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Sun S, Zhang R, Chen Y, Xu Y, Li X, Liu C, Chen G, Wei X. E4bp4-Cyp3a11 axis in high-fat diet-induced obese mice with weight fluctuation. Nutr Metab (Lond) 2024; 21:30. [PMID: 38802929 PMCID: PMC11131204 DOI: 10.1186/s12986-024-00803-1] [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: 01/01/2024] [Accepted: 05/01/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE Weight regain after weight loss is a challenge in obesity management. The metabolic changes and underlying mechanisms in obese people with weight fluctuation remain to be elucidated. In the present study, we aimed to profile the features and clinical significance of liver transcriptome in obese mice with weight regain after weight loss. METHODS The male C57BL/6J mice were fed with standard chow diet or high-fat diet (HFD). After 9 weeks, the HFD-induced obese mice were randomly divided into weight gain (WG), weight loss (WL) and weight regain (WR) group. After 10 weeks of dietary intervention, body weight, fasting blood glucose (FBG), intraperitoneal glucose tolerance, triglycerides (TG), total cholesterol (T-CHO) and low-density lipoprotein cholesterol (LDL-C) were measured. Morphological structure and lipid droplet accumulation in the liver were observed by H&E staining and oil red O staining, respectively. The liver transcriptome was detected by RNA sequencing. Protein expressions of liver cytochrome P450 3a11 (Cyp3a11) and E4 promoter-binding protein 4 (E4bp4) were determined by Western blot. RESULTS After 10 weeks of dietary intervention, the body weight, FBG, glucose area under the curve, T-CHO and LDL-C in WL group were significantly lower than those in WG group (P < 0.05). At 4 weeks of HFD re-feeding, the mice in WR group presented body weight and T-CHO significantly lower than those in WG group, whereas higher than those in WL group (P < 0.05). Hepatic vacuolar degeneration and lipid droplet accumulation in the liver were significantly alleviated in WL group and WR group, compared to those in WG group. The liver transcriptome associated with lipid metabolism was significantly altered during weight fluctuation in obese mice. Compared with those in WG group, Cyp3a11 in the liver was significantly upregulated, and E4bp4 was significantly downregulated in WL and WR groups. CONCLUSION Obese mice experience weight regain after weight loss by HFD re-feeding, but their glucose and lipid metabolism disorders are milder than those induced by the persistence of obesity. Downregulated E4bp4 and upregulated Cyp3a11 are detected in obese mice after weight loss, suggesting that the E4bp4-Cyp3a11 axis may involved in metabolic mechanisms underlying weight regulation.
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Affiliation(s)
- Shuoshuo Sun
- Department of Endocrinology, Affiliated Hospital of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, People's Republic of China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, People's Republic of China
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Ruixiang Zhang
- Department of Endocrinology, Affiliated Hospital of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, People's Republic of China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, People's Republic of China
| | - Yu Chen
- Department of Endocrinology, Affiliated Hospital of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, People's Republic of China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, People's Republic of China
| | - Yijiao Xu
- Department of Endocrinology, Affiliated Hospital of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, People's Republic of China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, People's Republic of China
| | - Xingjia Li
- Department of Endocrinology, Affiliated Hospital of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, People's Republic of China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, People's Republic of China
| | - Chao Liu
- Department of Endocrinology, Affiliated Hospital of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, People's Republic of China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, People's Republic of China
| | - Guofang Chen
- Department of Endocrinology, Affiliated Hospital of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, People's Republic of China.
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, People's Republic of China.
| | - Xiao Wei
- Department of Endocrinology, Affiliated Hospital of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, People's Republic of China.
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Castelnuovo G, Capodaglio P, De Amicis R, Gilardini L, Mambrini SP, Pietrabissa G, Cavaggioni L, Piazzolla G, Galeone C, Garavaglia G, Bertoli S. Study protocol of a clinical randomized controlled trial on the efficacy of an innovative Digital thErapy to proMote wEighT loss in patients with obesity by incReasing their Adherence to treatment: the DEMETRA study. Front Digit Health 2023; 5:1159744. [PMID: 38098734 PMCID: PMC10720313 DOI: 10.3389/fdgth.2023.1159744] [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: 03/27/2023] [Accepted: 11/13/2023] [Indexed: 12/17/2023] Open
Abstract
Despite the increasing importance of innovative medications and bariatric surgery for the treatment of obesity, lifestyle interventions (diet and physical activity) remain the first-line therapy for this disease. The use of digital devices in healthcare aims to respond to the patient's needs, in order to make obesity treatment more accessible, so our study aims to assess the safety and efficacy of a Digital Therapy for Obesity App (DTxO) for achieving weight loss and its maintenance in patients affected with obesity undergoing an experimental non-pharmacological treatment. Here we present the study protocol of a prospective, multicenter, pragmatic, randomized, double-arm, placebo-controlled, parallel, single-blind study on obese patients who will be treated with a new digital therapy to obtain an improvement in their disease condition through the application of different simultaneous strategies (a dietary regimen and personalized advice program, a tailored physical exercise program, a cognitive-behavioural assessment and program, alerts and reminders, dedicated section on prescribed drugs intake, and chat and online visits with clinical professionals). We believe that DTxO will offer a promising intervention channel and self-regulation tool holding the potentiality to decrease treatment burden and treat more patients thanks to the partial replacement of traditional medical consultation with digital or telephone management, improving self- engagement and reducing the high demands the "obesity pandemic" for both patients and national health services in terms of time, cost, and effort. Clinical trial registration: clinicaltrials.gov, identifier, NCT05394779.
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Affiliation(s)
- Gianluca Castelnuovo
- Clinical Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Paolo Capodaglio
- Orthopaedic Rehabilitation Unit and Research Lab in Biomechanics, Rehabilitation and Ergonomics, IRCCS Istituto Auxologico Italiano, Piancavallo, Italy
- Department of Surgical Sciences, Physical and Rehabilitation Medicine, University of Turin, Turin, Italy
| | - Ramona De Amicis
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Luisa Gilardini
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Sara Paola Mambrini
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy
- Division of Nutritional Rehabilitation, IRCCS Istituto Auxologico Italiano, Piancavallo, Italy
| | - Giada Pietrabissa
- Clinical Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Luca Cavaggioni
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Giuseppina Piazzolla
- Interdisciplinary Department of Medicine, School of Medicine, University of Bari “Aldo Moro”, Bari, Italy
| | - Carlotta Galeone
- Bicocca Applied Statistics Center (B-ASC), Università degli Studi di Milano-Bicocca, Milan, Italy
- Biostatistics & Outcome Research, Statinfo, Milan, Italy
| | | | - Simona Bertoli
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Guerra-Cantera S, Frago LM, Jiménez-Hernaiz M, Collado-Pérez R, Canelles S, Ros P, García-Piqueras J, Pérez-Nadador I, Barrios V, Argente J, Chowen JA. The metabolic effects of resumption of a high fat diet after weight loss are sex dependent in mice. Sci Rep 2023; 13:13227. [PMID: 37580448 PMCID: PMC10425431 DOI: 10.1038/s41598-023-40514-w] [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: 05/29/2023] [Accepted: 08/11/2023] [Indexed: 08/16/2023] Open
Abstract
Dietary restriction is a frequent strategy for weight loss, but adherence is difficult and returning to poor dietary habits can result in more weight gain than that previously lost. How weight loss due to unrestricted intake of a healthy diet affects the response to resumption of poor dietary habits is less studied. Moreover, whether this response differs between the sexes and if the insulin-like growth factor (IGF) system, sex dependent and involved in metabolic control, participates is unknown. Mice received rodent chow (6% Kcal from fat) or a high-fat diet (HFD, 62% Kcal from fat) for 4 months, chow for 3 months plus 1 month of HFD, or HFD for 2 months, chow for 1 month then HFD for 1 month. Males and females gained weight on HFD and lost weight when returned to chow at different rates (p < 0.001), but weight gain after resumption of HFD intake was not affected by previous weight loss in either sex. Glucose metabolism was more affected by HFD, as well as the re-exposure to HFD after weight loss, in males. This was associated with increases in hypothalamic mRNA levels of IGF2 (p < 0.01) and IGF binding protein (IGFBP) 2 (p < 0.05), factors involved in glucose metabolism, again only in males. Likewise, IGF2 increased IGFBP2 mRNA levels only in hypothalamic astrocytes from males (p < 0.05). In conclusion, the metabolic responses to dietary changes were less severe and more delayed in females and the IGF system might be involved in some of the sex specific observations.
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Affiliation(s)
- Santiago Guerra-Cantera
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, Spain
- Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Laura M Frago
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, Spain
- Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - María Jiménez-Hernaiz
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Roberto Collado-Pérez
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, Spain
- Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, Spain
| | - Sandra Canelles
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Purificación Ros
- Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, Spain
- Department of Endocrinology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Jorge García-Piqueras
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, Spain
| | - Iris Pérez-Nadador
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, Spain
| | - Vicente Barrios
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Jesús Argente
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, Spain.
- Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
- IMDEA Food Institute, CEI UAM + CSIC, Madrid, Spain.
| | - Julie A Chowen
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
- IMDEA Food Institute, CEI UAM + CSIC, Madrid, Spain.
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Mengi Çelik Ö, Köksal E, Aktürk M. Time-restricted eating (16/8) and energy-restricted diet: effects on diet quality, body composition and biochemical parameters in healthy overweight females. BMC Nutr 2023; 9:97. [PMID: 37559145 PMCID: PMC10410965 DOI: 10.1186/s40795-023-00753-6] [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: 01/12/2023] [Accepted: 07/26/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Time-restricted eating (TRE) is a current popular dietary strategy for noncommunicable diseases. However, studies demonstrated contradictory results for it and in all dietary strategies, diet quality is an the important part of the well-being. Our study aimed to investigate the effect of TRE and energy-restricted diet (ERD) on the nutritional status and diet quality of individuals. METHODS This pilot study was completed 23 healthy overweight female. Anthropometric and body composition measurements of individuals were taken. The energy expenditure was measured using indirect calorimetry. Blood pressure and heart rate measurements were made. Biochemical parameters were evaluated and food consumption were taken. The quality of dietary intake was assessed using the Healthy Eating Index (HEI) -2015. The physical activity levels of the individuals were estimated using the physical activity record. The Statistical Package for the Social Sciences (version 22.0) software was used for all analyses. A p-value of less than 0.05 was considered to be statistically significant. RESULTS After 8 weeks of intervention, while no change was observed in the diet quality of the individuals in the TRE group (p > 0.05), a significant increase was found in the diet quality score of the individuals in the ERD group (p < 0.05). There was a 3.2% and 5.5% decrease in body weight of individuals in the TRE and ERD groups, respectively (p < 0.05). While no significant change was observed in the body fat percentage of individuals in the TRE group (p > 0.05), a 7.1% decrease was observed in the ERD group (p < 0.05). A statistically significant decrease was found in the total cholesterol (3.7%) in the ERD group, and in the total cholesterol (6.7%) and low density lipoprotein cholesterol (LDL-C) (6.5%) in the TRE group. In addition, a statistically significant increase was found in adiponectin (77.3%) and total antioxidant status (TAS) (13.2%) in the ERD group. CONCLUSION Energy-restricted diet yielded better results in weight loss and improvement of body composition and diet quality compared to TRE. Also, a decrease in total cholesterol level was found in the ERD group. However, more studies should be done with longer follow-ups and high sample sizes are very important in terms of creating public health-based recommendations.
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Affiliation(s)
- Özge Mengi Çelik
- Faculty of Health Sciences, Department of Nutrition and Dietetics, University of Health Sciences, Ankara, Turkey.
| | - Eda Köksal
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey
| | - Müjde Aktürk
- Faculty of Medicine, Department of Endocrinology, Gazi University, Ankara, Turkey
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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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Polhuis KCMM, Vaandrager L, Koelen MA, Geleijnse JM, Soedamah-Muthu SS. Effects of a Salutogenic Healthy Eating Program in Type 2 Diabetes (the SALUD Study): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e40490. [PMID: 36943335 PMCID: PMC10131793 DOI: 10.2196/40490] [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: 06/27/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Healthy eating can improve the course of type 2 diabetes mellitus (T2DM) considerably. As changing eating behaviors in everyday is challenging, there is a need for a nutritional strategy with an eye for everyday life of people with T2DM. A theory centered around the everyday life context is salutogenesis. Salutogenic principles have been operationalized in a new nutritional program for T2DM on food literacy and well-being: the Salutogenic Intervention for Type 2 Diabetes (SALUD) program. OBJECTIVE This study aims to describe the protocol of the invention study that will examine the quantitative and qualitative effects of the SALUD program. METHODS A semiblinded randomized controlled trial will be performed in the Netherlands. A sample size of 56 (including a 30% dropout rate) people with T2DM has been calculated, of whom half (n=28, 50%) will follow the SALUD program (intervention) and half (n=28, 50%) will receive usual care (control). Recruitment strategies consist of advertisement via local health care professionals, posters, social media, and local newspapers. The SALUD program consists of 12 weekly web-based group sessions under the supervision of a certified lifestyle coach. Fidelity of the delivery is guaranteed by selecting a salutogenic coach, use of an intervention manual, training of the coach, weekly evaluation forms, and recording several sessions. The theoretical salutogenic principle of the intervention is mobilizing 2 important psychosocial resources required for organizing healthy eating in everyday life: self-identity and social support. Measurements will be performed at 3 times: at baseline (T0), after 12 weeks (postintervention; T1), and after 24 weeks (follow-up; T2). The primary outcome is food literacy, measured with the self-perceived food literacy scale questionnaire (expected effect size=0.9). Secondary outcomes are self-efficacy, quality of life, sense of coherence, diet quality, body weight, BMI, and waist-hip ratio. All outcomes will be tested with linear mixed models, following an intention-to-treat approach and standard principles of randomized controlled trials. In addition, a qualitative analysis will be performed. RESULTS The proposed study will provide useful information on the effects of a salutogenic program on healthy eating and well-being in people with T2DM in everyday life. Recruitment started on October 1, 2021. The intervention participants followed the SALUD program between January and August, 2022. The acquisition of the data was completed on August 1, 2022; publications are expected in 2023. CONCLUSIONS This study will be one of the first salutogenic interventions for T2DM, which will provide valuable information on what salutogenic intervention entail. The SALUD program may serve as a concrete, web-based tool. The combination of quantitative and qualitative measures allows a comprehensive evaluation of effects. These insights can be used for further optimalization of T2DM interventions. TRIAL REGISTRATION Netherlands Trial Registry, NL8963; https://trialsearch.who.int/Trial2.aspx?TrialID=NL8963. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40490.
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Affiliation(s)
| | - Lenneke Vaandrager
- Health & Society, Wageningen University & Research, Wageningen, Netherlands
| | - Maria A Koelen
- Health & Society, Wageningen University & Research, Wageningen, Netherlands
| | - Johanna M Geleijnse
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Sabita S Soedamah-Muthu
- Department of Medical and Clinical Psychology, Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Tilburg, Netherlands
- Institute for Food, Nutrition and Health (IFNH), University of Reading, Reading, United Kingdom
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Dugan B, Conway J, Duggal NA. Inflammaging as a target for healthy ageing. Age Ageing 2023; 52:7024516. [PMID: 36735849 DOI: 10.1093/ageing/afac328] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 11/11/2022] [Indexed: 02/05/2023] Open
Abstract
Life expectancy has been on the rise for the past few decades, but healthy life expectancy has not kept pace, leading to a global burden of age-associated disorders. Advancing age is accompanied by a chronic increase in basal systemic inflammation, termed inflammaging, contributing towards an increased risk of developing chronic diseases in old age. This article reviews the recent literature to formulate hypotheses regarding how age-associated inflammaging plays a crucial role in driving chronic diseases and ill health in older adults. Here, we discuss how non-pharmacological intervention strategies (diet, nutraceutical supplements, phytochemicals, physical activity, microbiome-based therapies) targeting inflammaging restore health in older adults. We also consider alternative existing pharmacological interventions (Caloric restriction mimetics, p38 mitogen-activated protein kinase inhibitors) and explore novel targets (senolytics) aimed at combating inflammaging and optimising the ageing process to increase healthy lifespan.
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Affiliation(s)
- Ben Dugan
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
| | - Jessica Conway
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
| | - Niharika A Duggal
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
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Perry AS, Tanriverdi K, Risitano A, Hwang SJ, Murthy VL, Nayor M, Zhao S, Levy D, Shah RV, Freedman JE. The inflammatory proteome, obesity, and medical weight loss and regain in humans. Obesity (Silver Spring) 2023; 31:150-158. [PMID: 36334095 PMCID: PMC9923277 DOI: 10.1002/oby.23587] [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: 06/12/2022] [Revised: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Weight regain occurs after medical weight loss via mechanisms of post-weight-loss "metabolic adaptation." The relationship of inflammatory proteins with weight loss/regain was studied to determine a role for inflammation in metabolic adaptation. METHODS Seventy-four proteins central to inflammation and immune regulation (Olink) were analyzed in plasma from up to 490 participants in a trial of medical weight-loss maintenance. Cross-sectional and longitudinal associations of proteins with weight were measured using linear and mixed effects regression models and t testing, with replication in the Framingham Heart Study. RESULTS Broad changes in the inflammatory proteome were observed among the study cohort (60% women, 35% African American) with initial weight loss of ≈8 kg from a median 94 kg at study entry (33/74 proteins; 7 increased; 26 decreased), many of which tracked with weight regain of median ≈2 kg over the next 30 months. Ten proteins were associated with different rates of weight regain, some specifying pathways of chemotaxis and innate immune responses. Several of the observed protein associations were also linked to prevalent obesity in the Framingham Heart Study. CONCLUSIONS Broad changes in the inflammatory proteome track with changes in weight and may identify specific pathways that modify patterns of weight regain.
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Affiliation(s)
- Andrew S Perry
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Kahraman Tanriverdi
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Antonina Risitano
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Shih-Jen Hwang
- Framingham Heart Study, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Venkatesh L Murthy
- Department of Medicine and Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Matthew Nayor
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Shilin Zhao
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Daniel Levy
- Framingham Heart Study, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Ravi V Shah
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Jane E Freedman
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
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Gaesser GA. Type 2 Diabetes Incidence and Mortality: Associations with Physical Activity, Fitness, Weight Loss, and Weight Cycling. Rev Cardiovasc Med 2022; 23:364. [PMID: 39076198 PMCID: PMC11269068 DOI: 10.31083/j.rcm2311364] [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: 06/13/2022] [Revised: 08/21/2022] [Accepted: 09/06/2022] [Indexed: 07/31/2024] Open
Abstract
Cardiometabolic diseases, including cardiovascular disease (CVD) and type 2 diabetes (T2D), are the leading cause of death globally. Because T2D and obesity are strongly associated, weight loss is the cornerstone of treatment. However, weight loss is rarely sustained, which may lead to weight cycling, which is associated with increased mortality risk in patients with T2D. Meta-analyses show that weight loss is not generally associated with reduced mortality risk in T2D, whereas weight cycling is associated with increased all-cause and CVD mortality. This may be attributable in part to increased variability in CVD risk factors that often accompany weight cycling, which studies show is consistently associated with adverse CVD outcomes in patients with T2D. The inconsistent associations between weight loss and mortality risk in T2D, and consistent findings of elevated mortality risk associated with weight cycling, present a conundrum for a weight-loss focused T2D prevention and treatment strategy. This is further complicated by the findings that among patients with T2D, mortality risk is lowest in the body mass index (BMI) range of ~25-35 kg/ m 2 . Because this "obesity paradox" has been consistently demonstrated in 7 meta-analyses, the lower mortality risk for individuals with T2D in this BMI range may not be all that paradoxical. Physical activity (PA), cardiorespiratory fitness (CRF), and muscular fitness (MF) are all associated with reduced risk of T2D, and lower risk of CVD and all-cause mortality in individuals with T2D. Reducing sedentary behavior, independent of PA status, also is strongly associated with reduced risk of T2D. Improvements in cardiometabolic risk factors with exercise training are comparable to those observed in weight loss interventions, and are largely independent of weight loss. To minimize risks associated with weight cycling, it may be prudent to adopt a weight-neutral approach for prevention and treatment of individuals with obesity and T2D by focusing on increasing PA and improving CRF and MF without a specific weight loss goal.
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Affiliation(s)
- Glenn A. Gaesser
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
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10
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Evaluation of a Supervised Adapted Physical Activity Program Associated or Not with Oral Supplementation with Arginine and Leucine in Subjects with Obesity and Metabolic Syndrome: A Randomized Controlled Trial. Nutrients 2022; 14:nu14183708. [PMID: 36145083 PMCID: PMC9501942 DOI: 10.3390/nu14183708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background: In patients with obesity and metabolic syndrome (MetS), lifestyle interventions combining diet, in particular, and physical exercise are recommended as the first line treatment. Previous studies have suggested that leucine or arginine supplementation may have beneficial effects on the body composition or insulin sensitivity and endothelial function, respectively. We thus conducted a randomized controlled study to evaluate the effects of a supervised adapted physical activity program associated or not with oral supplementation with leucine and arginine in MetS-complicated patients with obesity. Methods: Seventy-nine patients with obesity and MetS were randomized in four groups: patients receiving arginine and leucine supplementation (ALs group, n = 20), patients on a supervised adapted physical activity program (APA group, n = 20), patients combining ALs and APA (ALs+APA group, n = 20), and a control group (n = 19). After the baseline evaluation (m0), patients received ALs and/or followed the APA program for 6 months (m6). Body composition, MetS parameters, lipid and glucose metabolism markers, inflammatory markers, and a cardiopulmonary exercise test (CPET) were assessed at m0, m6, and after a 3-month wash-out period (m9). Results: After 6 months of intervention, we did not observe variable changes in body weight, body composition, lipid and glucose metabolism markers, inflammatory parameters, or quality of life scores between the four groups. However, during the CPET, the maximal power (Pmax and Ppeak), power, and O2 consumption at the ventilatory threshold (P(VT) and O2(VT)) were improved in the APA and ALs+APA groups (p < 0.05), as well as the forced vital capacity (FVC). Between m6 and m9, a gain in fat mass was only observed in patients in the APA and ALs+APA groups. Conclusion: In our randomized controlled trial, arginine and leucine supplementation failed to improve MetS in patients with obesity, as did the supervised adapted physical activity program and the combination of both. Only the cardiorespiratory parameters were improved by exercise training.
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11
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Association between dietary patterns and body composition in normal-weight subjects with metabolic syndrome. J Diabetes Metab Disord 2022; 21:735-741. [PMID: 35673495 DOI: 10.1007/s40200-022-01043-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 04/15/2022] [Indexed: 12/19/2022]
Abstract
Background and aims The development of metabolic syndrome (MetS) has been proposed to be related to dietary pattern and body compostion indexes. Diet is one of the most important lifestyle-related factors which may regulate the inflammatory process. Numerous individual foods and dietary patterns can have a valuable health effect that is associated with their anti-inflammatory properties. Here we aimed to investigate the association between body composition indexes and dietary patterns in individuals with metabolic syndrome who were nnormal for weight. Methods and materials Normal weight subjects with MetS were recruited as part of Survey of Ultraviolet Intake by Nutritional Approach (SUVINA). A validated food frequency questionnaire (FFQ) was used to determine dietary patterns that were: low-, or high in antioxidant; dietary inflammation index (DII) and health eating index (HEI) were also determined. Body composition indexes including basal metabolic rate (BMR), body free fat mass (BFFM), body fat mass (BFM), body fat percentage (BFP), trunk fat and total body water (TBW) were measured using a InBody body composition analyser. A P value <0.05 was considered significant. Results A total 77 individuals including 29 males and 48 females were recruited into the study. A high-antioxidant dietary pattern was significantly correlated with BMR (p = 0.002), BFFM (p = 0.007) and TBW (p = 0.002). There was no significant relationship between body compostion with a low-antioxidant dietary pattern, DII and HEI. After adjusting for age and sex, our findings showed that a high-antioxidant dietary pattern were independently associated with BMR, BFFM and TBW. Conclusion A high-antioxidant dietary pattern was independently associated with decreased BMR, BFFM and TBW, while no association was found between body composition indexes and DII and HEI in normal weight paticipants with MetS.
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12
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Astbury NM, Edwards RM, Ghebretinsea F, Shanyinde M, Mollison J, Aveyard P, Jebb SA. Extended follow-up of a short total diet replacement programme: results of the Doctor Referral of Overweight People to Low Energy total diet replacement Treatment (DROPLET) randomised controlled trial at 3 years. Int J Obes (Lond) 2021; 45:2432-2438. [PMID: 34302120 PMCID: PMC8528708 DOI: 10.1038/s41366-021-00915-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 07/07/2021] [Accepted: 07/07/2021] [Indexed: 12/21/2022]
Abstract
Objectives To test the long-term effectiveness of a total diet replacement programme (TDR) for routine treatment of obesity in a primary care setting. Methods This study was a pragmatic, two-arm, parallel-group, open-label, individually randomised controlled trial in adults with obesity. The outcomes were change in weight and biomarkers of diabetes and cardiovascular disease risk from baseline to 3 years, analysed as intention-to-treat with mixed effects models. Interventions The intervention was TDR for 8 weeks, followed by food-reintroduction over 4 weeks. Behavioural support was provided weekly for 8 weeks, bi-weekly for the next 4 weeks, then monthly for 3 months after which no further support was provided. The usual care (UC) group received dietary advice and behavioural support from a practice nurse for up to 3 months. Results Outcome measures were collected from 179 (66%) participants. Compared with baseline, at 3 years the TDR group lost −6.2 kg (SD 9.1) and usual care −2.7 kg (SD 7.7); adjusted mean difference −3.3 kg (95% CI: −5.2, −1.5), p < 0.0001. Regain from programme end (6 months) to 3 years was greater in TDR group +8.9 kg (SD 9.4) than UC + 1.2, (SD 9.1); adjusted mean difference +6.9 kg (95% CI 4.2, 9.5) P < 0.001. At 3 years TDR led to greater reductions than UC in diastolic blood pressure (mean difference −3.3 mmHg (95% CI:−6.2; −0.4) P = 0.024), and systolic blood pressure (mean differences −3.7 mmHg (95% CI: −7.4; 0.1) P = 0.057). There was no evidence of differences between groups in the change from baseline to 3 years HbA1c (−1.9 mmol/mol (95% CI: −0.7; 4.5; P = 0.15), LDL cholesterol concentrations (0.2 mmol/L (95% CI −0.3, 0.7) P = 0.39), cardiovascular risk score (QRISK2) (−0.37 (95% CI −0.96; 0.22); P = 0.22). Conclusions Treatment of people with obesity with a TDR programme compared with support from a practice nurse leads to greater weight loss which persists to at least 3 years, but there was only evidence of sustained improvements in BP and not in other aspects of cardiometabolic risk.
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Affiliation(s)
- Nerys M Astbury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Rhiannon M Edwards
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Fitsum Ghebretinsea
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Milensu Shanyinde
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jill Mollison
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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14
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Rubino D, Abrahamsson N, Davies M, Hesse D, Greenway FL, Jensen C, Lingvay I, Mosenzon O, Rosenstock J, Rubio MA, Rudofsky G, Tadayon S, Wadden TA, Dicker D. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA 2021; 325:1414-1425. [PMID: 33755728 PMCID: PMC7988425 DOI: 10.1001/jama.2021.3224] [Citation(s) in RCA: 430] [Impact Index Per Article: 143.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE The effect of continuing vs withdrawing treatment with semaglutide, a glucagon-like peptide 1 receptor agonist, on weight loss maintenance in people with overweight or obesity is unknown. OBJECTIVE To compare continued once-weekly treatment with subcutaneous semaglutide, 2.4 mg, with switch to placebo for weight maintenance (both with lifestyle intervention) in adults with overweight or obesity after a 20-week run-in with subcutaneous semaglutide titrated to 2.4 mg weekly. DESIGN, SETTING, AND PARTICIPANTS Randomized, double-blind, 68-week phase 3a withdrawal study conducted at 73 sites in 10 countries from June 2018 to March 2020 in adults with body mass index of at least 30 (or ≥27 with ≥1 weight-related comorbidity) and without diabetes. INTERVENTIONS A total of 902 participants received once-weekly subcutaneous semaglutide during run-in. After 20 weeks (16 weeks of dose escalation; 4 weeks of maintenance dose), 803 participants (89.0%) who reached the 2.4-mg/wk semaglutide maintenance dose were randomized (2:1) to 48 weeks of continued subcutaneous semaglutide (n = 535) or switched to placebo (n = 268), plus lifestyle intervention in both groups. MAIN OUTCOMES AND MEASURES The primary end point was percent change in body weight from week 20 to week 68; confirmatory secondary end points were changes in waist circumference, systolic blood pressure, and physical functioning (assessed using the Short Form 36 Version 2 Health Survey, Acute Version [SF-36]). RESULTS Among 803 study participants who completed the 20-week run-in period (with a mean weight loss of 10.6%) and were randomized (mean age, 46 [SD, 12] years; 634 [79%] women; mean body weight, 107.2 kg [SD, 22.7 kg]), 787 participants (98.0%) completed the trial and 741 (92.3%) completed treatment. With continued semaglutide, mean body weight change from week 20 to week 68 was -7.9% vs +6.9% with the switch to placebo (difference, -14.8 [95% CI, -16.0 to -13.5] percentage points; P < .001). Waist circumference (-9.7 cm [95% CI, -10.9 to -8.5 cm]), systolic blood pressure (-3.9 mm Hg [95% CI, -5.8 to -2.0 mm Hg]), and SF-36 physical functioning score (2.5 [95% CI, 1.6-3.3]) also improved with continued subcutaneous semaglutide vs placebo (all P < .001). Gastrointestinal events were reported in 49.1% of participants who continued subcutaneous semaglutide vs 26.1% with placebo; similar proportions discontinued treatment because of adverse events with continued semaglutide (2.4%) and placebo (2.2%). CONCLUSIONS AND RELEVANCE Among adults with overweight or obesity who completed a 20-week run-in period with subcutaneous semaglutide, 2.4 mg once weekly, maintaining treatment with semaglutide compared with switching to placebo resulted in continued weight loss over the following 48 weeks. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03548987.
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Affiliation(s)
- Domenica Rubino
- Washington Center for Weight Management, Arlington, Virginia
| | - Niclas Abrahamsson
- Endocrinology Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Melanie Davies
- Diabetes Research Centre, University of Leicester, Leicester, England
- NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, England
| | | | - Frank L. Greenway
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge
| | | | - Ildiko Lingvay
- Departments of Internal Medicine/Endocrinology and Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas
| | - Ofri Mosenzon
- Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Miguel A. Rubio
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Faculty of Medicine, Universidad Complutense, Madrid, Spain
| | - Gottfried Rudofsky
- Department of Endocrinology and Metabolic Diseases, Kantonsspital Olten, Olten, Switzerland
| | | | - Thomas A. Wadden
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Dror Dicker
- Internal Medicine Department and Obesity Clinic, Hasharon Hospital–Rabin Medical Center, Petach-Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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15
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Swift DL, McGee JE, Huff AC, Clunan MC, Gniewek NR, Brown TT, Osborne BG, Bucher C, Tanner CJ, Barefoot SG, Brophy P, Clark A, Dubis GS, Martin CK, Beyl RA, Houmard JA, Carels RA, Pories W, Matarese LE. Prescribed exercise to Reduce Recidivism After Weight Loss-Pilot (PREVAIL-P): Design, methods and rationale. Contemp Clin Trials Commun 2021; 21:100717. [PMID: 33553797 PMCID: PMC7848432 DOI: 10.1016/j.conctc.2021.100717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/12/2020] [Accepted: 01/11/2021] [Indexed: 11/20/2022] Open
Abstract
Clinically significant weight loss is associated with health benefits for overweight and obese adults. Participation in adequate amounts of physical activity is critical for weight maintenance. However, the recommended amount of physical activity needed to promote weight maintenance is based primarily on retrospective studies that quantified physical activity levels through questionnaires which tend to overestimate physical activity levels. In addition, the present literature has provided little data on the impact of these physical activity levels on cardiovascular and diabetes risk factors, which may have equal or more clinical importance than weight changes. The Prescribed Exercise to Reduce Recidivism After Weight Loss-Pilot (PREVAIL-P) study will evaluate the effect of aerobic exercise training amount on weight maintenance following clinically significant weight loss in overweight and obese adults (BMI 25-40 kg/m2) age 30-65 years. Participants (N = 39) will complete a 10-week OPTIFAST® weight loss program with supervised aerobic exercise training. Individuals who achieve ≥7% weight loss from baseline will be subsequently randomized to levels of aerobic training consistent with physical activity recommendations (PA-REC) or weight maintenance recommendations (WM-REC) for 18 additional weeks. The primary outcome of the PREVAIL-P study will be change in weight from the completion of OPTIFAST® program to the end of the study. Notable secondary measures include changes in clinically relevant cardiometabolic risk factors between study groups (e.g. blood lipids concentrations, oral glucose tolerance, arterial stiffness). This pilot study will be used to estimate the effect sizes needed for a randomized controlled trial on this topic.
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Affiliation(s)
- Damon L. Swift
- Department of Kinesiology, East Carolina University, Greenville, NC, 27858, USA
- Human Performance Laboratory, East Carolina Univeristy, Greenville, NC, 27858, USA
| | - Joshua E. McGee
- Department of Kinesiology, East Carolina University, Greenville, NC, 27858, USA
- Human Performance Laboratory, East Carolina Univeristy, Greenville, NC, 27858, USA
| | - Anna C. Huff
- Department of Kinesiology, East Carolina University, Greenville, NC, 27858, USA
- Human Performance Laboratory, East Carolina Univeristy, Greenville, NC, 27858, USA
| | - Marie C. Clunan
- Department of Kinesiology, East Carolina University, Greenville, NC, 27858, USA
- Human Performance Laboratory, East Carolina Univeristy, Greenville, NC, 27858, USA
| | - Nicole R. Gniewek
- Department of Kinesiology, East Carolina University, Greenville, NC, 27858, USA
- Human Performance Laboratory, East Carolina Univeristy, Greenville, NC, 27858, USA
| | - Taylor T. Brown
- Department of Kinesiology, East Carolina University, Greenville, NC, 27858, USA
- Human Performance Laboratory, East Carolina Univeristy, Greenville, NC, 27858, USA
| | | | | | - Charles J. Tanner
- Department of Kinesiology, East Carolina University, Greenville, NC, 27858, USA
- Human Performance Laboratory, East Carolina Univeristy, Greenville, NC, 27858, USA
| | - Savanna G. Barefoot
- Department of Kinesiology, East Carolina University, Greenville, NC, 27858, USA
- Human Performance Laboratory, East Carolina Univeristy, Greenville, NC, 27858, USA
| | - Patricia Brophy
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, NC, 27858, USA
| | - Angela Clark
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, NC, 27858, USA
| | - Gabriel S. Dubis
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, NC, 27858, USA
| | - Corby K. Martin
- Ingestive Behavior Laboratory, Pennington Biomedical, Baton Rouge, LA, 70808, USA
| | - Robbie A. Beyl
- Biostatistics & Analysis Laboratory, Pennington Biomedical, Baton Rouge, LA, 70808, USA
| | - Joseph A. Houmard
- Department of Kinesiology, East Carolina University, Greenville, NC, 27858, USA
- Human Performance Laboratory, East Carolina Univeristy, Greenville, NC, 27858, USA
| | - Robert A. Carels
- Department of Psychology, East Carolina University, Greenville, NC, 27858, USA
| | - Walter Pories
- Department of Surgery, East Carolina University, Greenville, NC, 27858, USA
| | - Laura E. Matarese
- Department of Internal Medicine, East Carolina University, Greenville, NC, 27858, USA
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16
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Mitchell NS, Seyoum EA, Bhavsar NA, Webb FJ. Continuous Engagement in a Weight-Loss Program Promotes Sustained Significant Weight Loss. WMJ : OFFICIAL PUBLICATION OF THE STATE MEDICAL SOCIETY OF WISCONSIN 2020; 119:253-257. [PMID: 33428835 PMCID: PMC8274382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Significant weight loss improves health but regain is common. OBJECTIVE The objective of the study was to determine if 2,346 members of Take Off Pounds Sensibly-a national, low-cost, peer-led weight-loss program-achieved and maintained significant weight loss with 7 consecutive annual renewals. METHODS This study was a retrospective cohort design. For each renewal, the cumulative change from baseline weight was calculated. Weight change was placed into 1 of 3 categories: significant weight loss, loss ≥ 5%; weight stable, loss of 0 to < 5%; or weight gain, any amount above baseline weight. RESULTS The cohort included 2,346 individuals. Fifty-one percent (n=740) of participants were in the significant weight-loss category all 7 years; 256 (18%) were in the significant weight-loss category at year 1 but moved into at least 1 other category during years 2 through 6; 359 (25%) were in the weight stable category at year 1; and 98 (7%) were in the weight gain category at year 1. CONCLUSIONS Over 60% of the population achieved significant weight loss by year 7. Since continuous, long-term engagement in a weight-loss program can lead to significant weight loss, even if significant weight loss is not initially achieved, participation should be encouraged.
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Affiliation(s)
- Nia S Mitchell
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina,
| | | | - Nrupen A Bhavsar
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Fern J Webb
- Department of Community Health and Family Medicine, University of Florida College of Medicine, Jacksonville, Florida
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Turicchi J, O'Driscoll R, Horgan G, Duarte C, Santos I, Encantado J, Palmeira AL, Larsen SC, Olsen JK, Heitmann BL, Stubbs RJ. Body weight variability is not associated with changes in risk factors for cardiometabolic disease. Int J Cardiol Hypertens 2020; 6:100045. [PMID: 33447771 PMCID: PMC7803052 DOI: 10.1016/j.ijchy.2020.100045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/14/2020] [Accepted: 07/17/2020] [Indexed: 01/05/2023] Open
Abstract
CONTEXT Weight loss is known to improve health, however the influence of variability in body weight around the overall trajectory on these outcomes is unknown. Few studies have measured body weight frequently enough to accurately estimate the variability component. OBJECTIVE To investigate the association of 12-month weight variability and concurrent weight change with changes in health markers and body composition. METHODS This study was a secondary analysis of the NoHoW trial, a 2 × 2 factorial randomised controlled trial promoting evidence-based behaviour change for weight loss maintenance. Outcome measurements related to cardiometabolic health and body composition were taken at 0, 6 and 12 months. Participants were provided with Wi-Fi connected smart scales (Fitbit Aria 2) and asked to self-weigh regularly over this period. Associations of weight variability and weight change with change in outcomes were investigated using multiple linear regression with multiple levels of adjustment in 955 participants. RESULTS Twelve models were generated for each health marker. Associations between weight variability and changes in health markers were inconsistent between models and showed no evidence of a consistent relationship, with all effects explaining <1% of the outcome, and most 0%. Weight loss was consistently associated with improvements in health and body composition, with the greatest effects seen in percent body fat (R2 = 10.4-11.1%) followed by changes in diastolic (4.2-4.7%) and systolic (3-4%) blood pressure. CONCLUSION Over 12-months, weight variability was not consistently associated with any measure of cardiometabolic health or body composition, however weight loss consistently improved all outcomes. TRIAL REGISTRATION NUMBER ISRCTN88405328.
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Affiliation(s)
- Jake Turicchi
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, UK
| | - Ruairi O'Driscoll
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, UK
| | | | - Cristiana Duarte
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, UK
| | - Inês Santos
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Jorge Encantado
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | | | - Sofus C. Larsen
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - Jack K. Olsen
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - Berit L. Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
- The Boden Institute of Obesity, Nutrition and Eating Disorder, University of Sydney, Sydney, Australia
- Department of Public Health, Section for General Medicine, University of Copenhagen, Copenhagen, Denmark
| | - R. James Stubbs
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, UK
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Hoddy KK, Marlatt KL, Çetinkaya H, Ravussin E. Intermittent Fasting and Metabolic Health: From Religious Fast to Time-Restricted Feeding. Obesity (Silver Spring) 2020; 28 Suppl 1:S29-S37. [PMID: 32700827 PMCID: PMC7419159 DOI: 10.1002/oby.22829] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/03/2020] [Accepted: 04/05/2020] [Indexed: 12/14/2022]
Abstract
Over the past 10 to 15 years, intermittent fasting has emerged as an unconventional approach to reduce body weight and improve metabolic health beyond simple calorie restriction. In this review, we summarize findings related to Ramadan and Sunnah fasting. We then discuss the role of caloric restriction not only as an intervention for weight control, but importantly, as a strategy for healthy aging and longevity. Finally, we review the four most common intermittent fasting (IF) strategies used to date for weight management and to improve cardiometabolic health. Weight loss is common after IF but does not appear to be different than daily caloric restriction when compared directly. IF may also provide additional cardiometabolic benefit, such as insulin sensitization, that is independent from weight loss. While no specific fasting regimen stands out as superior at this time, there is indeed heterogeneity in responses to these different IF diets. This suggests that one dietary regimen may not be ideally suited for every individual. Future studies should consider strategies for tailoring dietary prescriptions, including IF, based on advanced phenotyping and genotyping prior to diet initiation.
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Affiliation(s)
- Kristin K. Hoddy
- Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA
| | - Kara L. Marlatt
- Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA
| | - Hatice Çetinkaya
- Department of Nutrition and Dietetics, Faculty of Health Science, Izmir Katip Celebi University, 35620, Izmir, Turkey
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA
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Valero-Pérez M, Bermejo LM, López-Plaza B, García MA, Palma-Milla S, Gómez-Candela C. Regular Consumption of Lipigo ® Promotes the Reduction of Body Weight and Improves the Rebound Effect of Obese People Undergo a Comprehensive Weight Loss Program. Nutrients 2020; 12:nu12071960. [PMID: 32630079 PMCID: PMC7399819 DOI: 10.3390/nu12071960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 11/23/2022] Open
Abstract
Obesity is a global public health problem. Objective: To evaluate the effect of the regular consumption of the product Lipigo® on body weight and rebound effect on overweight/obese subjects undergoing a comprehensive weight loss program. Methods: A randomized, parallel, double-blind, placebo-controlled clinical trial was conducted with male and female subjects presenting a BMI 25–39.9 kg/m2. All subjects underwent a comprehensive weight loss program (WLP) for 12 weeks, which included an individualized hypocaloric diet, physical activity recommendations, nutritional education seminars, and three times a day consumption of the product Lipigo® or Placebo. After-WLP, subjects continued the treatment for 9 months to assess rebound effect. Body weight (BW), BMI, and body composition were measured at the beginning and the end of the WLP, and in the follow-up. Results: A total of 120 subjects (85% women) 49.0 ± 9.5 years old and with a BW of 81.57 ± 13.26 kg (BMI 31.19 ± 3.44 kg/m2) were randomized and 73 subjects finished the study. At the end of the WLP, there was a tendency toward reduced BW (p = 0.093), BMI (p = 0.063), and WC (p = 0.059) in the treated group. However, subjects with obesity type 1 (OB1) from the treated group significantly reduced body weight (−5.27 ± 2.75 vs. −3.08 ± 1.73 kg; p = 0.017) and BMI (−1.99 ± 1.08 vs. −1.09 ± 0.55 kg/m2; p = 0.01) compared with placebo. They also presented a minor rebound effect after 9 months with product consumption (−4.19 ± 3.61 vs. −1.44 ± 2.51 kg; p = 0.026), minor BMI (−1.61 ± 1.43 vs. −0.52 ± 0.96 kg/m2; p = 0.025) and tended to have less fat-mass (−3.44 ± 2.46 vs. −1.44 ± 3.29 kg; p = 0.080) compared with placebo. Conclusions: The regular consumption of the product Lipigo® promotes the reduction of body weight and reduces the rebound effect of obese people after 52 weeks (12 months), mainly in obesity type 1, who undergo a comprehensive weight loss program.
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Affiliation(s)
- Marlhyn Valero-Pérez
- Nutrition Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), 2804 Madrid, Spain; (M.V.-P.); (B.L.-P.)
| | - Laura M. Bermejo
- Nutrition Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), Complutense University of Madrid, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-917-277-000 (ext. 42199)
| | - Bricia López-Plaza
- Nutrition Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), 2804 Madrid, Spain; (M.V.-P.); (B.L.-P.)
| | | | - Samara Palma-Milla
- Nutrition Department, La Paz University Hospital, Nutrition Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), Autonomous University of Madrid, 28046 Madrid, Spain; (S.P.-M.); (C.G.-C.)
| | - Carmen Gómez-Candela
- Nutrition Department, La Paz University Hospital, Nutrition Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), Autonomous University of Madrid, 28046 Madrid, Spain; (S.P.-M.); (C.G.-C.)
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20
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Polhuis CMM, Vaandrager L, Soedamah-Muthu SS, Koelen MA. Salutogenic model of health to identify turning points and coping styles for eating practices in type 2 diabetes mellitus. Int J Equity Health 2020; 19:80. [PMID: 32487086 PMCID: PMC7266427 DOI: 10.1186/s12939-020-01194-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 05/14/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND It is important for people with Type 2 Diabetes Mellitus (T2DM) to eat healthily. However, implementing dietary advice in everyday life is difficult, because eating is not a distinguishable action, but a chain of activities, embedded in social practices and influenced by previous life experiences. This research aims to understand why and how eating practices are developed over the life-course by investigating influential life experiences - turning points - and coping strategies for eating practices of people with T2DM. METHODS The Salutogenic Model of Health guided the study's objective, study design and analysis. Seventeen interviews were performed and analysed based on the principles of interpretative phenomenological analysis. Narrative inquiry and the creation of timelines and food boxes were used as tools to facilitate reflection on turning points and eating practices. RESULTS Turning points for unhealthier eating were experiences that strongly disturbed the participants' emotional stability. These experiences included psychosocial trauma, physical health disorders, job loss, and smoking cessation. Turning points for healthier eating were experiences that significantly changed participants views on life and made participants reflective about the effects of current eating practices on future health and life goals. These turning points included confrontation with ill-health, becoming a parent, psychosocial therapy, and getting married. Notably, turning points for healthier eating seemed only to happen when life was relatively stress-free. All participants experienced turning points for healthier eating, yet, not all participants succeeded in improving their diets. Two coping styles were distinguished: active and passive coping. Active coping individuals were able to act in line with their personal intentions, whereas passive coping individuals could not. Differences between active and passive coping styles seemed to be explained by differences in available resources important for adapting and maintaining a healthy diet. CONCLUSION Disadvantaged childhood and later life adversities together with the inability to manage the mental stress explained the development unhealthier eating practices. All participants experienced turning points for healthier eating that caused eating to become a priority in their life. Yet, the fact that not all were able to eat as they intended, advocates for nutritional guidance for people with T2DM, with a greater emphasis on reflexivity, psycho-social well-being and social support.
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Affiliation(s)
- C M M Polhuis
- Health and Society, Wageningen University, P.O. Box 8130, 6700 EW, Wageningen, The Netherlands.
| | - L Vaandrager
- Health and Society, Wageningen University, P.O. Box 8130, 6700 EW, Wageningen, The Netherlands
| | - S S Soedamah-Muthu
- Center of Research on Psychological and Somatic disorders (CORPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Institute for Food, Nutrition and Health, University of Reading, Reading, UK
| | - M A Koelen
- Health and Society, Wageningen University, P.O. Box 8130, 6700 EW, Wageningen, The Netherlands
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21
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Polhuis CMM, Bouwman LI, Vaandrager L, Soedamah-Muthu SS, Koelen MA. Systematic review of salutogenic-oriented lifestyle randomised controlled trials for adults with type 2 diabetes mellitus. PATIENT EDUCATION AND COUNSELING 2020; 103:764-776. [PMID: 31711677 DOI: 10.1016/j.pec.2019.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 10/18/2019] [Accepted: 10/19/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Describe the characteristics (development, intensity, deliverers, setting, strategies) and assess the effect of salutogenic-oriented lifestyle interventions on physical and psychosocial health outcomes in adults with type 2 diabetes mellitus (T2DM). METHOD PubMed, Scopus and PsycINFO were systematically searched for randomised controlled trials (RCTs) published up to August 2019 that complied with predefined salutogenic criteria: the participant as a whole, the participant's active involvement and the participant's individual learning process. Characteristics of the salutogenic-oriented interventions with and without significant results were compared and qualitatively summarised. RESULTS Twenty-eight RCTs were identified. Salutogenic oriented interventions that significantly improved both physical and psychosocial health were characterized by being based on formative research, culturally targeted, and delivered in 10-20 sessions in group settings, whereas salutogenic oriented interventions that neither improved physical or psychosocial health significantly were characterized by being individually tailored and delivered in less than 10 group sessions in individual settings. CONCLUSIONS This systematic review suggests that salutogenic-oriented lifestyle interventions are effective for physical and psychosocial health in the short term. More research is needed to determine how intervention characteristics moderate (long-term) effectiveness. PRACTICE IMPLICATIONS The results provide a basis for purposefully developing effective salutogenic interventions for adults with T2DM.
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Affiliation(s)
- C M M Polhuis
- Health and Society, Wageningen University, Wageningen, The Netherlands.
| | - L I Bouwman
- Health and Society, Wageningen University, Wageningen, The Netherlands
| | - L Vaandrager
- Health and Society, Wageningen University, Wageningen, The Netherlands
| | - S S Soedamah-Muthu
- Center of Research on Psychological and Somatic disorders (CORPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands; Institute for Food, Nutrition and Health, University of Reading, Reading, United Kingdom
| | - M A Koelen
- Health and Society, Wageningen University, Wageningen, The Netherlands
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22
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Contreras RE, Schriever SC, Pfluger PT. Physiological and Epigenetic Features of Yoyo Dieting and Weight Control. Front Genet 2019; 10:1015. [PMID: 31921275 PMCID: PMC6917653 DOI: 10.3389/fgene.2019.01015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 09/24/2019] [Indexed: 12/16/2022] Open
Abstract
Obesity and being overweight have become a worldwide epidemic affecting more than 1.9 billion adults and 340 million children. Efforts to curb this global health burden by developing effective long-term non-surgical weight loss interventions continue to fail due to weight regain after weight loss. Weight cycling, often referred to as Yoyo dieting, is driven by physiological counter-regulatory mechanisms that aim at preserving energy, i.e. decreased energy expenditure, increased energy intake, and impaired brain-periphery communication. Models based on genetically determined set points explained some of the weight control mechanisms, but exact molecular underpinnings remained elusive. Today, gene–environment interactions begin to emerge as likely drivers for the obesogenic memory effect associated with weight cycling. Here, epigenetic mechanisms, including histone modifications and DNA methylation, appear as likely factors that underpin long-lasting deleterious adaptations or an imprinted obesogenic memory to prevent weight loss maintenance. The first part summarizes our current knowledge on the physiology of weight cycling by discussing human and murine studies on the Yoyo-dieting phenomenon and physiological adaptations associated with weight loss and weight re-gain. The second part provides an overview on known associations between obesity and epigenetic modifications. We further interrogate the roles of epigenetic mechanisms in the CNS control of cognitive functions as well as reward and addictive behaviors, and subsequently discuss whether such mechanisms play a role in weight control. The final two parts describe major opportunities and challenges associated with studying epigenetic mechanisms in the CNS with its highly heterogenous cell populations, and provide a summary of recent technological advances that will help to delineate whether an obese memory is based upon epigenetic mechanisms.
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Affiliation(s)
- Raian E Contreras
- Research Unit Neurobiology of Diabetes, Helmholtz Zentrum München, Neuherberg, Germany.,Institute for Diabetes and Obesity, Helmholtz Zentrum München, Neuherberg, Germany.,German Centre for Diabetes Research (DZD), Neuherberg, Germany.,Neurobiology of Diabetes, TUM School of Medicine, Technische Universität München, Munich, Germany
| | - Sonja C Schriever
- Research Unit Neurobiology of Diabetes, Helmholtz Zentrum München, Neuherberg, Germany.,Institute for Diabetes and Obesity, Helmholtz Zentrum München, Neuherberg, Germany.,German Centre for Diabetes Research (DZD), Neuherberg, Germany
| | - Paul T Pfluger
- Research Unit Neurobiology of Diabetes, Helmholtz Zentrum München, Neuherberg, Germany.,Institute for Diabetes and Obesity, Helmholtz Zentrum München, Neuherberg, Germany.,German Centre for Diabetes Research (DZD), Neuherberg, Germany.,Neurobiology of Diabetes, TUM School of Medicine, Technische Universität München, Munich, Germany
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23
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Jensen SBK, Lundgren JR, Janus C, Juhl CR, Olsen LM, Rosenkilde M, Holst JJ, Stallknecht BM, Madsbad S, Torekov SS. Protocol for a randomised controlled trial of the combined effects of the GLP-1 receptor agonist liraglutide and exercise on maintenance of weight loss and health after a very low-calorie diet. BMJ Open 2019; 9:e031431. [PMID: 31678947 PMCID: PMC6830609 DOI: 10.1136/bmjopen-2019-031431] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 09/12/2019] [Accepted: 09/30/2019] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION The success rate of weight loss maintenance is limited. Therefore, the purpose of this study is to investigate the maintenance of weight loss and immunometabolic health outcomes after diet-induced weight loss followed by 1-year treatment with a glucagon-like peptide-1 receptor agonist (liraglutide), physical exercise or the combination of both treatments as compared with placebo in individuals with obesity. METHODS AND ANALYSIS This is an investigator-initiated, randomised, placebo-controlled, parallel group trial. We will enrol expectedly 200 women and men (age 18-65 years) with obesity (body mass index 32-43 kg/m2) to adhere to a very low-calorie diet (800 kcal/day) for 8 weeks in order to lose at least 5% of body weight. Subsequently, participants will be randomised in a 1:1:1:1 ratio to one of four study groups for 52 weeks: (1) placebo, (2) exercise 150 min/week+placebo, (3) liraglutide 3.0 mg/day and (4) exercise 150 min/week+liraglutide 3.0 mg/day. The primary endpoint is change in body weight from randomisation to end-of-treatment. ETHICS AND DISSEMINATION The trial has been approved by the ethical committee of the Capital Region of Denmark and the Danish Medicines Agency. The trial will be conducted in agreement with the Declaration of Helsinki and monitored to follow the guidelines for good clinical practice. Results will be submitted for publication in international peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER 2015-005585-32.
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Affiliation(s)
- Simon Birk Kjær Jensen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Julie Rehné Lundgren
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Janus
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Christian Rimer Juhl
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Lisa Møller Olsen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Mads Rosenkilde
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Jens Juul Holst
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | | | - Sten Madsbad
- Department of Endocrinology, Hvidovre Hospital, Hvidovre, Denmark
| | - Signe Sørensen Torekov
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
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24
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Albert Pérez E, Poveda González M, Martínez-Espinosa RM, Molina Vila MD, Reig García-Galbis M. Practical Guidance for Interventions in Adults with Metabolic Syndrome: Diet and Exercise vs. Changes in Body Composition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3481. [PMID: 31540536 PMCID: PMC6765968 DOI: 10.3390/ijerph16183481] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 08/29/2019] [Accepted: 09/02/2019] [Indexed: 12/12/2022]
Abstract
(1) Objective: to establish practical guidance for the design of future clinical trials in MS (metabolic syndrome) patients aged 18 and older, based on a systematic review of randomized clinical trials connecting diet, physical exercise and changes in body composition. (2) Method: this systematic review of randomized clinical trials (RCT) is based on the guidelines recommended by PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses). Criteria of selection: ≥18 years of age; patients diagnosed with MS; intervention programs including diet, physical exercise and/or modifications in the style of life as treatment, as well as the magnitude of changes in body composition (BC); randomized clinical trial published between 2004 and 2018. (3) Results: the multidisciplinary interventions describe major changes in BC, and the recurring pattern in these clinical trials is an energy reduction and control in the percentage of intake of macronutrients along with the performance of regularly structured exercise; the most analyzed parameter was waist circumference (88.9% of the trials), followed by body weight (85.2%), BMI (77.8%) and body fat (55.6%). (4) Conclusions: The analysis of the information here reported sheds light for the design of future clinical trials in adults with MS. The best anthropometric parameters and units of measurement to monitor the interventions are related to dietary and physical exercise interventions. A list of practical advice that is easy to implement in daily practice in consultation is here proposed in order to guarantee the best results in changes of body composition.
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Affiliation(s)
- Enrique Albert Pérez
- Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain; (E.A.P.); (M.P.G.)
| | - Marina Poveda González
- Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain; (E.A.P.); (M.P.G.)
| | - Rosa María Martínez-Espinosa
- Division of Biochemistry and Molecular Biology, Department of Agrochemistry and Biochemistry, Faculty of Sciences. University of Alicante, 03690 Alicante, Spain;
| | - Mariola D Molina Vila
- Department of Mathematics, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain;
| | - Manuel Reig García-Galbis
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Atacama, Avda. Copayapu 2862, III Region, Copiapó 1530000, Chile
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25
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Ayisi Addo S, Nti C, Vuvor F, Adjimani J, Steiner-Asiedu M. Impact of Successful Weight Loss Maintenance on Serum Lipids and Glucose Concentrations of Previous Participants of a Weight Loss Programme in Accra, Ghana. J Nutr Metab 2019; 2019:4729040. [PMID: 31061735 PMCID: PMC6466963 DOI: 10.1155/2019/4729040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/18/2019] [Accepted: 03/04/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND AIM There is a need to investigate the long-term impact of successful weight loss maintenance on blood lipids and glucose concentrations in populations within Africa, where obesity and cardiovascular disease (CVD) rates are increasingly becoming a public health threat. The aim of this study was to compare the serum lipid and glucose concentrations of successful and unsuccessful weight loss maintainers who previously participated in the Nutriline Weight Loss Programme (NWLP) in Accra, Ghana. METHODS 112 participants were randomly selected to participate in this cross-sectional study. Baseline and end of weight loss programme anthropometric and programmatic data were accessed via the NWLP archival database. On follow-up, anthropometric data, physical activity, dietary behaviour, serum lipid, and glucose indices were taken. Successful weight loss maintainers (SWLM) were defined as those achieving at least 5% weight loss below the baseline weight at follow-up, otherwise unsuccessful (UWLM). RESULTS The adjusted serum total cholesterol (TC) concentration was significantly lower for SWLM (5.17 ± 0.99 mmol/L) compared to UWLM (5.59 ± 1.06 mmol/L). Serum low-density lipoprotein (LDL), high-density lipoprotein (HDL), fasting blood glucose (FBG), and glycosylated haemoglobin (HbA1c) concentrations for SWLM versus UWLM did not differ significantly and were as follows: 3.58 ± 0.92 mmol/L versus 3.87 ± 0.99 mmol/L, 1.22 ± 0.38 mmol/L versus 1.17 ± 0.32 mmol/L, 4.48 ± 0.72 mmol/L versus 4.73 ± 1.00 mmol/L, and 5.52 ± 0.39% versus 5.59 ± 0.59%, respectively. Triglyceride (TG) concentration was significantly (P < 0.001) lower for SWLM (0.79 ± 0.28 mmol/L) compared to UWLM (1.17 ± 0.51 mmol/L). After adjusting for covariates, it was no longer significant. Additionally, there was no significant association between weight loss maintenance success and having a normal status for selected lipids and glucose parameters. CONCLUSION SWLM had a significantly lower serum TC compared to UWLM. In addition, a greater proportion of SWLM had normal values for TC, TG, HbA1c, and LDL out of the six parameters measured although not statistically significant.
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Affiliation(s)
- Sandra Ayisi Addo
- Department of Nutrition and Food Science, University of Ghana, Legon-Accra, Ghana
| | - Christiana Nti
- Department of Family and Consumer Sciences, University of Ghana, Legon-Accra, Ghana
| | - Frederick Vuvor
- Department of Nutrition and Food Science, University of Ghana, Legon-Accra, Ghana
| | - Jonathan Adjimani
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon-Accra, Ghana
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26
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Petridou A, Siopi A, Mougios V. Exercise in the management of obesity. Metabolism 2019; 92:163-169. [PMID: 30385379 DOI: 10.1016/j.metabol.2018.10.009] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/10/2018] [Accepted: 10/22/2018] [Indexed: 01/06/2023]
Abstract
Obesity is a multifactorial disease with increasing incidence and burden on societies worldwide. Obesity can be managed through everyday behavioral changes involving energy intake and energy expenditure. Concerning the latter, there is strong evidence that regular exercise contributes to body weight and fat loss, maintenance of body weight and fat reduction, and metabolic fitness in obesity. Appropriate exercise programs should ideally combine large negative energy balance, long-term adherence, and beneficial effects on health and well-being. Endurance training appears to be the most effective in this respect, although resistance training and high-intensity interval training play distinct roles in the effectiveness of exercise interventions. With weight regain being so common, weight loss maintenance is probably the greatest challenge in the successful treatment of obesity. There is an established association between higher levels of physical activity and greater weight loss maintenance, based on the abundance of evidence from prospective observational studies and retrospective analyses. However, proving a causative relationship between exercise and weight loss maintenance is difficult at present. Exercise has the potential to alleviate the health consequences of obesity, even in the absence of weight loss. All in all, exercise constitutes an indispensable, yet often underestimated, tool in the management of obesity.
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Affiliation(s)
- Anatoli Petridou
- Laboratory of Evaluation of Human Biological Performance, School of Physical Education and Sport Science at Thessaloniki, Aristotle University of Thessaloniki, Greece
| | - Aikaterina Siopi
- Laboratory of Evaluation of Human Biological Performance, School of Physical Education and Sport Science at Thessaloniki, Aristotle University of Thessaloniki, Greece
| | - Vassilis Mougios
- Laboratory of Evaluation of Human Biological Performance, School of Physical Education and Sport Science at Thessaloniki, Aristotle University of Thessaloniki, Greece.
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27
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Eykelenboom M, van Stralen MM, Poelman MP, Steenhuis IHM. Patterns of weight loss and their determinants in a sample of adults with overweight and obesity intending to lose weight. Nutr Diet 2018; 77:240-246. [PMID: 30402896 DOI: 10.1111/1747-0080.12489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/24/2018] [Accepted: 09/14/2018] [Indexed: 12/13/2022]
Abstract
AIM Weight loss success is highly variable among individuals. Cluster analysis contributes to future intervention development by recognising this individual variability and identifying different weight loss patterns. Identifying determinants that differentiate between these patterns would explain the source of variability. Thus, we aimed to identify weight loss patterns and their determinants in adults with overweight and obesity. METHODS The present study is a secondary analysis of data from the PortionControl@HOME study. The weight of 175 adults was measured at 0, 3 and 12 months and potential determinants were self-reported using validated questionnaires at 0 and 3 months. Weight loss patterns were identified based on percent weight change during Phase 1 (0-3 months) and Phase 2 (3-12 months) using cluster analysis. Determinants were assessed using multinomial logistic regression. RESULTS We identified three weight loss patterns: (i) low success, demonstrating low weight loss achievement, (ii) moderate success, demonstrating successful weight loss in Phase 1 followed by partial regain in Phase 2 and (iii) high success, demonstrating weight loss in Phase 1 followed by continued weight loss in Phase 2. Compared to the moderate success pattern, the low success pattern was negatively associated with power of food at baseline (i.e. the appetitive drive to consume highly palatable food) (odds ratio, OR = 0.42, 95% CI = 0.21-0.86) and change in portion control behaviour (i.e. the use of behavioural strategies to control the amount of food consumed) (OR = 0.28, 95% CI = 0.10-0.78). CONCLUSIONS Three weight loss patterns were identified in adults with overweight and obesity. Adults with greater power of food and increased portion control behaviour were less likely to exhibit an unsuccessful weight loss pattern.
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Affiliation(s)
- Michelle Eykelenboom
- Department of Health Sciences, Amsterdam Public Health Research Institute, VU Amsterdam, Amsterdam, the Netherlands
| | - Maartje M van Stralen
- Department of Health Sciences, Amsterdam Public Health Research Institute, VU Amsterdam, Amsterdam, the Netherlands
| | - Maartje P Poelman
- Department of Health Sciences, Amsterdam Public Health Research Institute, VU Amsterdam, Amsterdam, the Netherlands.,Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, the Netherlands
| | - Ingrid H M Steenhuis
- Department of Health Sciences, Amsterdam Public Health Research Institute, VU Amsterdam, Amsterdam, the Netherlands
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Pereira MJ, Lundkvist P, Kamble PG, Lau J, Martins JG, Sjöström CD, Schnecke V, Walentinsson A, Johnsson E, Eriksson JW. A Randomized Controlled Trial of Dapagliflozin Plus Once-Weekly Exenatide Versus Placebo in Individuals with Obesity and Without Diabetes: Metabolic Effects and Markers Associated with Bodyweight Loss. Diabetes Ther 2018; 9:1511-1532. [PMID: 29949016 PMCID: PMC6064580 DOI: 10.1007/s13300-018-0449-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The sodium-glucose cotransporter 2 inhibitor dapagliflozin and the glucagon-like peptide-1 (GLP-1) receptor agonist exenatide reduce bodyweight via differing and complementary mechanisms. This post hoc analysis investigated the metabolic effects and baseline associations with bodyweight loss on coadministration of dapagliflozin and exenatide once weekly (QW) among adults with obesity and without diabetes. METHODS In the primary trial, adults with obesity and without diabetes [n = 50; 18-70 years; body mass index (BMI) 30-45 kg/m2] were randomized to double-blind oral dapagliflozin 10 mg (DAPA) once daily plus subcutaneous long-acting exenatide 2 mg QW (ExQW) or placebo over 24 weeks, followed by an open-label extension from 24-52 weeks during which all participants received active treatment. Primary results have been published previously. This analysis evaluated: (1) the effects of DAPA + ExQW on changes in substrates [free fatty acids (FFAs), glycerol, beta-OH-butyrate, and glucose], hormones (glucagon and insulin), and insulin secretion [insulinogenic index (IGI)] via an oral glucose tolerance test (OGTT) and (2) associations between bodyweight loss and baseline characteristics (e.g., BMI), single-nucleotide polymorphisms (SNPs) associated with the GLP-1 pathway, and markers of glucose regulation. RESULTS Compared with placebo at 24 weeks, 2-h FFAs post-OGTT increased (mean difference, +20.4 μmol/l; P < 0.05), and fasting glucose, 2-h glucose post-OGTT, and glucose area under the concentration-time curve (AUC) decreased with DAPA + ExQW [mean differences, -0.68 mmol/l [P < 0.001], -2.20 mmol/l (P < 0.01), and -306 mmol/l min (P < 0.001), respectively]. Glucagon, glycerol, beta-OH-butyrate, and IGI did not differ by treatment group at 24 weeks. Over 52 weeks, DAPA + ExQW decreased fasting insulin, 2-h post-OGTT insulin, and insulin AUC. Among DAPA + ExQW-treated participants, for each copy of the SNP variant rs10010131 A allele (gene WFS1), bodyweight decreased by 2.4 kg (P < 0.05). Lower BMI and a lower IGI were also associated with greater bodyweight loss with DAPA + ExQW. CONCLUSIONS Metabolic effects with DAPA + ExQW included less FFA suppression versus placebo during the OGTT, suggesting compensatory lipid mobilization for energy production when glucose availability was reduced because of glucosuria. The expected increase in glucagon with DAPA did not occur with DAPA + ExQW coadministration. Bodyweight loss with DAPA + ExQW was associated with the SNP variant rs10010131 A allele, lower baseline adiposity (BMI), and lower baseline insulin secretion (IGI). These findings require further validation. FUNDING AstraZeneca.
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Affiliation(s)
- Maria J Pereira
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Per Lundkvist
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Prasad G Kamble
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Joey Lau
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | | | | | | | | | | | - Jan W Eriksson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
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Swift DL, McGee JE, Earnest CP, Carlisle E, Nygard M, Johannsen NM. The Effects of Exercise and Physical Activity on Weight Loss and Maintenance. Prog Cardiovasc Dis 2018; 61:206-213. [PMID: 30003901 DOI: 10.1016/j.pcad.2018.07.014] [Citation(s) in RCA: 240] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 07/08/2018] [Indexed: 01/12/2023]
Abstract
Obesity represents a major health problem in the United States and is associated with increased prevalence of cardiovascular (CV) disease risk factors. Physical activity (PA) and exercise training (ET) are associated with reduced CV risk, improved cardiometabolic risk factors, and facilitated weight loss through creating a negative energy balance. Clinicians need to counsel overweight and obese patients on how much PA/ET is needed to promote weight loss and weight loss maintenance. This will help establish realistic expectations and maximize improvements in CV risk factors. Although the minimum guidelines for aerobic PA (150 min of moderate or 75 min of vigorous physical activity per week) can improve CV health, these levels are generally inadequate for clinically significant weight loss or weight maintenance without caloric restriction. The purpose of this review is to evaluate the role of ET to promote clinically significant weight loss and promote weight maintenance. In particular, we will evaluate the likelihood of weight loss from ET programs composed of aerobic training only, resistance training only and programs that combine diet and ET. We will also explore the role of PA in promoting short-term and long-term weight maintenance.
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Affiliation(s)
- Damon L Swift
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America.
| | - Joshua E McGee
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America
| | - Conrad P Earnest
- Department of Kinesiology, Texas A&M University, College Station, TX, United States of America
| | - Erica Carlisle
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America
| | - Madison Nygard
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America
| | - Neil M Johannsen
- Department of Kinesiology, Louisiana State University, Baton Rouge, LA, United States of America
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Albert Pérez E, Mateu Olivares V, Martínez-Espinosa RM, Molina Vila MD, Reig García-Galbis M. New Insights about How to Make an Intervention in Children and Adolescents with Metabolic Syndrome: Diet, Exercise vs. Changes in Body Composition. A Systematic Review of RCT. Nutrients 2018; 10:E878. [PMID: 29986479 PMCID: PMC6073719 DOI: 10.3390/nu10070878] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 06/22/2018] [Accepted: 07/02/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To record which interventions produce the greatest variations in body composition in patients ≤19 years old with metabolic syndrome (MS). METHOD search dates between 2005 and 2017 in peer reviewed journals, following the PRISMA method (Preferred Reporting Items for Systematic reviews and Meta-Analyses). The selection criteria were: diagnostic for MS or at least a criterion for diagnosis; randomized clinical trials, ≤19 years of age; intervention programs that use diet and/or exercise as a tool (interventions showing an interest in body composition). RESULTS 1781 clinical trials were identified under these criteria but only 0.51% were included. The most frequent characteristics of the selected clinical trials were that they used multidisciplinary interventions and were carried out in America. The most utilized parameters were BMI (body mass index) in kg/m² and BW (body weight) in kg. CONCLUSIONS Most of the clinical trials included had been diagnosed through at least 2 diagnostic criteria for MS. Multidisciplinary interventions obtained greater changes in body composition in patients with MS. This change was especially prevalent in the combinations of dietary interventions and physical exercise. It is proposed to follow the guidelines proposed for patients who are overweight, obese, or have diabetes type 2, and extrapolate these strategies as recommendations for future clinical trials designed for patients with MS.
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Affiliation(s)
| | | | - Rosa María Martínez-Espinosa
- Division of Biochemistry and Molecular Biology, Department of Agrochemistry and Biochemistry, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain.
- Members of the Research Group of Applied Biochemistry (AppBiochem), Faculty of Sciences, University of Alicante, 03690 Alicante, Spain.
| | - Mariola D Molina Vila
- Members of the Research Group of Applied Biochemistry (AppBiochem), Faculty of Sciences, University of Alicante, 03690 Alicante, Spain.
- Department of Mathematics, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain.
| | - Manuel Reig García-Galbis
- Members of the Research Group of Applied Biochemistry (AppBiochem), Faculty of Sciences, University of Alicante, 03690 Alicante, Spain.
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Atacama, Avda Copayapu 2862, III Region, Copiapo 1530000, Chile.
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Fischer IP, Irmler M, Meyer CW, Sachs SJ, Neff F, Hrabě de Angelis M, Beckers J, Tschöp MH, Hofmann SM, Ussar S. A history of obesity leaves an inflammatory fingerprint in liver and adipose tissue. Int J Obes (Lond) 2018; 42:507-517. [PMID: 28901330 PMCID: PMC5880583 DOI: 10.1038/ijo.2017.224] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/28/2017] [Accepted: 09/04/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND/OBJECTIVES Dieting is a popular yet often ineffective way to lower body weight, as the majority of people regain most of their pre-dieting weights in a relatively short time. The underlying molecular mechanisms driving weight regain and the increased risk for metabolic disease are still incompletely understood. Here we investigate the molecular alterations inherited from a history of obesity. METHODS In our model, male high-fat diet (HFD)-fed obese C57BL/6J mice were switched to a low caloric chow diet, resulting in a decline of body weight to that of lean mice. We measured body composition, as well as metrics of glucose, insulin and lipid homeostasis. This was accompanied by histological and gene expression analysis of adipose tissue and liver to assess adipose tissue inflammation and hepatosteatosis. Moreover, acute hypothalamic response to (re-) exposure to HFD was assessed by qPCR. RESULTS & CONCLUSIONS Within 7 weeks after diet switch, most obesity-associated phenotypes, such as body mass, glucose intolerance and blood metabolite levels were reversed. However, hepatic inflammation, hepatic steatosis as well as hypertrophy and inflammation of perigonadal, but not subcutaneous, adipocytes persisted in formerly obese mice. Transcriptional profiling of liver and perigonadal fat revealed an upregulation of pathways associated with immune function and cellularity. Thus, we show that weight reduction leaves signs of inflammation in liver and perigonadal fat, indicating that persisting proinflammatory signals in liver and adipose tissue could contribute to an increased risk of formerly obese subjects to develop the metabolic syndrome upon recurring weight gain.
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Affiliation(s)
- I P Fischer
- JRG Adipocytes and Metabolism, Institute for Diabetes and Obesity, Helmholtz Diabetes Center at Helmholtz Center Munich, Garching, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Division of Metabolic Diseases, Department of Medicine, Technische Universität München, Munich, Germany
| | - M Irmler
- Institute for Experimental Genetics, Helmholtz Zentrum München, München-Neuherberg, Germany
| | - C W Meyer
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Division of Metabolic Diseases, Department of Medicine, Technische Universität München, Munich, Germany
| | - S J Sachs
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Medizinische Klinik und Poliklinik IV der LMU, Munich, Germany
- Institute for Diabetes and Regeneration, Helmholtz Diabetes Center at Helmholtz Zentrum München, Garching, Germany
| | - F Neff
- Institute for Pathology, Helmholtz Zentrum München, München-Neuherberg, Germany
| | - M Hrabě de Angelis
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Experimental Genetics, Helmholtz Zentrum München, München-Neuherberg, Germany
- Technische Universität München, Lehrstuhl für Experimentelle Genetik, Freising, Germany
| | - J Beckers
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Experimental Genetics, Helmholtz Zentrum München, München-Neuherberg, Germany
- Technische Universität München, Lehrstuhl für Experimentelle Genetik, Freising, Germany
| | - M H Tschöp
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Division of Metabolic Diseases, Department of Medicine, Technische Universität München, Munich, Germany
- Institute for Diabetes and Obesity, Helmholtz Diabetes Center at Helmholtz Zentrum München, Garching, Germany
| | - S M Hofmann
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Medizinische Klinik und Poliklinik IV der LMU, Munich, Germany
- Institute for Diabetes and Regeneration, Helmholtz Diabetes Center at Helmholtz Zentrum München, Garching, Germany
| | - S Ussar
- JRG Adipocytes and Metabolism, Institute for Diabetes and Obesity, Helmholtz Diabetes Center at Helmholtz Center Munich, Garching, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
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El Ghoch M, Calugi S, Dalle Grave R. Weight cycling in adults with severe obesity: A longitudinal study. Nutr Diet 2017; 75:256-262. [PMID: 29114979 DOI: 10.1111/1747-0080.12387] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/12/2017] [Accepted: 08/29/2017] [Indexed: 11/28/2022]
Abstract
AIM Although weight cycling is a common phenomenon in treatment-seeking patients with obesity, its consequences on health outcomes have not yet been completely clarified. We therefore aimed to investigate the effect of one cycle of intentional weight loss and regain on energy expenditure, body composition, cardiovascular risk factors and psychosocial variables in patients with severe obesity. METHODS Clinical and psychosocial variables were measured in 38 adult patients with severe obesity (body mass index (BMI): 43.5 ± 7.2 kg/m2 ) consecutively readmitted to rehabilitative residential treatment (T1) for severe obesity after a cycle of weight loss (16.7 ±7.7 kg) and regain (15.1 ±11.3 kg), and compared with those recorded at a prior admission (T0). RESULTS No significant differences were found between T0 and T1 values for weight, BMI, waist circumference, total body fat percentage, fat-free mass percentage, respiratory quotient, measured or predicted resting energy expenditure, metabolic adaptation, cardiovascular risk factors or psychosocial variables. However, younger patients (r = -0.38, P = 0.023) and those with higher historical weight (r = 0.43, P = 0.010) tended to regain more weight. CONCLUSIONS The absence of negative physical and psychological effects of weight cycling indicates that the risk of weight regain should not be a barrier to encouraging weight loss efforts in patients with severe obesity.
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Affiliation(s)
- Marwan El Ghoch
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Verona, Italy
| | - Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Verona, Italy
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Verona, Italy
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Santas J, Lázaro E, Cuñé J. Effect of a polysaccharide-rich hydrolysate from Saccharomyces cerevisiae (LipiGo®) in body weight loss: randomised, double-blind, placebo-controlled clinical trial in overweight and obese adults. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2017; 97:4250-4257. [PMID: 28251654 DOI: 10.1002/jsfa.8301] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 02/27/2017] [Accepted: 02/27/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND In the present study we evaluated the weight loss effect of a polysaccharide-rich food supplement, LipiGo®, comprising a specific β-glucan-chitin-chitosan fraction (BGCC) obtained from the chemical hydrolysis of Saccharomyces cerevisiae, resulting as a by-product of the brewing process. RESULTS A randomised, double-blind, placebo-controlled clinical trial was performed enrolling 56 overweight and obese subjects (body mass index, BMI, 25-35 kg m-2 ) who were not following any specific diet, and were given placebo or BGCC (3 g d-1 ) for 12 weeks. Results were analysed by intention-to-treat (ITT) and per-protocol (PP) methods. Body weight increased in the placebo group compared to baseline (ITT: 1.0 kg, P < 0.001; PP: 1.5 kg, P = 0.003), while it was slightly lowered in the BGCC group (ITT: -0.8 kg, P = 0.210; PP: -1.1 kg, P = 0.182). BGCC, but not the consumption of placebo, also resulted in a reduction of waist circumference and body fat compared to baseline. CONCLUSIONS Results suggest that daily supplementation of BGCC may be useful for improving body weight and waist circumference in overweight and obese subjects, without relevant adverse effects. © 2017 Society of Chemical Industry.
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Affiliation(s)
| | | | - Jordi Cuñé
- AB-Biotics, Sant Cugat del Vallès, Barcelona, Spain
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Puhl RM, Quinn DM, Weisz BM, Suh YJ. The Role of Stigma in Weight Loss Maintenance Among U.S. Adults. Ann Behav Med 2017; 51:754-763. [DOI: 10.1007/s12160-017-9898-9] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Soleymani T, Daniel S, Garvey WT. Weight maintenance: challenges, tools and strategies for primary care physicians. Obes Rev 2016; 17:81-93. [PMID: 26490059 PMCID: PMC4715703 DOI: 10.1111/obr.12322] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 08/18/2015] [Accepted: 08/18/2015] [Indexed: 12/12/2022]
Abstract
Obesity is recognized as a chronic disease and one of the major healthcare challenges facing us today. Weight loss can be achieved via lifestyle, pharmacological and surgical interventions, but weight maintenance remains a lifetime challenge for individuals with obesity. Guidelines for the management of obesity have highlighted the role of primary care providers (PCPs). This review examines the long-term outcomes of clinical trials to identify effective weight maintenance strategies that can be utilized by PCPs. Because of the broad nature of the topic, a structured PubMed search was conducted to identify relevant research articles, peer-reviewed reviews, guidelines and articles published by regulatory bodies. Trials have demonstrated the benefit of sustained weight loss in managing obesity and its comorbidities. Maintaining 5-10% weight loss for ≥1 year is known to ameliorate many comorbidities. Weight maintenance with lifestyle modification - although challenging - is possible but requires long-term support to reinforce diet, physical activity and behavioural changes. The addition of pharmacotherapy to lifestyle interventions promotes greater and more sustained weight loss. Clinical evidence and recently approved pharmacotherapy has given PCPs improved strategies to support their patients with maintenance of weight loss. Further studies are needed to assess the translation of these strategies into clinical practice.
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Affiliation(s)
- T. Soleymani
- Department of Nutritional SciencesUniversity of Alabama at BirminghamBirminghamALUSA
- Birmingham Veterans Affairs Medical CenterBirminghamALUSA
| | - S. Daniel
- Department of Nutritional SciencesUniversity of Alabama at BirminghamBirminghamALUSA
| | - W. T. Garvey
- Department of Nutritional SciencesUniversity of Alabama at BirminghamBirminghamALUSA
- Birmingham Veterans Affairs Medical CenterBirminghamALUSA
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Lenoir L, Maillot M, Guilbot A, Ritz P. Primary care weight loss maintenance with behavioral nutrition: An observational study. Obesity (Silver Spring) 2015; 23:1771-7. [PMID: 26308476 PMCID: PMC4660887 DOI: 10.1002/oby.21157] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 04/24/2015] [Accepted: 04/27/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the rate of weight loss maintenance, defined as a 10% loss of initial weight maintained beyond 1 year, among patients with BMI > 25 kg/m(2) who had been managed by primary care physicians practicing behavioral nutrition (moderately high-protein diet, carbohydrate restriction, and behavioral therapy). METHODS Restrospective analysis of anthropometric characteristics, weight loss, and its determinants was conducted in 14,256 patients. RESULTS 26.7% of subjects met the success criterion (successful maintenance group; SM), 25.7% did not maintain their weight loss (unsuccessful maintenance group; UM), and 47.6% did not lose 10% of their initial weight (failure group; F). At inclusion, patients in the SM group had a greater BMI and fat mass percentage (40.5% in SM, 38.5% in UM, and 37.0% in F). These patients lost more weight (-14.1% vs. -4.59%) and fat mass (-24.7% vs. -8.21%) than patients in the UM group, and contribution of adiposity to their weight loss was 75.1%. Follow-up of patients in the SM group was characterized by a greater frequency of consultations. CONCLUSIONS Management by primary care providers with behavioral nutrition facilitates weight loss maintenance in patients with overweight and obesity. The determinants of success are frequency of consultations, initial BMI, and initial weight loss.
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Affiliation(s)
| | | | | | - Patrick Ritz
- Unité De Nutrition, Pôle Cardiovasculaire Et MétaboliqueToulouse, France.
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Fontana L, Partridge L. Promoting health and longevity through diet: from model organisms to humans. Cell 2015; 161:106-118. [PMID: 25815989 DOI: 10.1016/j.cell.2015.02.020] [Citation(s) in RCA: 794] [Impact Index Per Article: 88.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 01/20/2015] [Accepted: 01/20/2015] [Indexed: 12/19/2022]
Abstract
Reduced food intake, avoiding malnutrition, can ameliorate aging and aging-associated diseases in invertebrate model organisms, rodents, primates, and humans. Recent findings indicate that meal timing is crucial, with both intermittent fasting and adjusted diurnal rhythm of feeding improving health and function, in the absence of changes in overall intake. Lowered intake of particular nutrients rather than of overall calories is also key, with protein and specific amino acids playing prominent roles. Nutritional modulation of the microbiome can also be important, and there are long-term, including inter-generational, effects of diet. The metabolic, molecular, and cellular mechanisms that mediate both improvement in health during aging to diet and genetic variation in the response to diet are being identified. These new findings are opening the way to specific dietary and pharmacological interventions to recapture the full potential benefits of dietary restriction, which humans can find difficult to maintain voluntarily.
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Affiliation(s)
- Luigi Fontana
- Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Clinical and Experimental Science, Brescia University, 25123 Brescia, Italy; CEINGE Biotecnologie Avanzate, 80145 Napoli, Italy.
| | - Linda Partridge
- Max Planck Institute for Biology of Ageing, 50931 Cologne, Germany; Institute of Healthy Ageing and Department of Genetics, Environment, and Evolution, University College London, London WC1E 6BT, UK.
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Grube B, Chong PW, Alt F, Uebelhack R. Weight Maintenance with Litramine (IQP-G-002AS): A 24-Week Double-Blind, Randomized, Placebo-Controlled Study. J Obes 2015; 2015:953138. [PMID: 26435849 PMCID: PMC4576018 DOI: 10.1155/2015/953138] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 08/20/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Litramine (IQP-G-002AS) was shown to be effective and safe for weight loss in overweight and obese subjects. However, long-term effectiveness on maintenance of body weight loss has yet to be ascertained. OBJECTIVE To assess effect of Litramine on maintenance of body weight loss. METHODS A double-blind, randomised, placebo-controlled trial on overweight and obese patients was conducted over two sites in Germany for 24 weeks. Subjects with documented previous weight loss of 3% over the last 3-6 months were randomised to groups given either Litramine (3 g/day) or a matching placebo. Primary endpoints were difference of mean body weight (kg) between baseline and end of study and maintenance of initially lost body weight in verum group, where maintenance is defined as ≤1% weight gain. RESULTS Subjects who were taking Litramine lost significantly more body weight compared to the subjects taking placebo who gained weight instead (-0.62 ± 1.55 kg versus 1.62 ± 1.48 kg, p < 0.001). More importantly, 92% of subjects in Litramine group were able to maintain their body weight after initial weight loss, versus 25% in placebo group. No serious adverse events were reported throughout. CONCLUSION Litramine is effective and safe for long-term body weight maintenance. Trial Registration. This trial is registered with Clinicaltrials.gov identifier: NCT01505387.
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Affiliation(s)
- Barbara Grube
- Practice for General Medicine, Kurfürstendamm 157/158, 10709 Berlin, Germany
| | - Pee-Win Chong
- Zaluvida Corporate Sdn Bhd, E-16 Plaza Mont Kiara, 2 Jalan Kiara, 50480 Kuala Lumpur, Malaysia
- *Pee-Win Chong:
| | - Felix Alt
- Analyze & Realize GmbH, Waldseeweg 6, 13467 Berlin, Germany
| | - Ralf Uebelhack
- Analyze & Realize GmbH, Weißenseer Weg 111, 10369 Berlin, Germany
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