, Columbia University, New York, New York, USA
| | - Michael R. Lowe
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Michael Rosenbaum
- Departments of Pediatrics and Medicine, Division of Molecular Genetics, Columbia University, New York, New York, USA
| | - Samuel Klein
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
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13
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Laughlin MR, Osganian SK, Yanovski SZ, Lynch CJ. Physiology of the Weight-Reduced State: A Report from a National Institute of Diabetes and Digestive and Kidney Diseases Workshop. Obesity (Silver Spring) 2021; 29 Suppl 1:S5-S8. [PMID: 33759392 PMCID: PMC8978330 DOI: 10.1002/oby.23079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/11/2020] [Indexed: 12/19/2022]
Abstract
Preventing regain of lost weight is the most difficult challenge in the treatment of obesity. The National Institute of Diabetes and Digestive and Kidney Diseases convened a workshop, "The Physiology of the Weight-Reduced State," on June 3 to 4, 2019, in order to explore the physiologic mechanisms of appetitive and metabolic adaptation that take place in the weight-reduced state and counter an individual's efforts to maintain reduced weight following weight loss.
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Affiliation(s)
- Maren R Laughlin
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Stavroula K Osganian
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Susan Z Yanovski
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Christopher J Lynch
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
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14
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Miles-Chan JL, Isacco L. Weight cycling practices in sport: A risk factor for later obesity? Obes Rev 2021; 22 Suppl 2:e13188. [PMID: 33372395 DOI: 10.1111/obr.13188] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/31/2022]
Abstract
Weight cycling, repeated cycles of weight loss and weight regain over time, is commonplace amongst many population groups. Although the effect of weight cycling on future obesity and cardiometabolic risk is still hotly debated, evidence does indicate that individuals who were normal weight prior to weight cycling are more susceptible to its adverse consequences than those who were overweight or with obesity. Athletes, and particularly those who compete in the so-called weight-sensitive sports, are prone to dieting and weight cycling practice owing to the competitive advantage to be gained from manipulating their body weight. However, in comparison with the general population, athletes tend to be leaner and weight loss phases more rapid and superimposed on a background of a high level of physical activity. In this context, it can be questioned whether weight cycling in this subpopulation will indeed increase risk for future obesity. It is perhaps surprising that despite recognition that athletes commonly partake in weight cycling during their career, studies are scarce and firm conclusions regarding the effect of this practice on future cardiometabolic risk remain to be drawn. In this review, we examine weight cycling prevalence and strategies in athletes and the current evidence relating to its short- and long-term consequences. In addition, a conceptual framework relating the dynamics of weight loss and recovery to athlete characteristics will be discussed, highlighting the need for well-controlled, prospective studies in this specific subpopulation.
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Affiliation(s)
- Jennifer L Miles-Chan
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Laurie Isacco
- AME2P Laboratory (AME2P, EA 3533), CRNH Auvergne, Clermont Auvergne University, Clermont-Ferrand, France.,Research Unit EA3920 Prognostic Markers and Regulatory Factors of Cardiovascular Diseases and Exercise Performance Health Innovation Platform, University of Bourgogne Franche-Comté, Besançon, France
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15
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Early changes in appetite and energy expenditure are not associated to body weight and fat losses in pre-menopausal women living with overweight/obesity. Physiol Behav 2021; 228:113201. [PMID: 33039382 DOI: 10.1016/j.physbeh.2020.113201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/02/2020] [Accepted: 10/07/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND The aim of the study was to investigate whether early changes (1-week) in energy balance-related measures would predict changes in body weight (BW) and fat losses in women living with overweight/obesity. METHODS BW, body composition (DXA), resting energy expenditure (REE)(indirect calorimetry), olfactory performance (Sniffin' Sticks), appetite and palatability (visual analogue scale) were measured at baseline, after a 1-week of caloric restriction as well as post-intervention (at 10 and 20 weeks) in a group of 30 women living with overweight/obesity. RESULTS A significant decrease in REE (p = 0.033) was noted after 1 week. Fasting desire to eat (p = 0.004), hunger (p = 0.001) and prospective food consumption (p = 0.001) all increased after 1 week. Similarly, significant increases in AUC SQ for desire to eat (p = 0.01), hunger (p = 0.005) and prospective food consumption (p = 0.001) were noted after 1 week. However, these early changes were not associated to final BW or FM losses at the end of the weight loss intervention. CONCLUSION Despite significant changes in REE and appetite soon after the onset of a BW loss intervention, these early changes do not seem to predict final BW or FM losses at the end of the program in women living with overweight/obesity.
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16
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Dorenbos E, Drummen M, Adam T, Rijks J, Winkens B, Martínez JA, Navas‐Carretero S, Stratton G, Swindell N, Stouthart P, Mackintosh K, Mcnarry M, Tremblay A, Fogelholm M, Raben A, Westerterp‐Plantenga M, Vreugdenhil A. Effect of a high protein/low glycaemic index diet on insulin resistance in adolescents with overweight/obesity-A PREVIEW randomized clinical trial. Pediatr Obes 2021; 16:e12702. [PMID: 32681547 PMCID: PMC7757177 DOI: 10.1111/ijpo.12702] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 06/10/2020] [Accepted: 06/20/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Pubertal insulin resistance (IR) is associated with increased risk of type 2 diabetes mellitus development in adolescents with overweight/obesity. OBJECTIVES The PREVIEW study was a randomized parallel trial assessing the change in IR, analyzed by Homeostatic Model Assessment of IR (HOMA-IR), at 2 years after randomization to a high protein vs a moderate protein diet in adolescents with overweight/obesity. It was hypothesized that a high protein/low glycaemic index diet would be superior in reducing IR compared to a medium protein/medium GI diet, in insulin resistant adolescents with overweight or obesity. METHODS Adolescents with overweight/obesity and IR from the Netherlands, United Kingdom and Spain were randomized into a moderate protein/moderate GI (15/55/30En% protein/carbohydrate/fat, GI ≥ 56) or high protein/low GI (25/45/30En% protein/carbohydrate/fat, GI < 50) diet. Anthropometric and cardiometabolic parameters, puberty, dietary intake and physical activity (PA) were measured and effects on HOMA-IR were analyzed. RESULTS 126 adolescents were included in this study (13.6 ± 2.2 years, BMI z-score 3.04 ± 0.66, HOMA-IR 3.48 ± 2.28, HP n = 68, MP n = 58). At 2 years, changes in protein intake were not significantly different between timepoints or intervention groups and no effects of the intervention on IR were observed. The retention rate was 39%, while no compliance to the diets was observed. CONCLUSIONS The PREVIEW study observed no effect of a high protein/low GI diet on IR in adolescents with overweight/obesity and IR because of lack of feasibility, due to insufficient retention and dietary compliance after 2 years.
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Affiliation(s)
- Elke Dorenbos
- NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht UniversityMaastrichtThe Netherlands,Centre for Overweight Adolescent and Children's Healthcare (COACH)Maastricht University Medical CentreMaastrichtThe Netherlands
| | - Mathijs Drummen
- NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht UniversityMaastrichtThe Netherlands
| | - Tanja Adam
- NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht UniversityMaastrichtThe Netherlands
| | - Jesse Rijks
- Centre for Overweight Adolescent and Children's Healthcare (COACH)Maastricht University Medical CentreMaastrichtThe Netherlands
| | - Bjorn Winkens
- Department of Methodology and StatisticsCare and Public Health Research Institute (CAPHRI), Maastricht UniversityMaastrichtThe Netherlands
| | - J. Alfredo Martínez
- Department of Nutrition, Food Science and Physiology, Centre for Nutrition Research (CIN)Universidad de NavarraPamplonaSpain,CIBERobn, Instituto de Salud Carlos IIIMadridSpain,IMDEA Research Institute on Food and Health SciencesMadridSpain
| | - Santiago Navas‐Carretero
- Department of Nutrition, Food Science and Physiology, Centre for Nutrition Research (CIN)Universidad de NavarraPamplonaSpain,CIBERobn, Instituto de Salud Carlos IIIMadridSpain
| | - Gareth Stratton
- Research Centre in Applied Sports, Technology, Exercise and Medicine (A‐STEM)Swansea UniversitySwanseaUK
| | - Nils Swindell
- Research Centre in Applied Sports, Technology, Exercise and Medicine (A‐STEM)Swansea UniversitySwanseaUK
| | - Pauline Stouthart
- Centre for Overweight Adolescent and Children's Healthcare (COACH)Maastricht University Medical CentreMaastrichtThe Netherlands
| | - Kelly Mackintosh
- Research Centre in Applied Sports, Technology, Exercise and Medicine (A‐STEM)Swansea UniversitySwanseaUK
| | - Melitta Mcnarry
- Research Centre in Applied Sports, Technology, Exercise and Medicine (A‐STEM)Swansea UniversitySwanseaUK
| | | | - Mikael Fogelholm
- Department of Food and Nutrition, University of HelsinkiHelsinkiFinland
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of ScienceUniversity of CopenhagenFrederiksbergDenmark
| | | | - Anita Vreugdenhil
- NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht UniversityMaastrichtThe Netherlands,Centre for Overweight Adolescent and Children's Healthcare (COACH)Maastricht University Medical CentreMaastrichtThe Netherlands
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17
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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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18
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Determinants favoring weight regain after weight-loss therapy among postmenopausal women. Sci Rep 2020; 10:17713. [PMID: 33077809 PMCID: PMC7572409 DOI: 10.1038/s41598-020-74302-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 09/28/2020] [Indexed: 11/18/2022] Open
Abstract
Little is known about the factors affecting body weight-loss maintenance among postmenopausal women. We thus performed an analysis to identify some sociodemographic, physiological, and behavioral predictors of weight regain in a targeted subpopulation of women who had lost weight 1 year earlier. We also measured how eating behaviors and habits as well as physical activity pattern differ among successful and unsuccessful weight-loss maintainers over the trial. Sixty-four postmenopausal women were followed up for a year after dieting, and the successful and unsuccessful maintainers were identified. The regainers had regained an average of 4.9 kg of their lost body weight, while the maintainers had regained only 1.5 kg. Regainers had fewer years of education and lower initial body weight loss than maintainers. They also showed poor dietary adherence during dieting, and had unhealthy patterns of eating involving the avoidance of breakfast and a lower intake of nuts, seeds, and pulses, and a higher intake of sweets, biscuits, cakes, and pastries over time (excluding the dieting period). All the significant sociodemographic, physiological and behavioral variables differentiating regainers and maintainers before and after dieting were then examined as independent variables in a logistic regression model. The model showed that less weight reduction during dieting, higher disinhibition scores after dieting, and avoidance of breakfast before dieting were significant predictors of body weight regain in postmenopausal women. From a practical point of view, early identification of postmenopausal women who are at risk of regaining lost weight can allow health professionals to create behavioral and dietary supports to help prevent this. A regular schedule of follow-ups over at least the first year should be considered for them—including psychological and dietary intervention, if necessary. Since this sample study included only postmenopausal women, our findings are not generalizable to other populations.
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Challenging energy balance - during sensitivity to food reward and modulatory factors implying a risk for overweight - during body weight management including dietary restraint and medium-high protein diets. Physiol Behav 2020; 221:112879. [PMID: 32199999 DOI: 10.1016/j.physbeh.2020.112879] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/10/2020] [Accepted: 03/15/2020] [Indexed: 02/03/2023]
Abstract
Energy balance is a key concept in the etiology and prevalence of obesity and its co-morbidities, as well as in the development of possible treatments. If energy intake exceeds energy expenditure, a positive energy balance develops and the risk for overweight, obesity, and its co-morbidities increases. Energy balance is determined by energy homeostasis, and challenged by sensitivity to food reward, and to modulatory factors such as circadian misalignment, high altitude, environmental temperature, and physical activity. Food reward and circadian misalignment increase the risk for overweight and obesity, while high altitude, changes in environmental temperature, or physical activity modulate energy balance in different directions. Modulations by hypobaric hypoxia, lowering environmental temperature, or increasing physical activity have been hypothesized to contribute to body weight loss and management, yet no clear evidence has been shown. Dietary approach as part of a lifestyle approach for body weight management should imply reduction of energy intake including control of food reward, thereby sustaining satiety and fat free body mass, sustaining energy expenditure. Green tea catechins and capsaicin in red pepper in part meet these requirements by sustaining energy expenditure and increasing fat oxidation, while capsaicin also suppresses hunger and food intake. Protein intake of at least 0,8 g/kg body weight meets these requirements in that it, during decreased energy intake, increases food intake control including control of food reward, and counteracts adaptive thermogenesis. Prevention of overweight and obesity is underscored by dietary restraint, implying control of sensitivity to challenges to energy balance such as food reward and circadian misalignment. Treatment of overweight and obesity may be possible using a medium-high protein diet (0,8-1,2 g/kg), together with increased dietary restraint, while controlling challenges to energy balance.
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20
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Martins C, Gower BA, Hunter GR. Baseline Metabolic Variables Do Not Predict Weight Regain in Premenopausal Women. Obesity (Silver Spring) 2020; 28:902-906. [PMID: 32320142 PMCID: PMC7668116 DOI: 10.1002/oby.22780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/23/2020] [Accepted: 02/16/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The aim of this study was to investigate whether baseline (pre-weight loss) metabolic variables can predict weight regain. METHODS About 117 women with overweight completed a weight loss program to achieve BMI < 25 kg/m2 and were followed for 2 years. Resting metabolic rate, respiratory quotient, insulin sensitivity, and serum leptin concentration were measured pre-weight loss, while on energy balance, and as predictors of weight regain at 1 and 2 years. Rate and amount of weight loss also were examined as predictors, as these outcomes may reflect metabolic phenotype. RESULTS Average weight loss was 12 (SD 2.5) kg, and regain was 48% (SD 35%) and 80% (SD 52%) at 1 and 2 years, respectively. In regression modeling, metabolic variables (both pre-weight loss and changes with weight loss) did not predict weight regain. However, initial weight loss and time to achieve BMI < 25 were significant predictors of weight regain at 1 and 2 years, even after adjusting for confounders. CONCLUSIONS Baseline (pre-weight loss) resting metabolic rate, respiratory quotient, insulin sensitivity, and leptin did not predict weight regain. However, a larger and faster weight loss was associated with a lower weight regain. Understanding the mechanisms behind interindividual variation in magnitude and rate of weight loss is needed to ensure better weight loss maintenance.
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Affiliation(s)
- Catia Martins
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Centre for Obesity and Innovation (ObeCe), Clinic of Surgery, St. Olav University Hospital, Trondheim, Norway
- Department of Nutrition Sciences, University of Alabama at Birmingham, USA
| | - Barbara A. Gower
- Department of Nutrition Sciences, University of Alabama at Birmingham, USA
| | - Gary R. Hunter
- Department of Nutrition Sciences, University of Alabama at Birmingham, USA
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21
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Nordmo M, Danielsen YS, Nordmo M. The challenge of keeping it off, a descriptive systematic review of high-quality, follow-up studies of obesity treatments. Obes Rev 2020; 21:e12949. [PMID: 31675146 DOI: 10.1111/obr.12949] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/02/2019] [Accepted: 09/02/2019] [Indexed: 01/10/2023]
Abstract
The aim of this systematic review is to answer the question: Is substantial, stable, and long-term weight loss a viable goal for adults with obesity? To answer this question, we conducted a broad systematic search of non-surgical and non-pharmacological obesity treatment studies with the following strict criteria: (a) minimum 3-year follow-up, (b) 5% body mass lost, (c) no continued interventions in the follow-up-period, (d) prospective design, and (e) less than 30% attrition from the start of the follow-up period. While the search revealed a very large number of published articles, only eight studies met the inclusion criteria. Several of the nonincluded studies report a majority of participants achieving satisfactory weight loss and little regain, especially among studies with continued interventions during the follow-up period. In contrast, the eight high-quality studies included in this study demonstrate a trend of weight regain towards pretreatment baseline. This review concludes that the majority of high-quality follow-up treatment studies of individuals with obesity are not successful in maintaining weight loss over time. The results suggest that excess weight can be lost but is likely regained over time, for the majority of participants.
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Affiliation(s)
- Morten Nordmo
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | | | - Magnus Nordmo
- Department of Psychology, University of Oslo, Oslo, Norway
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22
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Péronnet F, Haman F. Low capacity to oxidize fat and body weight. Obes Rev 2019; 20:1367-1383. [PMID: 31353786 DOI: 10.1111/obr.12910] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 06/09/2019] [Accepted: 06/10/2019] [Indexed: 12/16/2022]
Abstract
For a given positive energy balance, a low capacity to oxidize fat could contribute to weight gain (low fat oxidation hypothesis). This hypothesis is based on the arguments that for a given stable diet and food quotient (FQ), the respiratory quotient (RQ) is higher in obesity prone (OP) than in obesity resistant individuals (OR) and that a high RQ predicts higher future weight gain. A review of 42 studies shows that there is no convincing experimental support to these arguments and thus for the low fat oxidation hypothesis. A power analysis also shows that this hypothesis might be impossible to experimentally confirm because very large numbers of subjects would be needed to reject the null hypotheses that the 24-h RQ is not different in OP and OR or that future weight gain is not different in individuals with a low and high 24-h RQ at baseline. A re-examination of the significance of the 24-hour and fasting RQ also shows that the assumption underlying the low fat oxidation hypothesis that a high RQ reflects a low capacity to oxidize fat is not valid: For a stable diet, the 24-h RQ entirely depends on FQ and energy balance, and the fasting RQ mainly depends on the FQ and energy balance and on the size of glycogen stores.
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Affiliation(s)
- François Péronnet
- École de kinésiologie et des sciences de l'activité physique, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - François Haman
- École des sciences de l'activité physique, Faculté des sciences de la santé, Université d'Ottawa, Ottawa, ON, Canada
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23
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Neumann M, Holzapfel C, Müller A, Hilbert A, Crosby RD, de Zwaan M. Features and Trajectories of Eating Behavior in Weight-Loss Maintenance: Results from the German Weight Control Registry. Obesity (Silver Spring) 2018; 26:1501-1508. [PMID: 30230246 DOI: 10.1002/oby.22270] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 06/22/2018] [Accepted: 07/03/2018] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Eating behaviors such as dietary restraint and disinhibition caused by emotional and external cues play a relevant role in weight-loss maintenance. METHODS Four hundred forty individuals with successful weight-loss maintenance included in the prospective German Weight Control Registry completed the Dutch Eating Behavior Questionnaire. Participants were categorized into the following two weight groups: stable weight trajectory (WS) (n = 280) and unstable weight trajectory (WUS) (n = 160) over the 2-year assessment period. RESULTS Those with successful weight-loss maintenance had significantly higher scores on the restrained and emotional eating subscales compared with a general population (GP) sample. At baseline, the WS individuals had lower restrained, emotional, and external eating scores compared with the WUS individuals. Over the 2-year follow-up period, the trajectories of the restraint scores decreased in both groups but stayed elevated compared with the GP sample. Scores of the emotional and external eating subscales remained stable in the WS group but increased in the WUS group. CONCLUSIONS A certain degree of restraint seems to be necessary for successful weight-loss maintenance; however, high emotional and external eating may counteract this effect, resulting in weight regain in the long run.
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Affiliation(s)
- Maria Neumann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Christina Holzapfel
- Institute for Nutritional Medicine, Technical University of Munich, University Hospital "Klinikum rechts der Isar,", Munich, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, Leipzig, Germany
| | - Ross D Crosby
- Neuropsychiatric Research Institute, Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
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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: 74] [Impact Index Per Article: 12.3] [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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Vink RG, Roumans NJ, Mariman EC, van Baak MA. Dietary weight loss-induced changes in RBP4, FFA, and ACE predict weight regain in people with overweight and obesity. Physiol Rep 2018; 5:5/21/e13450. [PMID: 29122953 PMCID: PMC5688773 DOI: 10.14814/phy2.13450] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 08/20/2017] [Accepted: 08/24/2017] [Indexed: 01/22/2023] Open
Abstract
Adipokines and other biomarkers were previously identified with roles in energy expenditure, appetite, satiety, and adiposity. Therefore, we investigated whether dietary weight loss‐induced changes in adipokines and other biomarkers known to play a role in weight regulation or energy expenditure could predict weight regain in people with overweight and obesity. In this randomized controlled trial 26 males and 30 females (BMI: 28–35 kg/m2) followed either a low‐calorie diet (LCD; 1250 kcal/day) for 12 weeks or a very‐low‐calorie diet (VLCD; 500 kcal/day) for 5 weeks followed by a weight stable period of 4 weeks (dietary intervention (DI) period) and a 9‐month follow‐up period. Blood samples were taken before and after each period to measure FFA, TAG, total cholesterol, insulin, glucose, angiotensin‐converting enzyme (ACE) activity, IL‐6, RBP4, apelin, leptin, adiponectin, vaspin, and nesfatin‐1 concentrations. Weight loss was similar between groups (LCD: −8.2 ± 0.5 kg; VLCD: −8.9 ± 0.4 kg, P = 0.30). Only changes in ACE activity, FFA and RBP4 concentrations during DI were correlated with weight regain in the whole group (r = −0.299, P = 0.030, r = −0.274, P = 0.047, and r = 0.357, P = 0.008, respectively). Together they explained 28% (r = 0.532) of weight regain variation. Dietary weight loss‐induced changes in ACE activity, FFA and RBP4 independently contribute to weight regain prediction.
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Affiliation(s)
- Roel G Vink
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Nadia J Roumans
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Edwin C Mariman
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Marleen A van Baak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, the Netherlands
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Hernandez-Carretero A, Weber N, La Frano MR, Ying W, Rodriguez JL, Sears DD, Wallenius V, Börgeson E, Newman JW, Osborn O. Obesity-induced changes in lipid mediators persist after weight loss. Int J Obes (Lond) 2018; 42:728-736. [PMID: 29089614 PMCID: PMC6055936 DOI: 10.1038/ijo.2017.266] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 09/01/2017] [Accepted: 10/16/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Obesity induces significant changes in lipid mediators, however, the extent to which these changes persist after weight loss has not been investigated. SUBJECTS/METHODS We fed C57BL6 mice a high-fat diet to generate obesity and then switched the diet to a lower-fat diet to induce weight loss. We performed a comprehensive metabolic profiling of lipid mediators including oxylipins, endocannabinoids, sphingosines and ceramides in key metabolic tissues (including adipose, liver, muscle and hypothalamus) and plasma. RESULTS We found that changes induced by obesity were largely reversible in most metabolic tissues but the adipose tissue retained a persistent obese metabolic signature. Prostaglandin signaling was perturbed in the obese state and lasting increases in PGD2, and downstream metabolites 15-deoxy PGJ2 and delta-12-PGJ2 were observed after weight loss. Furthermore expression of the enzyme responsible for PGD2 synthesis (hematopoietic prostaglandin D synthase, HPGDS) was increased in obese adipose tissues and remained high after weight loss. We found that inhibition of HPGDS over the course of 5 days resulted in decreased food intake in mice. Increased HPGDS expression was also observed in human adipose tissues obtained from obese compared with lean individuals. We then measured circulating levels of PGD2 in obese patients before and after weight loss and found that while elevated relative to lean subjects, levels of this metabolite did not decrease after significant weight loss. CONCLUSIONS These results suggest that lasting changes in lipid mediators induced by obesity, still present after weight loss, may play a role in the biological drive to regain weight.
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Affiliation(s)
| | - Natalie Weber
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, CA, USA
| | - Michael R. La Frano
- Department of Nutrition, University of California, Davis, CA, USA
- NIH West Coast Metabolomics Center, Davis, CA, USA
- Department of Food Science and Nutrition, California Polytechnic State University, San Luis Obispo, USA
| | - Wei Ying
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, CA, USA
| | - Juan Lantero Rodriguez
- The Wallenberg Laboratory for Cardiovascular and Metabolic Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Dorothy D. Sears
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, CA, USA
| | - Ville Wallenius
- Department of Gastrosurgical Research and Education, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Emma Börgeson
- The Wallenberg Laboratory for Cardiovascular and Metabolic Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - John W. Newman
- Department of Nutrition, University of California, Davis, CA, USA
- NIH West Coast Metabolomics Center, Davis, CA, USA
- Obesity and Metabolism Research Unit, USDA-ARS-Western Human Nutrition Research Center, Davis, CA, USA
| | - Olivia Osborn
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, CA, USA
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Sumithran P, Purcell K, Kuyruk S, Proietto J, Prendergast LA. Combining biological and psychosocial baseline variables did not improve prediction of outcome of a very-low-energy diet in a clinic referral population. Clin Obes 2018; 8:30-38. [PMID: 29119687 DOI: 10.1111/cob.12229] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/13/2017] [Accepted: 09/29/2017] [Indexed: 12/31/2022]
Abstract
Consistent, strong predictors of obesity treatment outcomes have not been identified. It has been suggested that broadening the range of predictor variables examined may be valuable. We explored methods to predict outcomes of a very-low-energy diet (VLED)-based programme in a clinically comparable setting, using a wide array of pre-intervention biological and psychosocial participant data. A total of 61 women and 39 men (mean ± standard deviation [SD] body mass index: 39.8 ± 7.3 kg/m2 ) underwent an 8-week VLED and 12-month follow-up. At baseline, participants underwent a blood test and assessment of psychological, social and behavioural factors previously associated with treatment outcomes. Logistic regression, linear discriminant analysis, decision trees and random forests were used to model outcomes from baseline variables. Of the 100 participants, 88 completed the VLED and 42 attended the Week 60 visit. Overall prediction rates for weight loss of ≥10% at weeks 8 and 60, and attrition at Week 60, using combined data were between 77.8 and 87.6% for logistic regression, and lower for other methods. When logistic regression analyses included only baseline demographic and anthropometric variables, prediction rates were 76.2-86.1%. In this population, considering a wide range of biological and psychosocial data did not improve outcome prediction compared to simply-obtained baseline characteristics.
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Affiliation(s)
- P Sumithran
- Department of Medicine (Austin Health), University of Melbourne, Melbourne, Australia
| | - K Purcell
- Department of Medicine (Austin Health), University of Melbourne, Melbourne, Australia
| | - S Kuyruk
- Department of Medicine (Austin Health), University of Melbourne, Melbourne, Australia
| | - J Proietto
- Department of Medicine (Austin Health), University of Melbourne, Melbourne, Australia
| | - L A Prendergast
- Department of Medicine (Austin Health), University of Melbourne, Melbourne, Australia
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
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Skogar M, Holmbäck U, Hedberg J, Risérus U, Sundbom M. Preserved Fat-Free Mass after Gastric Bypass and Duodenal Switch. Obes Surg 2018; 27:1735-1740. [PMID: 27885535 PMCID: PMC5489570 DOI: 10.1007/s11695-016-2476-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background Concerns for the possibility of an excessive loss of fat-free mass (FFM) and resting metabolic rate (RMR) after bariatric surgery, such as Roux-en-Y gastric bypass (RYGB) and duodenal switch (BPD/DS), have been raised. Objectives This study aims to examine body composition and RMR in patients after RYGB and BPD/DS and in non-operated controls. Methods Body composition and RMR were studied with Bod Pod and indirect calorimetry in weight-stable RYGB (n = 15) and BPD/DS patients (n = 12) and compared with non-operated controls (n = 17). All patients were 30–55 years old and weight stable with BMI 28–35 kg/m2. Results FFM% was 58% (RYGB), 61% (BPD/DS), and 58% (controls). Body composition did not differ after RYGB and BPD/DS compared to controls, despite 27 and 40% total body weight loss, respectively. No difference in RMR or RMR/FFM was observed (1539, 1617, and 1490 kcal/24 h; and 28.9, 28.4, and 28.8 kcal/24 h/kg). Conclusion Weight-stable patients with BMI 28–35 kg/m2 after RYGB and BPD/DS have a body composition and RMR similar to that of non-operated individuals within the same BMI interval.
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Affiliation(s)
- Martin Skogar
- Department of Surgical Sciences, Uppsala University, SE-751 85, Uppsala, Sweden.
| | - Ulf Holmbäck
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, SE-751 85, Uppsala, Sweden
| | - Jakob Hedberg
- Department of Surgical Sciences, Uppsala University, SE-751 85, Uppsala, Sweden
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, SE-751 85, Uppsala, Sweden
| | - Magnus Sundbom
- Department of Surgical Sciences, Uppsala University, SE-751 85, Uppsala, Sweden
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Drummen M, Tischmann L, Gatta-Cherifi B, Adam T, Westerterp-Plantenga M. Dietary Protein and Energy Balance in Relation to Obesity and Co-morbidities. Front Endocrinol (Lausanne) 2018; 9:443. [PMID: 30127768 PMCID: PMC6087750 DOI: 10.3389/fendo.2018.00443] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 07/17/2018] [Indexed: 12/18/2022] Open
Abstract
Dietary protein is effective for body-weight management, in that it promotes satiety, energy expenditure, and changes body-composition in favor of fat-free body mass. With respect to body-weight management, the effects of diets varying in protein differ according to energy balance. During energy restriction, sustaining protein intake at the level of requirement appears to be sufficient to aid body weight loss and fat loss. An additional increase of protein intake does not induce a larger loss of body weight, but can be effective to maintain a larger amount of fat-free mass. Protein induced satiety is likely a combined expression with direct and indirect effects of elevated plasma amino acid and anorexigenic hormone concentrations, increased diet-induced thermogenesis, and ketogenic state, all feed-back on the central nervous system. The decline in energy expenditure and sleeping metabolic rate as a result of body weight loss is less on a high-protein than on a medium-protein diet. In addition, higher rates of energy expenditure have been observed as acute responses to energy-balanced high-protein diets. In energy balance, high protein diets may be beneficial to prevent the development of a positive energy balance, whereas low-protein diets may facilitate this. High protein-low carbohydrate diets may be favorable for the control of intrahepatic triglyceride IHTG in healthy humans, likely as a result of combined effects involving changes in protein and carbohydrate intake. Body weight loss and subsequent weight maintenance usually shows favorable effects in relation to insulin sensitivity, although some risks may be present. Promotion of insulin sensitivity beyond its effect on body-weight loss and subsequent body-weight maintenance seems unlikely. In conclusion, higher-protein diets may reduce overweight and obesity, yet whether high-protein diets, beyond their effect on body-weight management, contribute to prevention of increases in non-alcoholic fatty liver disease NAFLD, type 2 diabetes and cardiovascular diseases is inconclusive.
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Affiliation(s)
- Mathijs Drummen
- Faculty of Health, Medicine and Life Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht UMC+, Maastricht University, Maastricht, Netherlands
| | - Lea Tischmann
- Faculty of Health, Medicine and Life Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht UMC+, Maastricht University, Maastricht, Netherlands
| | - Blandine Gatta-Cherifi
- Department of Endocrinology, Diabetology and Nutrition, Universite de Bordeaux, Bordeaux, France
| | - Tanja Adam
- Faculty of Health, Medicine and Life Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht UMC+, Maastricht University, Maastricht, Netherlands
| | - Margriet Westerterp-Plantenga
- Faculty of Health, Medicine and Life Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht UMC+, Maastricht University, Maastricht, Netherlands
- *Correspondence: Margriet Westerterp-Plantenga
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West NR, Dorling J, Thackray AE, Hanson NC, Decombel SE, Stensel DJ, Grice SJ. Effect of Obesity-Linked FTO rs9939609 Variant on Physical Activity and Dietary Patterns in Physically Active Men and Women. J Obes 2018; 2018:7560707. [PMID: 29686893 PMCID: PMC5852866 DOI: 10.1155/2018/7560707] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 11/10/2017] [Accepted: 11/26/2017] [Indexed: 11/17/2022] Open
Abstract
Single nucleotide polymorphisms (SNPs) in the fat mass and obesity-associated (FTO) locus are associated with obesity, but lifestyle factors may modulate the obesity risk related to FTO. This study examined the physical activity and dietary patterns of 528 physically active white men and women (mean (SD): 34.9 (9.5) years, 26.6 (4.3) kg·m-2) carrying different risk variants of FTO SNP rs9939609. Sex, age, and anthropometric measurements (stature, body mass, and waist circumference) were self-reported using an online questionnaire, and body mass index and waist-to-height ratio were calculated. Physical activity and eating behaviour were assessed using the International Physical Activity Questionnaire (IPAQ) and Three-Factor Eating Questionnaire (TFEQ), respectively. Body mass, body mass index (BMI), waist circumference, and waist-to-height ratio were not significantly different between individuals expressing different FTO rs9939609 risk variants (all P ≥ 0.66). The cohort was physically active (4516 (3043) total MET min·week-1), although homozygous risk allele carriers (AA) displayed higher TFEQ cognitive restraint compared with nonrisk allele carriers (TT) (ES = 0.33 and P=0.03). In conclusion, obesity-related parameters were not different in physically active individuals expressing different risk variants of FTO rs9939609, although homozygous risk allele carriers exhibited higher cognitive restraint.
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Affiliation(s)
- Nathan R. West
- FitnessGenes, Bicester Innovation Centre, Commerce House, Telford Rd., Bicester OX26 4LD, UK
| | - James Dorling
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK
| | - Alice E. Thackray
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK
| | - Nicola C. Hanson
- FitnessGenes, Bicester Innovation Centre, Commerce House, Telford Rd., Bicester OX26 4LD, UK
| | - Samantha E. Decombel
- FitnessGenes, Bicester Innovation Centre, Commerce House, Telford Rd., Bicester OX26 4LD, UK
| | - David J. Stensel
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK
| | - Stuart J. Grice
- FitnessGenes, Bicester Innovation Centre, Commerce House, Telford Rd., Bicester OX26 4LD, UK
- MRC Functional Genomics Unit, Department of Physiology, Anatomy and Genetics, University of Oxford, South Parks Road, Oxford OX1 3PT, UK
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Christensen RAG, Raiber L, Wharton S, Rotondi MA, Kuk JL. The associations of resting metabolic rate with chronic conditions and weight loss. Clin Obes 2017; 7:70-76. [PMID: 28170155 DOI: 10.1111/cob.12178] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/23/2016] [Accepted: 10/24/2016] [Indexed: 11/28/2022]
Abstract
The aim of this study was to examine the associations between baseline and changes in resting metabolic rate (RMR) with chronic condition(s) and weight loss (WL). Sex stratified analysis was undertaken on 393 adults from the Wharton Weight Management Clinics. The association between baseline RMR and WL was examined adjusting for age, BMI, ethnicity and treatment time. The association between changes in RMR (ΔRMR) and WL was also examined adjusting for baseline RMR and above covariates. Models were further adjusted for high glucose, triglycerides, blood pressure, low-density lipoprotein (LDL) and low high-density lipoprotein (HDL). While men (6.0 ± 8.6 kg) and women (5.6 ± 8.3 kg) had significant WL throughout the intervention, their measured decreases in RMR (-48 ± 322 kcal and -5 ± 322 kcal, respectively) were non-significant (P > 0.05). Individuals with a high blood pressure had a higher baseline RMR and women with a high LDL had a lower baseline RMR than those without the chronic condition (P < 0.05). Regardless of sex, WL was not significantly associated with baseline RMR or ΔRMR (P > 0.05) in both models. Participants with a low baseline RMR do not appear to be at a disadvantage for WL. Further, WL can occur without decreases in RMR in populations with high levels of obesity and obesity-related comorbidities.
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Affiliation(s)
- R A G Christensen
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - L Raiber
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - S Wharton
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
- Wharton Weight Management Clinic, Toronto, Ontario, Canada
| | - M A Rotondi
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - J L Kuk
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
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Hübner C, Baldofski S, Crosby RD, Müller A, de Zwaan M, Hilbert A. Weight-related teasing and non-normative eating behaviors as predictors of weight loss maintenance. A longitudinal mediation analysis. Appetite 2016; 102:25-31. [DOI: 10.1016/j.appet.2016.02.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 01/26/2016] [Accepted: 02/09/2016] [Indexed: 02/05/2023]
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Rosenbaum DL, Schumacher LM, Schaumberg K, Piers AD, Gaspar ME, Lowe MR, Forman EM, Butryn ML. Energy intake highs and lows: how much does consistency matter in weight control? Clin Obes 2016; 6:193-201. [PMID: 27020845 PMCID: PMC4864054 DOI: 10.1111/cob.12142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 12/21/2015] [Accepted: 02/17/2016] [Indexed: 11/26/2022]
Abstract
Behavioural weight control programmes recommend adherence to daily energy intake goals, yet also allow for flexibility in intake across days. Evidence is lacking as to whether intake consistency is important for weight control. The current study explored the relation between day-to-day intake consistency and weight loss in the context of behavioural weight loss treatment and examined the relationship between variability in intake and several factors known to be associated with weight control success. Participants (N = 283) enrolled in a 12-month behavioural weight loss programme completed 24-h recalls of dietary intake and psychological measures. At the end of treatment, low intake variability and greater weight loss were associated, but variability was not predictive of weight loss independent of mean intake in continuous analyses. Interestingly, participants who met the programme goal of ≥10% weight loss had less intake variability compared to those who lost <10%, although groups did not differ significantly on mean intake. Results suggest that daily intake consistency may facilitate successful weight loss for some. Additionally, autonomous motivation for weight management and cognitive dietary restraint were inversely related to end-of-treatment intake variability. Additional research is needed to examine whether recommendations to limit intake variability during behavioural weight loss treatment improve long-term weight control.
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Affiliation(s)
| | | | | | - Amani D Piers
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - Monika E Gaspar
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - Michael R Lowe
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - Evan M Forman
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - Meghan L Butryn
- Department of Psychology, Drexel University, Philadelphia, PA, USA
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Abstract
Initial successful weight loss is often followed by weight regain after the dietary intervention. Compared with lean people, cellular stress in adipose tissue is increased in obese subjects. However, the relation between cellular stress and the risk for weight regain after weight loss is unclear. Therefore, we determined the expression levels of stress proteins during weight loss and weight maintenance in relation to weight regain. In vivo findings were compared with results from in vitro cultured human Simpson-Golabi-Behmel syndrome (SGBS) adipocytes. In total, eighteen healthy subjects underwent an 8-week diet programme with a 10-month follow-up. Participants were categorised as weight maintainers or weight regainers (WR) depending on their weight changes during the intervention. Abdominal subcutaneous adipose tissue biopsies were obtained before and after the diet and after the follow-up. In vitro differentiated SGBS adipocytes were starved for 96 h with low (0·55 mm) glucose. Levels of stress proteins were determined by Western blotting. WR showed increased expressions of β-actin, calnexin, heat shock protein (HSP) 27, HSP60 and HSP70. Changes of β-actin, HSP27 and HSP70 are linked to HSP60, a proposed key factor in weight regain after weight loss. SGBS adipocytes showed increased levels of β-actin and HSP60 after 96 h of glucose restriction. The increased level of cellular stress proteins in the adipose tissue of WR probably resides in the adipocytes as shown by in vitro experiments. Cellular stress accumulated in adipose tissue during weight loss may be a risk factor for weight regain.
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Palascha A, van Kleef E, van Trijp HCM. How does thinking in Black and White terms relate to eating behavior and weight regain? J Health Psychol 2015; 20:638-48. [DOI: 10.1177/1359105315573440] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study explores the role of dichotomous thinking on eating behavior and its association with restraint eating and weight regain in a wide range of people. In a web-based survey with 241 adults, dichotomous thinking and behavioral outcomes related to eating (restraint eating, weight regain, body mass index, dieting) were assessed. Results showed that eating-specific dichotomous thinking (dichotomous beliefs about food and eating) mediates the association between restraint eating and weight regain. We conclude that holding dichotomous beliefs about food and eating may be linked to a rigid dietary restraint, which in turn impedes people’s ability to maintain a healthy weight.
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36
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Ismail S, Shamsuddin K, Latiff KA, Saad HA, Majid LA, Othman FM. Voluntary Fasting to Control Post-Ramadan Weight Gain among Overweight and Obese Women. Sultan Qaboos Univ Med J 2015; 15:e98-e104. [PMID: 25685394 PMCID: PMC4318615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 09/09/2014] [Accepted: 09/25/2014] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVES This study aimed to examine the effectiveness of an Islamic voluntary fasting intervention to control post-Ramadan weight gain. METHODS This study was conducted between July and November 2011. Two weight loss intervention programmes were developed and implemented among groups of overweight or obese Malay women living in the Malaysian cities of Putrajaya and Seremban: a standard programme promoting control of food intake according to national dietary guidelines (group B) and a faith-based programme promoting voluntary fasting in addition to the standard programme (group A). Participants' dietary practices (i.e., voluntary fasting practices, frequency of fruit/vegetable consumption per week and quantity of carbohydrates/protein consumed per day), body mass index (BMI), blood pressure, fasting blood high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC):HDL-C ratio were assessed before Ramadan and three months post-Ramadan. RESULTS Voluntary fasting practices increased only in group A (P <0.01). Additionally, the quantity of protein/carbohydrates consumed per day, mean diastolic pressure and TC:HDL-C ratio decreased only in group A (P <0.01, 0.05, 0.02 and <0.01, respectively). Frequency of fruit/vegetable consumption per week, as well as HDL-C levels, increased only in group A (P = 0.03 and <0.01, respectively). Although changes in BMI between the groups was not significant (P = 0.08), BMI decrease among participants in group A was significant (P <0.01). CONCLUSION Control of post-Ramadan weight gain was more evident in the faith-based intervention group. Healthcare providers should consider faith-based interventions to encourage weight loss during Ramadan and to prevent post-Ramadan weight gain among patients.
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Affiliation(s)
- Suriani Ismail
- Departments of Community Health, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Selangor, Malaysia
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Khadijah Shamsuddin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Khalib A. Latiff
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Hazizi A. Saad
- Nutrition & Dietetics, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Selangor, Malaysia
| | - Latifah A. Majid
- Department of al-Quran and Sunnah, Faculty of Islamic Studies, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Fadlan M. Othman
- Department of al-Quran and Sunnah, Faculty of Islamic Studies, Universiti Kebangsaan Malaysia, Selangor, Malaysia
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MacLean PS, Wing RR, Davidson T, Epstein L, Goodpaster B, Hall KD, Levin BE, Perri MG, Rolls BJ, Rosenbaum M, Rothman AJ, Ryan D. NIH working group report: Innovative research to improve maintenance of weight loss. Obesity (Silver Spring) 2015; 23:7-15. [PMID: 25469998 PMCID: PMC5841916 DOI: 10.1002/oby.20967] [Citation(s) in RCA: 365] [Impact Index Per Article: 40.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 10/21/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The National Institutes of Health, led by the National Heart, Lung, and Blood Institute, organized a working group of experts to discuss the problem of weight regain after weight loss. A number of experts in integrative physiology and behavioral psychology were convened with the goal of merging their perspectives regarding the barriers to scientific progress and the development of novel ways to improve long-term outcomes in obesity therapeutics. The specific objectives of this working group were to: (1) identify the challenges that make maintaining a reduced weight so difficult; (2) review strategies that have been used to improve success in previous studies; and (3) recommend novel solutions that could be examined in future studies of long-term weight control. RESULTS Specific barriers to successful weight loss maintenance include poor adherence to behavioral regimens and physiological adaptations that promote weight regain. A better understanding of how these behavioral and physiological barriers are related, how they vary between individuals, and how they can be overcome will lead to the development of novel strategies with improved outcomes. CONCLUSIONS Greater collaboration and cross-talk between physiological and behavioral researchers is needed to advance the science and develop better strategies for weight loss maintenance.
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Affiliation(s)
- Paul S. MacLean
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Rena R. Wing
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Terry Davidson
- Department of Psychology, American University, Washington, DC, USA
| | - Leonard Epstein
- Department of Pediatrics, University of Buffalo, Buffalo, New York, USA
| | - Bret Goodpaster
- Florida Hospital Translational Institute for Metabolism and Diabetes and Sanford Burnham Medical Research Institute, Orlando, Florida, USA
| | - Kevin D. Hall
- Laboratory of Biological Modeling, Integrative Physiology Section, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Barry E. Levin
- Department of Neurology and Neurosciences, Rutgers-New Jersey Medical School, Neurology Service, East Orange VA Medical Center, East Orange, New Jersey, USA
| | - Michael G. Perri
- College of Public Health and Health Professions, Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Barbara J. Rolls
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Michael Rosenbaum
- Department of Pediatrics, Columbia University, New York, New York, USA
| | | | - Donna Ryan
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
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Harbron J, van der Merwe L, Zaahl MG, Kotze MJ, Senekal M. Fat mass and obesity-associated (FTO) gene polymorphisms are associated with physical activity, food intake, eating behaviors, psychological health, and modeled change in body mass index in overweight/obese Caucasian adults. Nutrients 2014; 6:3130-52. [PMID: 25102252 PMCID: PMC4145299 DOI: 10.3390/nu6083130] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 06/30/2014] [Accepted: 07/16/2014] [Indexed: 01/24/2023] Open
Abstract
The fat mass and obesity-associated (FTO) gene is currently recognized as the most robust predictor of polygenic obesity. We investigated associations between the FTO rs1421085 and rs17817449 polymorphisms and the FTO rs1421085–rs17817449 haplotype and dietary intake, eating behavior, physical activity, and psychological health, as well as the effect of these associations on BMI. N = 133 treatment seeking overweight/obese Caucasian adults participated in this study. Genotyping was performed from whole blood samples. Weight and height was measured and a non-quantified food frequency questionnaire was completed to assess food group intake. Validated questionnaires were completed to assess physical activity (Baecke questionnaire), psychological health (General Health questionnaire, Rosenburg self-esteem scale and Beck Depression Inventory), and eating behavior (Three Factor Eating questionnaire). The risk alleles of the FTO polymorphisms were associated with poorer eating behaviors (higher hunger, internal locus for hunger, and emotional disinhibition scores), a higher intake of high fat foods and refined starches and more depressive symptoms. The modeled results indicate that interactions between the FTO polymorphisms or haplotypes and eating behavior, psychological health, and physical activity levels may be associated with BMI. The clinical significance of these results for implementation as part of weight management interventions needs further investigation.
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Affiliation(s)
- Janetta Harbron
- Division of Human Nutrition, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Private Bag X3, Observatory 7925, South Africa.
| | - Lize van der Merwe
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa.
| | - Monique G Zaahl
- Department of Genetics, Faculty of Sciences, Stellenbosch University, Private Bag X1, Matieland 7602, South Africa.
| | - Maritha J Kotze
- Division of Anatomical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, P.O. Box 19063, Tygerberg 7505, South Africa.
| | - Marjanne Senekal
- Division of Human Nutrition, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Private Bag X3, Observatory 7925, South Africa.
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Kulovitz MG, Kolkmeyer D, Conn CA, Cohen DA, Ferraro RT. Medical weight loss versus bariatric surgery: Does method affect body composition and weight maintenance after 15% reduction in body weight? Nutrition 2014; 30:49-54. [DOI: 10.1016/j.nut.2013.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 06/10/2013] [Accepted: 06/11/2013] [Indexed: 12/17/2022]
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Buscemi S, Castellini G, Batsis JA, Ricca V, Sprini D, Galvano F, Grosso G, Rosafio G, Caravello M, Rini GB. Psychological and behavioural factors associated with long-term weight maintenance after a multidisciplinary treatment of uncomplicated obesity. Eat Weight Disord 2013; 18:351-8. [PMID: 24022273 DOI: 10.1007/s40519-013-0059-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Accepted: 08/21/2013] [Indexed: 02/06/2023] Open
Abstract
Obesity is a multifactorial syndrome and the likelihood of success of a medical nutritional treatment (MNT) over the long term is low. As psychological and behavioural factors have an important role in both pathogenesis and the treatment of obesity, these issues were investigated in individuals with obesity who reported a long-term success or a failure in terms of weight loss following a MNT. Eighty-eight individuals of an original cohort of 251 subjects were re-evaluated 10 years after a MNT with cognitive-behavioural approach for uncomplicated obesity. Fifty-three participants were classified as failure (body weight change ≥0.5 kg) and 35 as a success (10-year body weight change <0.5 kg) of the MNT. Prior to the beginning of the weight-management program, both the Dieting Readiness Test (DRT) and the Hospital Anxiety and Depression Scale (HADS) were administered. At a 10-year follow-up after the MNT, self-reported questionnaires were administered: quality of life was assessed by the Obesity Related Well-Being (ORWELL 97) questionnaire, eating attitudes and behaviours by the Eating Disorder Examination Questionnaire (EDE-Q), the Binge Eating Scale (BES) investigated the presence and severity of binge eating and the Symptom Checklist (SCL 90-R) was used to identify the psychopathological distress. The scores of the ORWELL 97 items concerning symptoms (P = 0.005), discomfort (P = 0.03) and the total score (P = 0.02) were significantly lower in the success group. The depression score of the HADS was positively correlated with the percentage of body weight change observed 10 years after the MNT (r = 0.22; P = 0.045). The scores of the shape concern (EDE-Q) (r = 0.35; P = 0.013) and of the discomfort (ORWELL 97) (r = 0.36; P = 0.012) were significantly correlated with the percentage of body weight change 10 years after the MNT. In conclusion, this study is in agreement with the possibility that the psychological quality of life is associated even with modest amounts of weight loss in the long run. Further research should support identifying successful predictors of weight loss.
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Kent L, Morton D, Hurlow T, Rankin P, Hanna A, Diehl H. Long-term effectiveness of the community-based Complete Health Improvement Program (CHIP) lifestyle intervention: a cohort study. BMJ Open 2013; 3:e003751. [PMID: 24259389 PMCID: PMC3840335 DOI: 10.1136/bmjopen-2013-003751] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To examine the long-term (three or more years) effectiveness of the volunteer-delivered Complete Health Improvement Program (CHIP) intervention. DESIGN Cohort study. SETTING Hawera, New Zealand. PARTICIPANTS Of the total cohort of 284 individuals who self-selected to complete the CHIP lifestyle intervention between 2007 and 2009, 106 (37% of the original cohort, mean age=64.9±7.4 years, range 42-87 years; 35% males, 65% female) returned in 2012 for a complimentary follow-up health assessment (mean follow-up duration=49.2+10.4 months). INTERVENTION 30-day lifestyle modification programme (diet, physical activity, substance use and stress management) delivered by volunteers in a community setting. MAIN OUTCOME MEASURES Changes in body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP), fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides (TG). RESULTS After approximately 4 years, participants with elevated biometrics at programme entry maintained significantly lowered BMI (-3.2%; 34.8±5.4 vs 33.7±5.3 kg/m(2), p=0.02), DBP (-9.4%; 89.1±4.1 vs 80.8±12.6 mm Hg, p=0.005), TC (-5.5%; 6.1±0.7 vs 5.8±1.0 mmol/L, p=0.04) and TG (-27.5%; 2.4±0.8 vs 1.7±0.7 mmol/L, p=0.002). SBP, HDL, LDL and FPG were not significantly different from baseline. Participants with elevated baseline biometrics who reported being compliant to the lifestyle principles promoted in the intervention (N=71, 67% of follow-up participants) recorded further reductions in BMI (-4.2%; 34.8±4.5 vs 33.4±4.8 kg/m(2), p=0.02), DBP (-13.3%; 88.3±3.2 vs 77.1±12.1 mm Hg, p=0.005) and FPG (-10.4%; 7.0±1.5 vs 6.3±1.3 mmol/L, p=0.02). CONCLUSIONS Individuals who returned for follow-up assessment and entered the CHIP lifestyle intervention with elevated risk factors were able to maintain improvements in most biometrics for more than 3 years. The results suggest that the community-based CHIP lifestyle intervention can be effective in the longer term, even when delivered by volunteers.
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Affiliation(s)
- Lillian Kent
- Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, New South Wales, Australia
| | - Darren Morton
- Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, New South Wales, Australia
| | - Trevor Hurlow
- Waratah Medical Services, Morisset, New South Wales, Australia
| | - Paul Rankin
- Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, New South Wales, Australia
| | - Althea Hanna
- Department of Health, New Zealand Pacific Union Conference, Auckland, New Zealand
| | - Hans Diehl
- Lifestyle Medicine Institute, Loma Linda, California, USA
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French SA, Mitchell NR, Wolfson J, Finlayson G, Blundell JE, Jeffery RW. Questionnaire and laboratory measures of eating behavior. Associations with energy intake and BMI in a community sample of working adults. Appetite 2013; 72:50-8. [PMID: 24096082 DOI: 10.1016/j.appet.2013.09.020] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 09/19/2013] [Accepted: 09/20/2013] [Indexed: 11/15/2022]
Abstract
PURPOSE The present research compared a self-report measure of usual eating behaviors with two laboratory-based behavioral measures of food reward and food preference. METHODS Eating behaviors were measured among 233 working adults. A self-report measure was the Three Factor Eating Questionnaire (TFEQ) Restraint, Disinhibition and Hunger subscales. Laboratory measures were the (RVF) and Explicit Liking (EL) and Implicit Wanting (IW) for high fat food. Outcome measures were body mass index (BMI), and energy intake measured using three 24-h dietary recalls. RESULTS Significant bivariate associations were observed between each of the eating behavior measures and energy intake, but only Disinhibition and Hunger were associated with BMI. Multiple regression results showed RVF and EL and IW predicted energy intake independent of the TFEQ scales but did not predict BMI. CONCLUSION Laboratory and self-report measures capture unique aspects of individual differences in eating behaviors that are associated with energy intake.
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Affiliation(s)
- Simone A French
- University of Minnesota, School of Public Health, Division of Epidemiology & Community Health, Minneapolis, MN, USA; Division of Epidemiology & Community Health, 1300 South 2nd St, #300, Minneapolis, MN 55454, USA.
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Stubbs RJ, Lavin JH. The challenges of implementing behaviour changes that lead to sustained weight management. NUTR BULL 2013. [DOI: 10.1111/nbu.12002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- R. J. Stubbs
- Nutrition and Research Department; Slimming World; Derbyshire; UK
| | - J. H. Lavin
- Nutrition and Research Department; Slimming World; Derbyshire; UK
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Hoevenaars FPM, Keijer J, Swarts HJ, Snaas-Alders S, Bekkenkamp-Grovenstein M, van Schothorst EM. Effects of dietary history on energy metabolism and physiological parameters in C57BL/6J mice. Exp Physiol 2012; 98:1053-62. [PMID: 23243145 DOI: 10.1113/expphysiol.2012.069518] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Understanding body weight regulation is essential to fight obesity. Mouse studies, using different types of diets, showed conflicting results in terms of body weight persistence after changing from an ad libitum high-fat diet to an ad libitum low-fat diet. In this study, we questioned specifically whether the energy content of the diet has a lasting effect on energy balance and body weight, using multiple switches and two purified diets with a different fat-to-sugar ratio, but otherwise identical ingredients. Young-adult obesity-prone male C57BL/6J mice were fed single or double switches of semi-purified diets with either 10 energy % (en%) fat (LF) or 40en% fat (HF), with starch replaced by fat, while protein content remained equal. After none, one or two dietary changes, energy metabolism was assessed at 5, 14 and 19 weeks. We observed no systematic continuous compensation in diet and energy intake when returning to LF after HF consumption. Body weight, white adipose tissue mass and histology, serum metabolic parameters, energy expenditure and substrate usage all significantly reflected the current diet intake, independent of dietary changes. This contrasts with studies that used diets with different ingredients and showed persistent effects of dietary history on body weight, suggesting diet-dependent metabolic set points. We conclude that body weight and metabolic parameters 'settle', based on current energetic input and output. This study also highlights the importance of considering the choice of diet in physiological and metabolic intervention studies.
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Affiliation(s)
- Femke P M Hoevenaars
- Human and Animal Physiology, Wageningen University, De Elst 1, 6708 WD Wageningen, PO Box 338, 6700AH Wageningen, The Netherlands
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Cappello G, Franceschelli A, Cappello A, De Luca P. Ketogenic enteral nutrition as a treatment for obesity: short term and long term results from 19,000 patients. Nutr Metab (Lond) 2012; 9:96. [PMID: 23110922 PMCID: PMC3557201 DOI: 10.1186/1743-7075-9-96] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 10/10/2012] [Indexed: 12/25/2022] Open
Abstract
Background Only protein diet has been used successfully to prevent loss of lean body mass first in post-surgical and then in obese patients. We studied overweight and obese patients receiving short treatments of an exclusively protein-based nutritional solution as 24-hour enteral infusion. Methods 19,036 patients (age 44.3 ± 13, M:F = 2:5) with an initial body mass index of 36.5 ± 7.1 underwent 10-day cycles of enteral nutrition through a fine nasogastric tube. The nutritional solution consisted solely of 50–65 g of proteins, plus vitamins and electrolytes. The 24-hour infusion was controlled with a small portable pump. Before and after each 10-day cycle body composition was checked with a Handy 3000 impedance analyzer. At the onset of treatment, average fat mass was 40.9 ± 12.8 kg while body cell mass was 42.7 ± 7.2 kg in males and 27.4 ± 4.6 kg in females. Results After an average of 2.5 cycles the patients lost 10.2 ± 7.0 kg of body weight, 5.8 ± 5.5 kg of fat mass and 2.2 ± 3.3 kg of body cell mass. No significant adverse effects were recorded except asthenia and constipation which were easily controlled with therapy. Long-term results were obtained from 15,444 patients and after an average of 362 ± 296 days we found a mean weight regain of 15.4%. Conclusion Ketogenic Enteral Nutrition treatment of over 19,000 patients induced a rapid 10% weight loss, 57% of which was Fat Mass. No significant adverse effects were found. The treatment is safe, fast, inexpensive and has good one-year results for weight maintenance.
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Affiliation(s)
- Gianfranco Cappello
- Clinical Nutrition Service of the Department of Surgery Paride Stefanini, University of Rome La Sapienza, Rome, Italy.
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French SA, Epstein LH, Jeffery RW, Blundell JE, Wardle J. Eating behavior dimensions. Associations with energy intake and body weight. A review. Appetite 2012; 59:541-9. [PMID: 22796186 PMCID: PMC3454469 DOI: 10.1016/j.appet.2012.07.001] [Citation(s) in RCA: 219] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 06/27/2012] [Accepted: 07/01/2012] [Indexed: 01/25/2023]
Abstract
The purpose of this review is to spark integrative thinking in the area of eating behaviors by critically examining research on exemplary constructs in this area. The eating behaviors food responsiveness, enjoyment of eating, satiety responsiveness, eating in the absence of hunger, reinforcing value of food, eating disinhibition and impulsivity/self-control are reviewed in relation to energy intake, body mass index and weight gain over time. Each of these constructs has been developed independently, and little research has explored the extent to which they overlap or whether they differentially predict food choices, energy intake and weight gain in the naturalistic environment. Most available data show positive cross-sectional associations with body mass index, but fewer studies report associations with energy intake or food choices. Little prospective data are available to link measures of eating behaviors with weight gain. Disinhibition has the largest and most consistent body of empirical data that link it prospectively with weight gain. An overarching conceptual model to integrate the conceptual and empirical research base for the role of eating behavior dimensions in the field of obesity research would highlight potential patterns of interaction between individual differences in eating behaviors, specific aspects of the individual's food environment and individual variation in state levels of hunger and satiety.
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Affiliation(s)
- Simone A French
- Division of Epidemiology & Community Health, University of Minnesota, 1300 South 2nd St, Minneapolis, MN 55454, USA.
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Lesdéma A, Fromentin G, Daudin JJ, Arlotti A, Vinoy S, Tome D, Marsset-Baglieri A. Characterization of the Three-Factor Eating Questionnaire scores of a young French cohort. Appetite 2012; 59:385-90. [DOI: 10.1016/j.appet.2012.05.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 05/24/2012] [Accepted: 05/27/2012] [Indexed: 11/15/2022]
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Abstract
The majority of US adults are overweight or obese, which is a primary risk factor for type 2 diabetes and other chronic diseases. Recent advances in behavioral treatment of obesity have produced significant short- and long-term weight losses that reduce the risk of type 2 diabetes and cardiovascular disease. This article reviews key components of effective behavioral treatment interventions, including diet, exercise, and behavioral and psychosocial strategies. The authors review newer treatment modalities that may enhance dissemination (Internet, smartphone) and discuss applications to clinical practice. Practitioners face multiple barriers to effectively delivering lifestyle interventions in today’s health care setting but, nonetheless, remain powerful motivators in helping patients initiate and maintain weight loss efforts that reduce the risk of type 2 diabetes and other chronic diseases.
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Affiliation(s)
- Todd Alan Hagobian
- California Polytechnic State University, Kinesiology Department, San Luis Obispo, CA
| | - Suzanne Phelan
- California Polytechnic State University, Kinesiology Department, San Luis Obispo, CA
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How dieting makes some fatter: from a perspective of human body composition autoregulation. Proc Nutr Soc 2012; 71:379-89. [PMID: 22475574 DOI: 10.1017/s0029665112000225] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Dieting makes you fat - the title of a book published in 1983 - embodies the notion that dieting to control body weight predisposes the individual to acquire even more body fat. While this notion is controversial, its debate underscores the large gap that exists in our understanding of basic physiological laws that govern the regulation of human body composition. A striking example is the key role attributed to adipokines as feedback signals between adipose tissue depletion and compensatory increases in food intake. Yet, the relative importance of fat depletion per se as a determinant of post-dieting hyperphagia is unknown. On the other hand, the question of whether the depletion of lean tissues can provide feedback signals on the hunger-appetite drive is rarely invoked, despite evidence that food intake during growth is dominated by the impetus for lean tissue deposition, amidst proposals for the existence of protein-static mechanisms for the regulation of growth and maintenance of lean body mass. In fact, a feedback loop between fat depletion and food intake cannot explain why human subjects recovering from starvation continue to overeat well after body fat has been restored to pre-starvation values, thereby contributing to 'fat overshooting'. In addressing the plausibility and mechanistic basis by which dieting may predispose to increased fatness, this paper integrates the results derived from re-analysis of classic longitudinal studies of human starvation and refeeding. These suggest that feedback signals from both fat and lean tissues contribute to recovering body weight through effects on energy intake and thermogenesis, and that a faster rate of fat recovery relative to lean tissue recovery is a central outcome of body composition autoregulation that drives fat overshooting. A main implication of these findings is that the risk of becoming fatter in response to dieting is greater in lean than in obese individuals.
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Yaman M, Ucok K, Demirbas H, Genc A, Oruc S, Karabacak H, Koyuncu G. Effects of topiramate use on body composition and resting metabolic rate in migraine patients. Neurol Sci 2012; 34:225-9. [DOI: 10.1007/s10072-012-0977-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 02/09/2012] [Indexed: 10/28/2022]
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