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Olson K, Eccleston C. Reconsidering the role of weight loss in treatment for chronic pain: Knee Osteoarthritis as an exemplar. THE JOURNAL OF PAIN 2024:104647. [PMID: 39103008 DOI: 10.1016/j.jpain.2024.104647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 07/26/2024] [Accepted: 07/28/2024] [Indexed: 08/07/2024]
Abstract
Chronic pain is prevalent among individuals with higher body weight and associated with greater impairment. As a result, weight loss is a common recommendation for pain management among those with higher body weight. Body weight is an appealing target because it is modifiable and evidence-based treatments to produce weight loss are well-established. In the last two decades there has been a growing line of scientific work investigating the application of weight loss to individuals with chronic pain. This represents an important step to integrate the conceptualization of pain and body weight and there is preliminary work suggesting treatment effects are enhanced when weight loss treatment is combined with pain coping skills. However, weight loss outcomes are variable and difficult to sustain, and access to evidence-based treatment is limited. These concerns are set against the backdrop of growing public and academic concern about the weight-centric approach to healthcare that dominates western medicine. This is a timely moment to reconsider the conceptualization of weight and pain, and the role of weight loss in chronic pain treatment. Using osteoarthritis as an exemplar, we review the evidence for and clinical uptake of weight loss as a chronic pain management strategy and conclude with key areas for consideration to advance the scientif ic understanding of these comorbid conditions and how to optimize pain management for individuals of higher body weight. PERSPECTIVE: This focus article critically considers the role of weight loss in management of chronic pain among individuals of higher body. Using knee osteoarthritis as an exemplar, the evidence and clinical uptake of weight loss for pain management is reviewed. Limitations are considered to guide future research and clinical care.
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Affiliation(s)
- KayLoni Olson
- Weight Control and Diabetes Research Center, Miriam Hospital; Department of Psychiatry and Human Behavior, Brown Medical School.
| | - Christopher Eccleston
- Research Department for Health, University of Bath; Centre for Pain Research, University of Bath
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2
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Waldrop SW, Johnson VR, Stanford FC. Inequalities in the provision of GLP-1 receptor agonists for the treatment of obesity. Nat Med 2024; 30:22-25. [PMID: 38172631 PMCID: PMC10921848 DOI: 10.1038/s41591-023-02669-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
GLP-1 receptor agonists are effective treatments for obesity but are less accessible worldwide than pharmacological treatments for diabetes, reflecting biases and lack of education, and perpetuating health inequalities.
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Affiliation(s)
- Stephanie W Waldrop
- University of Colorado School of Medicine-Anschutz Medical Campus, Department of Pediatrics, Section on Nutrition and Lifestyle Medicine, Nutrition Obesity Research Center at the University of Colorado (CUNORC), Aurora, CO, USA.
| | - Veronica R Johnson
- Northwestern University Feinberg School of Medicine, Department of Medicine, Division of General Internal Medicine, Chicago, IL, USA
| | - Fatima Cody Stanford
- Massachusetts General Hospital, Massachusetts General Hospital Weight Center, Department of Medicine-Division of Endocrinology-Neuroendocrine, Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Boston, MA, USA
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3
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Blüher M. [Medical care situation for people with obesity in Germany]. Dtsch Med Wochenschr 2023; 148:957-963. [PMID: 37494561 DOI: 10.1055/a-1847-2586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Obesity is a highly prevalent, chronically progressing disease. Obesity represents a challenge for people living with obesity, health care professionals and the society, because it is also associated with several comorbid diseases. For people with obesity in Germany, there is a significant deficit in the medical treatment infrastructure. The treatment access gap is mainly caused by a lack of legal frameworks for the guideline-driven obesity management. A currently developed disease management program for obesity has the potential to fill the gap in obesity management in the future.
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Geography and equity: expanding access to obesity medicine diplomate care. Int J Obes (Lond) 2022; 46:447-448. [PMID: 34992241 PMCID: PMC9908424 DOI: 10.1038/s41366-021-01044-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/18/2021] [Accepted: 11/25/2021] [Indexed: 11/08/2022]
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5
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Zeng Q, Li N, Pan XF, Chen L, Pan A. Clinical management and treatment of obesity in China. Lancet Diabetes Endocrinol 2021; 9:393-405. [PMID: 34022157 DOI: 10.1016/s2213-8587(21)00047-4] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 02/03/2021] [Accepted: 02/12/2021] [Indexed: 02/08/2023]
Abstract
China has one of the largest populations with obesity in the world, and obesity has become a major challenge for the country's health-care system. Current guidelines for obesity management are not adequately supported by evidence from clinical studies in Chinese populations. Effective lifestyle interventions suitable for Chinese populations are scarce, insufficient weight-loss medications have been approved by regulatory bodies, and there is low acceptance of non-lifestyle interventions (ie, medications and surgery) among both health-care providers and the general public. Large, well designed, and well implemented clinical trials are needed to strengthen the evidence base for the clinical management of obesity in China. Obesity management can be improved through use of a tiered system involving health management centres, integrated lifestyle interventions and medical treatments, strengthened obesity education and training, and use of advanced electronic health technologies. Resource mobilisation, support from major stakeholders for people with overweight or obesity, and education and changes to social norms among the wider public are also needed. National health policies should prioritise both obesity prevention and improvement of the treatment and management of obesity.
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Affiliation(s)
- Qiang Zeng
- Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Naishi Li
- Department of Endocrinology, Key Laboratory of Endocrinology of the National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiong-Fei Pan
- Department of Epidemiology and Biostatistics and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lulu Chen
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.
| | - An Pan
- Department of Epidemiology and Biostatistics and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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6
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Transcriptional analyses of the effects of Catharanthus roseus L. medicinal plant extracts on some markers related to obesity and inflammation in 3T3-L1 mouse cell lines. Biologia (Bratisl) 2021. [DOI: 10.2478/s11756-020-00567-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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7
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Brüggen F, Gellert P, Baer NR, Jödicke B, Brauchmann J, Wiegand S, Schenk L. Cooperation behaviour of primary care paediatricians: facilitators and barriers to multidisciplinary obesity management. Eur J Public Health 2020; 30:484-491. [PMID: 31998959 DOI: 10.1093/eurpub/ckz244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Multidisciplinary management of obesity by primary care paediatricians, providing a promising approach to tackle childhood obesity includes cooperation with other health care professionals. However, facilitators for and barriers to multidisciplinary cooperation in ambulatory care are not yet well understood and are investigated in the present study. METHODS A nationwide, cross-sectional survey of 83% of German primary care paediatricians was conducted, using a questionnaire based on qualitative expert interviews. Frequency of paediatricians' cooperation with external partners (i.e. nutrition counsellors; sports groups; interdisciplinary obesity centres; inpatient rehabilitation centres; and endocrinologists) was assessed. Individual and structural factors were associated with cooperation patterns. Missing values were addressed using multiple imputation. RESULTS Out of the 6081 primary care paediatricians approached, 2024 (33.3%) responded. Almost half of the respondents (40.8%) stated that they disengaged in the field of obesity prevention due to perceived inefficacy. Lack of financial reimbursement for consultation was agreed on by most of the respondents (90.4%). Identified barriers to cooperation included: higher proportion of patients with migration background, lack of time and available services. A more comprehensive conception of the professional role regarding overweight prevention, higher age, female gender, higher proportion of overweight/obese patients and practice location in urban or socially strained areas surfaced as facilitators for cooperation. CONCLUSION Low-perceived self-efficacy in obesity management and insufficient financial reimbursement for consultation are commonly stated among German paediatricians. For cooperation behaviour, however, other individual and structural factors seem to be relevant, which provide indications on how multidisciplinary childhood obesity management can be improved.
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Affiliation(s)
- Franca Brüggen
- Charité - Universitätsmedizin Berlin, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany
| | - Paul Gellert
- Charité - Universitätsmedizin Berlin, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany
| | - Nadja-Raphaela Baer
- Charité - Universitätsmedizin Berlin, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany
| | - Birgit Jödicke
- Charité - Universitätsmedizin Berlin, Department of Paediatric Endocrinology and Diabetes, Charité Children's Hospital, Berlin, Germany
| | - Jana Brauchmann
- Charité - Universitätsmedizin Berlin, Department of Paediatric Endocrinology and Diabetes, Charité Children's Hospital, Berlin, Germany
| | - Susanna Wiegand
- Charité - Universitätsmedizin Berlin, Department of Paediatric Endocrinology and Diabetes, Charité Children's Hospital, Berlin, Germany
| | - Liane Schenk
- Charité - Universitätsmedizin Berlin, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany
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Giusti EM, Spatola CA, Brunani A, Kumbhare D, Oral A, Ilieva E, Kiekens C, Pietrabissa G, Manzoni GM, Imamura M, Castelnuovo G, Capodaglio P. ISPRM/ESPRM guidelines on Physical and Rehabilitation Medicine professional practice for adults with obesity and related comorbidities. Eur J Phys Rehabil Med 2020; 56:496-507. [PMID: 32293813 DOI: 10.23736/s1973-9087.20.06232-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The World Health Organization (WHO) has declared obesity as the largest global chronic health problem in adults. In the last years, attention has been drawn to rehabilitative interventions for patients with obesity. AIM The aim of this manuscript is to provide Physical and Rehabilitation Medicine (PRM) physicians with evidence-based recommendations for the rehabilitation of patients with overweight or obesity and related comorbidities. DESIGN Evidence-based guidelines. POPULATION Adults with overweight or obesity. METHODS Guidelines were based on GRADE and WHO recommendations. A comprehensive search of the available evidence about rehabilitation treatments for obesity was performed, and 17 separate systematic literature reviews were conducted. For each outcome, estimates of the effects of rehabilitation treatments were computed and employed along with an assessment of quality of evidence, desirable and undesirable effects, values and preferences to formulate the recommendations. Recommendations were reviewed by a consensus expert panel using a modified Delphi process. RESULTS We strongly recommend providing comprehensive multiprofessional and multidisciplinary interventions including exercise, diet and behavioral or cognitive-behavioral therapy. The nutritional component of these treatments should include diets with either a high-protein or a low-fat content. It is strongly recommended to prescribe frequent moderate aerobic exercise. We strongly recommend providing cognitive-behavioral interventions as the behavioral component of rehabilitation programs. CONCLUSIONS PRM physicians should lead multidisciplinary teams providing comprehensive and individualized rehabilitation programs for patients with overweight or obesity. These guidelines were endorsed by the International Society of Physical and Rehabilitation Medicine (ISPRM) and by the European Society of Physical and Rehabilitation Medicine (ESPRM).
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Affiliation(s)
- Emanuele M Giusti
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy - .,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy -
| | - Chiara A Spatola
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
| | - Amelia Brunani
- Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
| | - Dinesh Kumbhare
- Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada
| | - Aydan Oral
- Department of Physical and Rehabilitation Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Elena Ilieva
- Department of Physical and Rehabilitation Medicine, Sv. Georgi University Hospital, Plovdiv, Bulgaria
| | - Carlotte Kiekens
- Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven Belgium.,Spinal Unit, Montecatone Rehabilitation Institute, Imola, Italy
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
| | - Gian Mauro Manzoni
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy.,Faculty of Psychology, eCampus University, Novedrate, Como, Italy
| | - Marta Imamura
- Institute of Physical and Rehabilitation Medicine, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
| | - Paolo Capodaglio
- Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania, Italy
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Body-Mass-Index Associated Differences in Ortho- and Retronasal Olfactory Function and the Individual Significance of Olfaction in Health and Disease. J Clin Med 2020; 9:jcm9020366. [PMID: 32013176 PMCID: PMC7074572 DOI: 10.3390/jcm9020366] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 01/27/2020] [Indexed: 12/16/2022] Open
Abstract
Odor (including flavor) perception plays a major role in dietary behavior. Orthonasal olfactory function (OOF) has been shown to decrease in obese subjects. Changes in retronasal olfactory function (ROF) after weight loss and in the individual significance of olfaction (ISO) in obesity are yet to be investigated. Firstly, 15 obese subjects were recruited in a pilot study and supported to conventionally lose weight. OOF (Sniffin’ Sticks) was measured at the beginning and after 5.6 ± 1.3 months. Eleven subjects re-visited but barely lost weight and no major changes in OOF were observed. Secondly, the body-mass-index (BMI), OOF, and ROF (Candy Smell Test, CST) were recorded in subjectively olfactory-healthy subjects (SOHSs) and additionally the ISO questionnaire was collected in patients with olfactory dysfunction (OD). BMI correlated significantly negatively with odor discrimination (p = 0.00004) in 74 SOHSs and negatively with CST (p < 0.0001) in 66 SOHSs. In 48 SOHSs, there was a gender difference in ISO scores (p = 0.034), but no significant correlation with BMI was found (p > 0.05). ISO scores were significantly higher in 52 OD patients in comparison to SOHSs (p = 0.0382). Not only OOF but also ROF may decline with higher BMI. ISO does not seem to alter with BMI, but olfaction becomes more important once it is consciously impaired.
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10
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Giusti E, Spatola CM, Brunani A, Kumbhare D, Oral A, Ilieva E, Kiekens C, Pietrabissa G, Manzoni G, Imamura M, Castelnuovo G, Capodaglio P. International society of physical and rehabilitation medicine/European society of physical and rehabilitation medicine guidelines on physical and rehabilitation medicine professional practice for adults with obesity and related comorbidities. THE JOURNAL OF THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE 2020. [DOI: 10.4103/jisprm.jisprm_6_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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11
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Dorner TE, Wilfinger J, Hoffman K, Lackinger C. Association between physical activity and the utilization of general practitioners in different age groups. Wien Klin Wochenschr 2019; 131:278-287. [PMID: 31076889 PMCID: PMC6570780 DOI: 10.1007/s00508-019-1503-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/24/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Physical activity (PA) is an important tool in health promotion, prevention, curation, and rehabilitation and should be part of general practitioners (GP) consultations. For tailoring GP's service it is important to know the PA habits of the clients. METHODS Data from the Austrian Health Interview Survey 2014 with 15,770 subjects were analyzed. The association between PA, measured with the Physical Activity Questionnaire of the European Health Intervies Survey (EHIS-PAQ) and having visited a GP within the last 4 weeks was examined in different age groups (15-29, 30-64, and 65+ years). In multivariate analyses we adjusted for sociodemographic and health-related variables (body mass index, 17 chronic diseases, and the use of medication). RESULTS In subjects aged 15-29 years and 30-64 years fulfilling aerobic PA recommendations was significantly associated with a lower chance of having consulted the GP with unadjusted OR (95% CI) 0.82 (0.70-0.96) and 0.90 (0.82-0.99), respectively, whereas work-related PA was associated with a higher chance, with OR 1.21 (1.03-1.42) and 1.10 (1.00-1.20), respectively. Adjusting for sociodemographic and health-related factors led to loss of significance. In subjects aged 30-64 years, muscle strengthening PA was associated with a higher chance for GP consultation with OR 1.12 (1.00-1.24) in the fully adjusted model. In subjects aged 65+ years, PA was associated with a lower chance of having visited the GP with OR 0.74 (0.64-0.86) and 0.83 (0.71-0.97) for work related PA and total PA, respectively, in the fully adjusted model. CONCLUSION The association of PA and GP consultation is dependent on age and type of PA, and partly mediated by sociodemographic and health-related factors.
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Affiliation(s)
- Thomas E Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria.
| | - Julia Wilfinger
- Department for Health Promotion and Prevention, SPORTUNION Austria, Falkestraße 1, 1010, Vienna, Austria
| | - Kathryn Hoffman
- Department of General Practice and Family Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/I, 1090, Vienna, Austria
| | - Christian Lackinger
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria.,Department for Health Promotion and Prevention, SPORTUNION Austria, Falkestraße 1, 1010, Vienna, Austria
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12
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Bucher Della Torre S, Courvoisier DS, Saldarriaga A, Martin XE, Farpour-Lambert NJ. Knowledge, attitudes, representations and declared practices of nurses and physicians about obesity in a university hospital: training is essential. Clin Obes 2018; 8:122-130. [PMID: 29327430 DOI: 10.1111/cob.12238] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/08/2017] [Accepted: 11/23/2017] [Indexed: 11/26/2022]
Abstract
In the context of a worldwide obesity epidemic, healthcare providers play a key role in obesity management. Knowledge of current guidelines and attitudes to prevent stigmatization are especially important. This study aimed to assess knowledge, attitudes, beliefs, perception of opportunity for intervention, declared practices and need for training and material of nurses and physicians about obesity in a Swiss University Hospital. A total of 834 physicians and nurses filled an online survey. The questionnaire was based on literature, exploratory interviews and expert committee review. It was pre-tested with 15 physicians and nurses. Participants declared a low level of negative attitudes towards individuals living with obesity. However, the results highlighted a lack of knowledge to diagnose obesity in adults and children, as well as confidence and training to care of patients with obesity. One-third of providers did not know how to calculate body mass index. Half of providers felt it was part of their role to take care of patients with obesity, even if 55% of them had the feeling that they did not have adequate training. Nurses and physicians working in a university hospital showed a low level of negative attitudes but a lack of knowledge and skills on obesity management. Training should be improved in this population to insure adequate and coherent messages and equal access to evidence-based treatment for patients living with obesity.
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Affiliation(s)
- S Bucher Della Torre
- Department of Nutrition and Dietetics, School of Health Sciences - Geneva, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - D S Courvoisier
- Quality of Care Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - A Saldarriaga
- Department of Public Education, Geneva Child and Youth Health Service, Geneva, Switzerland
| | - X E Martin
- Health and Movement Consultation, Unit of Pediatric Cardiology, Service of Pediatric Specialties, Department of Child and Adolescent, University Hospitals of Geneva, Switzerland
| | - N J Farpour-Lambert
- Obesity Prevention and Care Program, Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine, Primary Care and Emergency, University Hospitals of Geneva, Geneva, Switzerland
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Yuan F, Dong H, Fang K, Gong J, Lu F. Effects of green tea on lipid metabolism in overweight or obese people: A meta-analysis of randomized controlled trials. Mol Nutr Food Res 2017. [PMID: 28636182 DOI: 10.1002/mnfr.201601122] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
SCOPE The effects of green tea on lipid metabolism were inconsistent. The objective of this meta-analysis was to evaluate the effects of green tea on lipid metabolism in overweight or obese people. METHODS AND RESULTS We searched randomized controlled trials (RCTs) comparing green tea with a control on lipid metabolism on PUBMED and WEB OF SCIENCE (January 1990 to September 2016), COCHRANE and EMBASE (updated to October 2016), and the Chinese databases CNKI, WanFang and CBMD. Twenty-one articles studying 1704 overweight or obese subjects were selected for this meta-analysis. The pooled results demonstrated that green tea significantly decreased plasma total cholesterol (TC) and low-density lipoprotein cholesterol (LDL) levels in overweight or obese people. The weighted mean difference was -3.38 mg/dl for TC (95% CI: -6.42, -0.33 mg/dL) and -5.29 mg/dL for LDL (95% CI: -7.92, -2.6 6 mg/dL), respectively. Green tea intake, however, showed no effect on plasma triglyceride (TG) and high-density lipoprotein cholesterol(HDL) levels in overweight or obese people with a relatively high heterogeneity. CONCLUSION The meta-analysis shows that drinking green tea can lower plasma TC and LDL levels significantly. Nevertheless, green tea's effect on plasma TG and HDL must be further evaluated by additional high-quality and large-scale RCTs.
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Affiliation(s)
- Fen Yuan
- Institute of Integrated Traditional Chinese and Wertern Medicine, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, Hubei, China
| | - Hui Dong
- Institute of Integrated Traditional Chinese and Wertern Medicine, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, Hubei, China
| | - Ke Fang
- Institute of Integrated Traditional Chinese and Wertern Medicine, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Gong
- Institute of Integrated Traditional Chinese and Wertern Medicine, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, Hubei, China
| | - Fuer Lu
- Institute of Integrated Traditional Chinese and Wertern Medicine, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, Hubei, China
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Busetto L, Dicker D, Azran C, Batterham RL, Farpour-Lambert N, Fried M, Hjelmesæth J, Kinzl J, Leitner DR, Makaronidis JM, Schindler K, Toplak H, Yumuk V. Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management. Obes Facts 2017; 10:597-632. [PMID: 29207379 PMCID: PMC5836195 DOI: 10.1159/000481825] [Citation(s) in RCA: 203] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 09/21/2017] [Indexed: 12/17/2022] Open
Abstract
Bariatric surgery is today the most effective long-term therapy for the management of patients with severe obesity, and its use is recommended by the relevant guidelines of the management of obesity in adults. Bariatric surgery is in general safe and effective, but it can cause new clinical problems and is associated with specific diagnostic, preventive and therapeutic needs. For clinicians, the acquisition of special knowledge and skills is required in order to deliver appropriate and effective care to the post-bariatric patient. In the present recommendations, the basic notions needed to provide first-level adequate medical care to post-bariatric patients are summarised. Basic information about nutrition, management of co-morbidities, pregnancy, psychological issues as well as weight regain prevention and management is derived from current evidences and existing guidelines. A short list of clinical practical recommendations is included for each item. It remains clear that referral to a bariatric multidisciplinary centre, preferably the one performing the original procedure, should be considered in case of more complex clinical situations.
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Affiliation(s)
- Luca Busetto
- Department of Internal Medicine, University of Padova, Padova, Italy
- *Prof. Dr. Luca Busetto, Clinica Medica 3, Azienda Ospedaliera di Padova, Via Giustiniani 2, 35128 Padova, Italy,
| | - Dror Dicker
- Department of Internal Medicine D and Obesity Clinic, Hasharon Hospital, Rabin Medical Center, Petah Tikva, Sackler School of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Carmil Azran
- Clinical Pharmacy, Herzliya Medical Center, Herzliya, Israel
| | - Rachel L. Batterham
- Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London, UK
- University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, London, UK
- National Institute of Health Research, University College London Hospital Biomedical Research Centre, London, UK
| | - Nathalie Farpour-Lambert
- Obesity Prevention and Care Program Contrepoids, Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine, Primary Care and Emergency, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Martin Fried
- OB Klinika, Centre for Treatment of Obesity and Metabolic Disorders, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jøran Hjelmesæth
- Morbid Obesity Centre, Vestfold Hospital Trust and Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Johann Kinzl
- Department of Psychiatry and Psychotherapy II, Medical University Innsbruck, Innsbruck, Austria
| | | | - Janine M. Makaronidis
- Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London, UK
- National Institute of Health Research, University College London Hospital Biomedical Research Centre, London, UK
| | - Karin Schindler
- Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Hermann Toplak
- Department of Medicine, Medical University Graz, Graz, Austria
| | - Volkan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
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Hainer V, Tsigos C, Toplak H, Micic D. Comment on the Paper by Uerlich et al: Obesity Management in Europe: Current Status and Objectives for the Future. Obes Facts 2016;9:273-283. Obes Facts 2016; 9:392-396. [PMID: 27898413 PMCID: PMC5644818 DOI: 10.1159/000452249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 09/30/2016] [Indexed: 11/19/2022] Open
Affiliation(s)
- Vojtech Hainer
- Obesity Management Center, Institute of Endocrinology, Prague, Czech Republic
| | - Constantine Tsigos
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Hermann Toplak
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Dragan Micic
- Medical Faculty, University of Belgrade, Belgrade, Serbia
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