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Guerrero-Magaña DE, Urquijo-Ruiz LG, Ruelas-Yanes AL, Martínez-Contreras TDJ, Díaz-Zavala RG, Candia-Plata MDC, Esparza-Romero J, Haby MM. Interventions for the prevention of weight gain during festive and holiday periods in children and adults: A systematic review. Obes Rev 2024:e13836. [PMID: 39275907 DOI: 10.1111/obr.13836] [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: 01/16/2024] [Revised: 08/24/2024] [Accepted: 08/30/2024] [Indexed: 09/16/2024]
Abstract
Some periods during the year, such as festive and summer holiday periods, have been associated with weight gain. We aimed to assess the effect of interventions for the prevention of body weight gain during festive and holiday periods in children and adults. A systematic search was conducted in six databases and supplementary sources until January 4, 2023. We included randomized controlled trials (RCTs), cluster-RCTs, and non-RCTs. Our primary outcome measure was the change in body weight in adults or the change in BMI z-score or BMI percentile in children and adolescents. From 4216 records, 12 primary studies (from 22 reports) met the inclusion criteria-10 from the United States, one from the United Kingdom, and one from Chile. Two studies had a low risk of bias, two moderate, seven high, and one critical risk of bias. The meta-analysis in children included four of seven studies during the summer holidays (six interventions) and showed a mean difference in BMI z-score favoring the intervention group (-0.06 [95% CI -0.10, -0.01], p = 0.01, I2 = 0%, very low certainty evidence). The meta-analysis in adults included five studies during festive periods with a mean difference in weight favoring the intervention group (-0.99 kg [95% CI -2.15, 0.18], p = 0.10, I2 = 89%, very low certainty evidence). This review has highlighted potential interventions to prevent the increase in body weight during holiday periods. More work is needed to improve the quality of the evidence and to extend it to countries outside of the United States and United Kingdom and to the adolescent population.
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Affiliation(s)
- Diego E Guerrero-Magaña
- Posgrado en Ciencias de la Salud, Facultad Interdisciplinaria de Ciencias Biológicas y de la Salud, Universidad de Sonora, Hermosillo, Sonora, Mexico
- Departamento de Ciencias Químico-Biológicas, Facultad Interdisciplinaria de Ciencias Biológicas y de la Salud, Universidad de Sonora, Hermosillo, Sonora, Mexico
| | - Lucía G Urquijo-Ruiz
- Posgrado en Ciencias de la Salud, Facultad Interdisciplinaria de Ciencias Biológicas y de la Salud, Universidad de Sonora, Hermosillo, Sonora, Mexico
| | - Alma L Ruelas-Yanes
- Posgrado en Ciencias de la Salud, Facultad Interdisciplinaria de Ciencias Biológicas y de la Salud, Universidad de Sonora, Hermosillo, Sonora, Mexico
| | - Teresita de J Martínez-Contreras
- Departamento de Ciencias Químico-Biológicas, Facultad Interdisciplinaria de Ciencias Biológicas y de la Salud, Universidad de Sonora, Hermosillo, Sonora, Mexico
| | - Rolando G Díaz-Zavala
- Departamento de Ciencias Químico-Biológicas, Facultad Interdisciplinaria de Ciencias Biológicas y de la Salud, Universidad de Sonora, Hermosillo, Sonora, Mexico
| | - Maria Del Carmen Candia-Plata
- Departamento de Medicina y Ciencias de la Salud, Facultad Interdisciplinaria de Ciencias Biológicas y de la Salud, Universidad de Sonora, Hermosillo, Sonora, Mexico
| | - Julián Esparza-Romero
- Unidad de Investigación en Obesidad y Diabetes, Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo (CIAD), Carretera Gustavo Enrique Astiazarán Rosas, Hermosillo, Sonora, Mexico
| | - Michelle M Haby
- Departamento de Ciencias Químico-Biológicas, Facultad Interdisciplinaria de Ciencias Biológicas y de la Salud, Universidad de Sonora, Hermosillo, Sonora, Mexico
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
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Kelly AS, Armstrong SC, Michalsky MP, Fox CK. Obesity in Adolescents: A Review. JAMA 2024; 332:738-748. [PMID: 39102244 DOI: 10.1001/jama.2024.11809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
Importance Obesity affects approximately 21% of US adolescents and is associated with insulin resistance, hypertension, dyslipidemia, sleep disorders, depression, and musculoskeletal problems. Obesity during adolescence has also been associated with an increased risk of mortality from cardiovascular disease and type 2 diabetes in adulthood. Observations Obesity in adolescents aged 12 to younger than 18 years is commonly defined as a body mass index (BMI) at the 95th or greater age- and sex-adjusted percentile. Comprehensive treatment in adolescents includes lifestyle modification therapy, pharmacotherapy, and metabolic and bariatric surgery. Lifestyle modification therapy, which includes dietary, physical activity, and behavioral counseling, is first-line treatment; as monotherapy, lifestyle modification requires more than 26 contact hours over 1 year to elicit approximately 3% mean BMI reduction. Newer antiobesity medications, such as liraglutide, semaglutide, and phentermine/topiramate, in combination with lifestyle modification therapy, can reduce mean BMI by approximately 5% to 17% at 1 year of treatment. Adverse effects vary, but severe adverse events from these newer antiobesity medications are rare. Surgery (Roux-en-Y gastric bypass and vertical sleeve gastrectomy) for severe adolescent obesity (BMI ≥120% of the 95th percentile) reduces mean BMI by approximately 30% at 1 year. Minor and major perioperative complications, such as reoperation and hospital readmission for dehydration, are experienced by approximately 15% and 8% of patients, respectively. Determining the long-term durability of all obesity treatments warrants future research. Conclusions and Relevance The prevalence of adolescent obesity is approximately 21% in the US. Treatment options for adolescents with obesity include lifestyle modification therapy, pharmacotherapy, and metabolic and bariatric surgery. Intensive lifestyle modification therapy reduces BMI by approximately 3% while pharmacotherapy added to lifestyle modification therapy can attain BMI reductions ranging from 5% to 17%. Surgery is the most effective intervention for adolescents with severe obesity and has been shown to achieve BMI reduction of approximately 30%.
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Affiliation(s)
- Aaron S Kelly
- Department of Pediatrics and Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis
| | - Sarah C Armstrong
- Department of Pediatrics, Department of Population Health Sciences, Duke University, Durham, North Carolina
- Duke Clinical Research Institute, Duke Center for Childhood Obesity Research, Durham, North Carolina
| | - Marc P Michalsky
- Department of Pediatric Surgery, Nationwide Children's Hospital and The Ohio State University, College of Medicine, Columbus
| | - Claudia K Fox
- Department of Pediatrics and Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis
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Carneiro FS, Katashima CK, Dodge JD, Cintra DE, Pauli JR, Da Silva ASR, Ropelle ER. Tissue-specific roles of mitochondrial unfolded protein response during obesity. Obes Rev 2024; 25:e13791. [PMID: 38880974 DOI: 10.1111/obr.13791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 03/20/2024] [Accepted: 06/02/2024] [Indexed: 06/18/2024]
Abstract
Obesity is a worldwide multifactorial disease caused by an imbalance in energy metabolism, increasing adiposity, weight gain, and promoting related diseases such as diabetes, cardiovascular diseases, neurodegeneration, and cancer. Recent findings have reported that metabolic stress related to obesity induces a mitochondrial stress response called mitochondrial unfolded protein response (UPRmt), a quality control pathway that occurs in a nuclear DNA-mitochondria crosstalk, causing transduction of chaperones and proteases under stress conditions. The duality of UPRmt signaling, with both beneficial and detrimental effects, acts in different contexts depending on the tissue, cell type, and physiological states, affecting the mitochondrial function and efficiency and the metabolism homeostasis during obesity, which remains not fully clarified. Therefore, this review discusses the most recent findings regarding UPRmt signaling during obesity, bringing an overview of UPRmt across different metabolic tissues.
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Affiliation(s)
- Fernanda S Carneiro
- Laboratory of Molecular Biology of Exercise (LaBMEx), Faculty of Applied Sciences, University of Campinas (UNICAMP), Limeira, São Paulo, Brazil
| | - Carlos K Katashima
- Laboratory of Molecular Biology of Exercise (LaBMEx), Faculty of Applied Sciences, University of Campinas (UNICAMP), Limeira, São Paulo, Brazil
| | - Joshua D Dodge
- Department of Biology, The University of Texas at Arlington (UTA), Arlington, Texas, USA
| | - Dennys E Cintra
- Laboratory of Nutritional Genomic, School of Applied Sciences, University of Campinas (UNICAMP), Limeira, São Paulo, Brazil
| | - José Rodrigo Pauli
- Laboratory of Molecular Biology of Exercise (LaBMEx), Faculty of Applied Sciences, University of Campinas (UNICAMP), Limeira, São Paulo, Brazil
- Obesity and Comorbidities Research Center (OCRC), University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Adelino S R Da Silva
- Postgraduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Eduardo R Ropelle
- Laboratory of Molecular Biology of Exercise (LaBMEx), Faculty of Applied Sciences, University of Campinas (UNICAMP), Limeira, São Paulo, Brazil
- Obesity and Comorbidities Research Center (OCRC), University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
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Karczewska-Kupczewska M, Stefanowicz M, Nikołajuk A, Strączkowski M. Weight-Reducing Dietary Intervention Increases the Ability of Hyperinsulinemia to Suppress Serum Ghrelin Concentration in Individuals with Obesity. J Nutr 2024; 154:1631-1639. [PMID: 38159811 DOI: 10.1016/j.tjnut.2023.12.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/20/2023] [Accepted: 12/27/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Ghrelin is an orexigenic peptide secreted mainly by the stomach. Serum ghrelin concentrations are suppressed after a meal, probably due to insulin release. Individuals with obesity are characterized by a lower fasting serum ghrelin and a lower ghrelin decrease after a meal. The effect of weight loss on the ability of insulin to suppress serum ghrelin concentration remains unknown. OBJECTIVE The aim of the present study was to analyze the effect of weight-reducing dietary intervention on the ability of hyperinsulinemia to suppress serum ghrelin concentration in young individuals with uncomplicated obesity. METHODS We examined 38 individuals with marked overweight or obesity, who underwent a 12-wk dietary intervention program. Serum ghrelin concentration was measured before and after a 2-h hyperinsulinemic-euglycemic clamp, both pre- and post-intervention. Twenty normal-weight individuals served as a control group and were examined at baseline only. RESULTS Individuals with overweight/obesity were characterized by a lower fasting serum ghrelin concentration than normal-weight individuals (P = 0.006). Insulin decreased serum ghrelin concentration in both groups (P < 0.001); however, this decrease was markedly lower in individuals with overweight/obesity than in normal-weight individuals (99.70 ± 136.37 vs. 215.45 ± 250.28 pg/mL; P = 0.026). Fasting serum ghrelin concentration increased after the intervention. After weight-reducing dietary intervention, the decrease in serum ghrelin concentration after the clamp was significantly greater than the pre-intervention value (99.70 ± 136.37 vs. 221.82 ± 228.75 pg/mL; P = 0.002). CONCLUSIONS Weight-reducing dietary intervention restores the ability of hyperinsulinemia to suppress serum ghrelin concentration. It may suggest an enhanced feeling of satiety after moderate weight loss in individuals with overweight/obesity.
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Affiliation(s)
| | | | - Agnieszka Nikołajuk
- Department of Prophylaxis of Metabolic Diseases, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Marek Strączkowski
- Department of Prophylaxis of Metabolic Diseases, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
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Bosch de Basea L, Boguñà M, Sánchez A, Esteve M, Grasa M, Romero MDM. Sex-Dependent Metabolic Effects in Diet-Induced Obese Rats following Intermittent Fasting Compared with Continuous Food Restriction. Nutrients 2024; 16:1009. [PMID: 38613042 PMCID: PMC11013430 DOI: 10.3390/nu16071009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Recently, intermittent fasting has gained relevance as a strategy to lose weight and improve health as an alternative to continuous caloric restriction. However, the metabolic impact and the sex-related differences are not fully understood. The study aimed to compare the response to a continuous or intermittent caloric restriction in male and female rats following a previous induction of obesity through a cafeteria diet by assessing changes in body weight, energy intake, metabolic parameters, and gene expression in liver hepatic and adipose tissue. The continuous restriction reduced the energy available by 30% and the intermittent restriction consisted of a 75% energy reduction on two non-consecutive days per week. The interventions reduced body weight and body fat in both sexes, but the loss of WAT in females was more marked in both models of caloric restriction, continuous and intermittent. Both caloric restrictions improved insulin sensitivity, but more markedly in females, which showed a more pronounced decrease in HOMA-IR score and an upregulation of hepatic IRS2 and Sirt1 gene expression that was not observed in males. These findings suggest the fact that females are more sensitive than males to reduced caloric content in the diet.
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Affiliation(s)
- Laia Bosch de Basea
- Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, 08028 Barcelona, Spain; (L.B.d.B.); (M.B.); (A.S.)
| | - Marina Boguñà
- Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, 08028 Barcelona, Spain; (L.B.d.B.); (M.B.); (A.S.)
| | - Alicia Sánchez
- Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, 08028 Barcelona, Spain; (L.B.d.B.); (M.B.); (A.S.)
| | - Montserrat Esteve
- Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, 08028 Barcelona, Spain; (L.B.d.B.); (M.B.); (A.S.)
- CIBER Obesity and Nutrition, Institute of Health Carlos III, 08028 Madrid, Spain
- Institute of Biomedicine of the University of Barcelona, 08028 Barcelona, Spain
| | - Mar Grasa
- Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, 08028 Barcelona, Spain; (L.B.d.B.); (M.B.); (A.S.)
- CIBER Obesity and Nutrition, Institute of Health Carlos III, 08028 Madrid, Spain
- Institute of Biomedicine of the University of Barcelona, 08028 Barcelona, Spain
| | - Maria del Mar Romero
- CIBER Obesity and Nutrition, Institute of Health Carlos III, 08028 Madrid, Spain
- Institute of Biomedicine of the University of Barcelona, 08028 Barcelona, Spain
- Department of Biochemistry and Physiology, Faculty of Pharmacy, University of Barcelona, 02028 Barcelona, Spain
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von Hippel PT, Bogolasky Fliman F. Did child obesity decline after 2016 food regulations in Chile? Rev Panam Salud Publica 2024; 48:e16. [PMID: 38464880 PMCID: PMC10921911 DOI: 10.26633/rpsp.2024.16] [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: 09/15/2023] [Accepted: 12/19/2023] [Indexed: 03/12/2024] Open
Abstract
We estimated trends in the prevalence of obesity and overweight among Chilean primary and secondary students before and after Chile's 2016 regulations on the marketing and availability of foods high in energy, total sugars, sodium, or saturated fat. We used data from Chile's Survey of Nutrition, which measured the body mass index (BMI) of students in government-funded schools. Using BMI thresholds defined by the World Health Organization, we calculated the prevalence of overweight and obesity for each year from 2013 to 2019 among students attending pre-kindergarten (age 4 years), kindergarten (age 5 years), first grade (6 years), and ninth grade (14 years). In ninth grade students, overweight and obesity prevalence rose by 2 percentage points over the 3 years after introduction of the 2016 regulations. In pre-kindergarten, kindergarten, and first grade, overweight and obesity fell 1 to 3 percentage points 1 year after the regulations were introduced, but rebounded to previous levels the next year. Chile's food regulations were not followed by a sustained decline in obesity in primary- and secondary-school students. Future research should examine whether and how children in Chile and other countries maintain high levels of overweight and obesity despite food regulations designed to reduce consumption of obesogenic foods and beverages.
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Affiliation(s)
- Paul T von Hippel
- LBJ School of Public Affairs University of Texas Austin United States of America LBJ School of Public Affairs, University of Texas, Austin, United States of America
| | - Francisca Bogolasky Fliman
- Facultad de Gobierno Universidad de Chile Santiago Chile Facultad de Gobierno, Universidad de Chile, Santiago, Chile
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Dabas J, Shunmukha Priya S, Alawani A, Budhrani P. What could be the reasons for not losing weight even after following a weight loss program? JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:37. [PMID: 38429842 PMCID: PMC10908186 DOI: 10.1186/s41043-024-00516-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/28/2024] [Indexed: 03/03/2024]
Abstract
INTRODUCTION Approximately four million people worldwide die annually because of obesity. Weight loss is commonly recommended as a first-line therapy in overweight and obese patients. Although many individuals attempt to lose weight, not everyone achieves optimal success. Few studies point out that weight loss eventually slows down, stagnates or reverses in 85% of the cases. RESEARCH QUESTION What could be the reasons for not losing weight even after following a weight loss program? METHODS A scoping review of the literature was performed using weight loss-related search terms such as 'Obesity,' 'Overweight,' 'Lifestyle,' 'weight loss,' 'Basal Metabolism,' 'physical activity,' 'adherence,' 'energy balance,' 'Sleep' and 'adaptations. The search involved reference tracking and database and web searches (PUBMED, Science Direct, Elsevier, Web of Science and Google Scholar). Original articles and review papers on weight loss involving human participants and adults aged > 18 years were selected. Approximately 231 articles were reviewed, and 185 were included based on the inclusion criteria. DESIGN Scoping review. RESULTS In this review, the factors associated with not losing weight have broadly been divided into five categories. Studies highlighting each subfactor were critically reviewed and discussed. A wide degree of interindividual variability in weight loss is common in studies even after controlling for variables such as adherence, sex, physical activity and baseline weight. In addition to these variables, variations in factors such as previous weight loss attempts, sleep habits, meal timings and medications can play a crucial role in upregulating or downregulating the association between energy deficit and weight loss results. CONCLUSION This review identifies and clarifies the role of several factors that may hinder weight loss after the exploration of existing evidence. Judging the effectiveness of respective lifestyle interventions by simply observing the 'general behavior of the groups' is not always applicable in clinical practice. Each individual must be monitored and advised as per their requirements and challenges.
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Affiliation(s)
- Jyoti Dabas
- Institute of Nutrition and Fitness Sciences, Platinum Square, 4th floor, Office, 403, Opp. WNS, Sakore Nagar, Viman Nagar, Pune, Maharashtra, 411014, India
| | - S Shunmukha Priya
- Institute of Nutrition and Fitness Sciences, Platinum Square, 4th floor, Office, 403, Opp. WNS, Sakore Nagar, Viman Nagar, Pune, Maharashtra, 411014, India.
| | - Akshay Alawani
- Institute of Nutrition and Fitness Sciences, Platinum Square, 4th floor, Office, 403, Opp. WNS, Sakore Nagar, Viman Nagar, Pune, Maharashtra, 411014, India
| | - Praveen Budhrani
- Institute of Nutrition and Fitness Sciences, Platinum Square, 4th floor, Office, 403, Opp. WNS, Sakore Nagar, Viman Nagar, Pune, Maharashtra, 411014, India
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Bomberg EM, Kyle TK, Stanford FC. The need for increasing pediatric obesity advocacy. Complement Ther Med 2024; 80:103012. [PMID: 38161055 PMCID: PMC10908360 DOI: 10.1016/j.ctim.2023.103012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 12/28/2023] [Indexed: 01/03/2024] Open
Affiliation(s)
- Eric M Bomberg
- Center for Pediatric Obesity Medicine, Division of Pediatric Endocrinology, Department of Pediatrics, University of Minnesota Medical School, 717 Delaware Street SE, Room 370, Minneapolis, MN 55414, USA.
| | - Theodore K Kyle
- ConscienHealth, 2270 Country Club Drive, Pittsburgh, PA 15421, USA.
| | - Fatima C Stanford
- Massachusetts General Hospital, Department of Medicine - Division of Endocrinology -Neuroendocrine, Department of Pediatrics - Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Harvard Medical School, 4th Floor Weight Center, 50 Staniford Street, Boston, MA 02114, USA.
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Salazar J, Duran P, Garrido B, Parra H, Hernández M, Cano C, Añez R, García-Pacheco H, Cubillos G, Vasquez N, Chacin M, Bermúdez V. Weight Regain after Metabolic Surgery: Beyond the Surgical Failure. J Clin Med 2024; 13:1143. [PMID: 38398456 PMCID: PMC10888585 DOI: 10.3390/jcm13041143] [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: 12/11/2023] [Revised: 01/20/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
Patients undergoing metabolic surgery have factors ranging from anatomo-surgical, endocrine metabolic, eating patterns and physical activity, mental health and psychological factors. Some of the latter can explain the possible pathophysiological neuroendocrine, metabolic, and adaptive mechanisms that cause the high prevalence of weight regain in postbariatric patients. Even metabolic surgery has proven to be effective in reducing excess weight in patients with obesity; some of them regain weight after this intervention. In this vein, several studies have been conducted to search factors and mechanisms involved in weight regain, to stablish strategies to manage this complication by combining metabolic surgery with either lifestyle changes, behavioral therapies, pharmacotherapy, endoscopic interventions, or finally, surgical revision. The aim of this revision is to describe certain aspects and mechanisms behind weight regain after metabolic surgery, along with preventive and therapeutic strategies for this complication.
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Affiliation(s)
- Juan Salazar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela
| | - Pablo Duran
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela
| | - Bermary Garrido
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela
| | - Heliana Parra
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela
| | - Marlon Hernández
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela
| | - Clímaco Cano
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela
| | - Roberto Añez
- Departamento de Endocrinología y Nutrición, Hospital Quirónsalud, 28009 Madrid, Spain
| | - Henry García-Pacheco
- Facultad de Medicina, Departamento de Cirugía, Universidad del Zulia, Hospital General del Sur, Dr. Pedro Iturbe, Maracaibo 4004, Venezuela
- Unidad de Cirugía para Obesidad y Metabolismo (UCOM), Maracaibo 4004, Venezuela
| | | | | | - Maricarmen Chacin
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla 080001, Colombia
- Centro de Investigaciones en Ciencias de la Vida, Universidad Simón Bolívar, Barranquilla 080001, Colombia
| | - Valmore Bermúdez
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla 080001, Colombia
- Centro de Investigaciones en Ciencias de la Vida, Universidad Simón Bolívar, Barranquilla 080001, Colombia
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Nunes CL, Jesus F, Rosa GB, Marianito M, Francisco R, Bosy-Westphal A, Minderico CS, Martins P, Sardinha LB, Silva AM. Interindividual variability in energy intake and expenditure during a weight loss intervention. Appetite 2024; 193:107162. [PMID: 38101517 DOI: 10.1016/j.appet.2023.107162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION Behavioral compensations may occur as a response to a negative energy balance. The aim of this study was to explore the associations between changes in energy intake (EI) and changes in physical activity (PA, min/day; kcal/d) as a response to a weight loss (WL) intervention and to understand if interindividual differences occur in EI and energy expenditure (EE). METHODS Eighty-one participants [mean (SD): age = 42.8 (9.4)y, BMI = 31.2 (4.4)kg/m2, 37% females] divided in intervention (IG, n = 43) and control group (CG, n = 38) were included. The IG underwent a moderate energy restriction (300-500 kcal/d). EI was measured through the intake-balance method. Non-exercise PA (NEPA) and exercise (through logbook) were assessed by accelerometery. The EE in NEPA (NEAT) and in exercise (EiEE) was calculated by applying the Freedson Combination'98 algorithm over the time spent in these activities. Pearson correlations were performed in IG to examine associations between EE components, EI and body composition. To understand if interindividual differences were observed, the SD of individual response (SDIR) and the smallest worthwhile change (SWC, SDbaselineCG×0.2) were calculated. RESULTS Changes in EI [Δ EI, (kcal/d)] was negatively associated with Δ exercise (min/d:r = -0.413, p = 0.045; %:r = -0.846, p = 0.008) and with Δ EiEE (kcal/d:r = -0.488, p = 0.016; %:r = -0.859, p = 0.006). A negative correlation was found between Δ sedentary time and Δ NEPA (min/d:r = -0.622, p = 0.002; %:r = -0.487, p = 0.018). An interindividual variability was found for EI(SDIR = 151.6, SWC = 72.3) and EE (SDIR = 165, SWC = 134). CONCLUSIONS Decreases in EI were not associated to compensatory responses such as decreases in PA and/or increases in sedentary time. Interindividual variability was found for EI and EE. Nevertheless, behavioral compensations and the interindividual variability should be considered when implementing WL interventions, to increase the likelihood of achieving sustainable results. (clinicaltrials.gov ID: NCT03031951).
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Affiliation(s)
- Catarina L Nunes
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal; Atlântica, Instituto Universitário, Fábrica da Pólvora de Barcarena, Portugal
| | - Filipe Jesus
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal
| | - Gil B Rosa
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal
| | - Mariana Marianito
- Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz MB, 1649-028 Lisboa, Portugal
| | - Ruben Francisco
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal
| | - Anja Bosy-Westphal
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, Kiel, Germany
| | - Cláudia S Minderico
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal
| | - Paulo Martins
- Laboratory of Sport Psychology, Faculdade de Motricidade Humana da Universidade de Lisboa, 1499-002 Cruz-Quebrada, Portugal
| | - Luis B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal.
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11
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Grannell A, Al-Najim W, le Roux C. Long-term weight outcomes in patients treated with liraglutide 3.0 mg in real-world clinical practice. Clin Obes 2024; 14:e12622. [PMID: 37615384 DOI: 10.1111/cob.12622] [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: 02/10/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/25/2023]
Abstract
Long-term weight outcomes reflect the success of obesity treatment. Weight regain during treatment for obesity is a biologically maladaptive response that can be considered a central feature of the disease. This phenomenon has been well documented in patients treated with lifestyle changes and bariatric surgery. In patients treated with liraglutide 3.0 mg this has been documented in randomized control trials, but real-world analysis is lacking. The aim of this retrospective observational study was to explore the long-term weight outcomes in patients treated with liraglutide 3.0 mg in a real-world clinical practice. The association between body composition changes and weight outcomes was also explored. The study included 25 patients treated with multi-modal care that included liraglutide 3.0 mg over a period of 78 weeks. Body composition was examined via dual x-ray absorptiometry at 16 and 32 weeks, with body weight captured up until 78 weeks for all patients. Weight loss (R2 = 0.39, p < .001), fat mass loss (R2 = 0.32, p = .003) and fat-free mass loss (R2 = 0.19, p = .03) were all associated with weight change from artificial nadir, which was, on average, 3.8 kg. For body composition, after adjustment, only fat mass loss was associated weight regain (R2 = 0.32, p = .01). In conclusion, in patients with clinical obesity treated with liraglutide 3.0 mg in a real-world clinical setting, fat mass loss was associated with weight regain. Whilst weight regain occurred on average, the magnitude was less than that observed in patients treated with lifestyle alone and weight loss remained clinically significant for most patients.
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Affiliation(s)
- Andrew Grannell
- Sidekick Health, Medical & Research Department, Kópavogur, Iceland
- UCD Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
| | - Werd Al-Najim
- UCD Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
| | - Carel le Roux
- UCD Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
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12
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Allard C, Cota D, Quarta C. Poly-Agonist Pharmacotherapies for Metabolic Diseases: Hopes and New Challenges. Drugs 2024; 84:127-148. [PMID: 38127286 DOI: 10.1007/s40265-023-01982-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 12/23/2023]
Abstract
The use of glucagon-like peptide-1 (GLP-1) receptor-based multi-agonists in the treatment of type 2 diabetes and obesity holds great promise for improving glycaemic control and weight management. Unimolecular dual and triple agonists targeting multiple gut hormone-related pathways are currently in clinical trials, with recent evidence supporting their efficacy. However, significant knowledge gaps remain regarding the biological mechanisms and potential adverse effects associated with these multi-target agents. The mechanisms underlying the therapeutic efficacy of GLP-1 receptor-based multi-agonists remain somewhat mysterious, and hidden threats may be associated with the use of gut hormone-based polyagonists. In this review, we provide a critical analysis of the benefits and risks associated with the use of these new drugs in the management of obesity and diabetes, while also exploring new potential applications of GLP-1-based pharmacology beyond the field of metabolic disease.
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Affiliation(s)
- Camille Allard
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000, Bordeaux, France
| | - Daniela Cota
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000, Bordeaux, France
| | - Carmelo Quarta
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000, Bordeaux, France.
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13
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Foright RM, McQuillan TE, Frick JM, Minchella PM, Levasseur BM, Tinoco O, Birmingham L, Blankenship AE, Thyfault JP, Christianson JA. Exposure to early-life stress impairs weight-loss maintenance success in mice. Obesity (Silver Spring) 2024; 32:131-140. [PMID: 38131100 PMCID: PMC10751986 DOI: 10.1002/oby.23931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/03/2023] [Accepted: 09/06/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The impact of early-life stress on weight-loss maintenance is unknown. METHODS Mice underwent neonatal maternal separation (NMS) from 0 to 3 weeks and were weaned onto a high-fat sucrose diet (HFSD) from 3 to 20 weeks. Calorie-restricted weight loss on a low-fat sucrose diet (LFSD) occurred over 2 weeks to induce a 20% loss in body weight, which was maintained for 6 weeks. After weight loss, half of the mice received running wheels, and the other half remained sedentary. Mice were then fed ad libitum on an HFSD or LFSD for 10 weeks and were allowed to regain body weight. RESULTS NMS mice had greater weight regain, total body weight, and adiposity compared with naïve mice. During the first week of refeeding, NMS mice had increased food intake and were in a greater positive energy balance than naïve mice. Female mice were more susceptible to NMS-induced effects, including increases in adiposity. NMS and naïve females were more susceptible to HFSD-induced weight regain. Exercise was beneficial in the first week of regain in male mice, but, long-term, only those on the LFSD benefited from exercise. As expected, HFSD led to greater weight regain than LFSD. CONCLUSIONS Early-life stress increases weight regain in mice.
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Affiliation(s)
- Rebecca M Foright
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Tara E McQuillan
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Jenna M Frick
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Paige M Minchella
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Brittni M Levasseur
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Omar Tinoco
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Lauryn Birmingham
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Anneka E Blankenship
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - John P Thyfault
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
- Kansas Center for Metabolism and Obesity Research
- Research Service, Kansas City Veterans Affairs Medical Center, Kansas City, Kansas
| | - Julie A Christianson
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
- Kansas Center for Metabolism and Obesity Research
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14
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Ross KM, You L, Qiu P, Shankar MN, Swanson TN, Ruiz J, Anthony L, Perri MG. Predicting high-risk periods for weight regain following initial weight loss. Obesity (Silver Spring) 2024; 32:41-49. [PMID: 37919882 PMCID: PMC10872625 DOI: 10.1002/oby.23923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE The aim of this study was to develop a predictive algorithm of "high-risk" periods for weight regain after weight loss. METHODS Longitudinal mixed-effects models and random forest regression were used to select predictors and develop an algorithm to predict weight regain on a week-to-week basis, using weekly questionnaire and self-monitoring data (including daily e-scale data) collected over 40 weeks from 46 adults who lost ≥5% of baseline weight during an initial 12-week intervention (Study 1). The algorithm was evaluated in 22 adults who completed the same Study 1 intervention but lost <5% of baseline weight and in 30 adults recruited for a separate 30-week study (Study 2). RESULTS The final algorithm retained the frequency of self-monitoring caloric intake and weight plus self-report ratings of hunger and the importance of weight-management goals compared with competing life demands. In the initial training data set, the algorithm predicted weight regain the following week with a sensitivity of 75.6% and a specificity of 45.8%; performance was similar (sensitivity: 81%-82%, specificity: 30%-33%) in testing data sets. CONCLUSIONS Weight regain can be predicted on a proximal, week-to-week level. Future work should investigate the clinical utility of adaptive interventions for weight-loss maintenance and develop more sophisticated predictive models of weight regain.
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Affiliation(s)
- Kathryn M. Ross
- Department of Clinical & Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Lu You
- Department of Biostatistics, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA
- Health Informatics Institute, University of South Florida, Tampa, FL, USA
| | - Peihua Qiu
- Department of Biostatistics, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA
| | - Meena N. Shankar
- Department of Clinical & Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Taylor N. Swanson
- Department of Clinical & Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Jaime Ruiz
- Department of Computer and Information Science and Engineering, Herbert Wertheim College of Engineering, University of Florida, Gainesville, FL, USA
| | - Lisa Anthony
- Department of Computer and Information Science and Engineering, Herbert Wertheim College of Engineering, University of Florida, Gainesville, FL, USA
| | - Michael G. Perri
- Department of Clinical & Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
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15
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Broome HAO, Woods-Lee GRT, Flanagan J, Biourge V, German AJ. Weight loss outcomes are generally worse for dogs and cats with class II obesity, defined as > 40% overweight. Sci Rep 2023; 13:22958. [PMID: 38151525 PMCID: PMC10752889 DOI: 10.1038/s41598-023-50197-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/16/2023] [Indexed: 12/29/2023] Open
Abstract
In pet dogs and cats, adiposity is most-often estimated clinically using a 9-category body condition score (BCS), with BCS 9 equating to ~ 40% overweight. Animals that are more overweight (> 40%) are seen in clinical practice but are not appropriately depicted by descriptions in the existing categories. To determine whether being > 40% overweight has clinical relevance, this study aimed to compare the outcomes of weight management in animals that were > 40% overweight with those < 40% overweight. Records of dogs and cats attending a specialist obesity care clinic, where adiposity is determined using dual-energy X-ray absorptiometry (DXA), were reviewed. Animals were assigned to two classes (class I ≤ 40% overweight: 118/398 [40%] dogs and 68/116 [59%] cats; class II, > 40% overweight: 180/398 [60%] dogs and 48/116 [41%] cats) based on DXA results, and weight loss outcomes were compared. Fewer class II dogs obesity completed weight management than class I dogs (P < 0.001), rate of weight loss was also slower (P = 0.012) and lean tissue loss greater (P < 0.001). Compared with class I, cats with class II obesity lost more weight (P = 0.048) albeit over a longer period (P = 0.043) leading to greater lean tissue loss (P = 0.004). Approximately half the pets presenting to a specialist clinic were have class II obesity (> 40% overweight), and some weight loss outcomes are worse for these animals.
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Affiliation(s)
- H A O Broome
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - G R T Woods-Lee
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - J Flanagan
- Royal Canin Research Centre, Aimargues, France
| | - V Biourge
- Royal Canin Research Centre, Aimargues, France
| | - A J German
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
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16
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Margolis LM, Pasiakos SM. Performance nutrition for cold-weather military operations. Int J Circumpolar Health 2023; 82:2192392. [PMID: 36934427 PMCID: PMC10026745 DOI: 10.1080/22423982.2023.2192392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2023] Open
Abstract
.High daily energy expenditure without compensatory increases in energy intake results in severe energy deficits during cold-weather military operations. The severity of energy deficits has been proportionally linked to declines in body mass, negative protein balance, suppression of androgen hormones, increases in systemic inflammation and degraded physical performance. Food availability does not appear to be the predominant factor causing energy deficits; providing additional rations or supplement snack bars does not reduce the severity of the energy deficits. Nutrition interventions that allow greater energy intake could be effective for reducing energy deficits during cold-weather military operations. One potential intervention is to increase energy density (i.e. energy per unit mass of food) by increasing dietary fat. Our laboratory recently reported that self-selected higher energy intakes and reductions in energy deficits were primarily driven by fat intake (r = 0.891, r2 = 0.475), which, of the three macronutrients. Further, soldiers who ate more fat lost less body mass, had lower inflammation, and maintained net protein balance compared to those who ate less fat. These data suggest that consuming high-fat energy-dense foods may be a viable nutritional intervention that mitigates the negative physiological effects of energy deficit and sustains physical performance during cold-weather military operations.
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Affiliation(s)
- Lee M Margolis
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Stefan M Pasiakos
- Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA
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17
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Spreckley M, de Lange J, Seidell J, Halberstadt J. Primary care-led weight-management intervention: qualitative insights into patient experiences at two-year follow-up. Int J Qual Stud Health Well-being 2023; 18:2276576. [PMID: 38016037 PMCID: PMC11007633 DOI: 10.1080/17482631.2023.2276576] [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: 09/18/2023] [Accepted: 10/25/2023] [Indexed: 11/30/2023] Open
Abstract
PURPOSE The prevalence of overweight and obesity is continuously increasing globally and long-term weight loss intervention outcomes remain disappointing. To determine which behavioural intervention approaches improve the probability of achieving long-term weight loss, this two-year follow-up study aimed to identify distinct factors and strategies for successful long-term weight loss maintenance. METHODS A cohort of 20 participants with overweight and obesity from a primary-care led weight management programme with diverse backgrounds was interviewed at baseline, after 1 and 2 years, and asked to do quantitative self-description. This study focused on the 2-year follow-up interviews from this study series. RESULTS We found that agile, continuous self-monitoring with personalized, sustainable lifestyle habits correlated with positive outcomes. Participants reported health benefits, maintained weight loss, and found motivation in supportive peer networks. Challenges like anxiety, disappointment, and disruptions derailed progress. Long-term success relied on a strong support system of healthcare professionals, friends, and family. CONCLUSIONS The findings of this study series highlight the intricate nature of long-term weight loss maintenance. This study corroborates the persistence of overarching themes while highlighting the individual variability in their relative importance. Findings emphasize the importance of long-term support to effectively address the diverse needs of patients trying to achieve long-term weight loss maintenance.
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Affiliation(s)
- Marie Spreckley
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, London, UK
| | | | - Jaap Seidell
- Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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18
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Fontana A, Vieira JG, Vianna JM, Bichowska M, Krzysztofik M, Wilk M, Reis VM. Reduction of leptin levels during acute exercise is dependent on fasting but not on caloric restriction during chronic exercise: A systematic review and meta-analysis. PLoS One 2023; 18:e0288730. [PMID: 38015889 PMCID: PMC10684016 DOI: 10.1371/journal.pone.0288730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/03/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND The importance of leptin in controlling body mass has recently gained more attention. Its levels are directly associated with the amount of fat mass, but not necessarily dependent on it. Exercise has great potential in reducing leptin levels, however the response of exercise to this cytokine is still not well understood. OBJECTIVE The objective of the review was to analyze the effects of physical exercise on plasma leptin concentration, either acutely (post-exercise/training session) and/or after a training period (short- or long-term), as well as to investigate the existence of possible moderating variables. METHODS The studies included in this systematic review were published between 2005 and May 2023. Only peer-reviewed studies, available in English, performed with humans that evaluated the effects of any form of exercise on leptin levels were included. The search was conducted on May 03, 2023, in Embase (Elsevier), MEDLINE via PubMed®, and Web of Science (Core collection). The risk of bias in the included trials was assessed by the Physiotherapy Evidence Database tool, considering 11 questions regarding the methodology of each study with 10 questions being scored. The data (n, mean, and standard deviation) were extracted from included studies to perform random effects meta-analyses using standardized mean difference between the pre- and post-intervention effects. RESULTS Twenty-five studies (acute effect: 262 subjects; short- and long-term effect: 377 subjects) were included in this systematic review and meta-analysis. Short- and long-term physical exercise and caloric restriction plus exercise reduce plasma leptin levels, presenting statistically significant differences (p<0.001); as well as acute effect (p = 0.035), however the latter result was influenced by the pre-exercise meal as shown in the subgroup analysis. In this meta-analysis the effect of moderating factors on leptin reduction, not addressed by past reviews, is verified, such as the relationship with caloric restriction, exercise intensity and pre-exercise meal on acute responses. CONCLUSION Both acute and chronic exercise reduce leptin levels, yet the acute effect is dependent on the pre-exercise meal. In addition to having a long-term reduction in leptin levels, the minimum amount of weekly exercise to have a significant reduction in plasma leptin is 180 minutes of moderate-intensity exercise and 120 minutes of high-intensity exercise.
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Affiliation(s)
- Alexandre Fontana
- Master in Sports Science, University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal
| | - João Guilherme Vieira
- Graduate Program in Physical Education, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
- Strength Training Research Laboratory, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - Jeferson Macedo Vianna
- Graduate Program in Physical Education, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
- Strength Training Research Laboratory, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - Marta Bichowska
- Faculty of Physical Education, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Michal Krzysztofik
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Michal Wilk
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Victor Machado Reis
- Research Center in Sports Sciences, Health Sciences & Human Development (CIDESD), University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal
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19
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Zhou HY, Feng X, Wang LW, Zhou R, Sun H, Chen X, Lu RB, Huang Y, Guo Q, Luo XH. Bone marrow immune cells respond to fluctuating nutritional stress to constrain weight regain. Cell Metab 2023; 35:1915-1930.e8. [PMID: 37703873 DOI: 10.1016/j.cmet.2023.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/19/2023] [Accepted: 08/18/2023] [Indexed: 09/15/2023]
Abstract
Weight regain after weight loss is a major challenge in the treatment of obesity. Immune cells adapt to fluctuating nutritional stress, but their roles in regulating weight regain remain unclear. Here, we identify a stem cell-like CD7+ monocyte subpopulation accumulating in the bone marrow (BM) of mice and humans that experienced dieting-induced weight loss. Adoptive transfer of CD7+ monocytes suppresses weight regain, whereas inducible depletion of CD7+ monocytes accelerates it. These cells, accumulating metabolic memories via epigenetic adaptations, preferentially migrate to the subcutaneous white adipose tissue (WAT), where they secrete fibrinogen-like protein 2 (FGL2) to activate the protein kinase A (PKA) signaling pathway and facilitate beige fat thermogenesis. Nevertheless, CD7+ monocytes gradually enter a quiescent state after weight loss, accompanied by increased susceptibility to weight regain. Notably, administration of FMS-like tyrosine kinase 3 ligand (FLT3L) remarkably rejuvenates CD7+ monocytes, thus ameliorating rapid weight regain. Together, our findings identify a unique bone marrow-derived metabolic-memory immune cell population that could be targeted to combat obesity.
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Affiliation(s)
- Hai-Yan Zhou
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, China
| | - Xu Feng
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, China
| | - Li-Wen Wang
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, China
| | - Rui Zhou
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, China
| | - Heng Sun
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, China
| | - Xin Chen
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, China
| | - Ren-Bin Lu
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, China
| | - Yan Huang
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, China
| | - Qi Guo
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, China
| | - Xiang-Hang Luo
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan 410008, China; Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Hunan 410008, China.
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20
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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: 11] [Impact Index Per Article: 11.0] [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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21
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Gou Y, Schwartz MW. How should we think about the unprecedented weight loss efficacy of incretin-mimetic drugs? J Clin Invest 2023; 133:e174597. [PMID: 37781919 PMCID: PMC10541183 DOI: 10.1172/jci174597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
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22
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Stamos J, Stalnaker K, Teegala S, Routh VH, Beck KD. Effects of glucose modulation in lateral hypothalamus on motivated behavior to obtain sucrose in an operant task. Appetite 2023; 189:106621. [PMID: 37311483 DOI: 10.1016/j.appet.2023.106621] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/15/2023]
Abstract
Orexin neurons in the Lateral Hypothalamus (LH) play an important role in food seeking behavior. Approximately 60 percent of LH orexin neurons are inhibited by elevated extracellular glucose. It has been shown that elevated LH glucose decreases conditioned place preference for a food associated chamber. However, it has never been shown how modulation of LH extracellular glucose effects a rat's motivation to work for food. In this experiment we used reverse microdialysis to modulate extracellular glucose levels in LH during an operant task. Results from a progressive ratio task demonstrated that 4 mM glucose perfusion significantly decreased the animal's motivation to work for sucrose pellets while not effecting the hedonic value of the pellets. In a second experiment we demonstrated that 4 mM but not 2.5 mM glucose perfusion was sufficient to significantly decrease the number of sucrose pellets earned. Finally, we showed that modulating LH extracellular glucose mid-session from 0.7 mM to 4 mM did not affect behavior. This indicates that once feeding behavior has begun the animal becomes unresponsive to changes in extracellular glucose levels in LH. Taken together these experiments indicate that LH glucose sensing neurons play an important role in motivation to initiate feeding. However, once consumption has begun it is likely that feeding is controlled by brain regions downstream of LH.
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Affiliation(s)
- Joshua Stamos
- Neurobehavioral Research Laboratory, Research Service, Veterans Affairs New Jersey Health Care System, East Orange, NJ, USA
| | - Katherine Stalnaker
- School of Graduate Studies, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Suraj Teegala
- School of Graduate Studies, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Vanessa H Routh
- School of Graduate Studies, Rutgers, The State University of New Jersey, Newark, NJ, USA; Department of Pharmacology, Physiology & Neuroscience, Rutgers - New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Kevin D Beck
- Neurobehavioral Research Laboratory, Research Service, Veterans Affairs New Jersey Health Care System, East Orange, NJ, USA; School of Graduate Studies, Rutgers, The State University of New Jersey, Newark, NJ, USA; Department of Pharmacology, Physiology & Neuroscience, Rutgers - New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA.
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Kelly AS. Current and future pharmacotherapies for obesity in children and adolescents. Nat Rev Endocrinol 2023; 19:534-541. [PMID: 37337008 DOI: 10.1038/s41574-023-00858-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/21/2023]
Abstract
Obesity is a common chronic disease in children and adolescents and its prevalence is increasing worldwide. The causes are multifactorial but involve biological predisposition towards a specific body-weight set point and defended adipose tissue mass converging with an obesogenic environment. Comprehensive treatment of paediatric obesity includes lifestyle modification therapy, anti-obesity medications (AOMs) and/or metabolic surgery. Lifestyle modification therapy used alone produces fairly modest weight loss for most youth with obesity. The emergence of new AOMs has changed the landscape of paediatric weight management, improving the outlook for youth with obesity. This Review briefly highlights obesity development pathways in youth and the role that pharmacotherapy can play in counteracting these pathophysiological forces. Here, results from adolescent AOM clinical trials published since 2020 are reviewed, including the safety, efficacy and tolerability of the newest treatments (glucagon-like peptide 1 receptor agonists and phentermine-topiramate). The importance of a comprehensive and chronic care model, including both lifestyle modification and ongoing pharmacotherapy, will be discussed in the context of maximizing long-term health outcomes. Finally, insight will be provided into the emerging pipeline of AOMs (for example, incretin receptor co-agonists and tri-agonists) and how future therapies might fundamentally change the prognosis for youth with obesity.
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Affiliation(s)
- Aaron S Kelly
- Department of Pediatrics and Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
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24
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Siedler MR, De Souza MJ, Albracht-Schulte K, Sekiguchi Y, Tinsley GM. The Influence of Energy Balance and Availability on Resting Metabolic Rate: Implications for Assessment and Future Research Directions. Sports Med 2023; 53:1507-1526. [PMID: 37213050 DOI: 10.1007/s40279-023-01856-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/23/2023]
Abstract
Resting metabolic rate (RMR) is a significant contributor to an individual's total energy expenditure. As such, RMR plays an important role in body weight regulation across populations ranging from inactive individuals to athletes. In addition, RMR may also be used to screen for low energy availability and energy deficiency in athletes, and thus may be useful in identifying individuals at risk for the deleterious consequences of chronic energy deficiency. Given its importance in both clinical and research settings within the fields of exercise physiology, dietetics, and sports medicine, the valid assessment of RMR is critical. However, factors including varying states of energy balance (both short- and long-term energy deficit or surplus), energy availability, and prior food intake or exercise may influence resulting RMR measures, potentially introducing error into observed values. The purpose of this review is to summarize the relationships between short- and long-term changes in energetic status and resulting RMR measures, consider these findings in the context of relevant recommendations for RMR assessment, and provide suggestions for future research.
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Affiliation(s)
- Madelin R Siedler
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Mary Jane De Souza
- Departments of Kinesiology and Physiology, Pennsylvania State University, University Park, PA, USA
| | | | - Yasuki Sekiguchi
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA.
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25
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Foright RM, McQuillan TE, Frick JM, Minchella PM, Levasseur BM, Tinoco O, Birmingham L, Blankenship AE, Thyfault JP, Christianson JA. Exposure to early life stress impairs weight loss maintenance success in mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.19.549724. [PMID: 37503190 PMCID: PMC10370125 DOI: 10.1101/2023.07.19.549724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Early life stress increases obesity risk, but its impact on weight loss maintenance is unknown. Mice underwent neonatal maternal separation (NMS) from 0-3 weeks and were weaned onto high fat sucrose diet (HFSD) from 3-20 weeks. Calorie-restricted weight loss on a low fat sucrose diet (LFSD) occurred over 2 weeks to induce a 20% loss in body weight, which was maintained for 6 weeks. After weight loss, half the mice received running wheels (EX) the other half remained sedentary (SED). Mice were then fed ad libitum on HFSD or LFSD for 10 weeks and allowed to regain body weight. NMS mice had greater weight regain, total body weight and adiposity compared to naïve mice. During the first week of refeeding, NMS mice had increased food intake and were in a greater positive energy balance than naïve mice, but total energy expenditure was not affected by NMS. Female mice were more susceptible to NMS-induced effects, including increases in adiposity. NMS and naïve females were more susceptible to HFSD-induce weight regain. Exercise was beneficial in the first week of regain in male mice, but long-term only those on LFSD benefited from EX. As expected, HFSD led to greater weight regain than LFSD.
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Affiliation(s)
- Rebecca M Foright
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Tara E McQuillan
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Jenna M Frick
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Paige M Minchella
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Brittni M Levasseur
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Omar Tinoco
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Lauryn Birmingham
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Anneka E Blankenship
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - John P Thyfault
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
- Kansas Center for Metabolism and Obesity Research
- Research Service, Kansas City Veterans Affairs Medical Center, Kansas City, Kansas
| | - Julie A Christianson
- Department of Cell Biology & Physiology, University of Kansas Medical Center, Kansas City, Kansas
- Kansas Center for Metabolism and Obesity Research
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26
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Zhang R, Hou QC, Li BH, Deng L, Yang YM, Li TX, Yao XQ, Yang LL, Lin XL, Liao YQ, Wang L, Liu YP, Tan J, Wan ZW, Shuai P. Efficacy and safety of subcutaneous semaglutide in adults with overweight or obese: a subgroup meta-analysis of randomized controlled trials. Front Endocrinol (Lausanne) 2023; 14:1132004. [PMID: 37455913 PMCID: PMC10338217 DOI: 10.3389/fendo.2023.1132004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 05/29/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Semaglutide shows significant performance on weight reduction in several clinical trials. However, it is not clear what kind of administration frequency or dosage will achieve better effects. This study aims to explore the different therapeutic effect of semaglutide on weight control under the diverse administration circumstances. Methods The PubMed, Embase, Web of Science, Cochrane Library, and the Clinical Trials.gov were searched from inception until 6 June, 2022 to include randomized controlled trials evaluating the Efficacy and safety of subcutaneous semaglutide in overweight or obese adults. Random effects or fixed effects model was conducted based on the heterogeneity among trials. Subgroup analysis was performed to identify the detailed effects under different intervention situations. Results and discussion Our study included 13 RCTs involving 5,838 participants with 3,794 ones in semaglutide group and 2,044 in placebo group. Semaglutide was associated with a significant reduction on weight loss related outcomes, including the absolute value of weight loss (WMD -8·97, 95% CI -10·73 to -7·21), percentage of weight loss (WMD -10·00, 95% CI -11·99 to -8·00), body mass index (WMD-3·19, 95% CI -4·02 to -2·37) and waist circumference (WMD -7·21,95% CI -8·87 to -5·56). Subgroup analyses illustrated participants with high weekly dosage, long-term treatment duration and severe baseline BMI (Class II obesity) had a more remarkably decreasing on the main outcomes of weight loss (P for interaction<0·05). Total adverse reactions occurred more frequently in the daily administration group than that in the weekly group (P for interaction =0·01). During the treatment, the incidence rate of hypoglycemia was higher in the group without lifestyle intervention compared with that with lifestyle intervention (P for interaction =0·04). Interpretation Subcutaneous semaglutide had significant benefits on weight loss with reasonable safety in overweight or obese adults. Moreover, additional benefits on cardiometabolic profiles were also seen. We recommended semaglutide treatment to be coupled with lifestyle interventions, and target dose of 2·0 mg or more subcutaneously once weekly. Clinicians can choose suitable treatment schemes based on diverse individual situations. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=337099, identifier PROSPERO (CRD42022337099).
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Affiliation(s)
- Rui Zhang
- Department of Health Management & Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- School of Public Health, Southwest Medical University, Luzhou, China
| | - Qin-chuan Hou
- Department of Health Management & Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- School of Public Health, Southwest Medical University, Luzhou, China
| | - Bing-hong Li
- Department of Health Management & Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Ling Deng
- Department of Health Management & Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yu-mei Yang
- Department of Health Management & Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Ting-xin Li
- Department of Health Management & Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiao-qin Yao
- Department of Health Management & Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Liang-liang Yang
- Department of Health Management & Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xi-long Lin
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yi-qian Liao
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Lin Wang
- Department of Health Management & Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yu-ping Liu
- Department of Health Management & Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jing Tan
- Chinese Evidence-based Medicine Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zheng-wei Wan
- Department of Health Management & Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Ping Shuai
- Department of Health Management & Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- School of Public Health, Southwest Medical University, Luzhou, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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27
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Eo H, Kim SH, Ju IG, Huh E, Kim S, Choi JG, Kim SW, Son M, Oh MS. Longan extract suppresses food intake through regulation of POMC/AgRP neuronal activities and endoplasmic reticulum stress in hypothalamus of db/db mice. Front Nutr 2023; 10:1143613. [PMID: 37415911 PMCID: PMC10322219 DOI: 10.3389/fnut.2023.1143613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/02/2023] [Indexed: 07/08/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is one of the biggest public health issues worldwide and closely related to development of other chronic diseases such as cardiovascular diseases, cancer and neurodegenerative diseases. Considerable percentage of T2DM patients undergo have suffered from binge eating disorder which exacerbates insulin resistance and metabolic challenges. Longan (Dimocarpus longan L.) and its constituents are reported for their various health benefits. However, it is still unknown whether longan fruit supplementation can ameliorate glucose homeostasis and binge eating disorder found in T2DM. The current study aimed to investigate whether longan fruit extract (LE) supplementation can improve diabetic hyperglycemia through modulation of feeding center located in hypothalamus of db/db T2DM mice. As a result, LE supplementation ameliorated fasting blood glucose levels and reduced excessive epididymal fat accumulation. In addition, LE administration improved glucose tolerance and insulin sensitivity in db/db mice. Especially, LE supplemented mice showed less food consumption which was in line with increase of pro-opiomelanocortin (POMC) neuronal activities and decrease of agouti-related peptide (AgRP) neuronal activities. Furthermore, LE supplementation reduced hypothalamic endoplasmic reticulum (ER) stress which was stimulated in db/db mice. As ER stress is a crucial factor involving in appetite control and glucose homeostasis, the effect of LE supplementation on circulating glucose levels and feeding behavior might be mediated by suppression of hypothalamic ER stress. Collectively, these findings suggest that LE could be a potential nutraceutical for improvement of T2DM as well as patients with satiety issues.
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Affiliation(s)
- Hyeyoon Eo
- Department of Biomedical and Pharmaceutical Sciences, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Seong Hye Kim
- Department of Biomedical and Pharmaceutical Sciences, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - In Gyoung Ju
- Department of Oriental Pharmaceutical Science, Kyung Hee University, Seoul, Republic of Korea
| | - Eugene Huh
- Department of Oriental Pharmaceutical Science, Kyung Hee University, Seoul, Republic of Korea
| | | | | | | | - Miwon Son
- MThera Pharma Co., Seoul, Republic of Korea
| | - Myung Sook Oh
- Department of Biomedical and Pharmaceutical Sciences, Graduate School, Kyung Hee University, Seoul, Republic of Korea
- Department of Oriental Pharmaceutical Science, Kyung Hee University, Seoul, Republic of Korea
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Triffoni-Melo ADT, Castro MD, Jordão AA, Leandro-Merhi VA, Dick-DE-Paula I, Diez-Garcia RW. HIGH-FIBER DIET PROMOTES METABOLIC, HORMONAL, AND SATIETY EFFECTS IN OBESE WOMEN ON A SHORT-TERM CALORIC RESTRICTION. ARQUIVOS DE GASTROENTEROLOGIA 2023; 60:163-171. [PMID: 37556741 DOI: 10.1590/s0004-2803.202302022-96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 12/08/2022] [Indexed: 08/11/2023]
Abstract
•Body weight and BMI decrease in both the EG and CG groups during the period of caloric restriction. •For both the EG and CG groups, fat-free mass decreases during food restriction. •Subjects on a high-fiber diet have reduced fasting glucose and basal insulin as well as improved insulin resistance, as attested by the lower HOMA-IR index. •Obese women on a high-fiber diet have suppressed postprandial (after 60 min) acylated ghrelin, confirming that the diet composition influences ghrelin levels from the first day. •In the present study, it was possible to verify that fasting leptin concentration diminishes in obese women on a high-fiber diet. Background - Several mechanisms, including excessive hunger, account for patients' difficulties in maintaining weight loss and dietary changes after caloric restriction. Objective - To evaluate the effect of short-term high-fiber calorie-restricted diet in appetite-regulating hormones, and hunger and satiety sensations in women with obesity. In a randomized controlled trial study, thirty women with body mass index (BMI) higher than 30 kg/m2, and aged from 20 to 50 years were hospitalized following a calorie-restricted diet (1000 kcal/day) for three days. The experimental group (n=15) received high-fiber diet and the control group (n=15), conventional diet. Results - Body weight, BMI, resting energy expenditure (REE), acylated and total ghrelin, leptin, insulin and glucose, and hunger and satiety sensations were evaluated. Linear regression models with mixed effects (fixed and random effects) helped to assess the variables between the two groups and within the groups. Body weight and BMI decreased in both the experimental and control groups (P<0.001). After the high-fiber diet, postprandial acylated ghrelin (P=0.04), glucose (P<0.001), insulin (P=0.04), and leptin (P=0.03) levels as well as the HOMA-IR index (P=0.01) decreased, whereas satiety improved (P=0.02). Obese women that followed the conventional diet had increased body fat percentage (P=0.04) and lower REE (P=0.02). The two diets did not differ in terms of hunger sensation. Conclusion - A short-term high-fiber diet improves satiety sensations and metabolic parameters while suppressing postprandial acylated ghrelin (60 minutes) and maintaining the resting energy expenditure.
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Affiliation(s)
| | - Margaret de Castro
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Clínica Médica - Endocrinologia, Ribeirão Preto, SP, Brasil
| | - Alceu Afonso Jordão
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Ciências da Saúde - Nutrição e Metabolismo, Ribeirão Preto, SP, Brasil
| | | | - Ingrid Dick-DE-Paula
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Rosa Wanda Diez-Garcia
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Ciências da Saúde - Nutrição e Metabolismo, Ribeirão Preto, SP, Brasil
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29
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Al-Reshed F, Sindhu S, Al Madhoun A, Bahman F, AlSaeed H, Akhter N, Malik MZ, Alzaid F, Al-Mulla F, Ahmad R. Low carbohydrate intake correlates with trends of insulin resistance and metabolic acidosis in healthy lean individuals. Front Public Health 2023; 11:1115333. [PMID: 37006572 PMCID: PMC10061153 DOI: 10.3389/fpubh.2023.1115333] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 02/16/2023] [Indexed: 03/18/2023] Open
Abstract
Introduction Both obesity and a poor diet are considered major risk factors for triggering insulin resistance syndrome (IRS) and the development of type 2 diabetes mellitus (T2DM). Owing to the impact of low-carbohydrate diets, such as the keto diet and the Atkins diet, on weight loss in individuals with obesity, these diets have become an effective strategy for a healthy lifestyle. However, the impact of the ketogenic diet on IRS in healthy individuals of a normal weight has been less well researched. This study presents a cross-sectional observational study that aimed to investigate the effect of low carbohydrate intake in healthy individuals of a normal weight with regard to glucose homeostasis, inflammatory, and metabolic parameters. Methods The study included 120 participants who were healthy, had a normal weight (BMI 25 kg/m2), and had no history of a major medical condition. Self-reported dietary intake and objective physical activity measured by accelerometry were tracked for 7 days. The participants were divided into three groups according to their dietary intake of carbohydrates: the low-carbohydrate (LC) group (those consuming <45% of their daily energy intake from carbohydrates), the recommended range of carbohydrate (RC) group (those consuming 45-65% of their daily energy intake from carbohydrates), and the high-carbohydrate (HC) group (those consuming more than 65% of their daily energy intake from carbohydrates). Blood samples were collected for the analysis of metabolic markers. HOMA of insulin resistance (HOMA-IR) and HOMA of β-cell function (HOMA-β), as well as C-peptide levels, were used for the evaluation of glucose homeostasis. Results Low carbohydrate intake (<45% of total energy) was found to significantly correlate with dysregulated glucose homeostasis as measured by elevations in HOMA-IR, HOMA-β% assessment, and C-peptide levels. Low carbohydrate intake was also found to be coupled with lower serum bicarbonate and serum albumin levels, with an increased anion gap indicating metabolic acidosis. The elevation in C-peptide under low carbohydrate intake was found to be positively correlated with the secretion of IRS-related inflammatory markers, including FGF2, IP-10, IL-6, IL-17A, and MDC, but negatively correlated with IL-3. Discussion Overall, the findings of the study showed that, for the first time, low-carbohydrate intake in healthy individuals of a normal weight might lead to dysfunctional glucose homeostasis, increased metabolic acidosis, and the possibility of triggering inflammation by C-peptide elevation in plasma.
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Affiliation(s)
- Fatema Al-Reshed
- Immunology and Microbiology Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Sardar Sindhu
- Animal and Imaging Core Facility, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Ashraf Al Madhoun
- Animal and Imaging Core Facility, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Fatemah Bahman
- Immunology and Microbiology Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Halemah AlSaeed
- Immunology and Microbiology Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Nadeem Akhter
- Immunology and Microbiology Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Md Zubbair Malik
- Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman, Kuwait
| | - Fawaz Alzaid
- Institute Necker Enfants Malades (INEM), French Institute of Health and Medical Research (INSERM), Immunity and Metabolism of Diabetes (IMMEDIAB), Université de Paris Cité, Paris, France
| | - Fahd Al-Mulla
- Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman, Kuwait
| | - Rasheed Ahmad
- Immunology and Microbiology Department, Dasman Diabetes Institute, Kuwait City, Kuwait
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30
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Uncovering Barriers and Facilitators of Weight Loss and Weight Loss Maintenance: Insights from Qualitative Research. Nutrients 2023; 15:nu15051297. [PMID: 36904294 PMCID: PMC10005538 DOI: 10.3390/nu15051297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 03/08/2023] Open
Abstract
Long-term weight loss maintenance is often difficult to achieve. This review analysed qualitative data on self-perceived barriers and facilitators of weight loss and weight loss maintenance among weight loss intervention participants. A literature search was conducted using electronic databases. Qualitative studies written in English and published between 2011-2021 were eligible for inclusion if they explored the perspectives and experiences of individuals who received standardised dietary and behavioural support for weight loss. Studies were excluded if weight loss was achieved through self-directed methods, only increasing physical activity, or surgical or pharmacological interventions. Fourteen studies were included, totaling 501 participants from six countries. Thematic analysis was used to identify four aggregate themes: internal factors (i.e., motivation and self-efficacy), programme-specific factors (i.e., the intervention diet), social factors (i.e., supporters and saboteurs), and environmental factors (i.e., an obesogenic environment). Our findings demonstrate that internal, social, and environmental factors all influence weight loss success, as well as the acceptability of the weight loss intervention. Future interventions may be more successful if they prioritise participant acceptability and engagement by, for example, providing tailored interventions, a structured relapse management plan, strategies to enhance autonomous motivation and emotional self-regulation, and extended contact during weight loss maintenance.
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31
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Korgan AC, Oliveira-Abreu K, Wei W, Martin SLA, Bridges ZJD, Leal-Cardoso JH, Kaczorowski CC, O'Connell KMS. High sucrose consumption decouples intrinsic and synaptic excitability of AgRP neurons without altering body weight. Int J Obes (Lond) 2023; 47:224-235. [PMID: 36725979 PMCID: PMC10023568 DOI: 10.1038/s41366-023-01265-w] [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: 10/04/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 02/03/2023]
Abstract
BACKGROUND/OBJECTIVE As the obesity epidemic continues, the understanding of macronutrient influence on central nervous system function is critical for understanding diet-induced obesity and potential therapeutics, particularly in light of the increased sugar content in processed foods. Previous research showed mixed effects of sucrose feeding on body weight gain but has yet to reveal insight into the impact of sucrose on hypothalamic functioning. Here, we explore the impact of liquid sucrose feeding for 12 weeks on body weight, body composition, caloric intake, and hypothalamic AgRP neuronal function and synaptic plasticity. METHODS Patch-clamp electrophysiology of hypothalamic AgRP neurons, metabolic phenotyping and food intake were performed on C57BL/6J mice. RESULTS While mice given sugar-sweetened water do not gain significant weight, they do show subtle differences in body composition and caloric intake. When given sugar-sweetened water, mice show similar alterations to AgRP neuronal excitability as in high-fat diet obese models. Increased sugar consumption also primes mice for increased caloric intake and weight gain when given access to a HFD. CONCLUSIONS Our results show that elevated sucrose consumption increased activity of AgRP neurons and altered synaptic excitability. This may contribute to obesity in mice and humans with access to more palatable (HFD) diets.
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Affiliation(s)
- Austin C Korgan
- The Jackson Laboratory for Mammalian Genetics, Bar Harbor, ME, USA
| | - Klausen Oliveira-Abreu
- The Jackson Laboratory for Mammalian Genetics, Bar Harbor, ME, USA
- Instituto Superior de Ciências Biomédicas, Universidade Estadual do Ceará, Fortaleza, CE, Brazil
| | - Wei Wei
- The Jackson Laboratory for Mammalian Genetics, Bar Harbor, ME, USA
- Georgia State University, Atlanta, GA, USA
| | | | - Zoey J D Bridges
- The Jackson Laboratory for Mammalian Genetics, Bar Harbor, ME, USA
| | | | - Catherine C Kaczorowski
- The Jackson Laboratory for Mammalian Genetics, Bar Harbor, ME, USA
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME, USA
- Neuroscience Program, Graduate School of Biomedical Science, Tufts University School of Medicine, Boston, MA, USA
| | - Kristen M S O'Connell
- The Jackson Laboratory for Mammalian Genetics, Bar Harbor, ME, USA.
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME, USA.
- Neuroscience Program, Graduate School of Biomedical Science, Tufts University School of Medicine, Boston, MA, USA.
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32
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Mäkinen VP, Kettunen J, Lehtimäki T, Kähönen M, Viikari J, Perola M, Salomaa V, Järvelin MR, Raitakari OT, Ala-Korpela M. Longitudinal metabolomics of increasing body-mass index and waist-hip ratio reveals two dynamic patterns of obesity pandemic. Int J Obes (Lond) 2023; 47:453-462. [PMID: 36823293 DOI: 10.1038/s41366-023-01281-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND/OBJECTIVE This observational study dissects the complex temporal associations between body-mass index (BMI), waist-hip ratio (WHR) and circulating metabolomics using a combination of longitudinal and cross-sectional population-based datasets and new systems epidemiology tools. SUBJECTS/METHODS Firstly, a data-driven subgrouping algorithm was employed to simplify high-dimensional metabolic profiling data into a single categorical variable: a self-organizing map (SOM) was created from 174 metabolic measures from cross-sectional surveys (FINRISK, n = 9708, ages 25-74) and a birth cohort (NFBC1966, n = 3117, age 31 at baseline, age 46 at follow-up) and an expert committee defined four subgroups of individuals based on visual inspection of the SOM. Secondly, the subgroups were compared regarding BMI and WHR trajectories in an independent longitudinal dataset: participants of the Young Finns Study (YFS, n = 1286, ages 24-39 at baseline, 10 years follow-up, three visits) were categorized into the four subgroups and subgroup-specific age-dependent trajectories of BMI, WHR and metabolic measures were modelled by linear regression. RESULTS The four subgroups were characterised at age 39 by high BMI, WHR and dyslipidemia (designated TG-rich); low BMI, WHR and favourable lipids (TG-poor); low lipids in general (Low lipid) and high low-density-lipoprotein cholesterol (High LDL-C). Trajectory modelling of the YFS dataset revealed a dynamic BMI divergence pattern: despite overlapping starting points at age 24, the subgroups diverged in BMI, fasting insulin (three-fold difference at age 49 between TG-rich and TG-poor) and insulin-associated measures such as triglyceride-cholesterol ratio. Trajectories also revealed a WHR progression pattern: despite different starting points at the age of 24 in WHR, LDL-C and cholesterol-associated measures, all subgroups exhibited similar rates of change in these measures, i.e. WHR progression was uniform regardless of the cross-sectional metabolic profile. CONCLUSIONS Age-associated weight variation in adults between 24 and 49 manifests as temporal divergence in BMI and uniform progression of WHR across metabolic health strata.
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Affiliation(s)
- Ville-Petteri Mäkinen
- Systems Epidemiology, Faculty of Medicine, University of Oulu, Oulu, Finland. .,Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland. .,Computational and Systems Biology Program, Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia. .,Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia.
| | - Johannes Kettunen
- Systems Epidemiology, Faculty of Medicine, University of Oulu, Oulu, Finland.,Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland.,Biocenter Oulu, Oulu, Finland.,Department of Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, and Finnish Cardiovascular Research Center Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jorma Viikari
- Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Markus Perola
- Department of Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland.,Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Veikko Salomaa
- Department of Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland.,Unit of Primary Health Care, Oulu University Hospital, OYS, Oulu, Finland.,Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.,Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Mika Ala-Korpela
- Systems Epidemiology, Faculty of Medicine, University of Oulu, Oulu, Finland. .,Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland. .,Biocenter Oulu, Oulu, Finland. .,NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
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Halliday TM, McFadden M, Cedillo M, Barone Gibbs B, Hess R, Bryce C, Fischer GS, Huber K, McTigue KM, Conroy MB. Lifestyle strategies after intentional weight loss: results from the MAINTAIN-pc randomized trial. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2023; 8:e000220. [PMID: 37458000 PMCID: PMC10348773 DOI: 10.1249/tjx.0000000000000220] [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] [Indexed: 02/16/2023]
Abstract
Introduction/Purpose Weight maintenance following intentional weight loss is challenging and often unsuccessful. Physical activity and self-monitoring are strategies associated with successful weight loss maintenance. However, less is known about the type and number of lifestyle strategies used following intentional weight loss. The purpose of this study was to determine the types and amounts of strategies associated with successful long-term weight loss maintenance. Methods Data from the 24-month Maintaining Activity and Nutrition Through Technology-Assisted Innovation in Primary Care (MAINTAIN-pc) trial were analyzed. MAINTAIN-pc recruited adults (n=194; 53.4±12.2 years of age, body mass index (BMI): 30.4±5.9 kg/m2, 74% female) with recent intentional weight loss of ≥5%, randomized to tracking tools plus coaching (i.e., coaching group) or tracking tools without coaching (i.e., tracking-only group). At baseline, 6, 12, and 24 months, participants reported lifestyle strategies used in the past 6 months, including self-monitoring, group support, behavioral skills, and professional support. General linear models evaluated changes in the number of strategies over time between groups and the consistency of strategies used over the 24-month intervention. Results At baseline, 100% used behavioral skills, 73% used group support, 69% used self-monitoring, and 68% used professional support in the past 6 months; at 24 months, these rates were 98%, 60%, 75%, and 61%, respectively. While the number of participants utilizing individual strategies did not change significantly over time, the overall number of strategies participants reported decreased. More strategies were used at baseline and 6 months compared to 12- and 24-month follow-ups. The coaching group used more strategies at months 6 and 12 than the tracking-only group. Consistent use of professional support strategies over the 24-month study period was associated with less weight regain. Conclusion Weight loss maintenance interventions that incorporate continued follow-up and support from healthcare professionals are likely to prevent weight regain after intentional weight loss.
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Affiliation(s)
- Tanya M. Halliday
- Department of Health and Kinesiology, College of Health, University of Utah, Salt Lake City, UT, USA
| | - Molly McFadden
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Maribel Cedillo
- Division of General Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Bethany Barone Gibbs
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rachel Hess
- Division of Health System Innovation and Research, Departments of Population Health Sciences and Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Cindy Bryce
- Department of Health Policy & Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh PA, USA
| | - Gary S. Fischer
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kimberly Huber
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathleen M. McTigue
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Molly B. Conroy
- Division of General Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
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Poghosyan V, Ioannou S, Al-Amri KM, Al-Mashhadi SA, Al-Mohammed F, Al-Otaibi T, Al-Saeed W. Spatiotemporal profile of altered neural reactivity to food images in obesity: Reward system is altered automatically and predicts efficacy of weight loss intervention. Front Neurosci 2023; 17:948063. [PMID: 36845430 PMCID: PMC9944082 DOI: 10.3389/fnins.2023.948063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 01/24/2023] [Indexed: 02/10/2023] Open
Abstract
Introduction Obesity presents a significant public health problem. Brain plays a central role in etiology and maintenance of obesity. Prior neuroimaging studies have found that individuals with obesity exhibit altered neural responses to images of food within the brain reward system and related brain networks. However, little is known about the dynamics of these neural responses or their relationship to later weight change. In particular, it is unknown if in obesity, the altered reward response to food images emerges early and automatically, or later, in the controlled stage of processing. It also remains unclear if the pretreatment reward system reactivity to food images is predictive of subsequent weight loss intervention outcome. Methods In this study, we presented high-calorie and low-calorie food, and nonfood images to individuals with obesity, who were then prescribed lifestyle changes, and matched normal-weight controls, and examined neural reactivity using magnetoencephalography (MEG). We performed whole-brain analysis to explore and characterize large-scale dynamics of brain systems affected in obesity, and tested two specific hypotheses: (1) in obese individuals, the altered reward system reactivity to food images occurs early and automatically, and (2) pretreatment reward system reactivity predicts the outcome of lifestyle weight loss intervention, with reduced activity associated with successful weight loss. Results We identified a distributed set of brain regions and their precise temporal dynamics that showed altered response patterns in obesity. Specifically, we found reduced neural reactivity to food images in brain networks of reward and cognitive control, and elevated reactivity in regions of attentional control and visual processing. The hypoactivity in reward system emerged early, in the automatic stage of processing (< 150 ms post-stimulus). Reduced reward and attention responsivity, and elevated neural cognitive control were predictive of weight loss after six months in treatment. Discussion In summary, we have identified, for the first time with high temporal resolution, the large-scale dynamics of brain reactivity to food images in obese versus normal-weight individuals, and have confirmed both our hypotheses. These findings have important implications for our understanding of neurocognition and eating behavior in obesity, and can facilitate development of novel integrated treatment strategies, including tailored cognitive-behavioral and pharmacological therapies.
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Affiliation(s)
- Vahe Poghosyan
- Department of Neurophysiology, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia,*Correspondence: Vahe Poghosyan,
| | - Stephanos Ioannou
- Department of Physiological Sciences, Alfaisal University, Riyadh, Saudi Arabia
| | - Khalid M. Al-Amri
- Obesity, Endocrinology and Metabolism Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Sufana A. Al-Mashhadi
- Research Unit, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Fedaa Al-Mohammed
- Department of Neurophysiology, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Tahani Al-Otaibi
- Department of Neurophysiology, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Wjoud Al-Saeed
- Research Unit, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
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Bermudez B, Ishii T, Wu YH, Carpenter RD, Sherk VD. Energy Balance and Bone Health: a Nutrient Availability Perspective. Curr Osteoporos Rep 2023; 21:77-84. [PMID: 36542294 DOI: 10.1007/s11914-022-00765-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Obesity is highly prevalent and is associated with bone fragility and fracture. The changing nutrient availability to bone in obesity is an important facet of bone health. The goal of this article is to summarize current knowledge on the effects of carbohydrate and dietary fat availability on bone, particularly in the context of other tissues. RECENT FINDINGS The skeleton is a primary site for fatty acid and glucose uptake. The trafficking of carbohydrates and fats into tissues changes with weight loss and periods of weight gain. Exercise acutely influences nutrient uptake into bone and may affect nutrient partitioning to bone. Bone cells secrete hormones that signal to the brain and other tissues information about its energetic state, which may alter whole-body nutrient trafficking. There is a critical need for studies to address the changes that metabolic perturbations have on nutrient availability in bone.
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Affiliation(s)
- Beatriz Bermudez
- Department of Mechanical Engineering, University of Colorado Denver, Denver, CO, USA
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Toru Ishii
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Yuan-Haw Wu
- Department of Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - R Dana Carpenter
- Department of Mechanical Engineering, University of Colorado Denver, Denver, CO, USA
| | - Vanessa D Sherk
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
- Division of Translational and Clinical Sciences, Center for Scientific Review, National Institutes of Health, Bethesda, MD, USA.
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Albaugh VL, He Y, Münzberg H, Morrison CD, Yu S, Berthoud HR. Regulation of body weight: Lessons learned from bariatric surgery. Mol Metab 2023; 68:101517. [PMID: 35644477 PMCID: PMC9938317 DOI: 10.1016/j.molmet.2022.101517] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 05/04/2022] [Accepted: 05/21/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Bariatric or weight loss surgery is currently the most effective treatment for obesity and metabolic disease. Unlike dieting and pharmacology, its beneficial effects are sustained over decades in most patients, and mortality is among the lowest for major surgery. Because there are not nearly enough surgeons to implement bariatric surgery on a global scale, intensive research efforts have begun to identify its mechanisms of action on a molecular level in order to replace surgery with targeted behavioral or pharmacological treatments. To date, however, there is no consensus as to the critical mechanisms involved. SCOPE OF REVIEW The purpose of this non-systematic review is to evaluate the existing evidence for specific molecular and inter-organ signaling pathways that play major roles in bariatric surgery-induced weight loss and metabolic benefits, with a focus on Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG), in both humans and rodents. MAJOR CONCLUSIONS Gut-brain communication and its brain targets of food intake control and energy balance regulation are complex and redundant. Although the relatively young science of bariatric surgery has generated a number of hypotheses, no clear and unique mechanism has yet emerged. It seems increasingly likely that the broad physiological and behavioral effects produced by bariatric surgery do not involve a single mechanism, but rather multiple signaling pathways. Besides a need to improve and better validate surgeries in animals, advanced techniques, including inducible, tissue-specific knockout models, and the use of humanized physiological traits will be necessary. State-of-the-art genetically-guided neural identification techniques should be used to more selectively manipulate function-specific pathways.
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Affiliation(s)
- Vance L Albaugh
- Translational and Integrative Gastrointestinal and Endocrine Research Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Yanlin He
- Brain Glycemic and Metabolism Control Department, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Heike Münzberg
- Neurobiology of Nutrition & Metabolism Department, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Christopher D Morrison
- Neurobiology of Nutrition & Metabolism Department, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Sangho Yu
- Neurobiology of Nutrition & Metabolism Department, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Hans-Rudolf Berthoud
- Neurobiology of Nutrition & Metabolism Department, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA.
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Bourdier P, Simon C, Bessesen DH, Blanc S, Bergouignan A. The role of physical activity in the regulation of body weight: The overlooked contribution of light physical activity and sedentary behaviors. Obes Rev 2023; 24:e13528. [PMID: 36394185 PMCID: PMC10910694 DOI: 10.1111/obr.13528] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/31/2022] [Accepted: 10/23/2022] [Indexed: 11/18/2022]
Abstract
The role of physical activity (PA) in the regulation of body weight is still a major topic of debate. This may be because studies have essentially focused on the effects of moderate/vigorous PA (MVPA) on body weight while overlooking the other components of PA, namely, light-intensity PA (LPA, daily life activities) and sedentary behaviors (SB, too much sitting). In this review, we will (i) describe the history of changes in PA behaviors that occurred with modernization; (ii) review data from cross-sectional and longitudinal studies that examined the associations between PA, SB, and measures of obesity; (iii) review interventional studies that investigated the effects of changes in PA and SB on body weight and adiposity; and (iv) discuss experimental studies that addressed potential biological mechanisms underlying the effects of PA and SB on weight regulation. Overall recent findings support the importance of considering all components of PA to better understand the regulation of energy balance and suggest an important role for LPA and SB in addition to MVPA on body weight regulation. Longitudinal large-scale rigorous studies are needed to advance our knowledge of the role of PA/SB in combating the obesity epidemic.
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Affiliation(s)
- Pierre Bourdier
- CNRS IPHC UMR 7178 Université de Strasbourg, Strasbourg, France
| | - Chantal Simon
- CarMen Laboratory, INSERM 1060, INRAE 1397, University of Lyon, Oullins, France
- Human Nutrition Research Centre of Rhône-Alpes, Hospices Civils de Lyon, Lyon, France
| | - Daniel H. Bessesen
- Anschutz Health and Wellness Center, Division of Endocrinology, University of Colorado, Aurora, Colorado, USA
| | - Stéphane Blanc
- CNRS IPHC UMR 7178 Université de Strasbourg, Strasbourg, France
| | - Audrey Bergouignan
- CNRS IPHC UMR 7178 Université de Strasbourg, Strasbourg, France
- Anschutz Health and Wellness Center, Division of Endocrinology, University of Colorado, Aurora, Colorado, USA
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Hafida S, Apovian C. Physiology of the Weight-Reduced State and Its Impact on Weight Regain. Endocrinol Metab Clin North Am 2022; 51:795-815. [PMID: 36244694 DOI: 10.1016/j.ecl.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Obesity is a chronic disease characterized by long duration, slow progression, and periods of remission and relapses. Despite the development of effective medical and surgical interventions and millions of people conducting tremendous personal efforts to manage their weight every year, recidivism remains a significant barrier to attaining long-term weight maintenance. This review aimed to explain the underlying physiology of the weight-reduced state including changes in energy balance, adipose tissue, genetic, environmental, and behavioral factors that may predispose individuals to weight regain following weight loss.
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Affiliation(s)
- Samar Hafida
- Division of Endocrinology, Diabetes, Nutrition and Weight Management, 72 East, Concord Street C3 (Room 321 A), Collamore Building, Boston, MA 02118, USA.
| | - Caroline Apovian
- Division of Endocrinology, Diabetes and Hypertension, Center for Weight Management and Wellness, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Suite RFB-2, Brigham and Women's at 221 Longwood, Boston, MA 02115, USA
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Hanson P, Lange M, Oduro-Donkor D, Shuttlewood E, Weickert MO, Randeva HS, Menon V, Alexander RT, Basset P, Shankar R, Barber TM. The role of mindfulness training in sustaining weight reduction: retrospective cohort analysis. BJPsych Open 2022; 8:e198. [PMID: 36377522 PMCID: PMC9707508 DOI: 10.1192/bjo.2022.602] [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] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Psychological stress has an established bi-directional relationship with obesity. Mindfulness techniques reduce stress and improve eating behaviours, but their long-term impact remains untested. CALMPOD (Compassionate Approach to Living Mindfully for Prevention of Disease) is a psychoeducational mindfulness-based course evidenced to improve eating patterns across a 6-month period, possibly by reducing stress. However, no long-term evaluation of impact exists. AIMS This study retrospectively evaluates 2-year outcomes of CALMPOD on patient engagement, weight and metabolic markers. METHOD All adults with a body mass index >35 kg/m2 attending an UK obesity service during 2016-2020 were offered CALMPOD. Those who refused CALMPOD were offered standard lifestyle advice. Routine clinic data over 2 years, including age, gender, 6-monthly appointment attendance, weight, haemoglobin A1C and total cholesterol, were pooled and analysed to evaluate CALMPOD. RESULTS Of 289 patients, 163 participated in the CALMPOD course and 126 did not. No baseline demographic differences existed between the participating and non-participating groups. The CALMPOD group had improved attendance across all 6-monthly appointments compared with the non-CALMPOD group (P < 0.05). Mean body weight reduction at 2 years was 5.6 kg (s.d. 11.2, P < 0.001) for the CALMPOD group compared with 3.9 kg (s.d. 10.5, P < 0.001) for the non-CALMPOD group. No differences in haemoglobin A1C and fasting serum total cholesterol were identified between the groups. CONCLUSIONS The retrospective evaluation of CALMPOD suggests potential for mindfulness and compassion-based group educational techniques to improve longer-term patient and clinical outcomes. Prospective large-scale studies are needed to evaluate the impact of stress on obesity and the true impact of CALMPOD.
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Affiliation(s)
- Petra Hanson
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK; and NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Maria Lange
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK; and NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Dominic Oduro-Donkor
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK; and NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Emma Shuttlewood
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Martin O Weickert
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, UK; and Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, UK
| | - Harpal S Randeva
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, UK; and Aston Medical Research Institute, Aston Medical School, Aston University, UK
| | - Vinod Menon
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Regi T Alexander
- Adult Learning Disability Services, Hertfordshire Partnership University NHS Foundation Trust, Little Plumstead Hospital, Norwich, UK; and School of Life and Medical Sciences, University of Hertfordshire, UK
| | | | - Rohit Shankar
- Cornwall Institute of Intellectual Disability Research (CIDER), Peninsula Medical School, University of Plymouth, UK and Cornwall Partnership NHS Foundation Trust, UK
| | - Tom M Barber
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, UK; and NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, UK
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Shi H, Zhao J, Li Y, Li J, Li Y, Zhang J, Qiu Z, Wu C, Qin M, Liu C, Zeng Z, Zhang C, Gao L. Ginsenosides Rg1 regulate lipid metabolism and temperature adaptation in Caenorhabditis elegans. J Ginseng Res 2022. [DOI: 10.1016/j.jgr.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Nebot E, Martínez R, Kapravelou G, Sánchez C, Llopis J, Aranda P, Porres JM, López-Jurado M, Pietschmann P. Combination of Caloric Restriction and a Mixed Training Protocol as an Effective Strategy to Counteract the Deleterious Effects in Trabecular Bone Microarchitecture Caused by a Diet-Induced Obesity in Sprague Dawley Rats. Nutrients 2022; 14:nu14183672. [PMID: 36145048 PMCID: PMC9504808 DOI: 10.3390/nu14183672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
The association of obesity with changes in bone mass is not clear. Obese individuals tend to have an increased bone mineral density, but other studies have shown that obesity is a major risk factor for fractures. The mechanisms of bone response during a weight loss therapy as well as the possible osteoprotective effect of exercise should be analyzed. The aim of this study was to test the effects of a weight-loss program based on the combination of caloric restriction and/or a mixed training protocol on different parameters of bone morphology and functionality in a DIO rat model. Three stages were established over a 21-week period (obesity induction 0–12 w, weight loss intervention 12–15 w, weight maintenance intervention 15–21 w) in 88 male Sprague Dawley rats. Bone microarchitecture, total mineral and elemental composition, and bone metabolism parameters were assessed. Weight loss interventions were associated to healthy changes in body composition, decreasing body fat and increasing lean body mass. On the other hand, obesity was related to a higher content of bone resorption and inflammatory markers, which was decreased by the weight control interventions. Caloric restriction led to marked changes in trabecular microarchitecture, with a significant decrease in total volume but no changes in bone volume (BV). In addition, the intervention diet caused an increase in trabeculae number and a decrease in trabecular spacing. The training protocol increased the pore diameter and reversed the changes in cortical porosity and density of BV induced by the high protein diet at diaphysis level. Regarding the weight-maintenance stage, diminished SMI values indicate the presence of more plate-like spongiosa in sedentary and exercise groups. In conclusion, the lifestyle interventions of caloric restriction and mixed training protocol implemented as weight loss strategies have been effective to counteract some of the deleterious effects caused by a dietary induction of obesity, specifically in trabecular bone morphometric parameters as well as bone mineral content.
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Affiliation(s)
- Elena Nebot
- Department of Physiology, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Rosario Martínez
- Department of Physiology, Institute of Nutrition and Food Technology (INyTA), Biomedical Research Center (CIBM), University of Granada, Avda del Conocimiento s/n, 18100 Armilla, Spain
| | - Garyfallia Kapravelou
- Department of Physiology, Institute of Nutrition and Food Technology (INyTA), Biomedical Research Center (CIBM), University of Granada, Avda del Conocimiento s/n, 18100 Armilla, Spain
| | - Cristina Sánchez
- Department of Physiology, Institute of Nutrition and Food Technology (INyTA), Biomedical Research Center (CIBM), University of Granada, Avda del Conocimiento s/n, 18100 Armilla, Spain
| | - Juan Llopis
- Department of Physiology, Institute of Nutrition and Food Technology (INyTA), Biomedical Research Center (CIBM), University of Granada, Avda del Conocimiento s/n, 18100 Armilla, Spain
| | - Pilar Aranda
- Department of Physiology, Institute of Nutrition and Food Technology (INyTA), Biomedical Research Center (CIBM), University of Granada, Avda del Conocimiento s/n, 18100 Armilla, Spain
| | - Jesús M. Porres
- Department of Physiology, Institute of Nutrition and Food Technology (INyTA), Biomedical Research Center (CIBM), University of Granada, Avda del Conocimiento s/n, 18100 Armilla, Spain
- Correspondence:
| | - María López-Jurado
- Department of Physiology, Institute of Nutrition and Food Technology (INyTA), Biomedical Research Center (CIBM), University of Granada, Avda del Conocimiento s/n, 18100 Armilla, Spain
| | - Peter Pietschmann
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria
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Bays HE, Golden A, Tondt J. Thirty Obesity Myths, Misunderstandings, and/or Oversimplifications: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. OBESITY PILLARS (ONLINE) 2022; 3:100034. [PMID: 37990730 PMCID: PMC10661978 DOI: 10.1016/j.obpill.2022.100034] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) is intended to provide clinicians an overview of 30 common obesity myths, misunderstandings, and/or oversimplifications. Methods The scientific support for this CPS is based upon published citations, clinical perspectives of OMA authors, and peer review by the Obesity Medicine Association leadership. Results This CPS discusses 30 common obesity myths, misunderstandings, and/or oversimplifications, utilizing referenced scientific publications such as the integrative use of other published OMA CPSs to help explain the applicable physiology/pathophysiology. Conclusions This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on 30 common obesity myths, misunderstandings, and/or oversimplifications is one of a series of OMA CPSs designed to assist clinicians in the care of patients with the disease of obesity. Knowledge of the underlying science may assist the obesity medicine clinician improve the care of patients with obesity.
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Affiliation(s)
- Harold Edward Bays
- Louisville Metabolic and Atherosclerosis Research Center, University of Louisville School of Medicine, 3288, Illinois Avenue, Louisville, KY, 40213, USA
| | - Angela Golden
- NP Obesity Treatment Clinic, Flagstaff, AZ, 86001, USA
| | - Justin Tondt
- Department of Family and Community Medicine, Penn State Health, Penn State College of Medicine, 700 HMC Crescent Rd Hershey, PA, 17033, USA
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Ehrlicher SE, Chui TK, Clina JG, Ellison KM, Sayer RD. The Data Behind Popular Diets for Weight Loss. Med Clin North Am 2022; 106:739-766. [PMID: 36154698 DOI: 10.1016/j.mcna.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Both scientific evidence and popular diet trends have sought to identify the ideal diet for weight loss with strategies focused on either restricting carbohydrates or fat. While there is a strong physiologic rationale for either carbohydrate restriction or fat restriction to achieve a calorie deficit needed for weight loss, evidence from randomized controlled trials suggest either type of diet is effective for weight loss. The level of adherence, rather than macronutrient content, is the driver of successful weight loss.
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Affiliation(s)
- Sarah E Ehrlicher
- Department of Nutrition Sciences, University of Alabama at Birmingham, Webb 256, 1675 University Boulevard, Birmingham, AL 35294, USA.
| | - Tsz-Kiu Chui
- Department of Nutrition Sciences, University of Alabama at Birmingham, Webb 630, 1675 University Blvd, Birmingham, AL 35294, USA
| | - Julianne G Clina
- Department of Nutrition Sciences, University of Alabama at Birmingham, Webb 630, 1675 University Blvd, Birmingham, AL 35294, USA
| | - Katie M Ellison
- Department of Nutrition Sciences, University of Alabama at Birmingham, Webb 630, 1675 University Blvd, Birmingham, AL 35294, USA
| | - R Drew Sayer
- Department of Nutrition Sciences, University of Alabama at Birmingham, Webb 634, 1675 University Boulevard, Birmingham, AL 35294, USA
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Sargeant JA, King JA, Yates T, Redman EL, Bodicoat DH, Chatterjee S, Edwardson CL, Gray LJ, Poulin B, Waheed G, Waller HL, Webb DR, Willis SA, Wilding JPH, Khunti K, Stensel DJ, Davies MJ. The effects of empagliflozin, dietary energy restriction, or both on appetite-regulatory gut peptides in individuals with type 2 diabetes and overweight or obesity: The SEESAW randomized, double-blind, placebo-controlled trial. Diabetes Obes Metab 2022; 24:1509-1521. [PMID: 35441435 PMCID: PMC9541107 DOI: 10.1111/dom.14721] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/07/2022] [Accepted: 04/18/2022] [Indexed: 11/28/2022]
Abstract
AIM To assess the impact of the sodium-glucose co-transporter-2 (SGLT2) inhibitor empagliflozin (25 mg once-daily), dietary energy restriction, or both combined, on circulating appetite-regulatory peptides in people with type 2 diabetes (T2D) and overweight or obesity. MATERIALS AND METHODS In a double-blind, placebo-controlled trial, 68 adults (aged 30-75 years) with T2D (drug naïve or on metformin monotherapy; HbA1c 6.0%-10.0% [42-86 mmol/mol]) and body mass index of 25 kg/m2 or higher were randomized to (a) placebo only, (b) placebo plus diet, (c) empagliflozin only or (d) empagliflozin plus diet for 24 weeks. Dietary energy restriction matched the estimated energy deficit elicited by SGLT2 inhibitor therapy through urinary glucose excretion (~360 kcal/day). The primary outcome was change in postprandial circulating total peptide-YY (PYY) during a 3-hour mixed-meal tolerance test from baseline to 24 weeks. Postprandial total glucagon-like peptide-1 (GLP-1), acylated ghrelin and subjective appetite perceptions formed secondary outcomes, along with other key components of energy balance. RESULTS The mean weight loss in each group at 24 weeks was 0.44, 1.91, 2.22 and 5.74 kg, respectively. The change from baseline to 24 weeks in postprandial total PYY was similar between experimental groups and placebo only (mean difference [95% CI]: -8.6 [-28.6 to 11.4], 13.4 [-6.1 to 33.0] and 1.0 [-18.0 to 19.9] pg/ml in placebo-plus diet, empagliflozin-only and empagliflozin-plus-diet groups, respectively [all P ≥ .18]). Similarly, there was no consistent pattern of difference between groups for postprandial total GLP-1, acylated ghrelin and subjective appetite perceptions. CONCLUSIONS In people with T2D and overweight or obesity, changes in postprandial appetite-regulatory gut peptides may not underpin the less than predicted weight loss observed with empagliflozin therapy. CLINICAL TRIALS REGISTRATION NCT02798744, www. CLINICALTRIALS gov; 2015-001594-40, www.EudraCT.ema.europa.eu; ISRCTN82062639, www.ISRCTN.org.
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Affiliation(s)
- Jack A. Sargeant
- Diabetes Research CentreUniversity of LeicesterLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
| | - James A. King
- National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
- School of Sport, Exercise and Health SciencesLoughborough UniversityLeicestershireUK
| | - Thomas Yates
- Diabetes Research CentreUniversity of LeicesterLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
| | - Emma L. Redman
- Diabetes Research CentreUniversity of LeicesterLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
- Leicester Diabetes CentreUniversity Hospitals of Leicester NHS TrustLeicesterUK
| | | | | | - Charlotte L. Edwardson
- Diabetes Research CentreUniversity of LeicesterLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
| | - Laura J. Gray
- Department of Health SciencesUniversity of LeicesterLeicesterUK
| | - Benoit Poulin
- Diabetes Research CentreUniversity of LeicesterLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
| | - Ghazala Waheed
- Diabetes Research CentreUniversity of LeicesterLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
| | - Helen L. Waller
- Diabetes Research CentreUniversity of LeicesterLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
| | - David R. Webb
- Diabetes Research CentreUniversity of LeicesterLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
- Leicester Diabetes CentreUniversity Hospitals of Leicester NHS TrustLeicesterUK
| | - Scott A. Willis
- National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
- School of Sport, Exercise and Health SciencesLoughborough UniversityLeicestershireUK
| | - John P. H. Wilding
- Department of Cardiovascular and Metabolic MedicineUniversity of LiverpoolLiverpoolUK
| | - Kamlesh Khunti
- Diabetes Research CentreUniversity of LeicesterLeicesterUK
- Leicester Diabetes CentreUniversity Hospitals of Leicester NHS TrustLeicesterUK
- NIHR Applied Research Collaboration East MidlandsLeicesterUK
| | - David J. Stensel
- National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
- School of Sport, Exercise and Health SciencesLoughborough UniversityLeicestershireUK
- Faculty of Sport SciencesWaseda UniversityTokorozawaJapan
| | - Melanie J. Davies
- Diabetes Research CentreUniversity of LeicesterLeicesterUK
- National Institute for Health Research (NIHR) Leicester Biomedical Research CentreLeicesterUK
- Leicester Diabetes CentreUniversity Hospitals of Leicester NHS TrustLeicesterUK
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45
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Anti-obesity weight loss medications: Short-term and long-term use. Life Sci 2022; 306:120825. [PMID: 35870619 DOI: 10.1016/j.lfs.2022.120825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/21/2022]
Abstract
As obesity prevalence increases, more and more drugs that assist with weight loss have been developed. Numerous weight loss drugs had been approved, but many have also been withdrawn based on their lack of efficacy as well as safety concerns. Initial approaches in developing weight loss drugs was by increasing physiological energy expenditure and suppressing the appetite. Subsequently, as more physiological mechanisms for weight gain has been unearthed, drugs targeting newly discovered receptors and/or enzymes have been introduced with improved safety profiles and fewer psychological adverse events. Additionally, drugs targeting hunger or satiety signaling have been actively studied, and have shown increased adoption by physicians. Studies have also evaluated drugs that target metabolic tissues-such as adipose tissue or muscle-to promote weight loss, however to-date nothing has carried on into clinical practice. Starting with a brief history of early obesity treatments, this review evaluates current weight loss pharmaceutical options based on their duration of therapy status.
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46
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Nunes CL, Jesus F, Francisco R, Hopkins M, Sardinha LB, Martins P, Minderico CS, Silva AM. Effects of a 4-month active weight loss phase followed by weight loss maintenance on adaptive thermogenesis in resting energy expenditure in former elite athletes. Eur J Nutr 2022; 61:4121-4133. [PMID: 35833970 DOI: 10.1007/s00394-022-02951-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 06/27/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE Despite adaptive thermogenesis (AT) being studied as a barrier to weight loss (WL), few studies assessed AT in the resting energy expenditure (REE) compartment after WL maintenance. The aim of this study was twofold: (1) to understand if AT occurs after a moderate WL and if AT persists after a period of WL maintenance; and (2) if AT is associated with changes in body composition, hormones and energy intake (EI). METHODS Ninety-four participants [mean (SD); BMI, 31.1(4.3)kg/m2; 43.0(9.4)y; 34% female] were randomized to intervention (IG, n = 49) or control groups (CG, n = 45). Subjects underwent a 1-year lifestyle intervention, divided in 4 months of an active WL followed by 8 months of WL maintenance. Fat mass (FM) and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry and REE by indirect calorimetry. Predicted REE (pREE) was estimated through a model using FM, FFM. EI was measured by the "intake-balance" method. RESULTS For the IG, the weight and FM losses were - 4.8 (4.9) and - 11.3 (10.8)%, respectively (p < 0.001). A time-group interaction was found between groups for AT. After WL, the IG showed an AT of -85(29) kcal.d-1 (p < 0.001), and remained significant after 1 year [AT = - 72(31)kcal.d-1, p = 0.031]. Participants with higher degrees of restriction were those with an increased energy conservation (R = - 0.325, p = 0.036 and R = - 0.308, p = 0.047, respectively). No associations were found between diet adherence and AT. Following a sub-analysis in the IG, the group with a higher energy conservation showed a lower WL and fat loss and a higher initial EI. CONCLUSION AT in REE occurred after a moderate WL and remained significant after WL maintenance. More studies are needed to better clarify the mechanisms underlying the large variability observed in AT and providing an accurate methodological approach to avoid overstatements. Future studies on AT should consider not only changes in FM and FFM but also the FFM composition.
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Affiliation(s)
- Catarina L Nunes
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Filipe Jesus
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Ruben Francisco
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Mark Hopkins
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, UK
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Paulo Martins
- Laboratory of Sport Psychology, Faculdade de Motricidade Humana da Universidade de Lisboa, 1499-002, Cruz-Quebrada, Portugal
| | - Cláudia S Minderico
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal.
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Mauldin K, May M, Clifford D. The consequences of a weight-centric approach to healthcare: A case for a paradigm shift in how clinicians address body weight. Nutr Clin Pract 2022; 37:1291-1306. [PMID: 35819360 DOI: 10.1002/ncp.10885] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/27/2022] [Accepted: 05/14/2022] [Indexed: 11/10/2022] Open
Abstract
Current healthcare is weight-centric, equating weight and health. This approach to healthcare has negative consequences on patient well-being. The aim of this article is to make a case for a paradigm shift in how clinicians view and address body weight. In this review, we (1) address common flawed assumptions in the weight-centric approach to healthcare, (2) review the weight science literature and provide evidence for the negative consequences of promoting dieting and weight loss, and (3) provide practice recommendations for weight-inclusive care.
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Affiliation(s)
- Kasuen Mauldin
- Department of Nutrition, Food Science, and Packaging, San José State University, San José, California, USA.,Department of Clinical Nutrition, Stanford Health Care, Stanford, California, USA
| | - Michelle May
- Am I Hungry? Mindful Eating Programs and Training, USA.,Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Dawn Clifford
- Department of Health Sciences, Northern Arizona University, Flagstaff, Arizona, USA
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48
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Spreckley M, de Lange J, Seidell JC, Halberstadt J. Patient insights into the experience of trying to achieve weight-loss and future expectations upon commencement of a primary care-led weight management intervention: A qualitative, baseline exploration. PLoS One 2022; 17:e0270426. [PMID: 35767563 PMCID: PMC9242434 DOI: 10.1371/journal.pone.0270426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 06/09/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction The long-term effects of interventions aiming to achieve substantial, sustainable weight loss maintenance have been disappointing. Most people regain their lost weight over time but some seem to be able to maintain their weight loss. We are following the experiences of patients over time prospectively. This study forms the baseline to provide insights into patient experiences prior to entering a primary care-led weight management intervention and their expectations going forward. Materials and methods We recruited 21 adult male and female patients of varying ethnicity with a BMI between 27.7kg/m2 and 48.4kg/m2 from a cohort of patients entering a primary care-led weight management intervention. Patients were offered video and audio interview options during the COVID-19 lockdown. In total, twenty chose the audio option, while one chose the video option. The interview format was semi-structured with room for individual exploration. Discussion We found that participants experienced feeling unable to control their weight and encountered a multitude of internal and external barriers to weight management. Some had supportive environments, while others experienced discouraging external influences. Though personal characteristics varied, motivations, goals and expected benefits were similar across this cohort. Most participants had previously experienced transient successful weight-loss attempts with varying approaches. COVID-19 was experienced as an opportunity or barrier for change. Conclusion This study illustrates the importance of gaining comprehensive insights into the diverse experiences patients encounter when trying to achieve weight loss. Personalized support taking into account individual experiences and circumstances may enhance long-term treatment outcomes. Future research into the complexities of weight management based on individual accounts can aid in the creation of improved treatment protocols.
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Affiliation(s)
- Marie Spreckley
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- * E-mail:
| | - Judith de Lange
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Jacob C. Seidell
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Jutka Halberstadt
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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49
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Pressanto C, Scholtz S, Ali N. Obesity and bariatric surgery in adults living with severe mental illness: perceptions and clinical challenges. BJPsych Bull 2022; 47:165-171. [PMID: 35698857 DOI: 10.1192/bjb.2022.31] [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] [Indexed: 11/23/2022] Open
Abstract
Overweight and obesity are twice as likely to develop in people living with severe mental illness (SMI), compared with those without. Many factors contribute to this, such as reduced physical activity and the use of certain medications that induce weight gain. Obesity contributes to the premature mortality seen in people living with SMI, as it is one of the fundamental risk factors for cardiovascular disease and diabetes. Bariatric surgery is an effective treatment option, although patients living with SMI might face stigma when being considered for surgical intervention. This article proposes a discussion around obesity and bariatric surgery in patients living with SMI. It will also reflect on the challenges faced by healthcare professionals and patients living with SMI and obesity, when considering appropriate treatments for weight loss. The paper utilises a fictional case, informed by contributions from a lived experience author, to explore bariatric surgery in people living with SMI.
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Affiliation(s)
| | - Samantha Scholtz
- St Mary's Hospital, Imperial College Healthcare NHS Trust, UK.,West London NHS Trust, UK
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50
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Chandra SS, Calvert F, Sui Z, Sartoretto A, Raman J. Perceived barriers and facilitators to healthy eating and physical activity in endoscopic bariatric patients: a qualitative study. Eat Weight Disord 2022; 27:1633-1640. [PMID: 34668166 DOI: 10.1007/s40519-021-01299-x] [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: 06/14/2021] [Accepted: 09/03/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To explore the perceived barriers and facilitators to healthy eating and physical activity in individuals opting for endoscopic bariatric procedures. METHODS A total of 55 participants were recruited from a metropolitan bariatric clinic in Australia. Participants were interviewed at one of two stages of treatment: pre-procedure (n = 34) or 5-6 months post-procedure (n = 18). Interviews were transcribed and analyzed using content analysis. RESULTS Five themes emerged from analysis of participant responses in both groups including lifestyle, psychological, physiological, social, and eating behaviors. Each theme consisted of subthemes which were either perceived barriers, or facilitators, to healthy eating and physical activity. Perceived barriers consisted of factors such as time constraints, low motivation, unhealthy habits and portion control, low priority of personal health, emotional difficulties, and pain/mobility issues. Facilitators included subthemes such as planning/organization, high motivation, seeing results, improved self-esteem, increased energy, improved mobility, and changing mindset about portions. CONCLUSION The results highlight the importance of delivering individualized and targeted treatment plans for individuals opting for bariatric procedures. LEVEL OF EVIDENCE Level III: Evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
- Shianika S Chandra
- University of Technology Sydney, (Discipline of Clinical Psychology), Sydney, NSW, Australia
| | - Fiona Calvert
- Australian College of Applied Psychology, (Psychological Sciences), Sydney, NSW, Australia
| | - Zhixian Sui
- University of New South Wales, (Health Management Programme), Sydney, Australia
| | | | - Jayanthi Raman
- University of Technology Sydney, (Discipline of Clinical Psychology), Sydney, NSW, Australia.
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