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Zeng H, Tian Q, Wang C, Zhu X, Li W, Guo H, Zhang Z, Wu X. Cel-CS1K: A Celastrol-Chitosan Conjugate for Treating Diet-Induced Obesity. Chem Res Toxicol 2024; 37:944-956. [PMID: 38771988 DOI: 10.1021/acs.chemrestox.4c00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2024]
Abstract
Celastrol (Cel), extracted from Tripterygium wilfordii Hook, is a potential antiobesity drug, except for its adverse reactions in clinic. In the present study, we synthesized a promising celastrol-chitosan conjugate (Cel-CS1K) and evaluated its antiobesity effect and biological safety in diet-induced obese mice. Cel-CS1K showed higher drug loading (over 10 wt %), good solubility (18-19 mg/mL) in water, slower peak time (Tmax = 4 h), and clearance (T1/2 = 8.97 h) in rats. Cel-CS1K effectively attenuated the cytotoxicity, celastrol-induced apoptosis, and fat accumulation of hepatocytes. Cel-CS1K reduced body weight and dietary amount same as the free Cel but with lower toxicity in blood, liver, and testis. Cel-CS1K improved the glucose homeostasis, HDL-C level, insulin sensitivity, and leptin sensitivity, while it significantly reduced the gene expression levels of LDL-C, TG, and TC in obese mice. Furthermore, the adipose-related gene expression levels provided evidence in support of a role for Cel-CS1K in losing weight by the multimode regulation. Overall, Cel-CS1K provides a translatable therapeutic strategy for the treatment of diet-induced obese humans.
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Affiliation(s)
- Huahui Zeng
- Academy of Chinese Medicine Science, Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - Qikang Tian
- Academy of Chinese Medicine Science, Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - Can Wang
- Collaborative Innovation Center of Research and Development on the Whole Industry Chain of Yu-Yao, Zhengzhou Henan 450046, China
| | - Xin Zhu
- Collaborative Innovation Center of Research and Development on the Whole Industry Chain of Yu-Yao, Zhengzhou Henan 450046, China
| | - Wenyang Li
- Collaborative Innovation Center of Research and Development on the Whole Industry Chain of Yu-Yao, Zhengzhou Henan 450046, China
| | - Hang Guo
- Collaborative Innovation Center of Research and Development on the Whole Industry Chain of Yu-Yao, Zhengzhou Henan 450046, China
| | - Zhenqiang Zhang
- Academy of Chinese Medicine Science, Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - Xiangxiang Wu
- Academy of Chinese Medicine Science, Henan University of Chinese Medicine, Zhengzhou 450046, China
- Collaborative Innovation Center of Research and Development on the Whole Industry Chain of Yu-Yao, Zhengzhou Henan 450046, China
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ElSayed NA, Aleppo G, Bannuru RR, Bruemmer D, Collins BS, Ekhlaspour L, Hilliard ME, Johnson EL, Khunti K, Kushner RF, Lingvay I, Matfin G, McCoy RG, Perry ML, Pilla SJ, Polsky S, Prahalad P, Pratley RE, Segal AR, Seley JJ, Stanton RC, Gabbay RA. 8. Obesity and Weight Management for the Prevention and Treatment of Type 2 Diabetes: Standards of Care in Diabetes-2024. Diabetes Care 2024; 47:S145-S157. [PMID: 38078578 PMCID: PMC10725806 DOI: 10.2337/dc24-s008] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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3
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Shagdarova B, Konovalova M, Varlamov V, Svirshchevskaya E. Anti-Obesity Effects of Chitosan and Its Derivatives. Polymers (Basel) 2023; 15:3967. [PMID: 37836016 PMCID: PMC10575173 DOI: 10.3390/polym15193967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
The number of obese people in the world is rising, leading to an increase in the prevalence of type 2 diabetes and other metabolic disorders. The search for medications including natural compounds for the prevention of obesity is an urgent task. Chitosan polysaccharide obtained through the deacetylation of chitin, and its derivatives, including short-chain oligosaccharides (COS), have hypolipidemic, anti-inflammatory, anti-diabetic, and antioxidant properties. Chemical modifications of chitosan can produce derivatives with increased solubility under neutral conditions, making them potential therapeutic substances for use in the treatment of metabolic disorders. Multiple studies both in animals and clinical trials have demonstrated that chitosan improves the gut microbiota, restores intestinal barrier dysfunction, and regulates thermogenesis and lipid metabolism. However, the effect of chitosan is rather mild, especially if used for a short periods, and is mostly independent of chitosan's physical characteristics. We hypothesized that the major mechanism of chitosan's anti-obesity effect is its flocculant properties, enabling it to collect the chyme in the gastrointestinal tract and facilitating the removal of extra food. This review summarizes the results of the use of COS, chitosan, and its derivatives in obesity control in terms of pathways of action and structural activity.
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Affiliation(s)
- Balzhima Shagdarova
- Research Center of Biotechnology, Russian Academy of Sciences, 119071 Moscow, Russia;
| | - Mariya Konovalova
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry of the Russian Academy of Sciences, 117997 Moscow, Russia;
| | - Valery Varlamov
- Research Center of Biotechnology, Russian Academy of Sciences, 119071 Moscow, Russia;
| | - Elena Svirshchevskaya
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry of the Russian Academy of Sciences, 117997 Moscow, Russia;
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Nazari M, Jalili M, As'habi A. Conjugated linoleic acid and L-carnitine combination effects on obesity-related miRNAs in diet-induced obese rats. Obes Res Clin Pract 2023; 17:378-382. [PMID: 37634961 DOI: 10.1016/j.orcp.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/01/2023] [Accepted: 08/21/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVES Obesity is a major global health issue, resulting in significant costs and increased mortality rates. Finding effective treatments for obesity is therefore essential. This study investigated the combined effects of L-Carnitine (LC) and Conjugated Linoleic Acid (CLA) on weight loss and adipose tissue microRNA levels. SUBJECTS /METHODS Forty male Wistar rats weighing 150-200 g and about 8 weeks old were fed either a normal fat diet (NFD) or a high-fat diet (HFD) for 8 weeks. Afterwards, the HFD group was randomly divided into four subgroups: control, LC (200 mg kg-1), CLA (500 mg kg-1), and both (n = 8 in each group). The study lasted for an additional 4 weeks. The animals' weights were recorded regularly, and after 12 weeks, miRNAs were extracted from epididymal adipose tissue and analysed using real-time PCR. The miRNA expression levels of miR-27a and miR-143 were compared between groups using Kolmogorov-Smirnov and one-way ANOVA tests in SPSS software. RESULTS At the end of the first 8 weeks, the HFD group weighed significantly more than the NFD group. LC significantly decreased weight gain (4.2%) compared to the control group, whereas CLA alone (3.5%) or in combination with LC (3.1%) did not significantly slow weight gain. Real-time PCR results showed that the HFD group had higher miR-143 levels and lower miR-27a levels compared to the NFD group. LC and CLA increased miR-27a expression after 4 weeks, but their combination decreased miR-27a expression. CLA alone reduced miR-143 expression, whereas LC had almost no effect. Their combination also reduced miR-143 expression. CONCLUSION CLA and LC, which are considered weight loss supplements, can potentially regulate metabolism and cellular pathways. However, their combination did not show a synergistic effect on weight loss, possibly due to the reduction in miR-27a expression. Further studies are needed to evaluate the effects of combined fat burners on obesity treatment.
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Affiliation(s)
- Maryam Nazari
- Food Safety Research Center (Salt), Semnan University of Medical Sciences, Semnan, Iran.
| | - Mahsa Jalili
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark.
| | - Atefeh As'habi
- Food Safety Research Center (Salt), Semnan University of Medical Sciences, Semnan, Iran.
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Ueno H, Haraguchi N, Azuma M, Shiiya T, Noda T, Ebihara E, Uehira Y, Uchida T, Sasaba K, Nakamura M, Uchimura N, Kita E, Umemura A, Nobe T, Sumoto E, Yano Y, Nakazato M. Active Consumption of Konjac and Konjac Products Improves Blood Glucose Control in Patients with Type 2 Diabetes Mellitus. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:123-129. [PMID: 34843410 DOI: 10.1080/07315724.2021.2002739] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Konjac is a food mainly consumed in Asian countries with high fiber and low energy. Although glucomannan, a component of konjac, have been used for several clinical studies, there is few reports using konjac itself. This study examined the effects of the active consumption of konjac in patients with type 2 diabetes mellitus (T2DM). METHODS The study included 26 Japanese patients with T2DM. Participants were recommended to take konjac at least once a day using free konjac products (various noodles, rice, and desserts) and plate konjac for 12 weeks. RESULTS HbA1c and fasting plasma glucose levels significantly decreased from 8.3 ± 0.9% to 8.0 ± 0.8% and from 173.2 ± 44.4 to 152.8 ± 36.7 mg/dL, respectively. No significant changes were observed in body weight and insulin resistance indices, but the index for insulin secretion significantly increased. Serum high molecular weight adiponectin levels significantly increased. Plasma ghrelin, leptin and glucagon-like peptide-1 levels tended to decrease (p = 0.084), decrease (p = 0.057) and increase (p = 0.071), respectively. Actual konjac intake positively correlated with age (r = 0.61, p = 0.001). Body weight and HbA1c significantly decreased in patients aged ≥50 years than in those aged <50 years, and the changes significantly inversely correlated with age. CONCLUSION Active consumption of konjac and konjac products seems to be a useful dietary therapy with multifaceted action for T2DM. Further studies with greater sample size and long-term are needed to confirm these findings.
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Affiliation(s)
- Hiroaki Ueno
- Division of Neurology, Respirology, Endocrinology and Metabolism, Faculty of Medicine, Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan
| | - Naoki Haraguchi
- Faculty of Medicine, Department of Nutrition Management, University of Miyazaki Hospital, Miyazaki, Japan
| | - Mayumi Azuma
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Tomomi Shiiya
- Department of Internal Medicine, Koga General Hospital, Miyazak, Japan
| | - Tomoho Noda
- Division of Neurology, Respirology, Endocrinology and Metabolism, Faculty of Medicine, Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan
| | - Emi Ebihara
- Division of Neurology, Respirology, Endocrinology and Metabolism, Faculty of Medicine, Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan
| | - Yudai Uehira
- Division of Neurology, Respirology, Endocrinology and Metabolism, Faculty of Medicine, Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan
| | - Taisuke Uchida
- Division of Neurology, Respirology, Endocrinology and Metabolism, Faculty of Medicine, Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan
| | - Keiko Sasaba
- Faculty of Medicine, Department of Nutrition Management, University of Miyazaki Hospital, Miyazaki, Japan
| | - Miyo Nakamura
- Faculty of Medicine, Department of Nutrition Management, University of Miyazaki Hospital, Miyazaki, Japan
| | - Naho Uchimura
- Faculty of Medicine, Department of Nutrition Management, University of Miyazaki Hospital, Miyazaki, Japan
| | - Emiko Kita
- Faculty of Medicine, Department of Nutrition Management, University of Miyazaki Hospital, Miyazaki, Japan
| | - Akemi Umemura
- Faculty of Medicine, Department of Nutrition Management, University of Miyazaki Hospital, Miyazaki, Japan
| | - Tomoko Nobe
- Faculty of Medicine, Department of Nutrition Management, University of Miyazaki Hospital, Miyazaki, Japan
| | - Eri Sumoto
- Faculty of Medicine, Department of Nutrition Management, University of Miyazaki Hospital, Miyazaki, Japan
| | - Yui Yano
- Faculty of Medicine, Department of Nutrition Management, University of Miyazaki Hospital, Miyazaki, Japan
| | - Masamitsu Nakazato
- Division of Neurology, Respirology, Endocrinology and Metabolism, Faculty of Medicine, Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan
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ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, Collins BS, Hilliard ME, Isaacs D, Johnson EL, Kahan S, Khunti K, Leon J, Lyons SK, Perry ML, Prahalad P, Pratley RE, Seley JJ, Stanton RC, Gabbay RA. 8. Obesity and Weight Management for the Prevention and Treatment of Type 2 Diabetes: Standards of Care in Diabetes-2023. Diabetes Care 2023; 46:S128-S139. [PMID: 36507637 PMCID: PMC9810466 DOI: 10.2337/dc23-s008] [Citation(s) in RCA: 81] [Impact Index Per Article: 81.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Mah E, Chen O, Liska DJ, Blumberg JB. Dietary Supplements for Weight Management: A Narrative Review of Safety and Metabolic Health Benefits. Nutrients 2022; 14:nu14091787. [PMID: 35565754 PMCID: PMC9099655 DOI: 10.3390/nu14091787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 12/15/2022] Open
Abstract
Dietary supplements for weight management include myriad ingredients with thermogenic, lipotropic, satiety, and other metabolic effects. Recently, the safety of this product category has been questioned. In this review, we summarize the safety evidence as well as relevant clinical findings on weight management and metabolic effects of six representative dietary supplement ingredients: caffeine, green tea extract (GTE), green coffee bean extract (GCBE), choline, glucomannan, and capsaicinoids and capsinoids. Of these, caffeine, GTE (specifically epigallocatechin gallate [EGCG]), and choline have recommended intake limits, which appear not to be exceeded when used according to manufacturers’ instructions. Serious adverse events from supplements with these ingredients are rare and typically involve unusually high intakes. As with any dietary component, the potential for gastrointestinal intolerance, as well as possible interactions with concomitant medications/supplements exist, and the health status of the consumer should be considered when consuming these components. Most of the ingredients reviewed also improved markers of metabolic health, such as glucose, lipids, and blood pressure, although the data are limited for some. In summary, weight management supplements containing caffeine, GTE, GCBE, choline, glucomannan, and capsaicinoids and capsinoids are generally safe when taken as directed and demonstrate metabolic health benefits for overweight and obese people.
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Affiliation(s)
- Eunice Mah
- Biofortis Research, Addison, IL 60101, USA
- Correspondence:
| | - Oliver Chen
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA; (O.C.); (J.B.B.)
| | | | - Jeffrey B. Blumberg
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA; (O.C.); (J.B.B.)
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García-Cordero J, Sierra-Cinos JL, Seguido MA, González-Rámila S, Mateos R, Bravo-Clemente L, Sarriá B. Regular Consumption of Green Coffee Phenol, Oat β-Glucan and Green Coffee Phenol/Oat β-Glucan Supplements Does Not Change Body Composition in Subjects with Overweight and Obesity. Foods 2022; 11:foods11050679. [PMID: 35267313 PMCID: PMC8909742 DOI: 10.3390/foods11050679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 02/04/2023] Open
Abstract
Many in vitro and in vivo studies support that green coffee polyphenols (GCP) and beta-glucans (BG) present important hypolipidaemic and hypoglycaemic effects. However, their weight-management/-reducing properties are less clear. Considering that these compounds act on different metabolic pathways, their combination could increase their beneficial health effects. The aim of the present study was to investigate the effects of regularly consuming supplements containing GCP, BG or the novel GCP/BG combination on body composition in overweight/obese subjects without changing their dietary and physical activity habits, hence addressing the difficulty to adapt to lifestyle changes. A randomised, cross-over, blind trial was carried out in 29 volunteers who consumed GCP (300 mg), BG (2.5 g) or GCP/BG (300 mg + 2.5 g) twice a day for 8 weeks. At the beginning and end of each of the interventions, body weight, body mass index, body fat%, intracellular and extracellular water, skinfolds (tricipital, bicipital, subscapularis, suprailiac, leg and thigh) and body circumferences (waist, hip, thigh, calf, branchial) were measured. Along the study, volunteers filled out 72 h dietary records, and physical activity was measured using accelerometers. The results show that dietary intake and physical activity were unchanged throughout the study; however, there were no changes in any of the body composition parameters analysed with any of the food supplements. In conclusion, the regular intake of GCP, BG and GCP/BG, without changes in diet and physical activity, is not an efficient strategy to lose weight or induce other positive changes in body composition, although results should be taken with caution as the study was underpowered.
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Affiliation(s)
- Joaquín García-Cordero
- Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), Spanish National Research Council (CSIC), José Antonio Nováis 10, 28040 Madrid, Spain; (J.G.-C.); (M.A.S.); (S.G.-R.); (R.M.); (L.B.-C.)
| | - José Luis Sierra-Cinos
- Department of Nutrition and Food Science I, School of Pharmacy, Complutense University of Madrid (UCM), Ciudad Universitaria, s/n, 28040 Madrid, Spain
- Department of Health Science, School of Health Science, Isabel I International University of Burgos (Ui1), 76 Fernán González St., 09003 Burgos, Spain
- Correspondence: (B.S.); (J.L.S.-C.); Tel.: +34-915492300 (B.S.); +34-913941810 (J.L.S.-C.)
| | - Miguel A. Seguido
- Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), Spanish National Research Council (CSIC), José Antonio Nováis 10, 28040 Madrid, Spain; (J.G.-C.); (M.A.S.); (S.G.-R.); (R.M.); (L.B.-C.)
| | - Susana González-Rámila
- Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), Spanish National Research Council (CSIC), José Antonio Nováis 10, 28040 Madrid, Spain; (J.G.-C.); (M.A.S.); (S.G.-R.); (R.M.); (L.B.-C.)
| | - Raquel Mateos
- Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), Spanish National Research Council (CSIC), José Antonio Nováis 10, 28040 Madrid, Spain; (J.G.-C.); (M.A.S.); (S.G.-R.); (R.M.); (L.B.-C.)
| | - Laura Bravo-Clemente
- Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), Spanish National Research Council (CSIC), José Antonio Nováis 10, 28040 Madrid, Spain; (J.G.-C.); (M.A.S.); (S.G.-R.); (R.M.); (L.B.-C.)
| | - Beatriz Sarriá
- Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), Spanish National Research Council (CSIC), José Antonio Nováis 10, 28040 Madrid, Spain; (J.G.-C.); (M.A.S.); (S.G.-R.); (R.M.); (L.B.-C.)
- Correspondence: (B.S.); (J.L.S.-C.); Tel.: +34-915492300 (B.S.); +34-913941810 (J.L.S.-C.)
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8. Obesity and Weight Management for the Prevention and Treatment of Type 2 Diabetes: Standards of Medical Care in Diabetes-2022. Diabetes Care 2022; 45:S113-S124. [PMID: 34964843 DOI: 10.2337/dc22-s008] [Citation(s) in RCA: 99] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc22-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc22-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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10
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Kyle TK, Stanford FC. Moving Toward Health Policy that Respects Both Science and People Living with Obesity. Nurs Clin North Am 2021; 56:635-645. [PMID: 34749901 PMCID: PMC8592383 DOI: 10.1016/j.cnur.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Through four decades of rising obesity, health policy has been mostly ineffective. Prevention policies failed to reverse rising trends in prevalence, partly because they are often based on biased mental models about what should work to prevent obesity, rather than empiric evidence for what does work. Bias toward people living with obesity harms health, while contributing to poor access to effective care that might serve to improve it. Better public policy will come from an increased application of objective obesity science, research to fill knowledge gaps, and respect for the human dignity of people who live with obesity.
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Affiliation(s)
- Theodore K Kyle
- ConscienHealth, 2270 Country Club Drive, Pittsburgh, PA 15241, USA.
| | - Fatima Cody Stanford
- Department of Medicine, Division of Endocrinology-Neuroendocrine, Massachusetts General Hospital, MGH Weight Center, 50 Staniford Street, Boston, MA 02114, USA; Department of Pediatrics, Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), 50 Staniford Street, Boston, MA 02114, USA
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11
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[Obesity treatment-legal and illegal drugs and the future]. Internist (Berl) 2021; 62:1354-1359. [PMID: 34591131 DOI: 10.1007/s00108-021-01159-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
Obesity and its comorbidities represent a worldwide growing health challenge. In Germany, at least 15 million people are suffering from this disease. To date, lifestyle modification is the most frequently used treatment modality, but offers only limited success concerning both the extent and the sustainability of weight loss, while surgical interventions are restricted to people with severe obesity (body mass index ≥40 kg/m2). For this reason, there are huge efforts to develop pharmacological options for better and clinically meaningful weight management. At present, only a few compounds (orlistat, liraglutide, amfepramon) are available for adjunct drug treatment of obesity in Germany. However, new principles and compounds that could revolutionize obesity management in the years to come are on the horizon. For alternative "slimming drugs", mainly dietary supplements, scientific evidence is lacking on efficacy or clinically meaningful weight loss.
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