Impact of obesity and diabetes on arthritis: An update

Effect of Ketogenic Diet on Obesity and Other Metabolic Disorders: Narrative Review

Obesity is defined as an abnormal or excessive accumulation of fat that increases the burden of different chronic diseases in the population. It has reached epidemic proportions and is a major risk factor for a variety of diseases, including hypertension, cardiovascular disease, type 2 diabetes, dyslipidaemia, atherosclerosis, and some malignancies. Weight gain is a result of excessive energy intake compared to energy expenditure (energy loss from metabolism and physical exercise). A ketogenic diet has a more useful effect on obesity than other diets. A ketogenic diet is a low-carbohydrate, high-fat, moderate-protein diet that induces the production of ketone bodies by mimicking the breakdown of a fasting state. The mechanism behind the ketogenic diet is still unknown, although it obviously helps people with obesity lose weight. Several pathways for the ketogenic diet effect on weight loss have been hypothesized by researchers, including reduced appetite due to effects on appetite control hormones and a possible direct appetite suppressant action of ketone bodies; reduced lipogenesis and increased lipolysis; greater metabolic efficiency; and increased metabolic costs.

Hydro alcoholic green tea extract effect on high fat diet treated NMRI mice and 3T3L1 cells

Purpose

In order to counteract the obesity has epidemics, since current anti-obesity drugs effects remain limited, there is a need to provide new options. As a project aiming to assess potential anti obesity natural compounds, the effects of consumption of a minimal dose of green tea hydro alcoholic extract (GT) on adipocyte differentiation of 3T3L1 cell line were investigated.

Methods

Obesity was induced in female NMRI mice (which are less used overall) by the use of a high fat diet. Mice were divided into four groups of control (C), treated control (TC), obese (O) and treated obese (TO). TC and TO groups received 8 mg/Kg/day of GT for 8 weeks, and weighted weekly, after what biochemical and histological parameters were measured. GT was used at doses of 100,150 and 200 µg/ml on 3T3L1, and staining with Oil-red-O was done for estimation of fat droplet accumulation.

Results

Body weight was found to be affected significantly by GT. Blood glucose levels did not show significant changes between groups, while triglycerides levels of the O group was significantly higher than the C group, but the TO group showed no significant difference with the C group upon GT treatment. Liver and visceral fat tissues showed more normalized tissue and less fat accumulation in the TO group. TO and TC groups showed an ameliorated morphologic state of liver tissues. GT was also able to decrease fat droplet formation in a dose-dependent manner.

Conclusions

Adding a minimal amount of GT to the daily consumption may have preventive effects on fat accumulation in healthy subjects, while in obese cases, GT shows significant therapeutic effect.

Adipocytokines in obese Ghanaian subjects with or without type 2 diabetes

OBJECTIVE

This study aimed to evaluate serum leptin and high sensitivity C-reactive protein (hsCRP) concentrations in obese Ghanaians with or without type 2 diabetes and to find out the extent to which their levels are influenced by underlying disorders.

RESULTS

Obese subjects with type 2 diabetes had lower leptin but higher hsCRP levels compared with obese non-diabetic controls. There were negative correlations within the control group for glucose vs % muscle mass (r = - 0.378, p = 0.016), leptin vs % muscle mass (r = - 0.555, p = 0.001) and within the obese diabetic group for leptin vs % muscle mass (r = - 0.602, p = 0.001). Obese persons without diabetes were about three times more likely to have higher leptin levels compared with their obese diabetic counterparts (Odds ratio = 3.315, p < 0.001). Obese females independently had a tenfold increase in leptin levels compared with obese males.

Can bariatric surgery delay the need for knee replacement in morbidly obese osteoarthritis patients

Objective:

The objective of the study was to find the weight reduction pattern and its outcome on knee pain and function in osteoarthritis (OA) morbidly obese patients’ post-bariatric surgery with dietary and exercise changes.

Methodology:

Thirty morbidly obese (body mass index [BMI] >40 kg/m²) OA patients gave consent for bariatric surgery. Despite wearisome lifestyle modifications for weight loss and knee pain, satisfactory results were not retrieved. We took consent from all the patients predetermined for knee replacement in future because of pain and disability as recommended by knee replacement surgeon. The dietary and exercise protocol was standardised for all patients for bariatrics. Data for weight loss, change in BMI and Western Ontario and McMaster Universities Arthritis Index score consisting of pain, stiffness and activities of daily livings (ADLs) scores were documented at baseline, 3 months and 6 months post-bariatric surgery.

Results

The male-to-female ratio was 1:2. Mean age of the patients was 49.8 ± 8.6 years. Significant changes in pain (P < 0.001), stiffness (P < 0.001) and ADLs (P < 0.001) were found postoperatively at 3 and 6 months. Positive correlation of percentage change of BMI was seen with percentage change in pain (r = 0.479, P = 0.007) and ADLs (r = 0.414, P = 0.023) after 6 months of bariatric surgery. Most of the patients were inclined to delay the knee replacement further by the end of 6 months post-bariatric surgery.

Conclusion:

Bariatric surgery when combined with dietary and exercise changes gave significant results in terms of weight loss, knee pain and function. It is an approach that tackles both obesity and OA. It is a major step forward in stemming the global epidemic of these two interlinked conditions.