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Chávez-Manzanera EA, Vera-Zertuche JM, Kaufer-Horwitz M, Vázquez-Velázquez V, Flores-Lázaro JR, Mireles-Zavala L, Calzada-León R, Garnica-Cuellar JC, Sánchez-Muñoz V, Ramírez-Butanda E, Hernández-González R, Vargas-Martínez MA, Laviada-Molina H, Violante-Ortíz R, Esquivias-Zavala H, García-García E, Lavalle-González FJ, Mancillas-Adame L, López-Alvarenga JC, Pérez-Hernández JF, Soto-Fuentes EV, Soriano-Cortés RR, Goicoechea-Turcott EW, Magallanes-Díaz G, Herrera-Hernández MF, Barquera-Cervera S, Vargas-Contreras E, Díaz-Wionczek CB, Salmon M, Jesús DRD, Villaseñor-Díaz JP, Peña J, Ramos-Rojas J, Ávila-Oliver C, Rada G, Hussey B, Salas XR. Mexican Clinical Practice Guidelines for Adult Overweight and Obesity Management. Curr Obes Rep 2024:10.1007/s13679-024-00585-w. [PMID: 39356455 DOI: 10.1007/s13679-024-00585-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2024] [Indexed: 10/03/2024]
Abstract
PURPOSE To develop Mexico's first methodologically rigorous clinical practice guideline for the management of adult overweight and obesity. The target audiences are interdisciplinary healthcare professionals across healthcare systems who are the first point of contact for patients with obesity in Mexico, patients, and health system decision makers. RECENT FINDINGS A review of recent international obesity clinical practice guidelines and an expert consensus process identified: i) common recommendations appropriate for implementation in Mexico and ii) knowledge gaps requiring the formulation of new recommendations. In all, 20 new recommendations and 20 good practice statements were developed using the GRADE Evidence-to-Decision Framework and expert consensus. Overweight and obesity negatively impact the health and well-being of individuals and populations in Mexico. This guideline aims to establish a new evidence-based, patient-centered, non-stigmatizing, and practical treatment and management framework, based on the fundamental principles of chronic disease prevention and management.
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Affiliation(s)
- Emma A Chávez-Manzanera
- Obesity Workgroup, Sociedad Mexicana de Nutrición y Endocrinología, Mexico City, México.
- Obesity and Eating Disorders Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México.
| | - Juan M Vera-Zertuche
- Obesity Workgroup, Sociedad Mexicana de Nutrición y Endocrinología, Mexico City, México
- ABC Medical Center, Mexico City, México
| | - Martha Kaufer-Horwitz
- Obesity Workgroup, Sociedad Mexicana de Nutrición y Endocrinología, Mexico City, México
- Nutrition Division, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México
| | - Verónica Vázquez-Velázquez
- Obesity and Eating Disorders Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México
- Obesidades S.C, Mexico City, México
| | - José R Flores-Lázaro
- Sports Medicine Division, Universidad Nacional Autónoma de México, Mexico City, México
| | - Leonor Mireles-Zavala
- Obesity Workgroup, Sociedad Mexicana de Nutrición y Endocrinología, Mexico City, México
| | - Raúl Calzada-León
- Obesity Workgroup, Sociedad Mexicana de Nutrición y Endocrinología, Mexico City, México
- Service of Endocrinology, Instituto Nacional de Pediatría, Mexico City, México
| | - Juan C Garnica-Cuellar
- Obesity Workgroup, Sociedad Mexicana de Nutrición y Endocrinología, Mexico City, México
- Endocrinology Division, Centro Médico Nacional 20 de Noviembre, Institute for Social Security and Services for State, Mexico City, México
| | | | - Eduardo Ramírez-Butanda
- Obesity and Eating Disorders Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México
| | | | - María A Vargas-Martínez
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México
| | - Hugo Laviada-Molina
- Obesity Workgroup, Sociedad Mexicana de Nutrición y Endocrinología, Mexico City, México
- School of Health Sciences, Universidad Marista de Mérida, Mérida, México
| | - Rafael Violante-Ortíz
- Obesity Workgroup, Sociedad Mexicana de Nutrición y Endocrinología, Mexico City, México
- Tampico Faculty of Medicine Alberto Romo Caballero, Universidad Autónoma de Tamaulipas, Tampico, Tamaulipas, México
| | - Héctor Esquivias-Zavala
- Department for Continuing Education, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, México
| | - Eduardo García-García
- Obesity Workgroup, Sociedad Mexicana de Nutrición y Endocrinología, Mexico City, México
| | - Fernando J Lavalle-González
- Obesity Workgroup, Sociedad Mexicana de Nutrición y Endocrinología, Mexico City, México
- Endocrine Service, Hospital Universitario Dr José E. González, Medicine School, Universidad Autónoma de Nuevo León, Nuevo Leon, México
| | - Leonardo Mancillas-Adame
- Obesity Workgroup, Sociedad Mexicana de Nutrición y Endocrinología, Mexico City, México
- Institute for Obesity Research, Instituto Tecnológico de Monterrey, Nuevo Leon, México
- Internal Medicine Division, Medical School, and University Hospital, Universidad Autónoma de Nuevo Leon, Nuevo Leon, México
| | - Juan C López-Alvarenga
- Obesity Workgroup, Sociedad Mexicana de Nutrición y Endocrinología, Mexico City, México
- Population Health & Biostatistics, School of Medicine, University of Texas Rio Grande Valley, Texas, United States
| | - Juan F Pérez-Hernández
- Obesity and Eating Disorders Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México
| | - Erika V Soto-Fuentes
- Obesity and Eating Disorders Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México
| | - Reina R Soriano-Cortés
- Obesity and Eating Disorders Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México
| | | | - Gerardo Magallanes-Díaz
- Department of Secondary Prevention Central level, Servicios de Salud IMSS-BIENESTAR, Mexico City, México
| | | | - Simón Barquera-Cervera
- School of Public Health of Mexico at, Instituto Nacional de Salud Pública, Morelos, México
| | - Edith Vargas-Contreras
- Department of Endocrinology, Hospital General de México "Dr. Eduardo Liceaga, Mexico City, México
| | | | | | | | | | | | | | | | | | - Brad Hussey
- Replica Communications, Hamilton, Ontario, Canada
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Forst T, De Block C, Del Prato S, Armani S, Frias J, Lautenbach A, Ludvik B, Marinez M, Mathieu C, Müller TD, Schnell O. The role of incretin receptor agonists in the treatment of obesity. Diabetes Obes Metab 2024; 26:4178-4196. [PMID: 39072877 DOI: 10.1111/dom.15796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/28/2024] [Accepted: 06/29/2024] [Indexed: 07/30/2024]
Abstract
INTRODRODUCTION Obesity and its associated metabolic conditions have become a significant global health problem in recent years, with many people living with obesity fulfilling criteria for pharmacological treatment. The development of the glucagon-like peptide-1 receptor agonists for chronic weight management has triggered new interest in the incretins and other hormones as targets for obesity, and investigations into dual and triple co-agonists. METHODS The objective of this narrative review was to summarize the available data on approved and emerging incretin-based agents for the treatment of obesity. RESULTS In clinical trials of currently available agents in people with overweight or obesity, weight loss of between 6% and 21% of baseline body weight has been observed, with between 23% and 94% of participants achieving 10% or higher weight loss, depending on the study and the agent used. Favourable outcomes have also been seen with regard to cardiovascular risk and outcomes, diabetes prevention, metabolic dysfunction-associated steatotic liver disease/steatohepatitis and prevention of weight regain after metabolic surgery. Limitations associated with these agents include high costs, the potential for weight regain once treatment is stopped, the potential loss of lean body mass and gastrointestinal adverse events; potential issues with respect to gallbladder and biliary diseases require further investigation. CONCLUSIONS Many dual and triple co-agonists are still in development, and more data are needed to assess the efficacy, safety and tolerability of these emerging therapies versus the established incretin-based therapies; however, data are promising, and further results are eagerly awaited.
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Affiliation(s)
- Thomas Forst
- CRS Clinical Research Services GmbH, Mannheim, Germany
| | | | - Stefano Del Prato
- Interdisciplinary Research Center "Health Science," Sant'Anna School of Advanced Studies, Pisa, Italy
| | - Sara Armani
- CRS Clinical Research Services GmbH, Mannheim, Germany
| | - Juan Frias
- Biomea Fusion, Redwood City, California, USA
| | - Anne Lautenbach
- University Medical-Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernhard Ludvik
- Landstrasse Clinic and Karl Landsteiner Institute for Obesity and Metabolic Disorders, Vienna, Austria
| | | | | | - Timo D Müller
- Institute for Diabetes and Obesity, Helmholtz Diabetes Center, Helmholtz Munich, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Walther-Straub Institute of Pharmacology and Toxicology, Ludwig-Maximilians-Universität München (LMU), Munich, Germany
| | - Oliver Schnell
- Forschergruppe Diabetes e.V. at the Helmholtz Center Munich, Munich, Germany
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Rochira V, Greco C, Boni S, Costantino F, Dalla Valentina L, Zanni E, Itani L, El Ghoch M. The Effect of Tirzepatide on Body Composition in People with Overweight and Obesity: A Systematic Review of Randomized, Controlled Studies. Diseases 2024; 12:204. [PMID: 39329873 PMCID: PMC11431103 DOI: 10.3390/diseases12090204] [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: 08/07/2024] [Revised: 08/26/2024] [Accepted: 09/03/2024] [Indexed: 09/28/2024] Open
Abstract
Tirzepatide (TZP) is a new anti-obesity drug, and little is currently known about its effect on body composition (BC) in people with overweight or obesity. The aim of this study is to conduct a systematic review on the impact of TZP on BC compartments in this population during weight loss programs. Literature searches, study selection, method development, and quality appraisal were performed. The data were synthesized using a narrative approach, in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Of the 1379 papers retrieved, 6 randomized controlled trials met the inclusion criteria and were reviewed, revealing the following findings. Firstly, TZP was shown to result in a significant reduction in total fat mass (FM), visceral adipose tissue (VAT) and waist circumference (WC) between baseline and short as well as intermediate follow-ups. Compared to other anti-obesity medications (e.g., dulaglutide and semaglutide) taken over the same duration, TZP showed a superior decrease in body fat compartments (i.e., total FM, VAT and WC). Finally, the effect of TZP on fat-free mass (FFM) is still uncertain because the findings remain inconclusive. In conclusion, TZP appears to be an effective strategy for achieving significant improvements in body fat and its distribution, but additional investigations are still needed to determine the impact of TZP on lean mass in this population.
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Affiliation(s)
- Vincenzo Rochira
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Carla Greco
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Stefano Boni
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Francesco Costantino
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Leonardo Dalla Valentina
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Eleonora Zanni
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut 11072809, Lebanon
| | - Marwan El Ghoch
- Center for the Study of Metabolism, Body Composition and Lifestyle, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
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Sarac Gul Y, Kose O, Altin A, Yemenoglu H, Arslan H, Akyildiz K, Yilmaz A. Melatonin supports nonsurgical periodontal treatment in patients with Type 2 diabetes mellitus and periodontitis: A randomized clinical trial. J Periodontol 2024; 95:832-841. [PMID: 38055628 DOI: 10.1002/jper.23-0335] [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: 06/02/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Diabetes mellitus (DM)-associated hyperinflammatory host response significantly provokes periodontal tissue destruction. In this context, the support of nonsurgical periodontal therapy in diabetics with host modulation agents is a current field of study. This clinical study aims to investigate the clinical efficacy of melatonin supplementation and discuss its possible biological mechanisms in nonsurgical periodontal treatment in patients with DM and periodontitis through some fundamental markers. METHODS In this randomized controlled and single-blind study, 27 of 55 diabetic patients with periodontitis (stage III/IV and grade C) underwent full-mouth scaling and root planing (fmSRP) alone and 28 patients underwent melatonin administration (6 mg daily, 30 days) in addition to fmSRP (full-mouth scaling and root planing plus melatonin, fmSRP-mel). The potential therapeutic contribution of melatonin was evaluated clinically and biochemically (gingival crevicular fluid RANKL, OPG, MMP-8, and serum IL-1β levels) at 3rd and 6th months. RESULTS Melatonin (tablet, 6 mg daily, 30 days) did not cause any local or systemic side effects. fmSRP alone resulted in significant reduction in serum IL-1β levels, pocket depths, gingival inflammation, and gingival crevicular fluid RANKL and MMP-8 levels (p < 0.05). Moreover, melatonin supplementation resulted in a more significant decrease in bleeding and pocket depth scores at probing, especially at 3 months (p < 0.05). Furthermore, RANKL and MMP-8 levels were significantly lower at 3 months and IL-1β levels at 6 months compared to the control group (p < 0.05). However, OPG levels were not affected significantly by the treatments (p > 0.05). CONCLUSION Melatonin, as a host modulation agent, significantly increases the clinical efficacy of fmSRP. The reduction in periodontal inflammation and pocket depths may be a result of marked suppression of RANKL-associated osteoclastogenesis and extracellular matrix damage by melatonin.
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Affiliation(s)
- Yagmur Sarac Gul
- School of Dentistry, Department of Periodontology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Oguz Kose
- School of Dentistry, Department of Periodontology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Ahmet Altin
- School of Dentistry, Department of Periodontology, Istanbul Kent University, Istanbul, Turkey
| | - Hatice Yemenoglu
- School of Dentistry, Department of Periodontology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Hatice Arslan
- School of Dentistry, Department of Periodontology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Kerimali Akyildiz
- School of Vocational Health Care Services, Department of Medical Services and Techniques, Recep Tayyip Erdogan University, Rize, Turkey
| | - Adnan Yilmaz
- School of Medicine, Department of Biochemistry, Recep Tayyip Erdogan University, Rize, Turkey
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Burian EA, Rungby J, Karlsmark T, Nørregaard S, Cestari M, Franks PJ, Moffatt CJ. The impact of obesity on chronic oedema/lymphoedema of the leg - an international multicenter cross-sectional study (LIMPRINT). Int J Obes (Lond) 2024; 48:1238-1247. [PMID: 38961152 PMCID: PMC11347371 DOI: 10.1038/s41366-024-01544-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 05/08/2024] [Accepted: 05/13/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND/OBJECTIVES Obesity and chronic oedema/lymphoedema are two distinct but related conditions, rarely investigated together. The aim was to study the impact of increased weight on chronic oedema and related factors. SUBJECTS/METHODS A cross-sectional study, 38 centers, nine countries. Patients with clinically confirmed chronic oedema/lymphoedema of the leg were included. Weight category was estimated as: normal weight (BMI 20-30), class I-II obesity (BMI 30-40), or class III obesity (BMI > 40). Factors were tested for an association with increased weight, using a multivariable model. RESULTS A total of 7397 patients were included; 43% with normal weight, 36% class I-II obesity and 21% class III obesity. Increased weight was associated with more advanced stages of chronic oedema (ISL stage III; the most advanced form); affecting 14% in normal weight, 18% class I-II obesity and 39% class III obesity (p < 0.001). Ten factors were independently associated with increased weight: diabetes (OR 2.4), secondary lymphoedema (OR 2.7), cellulitis/erysipelas within 12 months (OR 1.2), bilateral lymphoedema (OR 3.6), compression therapy (OR 2.1), increased swelling duration (1-2 years OR 1.3, 2-5 years OR 2.5, 5-10 years OR 3.6, >10 years OR 3.5) decreased mobility (walking with aid OR 1.9, being chair bound OR 1.2) and age (reference<45 years; 45-64 years OR 1.5, 75-84 years OR 0.6, 85+ years OR 0.2). Increased weight was associated with a lower presentation of peripheral arterial disease (OR 0.7) and poorer chronic oedema control (OR 0.8). Patients with obesity had lower function, appearance and more severe symptoms (LYMQOL) and lower quality of life (EuroQol). CONCLUSIONS Obesity negatively impacts chronic oedema, leading to more advanced stages. Achieving good control of swelling with compression is more difficult in these patients. Increased awareness of chronic oedema/lymphoedema as a complication of obesity is important for early detection and for developing effective strategies to prevent and manage them.
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Affiliation(s)
- Ewa Anna Burian
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
| | | | - Tonny Karlsmark
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Susan Nørregaard
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Peter J Franks
- Centre for Research and Implementation of Clinical Practice, London, United Kingdom
| | - Christine Joy Moffatt
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
- Centre for Research and Implementation of Clinical Practice, London, United Kingdom
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
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Sherf-Dagan S, Refaeli R, Buch A. Phenotyping of Obesity Treatment Candidates: A Narrative Review. Curr Obes Rep 2024; 13:564-573. [PMID: 38874701 DOI: 10.1007/s13679-024-00576-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/25/2024] [Indexed: 06/15/2024]
Abstract
PURPOSE OF REVIEW This review explores characterizing candidates for obesity treatments including pharmacotherapy, endoscopic bariatric therapies, and metabolic bariatric surgery (MBS), focusing on established clinical parameters for diagnosing obesity beyond body mass index alone. RECENT FINDINGS Existing literature primarily provides rates for fat mass percentage (i.e., a marker for adiposity quantity), waist circumference (i.e., a marker for adiposity distribution), and C-reactive protein levels (i.e., a marker for adiposity functionality) among obesity treatment candidates. Limited data on abnormal values and sex-based differentiation exist. The literature indicates high central-tendency measures for fat mass percentage and waist circumference, while C-reactive protein levels vary. Data on the Edmonton Obesity Staging System (i.e., a marker for adiposity-related disease severity) is predominantly available for MBS candidates. Future studies in obesity interventions should improve screening and diagnosis of obesity by incorporating sex-specific considerations and providing abnormal value rates for measurements to enhance understanding of patients' characteristics.
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Affiliation(s)
- Shiri Sherf-Dagan
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Kiryat H'mada 3, Ariel, Israel.
- Department of Nutrition, Assuta Medical Center, Tel Aviv, Israel.
| | - Rotem Refaeli
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Kiryat H'mada 3, Ariel, Israel
- Department of Nutrition, Rabin Medical Center, Beilinson hospital, Petah Tikva, Israel
| | - Assaf Buch
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Kiryat H'mada 3, Ariel, Israel
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Pereira V, Barreiros-Mota I, Cortez F, Castela I, Teixeira D, Calhau C, Camila Dias C, Moreira-Rosário A, Silvestre MP. A randomized controlled trial of a weight loss maintenance program in adults with obesity: the WLM3P study. Eur J Clin Nutr 2024; 78:694-702. [PMID: 38844671 DOI: 10.1038/s41430-024-01454-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/30/2024] [Accepted: 05/21/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND/OBJECTIVES The escalating obesity epidemic necessitates effective, sustainable weight loss (WL) and maintenance strategies. This study aimed to evaluate the effectiveness of the Weight Loss Maintenance 3 Phases Program (WLM3P) in achieving a clinically significant long-term weight loss (WL) (≥5% initial WL at 18 months) in adults with obesity compared to a standard low-carbohydrate diet (LCD). SUBJECTS/METHODS In this two-phase trial, 112 participants targeting initial WL (0-6 months) and subsequent maintenance (7-18 months) were randomly assigned to either WLM3P or LCD groups. Outcomes assessed included change in body weight (kg, %), improvements in body composition, and metabolic profile. RESULTS Of 112 randomized participants, 69% (n = 77) completed the study. At 18 months, WL in the WLM3P group (n = 40) was 15.5 ± 8.3% compared to 9.6 ± 8.5% in the LCD group (n = 37) (p < 0.001). The odds ratio of achieving WL ≥ 10% and ≥15% were significantly higher in the WLM3P group. Complete-case analysis revealed significantly greater improvements in BMI, body fat mass, visceral fat area, waist circumference, waist-to-hip ratio, HDL, and triglyceride/HDL ratio in WLM3P than in LCD. No serious adverse events were reported. CONCLUSION Both programs effectively promoted clinically relevant WL and its maintenance. However, the WLM3P program was more successful in helping participants achieve greater WL targets of ≥10% and ≥15%, along with other clinical benefits, after an 18-month intervention. TRIAL REGISTRATION NUMBER NCT04192357.
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Affiliation(s)
- Vanessa Pereira
- NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
- Nutrition Department Farmodiética, Farmodiética, 2785-723, Lisbon, Portugal
| | - Inês Barreiros-Mota
- NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
- CHRC, NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
| | - Filipa Cortez
- Nutrition Department Farmodiética, Farmodiética, 2785-723, Lisbon, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Inês Castela
- NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
- CHRC, NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
| | - Diana Teixeira
- NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
- CHRC, NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
- CINTESIS@RISE, NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
| | - Conceição Calhau
- NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
- CHRC, NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal
| | - Cláudia Camila Dias
- Knowledge Management Unit, Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal
| | - André Moreira-Rosário
- NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal.
- CINTESIS@RISE, NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal.
| | - Marta P Silvestre
- NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal.
- CINTESIS@RISE, NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal.
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Medina-Aedo M, Beltran J, Valli C, Canelo-Aybar C, Song Y, Ballester M, Bowman-Busato J, Christogiannis C, Grammatikopoulou MG, Groene O, Heijmans M, Hoogendorn M, Killeen SL, Kontouli KM, Mavridis D, Miñambres I, Mueller BS, Niño de Guzman E, Noordman J, Orrego C, Perestelo-Perez L, Saz-Parkinson Z, Seitidis G, Suñol R, Tsokani S, Alonso-Coello P. Recommendations on self-management interventions for adults living with obesity: COMPAR-EU project. Clin Obes 2024; 14:e12667. [PMID: 38757917 DOI: 10.1111/cob.12667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/29/2024] [Accepted: 03/29/2024] [Indexed: 05/18/2024]
Abstract
Self-management interventions (SMIs) may improve disease management in adults living with obesity. We formulated evidence-based recommendations for SMIs within the context of the COMPAR-EU project. The multidisciplinary panel selected critical outcomes based on the COMPAR-EU core outcome set and established decision thresholds for each outcome. Recommendations were informed by systematic reviews of effects, cost-effectiveness, and a contextual assessment. To assess the certainty of the evidence and formulate the recommendations, we used the GRADE approach guidance. Overall, SMIs were deemed to have a small impact, but the absence of harmful effects and potential cumulative benefits indicated a favourable balance of effects, despite low certainty. SMIs showed variations in structure, intensity, and resource utilisation, but overall are likely to be cost-effective. Adapting SMIs to local contexts would enhance equity, acceptability, and feasibility, considering patients' values, and availability of resources and teamwork. Consequently, the panel made conditional recommendations favouring SMIs over usual care. The rigorous and explicit recommendations demonstrated the effectiveness of SMIs for adults living with obesity. However, the gaps in the literature influenced the panel to make only conditional recommendations in favour of SMIs. Further research is needed to strengthen the evidence base and improve recommendations' certainty and applicability.
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Affiliation(s)
- Melixa Medina-Aedo
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Jessica Beltran
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Claudia Valli
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
| | - Carlos Canelo-Aybar
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Yang Song
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Marta Ballester
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
| | | | - Christos Christogiannis
- Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece
| | - Maria G Grammatikopoulou
- Immunonutrition and Clinical Nutrition Unit, Department of Rheumatology and Clinical Immunology, Medical School, University of Thessaly, Biopolis Campus, Larissa, Greece
| | | | - Monique Heijmans
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Martine Hoogendorn
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Katerina-Maria Kontouli
- Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece
| | - Dimitris Mavridis
- Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece
| | - Inka Miñambres
- Endocrinology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Barcelona, Spain
| | - Beate Sigrid Mueller
- Institute of General Practice, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ena Niño de Guzman
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Janneke Noordman
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Carola Orrego
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
| | - Lilisbeth Perestelo-Perez
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Canary Islands, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
| | | | - Georgios Seitidis
- Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece
| | - Rosa Suñol
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
| | - Sofia Tsokani
- Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
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Francque S, Krag A, Shawcross DL, Zelber-Sagi S. A turning point in hepatology? EASL reflects on the first approved drug for MASH. J Hepatol 2024; 81:192-194. [PMID: 38762170 DOI: 10.1016/j.jhep.2024.04.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/20/2024]
Affiliation(s)
- Sven Francque
- Department of Gastroenterology Hepatology, Antwerp University Hospital, Edegem, Belgium; InflaMed Centre of Excellence, Laboratory for Experimental Medicine and Paediatrics, Translational Sciences in Inflammation and Immunology, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Aleksander Krag
- Centre for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark; Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Debbie L Shawcross
- Institute of Liver Studies, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, UK
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Gołąbek KD, Chmielewska A, Karoluk E, Kujawa K, Regulska-Ilow B. Assessment of Diet Quality Based on Selected Dietary Quality Indices and Consumption of Specific Food Items of Midwives Working on a Shift Schedule in Wroclaw, Poland. Nutrients 2024; 16:2409. [PMID: 39125290 PMCID: PMC11314451 DOI: 10.3390/nu16152409] [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: 06/28/2024] [Revised: 07/23/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
The aim of this study was to assess the quality of diets among midwives working in a shift system and to analyze variations in their dietary habits according to their working hours. In a group of fifty midwives employed in four public hospitals in Wrocław, the HDI-2015, HEI-2015, AHEI-2010, and Mellen's DASH diet index were calculated. The significance of differences in terms of the prevalence of selected dietary habits, meal frequency, average content of selected food items, and the percentage of energy obtained from them was assessed. Over half of the diets of the participants exhibited low adherence to the selected dietary indices. Only the scores on Mellen's DASH diet index were significantly associated with other components of the diet. Diets scoring ≥ 4.5 points were characterized by significantly lower processed meat content, meal frequency, and energy value, as well as lower sugar content and lower dietary energy value, compared to diets scoring < 4.5 points. Regardless of their working hours, the diets of midwives are characterized by low quality. Therefore, it appears essential to introduce targeted educational programs and provide guidance on appropriate dietary models, such as the DASH diet.
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Affiliation(s)
- Katarzyna Daria Gołąbek
- Department of Dietetics and Bromatology, Pharmacy Faculty, Wroclaw Medical University, ul. Borowska 211, 50-556 Wrocław, Poland; (A.C.); (B.R.-I.)
| | - Anna Chmielewska
- Department of Dietetics and Bromatology, Pharmacy Faculty, Wroclaw Medical University, ul. Borowska 211, 50-556 Wrocław, Poland; (A.C.); (B.R.-I.)
| | - Ewa Karoluk
- Department of Obstetrics and Gynecological and Obstetric Nursing, Health Sciences Faculty, Wroclaw Medical University, 51-618 Wrocław, Poland;
| | - Krzysztof Kujawa
- Statistical Analysis Centre, Wroclaw Medical University, 50-368 Wrocław, Poland;
| | - Bożena Regulska-Ilow
- Department of Dietetics and Bromatology, Pharmacy Faculty, Wroclaw Medical University, ul. Borowska 211, 50-556 Wrocław, Poland; (A.C.); (B.R.-I.)
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Taimah M, Ahmad A, Al-Houqani M, Al Junaibi A, Idaghdour Y, Abdulle A, Ali R. Association between obstructive sleep apnea risk and type 2 diabetes among Emirati adults: results from the UAE healthy future study. Front Endocrinol (Lausanne) 2024; 15:1395886. [PMID: 39081790 PMCID: PMC11286458 DOI: 10.3389/fendo.2024.1395886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Obstructive sleep apnea (OSA) can have negative impacts on the health outcomes of individuals with type 2 diabetes. However, in the United Arab Emirates (UAE), there is a lack of understanding regarding the relationship between OSA and type 2 diabetes despite the significant implications it has on health. The primary objective of this study is to investigate the association between OSA risk and type 2 diabetes, associated risk factors, and gender differences in OSA symptoms among Emirati adults. Methods We conducted a cross-sectional analysis of the baseline data from the UAE Healthy Future Study (UAEHFS) collected between February 2016 and March 2023. Our sample consisted of 4578 participants aged 18-71 who completed the STOP-BANG survey, provided body measurements and blood samples. We stratified the patients according to their OSA risk and diabetes. We used univariate and multivariate logistic regression models to analyze the relationship between OSA risk and type 2 diabetes and to identify factors associated with risk for OSA and type 2 diabetes. We estimated odds ratios (ORs) with corresponding 95% confidence intervals (95% CI). Results The mean age was 27.5 years (± 8.35), and 55.81% (n=2555) were men. The overall prevalence of high risk for OSA was 16.58% and was higher in men compared to women (26.46% vs 4.10%). Women reported feeling tired more often than men (68.02% vs 48.96%). Both genders have similar rates of stop breathing and BMI ≥ 35. There was a significant association between the OSA risk and type 2 diabetes in the unadjusted model (OR=2.44; 95% CI: 1.78-3.35; p-value <0.0001) and (OR=6.44; 95% CI: 4.32-9.59; p-value < 0.0001) among those who reported intermediate and high OSA risk, respectively. After adjusting the model for education attainment, marital status, waist circumference, and smoking, the association remained significant between diabetes and OSA risk, with an OR of 1.65 (95%CI: 1.18-2.32; p-value =0.004) for intermediate OSA risk and 3.44 (95%CI: 2.23-5.33; p-value <0.0001) for high OSA risk. Conclusions This study conducted in the UAE found a significant correlation between OSA risk and type 2 diabetes. We suggest introducing routine screening of OSA for individuals with diabetes.
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Affiliation(s)
- Manal Taimah
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Amar Ahmad
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Mohammad Al-Houqani
- Department of Medicine, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Abdulla Al Junaibi
- Department of Pediatrics, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Youssef Idaghdour
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - AbdiShakur Abdulle
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Raghib Ali
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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12
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Colangeli L, Russo B, Capristo E, Mariani S, Tuccinardi D, Manco M, Scipione V, Parrotta ME, Capoccia D, Guglielmi V. Attitudes, weight stigma and misperceptions of weight loss strategies among patients living with obesity in the Lazio Region, Italy. Front Endocrinol (Lausanne) 2024; 15:1434360. [PMID: 39076509 PMCID: PMC11284042 DOI: 10.3389/fendo.2024.1434360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 07/01/2024] [Indexed: 07/31/2024] Open
Abstract
Introduction Patient engagement is essential to achieve long-term goals in obesity management. It is crucial to identify patients' perspectives, misperceptions and unmet educational needs on obesity etiology and treatments, to establish a correct therapeutic alliance between healthcare providers and patients. Methods Objective: This study, promoted by the regional section of the Italian Obesity Society (SIO Lazio), explores attitudes towards obesity, self-awareness, misperceptions of weight loss strategies, experiences of weight stigma and educational needs of patients living with overweight or obesity. Design and subject: We conducted an anonymous survey among patients who accessed an Obesity Management Centers across the Lazio region of Italy for the first time, from October 2023 to April 2024. Approach: The survey consisted of 27 closed-ended questions grouped into 4 sections: (1) sociodemographic factors and self-reported anthropometric measures; (2) self-awareness and attitudes towards obesity and weight loss strategies; (3) experiences of obesity-related stigma; (4) knowledge and perceptions of obesity treatment options. Results A total of 300 patients (67.9% women, aged 49.1 ± 14.4 years) returned completed surveys. Despite the self-reported BMI 35.3 ± 7.0 kg/m2 with three out of four (75.3%) of participants having a BMI ≥ 30 kg/m2, only 49% correctly identified themselves as affected by obesity. Almost one-third of the patients believed that obesity does not imply a genetic predisposition (31.9%) and that it is always secondary to psychological or behavioral disorders (29.7%). Interestingly, 66.7% of the patients declared themselves as completely responsible for their own condition and 39.4% considered obesity always treatable by means of lifestyle interventions. Stigma and weight discrimination in healthcare settings were reported by a substantial portion of patients (31.9%). A perception of inadequate support from the National Healthcare System emerged in most of the interviews (61.9%). Most patients (72.1%) felt they were not sufficiently informed about anti-obesity medications and a relevant part of their knowledge was derived from healthcare providers (57.7%) and social networks (19.1%). Weight loss medications were considered useful (63.2%) or necessary (18.4%) by the majority of patients, but only 60.1% would accept without any hesitation a pharmacologic treatment. The main reasons for refusal of pharmacological treatments were the belief that lifestyle intervention is a sufficient treatment (46.9%), the fear of adverse effects (28.1%) and feeling defeated (12.5%). Similarly, for most of participants bariatric surgery is useful (73.3%) or necessary (13.6%). Conclusion Despite advancements in obesity research, this study underscores the need to improve patient education and public awareness to optimize the management and treatment of obesity. Addressing misconceptions, stigma, and gaps in knowledge are critical steps towards improving patient outcomes and fostering a supportive healthcare environment.
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Affiliation(s)
- Luca Colangeli
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Internal Medicine Unit - Obesity Center, University Hospital Policlinico Tor Vergata, Rome, Italy
| | - Benedetta Russo
- Unit of Endocrinology, Isola Tiberina - Gemelli Isola Hospital, Rome, Italy
- Executive Committee of the Regional Section of the Italian Obesity Society (SIO Lazio), Rome, Italy
| | - Esmeralda Capristo
- Executive Committee of the Regional Section of the Italian Obesity Society (SIO Lazio), Rome, Italy
- Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
- Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, Rome, Italy
| | - Stefania Mariani
- Executive Committee of the Regional Section of the Italian Obesity Society (SIO Lazio), Rome, Italy
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Dario Tuccinardi
- Executive Committee of the Regional Section of the Italian Obesity Society (SIO Lazio), Rome, Italy
- Department of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy
| | - Melania Manco
- Executive Committee of the Regional Section of the Italian Obesity Society (SIO Lazio), Rome, Italy
- Preventive and Predictive Medicine Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Valeria Scipione
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Internal Medicine Unit - Obesity Center, University Hospital Policlinico Tor Vergata, Rome, Italy
| | - Maria Eugenia Parrotta
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Internal Medicine Unit - Obesity Center, University Hospital Policlinico Tor Vergata, Rome, Italy
| | - Danila Capoccia
- Department of Medical Surgical Sciences and Biotechnologies, Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy
| | - Valeria Guglielmi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Internal Medicine Unit - Obesity Center, University Hospital Policlinico Tor Vergata, Rome, Italy
- Executive Committee of the Regional Section of the Italian Obesity Society (SIO Lazio), Rome, Italy
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Adolph TE, Meyer M, Jukic A, Tilg H. Heavy arch: from inflammatory bowel diseases to metabolic disorders. Gut 2024; 73:1376-1387. [PMID: 38777571 PMCID: PMC11287632 DOI: 10.1136/gutjnl-2024-331914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/16/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Metabolic disorders and inflammatory bowel diseases (IBD) have captured the globe during Westernisation of lifestyle and related dietary habits over the last decades. Both disease entities are characterised by complex and heterogeneous clinical spectra linked to distinct symptoms and organ systems which, on a first glimpse, do not have many commonalities in clinical practice. However, experimental studies indicate a common backbone of inflammatory mechanisms in metabolic diseases and gut inflammation, and emerging clinical evidence suggests an intricate interplay between metabolic disorders and IBD. OBJECTIVE We depict parallels of IBD and metabolic diseases, easily overlooked in clinical routine. DESIGN We provide an overview of the recent literature and discuss implications of metabolic morbidity in patients with IBD for researchers, clinicians and healthcare providers. CONCLUSION The Western lifestyle and diet and related gut microbial perturbation serve as a fuel for metabolic inflammation in and beyond the gut. Metabolic disorders and the metabolic syndrome increasingly affect patients with IBD, with an expected negative impact for both disease entities and risk for complications. This concept implies that tackling the obesity pandemic exerts beneficial effects beyond metabolic health.
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Affiliation(s)
- Timon E Adolph
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, Innsbruck, Austria
| | - Moritz Meyer
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, Innsbruck, Austria
| | - Almina Jukic
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, Innsbruck, Austria
| | - Herbert Tilg
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, Innsbruck, Austria
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Dearos Sanchis M, Voltas Arribas B, Carrasco-Querol N, Sauras Colón E, Sánchez Juan C. [Impact on weight loss and body composition of a food education intervention associated with Liraglutide treatment to address obesity]. NUTR HOSP 2024; 41:585-593. [PMID: 38450509 DOI: 10.20960/nh.04995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024] Open
Abstract
Introduction Introduction: clinical practice guidelines recommend considering pharmacological treatment of obesity only as a complement to lifestyle modification. Drugs alone are usually ineffective in the long term after discontinuation, so pharmacological weight loss strategies should always be accompanied by lifestyle modifications. Objective: to analyze the changes in weight, body mass index and body composition by means of electrical bioimpedance after a 32-week treatment with liraglutide in patients with obesity, associated or not with a food education program. Materials and methods: the study involved 68 patients who were randomly divided into 2 groups. One group received treatment with liraglutide 3.0 mg/day along with individual dietary education, and the other group was treated with liraglutide 3.0 mg/day and standard medical follow-up for 32 weeks. The data collected were weight (kg), height (m) (Seca® brand), body mass index (kg/m2) and body composition using multifrequency bioimpedance (SECA 112® brand). The variables were analyzed at the beginning and at the end of the treatment. Results: after 32 weeks of treatment, both study groups lost weight significantly. The group treated with liraglutide and individual dietary education had a reduction of 8.77 kg (9.08 %) (p < 0.001) and the group treated with liraglutide without education had a reduction of 3.55 kg (3.45 %) (p < 0.001). The BMI of the participants treated with liraglutide and education decreased by -4,04 kg/m2 (10.35 %) (p < 0.001) and in the group without education it decreased by -3.22 kg/m2 (8.30 %) (p = 0.003). In the educated group, fat mass decreased by -7.65 kg (15.89 %) (p < 0.001), although skeletal muscle mass also decreased by -1.62 kg (6.8 %) (p < 0.001). In those treated with liraglutide without education, a reduction in fat mass and skeletal muscle mass was also observed - fat mass by -4.72 kg (9.43 %) (p < 0.001) and skeletal muscle mass by -0.17 kg (0.70 %) (p < 0.001). Differences were also observed between groups, observing a greater reduction in weight, BMI, fat mass and skeletal muscle mass in the group with liraglutide and education compared to the group without education, although these differences were not statistically significant. Conclusions: dietary education associated with liraglutide treatment may contribute to increasing weight and fat mass losses. However, it was also associated with an unwanted loss of skeletal muscle mass, probably related to the greater intensity of weight loss, which will have to be reversed in future therapeutic approaches. Habit modification through multidisciplinary treatment, including nutritional education, combined strength and resistance exercise, and cognitive-behavioral therapy, could be an effective way to treat obesity and maintain weight, body composition, and adherence to a lifestyle.
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Affiliation(s)
- Mónica Dearos Sanchis
- Unidad de Endocrinología y Nutrición. Hospital de Tortosa Verge de la Cinta. Institut Català de la Salut. Departamento de Medicina. Facultad de Medicina. Universidad de Valencia. Institut d'Investigació Sanitària Pere Virgili (IISPV)
| | - Beatriz Voltas Arribas
- Departamento de Medicina. Facultad de Medicina. Universidad de Valencia. Unidad de Endocrinología y Nutrición. Hospital de Manises
| | - Noelia Carrasco-Querol
- Unitat de Suport a la Recerca Terres de l'Ebre. Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol)
| | - Esther Sauras Colón
- Unitat de Suport a la Recerca. Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital de Tortosa Verge de la Cinta
| | - Carlos Sánchez Juan
- Departamento de Medicina. Facultad de Medicina. Universidad de Valencia. Servicio de Endocrinología y Nutrición. Consorcio Hospital General Universitario de Valencia
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Ebrahimzadeh Attari V, Nourmohammadi M, Asghari-Jafarabadi M, Mahluji S, Malek Mahdavi A, Esmaeili P. Prediction the changes of anthropometric indices following a weight-loss diet in overweight and obese women by mathematical models. Sci Rep 2024; 14:14491. [PMID: 38914732 PMCID: PMC11196268 DOI: 10.1038/s41598-024-65586-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 06/21/2024] [Indexed: 06/26/2024] Open
Abstract
Estimating the change rates in body size following the weight loss programs is very important in the compliance of those programs. Although, there is enough evidence on the significant association of body weight change with the other anthropometric indices and/ or body composition, there is so limited studies that have depicted this relationship as mathematical formulas. Therefore, the present research designed to use a mathematical model to predict changes of anthropometric indices following a weight-loss diet in the overweight and obese women. In this longitudinal study, 212 overweight/obese women who received an individualized low-calorie diet (LCD) were selected and followed-up for five months. Anthropometric measurements such as weight, waist circumference (WC), hip circumference (HC), and body composition (lean mass and fat mass) were performed. Then, body mass index, waist to hip ratio (WHR), waist to height ratio (WHtR), a body shape index (ABSI), abdominal volume index (AVI), and body adiposity index (BAI) were calculated using the related formula. Following the LCD led to the substantial and consistent changes in various anthropometric indices over time. All of these anthropometric variations were significantly related with the percent change (PC) of body weight except than WHR. Moreover, according to the mathematical formulas, weight loss was closely related to the decrease of WC (PC-WC = - 0.120 + 0.703 × PC-WT), HC (PC-HC = - 0.350 + 0.510 × PC-WT), body fat percentage (PC-Body Fat = - 0.019 + 0.915 × PC-WT), WHtR (PC-WHtR = - 0.113 + 0.702 × PC-WT), and improvements in ABSI (PC-ABSI = - 0.112 + 0.034 × PC-WT) and AVI (PC-AVI = - 0.324 + 1.320 × PC-WT). The decreasing rates of WC, HC, body fat percentage, WHtR, ABSI, and AVI in relation to the weight loss were clinically and statistically significant. This means that a healthy weight lowering diet would be accompanied by decreasing the body fat, body size and also the risk of morbidities.
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Affiliation(s)
- Vahideh Ebrahimzadeh Attari
- Department of Clinical Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Nutrition and Food Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | | | - Mohammad Asghari-Jafarabadi
- Cabrini Research, Cabrini Health, Malvern, VIC, 3144, Australia
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, 3004, Australia
- Department of Psychiatry, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, 3168, Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sepideh Mahluji
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Aida Malek Mahdavi
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Parya Esmaeili
- Department of Epidemiology and Biostatistics, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
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Shenoy MT, Mondal S, Fernandez CJ, Pappachan JM. Management of male obesity-related secondary hypogonadism: A clinical update. World J Exp Med 2024; 14:93689. [PMID: 38948417 PMCID: PMC11212738 DOI: 10.5493/wjem.v14.i2.93689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/22/2024] [Accepted: 05/15/2024] [Indexed: 06/19/2024] Open
Abstract
The global obesity pandemic has resulted in a rise in the prevalence of male obesity-related secondary hypogonadism (MOSH) with emerging evidence on the role of testosterone therapy. We aim to provide an updated and practical approach towards its management. We did a comprehensive literature search across MEDLINE (via PubMed), Scopus, and Google Scholar databases using the keywords "MOSH" OR "Obesity-related hypogonadism" OR "Testosterone replacement therapy" OR "Selective estrogen receptor modulator" OR "SERM" OR "Guidelines on male hypogonadism" as well as a manual search of references within the articles. A narrative review based on available evidence, recommendations and their practical implications was done. Although weight loss is the ideal therapeutic strategy for patients with MOSH, achievement of significant weight reduction is usually difficult with lifestyle changes alone in real-world practice. Therefore, androgen administration is often necessary in the management of hypogonadism in patients with MOSH which also improves many other comorbidities related to obesity. However, there is conflicting evidence for the appropriate use of testosterone replacement therapy (TRT), and it can also be associated with complications. This evidence-based review updates the available evidence including the very recently published results of the TRAVERSE trial and provides comprehensive clinical practice pearls for the management of patients with MOSH. Before starting testosterone replacement in functional hypogonadism of obesity, it would be desirable to initiate lifestyle modification to ensure weight reduction. TRT should be coupled with the management of other comorbidities related to obesity in MOSH patients. Balancing the risks and benefits of TRT should be considered in every patient before and during long-term management.
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Affiliation(s)
- Mohan T Shenoy
- Department of Endocrinology, Sree Gokulam Medical College, and Research Foundation, Trivandrum 695607, Kerala, India
| | - Sunetra Mondal
- Department of Endocrinology, NRS Medical College and Hospital, Kolkata 700014, West Bengal, India
| | - Cornelius James Fernandez
- Department of Endocrinology & Metabolism, Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust, Boston PE21 9QS, United Kingdom
| | - Joseph M Pappachan
- Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Preston PR2 9HT, United Kingdom
- Faculty of Science, Manchester Metropolitan University, Manchester M15 6BH, United Kingdom
- Faculty of Biology, Medicine & Health, The University of Manchester, Manchester M13 9PL, United Kingdom
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Dakanalis A, Voulgaridou G, Alexatou O, Papadopoulou SK, Jacovides C, Pritsa A, Chrysafi M, Papacosta E, Kapetanou MG, Tsourouflis G, Antonopoulou M, Mitsiou M, Antasouras G, Giaginis C. Overweight and Obesity Is Associated with Higher Risk of Perceived Stress and Poor Sleep Quality in Young Adults. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:983. [PMID: 38929600 PMCID: PMC11206025 DOI: 10.3390/medicina60060983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/07/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: Overweight and obesity are growing public health challenges, particularly concerning young adults. University life presents a unique set of stressors that may influence weight management alongside sleep quality. In this cross-sectional study, we aimed to investigate the association between overweight or obesity, stress, and sleep quality in a large sample of Greek university students. Materials and Methods: The study recruited 2116 active students from across various Greek universities. Participants completed questionnaires on sociodemographics, academic performance, and physical activity levels using the International Physical Activity Questionnaire (IPAQ). Stress and sleep quality were assessed using the Perceived Stress Scale (PSS) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Body weight and height were directly measured to calculate Body Mass Index (BMI). Results: Our analysis of 2116 Greek university students revealed significant associations between various factors and overweight/obesity. Compared to their rural counterparts, young adults in urban areas had an 88% higher prevalence of overweight/obesity (p = 0.0056). Regular smokers were twice as likely to be overweight or obese (p = 0.0012). Notably, those with low physical activity levels displayed a more than two-fold increased risk (p = 0.0008) compared to those with moderate or high activity levels. Similarly, students with moderate or high perceived stress levels had a more than two-fold prevalence of overweight/obesity compared to those with low stress (p = 0.0005). Inadequate sleep quality was also associated with an 86% higher risk of overweight/obesity (p = 0.0007). Interestingly, good academic performance showed a 57% greater prevalence of overweight/obesity compared to very good/excellent performance (p = 0.0103). Conclusions: Our findings reveal that perceived stress and poor sleep quality are significant risk factors for overweight and obesity in this young adult population.
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Affiliation(s)
- Antonios Dakanalis
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, 57001 Thessaloniki, Greece; (G.V.); (S.K.P.); (C.J.); (A.P.)
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece; (O.A.); (M.C.); (M.G.K.); (M.A.); (G.A.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, 57001 Thessaloniki, Greece; (G.V.); (S.K.P.); (C.J.); (A.P.)
| | - Constantina Jacovides
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, 57001 Thessaloniki, Greece; (G.V.); (S.K.P.); (C.J.); (A.P.)
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece; (O.A.); (M.C.); (M.G.K.); (M.A.); (G.A.)
| | - Agathi Pritsa
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, 57001 Thessaloniki, Greece; (G.V.); (S.K.P.); (C.J.); (A.P.)
| | - Maria Chrysafi
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece; (O.A.); (M.C.); (M.G.K.); (M.A.); (G.A.)
| | - Elena Papacosta
- Department of Physical Education and Sport Sciences, School of Education and Social Sciences, Frederick University, 3080 Limassol, Cyprus;
| | - Maria G. Kapetanou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece; (O.A.); (M.C.); (M.G.K.); (M.A.); (G.A.)
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, University of Athens, 11527 Athens, Greece;
| | - Marina Antonopoulou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece; (O.A.); (M.C.); (M.G.K.); (M.A.); (G.A.)
| | - Maria Mitsiou
- Department of Physiotherapy, School of Health Sciences, International Hellenic University, 57001 Thessaloniki, Greece;
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece; (O.A.); (M.C.); (M.G.K.); (M.A.); (G.A.)
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece; (O.A.); (M.C.); (M.G.K.); (M.A.); (G.A.)
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Khorrami Chokami K, Khorrami Chokami A, Cammarata G, Piras G, Albertelli M, Gatto F, Vera L, Ferone D, Boschetti M. Current perspectives in obesity management: unraveling the impact of different therapy approach in real life obesity care. J Transl Med 2024; 22:536. [PMID: 38844956 PMCID: PMC11155047 DOI: 10.1186/s12967-024-05322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/20/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND The challenge of addressing obesity persists in healthcare, necessitating nuanced approaches and personalized strategies. This study aims to evaluate the effects of diverse therapeutic interventions on anthropometric and biochemical parameters in individuals with overweight and obesity within a real-world clinical context. METHODS A retrospective analysis was conducted on 192 patients (141 females, 51 males) aged 18 to 75, with a BMI ranging from 25 to 30 (14.1%) and BMI ≥ 30 (85.9%), observed over a 12-month period at our Endocrinology Unit. Treatment cohorts comprised individuals following different regimens: Mediterranean Diet (MD), with an approximate daily intake of 1500 kcal for women and 1800 kcal for men (71% patients); Ketogenic Diet (KD), utilizing the VLCKD protocol characterized by a highly hypocaloric dietary regimen < 800 kcal/day (14% patients); metformin, administered using the oral formulation (5% patients); pharmacological intervention with GLP1-RA administered via subcutaneous injection with incremental dosage (10% patients). Supply constraints limited the efficacy of Liraglutide, whereas Semaglutide was excluded from comparisons due to its unavailability for obesity without diabetes. Blood tests were conducted to assess lipid profile, glycemic profile, and anthropometric parameters, including BMI, waist circumference, and waist-to-height ratio. RESULTS Significant BMI changes were observed from baseline to 6 months across MD, KD, and Liraglutide groups (p < 0.05). KD exhibited notable reductions in waist circumference and waist-to-height ratio within the initial quarter (p < 0.05), with a significant triglyceride decrease after 6 months (p < 0.05), indicating its efficacy over MD. Liraglutide demonstrated a substantial reduction in HbA1c levels in the first quarter (p < 0.05). During the first three months, the ANOVA test on fasting blood glucose showed a statistically significant impact of the time variable (p < 0.05) rather than the specific treatments themselves (Liraglutide and KD), suggesting that adherence during the early stages of therapy may be more critical than treatment choice. CONCLUSIONS Positive outcomes from targeted interventions, whether pharmacological or dietary should encourage the exploration of innovative, long-term strategies that include personalized treatment alternation. The absence of standardized protocols underscores the importance of careful and tailored planning in managing obesity as a chronic condition.
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Affiliation(s)
- Keyvan Khorrami Chokami
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI), University of Genova, Genoa, 16132, Italy
| | | | - Giuseppe Cammarata
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI), University of Genova, Genoa, 16132, Italy
| | - Grazia Piras
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI), University of Genova, Genoa, 16132, Italy
| | - Manuela Albertelli
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI), University of Genova, Genoa, 16132, Italy
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, 16132, Italy
| | - Federico Gatto
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, 16132, Italy
| | - Lara Vera
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, 16132, Italy
| | - Diego Ferone
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI), University of Genova, Genoa, 16132, Italy
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, 16132, Italy
| | - Mara Boschetti
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI), University of Genova, Genoa, 16132, Italy.
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, 16132, Italy.
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19
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Rodbard HW, Barnard-Kelly K, Pfeiffer AFH, Mauersberger C, Schnell O, Giorgino F. Practical strategies to manage obesity in type 2 diabetes. Diabetes Obes Metab 2024; 26:2029-2045. [PMID: 38514387 DOI: 10.1111/dom.15556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/20/2024] [Accepted: 02/28/2024] [Indexed: 03/23/2024]
Abstract
The rising phenomenon of obesity, a major risk factor for the development and progression of type 2 diabetes, is a complex and multifaceted issue that requires a comprehensive and coordinated approach to be prevented and managed. Although novel pharmacological measures to combat obesity have achieved unprecedented efficacy, a healthy lifestyle remains essential for the long-term success of any therapeutic intervention. However, this requires a high level of intrinsic motivation and continued behavioural changes in the face of multiple metabolic, psychological and environmental factors promoting weight gain, particularly in the context of type 2 diabetes. This review is intended to provide practical recommendations in the context of a holistic, person-centred approach to weight management, including evidence-based and expert recommendations addressing supportive communication, shared decision-making, as well as nutritional and pharmacological therapeutic approaches to achieve sustained weight loss.
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Affiliation(s)
| | - Katharine Barnard-Kelly
- Southern Health NHS Foundation Trust, Southampton, UK
- BHR Limited, Portsmouth, UK
- Spotlight Consultations, Fareham, UK
| | - Andreas F H Pfeiffer
- Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - Oliver Schnell
- Sciarc GmbH, Baierbrunn, Germany
- Forschergruppe Diabetes eV at the Helmholtz Centre, Munich-Neuherberg, Germany
| | - Francesco Giorgino
- Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro, Bari, Italy
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20
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Rosales A, Mendoza L, Miñambres I. [Strategies for the prevention and non-pharmacological treatment of obesity. Models of care]. Aten Primaria 2024; 56:102978. [PMID: 38820670 PMCID: PMC11170205 DOI: 10.1016/j.aprim.2024.102978] [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: 04/08/2024] [Revised: 04/16/2024] [Accepted: 04/29/2024] [Indexed: 06/02/2024] Open
Abstract
The prevalence of obesity has increased in recent years worldwide. In this context, strategies for management obesity in primary care are essential. The first step in the treatment of obesity are lifestyle intervention programs. The three pillars of these programs, ideally of high intensity (high frequency of visits), are dietary intervention, exercise and behavioral therapy. There is no universal model of care for patients with obesity, but it must take into account key aspects, such as facilitating the access and adherence of the patient and a multidisciplinary and coordinated care among professionals at different levels of healthcare. The components of the model of care and its format should be defined according to the resources available and the characteristics of the population to be treated.
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Affiliation(s)
- Angel Rosales
- Servicio de Endocrinología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Lilian Mendoza
- Servicio de Endocrinología, Hospital de la Santa Creu i Sant Pau, Barcelona, España; Universitat Autònoma de Barcelona (UAB), Campus de la UAB, Cerdanyola del Vallès, Barcelona, España; Ciber de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud CarlosIII (ISCIII), Madrid, España
| | - Inka Miñambres
- Servicio de Endocrinología, Hospital de la Santa Creu i Sant Pau, Barcelona, España; Universitat Autònoma de Barcelona (UAB), Campus de la UAB, Cerdanyola del Vallès, Barcelona, España; Ciber de Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud CarlosIII (ISCIII) Madrid, España.
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21
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Holmberg S, Lendahls L, Alle KÅ. "Dare to feel full"-A group treatment method for sustainable weight reduction in overweight and obese adults: A randomized controlled trial with 5-years follow-up. PLoS One 2024; 19:e0303021. [PMID: 38722871 PMCID: PMC11081318 DOI: 10.1371/journal.pone.0303021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/13/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVES To assess the long-term effects on weight reduction and health of a group-based behavioral weight intervention over six months focusing eating for fulfillment as compared to a control regime with brief intervention. METHOD Overweight or obese adults (n = 176, 80% female, mean BMI 33.8 ± 4.7 kg/m2, mean age 55.2 ±10.1 years) were randomized to a group treatment or control receiving a brief intervention. Ninety-three participants (53% of original sample) completed the 5-year follow-up. Anthropometrics, blood pressure and biochemical measurements, self-rated lifestyle habits, quality of life and medication were obtained at baseline, at the end of the 6-month intervention, and once a year for five years following randomization. RESULTS A per-protocol analysis, performed due to a high drop-out rate, found that weight reduction was small and similar in the two groups after five years. Reduction of waist/hip ratio, total-cholesterol and triglycerides were somewhat larger in the control group than in the treatment group. No changes regarding blood pressure, quality of life or medication use between the treatment and control groups were found. CONCLUSIONS No effect on weight reduction of the group intervention was found as compared to brief intervention but both groups achieved small weight loss over time. Findings indicate that any intervention or merely regular follow-ups might be promotive for weight maintenance in middle age.
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Affiliation(s)
- Sara Holmberg
- Department of Research and Development, Region Kronoberg, Växjö, Sweden
- Faculty of Health and Life Sciences, Department of Medicine and Optometry, Linnaeus University, Växjö, Sweden
- Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, Lund, Sweden
| | - Lena Lendahls
- Department of Research and Development, Region Kronoberg, Växjö, Sweden
- Faculty of Health and Life Sciences, Department of Medicine and Optometry, Linnaeus University, Växjö, Sweden
| | - Kjell-Åke Alle
- Department of Research and Development, Region Kronoberg, Växjö, Sweden
- Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
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22
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Krotter A, García-Fernández G, García-Pérez Á, Aonso-Diego G, Weidberg S. Contingency management for smoking cessation for individuals with overweight or obesity: A randomized controlled trial. Drug Alcohol Depend 2024; 258:111269. [PMID: 38547787 DOI: 10.1016/j.drugalcdep.2024.111269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/09/2024] [Accepted: 03/10/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Interventions for quitting smoking and weight control among individuals with excess weight are scarce. Our study evaluated the effectiveness of cognitive behavioral therapy (CBT) plus contingency management (CM) in this population, and examined whether CM for smoking cessation improved CBT treatment outcomes at end of treatment (EOT) and at 1-, 3-, 6-, and 12-month follow-ups (FU). METHODS In an 8-week randomized clinical trial, 120 adults who smoke with overweight or obesity (54.16% females; MBMI = 31.75 ± 4.31) were randomly assigned to CBT for both quitting smoking and weight control (n = 60) or the same treatment plus CM for smoking cessation (n = 60). Outcome variables were compared (i.e., treatment completion, smoking abstinence, weight change and secondary outcomes). RESULTS At EOT, the CBT + CM group achieved 78.33% 7-day point-prevalence abstinence rates compared to 61.67% in the CBT group (p = .073), and rates declined over time (12-month FU: 18% vs 12%). Participants who attained abstinence weighed more compared to baseline at EOT (Mkg = 1.07; SD = 1.88) and over time (12-month FU: Mkg = 4.19; SD = 4.31). No differences were found between the two groups in outcome variables. CONCLUSIONS Both interventions were effective in promoting abstinence and reducing tobacco use over time. Combining CBT with CM for smoking cessation did not improve treatment outcomes in individuals with overweight or obesity compared to CBT only. Future studies should evaluate whether implementing CM for weight maintenance helps control post-cessation weight gain in this population.
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Affiliation(s)
| | | | - Ángel García-Pérez
- Department of Psychology, Sociology and Philosophy, University of Leon, Spain
| | | | - Sara Weidberg
- Department of Psychology, University of Oviedo, Spain
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Gaskin CJ, Cooper K, Stephens LD, Peeters A, Salmon J, Porter J. Clinical practice guidelines for the management of overweight and obesity published internationally: A scoping review. Obes Rev 2024; 25:e13700. [PMID: 38296655 DOI: 10.1111/obr.13700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 10/17/2023] [Accepted: 12/20/2023] [Indexed: 02/02/2024]
Abstract
With the increasing prevalence of obesity placing additional demands on healthcare systems, many jurisdictions and professional bodies have developed clinical practice guidelines to support practitioners in the management of people with overweight and obesity. This scoping review aimed to identify key features of contemporary guidelines for the clinical management of overweight and obesity. Searches of MEDLINE, Guidelines International Network's international guidelines library, and other grey literature sources identified 38 guidelines of 18 countries and one region published since 2010. Guidelines were developed by committees (n = 36, 95%) that comprised knowledgeable experts (n = 36, 95%) and were multidisciplinary (n = 33, 87%), with limited consumer representation (n = 11, 29%). Guideline documentation incorporated review questions (n = 23, 61%), systematic reviews (n = 25, 66%), evidence grading systems (n = 33, 87%), processes for reaching consensus (n = 19, 50%), and guideline review details (n = 28, 74%). Treatment approaches included in most guidelines were nutrition and physical activity (n = 38, 100%), psychology (n = 37, 97%), pharmacotherapy (n = 32, 84%), and bariatric surgery (n = 31, 82%). Most guidelines targeted populations based on age (n = 30, 79%). Guidelines contained recommendations for pregnancy (n = 12, 32%), older adults (n = 9, 24%), and people with eating disorders (n = 8, 21%). Future guidelines would benefit from involvement of consumers including groups known to be at increased risk of overweight and obesity, targeted guidance for at risk groups, and consideration of weight bias and stigma.
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Affiliation(s)
- Cadeyrn J Gaskin
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Institute for Health Transformation (IHT), School of Health and Social Development, Deakin University, Geelong, Australia
| | - Kelly Cooper
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Lena D Stephens
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Institute for Health Transformation (IHT), School of Health and Social Development, Deakin University, Geelong, Australia
| | - Anna Peeters
- Institute for Health Transformation (IHT), School of Health and Social Development, Deakin University, Geelong, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Judi Porter
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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24
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Li C, Gong X, Wei Z, Gao L, Graham Y, Yang W. Novice Chinese Bariatric Nurses' Perceptions of Their Role as Bariatric Case Managers: A Qualitative Study. Obes Surg 2024; 34:1464-1470. [PMID: 38504064 DOI: 10.1007/s11695-024-07177-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION Bariatric case managers (BCM) are integral healthcare team members for patients undergoing bariatric surgery in China. As the demand for bariatric surgery increases in China, the number of BCMs has also risen. However, more is needed to know about the perceptions of novice bariatric nurses toward their role as case managers. This study aims to investigate the perceptions of novice Chinese bariatric nurses toward their roles during the early stages of their careers. METHODS This qualitative study employed semi-structured individual interviews with 15 novice bariatric nurses who received training as BCMs. The interviews were audio-recorded, transcribed line-by-line, and analyzed thematically. The study was conducted in a bariatric surgery center of a public tertiary hospital in Southern China. RESULTS Three themes emerged from the data related to the perceptions of being a BCM: "negotiating the ambiguity of the BCM role," "establishing a core set of behaviors for the BCM role," and "identifying areas of competence to develop a BCM role framework." The novice bariatric nurses expressed both positive and negative feelings toward their role. They highlighted the need for further training to improve their qualifications and the importance of support from colleagues, and hospital management. CONCLUSIONS The findings illuminate the role of the BCM in China. Future research should investigate effective and acceptable job descriptions and cooperation modes between BCMs, colleagues and hospital management. We recommend using these findings to develop training programs for novice BCMs and improve their capacity to provide quality care to patients undergoing bariatric surgery.
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Affiliation(s)
- Chunqun Li
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong Province, China
| | - Xue Gong
- School of Medical Technology and Nursing, Shenzhen Polytechnic University, Xili Lake, Nanshan District, Shenzhen, Guangdong Province, China
| | - Zhuoqi Wei
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong Province, China
| | - Lilian Gao
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong Province, China
| | - Yitka Graham
- Helen McArdle Nursing and Care Research Institute, University of Sunderland, Sunderland, SR1 3SD, UK.
- Bariatric Surgical Unit, South Tyneside and Sunderland NHS Foundation Trust, Kayll Road, Sunderland, SR4 7TP, UK.
- Faculty of Psychology, University of Anahuac, Mexico City, Mexico.
- Department of Biomedical Sciences, University Hospital Austral, Buenos Aires, Argentina.
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong Province, China.
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Abdalla Ahmed MA, Ssemmondo E, Mark-Wagstaff C, Sathyapalan T. Advancements in the management of obesity: a review of current evidence and emerging therapies. Expert Rev Endocrinol Metab 2024; 19:257-268. [PMID: 38685693 DOI: 10.1080/17446651.2024.2347258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/22/2024] [Indexed: 05/02/2024]
Abstract
INTRODUCTION Obesity is the modern world's current epidemic, with substantial health and economic impact. This study aimed to provide a narrative overview of the past, currently available, and future treatment options that offer therapeutic and preventive advantages for obesity management. AREAS COVERED Historically, rimonabant, and lorcaserin, were approved and used for managing non-syndromic obesity. Currently, orlistat, naltrexone/bupropion, glucagon-like peptide-1 receptor agonist (GLP-1 RA), and a few promising therapeutic agents are under investigation, including retatrutide, cagrilintide and orforglipron, which show promising weight reduction effects. We have developed a search string of the Medical Subject Headings (MeSH), including the terms GLP-1 RAs, obesity, and weight loss. This string was then used to perform a systematic literature search in the database including PubMed, EMBASE, MEDLINE, and Scopus up to January 31st, 2024. EXPERT OPINION Managing obesity often requires medical interventions, particularly in cases of severe obesity or obesity-related comorbidities. Thus, it is important to approach obesity management holistically, considering individual needs and circumstances. In our opinion, consulting with healthcare professionals is crucial to developing a personalized plan that addresses both weight loss and overall health improvement.
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Affiliation(s)
- Mohammed Altigani Abdalla Ahmed
- Department of Translational Research, Dasman Diabetes Institute, Kuwait City, Kuwait
- Hull York Medical School, University of Hull, Hull, UK
| | - Emmanuel Ssemmondo
- Hull York Medical School, University of Hull, Hull, UK
- Allam Diabetes Centre, Hull University Teaching Hospital, NHS Trust, Hull, UK
| | - Charlotte Mark-Wagstaff
- Hull York Medical School, University of Hull, Hull, UK
- Allam Diabetes Centre, Hull University Teaching Hospital, NHS Trust, Hull, UK
| | - Thozhukat Sathyapalan
- Hull York Medical School, University of Hull, Hull, UK
- Allam Diabetes Centre, Hull University Teaching Hospital, NHS Trust, Hull, UK
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Drapkina OM, Kontsevaya AV, Kalinina AM, Avdeev SN, Agaltsov MV, Alekseeva LI, Almazova II, Andreenko EY, Antipushina DN, Balanova YA, Berns SA, Budnevsky AV, Gainitdinova VV, Garanin AA, Gorbunov VM, Gorshkov AY, Grigorenko EA, Jonova BY, Drozdova LY, Druk IV, Eliashevich SO, Eliseev MS, Zharylkasynova GZ, Zabrovskaya SA, Imaeva AE, Kamilova UK, Kaprin AD, Kobalava ZD, Korsunsky DV, Kulikova OV, Kurekhyan AS, Kutishenko NP, Lavrenova EA, Lopatina MV, Lukina YV, Lukyanov MM, Lyusina EO, Mamedov MN, Mardanov BU, Mareev YV, Martsevich SY, Mitkovskaya NP, Myasnikov RP, Nebieridze DV, Orlov SA, Pereverzeva KG, Popovkina OE, Potievskaya VI, Skripnikova IA, Smirnova MI, Sooronbaev TM, Toroptsova NV, Khailova ZV, Khoronenko VE, Chashchin MG, Chernik TA, Shalnova SA, Shapovalova MM, Shepel RN, Sheptulina AF, Shishkova VN, Yuldashova RU, Yavelov IS, Yakushin SS. Comorbidity of patients with noncommunicable diseases in general practice. Eurasian guidelines. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2024; 23:3696. [DOI: 10.15829/1728-8800-2024-3996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2024] Open
Abstract
Создание руководства поддержано Советом по терапевтическим наукам отделения клинической медицины Российской академии наук.
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Juul-Hindsgaul N, Alalwani Z, Boylan AM, Hartmann-Boyce J, Nunan D. Defining success in adult obesity management: A systematic review and framework synthesis of clinical practice guidelines. Clin Obes 2024; 14:e12631. [PMID: 38320758 DOI: 10.1111/cob.12631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/18/2023] [Accepted: 11/16/2023] [Indexed: 03/16/2024]
Abstract
Obesity is a chronic and complex disease affecting millions of people worldwide. Currently, there is no standard definition of success for the management of obesity. We set out to complete a synthesis of clinical practice guidelines for obesity management for adult populations, aiming to provide both a quantitative descriptive and qualitative analysis of definitions of success in clinical practice guidelines. An electronic search retrieved 4477 references. Sixteen clinical practice guidelines were included after screening and full-text review. We coded definitions of success 147 times across the included guidelines. No standard or explicit definition of success was identified in the guidelines but rather success was implicitly defined. We developed three themes describing how success was defined in the clinical practice guidelines: Knowledge-based decision making; management of expectations; and the perception of control. The review reinforced that success is an inherently subjective and complex concept. Defining success is limited by existing studies that focus on weight loss and would benefit from additional research on different outcomes. Equally, the relationship between people living with obesity and their clinicians should be further explored to understand how defining success is controlled, discussed and framed in a clinical setting.
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Affiliation(s)
- Nicole Juul-Hindsgaul
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Department for Continuing Education, University of Oxford, Oxford, UK
| | - Zahra Alalwani
- Department for Continuing Education, University of Oxford, Oxford, UK
| | - Anne-Marie Boylan
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jamie Hartmann-Boyce
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - David Nunan
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Di Fusco SA, Mocini E, Gori M, Iacoviello M, Bilato C, Corda M, De Luca L, Di Marco M, Geraci G, Iacovoni A, Milli M, Navazio A, Pascale V, Riccio C, Scicchitano P, Tizzani E, Gabrielli D, Grimaldi M, Colivicchi F, Oliva F. Italian Association of Hospital Cardiologists position paper-obesity in adults: a clinical primer. Eur Heart J Suppl 2024; 26:ii221-ii235. [PMID: 38784672 PMCID: PMC11110455 DOI: 10.1093/eurheartjsupp/suae031] [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] [Indexed: 05/25/2024]
Abstract
Obesity is a chronic and relapsing disease characterized by the interaction between individual predispositions and an obesogenic environment. Recent advances in understanding the mechanisms of energetic homoeostasis paved the way to more effective therapeutic approaches compared with traditional treatments. Since obesity is a complex disease, it necessitates a multi-disciplinary approach whose implementation remains challenging. Nonetheless, emerging pharmacological interventions appear promising. Currently, therapeutic success is discreet in the short term but often fails to maintain long-term weight loss due to a high likelihood of weight regain. Cardiologists play a key role in managing patients with obesity, yet often lack familiarity with its comprehensive management. The aim of this document is to summarize knowledge to consolidate essential knowledge for clinicians to effectively treat patients living with obesity. The paper emphasizes the pivotal role of a strong patient-clinician relationship in navigating successful treatment. We analyse the criteria commonly used to diagnose obesity and point out the strengths and limitations of different criteria. Furthermore, we discuss the role of obesiologists and the contributions of cardiologists. In addition, we detail key components of effective therapeutic strategies, including educational aspects and pharmacological options.
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Affiliation(s)
- Stefania Angela Di Fusco
- U.O.C. Cardiologia Clinica e Riabilitativa, Dipartimento di Emergenza e Accettazione, Presidio Ospedaliero San Filippo Neri—ASL Roma 1, via Martinotti 20, 00135 Roma, Italy
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Mauro Gori
- Dipartimento Cardiovascolare, SSD Chirurgia dei Trapianti e del Trattamento Chirurgico dello Scompenso, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Massimo Iacoviello
- S.C. Di Cardiologia Universitaria-Utic Policlinico Riuniti, Foggia, Italy
| | - Claudio Bilato
- U.O.C. Cardiologia, Dipartimento di Medicina Cardiovascolare, Ospedali dell’Ovest Vicentino, Azienda ULSS 8 Berica, Vicenza, Italy
| | - Marco Corda
- S.C. Cardiologia e UTIC, Dipartimento Cardiovascolare, Azienda Ospedaliera G. Brotzu, Cagliari, Italy
| | - Leonardo De Luca
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Giovanna Geraci
- U.O. Cardiologia, P.O. Sant’Antonio Abate, ASP Trapani, Erice, TP, Italy
| | - Attilio Iacovoni
- Dipartimento Cardiovascolare, SSD Chirurgia dei Trapianti e del Trattamento Chirurgico dello Scompenso, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Massimo Milli
- Cardiologia Firenze 1 (Ospedali S. Maria Nuova e Nuovo San Giovanni di Dio), Azienda USL Toscana Centro, Firenze, Italy
| | - Alessandro Navazio
- S.O.C. Cardiologia Ospedaliera, Presidio Ospedaliero Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia—IRCCS, Reggio Emilia, Italy
| | - Vittorio Pascale
- SOC di Cardiologia-UTIC-Emodinamica e Cardiologia Interventistica, Presidio Ospedaliero ‘Pugliese’, Azienda Ospedaliero-Universitaria ‘Renato Dulbecco’, Catanzaro, Italy
| | - Carmine Riccio
- Dipartimento Cardio-Vascolare, U.O.S.D. Follow-up del Paziente Post-Acuto, AORN Sant’Anna e San Sebastiano, Caserta, Italy
| | | | - Emanuele Tizzani
- Dipartimento di Cardiologia, Ospedale degli Infermi, Rivoli, TO, Italy
| | - Domenico Gabrielli
- Fondazione per il Tuo cuore—Heart Care Foundation, Firenze, Italy
- Dipartimento Cardio-Toraco-Vascolare, U.O.C. Cardiologia, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
| | - Massimo Grimaldi
- U.O.C. Cardiologia-UTIC, Ospedale Miulli, Acquaviva delle Fonti, BA, Italy
| | - Furio Colivicchi
- U.O.C. Cardiologia Clinica e Riabilitativa, Dipartimento di Emergenza e Accettazione, Presidio Ospedaliero San Filippo Neri—ASL Roma 1, via Martinotti 20, 00135 Roma, Italy
| | - Fabrizio Oliva
- Cardiologia 1-Emodinamica, Dipartimento Cardiotoracovascolare ‘A. De Gasperis’, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
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Cappelletti AM, Valenzuela Montero A, Cercato C, Duque Ossman JJ, Fletcher Vasquez PE, García García JE, Mancillas-Adame LG, Manrique HA, Ranchos Monterroso FDM, Segarra P, Navas T. Consensus on pharmacological treatment of obesity in Latin America. Obes Rev 2024; 25:e13683. [PMID: 38123524 DOI: 10.1111/obr.13683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 09/25/2023] [Accepted: 10/30/2023] [Indexed: 12/23/2023]
Abstract
A panel of 10 experts in obesity from various Latin American countries held a Zoom meeting intending to reach a consensus on the use of anti-obesity medicines and make updated recommendations suitable for the Latin American population based on the available evidence. A questionnaire with 16 questions was developed using the Patient, Intervention, Comparison, Outcome (Result) methodology, which was iterated according to the modified Delphi methodology, and a consensus was reached with 80% or higher agreement. Failure to reach a consensus led to a second round of analysis with a rephrased question and the same rules for agreement. The recommendations were drafted based on the guidelines of the American College of Cardiology Foundation/American Heart Association Task Force on Practice. This panel of experts recommends drug therapy in patients with a body mass index of ≥30 or ≥27 kg/m2 plus at least one comorbidity, when lifestyle changes are not enough to achieve the weight loss objective; alternatively, lifestyle changes could be maintained while considering individual parameters. Algorithms for the use of long-term medications are suggested based on drugs that increase or decrease body weight, results, contraindications, and medications that are not recommended. The authors concluded that anti-obesity treatments should be individualized and multidisciplinary.
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Affiliation(s)
- Ana María Cappelletti
- Favaloro University, Buenos Aires, Argentina
- Argentine Society of Nutrition, Buenos Aires, Argentina
| | | | - Cintia Cercato
- Endocrinology and Metabology Service, Clinics Hospital, University of São Paulo Medical School, São Paulo, Brazil
| | | | | | | | | | | | | | - Pablo Segarra
- Ecuadorian Society of Endocrinology, Quito, Ecuador
- Ecuadorian Society of Internal Medicine, Quito, Ecuador
| | - Trina Navas
- General Hospital "Dr. José Gregorio Hernandez", Los Magallanes, Caracas, Venezuela
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Sayed Ahmed HA, Abo El-Ela SG, Joudeh AI, Moawd SM, El Hayek S, Shah J, Eldahshan NA. Prevalence and Correlates of Night Eating Syndrome, Insomnia, and Psychological Distress in Primary Care Patients with Obesity: A Cross-Sectional Study. Obes Facts 2024; 17:274-285. [PMID: 38484714 PMCID: PMC11149973 DOI: 10.1159/000538341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 03/05/2024] [Indexed: 06/06/2024] Open
Abstract
INTRODUCTION Management of obesity is challenging for both patients and healthcare workers. Considering the low success rate of current interventions, this study aimed to explore the prevalence and associated factors of night eating syndrome (NES), insomnia, and psychological distress among individuals with obesity in order to plan comprehensive obesity management interventions. METHODS A cross-sectional study on a convenient sample from five primary healthcare centers in Port Said, Egypt, was conducted from November 2020 to March 2021. Sociodemographic and clinical characteristics were collected in addition to the assessment of NES, insomnia, and psychological distress using the Arabic versions of the Night Eating Diagnostic Questionnaire (NEQ), the Insomnia Severity Index (ISI), and the Patient Health Questionnaire-4 (PHQ-4) scales, respectively. Associations of NES, insomnia, and psychological distress were assessed by multiple regression analysis. We performed Bonferroni adjustments for multiple comparisons. RESULTS We included 425 participants with obesity with a mean age of 45.52 ± 6.96 years. In all, 54.4% were females and the mean body mass index (BMI) was 35.20 ± 4.41 kg/m2. The prevalence rates of NES, insomnia, and psychological distress were 21.6% (95% CI: 17.7-25.6%), 15.3% (95% CI: 11.9-18.7%), and 18.8% (95% CI: 15.1-22.6%), respectively. NES was significantly associated with younger age (OR 0.974, p = 0.016), physical inactivity (OR 0.485, p = 0.010), insomnia (OR 2.227, p = 0.014), and psychological distress (OR 2.503, p = 0.002). Insomnia showed strong associations with NES (OR 2.255, p = 0.015) and psychological distress (OR 5.990, p < 0.001). Associated factors of psychological distress symptoms included insomnia (OR 6.098, p < 0.001) and NES (OR 2.463, p = 0.003). CONCLUSION The prevalence rates of NES, insomnia, and psychological distress were high among primary care patients with obesity, and these conditions were interrelated. Optimal obesity management necessitates individualized and targeted multidisciplinary care plans that take into consideration individual patients' mental, behavioral, and dietary habits needs.
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Affiliation(s)
- Hazem A Sayed Ahmed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Sohila G Abo El-Ela
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Anwar I Joudeh
- Internal Medicine Department, Al-Khor Hospital, Hamad Medical Corporation, Doha, Qatar
- Internal Medicine Department, College of Medicine, University of Qatar, Doha, Qatar
| | - Sally M Moawd
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Samer El Hayek
- Medical Department, Erada Center for Treatment and Rehabilitation in Dubai, Dubai, United Arab Emirates
| | - Jaffer Shah
- Weill Cornell Medicine, New York, New York, USA
| | - Nahed Amen Eldahshan
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Khatun A, Panchali T, Gorai S, Dutta A, Das TK, Ghosh K, Pradhan S, Mondal KC, Chakrabarti S. Impaired brain equanimity and neurogenesis in the diet-induced overweight mouse: a preventive role by syringic acid treatment. Nutr Neurosci 2024; 27:271-288. [PMID: 36947578 DOI: 10.1080/1028415x.2023.2187510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVES In this study mice were fed a high-fat diet for 12 weeks to establish diet-induced obesity and syringic acid (SA) was assessed for anti-obese, neuroprotective, and neurogenesis. METHOD Animals were given HFD for 12 weeks to measure metabolic characteristics and then put through the Barns-maze and T-maze tests to measure memory. Additionally, the physiology of the blood-brain barrier, oxidative stress parameters, the expression of inflammatory genes, neurogenesis, and histopathology was evaluated in the brain. RESULT DIO raised body weight, BMI, and other metabolic parameters after 12 weeks of overfeeding. A reduced spontaneous alternation in behavior (working memory, reference memory, and total time to complete a task), decreased enzymatic and non-enzymatic antioxidants, oxidative biomarkers, increased neurogenesis, and impaired blood-brain barrier were all seen in DIO mice. SA (50 mg/kg) treatment of DIO mice (4 weeks after 8 weeks of HFD feeding) reduced diet-induced changes in lipid parameters associated with obesity, hepatological parameters, memory, blood-brain barrier, oxidative stress, neuroinflammation, and neurogenesis. SA also reduced the impact of malondialdehyde and enhanced the effects of antioxidants such as glutathione, superoxide dismutase (SOD), and total thiol (MDA). Syringic acid improved neurogenesis, cognition, and the blood-brain barrier while reducing neurodegeneration in the hippocampal area. DISCUSSION According to the results of the study, syringic acid therapy prevented neurodegeneration, oxidative stress, DIO, and memory loss. Syringic acid administration may be a useful treatment for obesity, memory loss, and neurogenesis, but more research and clinical testing is needed.
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Affiliation(s)
- Amina Khatun
- Department of Biological Sciences, Midnapore City College, Paschim Medinipur, India
| | - Titli Panchali
- Department of Paramedical & Allied Health Science, Midnapore City College, Paschim Medinipur, India
| | - Sukhamoy Gorai
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Ananya Dutta
- Department of Paramedical & Allied Health Science, Midnapore City College, Paschim Medinipur, India
| | - Tridip Kumar Das
- Department of Biological Sciences, Midnapore City College, Paschim Medinipur, India
| | - Kuntal Ghosh
- Department of Biological Sciences, Midnapore City College, Paschim Medinipur, India
| | - Shrabani Pradhan
- Department of Paramedical & Allied Health Science, Midnapore City College, Paschim Medinipur, India
| | | | - Sudipta Chakrabarti
- Department of Biological Sciences, Midnapore City College, Paschim Medinipur, India
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Diao Z, Molludi J, Latef Fateh H, Moradi S. Comparison of the low-calorie DASH diet and a low-calorie diet on serum TMAO concentrations and gut microbiota composition of adults with overweight/obesity: a randomized control trial. Int J Food Sci Nutr 2024; 75:207-220. [PMID: 38149315 DOI: 10.1080/09637486.2023.2294685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/09/2023] [Indexed: 12/28/2023]
Abstract
This study compares two diets, Dietary Approaches to Stop Hypertension (DASH) and a Low-Calorie Diet on Trimethylamine N-oxide (TMAO) levels and gut microbiota. 120 obese adults were randomly allocated to these three groups: a low-calorie DASH diet, a Low-Calorie diet, or a control group for 12 weeks. Outcomes included plasma TMAO, lipopolysaccharides (LPS), and gut microbiota profiles. After the intervention, the low-calorie DASH diet group demonstrated a greater decrease in TMAO levels (-20 ± 8.1 vs. -10.63 ± 4.6 μM) and a significant decrease in LPS concentration (-19.76 ± 4.2 vs. -5.68 ± 2.3) compared to the low-calorie diet group. Furthermore, the low-calorie DASH diet showed a higher decrease in the Firmicutes and Bactericides (F/B) ratio, which influenced TMAO levels, compared to the Low-Calorie diet (p = 0.028). The current study found the low-calorie DASH diet improves TMAO and LPS in comparison to a Low-Calorie diet.
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Affiliation(s)
- Zhipeng Diao
- Tianjin Yite Life Science R&D Co. LTD, Tianjin, China
| | - Jalall Molludi
- Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hawal Latef Fateh
- Nursing Department, Kalar Technical College, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
- Nursing Department, Kalar Technical College, Garmian Polytechnic University, Kalar, Iraq
| | - Sara Moradi
- Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
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Wachiraphansakul N, Vongchaiudomchoke T, Manosroi W, Nochaiwong S. Comparative effectiveness of glucagon-like peptide-1 receptor agonists on body composition and anthropometric indices: A protocol for a systematic review and network meta-analysis of randomized controlled trials. PLoS One 2024; 19:e0297488. [PMID: 38408098 PMCID: PMC10896528 DOI: 10.1371/journal.pone.0297488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/05/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND To date, no studies have addressed the comparative efficacy of glucagon-like peptide-1 receptor agonists (GLP1-RAs) therapy on body composition and anthropometric indices among adult overweight or obese patients with or without type 2 diabetes. To provide evidence-based recommendations, we will conduct a traditional pairwise and network meta-analysis of all available randomized clinical trials that evaluated the effects of GLP1-RAs interventions for adult overweight or obese patients with or without type 2 diabetes. METHODS AND DESIGN Electronic databases, including Medline, Embase, PubMed, Cochrane Library (CENTRAL), Scopus, and CINAHL, will be searched from inception without language restriction. Grey literature will be searched, including Google Scholar, ongoing clinical trial registries, and preprint reports. Reference lists of included trials, relevant major endocrinology scientific meetings, and manual hand searches from key general medicine and obesity and endocrinology journals will also be browsed. Two authors will screen, select, extract, appraise the risk of bias, and rate the evidence findings. Any disagreement will be resolved through team discussion. Based on a random-effects model, we will employ a two-step approach of traditional pairwise meta-analysis and network meta-analysis for quantitative synthesis. The pooled effect estimates using a frequentist approach with 95% confidence intervals for continuous endpoints will be expressed as the standardized mean difference, whereas odds ratios will be used for categorical endpoints. The quality of included trials will be evaluated using the Cochrane risk-of-bias version 2 assessment tool. Certainty of evidence for each outcome will be assessed using the modified confidence in network meta-analysis approach and the Grading of Recommended Assessment, Development, and Evaluation approach. The magnitude of the effect size, prediction intervals, surface under the cumulative ranking curve values, and certainty of evidence will be incorporated to draw evidence-based conclusions. CONCLUSION This systematic review and network meta-analysis will summarize the comparative efficacy of GLP1-RAs therapy on body composition and anthropometric indices. Evidence identified from this review will promote the rational use of interventions for adult overweight or obese patients with or without type 2 diabetes and will serve as an important step for evidence-based practice within this area. TRIAL REGISTRATION PROSPERO registration number: CRD42023458228.
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Affiliation(s)
| | | | - Worapaka Manosroi
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Surapon Nochaiwong
- Pharmacoepidemiology and Statistical Research Center (PESRC), Chiang Mai University, Chiang Mai, Thailand
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
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Akbas F, Usta Atmaca H, Yazici D. Dynapenic Abdominal Obesity and Metabolic Health in Non-Geriatric Patients with Obesity. Metab Syndr Relat Disord 2024; 22:77-83. [PMID: 37878298 DOI: 10.1089/met.2023.0153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Background: Dynapenic abdominal obesity (DAO) is the combination of low muscle strength and high central adiposity, which can lead to functional and cardiometabolic impairments. Objective: The aim of this study was to examine the relationship between DAO and metabolic parameters in non-geriatric patients with obesity. Methods: All patients seen in the obesity outpatient clinic during a random month, along with 30 healthy individuals, were included in the study. Body mass index (BMI), waist circumference (WC), hip circumference (HC), serum fasting blood glucose, triglyceride, high-density lipoprotein, low-density lipoprotein (LDL), insulin, and glycated hemoglobin (HbA1c) levels were measured. Muscle function tests were conducted. Hypertension and diabetes mellitus diagnoses were recorded. DAO was determined using handgrip strength and WC. Metabolic syndrome was defined based on International Diabetes Federation (IDF) criteria. Data were analyzed using SPSS. Results: A total of 106 individuals participated in the study, including 76 individuals with obesity as the case group and 30 healthy individuals as the control group. In the case group, BMI, WC, HC, and chair stand test results were higher compared to the control group. There was no significant difference between the case and control groups in terms of gait speed or handgrip test results. In the case group, 30 people (39.5%) had dynapenic obesity (DO), and in the control group, 8 people (26.7%) had DO. There was no significant difference in DO rates between the case and control groups. In the case group, the HbA1c level was higher in DO (+) group than DO (-) group. In the control group, DO (+) group had higher LDL and HbA1c level than DO (-) group. No significant difference was observed in other search parameters between the DO (+) and DO (-) groups in both the case and control groups. Conclusion: DAO is common among people with obesity and contributes to a poor prognosis, increased morbidity, and mortality. Therefore, including its treatment in the management of obesity is crucial for individuals of all age ranges.
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Affiliation(s)
- Feray Akbas
- Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Hanife Usta Atmaca
- Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Dilek Yazici
- Department of Endocrinology and Metabolism, Koc University Medical School, Istanbul, Turkey
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Crompvoets PI, Nieboer AP, van Rossum EFC, Cramm JM. Perceived weight stigma in healthcare settings among adults living with obesity: A cross-sectional investigation of the relationship with patient characteristics and person-centred care. Health Expect 2024; 27:e13954. [PMID: 39102661 PMCID: PMC10790109 DOI: 10.1111/hex.13954] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION Patients living with obesity often experience weight stigma in healthcare settings, which has worrying consequences for their healthcare experiences. This cross-sectional study aimed to: (1) provide an overview of stigmatising experiences in healthcare settings reported by adults living with varying classes of obesity, (2) identify associations among patient characteristics and perceived weight stigma and (3) investigate the association between perceived weight stigma and person-centred care (PCC). METHODS Dutch adults living with obesity classes I (body mass index [BMI]: 30 to <35 kg/m2; n = 426), II (BMI: 35 to <40 kg/m2; n = 124) and III (BMI: ≥40 kg/m2; n = 40) completed measures of perceived weight stigma in healthcare settings and PCC. Descriptive, correlational and multivariate analyses were conducted. RESULTS Of patients living with classes I, II and III obesity, 41%, 59% and 80%, respectively reported experiences of weight stigma in healthcare settings. Younger age, greater obesity severity and the presence of chronic illnesses were associated with greater perceived weight stigma. Greater perceived weight stigma was associated with lower PCC. CONCLUSION The results of this study emphasise the significant role of weight stigma in the healthcare experiences of patients living with obesity. Reducing weight stigma is expected to improve PCC and the overall quality of care for these patients. Minimising weight stigma will require efforts across various healthcare domains, including increasing awareness among healthcare professionals about sensitive communication in weight-related discussions. PATIENT CONTRIBUTION Our sample consisted of patients living with obesity. Additionally, patients were involved in the pilot testing and refinement of the PCC instrument.
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Affiliation(s)
- Paige I. Crompvoets
- Department of Socio‐Medical SciencesErasmus School of Health Policy & Management, Erasmus University RotterdamRotterdamThe Netherlands
| | - Anna P. Nieboer
- Department of Socio‐Medical SciencesErasmus School of Health Policy & Management, Erasmus University RotterdamRotterdamThe Netherlands
| | - Elisabeth F. C. van Rossum
- Department of Internal MedicineDivision of Endocrinology, Erasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
- Obesity Center CGGErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Jane M. Cramm
- Department of Socio‐Medical SciencesErasmus School of Health Policy & Management, Erasmus University RotterdamRotterdamThe Netherlands
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Mohd Saad N, Mohamad M, Mat Ruzlin AN. Web-Based Intervention to Act for Weight Loss in Adults With Type 2 Diabetes With Obesity (Chance2Act): Protocol for a Nonrandomized Controlled Trial. JMIR Res Protoc 2024; 13:e48313. [PMID: 38294848 PMCID: PMC10867745 DOI: 10.2196/48313] [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: 05/02/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND In adults with type 2 diabetes (T2D), weight loss can improve hemoglobin A1c, blood pressure, and triglycerides, and reduce the frequency of medications needed. Unfortunately, a large proportion of these individuals are not ready to initiate weight efforts, making existing obesity management strategies less effective. Many digital health interventions aim at weight loss, but there is still limited evidence on their effectiveness in changing weight loss behavior, especially in adults with T2D. OBJECTIVE This study aims to develop and validate "Chance2Act," a new web-based intervention, designed specifically to facilitate behavioral change in adults with T2D with obesity who are not ready to act toward weight loss. Then, the effectiveness of the newly developed intervention will be determined from a nonrandomized controlled trial. METHODS A web-based intervention will be developed based on the Transtheoretical Model targeting adults with T2D with obesity who are not ready to change for weight loss. Phase 1 will involve the development and validation of the web-based health intervention module. In phase 2, a nonrandomized controlled trial will be conducted in 2 government health clinics selected by the investigator. This is an unblinded study with a parallel assignment (ie, intervention vs control [usual care] with an allocation ratio of 1:1). A total of 124 study participants will be recruited, of which 62 participants will receive the Chance2Act intervention in addition to the usual care. The primary outcome is the changes in an individual's readiness from a stage of not being ready to change (precontemplation, contemplation, or preparation stage) to being ready for weight loss (action stage). The secondary outcomes include changes in self-efficacy, decisional balance, family support for weight loss, BMI, waist circumference, and body fat composition. RESULTS The phase 1 study will reveal the intervention's validity through the Content Validity Index and Face Validity Index, considering it valid if both indices exceed 0.83. The effectiveness of the intervention will be determined in phase 2, where the differences within and between groups will be analyzed in terms of the improvement of stages of change and all secondary outcomes as defined in the methodology. Data analysis for phase 2 will commence in 2024, with the anticipated publication of results in March 2024. CONCLUSIONS If proven effective, the result of the study may give valuable insights into the effective behavioral modification strategies for a web-based intervention targeting adults with T2D with obesity but not yet ready to change for weight loss. This intervention may be replicated or adopted in different settings, focusing on behavioral modification support that patients need. This study offers a deeper understanding of the application of behavior change techniques for a more holistic approach to obesity care in T2D. TRIAL REGISTRATION ClinicalTrials.gov NCT05736536; https://clinicaltrials.gov/study/NCT05736536. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/48313.
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Affiliation(s)
- Noraini Mohd Saad
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Mariam Mohamad
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
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De Lorenzo A, Pellegrini M, Gualtieri P, Itani L, Frank G, El Ghoch M, Di Renzo L. The Association between Obesity and Reduced Weight-Adjusted Bone Mineral Content in Older Adults: A New Paradigm That Contrasts with the Obesity Paradox. Nutrients 2024; 16:352. [PMID: 38337637 PMCID: PMC10857150 DOI: 10.3390/nu16030352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
The relationship between body weight and bone mass in the elderly remains unclear, and whether obesity is a protective factor is still a matter of debate. For this reason, the aim of this study is to assess the association between body mass index (BMI) and bone mineral content adjusted by body weight, expressed as a percentage (w-BMC%), and to test the validity of the obesity paradox in this context. A cohort of 1404 older adults was categorized according to the World Health Organization's BMI cut-off points and completed a total and segmental body composition measurement by means of a dual X-ray absorptiometry scan. Individuals with obesity displayed a lower mean w-BMC% (3.06 ± 0.44%; 2.60 ± 0.37%) compared to those who were normal-weight (3.95 ± 0.54%; 3.38 ± 0.48%) and overweight (3.06 ± 0.44%; 3.04 ± 0.37%) in both genders. Linear regression analysis also showed a negative association between BMI and w-BMC% in males (β = -0.09; p < 0.001) and females (β = -0.06; p < 0.001). Finally, among individuals with obesity, and after adjusting for age, the linear regression models revealed a significant decrease of 0.75% and 0.28% in w-BMC% for every one-unit increase in the trunk fat/appendicular lean mass ratio in both males (β = -0.749; p < 0.0001) and females (β = -0.281; p < 0.001). In conclusion, we suggest a new paradigm regarding the impact of obesity on bone mass, in which the former does not appear to be a protective factor of the latter, especially in individuals with central obesity and low muscle mass.
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Affiliation(s)
- Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.D.L.); (L.D.R.)
| | - Massimo Pellegrini
- Centre for the Study of Metabolism, Body Composition, and Lifestyle, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy;
| | - Paola Gualtieri
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.D.L.); (L.D.R.)
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut 11072809, Lebanon;
| | - Giulia Frank
- PhD School of Applied Medical-Surgical Sciences, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy;
| | - Marwan El Ghoch
- Centre for the Study of Metabolism, Body Composition, and Lifestyle, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy;
| | - Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.D.L.); (L.D.R.)
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Nowicka P, Sjögren L, Bertilsson AS, Järvholm K, Sellberg F, Sundbom M, Thalén L, Lagerros YT. Systematic Development of National Guidelines for Obesity Care: The Swedish Approach. Obes Facts 2024; 17:183-190. [PMID: 38253042 PMCID: PMC10987176 DOI: 10.1159/000536320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 01/14/2024] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION With the rapid development of treatment modalities for obesity management, there is an increasing demand for guidance to facilitate the prioritization of interventions. In 2020, the Swedish National Board of Health and Welfare started the process of producing the first national guidelines for obesity care directed to decision makers who allocate resources to the best knowledge-based care. The main aim of this paper was to describe the systematic development of these guidelines, designed to guarantee uniformly high standards of care throughout the whole country. METHODS The standardized procedures of the National Board of Health and Welfare were applied to construct guidelines in a systematic and transparent way, including priority setting of recommendations and quality indicators to evaluate the progress of implementation. The process involved independent expert committees including professionals and patient representatives, and the guidelines were reviewed through an open public consultation. RESULTS National guidelines were issued in 2023, encompassing a broad scope, from identification and diagnosis to multiple treatment modalities, embedded in a life-course perspective from pregnancy to the elderly, as well as highlighting the need for improved knowledge and competence of health care providers. CONCLUSIONS National guidelines for improved standard care and evidence-based and efficient use of health care resources for obesity treatment can be developed in a systematic way with professionals and patient representatives.
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Affiliation(s)
- Paulina Nowicka
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Lovisa Sjögren
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Pediatrics, Hallands Hospital Halmstad, Halmstad, Sweden
| | - Ann-Sofie Bertilsson
- Department for Analysis, The National Board of Health and Welfare, Stockholm, Sweden
| | - Kajsa Järvholm
- Department of Psychology, Lund University, Lund, Sweden
- Childhood Obesity Unit, Skåne University Hospital, Malmö, Sweden
| | - Fanny Sellberg
- National Guidelines and Screening, Department for Knowledge-Based Policy of Health Care, the National Board of Health and Welfare, Stockholm, Sweden
| | - Magnus Sundbom
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
- Department of Surgery, University Hospital, Uppsala, Sweden
| | - Liv Thalén
- National Guidelines and Screening, Department for Knowledge-Based Policy of Health Care, the National Board of Health and Welfare, Stockholm, Sweden
| | - Ylva Trolle Lagerros
- Clinical Epidemiology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
- Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
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Milhem F, Hamilton LM, Skates E, Wilson M, Johanningsmeier SD, Komarnytsky S. Biomarkers of Metabolic Adaptation to High Dietary Fats in a Mouse Model of Obesity Resistance. Metabolites 2024; 14:69. [PMID: 38276304 PMCID: PMC10819356 DOI: 10.3390/metabo14010069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
Obesity-resistant (non-responder, NR) phenotypes that exhibit reduced susceptibility to developing obesity despite being exposed to high dietary fat are crucial in exploring the metabolic responses that protect against obesity. Although several efforts have been made to study them in mice and humans, the individual protective mechanisms are poorly understood. In this exploratory study, we used a polygenic C57BL/6J mouse model of diet-induced obesity to show that NR mice developed healthier fat/lean body mass ratios (0.43 ± 0.05) versus the obesity-prone (super-responder, SR) phenotypes (0.69 ± 0.07, p < 0.0001) by upregulating gene expression networks that promote the accumulation of type 2a, fast-twitch, oxidative muscle tissues. This was achieved in part by a metabolic adaptation in the form of blood glucose sparing, thus aggravating glucose tolerance. Resistance to obesity in NR mice was associated with 4.9-fold upregulated mitoferrin 1 (Slc25a37), an essential mitochondrial iron importer. SR mice also showed fecal volatile metabolite signatures of enhanced short-chain fatty acid metabolism, including increases in detrimental methyl formate and ethyl propionate, and these effects were reversed in NR mice. Continued research into obesity-resistant phenotypes can offer valuable insights into the underlying mechanisms of obesity and metabolic health, potentially leading to more personalized and effective approaches for managing weight and related health issues.
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Affiliation(s)
- Fadia Milhem
- Plants for Human Health Institute, North Carolina State University, 600 Laureate Way, Kannapolis, NC 28081, USA; (F.M.); (E.S.); (M.W.)
- Department of Food, Bioprocessing and Nutrition Sciences, North Carolina State University, 400 Dan Allen Drive, Raleigh, NC 27695, USA;
- Department of Nutrition, University of Petra, 317 Airport Road, Amman 11196, Jordan
| | - Leah M. Hamilton
- Department of Food, Bioprocessing and Nutrition Sciences, North Carolina State University, 400 Dan Allen Drive, Raleigh, NC 27695, USA;
- College of Agriculture, Virginia State University, 1 Hayden Drive, Petersburg, VA 23806, USA
| | - Emily Skates
- Plants for Human Health Institute, North Carolina State University, 600 Laureate Way, Kannapolis, NC 28081, USA; (F.M.); (E.S.); (M.W.)
| | - Mickey Wilson
- Plants for Human Health Institute, North Carolina State University, 600 Laureate Way, Kannapolis, NC 28081, USA; (F.M.); (E.S.); (M.W.)
| | - Suzanne D. Johanningsmeier
- United States Department of Agriculture-Agricultural Research Service, Southeast Area, Food Science and Market Quality & Handling Research Unit, North Carolina State University, 322 Schaub Hall, Box 7624, Raleigh, NC 27695, USA;
| | - Slavko Komarnytsky
- Plants for Human Health Institute, North Carolina State University, 600 Laureate Way, Kannapolis, NC 28081, USA; (F.M.); (E.S.); (M.W.)
- Department of Food, Bioprocessing and Nutrition Sciences, North Carolina State University, 400 Dan Allen Drive, Raleigh, NC 27695, USA;
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Lombardi R, Colavolpe L, Alletto F, Cespiati A, Fatta E, Bertelli C, Cinque F, Pisano G, Pulixi E, Francione P, Maffi G, Iuculano F, Dongiovanni P, Meroni M, Burdick L, Bignamini D, Maggioni M, Valenti L, Fargion S, Fracanzani AL. Comparison of the severity of metabolic, liver and cardiovascular damage in NAFLD patients attending the hepatology clinic over the last three decades. Dig Liver Dis 2024; 56:144-151. [PMID: 37507284 DOI: 10.1016/j.dld.2023.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/21/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND AND AIMS NAFLD prevalence is increasing worldwide. AIM to assess whether severity of hepatic, metabolic and cardiovascular (CV) disease changed over time. METHODS 422 NAFLD patients (388 biopsy proven and 34 clinical cirrhosis) diagnosed between 1990 and 2021 and subdivided according to decade of presentation. Metabolic parameters, early atherosclerosis (carotid plaques at Doppler ultrasound), severity of liver damage (NAS score, NASH, significant fibrosis (≥2) and cirrhosis) and PNPLA3 genotyping were assessed. RESULTS No difference in age, sex and prevalence of dyslipidemia and hypertension was found across decades (p for trend), whereas a higher prevalence of diabetes (p = 0.02), obesity (p<0.001), histological severe steatosis (p<0.001), NASH (p<0.001), fibrosis ≥2 (p<0.001), cirrhosis (p<0.001) and carotid plaques (p = 0.05) was observed in the last decade compared to the others. A higher prevalence of PNPLA3 GG polymorphism was found over time (p = 0.02). In the whole cohort, age, metabolic alterations and PNPLA3 G homozygosity were independent risk factors for hepatic fibrosis and carotid plaques, independently of the decade considered. CONCLUSION Over the past 10 years compared to previous decades, NAFLD patients presented to observation with more severe liver disease and subclinical atherosclerosis, paralleling the spread of diabetes and obesity. PNPLA3 unfavorable genotype became more prevalent over time.
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Affiliation(s)
- Rosa Lombardi
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Italy.
| | - Lucia Colavolpe
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Italy
| | - Francesca Alletto
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Italy
| | - Annalisa Cespiati
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Italy
| | - Erika Fatta
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy
| | - Cristina Bertelli
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy
| | - Felice Cinque
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Italy
| | - Giuseppina Pisano
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy
| | - Edoardo Pulixi
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy
| | - Paolo Francione
- UO di Medicina, Azienda Ospedaliera "Card. G. Panico" di Tricase, Italy
| | - Gabriele Maffi
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Italy
| | - Federica Iuculano
- UO Medicina Interna, Asst Nord Milano, Ospedale Edoardo Bassini, Cinisello Balsamo, Milan, Italy
| | - Paola Dongiovanni
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy
| | - Marica Meroni
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy
| | - Larry Burdick
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy
| | - Daniela Bignamini
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy
| | - Marco Maggioni
- Department of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy
| | - Luca Valenti
- Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Italy
| | - Silvia Fargion
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Italy
| | - Anna Ludovica Fracanzani
- Unit of Internal Medicine and Metabolic Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Italy
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Douglass B, Lau SH, Parkin B, Wilson M, Kynaston J. Changing Knowledge and Attitudes towards Bariatric Surgery in Primary Care: a 10-Year Cross-Sectional Survey. Obes Surg 2024; 34:71-76. [PMID: 37991710 DOI: 10.1007/s11695-023-06934-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Some 28% of the Scottish population suffer from obesity. Bariatric procedures per population carried out in England when compared to Scotland (NBSR 2018) are significantly higher. Primary care practitioners (PCP) influence equality of access to secondary care bariatrics and frequently manage post-operative bariatric patients. Examining changes in PCP knowledge and attitude could improve access to bariatric procedures in Scotland. METHODS Following a sample pilot, all PCPs within three Scottish NHS health boards were emailed a questionnaire-based survey (2011; n = 902). A subsequent 10-year follow-up encompassed a greater scope of practice, additionally distributed to all PCPs in five further health boards (2021; n = 2049). RESULTS Some 452 responses were achieved (2011, 230; 2021, 222). PCPs felt bariatric surgery offered a greater impact in both weight management and that of obesity-related diseases (p < .0001). More PCPs were aware of local bariatric surgical referral criteria (2011, 43%; 2021, 57% (p = .003)), and more made referrals (2011, 60%; 2021, 72% (p = .018)) but were less familiar with national bariatric surgical guidelines (2011, 70%; 2021, 48% (p < .001)). Comfort at managing post-operative bariatric surgical patients were unchanged (2011, 24%; 2021, 27% (p = .660)). Minimal progress through dietetic-lead weight management services, plus rejection of patients thought to be good candidates, was reasons for referral hesitancy. CONCLUSION Over 10 years, PCPs were more aware of local referral criteria, making increased numbers of referrals. Knowledge deficits of national guidelines remain, and overwhelmingly PCPs do not feel comfortable looking after post-operative bariatric surgical patients. Further research into PCP educational needs, in addition to improving the primary to secondary care interface, is required.
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Affiliation(s)
| | | | - Ben Parkin
- Forth Valley Royal Hospital, Larbert, FK5 4WR, Scotland, UK
| | - Michael Wilson
- Forth Valley Royal Hospital, Larbert, FK5 4WR, Scotland, UK
| | - James Kynaston
- Forth Valley Royal Hospital, Larbert, FK5 4WR, Scotland, UK
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Hankosky ER, Wang H, Neff LM, Kan H, Wang F, Ahmad NN, Griffin R, Stefanski A, Garvey WT. Tirzepatide reduces the predicted risk of atherosclerotic cardiovascular disease and improves cardiometabolic risk factors in adults with obesity or overweight: SURMOUNT-1 post hoc analysis. Diabetes Obes Metab 2024; 26:319-328. [PMID: 37932236 DOI: 10.1111/dom.15318] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 11/08/2023]
Abstract
AIM To assess the effect of tirzepatide on long-term risk of atherosclerotic cardiovascular disease (ASCVD) among people with obesity or overweight without diabetes from SURMOUNT-1. MATERIALS AND METHODS SURMOUNT-1, a phase 3 trial, evaluated the efficacy and safety of tirzepatide in adults with body mass index ≥30 or ≥27 kg/m2 and at least one weight-related complication, excluding diabetes. Participants were randomly assigned to tirzepatide (5/10/15 mg) or placebo. Changes from baseline in cardiometabolic variables were assessed. The predicted 10-year ASCVD risk scores were calculated (American College of Cardiology/American Heart Association risk engine) at baseline, week 24, and week 72 in SURMOUNT-1 participants without a history of ASCVD. Percent change in risk scores from baseline to weeks 24 and 72 was compared between tirzepatide and placebo using mixed model for repeated measures analysis. Analyses were also conducted in participants with intermediate to high risk at baseline. RESULTS Tirzepatide-treated groups demonstrated reductions in cardiometabolic variables over 72 weeks. In participants without a history of ASCVD (N = 2461), the baseline median risk score was low and did not differ across groups (1.5%-1.6%). Relative change in risk from baseline to week 72 was greater for tirzepatide (-23.5% to -16.4%) than placebo (12.7%; P < 0.001). Relative change among participants with intermediate-to-high baseline risk was significantly greater for tirzepatide (P < 0.05). Intermediate-to-high-risk participants demonstrated similar relative change but greater absolute risk reduction compared to the overall population. CONCLUSION Tirzepatide treatment significantly reduced the 10-year predicted risk of ASCVD versus placebo in patients with obesity or overweight without diabetes.
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Affiliation(s)
| | - Hui Wang
- TechData Services Company, King of Prussia, Pennsylvania, USA
| | - Lisa M Neff
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Hong Kan
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Fangyu Wang
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | | | - Ryan Griffin
- Eli Lilly and Company, Indianapolis, Indiana, USA
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Wang B, Kristiansen E, Fagerlund AJ, Zanaboni P, Hägglund M, Bärkås A, Kujala S, Cajander Å, Blease C, Kharko A, Huvila I, Kane B, Johansen MA. Users' Experiences With Online Access to Electronic Health Records in Mental and Somatic Health Care: Cross-Sectional Study. J Med Internet Res 2023; 25:e47840. [PMID: 38145466 PMCID: PMC10775043 DOI: 10.2196/47840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/06/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Patient-accessible electronic health records (PAEHRs) hold promise for empowering patients, but their impact may vary between mental and somatic health care. Medical professionals and ethicists have expressed concerns about the potential challenges of PAEHRs for patients, especially those receiving mental health care. OBJECTIVE This study aims to investigate variations in the experiences of online access to electronic health records (EHRs) among persons receiving mental and somatic health care, as well as to understand how these experiences and perceptions vary among those receiving mental health care at different levels of point of care. METHODS Using Norwegian data from the NORDeHEALTH 2022 Patient Survey, we conducted a cross-sectional descriptive analysis of service use and perceptions of perceived mistakes, omissions, and offensive comments by mental and somatic health care respondents. Content analysis was used to analyze free-text responses to understand how respondents experienced the most serious errors in their EHR. RESULTS Among 9505 survey participants, we identified 2008 mental health care respondents and 7086 somatic health care respondents. A higher percentage of mental health care respondents (1385/2008, 68.97%) reported that using PAEHR increased their trust in health care professionals compared with somatic health care respondents (4251/7086, 59.99%). However, a significantly larger proportion (P<.001) of mental health care respondents (976/2008, 48.61%) reported perceiving errors in their EHR compared with somatic health care respondents (1893/7086, 26.71%). Mental health care respondents also reported significantly higher odds (P<.001) of identifying omissions (758/2008, 37.75%) and offensive comments (729/2008, 36.3%) in their EHR compared with the somatic health care group (1867/7086, 26.35% and 826/7086, 11.66%, respectively). Mental health care respondents in hospital inpatient settings were more likely to identify errors (398/588, 67.7%; P<.001) and omissions (251/588, 42.7%; P<.001) than those in outpatient care (errors: 422/837, 50.4% and omissions: 336/837, 40.1%; P<.001) and primary care (errors: 32/100, 32% and omissions: 29/100, 29%; P<.001). Hospital inpatients also reported feeling more offended (344/588, 58.5%; P<.001) by certain content in their EHR compared with respondents in primary (21/100, 21%) and outpatient care (287/837, 34.3%) settings. Our qualitative findings showed that both mental and somatic health care respondents identified the most serious errors in their EHR in terms of medical history, communication, diagnosis, and medication. CONCLUSIONS Most mental and somatic health care respondents showed a positive attitude toward PAEHRs. However, mental health care respondents, especially those with severe and chronic concerns, expressed a more critical attitude toward certain content in their EHR compared with somatic health care respondents. A PAEHR can provide valuable information and foster trust, but it requires careful attention to the use of clinical terminology to ensure accurate, nonjudgmental documentation, especially for persons belonging to health care groups with unique sensitivities.
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Affiliation(s)
- Bo Wang
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Eli Kristiansen
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | | | - Paolo Zanaboni
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maria Hägglund
- Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Annika Bärkås
- Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Sari Kujala
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Åsa Cajander
- Department of Information Technology, Uppsala University, Uppsala, Sweden
| | - Charlotte Blease
- Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden
- Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Anna Kharko
- Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Medtech Science & Innovation Centre, Uppsala University Hospital, Uppsala, Sweden
- Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Isto Huvila
- Department of Archives, Libraries & Museums, Uppsala University, Uppsala, Sweden
| | - Bridget Kane
- Business School, Karlstad University, Karlstad, Sweden
| | - Monika Alise Johansen
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Leventhal-Perek S, Shani M, Schonmann Y. Effectiveness and persistence of anti-obesity medications (liraglutide 3 mg, lorcaserin, and orlistat) in a real-world primary care setting. Fam Pract 2023; 40:629-637. [PMID: 36477550 DOI: 10.1093/fampra/cmac141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Obesity is a chronic disease with rising prevalence. Guidelines suggest medications for obesity management if lifestyle interventions do not lead to substantial weight loss. Randomized control trials have shown the efficacy of anti-obesity medications in inducing weight loss, but real-world data are lacking. Therefore, our study aims to evaluate anti-obesity medications' effectiveness in reducing weight and improving cardiometabolic parameters and to assess their persistence in a real-world setting. METHODS A historical cohort study using routinely collected data from Clalit Health Services (CHS). We retrieved data on all CHS members aged ≥20 years who initiated anti-obesity medication (orlistat, liraglutide 3 mg, and lorcaserin) between 2018 and 2020. We assessed average weight loss and the percentage of patients that had lost ≥5% and ≥10% of their body weight at 3, 6, and 9 months and compared the effectiveness of these 3 medications. RESULTS We included 5,306 CHS members in our study; most (77.8%) were female, aged 40-59 years (52.4%). Treatment with liraglutide 3 mg and lorcaserin was associated with subsequent weight reduction. The average weight loss at 6 months was 5.6 kg (4.95-6.25, 95% confidence interval [CI]) with liraglutide 3 mg and 1.7 kg (1.2-2.2, 95% CI) with lorcaserin. There was no evidence that treatment with orlistat was associated with subsequent weight loss (-0.18 kg [-0.8 to 0.4, 95% CI]). At 6 months, 38% of the patients with orlistat, 43% with lorcaserin, and 51% with liraglutide 3 mg persisted with their treatments (P < 0.001). CONCLUSION Liraglutide 3 mg was the primary medication associated with clinically significant weight loss and had the highest persistence rate in our real-world study.
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Affiliation(s)
- Sharon Leventhal-Perek
- Department of Family Medicine, Tel Aviv District, Clalit Health Services, Tel Aviv, Israel
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Shani
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Family Medicine, Central District, Clalit Health Service, Rehovot, Israel
| | - Yochai Schonmann
- Department of Family Medicine, Tel Aviv District, Clalit Health Services, Tel Aviv, Israel
- Department of Quality Measurements and Research, Clalit Health Services, Tel Aviv, Israel
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Ji L, Jiang H, Cheng Z, Qiu W, Liao L, Zhang Y, Li X, Pang S, Zhang L, Chen L, Yang T, Li Y, Qu S, Wen J, Gu J, Deng H, Wang Y, Li L, Han-Zhang H, Ma Q, Qian L. A phase 2 randomised controlled trial of mazdutide in Chinese overweight adults or adults with obesity. Nat Commun 2023; 14:8289. [PMID: 38092790 PMCID: PMC10719339 DOI: 10.1038/s41467-023-44067-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023] Open
Abstract
Mazdutide is a once-weekly glucagon-like peptide-1 (GLP-1) and glucagon receptor dual agonist. We evaluated the efficacy and safety of 24-week treatment of mazdutide up to 6 mg in Chinese overweight adults or adults with obesity, as an interim analysis of a randomised, two-part (low doses up to 6 mg and high dose of 9 mg), double-blind, placebo-controlled phase 2 trial (ClinicalTrials.gov, NCT04904913). Overweight adults (body-mass index [BMI] ≥24 kg/m2) accompanied by hyperphagia and/or at least one obesity-related comorbidity or adults with obesity (BMI ≥ 28 kg/m2) were randomly assigned (3:1:3:1:3:1) to once-weekly mazdutide 3 mg, 4.5 mg, 6 mg or matching placebo at 20 hospitals in China. The primary endpoint was the percentage change from baseline to week 24 in body weight. A total of 248 participants were randomised to mazdutide 3 mg (n = 62), 4.5 mg (n = 63), 6 mg (n = 61) or placebo (n = 62). The mean percentage changes from baseline to week 24 in body weight were -6.7% (SE 0.7) with mazdutide 3 mg, -10.4% (0.7) with 4.5 mg, -11.3% (0.7) with 6 mg and 1.0% (0.7) with placebo, with treatment difference versus placebo ranging from -7.7% to -12.3% (all p < 0.0001). All mazdutide doses were well tolerated and the most common adverse events included diarrhoea, nausea and upper respiratory tract infection. In summary, in Chinese overweight adults or adults with obesity, 24-week treatment with mazdutide up to 6 mg was safe and led to robust and clinically meaningful body weight reduction.
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Affiliation(s)
- Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China.
| | - Hongwei Jiang
- The First Affiliated Hospital and Clinical Medicine College, Henan University of Science and Technology, Luoyang, China
| | - Zhifeng Cheng
- Department of Endocrinology and Metabolism, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wei Qiu
- Department of Endocrinology, Huzhou Central Hospital, Huzhou, China
| | - Lin Liao
- Department of Endocrinology, Shandong Province Qianfoshan Hospital, Jinan, China
| | - Yawei Zhang
- Department of Endocrinology, Pingxiang People's Hospital, Pingxiang, China
| | - Xiaoli Li
- Department of Endocrinology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Shuguang Pang
- Department of Endocrinology, Jinan Central Hospital, Jinan, China
| | - Lihui Zhang
- Department of Endocrinology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Liming Chen
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Tao Yang
- Department of Endocrinology, Jiangsu Province Hospital, Nanjing, China
| | - Yan Li
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Shen Qu
- Department of Endocrinology, Shanghai Tenth People's Hospital of Tong Ji University, Shanghai, China
| | - Jie Wen
- Innovent Biologics, Inc., Suzhou, China
| | - Jieyu Gu
- Innovent Biologics, Inc., Suzhou, China
| | - Huan Deng
- Innovent Biologics, Inc., Suzhou, China
| | | | - Li Li
- Innovent Biologics, Inc., Suzhou, China
| | | | | | - Lei Qian
- Innovent Biologics, Inc., Suzhou, China.
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Abstract
Obesity has been recognized to be increasing globally and is designated a disease with adverse consequences requiring early detection and appropriate care. In addition to being related to metabolic syndrome disorders such as type 2 diabetes, hypertension, stroke, and premature coronary artery disease. Obesity is also etiologically linked to several cancers. The non-gastrointestinal cancers are breast, uterus, kidneys, ovaries, thyroid, meningioma, and thyroid. Gastrointestinal (GI) cancers are adenocarcinoma of the esophagus, liver, pancreas, gallbladder, and colorectal. The brighter side of the problem is that being overweight and obese and cigarette smoking are mostly preventable causes of cancers. Epidemiology and clinical studies have revealed that obesity is heterogeneous in clinical manifestations. In clinical practice, BMI is calculated by dividing a person's weight in kilograms by the square of the person's height in square meters (kg/m2). A BMI above 30 kg/m2 (defining obesity in many guidelines) is considered obesity. However, obesity is heterogeneous. There are subdivisions for obesity, and not all obesities are equally pathogenic. Adipose tissue, in particular, visceral adipose tissue (VAT), is endocrine and abdominal obesity (a surrogate for VAT) is evaluated by waist-hip measurements or just waist measures. Visceral Obesity, through several hormonal mechanisms, induces a low-grade chronic inflammatory state, insulin resistance, components of metabolic syndrome, and cancers. Metabolically obese, normal-weight (MONW) individuals in several Asian countries may have BMI below normal levels to diagnose obesity but suffer from many obesity-related complications. Conversely, some people have high BMI but are generally healthy with no features of metabolic syndrome. Many clinicians advise weight loss by dieting and exercise to metabolically healthy obese with large body habitus than to individuals with metabolic obesity but normal BMI. The GI cancers (esophagus, pancreas, gallbladder, liver, and colorectal) are individually discussed, emphasizing the incidence, possible pathogenesis, and preventive measures. From 2005 to 2014, most cancers associated with overweight and Obesity increased in the United States, while cancers related to other factors decreased. The standard recommendation is to offer or refer adults with a body mass index (BMI) of 30 or more to intensive, multicomponent behavioral interventions. However, the clinicians have to go beyond. They should critically evaluate BMI with due consideration for ethnicity, body habitus, and other factors that influence the type of obesity and obesity-related risks. In 2001, the Surgeon General's ``Call to Action to Prevent and Decrease Overweight and Obesity'' identified obesity as a critical public health priority for the United States. At government levels reducing obesity requires policy changes that improve the food and physical activity for all. However, implementing some policies with the most significant potential benefit to public health is politically tricky. The primary care physician, as well as subspecialists, should identify overweight and Obesity based on all the variable factors in the diagnosis. The medical community should address the prevention of overweight and Obesity as an essential part of medical care as much as vaccination in preventing infectious diseases at all levels- from childhood, to adolescence, and adults.
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Affiliation(s)
- Yuntao Zou
- Department of Medicine, Saint Peter's University Hospital, 125 Andover DR, Kendall Park, New Brunswick, NJ 08901, USA
| | - Capecomorin S Pitchumoni
- Department of Medicine, Saint Peter's University Hospital, 125 Andover DR, Kendall Park, New Brunswick, NJ 08901, USA.
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Langyan S, Yadava P, Khan FN, Sharma S, Singh R, Bana RS, Singh N, Kaur V, Kalia S, Kumar A. Trends and advances in pre- and post-harvest processing of linseed oil for quality food and health products. Crit Rev Food Sci Nutr 2023:1-24. [PMID: 38032160 DOI: 10.1080/10408398.2023.2280768] [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] [Indexed: 12/01/2023]
Abstract
Linseed is an ancient crop used for diverse purposes since the beginning of civilization. In recent times, linseed has emerged as a superfood due to its high content of health-promoting omega-3 fatty acids and other bioactive compounds. Among primary health effects, it has potential to manage hypertension, diabetes, osteoporosis, atherosclerosis, cancer, arthritis, neurological, cardiovascular diseases including blood cholesterol levels, constipation, diarrhea, and autoimmune disorders etc. due to the presence of omega-3 fatty acid, lignans, high dietary fibers, and proteins, whereas, secondary health effects comprise of relieving from various skin disorders. Due to these health-beneficial properties, interest in linseed oil necessitates the intensification of research efforts on various aspects. These include cultivation technology, varietal and genetic improvement, post-harvest processing, profiling of nutrients and bioactive compounds, pre-clinical and clinical studies, etc. The present review discussed the advances in linseed research including pre- and post-harvest processing. However, focus on the bioactive compounds present in linseed oil and their health effects are also presented. Linseed cultivation, pre- and post-harvest processing aspects are covered including climatic, edaphic, agronomic factors, type of cultivar and storage conditions etc, which impact the overall oil yield and its nutritional quality. Various emerging applications of linseed oil in functional food, nutraceutical, pharmaceutical, and cosmeceutical preparations were also presented in detail. Further, recommendations were made on linseed oil research in the field of genetics, breeding germplasm resources and genome editing for exploring its full applications as a nutrition and health product.
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Affiliation(s)
- Sapna Langyan
- ICAR-National Bureau of Plant Genetic Resources, New Delhi, India
| | - Pranjal Yadava
- Indian Agricultural Research Institute, New Delhi, India
| | | | - Sanjula Sharma
- Oilseed Section, Punjab Agricultural University, Ludhiana, India
| | - Renu Singh
- Indian Agricultural Research Institute, New Delhi, India
| | | | - Nisha Singh
- National Institute for Plant Biotechnology, New Delhi, India
| | - Vikender Kaur
- ICAR-National Bureau of Plant Genetic Resources, New Delhi, India
| | | | - Ashok Kumar
- ICAR-National Bureau of Plant Genetic Resources, New Delhi, India
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Wangler J, Jansky M. How are people with obesity managed in primary care? - results of a qualitative, exploratory study in Germany 2022. Arch Public Health 2023; 81:196. [PMID: 37957725 PMCID: PMC10641940 DOI: 10.1186/s13690-023-01214-z] [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: 04/06/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Counselling and management of overweight and obesity are tasks for which general practitioners possess favourable qualifications. Based on a long-term doctor-patient relationship, GPs have various options for actions to deal with overweight problems. To date, however, there is only little evidence on the experiences which people with obesity have made with the primary physician model and the care needs and wishes they actually address to their GPs. This study investigated what experiences people with obesity have had with GP care and what care needs and wishes they communicated to their GPs. The results will be used to derive starting points for optimising the primary healthcare setting. METHODS A total of 32 individuals affected by obesity were recruited over 24 online health forums. With them, we conducted qualitative interviews in the time between April and October 2022. RESULTS The respondents considered the primary care physician to be the central contact person when they sought advice and support with weight problems. The advice of the GP was associated with an increased willingness to deal with reducing one's own weight. Despite this positive perception, widespread drawbacks existed from the perspective of the respondents: (1) incidental or late discovery of obesity, (2) absence of continuous weight counselling, (3) no agreement on specific weight reduction goals, (4) no referrals to help and support services, (5) insensitive discussion. Only some of the respondents who have recently been able to reduce their weight sustainably attributed their success primarily to the support they received from their GP. CONCLUSION GPs should be encouraged to address obesity consistently and promptly. In addition, concrete recommendations and realistic goals for weight loss should be formulated. Continuous and motivating discussions are crucial in this regard. A focus on nutrition and exercise counselling in the GP's office should also be encouraged. GPs should be strengthened in their role as mediators by integrating their patients into a network of further assistance as needed. The development of care structures for obesity management should be promoted.
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Affiliation(s)
- Julian Wangler
- University Medical Center of the Johannes Gutenberg University Mainz, Centre for General Medicine and Geriatrics - Mainz, Mainz, Germany.
| | - Michael Jansky
- University Medical Center of the Johannes Gutenberg University Mainz, Centre for General Medicine and Geriatrics - Mainz, Mainz, Germany
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Guglielmi V, Capoccia D, Russo B, Lubrano C, Mariani S, Poggiogalle E, Furia G, Alizadeh AH, Patrizi C, Sapienza M, Damiani G, Tarsitano MG, Conte C, Frontoni S. Knowledge, experiences, and perceptions relating to obesity management among primary care physicians in the Lazio Region, Italy. Front Endocrinol (Lausanne) 2023; 14:1249233. [PMID: 38027122 PMCID: PMC10668048 DOI: 10.3389/fendo.2023.1249233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Primary care providers (PCPs) play an essential role in obesity care as they represent the first contact for patients seeking weight loss interventions. Objective This study explored the knowledge, experiences, and perceptions of PCPs in the Lazio Region of Italy in the management of obesity. Design and subjects We conducted an anonymous survey delivered from March to July 2022 via the newsletter of Rome Provincial Order of Physicians and Dentists and at the annual meeting of the regional section of the Italian Obesity Society. Approach The survey consisted of 24 closed-ended questions grouped into 5 sections: sociodemographic and work information; assessment of obesity; management of obesity; connections with regional Centres for Obesity Management; attitudes towards obesity. Key results A total of 92 PCPs accessed the survey. Of those, 2.2% were excluded because they did not see any patients with obesity. A total of 68 PCPs (75.6%) had complete questionnaires and were included in this analysis. All participants reported asking their patients about their eating habits, lifestyle, and clinical complications at the first assessment. Body weight and blood pressure were measured by 98.5% of participants and 82% calculate body mass index (BMI), while a small proportion of PCPs analysed body composition and fat distribution. Over 80% prescribed laboratory tests and ECG. Approximately 40% of PCPs did not refer patients for nutritional counselling, and most prescribed a low-calorie diet. Sixty-three percent referred patients to an endocrinologist, 48.5% to a psychotherapist, and a minority to specialists for obesity complications. Twenty-three percent prescribed anti-obesity medications and 46.5% referred patients for bariatric surgery only in severe cases. Ninety-one percent stated that obesity is "a complex and multifactorial disease" and 7.4% considered obesity to be secondary to other conditions. Conclusions Despite most PCPs adopt a correct approach to manage patients with obesity, many aspects could be improved to ensure optimal and multidisciplinary management.
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Affiliation(s)
- Valeria Guglielmi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Internal Medicine Unit - Obesity Center, University Hospital Policlinico Tor Vergata, Rome, Italy
- Italian Obesity Society (SIO), Pisa, Italy
| | - Danila Capoccia
- Italian Obesity Society (SIO), Pisa, Italy
- Department of Medical Surgical Sciences and Biotechnologies, Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy
| | - Benedetta Russo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Italian Obesity Society (SIO), Pisa, Italy
- Unit of Endocrinology, Diabetes and Metabolism, Fatebenefratelli Gemelli Isola Hospital, Rome, Italy
| | - Carla Lubrano
- Italian Obesity Society (SIO), Pisa, Italy
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Stefania Mariani
- Italian Obesity Society (SIO), Pisa, Italy
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Eleonora Poggiogalle
- Italian Obesity Society (SIO), Pisa, Italy
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Furia
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Rome, Italy
- Local Health Authority Roma 1, Hospital Management Area, Rome, Italy
| | - Aurora Heidar Alizadeh
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cristina Patrizi
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Rome, Italy
| | - Martina Sapienza
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianfranco Damiani
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Maria Grazia Tarsitano
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Rome, Italy
- Department of Medical and Surgical Science, University Magna Grecia, Catanzaro, Italy
| | - Caterina Conte
- Italian Obesity Society (SIO), Pisa, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Sesto San Giovanni, Italy
| | - Simona Frontoni
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Italian Obesity Society (SIO), Pisa, Italy
- Unit of Endocrinology, Diabetes and Metabolism, Fatebenefratelli Gemelli Isola Hospital, Rome, Italy
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Szczyrska J, Brzeziński M, Szlagatys-Sidorkiewicz A. Long-term effects of 12-month integrated weight-loss programme for children with excess body weight- who benefits most? Front Endocrinol (Lausanne) 2023; 14:1221343. [PMID: 38027174 PMCID: PMC10656687 DOI: 10.3389/fendo.2023.1221343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
The aim of the study was to assess long-term effects of the 12-month integrated weight-loss programme in children with excess body weight. We also attempted to identify the determinants of intervention effectiveness. Two groups were included in the analysis: 241 children with excess body weight who participated in the full 12-month intervention (full participation group) and 891 children with excess body weight who did not participate in the intervention (no participation group). Changes in BMI SDS, SBP SDS, DBP SDS and post-exercise HR with a follow-up period of 4 years between this groups were compared. In the full participation group, the reduction in mean BMI SDS was greater, we also observed significantly higher decrease in DBP SDS. Subgroup analysis by age category and sex showed a significant difference in the change in mean BMI SDS (from baseline to follow-up) in the subgroup of younger children and in the subgroup of younger girls. In the subgroup of younger girls significantly higher decrease in DBP SDS and SBP was also observed. Younger children, who participated in the intervention at age 6, particularly girls, benefited the most.
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Affiliation(s)
- Joanna Szczyrska
- Department of Pediatrics, Gastroenterology, Allergology and Pediatric Nutrition, Medical University of Gdansk, Gdansk, Poland
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