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Salis Z, Driban JB, McAlindon TE, Eaton CB, Sainsbury A. Association of Weight Loss and Weight Gain With Structural Defects and Pain in Hand Osteoarthritis: Data From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2024; 76:652-663. [PMID: 38130021 PMCID: PMC11039366 DOI: 10.1002/acr.25284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/13/2023] [Accepted: 12/19/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Our aim was to define the association of weight change (weight loss or weight gain) with the incidence and progression of hand osteoarthritis (OA), assessed either by radiography or by pain, using data from the Osteoarthritis Initiative. METHODS Among the 4,796 participants, we selected 4,598 participants, excluding those with cancer or rheumatoid arthritis or a body mass index under 18.5 kg/m2. We investigated the association of weight change with incidence and progression of radiographic hand OA and the development and resolution of hand pain. Using multivariable logistic regression, we investigated the association of weight change from baseline to the 4-year follow-up with the incidence and progression of radiographic hand OA at the 4-year follow-up. Additionally, multivariable repeated-measure mixed-effects logistic regression analyzed the association of weight change with the development and resolution of hand pain across 2-year, 4-year, 6-year, and 8-year follow-ups. RESULTS No statistically significant associations were observed between weight change and the investigated outcomes. Specifically, for each 5% weight loss, the odds ratios for the incidence and progression of radiographic hand OA were 0.90 (95% confidence interval [95% CI] 0.67-1.23) and 0.92 (95% CI 0.84-1.00), respectively. Similarly, for each 5% weight loss, the odds ratios for the development and resolution of hand pain at the 8-year follow-up were 1.00 (95% CI 0.92-1.09) and 1.07 (95% CI 0.91-1.25), respectively. CONCLUSION Our study found no evidence of an association between weight change and the odds of incidence or progression of radiographic hand OA over 4 years, nor the development or resolution of hand pain over 8 years.
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Affiliation(s)
- Zubeyir Salis
- Division of Rheumatology, Geneva University Hospital and Faculty of Medicine, University of Geneva, Geneva, Switzerland
- The University of Western Australia, School of Human Sciences, Perth, WA, Australia
- The University of New South Wales, Centre for Big Data Research in Health, Kensington, NSW, Australia
| | - Jeffrey B. Driban
- UMass Chan Medical School, Department of Population and Quantitative Health Sciences
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, and Immunology; Tufts Medical Center; Boston, MA, USA
| | - Charles B. Eaton
- Alpert Medical School of Brown University, Providence, Rhode Island; Center for Primary Care and Prevention, Pawtucket, Rhode Island; and Brown University School of Public Health, Providence, Rhode Island
| | - Amanda Sainsbury
- The University of Western Australia, School of Human Sciences, Perth, WA, Australia
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Salis Z, Sainsbury A. Association of long-term use of non-steroidal anti-inflammatory drugs with knee osteoarthritis: a prospective multi-cohort study over 4-to-5 years. Sci Rep 2024; 14:6593. [PMID: 38504099 PMCID: PMC10950850 DOI: 10.1038/s41598-024-56665-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/08/2024] [Indexed: 03/21/2024] Open
Abstract
This study examines the long-term impact of non-steroidal anti-inflammatory drugs (NSAIDs) on the progression of symptoms and structural deterioration of the joint in knee osteoarthritis. The study analyzes data from 4197 participants (8394 knees) across the Osteoarthritis Initiative (OAI), Multicenter Osteoarthritis Study (MOST), and Cohort Hip and Cohort Knee (CHECK) over 4-to-5 years. Adjustments were made for major covariates. We focussed on binary outcomes to assess the presence or absence of significant changes. We found that, relative to non-users, individuals using NSAIDs long-term were significantly more likely to experience aggravated symptoms exceeding the minimally clinically important difference, specifically, pain (OR: 2.04, 95% CI: 1.66-2.49), disability (OR: 2.21, 95% CI: 1.74-2.80), and stiffness (OR: 1.58, 95% CI: 1.29-1.93). Long-term users also faced a higher probability than non-users of having total knee replacement (OR: 3.13, 95% CI: 2.08-4.70), although no significant difference between long-term users and non-users was observed for structural deterioration in the knee joint (OR: 1.25, 95% CI: 0.94-1.65). While acknowledging the limitations of this study due to its observational design and the potential for bidirectional causality, these findings suggest that long-term NSAID use could accelerate the progression to total knee replacement by markedly exacerbating symptoms.
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Affiliation(s)
- Zubeyir Salis
- Division of Rheumatology, Geneva University Hospital and Faculty of Medicine, University of Geneva, HUG Av. de Beau-Séjour 26, 1206, Geneva, Switzerland.
- Centre for Big Data Research in Health, The University of New South Wales, Kensington, NSW, Australia.
- School of Human Sciences, The University of Western Australia, Perth, WA, Australia.
| | - Amanda Sainsbury
- School of Human Sciences, The University of Western Australia, Perth, WA, Australia
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Salis Z, Driban JB, McAlindon TE, Sainsbury A. Evaluation of a measure of end-stage knee osteoarthritis compared to total knee replacement: An observational study using multicohort data. Semin Arthritis Rheum 2024; 64:152336. [PMID: 38096677 DOI: 10.1016/j.semarthrit.2023.152336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/31/2023] [Accepted: 11/28/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES To determine if an end-stage knee osteoarthritis (esKOA) measure, based on symptomatic and radiographic criteria, can indicate progression to severe KOA earlier and with fewer research participants than total knee replacement (TKR). We employed both interventional and observational study designs as examples to estimate the required sample sizes. EsKOA in a knee was declared if either of the following two conditions were met: 1) moderate, intense, or severe symptoms of KOA indicated by pain and disability measurement and severe KOA indicated by radiographically-assessed knee structure; 2) intense or severe symptoms of KOA indicated by pain and disability measurement and frequent knee pain with mild or moderate KOA as indicated by radiographically-assessed knee structure. METHODS We examined the association between weight loss from baseline to 2-to-2.5-year and 4-to-5-year follow-ups and the odds of esKOA and TKR in 5,593 participants (10,357 knees) from the Osteoarthritis Initiative (OAI) and the Multicenter Osteoarthritis Study (MOST). We also estimated the sample sizes needed for interventional and observational study designs to detect a 10, 20, or 50% reduction in the incidence of esKOA and TKR. RESULTS The association of weight loss with both esKOA and TKR was detected at the 4-to-5-year follow-up. However, at the 2-to-2.5-year follow-up, the association was detected for esKOA but not TKR. The required sample sizes for detecting associations of weight loss with the incidence of esKOA were 85% to 93% smaller than those for TKR at the 4-to-5-year and 2-to-2.5-year follow-ups, respectively. CONCLUSION The esKOA measure enables shorter and smaller studies compared to using TKR as an outcome.
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Affiliation(s)
- Zubeyir Salis
- Division of Rheumatology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland; School of Human Sciences, The University of Western Australia, Perth, WA, Australia; Centre for Big Data Research in Health, The University of New South Wales, Kensington, NSW, Australia.
| | - Jeffrey B Driban
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, MA, USA
| | - Timothy E McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA, USA
| | - Amanda Sainsbury
- School of Human Sciences, The University of Western Australia, Perth, WA, Australia
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Lobo I, da Luz FQ, Hay P, Gaeta TL, Teixeira PC, Cordás TA, Sainsbury A, Salis Z. Is binge eating associated with poor weight loss outcomes in people with a high body weight? A systematic review with meta-analyses. Eat Weight Disord 2023; 28:89. [PMID: 37889364 PMCID: PMC10611631 DOI: 10.1007/s40519-023-01613-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/15/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVES This systematic review aimed to compare the weight change in people with or without binge eating who underwent various weight loss treatments. METHODS We searched for studies in PubMed, American Psychological Association, and Embase from inception to January 2022. The studies selected included assessment of binge eating and body weight before and after weight loss treatment in people of any age. The meta-analyses were conducted using Comprehensive Meta-Analysis (CMA). We used Egger's regression test, the funnel plot, and the Trim and Fill test to assess the risk of publication bias. RESULTS Thirty-four studies were included in the systematic review, with a total of 10.184 participants. The included studies were divided into three categories according to types of weight loss treatments, namely, (1) bariatric surgery; (2) pharmacotherapy isolated or combined with behavioral interventions; and (3) behavioral and/or nutritional interventions. The meta-analyses showed no significant difference in weight loss between people with or without binge eating engaged in weight loss treatments, with an overall effect size of - 0.117 (95% CI - 0.405 to 0.171; P = 0.426). CONCLUSIONS Our findings showed no difference in weight loss in people with or without pre-treatment binge eating who received various weight loss treatments. Weight loss treatments should not be withheld on the basis that they will not be effective in people with pre-treatment binge eating, albeit their safety and longer term impacts are unclear. LEVEL OF EVIDENCE Level I, at least one properly designed randomized controlled trials; systematic reviews and meta-analyses; experimental studies.
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Affiliation(s)
- Isabella Lobo
- Faculty of Medicine, Institute of Psychiatry, Eating Disorders Program (AMBULIM), University of São Paulo, São Paulo, SP, Brazil
| | - Felipe Q da Luz
- Faculty of Medicine, Institute of Psychiatry, Eating Disorders Program (AMBULIM), University of São Paulo, São Paulo, SP, Brazil
| | - Phillipa Hay
- School of Medicine, Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Tamiris L Gaeta
- Faculty of Medicine, Institute of Psychiatry, Eating Disorders Program (AMBULIM), University of São Paulo, São Paulo, SP, Brazil
| | - Paula Costa Teixeira
- Faculty of Medicine, Institute of Psychiatry, Eating Disorders Program (AMBULIM), University of São Paulo, São Paulo, SP, Brazil
| | - Táki Athanássios Cordás
- Faculty of Medicine, Institute of Psychiatry, Eating Disorders Program (AMBULIM), University of São Paulo, São Paulo, SP, Brazil
| | - Amanda Sainsbury
- School of Human Sciences, The University of Western Australia, Perth, WA, Australia
| | - Zubeyir Salis
- School of Human Sciences, The University of Western Australia, Perth, WA, Australia.
- Faculty of Medicine, School of Public Health, Centre for Big Data Research in Health, University of New South Wales, Kensington, NSW, Australia.
- Division of Rheumatology, Geneva University Hospital and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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Salis Z, Lui LY, Lane NE, Ensrud K, Sainsbury A. Investigation of the association of weight loss with radiographic hip osteoarthritis in older community-dwelling female adults. J Am Geriatr Soc 2023; 71:2451-2461. [PMID: 37074126 PMCID: PMC10624600 DOI: 10.1111/jgs.18371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/06/2023] [Accepted: 03/18/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVE Most guidelines recommending weight loss for hip osteoarthritis are based on research on knee osteoarthritis. Prior studies found no association between weight loss and hip osteoarthritis, but no previous studies have targeted older adults. Therefore, we aimed to determine whether there is any clear benefit of weight loss for radiographic hip osteoarthritis in older adults because weight loss is associated with health risks in older adults. METHODS We used data from white female participants aged ≥65 years from the Study of Osteoporotic Fractures. Our exposure of interest was weight change from baseline to follow-up at 8 years. Our outcomes were the development of radiographic hip osteoarthritis (RHOA) and the progression of RHOA over 8 years. Generalized estimating equations (clustering of 2 hips per participant) were used to investigate the association between exposure and outcomes adjusted for major covariates. RESULTS There was a total of 11,018 hips from 5509 participants. There was no associated benefit of weight loss for either of our outcomes. The odds ratios (95% confidence intervals) for the development and progression of RHOA were 0.99 (0.92-1.07) and 0.97 (0.86-1.09) for each 5% weight loss, respectively. The results were consistent in sensitivity analyses where participants were limited to those who reported trying to lose weight and who also had a body mass index in the overweight or obese range. CONCLUSION Our findings suggest no associated benefit of weight loss in older female adults in the structure of the hip joint as assessed by radiography.
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Affiliation(s)
- Zubeyir Salis
- Centre for Big Data Research in Health, The University of New South Wales, Kensington, New South Wales, Australia
| | - Li-Yung Lui
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Nancy E Lane
- Department of Medicine, School of Medicine, University of California at Davis, Sacramento, California, USA
| | - Kristine Ensrud
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
| | - Amanda Sainsbury
- School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
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Jebeile H, Lister NB, Libesman S, Hunter KE, McMaster CM, Johnson BJ, Baur LA, Paxton SJ, Garnett SP, Ahern AL, Wilfley DE, Maguire S, Sainsbury A, Steinbeck K, Askie L, Braet C, Hill AJ, Nicholls D, Jones RA, Dammery G, Grunseit AM, Cooper K, Kyle TK, Heeren FA, Quigley F, Barnes RD, Bean MK, Beaulieu K, Bonham M, Boutelle KN, Branco BHM, Calugi S, Cardel MI, Carpenter K, Cheng HL, Dalle Grave R, Danielsen YS, Demarzo M, Dordevic A, Eichen DM, Goldschmidt AB, Hilbert A, Houben K, Lofrano do Prado M, Martin CK, McTiernan A, Mensinger JL, Pacanowski C, do Prado WL, Ramalho SM, Raynor HA, Rieger E, Robinson E, Salvo V, Sherwood NE, Simpson SA, Skjakodegard HF, Smith E, Partridge S, Tanofsky-Kraff M, Taylor RW, Van Eyck A, Varady KA, Vidmar AP, Whitelock V, Yanovski J, Seidler AL. Eating disorders in weight-related therapy (EDIT): Protocol for a systematic review with individual participant data meta-analysis of eating disorder risk in behavioural weight management. PLoS One 2023; 18:e0282401. [PMID: 37428754 PMCID: PMC10332604 DOI: 10.1371/journal.pone.0282401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/07/2023] [Indexed: 07/12/2023] Open
Abstract
The Eating Disorders In weight-related Therapy (EDIT) Collaboration brings together data from randomised controlled trials of behavioural weight management interventions to identify individual participant risk factors and intervention strategies that contribute to eating disorder risk. We present a protocol for a systematic review and individual participant data (IPD) meta-analysis which aims to identify participants at risk of developing eating disorders, or related symptoms, during or after weight management interventions conducted in adolescents or adults with overweight or obesity. We systematically searched four databases up to March 2022 and clinical trials registries to May 2022 to identify randomised controlled trials of weight management interventions conducted in adolescents or adults with overweight or obesity that measured eating disorder risk at pre- and post-intervention or follow-up. Authors from eligible trials have been invited to share their deidentified IPD. Two IPD meta-analyses will be conducted. The first IPD meta-analysis aims to examine participant level factors associated with a change in eating disorder scores during and following a weight management intervention. To do this we will examine baseline variables that predict change in eating disorder risk within intervention arms. The second IPD meta-analysis aims to assess whether there are participant level factors that predict whether participation in an intervention is more or less likely than no intervention to lead to a change in eating disorder risk. To do this, we will examine if there are differences in predictors of eating disorder risk between intervention and no-treatment control arms. The primary outcome will be a standardised mean difference in global eating disorder score from baseline to immediately post-intervention and at 6- and 12- months follow-up. Identifying participant level risk factors predicting eating disorder risk will inform screening and monitoring protocols to allow early identification and intervention for those at risk.
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Affiliation(s)
- Hiba Jebeile
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Natalie B Lister
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Sol Libesman
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Kylie E Hunter
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Caitlin M McMaster
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
| | - Brittany J Johnson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Weight Management Services, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Sarah P Garnett
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Kids Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Amy L Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Denise E Wilfley
- Washington University in St. Louis, St Louis, Missouri, United States of America
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Amanda Sainsbury
- The University of Western Australia, School of Human Sciences, Crawley, Western Australia, Australia
| | - Katharine Steinbeck
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- The Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Lisa Askie
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan, Ghent, Belgium
| | - Andrew J Hill
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Dasha Nicholls
- Division of Psychiatry, Imperial College London, London, United Kingdom
- NIHR ACR Northwest London, London, United Kingdom
| | - Rebecca A Jones
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Genevieve Dammery
- InsideOut Institute for Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Alicia M Grunseit
- Weight Management Services, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Kelly Cooper
- Weight Issues Network, New South Wales, Australia
| | - Theodore K Kyle
- ConscienHealth, Pittsburgh, Pennsylvania, United States of America
| | - Faith A Heeren
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, United States of America
| | - Fiona Quigley
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, Co. Antrim, Northern Ireland
| | - Rachel D Barnes
- University of Minnesota Medical School, Minneapolis, Minnesota, United States of America
| | - Melanie K Bean
- Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Kristine Beaulieu
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | | | - Kerri N Boutelle
- Department of Pediatrics, University of California, San Diego, San Diego, California, United States of America
| | | | - Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda (VR), Italy
| | - Michelle I Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, United States of America
- WW International, Inc., New York, NY, United States of America
| | - Kelly Carpenter
- Optum Center for Wellbeing Research, Seattle, Washington, United States of America
| | - Hoi Lun Cheng
- The Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda (VR), Italy
| | | | - Marcelo Demarzo
- Mente Aberta, The Brazilian Center for Mindfulness and Health Promotion, Univesidade Federal de São Paulo, UNIFESP, Brazil
| | | | - Dawn M Eichen
- Department of Pediatrics, University of California, San Diego, San Diego, California, United States of America
| | - Andrea B Goldschmidt
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Philadelphia, United States of America
| | - Anja Hilbert
- Research Unit Behavioral Medicine, Integrated Research and Treatment Center Adiposity Diseases, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Katrijn Houben
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Mara Lofrano do Prado
- Department of Psychology, California State University, San Bernardino, California, United States of America
- Department of Kinesiology, California State University, San Bernardino, California, United States of America
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
| | - Anne McTiernan
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, United States of America
| | - Janell L Mensinger
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, Florida, United States of America
| | - Carly Pacanowski
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, United States of America
| | - Wagner Luiz do Prado
- Department of Kinesiology, California State University, San Bernardino, California, United States of America
| | - Sofia M Ramalho
- Psychology Research Centre, School of Psychology, University of Minho, Campus Gualtar, Braga, Portugal
| | - Hollie A Raynor
- Department of Nutrition, University of Tennessee, Knoxville, Tennessee, United States of America
| | - Elizabeth Rieger
- Research School of Psychology, Australian National University, Canberra, Australia
| | - Eric Robinson
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Vera Salvo
- Mente Aberta, The Brazilian Center for Mindfulness and Health Promotion, Univesidade Federal de São Paulo, UNIFESP, Brazil
| | - Nancy E Sherwood
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Sharon A Simpson
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | | | - Evelyn Smith
- School of Psychology, Western Sydney University, Sydney, New South Wales, Australia
| | - Stephanie Partridge
- Engagement and Co-design Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Marian Tanofsky-Kraff
- Departments of Medical and Clinical Psychology and Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Annelies Van Eyck
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium
- Member of the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
- Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium
| | - Krista A Varady
- University of Illinois Chicago, Department of Kinesiology and Nutrition, Chicago, Illinois, United States of America
| | - Alaina P Vidmar
- Children's Hospital Los Angeles and Keck School of Medicine of University of Southern California, Los Angeles, CA, United States of America
- Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Los Angeles, California, United States of America
| | | | - Jack Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, Maryland, United States of America
| | - Anna L Seidler
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
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Salis Z, Sainsbury A. Association of Change in Body Mass Index With Incidence and Progression of the Structural Defects of Hip Osteoarthritis: Data From the Osteoarthritis Initiative and the Cohort Hip and Cohort Knee study. Arthritis Care Res (Hoboken) 2023; 75:1527-1537. [PMID: 36354244 PMCID: PMC10952232 DOI: 10.1002/acr.25057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 10/14/2022] [Accepted: 11/08/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To define the association between change in body mass index (BMI) and the incidence and progression of structural defects of hip osteoarthritis as assessed by radiography. METHODS We used data from 2 independent cohort studies: the Osteoarthritis Initiative (OAI) and the Cohort Hip and Cohort Knee (CHECK) study. Our exposure was change in BMI from baseline to 4-5 years' follow-up. Our outcomes were the incidence and progression of structural defects of hip osteoarthritis as assessed using a modified Croft grade in OAI and the Kellgren/Lawrence grade in the CHECK study. To study incidence, we created incidence cohorts of hips without definite overall structural defects at baseline (i.e., grade <2) and then investigated the odds of hips having definite overall structural defects at follow-up (i.e., grade ≥2). To study progression, we created progression cohorts of hips with definite overall structural defects at baseline (i.e., grade ≥2) and then investigated the odds of having a grade increase of ≥1 from baseline to follow-up. RESULTS There was a total of 5,896 and 1,377 hips in the incidence cohorts, and 303 and 129 hips in the progression cohorts for the OAI and CHECK study, respectively. Change in BMI (decrease or increase) was not associated with any change in odds of the incidence or progression of definite structural defects of hip osteoarthritis in either the OAI or CHECK cohorts. CONCLUSION Weight loss may not be an effective strategy for preventing, slowing, or delaying the structural defects of hip osteoarthritis over 4-5 years.
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Affiliation(s)
- Zubeyir Salis
- University of New South WalesKensingtonNew South WalesAustralia
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Salis Z, Sainsbury A. Association Between Change in Body Mass Index and Knee and Hip Replacements: A Survival Analysis of Seven to Ten Years Using Multicohort Data. Arthritis Care Res (Hoboken) 2023; 75:1340-1350. [PMID: 36106942 PMCID: PMC10953021 DOI: 10.1002/acr.25021] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/01/2022] [Accepted: 09/13/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To define the association between change in body mass index (BMI) and the risk of knee and hip replacement. METHODS We used data from 3 independent cohort studies: the Osteoarthritis Initiative (OAI), the Multicenter Osteoarthritis Study (MOST), and the Cohort Hip and Cohort Knee (CHECK) study, which collected data from adults (45-79 years of age) with or at risk of clinically significant knee osteoarthritis. We conducted Cox proportional hazards regression analysis with clustering of both knees and hips per person to determine the association between change in BMI (our exposure of interest) and the incidence of primary knee and hip replacement over 7-10 years' follow-up. Change in BMI (in kg/m2 ) was calculated between baseline and the last follow-up visit before knee or hip replacement, or for knees and hips that were not replaced, the last follow-up visit. RESULTS A total of 16,362 knees from 8,181 participants, and 16,406 hips from 8,203 participants, were eligible for inclusion in our knee and hip analyses, respectively. Change in BMI was positively associated with the risk of knee replacement (adjusted hazard ratio [HRadj ] 1.03 [95% confidence interval (95% CI) 1.00-1.06]) but not hip replacement (HRadj 1.00 [95% CI 0.95-1.04]). The association between change in BMI and knee replacement was independent of participants' BMI category at baseline (i.e., normal, overweight, or obese). CONCLUSION Public health strategies incorporating weight loss interventions could reduce the burden of knee but not hip replacement surgery.
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Affiliation(s)
- Zubeyir Salis
- University of New South Wales Centre for Big Data Research in HealthKensingtonNew South WalesAustralia
| | - Amanda Sainsbury
- The University of Western AustraliaCrawleyWestern AustraliaAustralia
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9
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Salis Z, Gallego B, Sainsbury A. Researchers in rheumatology should avoid categorization of continuous predictor variables. BMC Med Res Methodol 2023; 23:104. [PMID: 37101144 PMCID: PMC10134601 DOI: 10.1186/s12874-023-01926-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/18/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Rheumatology researchers often categorize continuous predictor variables. We aimed to show how this practice may alter results from observational studies in rheumatology. METHODS We conducted and compared the results of two analyses of the association between our predictor variable (percentage change in body mass index [BMI] from baseline to four years) and two outcome variable domains of structure and pain in knee and hip osteoarthritis. These two outcome variable domains covered 26 different outcomes for knee and hip combined. In the first analysis (categorical analysis), percentage change in BMI was categorized as ≥ 5% decrease in BMI, < 5% change in BMI, and ≥ 5% increase in BMI, while in the second analysis (continuous analysis), it was left as a continuous variable. In both analyses (categorical and continuous), we used generalized estimating equations with a logistic link function to investigate the association between the percentage change in BMI and the outcomes. RESULTS For eight of the 26 investigated outcomes (31%), the results from the categorical analyses were different from the results from the continuous analyses. These differences were of three types: 1) for six of these eight outcomes, while the continuous analyses revealed associations in both directions (i.e., a decrease in BMI had one effect, while an increase in BMI had the opposite effect), the categorical analyses showed associations only in one direction of BMI change, not both; 2) for another one of these eight outcomes, the categorical analyses suggested an association with change in BMI, while this association was not shown in the continuous analyses (this is potentially a false positive association); 3) for the last of the eight outcomes, the continuous analyses suggested an association of change in BMI, while this association was not shown in the categorical analyses (this is potentially a false negative association). CONCLUSIONS Categorization of continuous predictor variables alters the results of analyses and could lead to different conclusions; therefore, researchers in rheumatology should avoid it.
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Affiliation(s)
- Zubeyir Salis
- The University of New South Wales, Centre for Big Data Research in Health, Kensington, NSW, Australia
| | - Blanca Gallego
- The University of New South Wales, Centre for Big Data Research in Health, Kensington, NSW, Australia
| | - Amanda Sainsbury
- School of Human Sciences, The University of Western Australia, Crawley, Perth, WA, 6009, Australia.
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da Luz FQ, Sainsbury A, Salis Z, Hay P, Cordás T, Morin CM, Paulos-Guarnieri L, Pascoareli L, El Rafihi-Ferreira R. A systematic review with meta-analyses of the relationship between recurrent binge eating and sleep parameters. Int J Obes (Lond) 2023; 47:145-164. [PMID: 36581669 DOI: 10.1038/s41366-022-01250-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Sleep problems are known to compound the negative effects of other health issues, such as eating disorders and the associated behavior of binge eating. Previous studies suggested associations between binge eating and sleep problems, but the strength of the relationship is unknown. METHODS We conducted a systematic review with meta-analyses examining the relationship between binge eating and sleep parameters. We searched for studies in Scopus, PubMed, and PsycInfo. The quality of evidence, including risk of bias, was assessed with adaptations of the Newcastle-Ottawa Scale and the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies, depending on study design. Data was synthesized as the difference in sleep between people who did or did not have binge eating. RESULTS Thirty-one reports of studies met our eligibility criteria. Results are presented in 12 meta-analyses. In the 7 reports of studies (with 4448 participants) that assessed poor overall sleep quality, we found poorer overall sleep quality in people with binge eating compared to people without binge eating, with a standardized mean difference of 0.77 (95% confidence interval [CI] 0.61-0.92; P < 0.001), which is a large effect size. In addition, we found evidence that people with binge eating had significantly greater hypersomnia/daytime sleepiness (7 reports of studies with 4370 participants), insomnia (5 reports of studies with 12,733 participants), and difficulty falling asleep (3 reports of studies with 4089 participants) compared to people without binge eating, with moderate effect sizes (standardized mean differences of 0.57-0.66). CONCLUSIONS People with binge eating exhibit poorer overall sleep quality compared to people without binge eating, and may also exhibit greater hypersomnia/daytime sleepiness, insomnia, and difficulty falling asleep. It is recommended that healthcare professionals routinely screen for poor overall sleep quality when treating people with binge eating-and address sleep difficulties when present.
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Affiliation(s)
- Felipe Q da Luz
- The University of Sydney, Faculty of Medicine and Health, Sydney Medical School, Sydney, NSW, Australia.
- University of São Paulo, Faculty of Medicine, Institute of Psychiatry, Eating Disorders Program (AMBULIM), São Paulo, SP, Brazil.
| | - Amanda Sainsbury
- The University of Western Australia, School of Human Sciences, Perth, WA, Australia
| | - Zubeyir Salis
- University of New South Wales, Faculty of Medicine, School of Public Health, Centre for Big Data Research in Health, Kensington, NSW, Australia
| | - Phillipa Hay
- Western Sydney University, School of Medicine, Translational Health Research Institute, Sydney, NSW, Australia
| | - Táki Cordás
- University of São Paulo, Faculty of Medicine, Institute of Psychiatry, Eating Disorders Program (AMBULIM), São Paulo, SP, Brazil
| | - Charles M Morin
- Université Laval, École de Psychologie, Sainte-Foy, Québec, QC, Canada
| | - Léo Paulos-Guarnieri
- University of São Paulo, Faculty of Medicine, Institute of Psychiatry, Sleep Ambulatory (ASONO), São Paulo, SP, Brazil
| | - Luisa Pascoareli
- University of São Paulo, Faculty of Medicine, Institute of Psychiatry, Eating Disorders Program (AMBULIM), São Paulo, SP, Brazil
| | - Renatha El Rafihi-Ferreira
- University of São Paulo, Faculty of Medicine, Institute of Psychiatry, Sleep Ambulatory (ASONO), São Paulo, SP, Brazil
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Lister NB, Baur LA, Paxton SJ, Garnett SP, Ahern AL, Wilfley DE, Maguire S, Sainsbury A, Steinbeck K, Braet C, Hill AJ, Nicholls D, Jones RA, Dammery G, Grunseit A, Cooper K, Kyle TK, Heeren FA, Hunter KE, McMaster CM, Johnson BJ, Seidler AL, Jebeile H. Eating Disorders In weight-related Therapy (EDIT) Collaboration: rationale and study design. Nutr Res Rev 2023:1-11. [PMID: 36788665 DOI: 10.1017/s0954422423000045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The cornerstone of obesity treatment is behavioural weight management, resulting in significant improvements in cardio-metabolic and psychosocial health. However, there is ongoing concern that dietary interventions used for weight management may precipitate the development of eating disorders. Systematic reviews demonstrate that, while for most participants medically supervised obesity treatment improves risk scores related to eating disorders, a subset of people who undergo obesity treatment may have poor outcomes for eating disorders. This review summarises the background and rationale for the formation of the Eating Disorders In weight-related Therapy (EDIT) Collaboration. The EDIT Collaboration will explore the complex risk factor interactions that precede changes to eating disorder risk following weight management. In this review, we also outline the programme of work and design of studies for the EDIT Collaboration, including expected knowledge gains. The EDIT studies explore risk factors and the interactions between them using individual-level data from international weight management trials. Combining all available data on eating disorder risk from weight management trials will allow sufficient sample size to interrogate our hypothesis: that individuals undertaking weight management interventions will vary in their eating disorder risk profile, on the basis of personal characteristics and intervention strategies available to them. The collaboration includes the integration of health consumers in project development and translation. An important knowledge gain from this project is a comprehensive understanding of the impact of weight management interventions on eating disorder risk.
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Affiliation(s)
- Natalie B Lister
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales2145, Australia
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales2145, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Sarah P Garnett
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Kids Research, Sydney Children's Hospital Network, Westmead, New South Wales2145, Australia
| | - Amy L Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Denise E Wilfley
- School of Medicine, Washington University in St. Louis, St. Louis, USA
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, Boden Collaboration for Obesity, Nutrition and Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Amanda Sainsbury
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Katharine Steinbeck
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- The Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, New South Wales2145, Australia
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Andrew J Hill
- Leeds Institute of Health Sciences, University of Leeds, UK
| | - Dasha Nicholls
- Division of Psychiatry, Imperial College London, 2nd Floor, Commonwealth Building, Du Cane Road, London, W12 0NN, UK
| | - Rebecca A Jones
- MRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Genevieve Dammery
- InsideOut Institute for Eating Disorders, Boden Collaboration for Obesity, Nutrition and Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Alicia Grunseit
- The Children's Hospital at Westmead, Nutrition and Dietetics, Weight Management Services, Westmead, New South Wales, NSW 2145, Australia
| | | | | | - Faith A Heeren
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Kylie E Hunter
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Caitlin M McMaster
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
| | - Brittany J Johnson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia5042, Australia
| | - Anna Lene Seidler
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Hiba Jebeile
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales2145, Australia
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12
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Harper C, Maher J, Hsu M, Grunseit A, Seimon R, Sainsbury A. Postmenopausal women’s experiences of weight maintenance following a very low energy diet. Obes Sci Pract 2022. [DOI: 10.1002/osp4.654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Claudia Harper
- The Boden Collaboration for Obesity Nutrition Exercise Faculty of Medicine and Health Charles Perkins Centre The University of Sydney and Eating Disorders Camperdown New South Wales Australia
| | - Judith Maher
- University of the Sunshine Coast School of Health and Behavioural Sciences Sippy Downs QLD4556 Australia
| | - Michelle Hsu
- The Boden Collaboration for Obesity Nutrition Exercise Faculty of Medicine and Health Charles Perkins Centre The University of Sydney and Eating Disorders Camperdown New South Wales Australia
| | - Anne Grunseit
- The University of Sydney Prevention Research Collaboration Sydney School of Public Health Charles Perkins Centre Sydney NSW Australia2006
| | - Radhika Seimon
- The Boden Collaboration for Obesity Nutrition Exercise Faculty of Medicine and Health Charles Perkins Centre The University of Sydney and Eating Disorders Camperdown New South Wales Australia
| | - Amanda Sainsbury
- School of Human Sciences The University of Western Australia Crawley Western Australia Australia
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13
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Harris RA, Fernando HA, Seimon RV, da Luz FQ, Gibson AA, Touyz SW, Sainsbury A. Effects of total diet replacement programs on mental well-being: A systematic review with meta-analyses. Obes Rev 2022; 23:e13465. [PMID: 35997170 PMCID: PMC9786773 DOI: 10.1111/obr.13465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 12/30/2022]
Abstract
This systematic review with meta-analyses assessed the effects of total diet replacement (TDR) programs on mental well-being in clinical trial participants with a body mass index greater than or equal to 25 kg/m2 . TDR programs involve replacing all dietary requirements with nutritionally replete formula foods and are generally administered to induce rapid weight loss. To date, it is largely unclear what effects TDR programs may have on mental well-being, particularly in the long-term. To address this, we screened 25,976 references across six databases and extracted 35 publications. These 35 publications provided sufficient data to evaluate the effects of TDR programs on depression, anxiety, stress, positive affect, negative affect, vitality, role-emotional, social functioning, mental health, mental composite summary score, self-esteem, and general psychological health in 24 meta-analyses. Due to the lack of research comparing TDR programs to comparator groups, 22 of our 24 meta-analyses explored change in these mental well-being sub-domains over time in TDR programs without comparators. Specifically, we assessed the change from pre-diet (before the TDR program) to either post-diet (up to and including two months after the TDR program); and/or follow-up (more than two months after the TDR program). For depression and anxiety, we were also able to assess the change from pre-diet to mid-diet (which fell within two weeks of the diet half-way point). The remaining two meta-analyses assessed the difference in depression scores between a TDR group and a food-based comparator group from pre-diet to post-diet and from pre-diet to follow-up. Across all meta-analyses, our results found no marked adverse effects of TDR programs on any mental well-being sub-domain. In fact, clear improvements were observed for depression, anxiety, stress, vitality, role-emotional, and social functioning at post-diet. Interestingly, the improvements for depression, vitality and role-emotional were maintained at follow-up. All improvements were observed in meta-analyses without comparators. While the two comparator-based meta-analyses showed no difference between TDR programs and food-based diets in depression symptoms, there was low statistical power. For all meta-analyses containing three or more independent samples, we constructed prediction intervals to determine the range within which the mean of the true effects may fall for future populations. While these prediction intervals varied between sub-domains, we found that mean depression scores are only likely to increase (i.e., depression will worsen) in less than 3% of future TDR interventions which meet our inclusion/exclusion criteria. Taken together, we concluded that for adults with a body mass index greater than or equal to 25 kg/m2 , TDR programs are unlikely to lead to marked adverse effects on mental well-being. These findings do not support the exclusion of participants from trials or interventions involving TDR programs based on concerns that these programs may adversely affect mental well-being. In fact, by excluding these participants, they may be prevented from improving their metabolic health and mental well-being.
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Affiliation(s)
- Rebecca A Harris
- Faculty of Medicine and Health, Charles Perkins Centre, Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Camperdown, New South Wales, Australia.,School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Hamish A Fernando
- Faculty of Medicine and Health, Charles Perkins Centre, Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Camperdown, New South Wales, Australia.,School of Biomedical Engineering, Faculty of Engineering, The University of Sydney, Darlington, New South Wales, Australia
| | - Radhika V Seimon
- Faculty of Medicine and Health, Charles Perkins Centre, Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Camperdown, New South Wales, Australia
| | - Felipe Q da Luz
- Faculty of Medicine and Health, Charles Perkins Centre, Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Camperdown, New South Wales, Australia.,Faculty of Medicine, Institute of Psychiatry, Eating Disorders Program (AMBULIM), University of São Paulo, São Paulo, Brazil
| | - Alice A Gibson
- Faculty of Medicine and Health, Charles Perkins Centre, Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Camperdown, New South Wales, Australia.,Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Stephen W Touyz
- School of Psychology, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Amanda Sainsbury
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
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14
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Salis Z, Gallego B, Nguyen TV, Sainsbury A. Association of Decrease in Body Mass Index With Reduced Incidence and Progression of the Structural Defects of Knee Osteoarthritis: A Prospective Multi-Cohort Study. Arthritis Rheumatol 2022; 75:533-543. [PMID: 35974435 DOI: 10.1002/art.42307] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/10/2022] [Accepted: 07/13/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To define the association between change in body mass index (BMI) and the incidence and progression of the structural defects of knee osteoarthritis as assessed by radiography. METHODS Radiographic analyses of knees at baseline and at 4-5 years of follow-up were obtained from the following 3 independent cohort studies: the Osteoarthritis Initiative (OAI) study, the Multicenter Osteoarthritis Study (MOST), and the Cohort Hip and Cohort Knee (CHECK) study. Logistic regression analyses using generalized estimating equations, with clustering of both knees within individuals, were used to investigate the association between change in BMI from baseline to 4-5 years of follow-up and the incidence and progression of knee osteoarthritis. RESULTS A total of 9,683 knees (from 5,774 participants) in an "incidence cohort" and 6,075 knees (from 3,988 participants) in a "progression cohort" were investigated. Change in BMI was positively associated with both the incidence and progression of the structural defects of knee osteoarthritis. The adjusted odds ratio (OR) for osteoarthritis incidence was 1.05 (95% confidence interval [95% CI] 1.02-1.09), and the adjusted OR for osteoarthritis progression was 1.05 (95% CI 1.01-1.09). Change in BMI was also positively associated with degeneration (i.e., narrowing) of the joint space and with degeneration of the femoral and tibial surfaces (as indicated by osteophytes) on the medial but not on the lateral side of the knee. CONCLUSION A decrease in BMI was independently associated with lower odds of incidence and progression of the structural defects of knee osteoarthritis and could be a component in preventing the onset or worsening of knee osteoarthritis.
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Affiliation(s)
- Zubeyir Salis
- Centre for Big Data Research in Health, The University of New South Wales, Kensington, Australia
| | - Blanca Gallego
- Centre for Big Data Research in Health, The University of New South Wales, Kensington, Australia
| | - Tuan V Nguyen
- Centre for Health Technologies, University of Technology Sydney, Ultimo, New South Wales, Australia, and School of Population Health, UNSW Medicine & Health, The University of New South Wales, Kensington, New South Wales, Australia
| | - Amanda Sainsbury
- School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
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15
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Hay P, Palavras MA, da Luz FQ, dos Anjos Garnes S, Sainsbury A, Touyz S, Appolinario JC, Claudino AM. Physical and mental health outcomes of an integrated cognitive behavioural and weight management therapy for people with an eating disorder characterized by binge eating and a high body mass index: a randomized controlled trial. BMC Psychiatry 2022; 22:355. [PMID: 35610603 PMCID: PMC9131673 DOI: 10.1186/s12888-022-04005-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/17/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Bulimia nervosa (BN) and binge eating disorder (BED) are eating disorders (EDs) characterized by recurrent binge eating. They are associated with medical complications, impaired adaptive function and often a high BMI, for which a multidisciplinary treatment approach may be needed. This study explored the efficacy of a novel intervention integrating Cognitive Behavioural Therapy- Enhanced (CBT-E) and weight management for people with recurrent binge eating episodes and high BMI with respect to physical, psychopathological and quality of life outcomes. METHODS Ninety-eight adults diagnosed with BN, BED, or Other Specified/Unspecified Feeding or Eating Disorder (OSFED/UFED) and BMI ≥ 27 to <40 kg/m2 were randomized to a multidisciplinary approach, the Healthy APproach to weIght management and Food in Eating Disorders (HAPIFED) or to CBT-E. Metabolic parameters, health-related quality of life, general psychological and ED symptoms and ED diagnostic status outcomes are reported. Data were analyzed with mixed effects models adopting multiple imputed datasets where data were missing. RESULTS Both HAPIFED and CBT-E showed statistical significance for the time effect, with reduction in stress (p < 0.001), improvement in mental health-related quality of life (p = 0.032), reduction in binge eating severity (p < 0.001), and also in global ED symptoms scores (p < 0.001), with the significant changes found at end of treatment and sustained at 12-month follow-up. However, no statistical significance was found for differences between the interventions in any of the outcomes measured. Despite a high BMI, most participants (> 75%) had blood test results for glucose, insulin, triglycerides and cholesterol within the normal range, and 52% were within the normal range for the physical component of quality of life at baseline with no change during the trial period. CONCLUSION Integrating weight and ED management resulted in comparable outcomes to ED therapy alone. Although adding weight management to an ED intervention had no adverse effects on psychological outcomes, it also had no beneficial effect on metabolic outcomes. Therefore, more intense weight management strategies may be required where indicated to improve metabolic outcomes. Safety will need to be concurrently investigated. TRIAL REGISTRATION US National Institutes of Health clinical trial registration number NCT02464345 , date of registration 08/06/2015. Changes to the present paper from the published protocol paper (Trials 18:578, 2015) and as reported in the Trial registration (clinicaltrials.gov) are reported in Supplementary File 1.
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Affiliation(s)
- Phillipa Hay
- School of Medicine, Translational Health Research Institute, Western Sydney University, 1797 Locked Bag Avenue, Sydney, 2751, Australia.
| | - Marly Amorim Palavras
- grid.1029.a0000 0000 9939 5719School of Medicine, Translational Health Research Institute, Western Sydney University, 1797 Locked Bag Avenue, Sydney, 2751 Australia ,grid.411249.b0000 0001 0514 7202Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Major Maragliano 241, São Paulo, SP 04017-030 Brazil
| | - Felipe Quinto da Luz
- grid.11899.380000 0004 1937 0722Eating Disorders Program (AMBULIM), Faculty of Medicine, Universidade de São Paulo (USP), Rua Dr. Ovídio Pires de Campos, 785, São Paulo, SP 05403-010 Brazil ,grid.1013.30000 0004 1936 834XBoden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, 2006 Australia
| | - Sérgio dos Anjos Garnes
- grid.411249.b0000 0001 0514 7202Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Major Maragliano 241, São Paulo, SP 04017-030 Brazil
| | - Amanda Sainsbury
- grid.1012.20000 0004 1936 7910School of Human Sciences, The University of Western Australia, Perth, 6009 Australia
| | - Stephen Touyz
- grid.1013.30000 0004 1936 834XInside Out Institute and School of Psychology, Charles Perkins Centre, SLHD and The University of Sydney, Sydney, 2006 Australia
| | - José Carlos Appolinario
- grid.8536.80000 0001 2294 473XObesity and Eating Disorders Group – Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Avenida Pedro Calmon 550, Rio de Janeiro, RJ 21941-901 Brazil
| | - Angélica Medeiros Claudino
- grid.411249.b0000 0001 0514 7202Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Major Maragliano 241, São Paulo, SP 04017-030 Brazil
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16
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Jin X, Gibson AA, Salis Z, Seimon RV, Harper C, Markovic TP, Byrne NM, Keating SE, Stamatakis E, Inan-Eroglu E, da Luz FQ, Ayre J, Sainsbury A. Effect of severe compared with moderate energy restriction on physical activity among postmenopausal female adults with obesity: a prespecified secondary analysis of the Type of Energy Manipulation for Promoting optimum metabolic health and body composition in Obesity (TEMPO) Diet randomized controlled Trial. Am J Clin Nutr 2022; 115:1393-1403. [PMID: 35102380 PMCID: PMC9071468 DOI: 10.1093/ajcn/nqac024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/24/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND An under-explored strategy for increasing physical activity is the dietary treatment of obesity, but empirical evidence is lacking. OBJECTIVES We aimed to compare the effects of weight loss via severe as opposed to moderate energy restriction on physical activity over 36 mo. METHODS A total of 101 postmenopausal female adults (45-65 y, BMI 30-40 kg/m2, <180 min/wk of structured exercise) were randomly assigned to either 12 mo of moderate energy restriction (25%-35% of energy requirement) with a food-based diet, or a severe intervention involving 4 mo of severe energy restriction (65%-75% of energy requirement) with a total meal replacement diet, followed by 8 mo of moderate energy restriction. Physical activity was encouraged, but no tailored or supervised exercise prescription was provided. Physical activity was assessed with an accelerometer worn for 7 d before baseline (0 mo) and 0.25, 1, 4, 6, 12, 24, and 36 mo after intervention commencement. RESULTS Compared with the moderate group, the severe group exhibited greater mean: total volume of physical activity; duration of moderate-to-vigorous-intensity physical activity (MVPA); duration of light-intensity physical activity; step counts, as well as lower mean duration of sedentary time. All these differences (except step counts) were apparent at 6 mo [e.g., 1006 metabolic equivalent of task (MET)-min/wk; 95% CI: 564, 1449 MET-min/wk for total volume of physical activity], and some were also apparent at 4 and/or 12 mo. There were no differences between groups in the 2 other outcomes investigated (self-efficacy to regulate exercise; and proportion of participants meeting the WHO's 2020 Physical Activity Guidelines for MVPA). When the analyses were adjusted for weight at each time point, the differences between groups were either attenuated or abolished. CONCLUSIONS Among female adults with obesity, including a dietary component to reduce excess body weight-notably one involving severe energy restriction-could potentially enhance the effectiveness of physical activity interventions.This trial was registered at www.anzctr.org.au as ACTRN12612000651886.
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Affiliation(s)
- Xingzhong Jin
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia,The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia,Sydney Musculoskeletal Health, Kolling Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Alice A Gibson
- The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia,Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Zubeyir Salis
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Radhika V Seimon
- The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Claudia Harper
- The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Tania P Markovic
- The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia,Metabolism & Obesity Service, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Nuala M Byrne
- School of Health Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Elif Inan-Eroglu
- The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia,Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Felipe Q da Luz
- The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia,Eating Disorders Program (AMBULIM), Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Julie Ayre
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Pattinson AL, Seimon RV, Harper C, Nassar N, Grech A, Santoso EA, Franklin J, Inan-Eroglu E, Gibson AA, Sainsbury A. Diet Quality following Total Meal Replacement Compared with Food-Based Weight-Loss Diets in Postmenopausal Women with Obesity: A Secondary Analysis of the TEMPO Diet Trial. J Nutr 2021; 151:3299-3312. [PMID: 34515308 DOI: 10.1093/jn/nxab311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/12/2021] [Accepted: 08/16/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Severely energy-restricted diets that utilize meal-replacement products are the most effective dietary treatment for obesity. However, there are concerns they may fail to educate individuals on how to adopt a healthy food-based diet after weight loss. OBJECTIVES The aim of this research was to compare changes in diet quality following total meal replacement compared with food-based weight-loss diets. METHODS In this secondary analysis of a randomized controlled trial, 79 postmenopausal women aged 45-65 y, with a BMI (in kg/m2) of 30-40, were randomly assigned to either a total meal-replacement diet (energy intake restricted by 65-75% relative to requirements) for 16 wks, followed by a food-based diet (energy intake restricted by 25-35% relative to requirements) until 52 wks, or the food-based diet for the entire 52-wk period. Diet quality was scored at baseline and 52 wks using the Healthy Eating Index for Australian Adults, with score changes compared between groups using an independent t test. RESULTS Diet quality improved from baseline in both groups, but less so in the total meal-replacement group, with a mean (SD) increase of 3.6 (10.8) points compared with 11.8 (13.9) points in the food-based group, resulting in a mean between-group difference of -8.2 (P = 0.004; 95% CI: -13.8, -2.7) points. This improvement in diet quality within both groups was mostly driven by a reduction in the intake of discretionary foods. Intake remained below the recommendations at 52 wks for 4 of the 5 food groups in both dietary interventions. CONCLUSIONS In postmenopausal women with obesity, weight-loss interventions that involve either a total meal-replacement diet or a food-based diet both improve diet quality, however, not sufficiently to meet recommendations. This highlights the importance of addressing diet quality as a part of all dietary weight-loss interventions. This trial is registered with the Australia and New Zealand Clinical Trials Registry as 12612000651886.
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Affiliation(s)
- Andrea L Pattinson
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Radhika V Seimon
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Claudia Harper
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Amanda Grech
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Eunike A Santoso
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Janet Franklin
- Metabolism & Obesity Service, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Elif Inan-Eroglu
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Alice A Gibson
- Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Amanda Sainsbury
- School of Human Sciences, Faculty of Science, The University of Western Australia, Perth, Western Australia, Australia
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18
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Muirhead R, Kizirian N, Lal R, Black K, Prys-Davies A, Nassar N, Baur L, Sainsbury A, Sweeting A, Markovic T, Skilton M, Hyett J, de Vries B, Tarnow-Mordi W, Brand-Miller J, Gordon A. A Pilot Randomized Controlled Trial of a Partial Meal Replacement Preconception Weight Loss Program for Women with Overweight and Obesity. Nutrients 2021; 13:nu13093200. [PMID: 34579077 PMCID: PMC8469733 DOI: 10.3390/nu13093200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/05/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022] Open
Abstract
About half of Australian women have a body mass index in the overweight or obese range at the start of pregnancy, with serious consequences including preterm birth, gestational hypertension and diabetes, caesarean section, stillbirth, and childhood obesity. Trials to limit weight gain during pregnancy have had limited success and reducing weight before pregnancy has greater potential to improve outcomes. The PreBabe Pilot study was a randomised controlled pilot trial to assess the feasibility, acceptability and potential weight loss achieved using a commercial online partial meal replacement program, (MR) vs. telephone-based conventional dietary advice, (DA) for pre-conception weight-loss over a 10-week period. Women 18–40 years of age with a BMI ≥ 25 kg/m2 planning pregnancy within the next 6 to 12 months were included in the study. All participants had three clinic visits with a dietitian and one obstetric consultation. In total, 50 women were enrolled in the study between June 2018 and October 2019–26 in MR and 24 in DA. Study retention at the end of 10 week intervention 81% in the MR arm and 75% in the DA arm. In the-intention-to-treat analysis, women using meal replacements lost on average 5.4 ± 3.1% body weight compared to 2.3 ± 4.2% for women receiving conventional advice (p = 0.029). Over 80% of women in the MR arm rated the support received as excellent, compared to 39% in the DA arm (p < 0.001). Women assigned to the MR intervention were more likely to achieve pregnancy within 12 months of the 10 week intervention (57% (12 of 21) women assigned to MR intervention vs. 22% (4 of 18) assigned to the DA group (p = 0.049) became pregnant). The findings suggest that a weight loss intervention using meal replacements in the preconception period was acceptable and may result in greater weight loss than conventional dietary advice alone.
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Affiliation(s)
- Roslyn Muirhead
- Charles Perkins Centre, School of Life and Environmental Biosciences, University of Sydney, Sydney, NSW 2006, Australia; (R.M.); (J.B.-M.)
| | - Nathalie Kizirian
- Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia; (N.K.); (R.L.)
| | - Ravin Lal
- Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia; (N.K.); (R.L.)
| | - Kirsten Black
- Speciality of Obstetrics, Gynaecology and Neonatology, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia;
- Department of Women and Babies, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW 2050, Australia;
| | - Ann Prys-Davies
- Department of Women and Babies, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW 2050, Australia;
| | - Natasha Nassar
- Charles Perkins Centre, Childrens Hospital Westmead Clinical School, University of Sydney, Sydney, NSW 2006, Australia; (N.N.); (L.B.)
| | - Louise Baur
- Charles Perkins Centre, Childrens Hospital Westmead Clinical School, University of Sydney, Sydney, NSW 2006, Australia; (N.N.); (L.B.)
| | - Amanda Sainsbury
- School of Human Sciences, Faculty of Science, University of Western Australia, Crawley, WA 6009, Australia;
| | - Arianne Sweeting
- Sydney Medical School, The University of Sydney, NSW 2006, Australia; (A.S.); (T.M.); (M.S.)
| | - Tania Markovic
- Sydney Medical School, The University of Sydney, NSW 2006, Australia; (A.S.); (T.M.); (M.S.)
| | - Michael Skilton
- Sydney Medical School, The University of Sydney, NSW 2006, Australia; (A.S.); (T.M.); (M.S.)
| | - Jon Hyett
- Charles Perkins Centre, Boden Initiative, The University of Sydney, NSW 2006, Australia
| | - Bradley de Vries
- Charles Perkins Centre, Boden Initiative, The University of Sydney, NSW 2006, Australia
| | | | - Jennie Brand-Miller
- Charles Perkins Centre, School of Life and Environmental Biosciences, University of Sydney, Sydney, NSW 2006, Australia; (R.M.); (J.B.-M.)
| | - Adrienne Gordon
- Speciality of Obstetrics, Gynaecology and Neonatology, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia;
- Speciality of Obstetrics, Gynaecology and Neonatology, Central Clinical School, Faculty of Medicine and Health, Royal Prince Alfred Hospital Newborn Care, Sydney Local Health District, Sydney, NSW 2050, Australia; (J.H.); (B.d.V.)
- Correspondence:
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19
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Bessell E, Maunder A, Lauche R, Adams J, Sainsbury A, Fuller NR. Efficacy of dietary supplements containing isolated organic compounds for weight loss: a systematic review and meta-analysis of randomised placebo-controlled trials. Int J Obes (Lond) 2021; 45:1631-1643. [PMID: 33976376 DOI: 10.1038/s41366-021-00839-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 04/07/2021] [Accepted: 04/26/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND/OBJECTIVES A systematic review with meta-analysis was conducted to synthesise evidence on the efficacy of dietary supplements containing isolated organic compounds for weight loss. SUBJECTS/METHODS Four electronic databases (Medline, Embase, Web of Science, Cinahl) were searched until December 2019. Sixty-seven randomised placebo-controlled trials of dietary supplements containing isolated organic compounds for weight loss were included. Meta-analyses were conducted for chitosan, glucomannan, conjugated linoleic acid and fructans, comparing mean weight difference post-intervention between participants receiving the dietary supplement or placebo. RESULTS Statistically significant weight differences compared to placebo were observed for chitosan (-1.84 kg; 95% confidence interval [CI] -2.79, -0.88; p < 0.01), glucomannan (-1.27 kg; 95%CI -2.45, -0.09; p = 0.04), and conjugated linoleic acid (-1.08 kg; 95%CI -1.61, -0.55; p < 0.01). None met our threshold for clinical significance (≥2.5 kg). There was no statistically significant effect on weight for fructans compared to placebo (p = 0.24). For dietary supplements with an inadequate number of trials for meta-analysis, a statistically and borderline clinically significant weight difference compared to placebo was found for modified cellulose, manno-oligosaccharides (in males), blood orange juice extract, and three multiple-ingredient dietary supplements. These were only reported in one trial of each. Thus, more evidence is needed before recommending them for weight loss. CONCLUSIONS While some dietary supplements containing isolated organic compounds warrant further investigation to determine efficacy and safety, there is currently insufficient evidence to recommend any of these dietary supplements for weight loss.
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Affiliation(s)
- Erica Bessell
- The University of Sydney, The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, Sydney, NSW, Australia.
| | - Alison Maunder
- The University of Sydney, The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, Sydney, NSW, Australia.,Western Sydney University, NICM Health Research Institute, Penrith, NSW, Australia
| | - Romy Lauche
- Southern Cross University, National Centre for Naturopathic Medicine, Lismore, NSW, Australia.,University of Technology Sydney, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), School of Public Health, Faculty of Health, Sydney, NSW, Australia
| | - Jon Adams
- University of Technology Sydney, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), School of Public Health, Faculty of Health, Sydney, NSW, Australia
| | - Amanda Sainsbury
- The University of Western Australia, School of Human Sciences, Faculty of Science, Perth, WA, Australia
| | - Nicholas R Fuller
- The University of Sydney, The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, Sydney, NSW, Australia
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20
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Peos JJ, Helms ER, Fournier PA, Ong J, Hall C, Krieger J, Sainsbury A. Continuous versus Intermittent Dieting for Fat Loss and Fat-Free Mass Retention in Resistance-trained Adults: The ICECAP Trial. Med Sci Sports Exerc 2021; 53:1685-1698. [PMID: 33587549 DOI: 10.1249/mss.0000000000002636] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Can intermittent energy restriction (IER) improve fat loss and fat-free mass retention compared with continuous energy restriction (CER) in resistance-trained adults? METHODS Sixty-one adults (32 women) with a mean (SD) age of 28.7 (6.5) yr, body weight of 77.2 (16.1) kg, and body fat of 25.5% (6.1%) were randomized to 12 wk of 1) 4 × 3 wk of moderate (m) energy restriction interspersed with 3 × 1 wk of energy balance (mIER; n = 30; 15 wk total) or 2) 12 wk of continuous moderate energy restriction (mCER; n = 31). Analyses of all outcome measures were by intention-to-treat. RESULTS After accounting for baseline differences, mIER did not result in lower fat mass or body weight, or greater fat-free mass, compared with mCER after energy restriction. Mean (and 97.5% confidence interval for fat mass at the end of mIER versus mCER was 15.3 (12.5-18.0) kg versus 18.0 (14.3-21.7) kg (P = 0.321), that for fat-free mass was 56.7 (51.5-61.9) kg versus 56.7 (51.4-62.0) kg (P = 0.309), and that for body weight (with 95% confidence interval) was 72.1 (66.4-77.9) versus 74.6 (69.3-80.0) (P = 0.283). There were no differences between interventions in muscle strength or endurance or in resting energy expenditure, leptin, testosterone, insulin-like growth factor-1, free 3,3',5-triiodothyronine or active ghrelin, or in sleep, muscle dysmorphia, or eating disorder behaviors. However, participants in mIER exhibited lower hunger (P = 0.002) and desire to eat (P = 0.014) compared with those in mCER, and greater satisfaction (P = 0.016) and peptide YY (P = 0.034). CONCLUSIONS Similar fat loss and fat-free mass retention are achieved with mIER and mCER during 12 wk of energy restriction; however, mIER is associated with reduced appetite.
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Affiliation(s)
- Jackson J Peos
- School of Human Sciences (Exercise and Sports Science), Faculty of Science, The University of Western Australia, Crawley, Western Australia, AUSTRALIA
| | - Eric R Helms
- Auckland University of Technology, Sports Performance Institute New Zealand (SPRINZ), Auckland, NEW ZEALAND
| | - Paul A Fournier
- School of Human Sciences (Exercise and Sports Science), Faculty of Science, The University of Western Australia, Crawley, Western Australia, AUSTRALIA
| | - Julian Ong
- School of Human Sciences (Exercise and Sports Science), Faculty of Science, The University of Western Australia, Crawley, Western Australia, AUSTRALIA
| | - Carly Hall
- School of Human Sciences (Exercise and Sports Science), Faculty of Science, The University of Western Australia, Crawley, Western Australia, AUSTRALIA
| | | | - Amanda Sainsbury
- School of Human Sciences (Exercise and Sports Science), Faculty of Science, The University of Western Australia, Crawley, Western Australia, AUSTRALIA
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21
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Zhu R, Fogelholm M, Larsen TM, Poppitt SD, Silvestre MP, Vestentoft PS, Jalo E, Navas-Carretero S, Huttunen-Lenz M, Taylor MA, Stratton G, Swindell N, Kaartinen NE, Lam T, Handjieva-Darlenska T, Handjiev S, Schlicht W, Martinez JA, Seimon RV, Sainsbury A, Macdonald IA, Westerterp-Plantenga MS, Brand-Miller J, Raben A. Corrigendum: A High-Protein, Low Glycemic Index Diet Suppresses Hunger but Not Weight Regain After Weight Loss: Results From a Large, 3-Years Randomized Trial (PREVIEW). Front Nutr 2021; 8:736531. [PMID: 34368215 PMCID: PMC8344043 DOI: 10.3389/fnut.2021.736531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- Ruixin Zhu
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Thomas M Larsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Sally D Poppitt
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Marta P Silvestre
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand.,Center for Health Technology Services Research, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Pia S Vestentoft
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Santiago Navas-Carretero
- Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain.,IdisNA Instituto for Health Research, Pamplona, Spain
| | - Maija Huttunen-Lenz
- Institute for Nursing Science, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Moira A Taylor
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Gareth Stratton
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, United Kingdom
| | - Nils Swindell
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, United Kingdom
| | - Niina E Kaartinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tony Lam
- NetUnion sarl, Lausanne, Switzerland
| | | | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Wolfgang Schlicht
- Exercise and Health Sciences, University of Stuttgart, Stuttgart, Germany
| | - J Alfredo Martinez
- Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain.,IdisNA Instituto for Health Research, Pamplona, Spain.,Department of Nutrition and Physiology, University of Navarra, Pamplona, Spain.,Precision Nutrition and Cardiometabolic Health Program, IMDEA (Madrid Institute for Advanced Studies)-Food Institute, CEI UAM + CSIC (Campus de Excelencia Internacional, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas), Madrid, Spain
| | - Radhika V Seimon
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Amanda Sainsbury
- School of Human Sciences (Exercise and Sports Science), Faculty of Science, The University of Western Australia, Crawley, WA, Australia
| | - Ian A Macdonald
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Margriet S Westerterp-Plantenga
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Center Copenhagen, Gentofte, Denmark
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22
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Maston G, Franklin J, Hocking S, Swinbourne J, Gibson A, Manson E, Sainsbury A, Markovic T. Dietary adherence and program attrition during a severely energy-restricted diet among people with complex class III obesity: A qualitative exploration. PLoS One 2021; 16:e0253127. [PMID: 34138917 PMCID: PMC8211265 DOI: 10.1371/journal.pone.0253127] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 06/01/2021] [Indexed: 12/27/2022] Open
Abstract
Meal replacement Severely Energy-Restricted Diets (SERDs) produce ≥ 10% loss of body mass when followed for 6 weeks or longer in people with class III obesity (BMI ≥ 40 kg/m2). The efficacy of SERDs continues to be questioned by healthcare professionals, with concerns about poor dietary adherence. This study explored facilitators and barriers to dietary adherence and program attrition among people with class III obesity who had attempted or completed a SERD in a specialised weight loss clinic. Participants who commenced a SERD between January 2016 to May 2018 were invited to participate. Semi-structured in-depth interviews were conducted from September to October 2018 with 20 participants (12 women and 8 men). Weight change and recounted events were validated using the participants' medical records. Data were analysed by thematic analysis using line-by-line inductive coding. The mean age ± SD of participants was 51.2 ± 11.3 years, with mean ± SD BMI at baseline 63.7 ± 12.6 kg/m2. Five themes emerged from participants' recounts that were perceived to facilitate dietary adherence: (1.1) SERD program group counselling and psychoeducation sessions, (1.2) emotionally supportive clinical staff and social networks that accommodated and championed change in dietary behaviours, (1.3) awareness of eating behaviours and the relationship between these and progression of disease, (1.4) a resilient mindset, and (1.5) dietary simplicity, planning and self-monitoring. There were five themes on factors perceived to be barriers to adherence, namely: (2.1) product unpalatability, (2.2) unrealistic weight loss expectations, (2.3) poor program accessibility, (2.4) unforeseeable circumstances and (2.5) externalised weight-related stigma. This study highlights opportunities where SERD programs can be optimised to facilitate dietary adherence and reduce barriers, thus potentially improving weight loss outcomes with such programs. Prior to the commencement of a SERD program, healthcare professionals facilitating such programs could benefit from reviewing participants to identify common barriers. This includes identifying the presence of product palatability issues, unrealistic weight loss expectations, socio-economic disadvantage, and behaviour impacting experiences of externalised weight-related stigma.
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Affiliation(s)
- Gabrielle Maston
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Janet Franklin
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Samantha Hocking
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- Sydney School of Medicine (Central Clinical School), Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Jessica Swinbourne
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Alice Gibson
- Menzies Centre for Health Policy, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Elisa Manson
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Amanda Sainsbury
- School of Human Sciences, Faculty of Science, The University of Western Australia, Crawley, WA, Australia
| | - Tania Markovic
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- Sydney School of Medicine (Central Clinical School), Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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23
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Zhu R, Fogelholm M, Larsen TM, Poppitt SD, Silvestre MP, Vestentoft PS, Jalo E, Navas-Carretero S, Huttunen-Lenz M, Taylor MA, Stratton G, Swindell N, Kaartinen NE, Lam T, Handjieva-Darlenska T, Handjiev S, Schlicht W, Martinez JA, Seimon RV, Sainsbury A, Macdonald IA, Westerterp-Plantenga MS, Brand-Miller J, Raben A. A High-Protein, Low Glycemic Index Diet Suppresses Hunger but Not Weight Regain After Weight Loss: Results From a Large, 3-Years Randomized Trial (PREVIEW). Front Nutr 2021; 8:685648. [PMID: 34141717 PMCID: PMC8203925 DOI: 10.3389/fnut.2021.685648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 04/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Previous studies have shown an increase in hunger during weight-loss maintenance (WLM) after diet-induced weight loss. Whether a combination of a higher protein, lower glycemic index (GI) diet and physical activity (PA) can counteract this change remains unclear. Aim: To compare the long-term effects of two diets [high protein (HP)-low GI vs. moderate protein (MP)-moderate GI] and two PA programs [high intensity (HI) vs. moderate intensity (MI)] on subjective appetite sensations during WLM after ≥8% weight loss (WL). Methods: Data derived from the 3-years PREVIEW randomized intervention study. An 8-weeks WL phase using a low-energy diet was followed by a 148-weeks randomized WLM phase. For the WLM phase, participants were assigned to one of the four groups: HP-MI, HP-HI, MP-MI, and MP-HI. Available data from 2,223 participants with overweight or obesity (68% women; BMI ≥ 25 kg/m2). Appetite sensations including satiety, hunger, desire to eat, and desire to eat something sweet during the two phases (at 0, 8 weeks and 26, 52, 104, and 156 weeks) were assessed based on the recall of feelings during the previous week using visual analogue scales. Differences in changes in appetite sensations from baseline between the groups were determined using linear mixed models with repeated measures. Results: There was no significant diet × PA interaction. From 52 weeks onwards, decreases in hunger were significantly greater in HP-low GI than MP-moderate GI (P time × diet = 0.018, P dietgroup = 0.021). Although there was no difference in weight regain between the diet groups (P time × diet = 0.630), hunger and satiety ratings correlated with changes in body weight at most timepoints. There were no significant differences in appetite sensations between the two PA groups. Decreases in hunger ratings were greater at 52 and 104 weeks in HP-HI vs. MP-HI, and greater at 104 and 156 weeks in HP-HI vs. MP-MI. Conclusions: This is the first long-term, large-scale randomized intervention to report that a HP-low GI diet was superior in preventing an increase in hunger, but not weight regain, during 3-years WLM compared with a MP-moderate GI diet. Similarly, HP-HI outperformed MP-HI in suppressing hunger. The role of exercise intensity requires further investigation. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT01777893.
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Affiliation(s)
- Ruixin Zhu
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Thomas M Larsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Sally D Poppitt
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Marta P Silvestre
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand.,Center for Health Technology Services Research, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Pia S Vestentoft
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Santiago Navas-Carretero
- Department of Nutrition, University of Navarra, Pamplona, Spain.,CIBERobn, Instituto de Salud Carlos III, Madrid, Spain.,Precision Nutrition Program, IMDEA Food, Campus de Excelencia Internacional, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Maija Huttunen-Lenz
- Institute for Nursing Science, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Moira A Taylor
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Gareth Stratton
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, United Kingdom
| | - Nils Swindell
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, United Kingdom
| | - Niina E Kaartinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tony Lam
- NetUnion sarl, Lausanne, Switzerland
| | | | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Wolfgang Schlicht
- Exercise and Health Sciences, University of Stuttgart, Stuttgart, Germany
| | - J Alfredo Martinez
- Department of Nutrition, University of Navarra, Pamplona, Spain.,CIBERobn, Instituto de Salud Carlos III, Madrid, Spain.,Precision Nutrition Program, IMDEA Food, Campus de Excelencia Internacional, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Radhika V Seimon
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Amanda Sainsbury
- School of Human Sciences (Exercise and Sports Science), Faculty of Science, The University of Western Australia, Crawley, WA, Australia
| | - Ian A Macdonald
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, MRC/ARUK Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Margriet S Westerterp-Plantenga
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Center Copenhagen, Gentofte, Denmark
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24
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Jin X, Gibson AA, Gale J, Schneuer F, Ding D, March L, Sainsbury A, Nassar N. Does weight loss reduce the incidence of total knee and hip replacement for osteoarthritis?-A prospective cohort study among middle-aged and older adults with overweight or obesity. Int J Obes (Lond) 2021; 45:1696-1704. [PMID: 33993192 PMCID: PMC8310800 DOI: 10.1038/s41366-021-00832-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 03/17/2021] [Accepted: 04/21/2021] [Indexed: 02/08/2023]
Abstract
Objective This study aims to investigate the association between weight change and total knee or hip replacement (TKR or THR) for OA among middle-aged and older adults with overweight or obesity. Method Weight data were collected in 2006–2009 and in 2010 from the 45 and Up Study—a population-based cohort aged ≥45 years in New South Wales, Australia. Participants were included if they had a baseline body mass index (BMI) ≥ 25 kg/m2 and no history of TKR or THR. Weight change was categorised into four groups: >7.5% loss; >5–7.5% loss; stable (≤5% change) and >5% gain. Hospital admission data were linked to identify TKR and THR for OA, and multivariable Cox regression was used to assess risk of TKR and THR. Results Of 23,916 participants, 2139 lost >7.5% weight, 1655 lost 5–7.5% weight, and 4430 gained >5% weight. Over 5.2 years, 1009 (4.2%) underwent TKR and 483 (2.0%) THR. Compared to weight-stable, weight loss of >7.5% was associated with reduced risk of TKR after adjusting for age, sex, BMI, socioeconomic and lifestyle factors (hazard ratio 0.69, 95%CI 0.54–0.87), but had no association with THR. Weight loss of 5–7.5% was not associated with altered risk of either TKR or THR. Weight gain was associated with increased risk of THR after adjusting for confounders, but not TKR. Conclusion This study suggests that a weight loss target >7.5% is required to reduce the risk of TKR in adults with overweight or obesity. Weight gain should be avoided as it increases the risk of THR.
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Affiliation(s)
- Xingzhong Jin
- Centre for Big Data Research in Health, The University of New South Wales, Sydney, Australia. .,Institute of Bone and Joint Research, Kolling Institute, The University of Sydney, Sydney, Australia. .,The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, , The University of Sydney, Sydney, Australia.
| | - Alice A Gibson
- Menzies Centre for Health Policy, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Joanne Gale
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Francisco Schneuer
- Child Population and Translational Health, The Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, Australia
| | - Ding Ding
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Lyn March
- Institute of Bone and Joint Research, Kolling Institute, The University of Sydney, Sydney, Australia
| | - Amanda Sainsbury
- School of Human Sciences, The University of Western Australia, Perth, Australia
| | - Natasha Nassar
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
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25
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Buso MEC, Seimon RV, McClintock S, Muirhead R, Atkinson FS, Brodie S, Dodds J, Zibellini J, Das A, Wild-Taylor AL, Burk J, Fogelholm M, Raben A, Brand-Miller JC, Sainsbury A. Can a Higher Protein/Low Glycemic Index vs. a Conventional Diet Attenuate Changes in Appetite and Gut Hormones Following Weight Loss? A 3-Year PREVIEW Sub-study. Front Nutr 2021; 8:640538. [PMID: 33829034 PMCID: PMC8019730 DOI: 10.3389/fnut.2021.640538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/12/2021] [Indexed: 01/06/2023] Open
Abstract
Background: Previous research showed that weight-reducing diets increase appetite sensations and/or circulating ghrelin concentrations for up to 36 months, with transient or enduring perturbations in circulating concentrations of the satiety hormone peptide YY. Objective: This study assessed whether a diet that is higher in protein and low in glycemic index (GI) may attenuate these changes. Methods: 136 adults with pre-diabetes and a body mass index of ≥25 kg/m2 underwent a 2-month weight-reducing total meal replacement diet. Participants who lost ≥8% body weight were randomized to one of two 34-month weight-maintenance diets: a higher-protein and moderate-carbohydrate (CHO) diet with low GI, or a moderate-protein and higher-CHO diet with moderate GI. Both arms involved recommendations to increase physical activity. Fasting plasma concentrations of total ghrelin and total peptide YY, and appetite sensations, were measured at 0 months (pre-weight loss), at 2 months (immediately post-weight loss), and at 6, 12, 24, and 36 months. Results: There was a decrease in plasma peptide YY concentrations and an increase in ghrelin after the 2-month weight-reducing diet, and these values approached pre-weight-loss values by 6 and 24 months, respectively (P = 0.32 and P = 0.08, respectively, vs. 0 months). However, there were no differences between the two weight-maintenance diets. Subjective appetite sensations were not affected by the weight-reducing diet nor the weight-maintenance diets. While participants regained an average of ~50% of the weight they had lost by 36 months, the changes in ghrelin and peptide YY during the weight-reducing phase did not correlate with weight regain. Conclusion: A higher-protein, low-GI diet for weight maintenance does not attenuate changes in ghrelin or peptide YY compared with a moderate-protein, moderate-GI diet. Clinical Trial Registry:ClinicalTrials.gov registry ID NCT01777893 (PREVIEW) and ID NCT02030249 (Sub-study).
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Affiliation(s)
- Marion E C Buso
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands.,The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Radhika V Seimon
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Sally McClintock
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Fiona S Atkinson
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Shannon Brodie
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Jarron Dodds
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Jessica Zibellini
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Arpita Das
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Anthony L Wild-Taylor
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Jessica Burk
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Mikael Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Jennie C Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Amanda Sainsbury
- School of Human Sciences, Faculty of Science, The University of Western Australia, Crawley, WA, Australia
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26
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da Luz FQ, Hay P, Wisniewski L, Cordás T, Sainsbury A. The treatment of binge eating disorder with cognitive behavior therapy and other therapies: An overview and clinical considerations. Obes Rev 2020; 22. [PMID: 33350574 DOI: 10.1111/obr.13180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/13/2020] [Accepted: 11/15/2020] [Indexed: 11/29/2022]
Abstract
Binge eating disorder (BED) is a public health problem in several countries. BED is commonly associated with comorbidities such as obesity, diabetes, and depression. Notwithstanding the health problems associated with BED, evidence-based treatments for BED are not widely used by healthcare professionals worldwide. Thus, we provide an overview of the leading evidence-based psychological therapies for BED, with the intention of informing healthcare professionals and the general community and facilitating greater provision of treatment. Cognitive behavior therapy (CBT) for BED is briefly presented, focusing mainly on adaptations and stages of the cognitive behavior therapy-enhanced (CBT-E) transdiagnostic model for eating disorders. We also succinctly discuss the use of CBT in combination with weight management interventions or pharmacotherapy, as well as the use of interpersonal therapy and dialectical behavior therapy for BED. We conclude that there is a variety of evidence-based psychological therapies that can be used by a variety of healthcare professionals (not only by psychologists) to help reduce binge eating and associated psychopathology in people with BED. Given the high and increasing prevalence of BED, as well as the availability of effective evidence-based treatments, we encourage more healthcare professionals to explore up-skilling to assist people with BED.
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Affiliation(s)
- Felipe Q da Luz
- Eating Disorders Program (AMBULIM), Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Charles Perkins Centre, The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Lucene Wisniewski
- Center for Evidence Based Treatment, Shaker Heights, OH, USA
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Táki Cordás
- Eating Disorders Program (AMBULIM), Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Amanda Sainsbury
- School of Human Sciences, Faculty of Science, The University of Western Australia, Perth, WA, Australia
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27
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Peos J, Brown AW, Vorland CJ, Allison DB, Sainsbury A. Contrary to the Conclusions Stated in the Paper, Only Dry Fat-Free Mass Was Different between Groups upon Reanalysis. Comment on: "Intermittent Energy Restriction Attenuates the Loss of Fat-Free Mass in Resistance Trained Individuals. A Randomized Controlled Trial". J Funct Morphol Kinesiol 2020; 5:E85. [PMID: 33467300 PMCID: PMC7739336 DOI: 10.3390/jfmk5040085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/11/2020] [Indexed: 02/05/2023] Open
Abstract
Campbell and colleagues recently published a randomised controlled trial investigating the effects of diets involving intermittent energy restriction versus continuous energy restriction on changes in body composition and resting metabolic rate (RMR) in resistance-trained adults[...].
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Affiliation(s)
- Jackson Peos
- Faculty of Science, School of Human Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Andrew W. Brown
- Department of Applied Health Science, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47405, USA; (A.W.B.); (C.J.V.)
| | - Colby J. Vorland
- Department of Applied Health Science, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47405, USA; (A.W.B.); (C.J.V.)
| | - David B. Allison
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47405, USA;
| | - Amanda Sainsbury
- Faculty of Science, School of Human Sciences, The University of Western Australia, Crawley, WA 6009, Australia
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28
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Gibson AA, Eroglu EI, Rooney K, Harper C, McClintock S, Franklin J, Markovic TP, Seimon RV, Sainsbury A. Urine dipsticks are not accurate for detecting mild ketosis during a severely energy restricted diet. Obes Sci Pract 2020; 6:544-551. [PMID: 33082996 PMCID: PMC7556427 DOI: 10.1002/osp4.432] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 11/18/2022] Open
Abstract
Background Detection of the mild ketosis induced by severely energy‐restricted diets may be a clinically useful way to monitor and promote dietary adherence. Mild ketosis is often assessed using urine dipsticks, but accuracy for this purpose has not been tested. Objective To determine the accuracy of urine dipsticks to detect mild ketosis during adherence to a severely energy‐restricted diet. Methods Two hundred and sixty three (263) fasting urine and 263 fasting blood samples were taken from 50 women (mean [standard deviation, SD] age 58.0 [4.3] years and body mass index 34.3 [2.4] kg/m2) before and at six time points during or for up to 10 weeks after 16 weeks of severe energy restriction, achieved with a total meal replacement diet. The amount of ketones (acetoacetate) in the urine was classified as ‘0 (Negative)’, ‘+/− (Trace)’, ‘+ (Weak)’ or ‘++ (Medium)’ by urine dipsticks (Ketostix, Bayer). The concentration of ketones (β‐hydroxybutyrate) in the blood was measured with our reference method, a portable ketone monitor (FreeStyle Optium, Abbott). The diagnostic accuracy of the urine dipsticks was assessed from the percent of instances when a person was actually ‘in ketosis’ (as defined by a blood β‐hydroxybutyrate concentration at or above three different thresholds) that were also identified by the urine dipsticks as being from a person in ketosis (the percent ‘true positives’ or sensitivity), as well as the percent of instances when a person was not in ketosis (as defined by the blood monitor result) was correctly identified as such with the urine dipstick (the percent ‘true negatives’ or specificity). Thresholds of ≥0.3mM, ≥0.5mM or ≥1.0mM were selected, because mean blood concentrations of β‐hydroxybutyrate during ketogenic diets are approximately 0.5mM. Sensitivity and specificity were then used to generate receiver operating characteristic curves, with the area under these curves indicating the ability of the dipsticks to correctly identify people in ketosis (1 = perfect results, 0.5 = random results). Results At threshold blood β‐hydroxybutyrate concentrations of ≥0.3mM, ≥0.5mM and ≥1.0mM, the sensitivity of the urine dipsticks was 35%, 52% and 76%; the specificity was 100%, 97% and 78%; and the area under the receiver operating characteristic curves was 0.67, 0.74 and 0.77, respectively. These low levels of sensitivity mean that 65%, 48% or 24% of the instances when a person was in ketosis were not detected by the urine dipsticks. Conclusion Urine dipsticks are not an accurate or clinically useful means of detecting mild ketosis in people undergoing a severely energy‐restricted diet and should thus not be recommended in clinical treatment protocols. If monitoring of mild ketosis is indicated (eg, to monitor or help promote adherence to a severely energy‐restricted diet), then blood monitors should be used instead.
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Affiliation(s)
- Alice A Gibson
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales Australia.,The Menzies Centre for Health Policy, School of Public Health, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales Australia
| | - Elif I Eroglu
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales Australia
| | - Kieron Rooney
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, Charles Perkins Centre University of Sydney Sydney New South Wales Australia
| | - Claudia Harper
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales Australia
| | - Sally McClintock
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales Australia
| | - Janet Franklin
- Metabolism & Obesity Services Royal Prince Alfred Hospital Camperdown New South Wales Australia
| | - Tania P Markovic
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales Australia.,Metabolism & Obesity Services Royal Prince Alfred Hospital Camperdown New South Wales Australia
| | - Radhika V Seimon
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales Australia
| | - Amanda Sainsbury
- School of Human Sciences, Faculty of Science The University of Western Australia Crawley Western Australia Australia
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29
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Maston G, Franklin J, Gibson AA, Manson E, Hocking S, Sainsbury A, Markovic TP. Attitudes and Approaches to Use of Meal Replacement Products among Healthcare Professionals in Management of Excess Weight. Behav Sci (Basel) 2020; 10:E136. [PMID: 32906702 PMCID: PMC7551264 DOI: 10.3390/bs10090136] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/03/2020] [Accepted: 09/03/2020] [Indexed: 01/01/2023] Open
Abstract
Meal replacement product-based diets are an effective weight loss intervention used in the management of obesity. Historically, these diets have been underutilised by HealthCare Professionals (HCPs). An online survey of mixed methods design was distributed to HCPs to capture current perceptions and prescribing patterns of meal replacement products (MRPs) in the management of overweight and obesity. A total of 303 HCPs working in weight management across Australia began the survey and 197 (65%) completed it. While over 70% of HCPs have prescribed MRP currently or in the past, MRPs are only prescribed to a median 7% of patients seeking weight management treatment. Qualitative analysis identified potential barriers to MRP prescription, which include experience with patient non-compliance, perceived poor long-term weight loss durability and safety concerns regarding the product and its use as a total meal replacement program. Safety concerns are centred on the perceived risk of weight cycling and its potential negative psychological impact. MRP prescription is 66% more likely to occur if HCPs had formal training in the use of MRPs relative to those who did not, with a relative risk (RR) of 1.7 (95% CI 1.4, 2.0). This study highlights the potential barriers to the prescription of MRPs, which are centred around safety concerns. This also indicates that formal training may enhance the likelihood of prescribing MRPs, suggesting that once HCPs have a comprehensive understanding of the products and the evidence behind their use, their prescription is likely to be increased.
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Affiliation(s)
- Gabrielle Maston
- Faculty of Medicine and Health, The University of Sydney, The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Camperdown, NSW 2050, Australia; (S.H.); (T.P.M.)
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia; (J.F.); (E.M.)
| | - Janet Franklin
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia; (J.F.); (E.M.)
| | - Alice A. Gibson
- School of Public Health, Faculty of Medicine and Health, Centre for Health Policy, The University of Sydney, NSW 2050, Australia;
| | - Elisa Manson
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia; (J.F.); (E.M.)
| | - Samantha Hocking
- Faculty of Medicine and Health, The University of Sydney, The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Camperdown, NSW 2050, Australia; (S.H.); (T.P.M.)
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia; (J.F.); (E.M.)
| | - Amanda Sainsbury
- Faculty of Science, School of Human Sciences, The University of Western Australia, Crawley, WA 6009, Australia;
| | - Tania P. Markovic
- Faculty of Medicine and Health, The University of Sydney, The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Camperdown, NSW 2050, Australia; (S.H.); (T.P.M.)
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia; (J.F.); (E.M.)
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30
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Seimon RV, Wild-Taylor AL, McClintock S, Harper C, Gibson AA, Johnson NA, Fernando HA, Markovic TP, Center JR, Franklin J, Liu PY, Grieve SM, Lagopoulos J, Caterson ID, Byrne NM, Sainsbury A. 3-Year effect of weight loss via severe versus moderate energy restriction on body composition among postmenopausal women with obesity - the TEMPO Diet Trial. Heliyon 2020; 6:e04007. [PMID: 32613096 PMCID: PMC7322133 DOI: 10.1016/j.heliyon.2020.e04007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/06/2020] [Accepted: 05/13/2020] [Indexed: 12/15/2022] Open
Abstract
We have previously shown that a severely energy-restricted diet leads to greater loss of weight, fat, lean mass and bone mineral density (BMD) at 12 months in postmenopausal women with obesity than a moderately energy-restricted diet. We now aim to evaluate whether these effects are sustained longer term (ie, at 36 months). 101 postmenopausal women were randomized to either 12 months of moderate (25 to 35%) energy restriction with a food-based diet (moderate intervention), or 4 months of severe (65 to 75%) energy restriction with a total meal replacement diet followed by moderate energy restriction for 8 months (severe intervention). Body weight and composition were measured at 0, 24 and 36 months. Participants in the severe intervention lost ~1.5 to 1.7 times as much weight, waist circumference, whole-body fat mass and visceral adipose tissue compared to those in the moderate intervention, and were 2.6 times more likely (42% versus 16%) to have lost 10% or more of their initial body weight at 36 months (P < 0.01 for all). However, those in the severe versus moderate intervention lost ~1.4 times as much whole-body lean mass (P < 0.01), albeit this was proportional to total weight lost and there was no greater loss of handgrip strength, and they also lost ~2 times as much total hip BMD between 0 and 36 months (P < 0.05), with this bone loss occurring in the first 12 months. Thus, severe energy restriction is more effective than moderate energy restriction for reducing weight and adiposity in postmenopausal women in the long term (3 years), but attention to BMD loss in the first year is required. Trial registration Australian New Zealand Clinical Trials Registry Reference Number: 12612000651886, anzctr.org.au.
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Affiliation(s)
- Radhika V. Seimon
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Corresponding author.
| | - Anthony L. Wild-Taylor
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Sally McClintock
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Claudia Harper
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Alice A. Gibson
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Nathan A. Johnson
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Hamish A. Fernando
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Tania P. Markovic
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Jacqueline R. Center
- Bone Biology Program, Garvan Institute of Medical Research, St Vincent's Hospital Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Janet Franklin
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Peter Y. Liu
- Division of Endocrinology, Department of Medicine, Harbor-University of California Los Angeles Medical Center and Los Angeles BioMedical Research Institute, Los Angeles
| | - Stuart M. Grieve
- Imaging and Phenotyping Laboratory, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Jim Lagopoulos
- Sunshine Coast Mind and Neuroscience–Thompson Institute, University of the Sunshine Coast, Queensland, Australia
| | - Ian D. Caterson
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Nuala M. Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Amanda Sainsbury
- School of Human Sciences, Faculty of Science, The University of Western Australia, Crawley, Western Australia, Australia
- Corresponding author.
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Maunder A, Bessell E, Lauche R, Adams J, Sainsbury A, Fuller NR. Effectiveness of herbal medicines for weight loss: A systematic review and meta-analysis of randomized controlled trials. Diabetes Obes Metab 2020; 22:891-903. [PMID: 31984610 DOI: 10.1111/dom.13973] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 01/13/2020] [Accepted: 01/19/2020] [Indexed: 01/09/2023]
Abstract
AIM To update the available evidence on the efficacy and safety of complementary medicines to assist in weight loss by conducting a systematic review and meta-analysis of herbal medicines for weight loss. METHODS Four electronic databases (Medline, Embase, CINAHL and Web of Science) were searched from inception until August 2018. A total of 54 randomized placebo-controlled trials of healthy overweight or obese adults were identified. Meta-analyses were conducted for herbal medicines with ≥4 studies available. Weight differences of ≥2.5 kg were considered clinically significant. RESULTS As a single agent, only Phaseolus vulgaris resulted in a statistically significant weight loss compared to placebo, although this was not considered clinically significant. No effect was seen for Camellia sinensis or Garcinia cambogia. Statistically, but not clinically, significant differences were observed for combination preparations containing C. sinensis, P. vulgaris or Ephedra sinica. Of the herbal medicines trialled in ≤3 randomized controlled trials, statistically and clinically significant weight loss compared to placebo was reported for Irvingia gabonensis, Cissus quadrangularis, and Sphaeranthus indicus combined with Garcinia mangostana, among others, but these findings should be interpreted cautiously because of the small number of studies, generally poor methodological quality, and poor reporting of the herbal medicine interventions. Most herbal medicines appeared safe for consumption over the short duration of the studies (commonly ≤12 weeks). Some warrant further investigation to determine effect size, dosage and long-term safety. CONCLUSION There is currently insufficient evidence to recommend any of the herbal medicines for weight loss included in the present review.
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Affiliation(s)
- Alison Maunder
- University of Sydney, Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Central Clinical School, Charles Perkins Centre, New South Wales, Australia
| | - Erica Bessell
- University of Sydney, Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Central Clinical School, Charles Perkins Centre, New South Wales, Australia
| | - Romy Lauche
- University of Technology Sydney, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), NSW, Australia
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Germany
| | - Jon Adams
- University of Technology Sydney, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), NSW, Australia
| | - Amanda Sainsbury
- University of Sydney, Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Central Clinical School, Charles Perkins Centre, New South Wales, Australia
| | - Nicholas R Fuller
- University of Sydney, Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Central Clinical School, Charles Perkins Centre, New South Wales, Australia
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Maston G, Gibson AA, Kahlaee HR, Franklin J, Manson E, Sainsbury A, Markovic TP. Effectiveness and Characterization of Severely Energy-Restricted Diets in People with Class III Obesity: Systematic Review and Meta-Analysis. Behav Sci (Basel) 2019; 9:E144. [PMID: 31817943 PMCID: PMC6960910 DOI: 10.3390/bs9120144] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 11/24/2019] [Accepted: 12/03/2019] [Indexed: 12/17/2022] Open
Abstract
Severely energy-restricted diets are used in obesity management, but their efficacy in people with class III obesity (body mass index ≥40 kg/m2) is uncertain. The aims of this systematic review and meta-analysis were to determine the effectiveness and characteristics of severely energy-restricted diets in people with class III obesity. As there was a lack of publications reporting long-term dietary interventions and randomised controlled trial designs, our original publication inclusion criteria were broadened to include uncontrolled study designs and a higher upper limit of energy intake. Eligible publications reported studies including adults with class III obesity and that assessed a diet with daily energy intake ≤5000 kJ for ≥4 weeks. Among 572 unique publications from 4 databases, 11 were eligible and 10 were suitable for meta-analysis. Our original intention was to classify comparison arms into short-term (<6 months) and long-term (>1 year) interventions. Due to the lack of long-term data found, comparison arms were classified according to the commonalities in dietary intervention length among the included publications, namely dietary interventions of 4 weeks' duration and those of ≥6 weeks' duration. After a 4-week severely energy-restricted diet intervention, the pooled average weight loss was 9.81 (95% confidence interval 10.80, 8.83) kg, with a 95% prediction interval of 6.38 to 13.25 kg, representing a loss of approximately 4.1 to 8.6% of initial body weight. Diets ≥6 weeks' duration produced 25.78 (29.42, 22.15) kg pooled average weight loss, with a 95% prediction interval of 13.77 to 37.80 kg, representing approximately 10.2 to 28.0% weight loss. Daily dietary prescriptions ranged from 330 to 5000 kJ (mean ± standard deviation 2260 ± 1400 kJ), and had wide variations in macronutrient composition. The diets were administered mostly via liquid meal replacement products. While the included publications had a moderate risk of bias score, which may inflate reported weight loss outcomes, the published data to date suggest that severely energy-restricted diets, delivered via diets of varying composition, effectively produce clinically relevant weight loss (≥10% of initial body weight) when used for 6 weeks or more in people with class III obesity.
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Affiliation(s)
- Gabrielle Maston
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (A.A.G.); (A.S.); (T.P.M.)
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Sydney 2006, Australia; (J.F.); (E.M.)
| | - Alice A. Gibson
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (A.A.G.); (A.S.); (T.P.M.)
| | - H. Reza Kahlaee
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney 2006, Australia;
- School of Life, and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney 2006, Australia
| | - Janet Franklin
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Sydney 2006, Australia; (J.F.); (E.M.)
| | - Elisa Manson
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Sydney 2006, Australia; (J.F.); (E.M.)
| | - Amanda Sainsbury
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (A.A.G.); (A.S.); (T.P.M.)
| | - Tania P. Markovic
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (A.A.G.); (A.S.); (T.P.M.)
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Sydney 2006, Australia; (J.F.); (E.M.)
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Seimon RV, Wild-Taylor AL, Keating SE, McClintock S, Harper C, Gibson AA, Johnson NA, Fernando HA, Markovic TP, Center JR, Franklin J, Liu PY, Grieve SM, Lagopoulos J, Caterson ID, Byrne NM, Sainsbury A. Effect of Weight Loss via Severe vs Moderate Energy Restriction on Lean Mass and Body Composition Among Postmenopausal Women With Obesity: The TEMPO Diet Randomized Clinical Trial. JAMA Netw Open 2019; 2:e1913733. [PMID: 31664441 PMCID: PMC6824325 DOI: 10.1001/jamanetworkopen.2019.13733] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE Severely energy-restricted diets are the most effective dietary obesity treatment. However, there are concerns regarding potential adverse effects on body composition. OBJECTIVE To compare the long-term effects of weight loss via severe vs moderate energy restriction on lean mass and other aspects of body composition. DESIGN, SETTING, AND PARTICIPANTS The Type of Energy Manipulation for Promoting Optimum Metabolic Health and Body Composition in Obesity (TEMPO) Diet Trial was a 12-month, single-center, randomized clinical trial. A total of 101 postmenopausal women, aged 45 to 65 years with body mass index (calculated as weight in kilograms divided by height in meters squared) from 30 to 40, who were at least 5 years after menopause, had fewer than 3 hours of structured physical activity per week, and lived in the Sydney metropolitan area of New South Wales, Australia, were recruited between March 2013 and July 2016. Data analysis was conducted between October 2018 and August 2019. INTERVENTION Participants were randomized to either 12 months of moderate (25%-35%) energy restriction with a food-based diet (moderate intervention) or 4 months of severe (65%-75%) energy restriction with a total meal replacement diet followed by moderate energy restriction for an additional 8 months (severe intervention). Both interventions had a prescribed protein intake of 1.0 g/kg of actual body weight per day, and physical activity was encouraged but not supervised. MAIN OUTCOMES AND MEASURES The primary outcome was whole-body lean mass at 12 months after commencement of intervention. Secondary outcomes were body weight, thigh muscle area and muscle function (strength), bone mineral density, and fat mass and distribution, measured at 0, 4, 6, and 12 months. RESULTS A total of 101 postmenopausal women were recruited (mean [SD] age, 58.0 [4.2] years; mean [SD] weight, 90.8 [9.1] kg; mean [SD] body mass index, 34.4 [2.5]). Compared with the moderate group at 12 months, the severe group lost more weight (effect size, -6.6 kg; 95% CI, -8.2 to -5.1 kg), lost more whole-body lean mass (effect size, -1.2 kg; 95% CI, -2.0 to -0.4 kg), and lost more thigh muscle area (effect size, -4.2 cm2; 95% CI, -6.5 to -1.9 cm2). However, decreases in whole-body lean mass and thigh muscle area were proportional to total weight loss, and there was no difference in muscle (handgrip) strength between groups. Total hip bone mineral density (effect size, -0.017 g/cm2; 95% CI, -0.029 to -0.005 g/cm2), whole-body fat mass (effect size, -5.5 kg; 95% CI, -7.1 to -3.9 kg), abdominal subcutaneous adipose tissue (effect size, -1890 cm3; 95% CI, -2560 to -1219 cm3), and visceral adipose tissue (effect size, -1389 cm3; 95% CI, -1748 to -1030 cm3) loss were also greater for the severe group than for the moderate group at 12 months. CONCLUSIONS AND RELEVANCE Severe energy restriction had no greater adverse effect on relative whole-body lean mass or handgrip strength compared with moderate energy restriction and was associated with 2-fold greater weight and fat loss over 12 months. However, there was significantly greater loss of total hip bone mineral density with severe vs moderate energy restriction. Therefore, caution is necessary when implementing severe energy restriction in postmenopausal women, particularly those with osteopenia or osteoporosis. TRIAL REGISTRATION anzctr.org.au Identifier: 12612000651886.
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Affiliation(s)
- Radhika V. Seimon
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Anthony L. Wild-Taylor
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Shelley E. Keating
- School of Human Movement and Nutrition Sciences, Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Sally McClintock
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Claudia Harper
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Alice A. Gibson
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Nathan A. Johnson
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Hamish A. Fernando
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Tania P. Markovic
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Metabolism and Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Jacqueline R. Center
- Bone Biology Program, Garvan Institute of Medical Research, St Vincent’s Hospital Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Janet Franklin
- Metabolism and Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Peter Y. Liu
- Division of Endocrinology, Department of Medicine, Harbor-University of California Los Angeles Medical Center and Los Angeles BioMedical Research Institute, Los Angeles
| | - Stuart M. Grieve
- Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Jim Lagopoulos
- Sunshine Coast Mind and Neuroscience–Thompson Institute, University of the Sunshine Coast, Queensland, Australia
| | - Ian D. Caterson
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Metabolism and Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Nuala M. Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Amanda Sainsbury
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
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Pattinson AL, Nassar N, da Luz FQ, Hay P, Touyz S, Sainsbury A. The Real Happy Study: Protocol for a Prospective Assessment of the Real-World Effectiveness of the HAPIFED Program-a Healthy APproach to we Ight management and Food in Eating Disorders. Behav Sci (Basel) 2019; 9:bs9070072. [PMID: 31266238 PMCID: PMC6680425 DOI: 10.3390/bs9070072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/12/2019] [Accepted: 06/25/2019] [Indexed: 01/16/2023] Open
Abstract
The prevalence of obesity with comorbid binge eating behaviour is growing at a faster rate than that seen for either obesity or eating disorders as separate conditions. Approximately 6% of the population are affected and they potentially face a lifetime of poor physical and mental health outcomes and an inability to sustain long-term weight loss. Current treatment options are inadequate in that they typically address either obesity or eating disorders exclusively, not the combination of both conditions. By treating one condition without treating the other, relapse is common, and patients are often left disappointed with their lack of weight loss. An integrated approach to treating these individuals is needed to prevent a worsening of the comorbidities associated with excess body weight and eating disorders. A new therapy has recently been developed, named HAPIFED, which addresses both overweight/obesity and comorbid binge eating behaviour with the combination of behavioural weight loss therapy and cognitive behaviour therapy-enhanced (CBT-E). The aim of this paper is to document the protocol for the Real Happy Study, which will evaluate the effectiveness of the HAPIFED program in treating overweight or obesity with comorbid binge-eating behaviour in a real-world setting.
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Affiliation(s)
- Andrea L Pattinson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia
| | - Felipe Q da Luz
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia
| | - Phillipa Hay
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia
| | - Stephen Touyz
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006, Australia
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, NSW 2006, Australia.
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Maston G, Franklin J, Sainsbury A, Gibson AA, Manson E, Markovic T. Formal training and the use of meal replacement products among health professionals working in the management of obesity. Obes Res Clin Pract 2019. [DOI: 10.1016/j.orcp.2018.11.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Smith VM, Seimon RV, Harris RA, Sainsbury A, da Luz FQ. Less Binge Eating and Loss of Control over Eating Are Associated with Greater Levels of Mindfulness: Identifying Patterns in Postmenopausal Women with Obesity. Behav Sci (Basel) 2019; 9:E36. [PMID: 30965602 PMCID: PMC6523377 DOI: 10.3390/bs9040036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 11/16/2022] Open
Abstract
Obesity is a public health concern resulting in widespread personal, social, and economic burden. Many individuals with obesity report feeling unable to stop eating or to control their food intake (i.e., a loss of control over eating) despite their best efforts. Experiencing loss of control over eating predicts further eating pathology and is a key feature of binge eating. Mindfulness (i.e., awareness and acceptance of current thoughts, feelings, sensations, and surrounding events) has emerged as a potential strategy to treat such eating disorder behaviors, but it is not known whether there is merit in investigating this strategy to address binge eating in postmenopausal women with obesity. Thus, this study aimed to examine the relationships between binge eating and mindfulness in postmenopausal women with obesity seeking weight loss treatment. Participants (n = 101) were assessed with the Eating Disorder Examination Questionnaire, the Loss of Control over Eating Scale, the Five-Facet Mindfulness Questionnaire, and the Langer Mindfulness Scale. Participants´ overall scores on both mindfulness scales were significantly and negatively correlated with binge eating frequency or the severity of loss of control over eating. Moreover, participants who reported fewer binge eating episodes were significantly more mindful than those who reported greater frequencies of binge eating episodes within the past 28 days. These findings suggest a merit in investigating the use of mindfulness-based therapies to treat binge eating in postmenopausal women with obesity.
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Affiliation(s)
- Veronica M Smith
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia.
| | - Radhika V Seimon
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia.
| | - Rebecca A Harris
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia.
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia.
| | - Felipe Q da Luz
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia.
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Keating SE, Alzahrani A, Kirchner J, Caterson ID, King NA, Johnson NA, Seimon RV, Sainsbury A. Effects of exercise on appetite and gut hormones: Implications for weight management. Obes Res Clin Pract 2019. [DOI: 10.1016/j.orcp.2016.10.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sainsbury A, Wood RE, Seimon RV, Hills AP, King NA, Gibson AA, Byrne NM. Rationale for novel intermittent dieting strategies to attenuate adaptive responses to energy restriction. Obes Rev 2018; 19 Suppl 1:47-60. [PMID: 30511512 DOI: 10.1111/obr.12787] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/11/2018] [Indexed: 12/16/2022]
Abstract
Eating patterns involving intermittent energy restriction (IER) include 'intermittent fasting' where energy intake is severely restricted for several 'fasting' days per week, with 'refeeding' days (involving greater energy intake than during fasting days) at other times. Intermittent fasting does not improve weight loss compared to continuous energy restriction (CER), where energy intake is restricted every day. We hypothesize that weight loss from IER could be improved if refeeding phases involved restoration of energy balance (i.e. not ongoing energy restriction, as during intermittent fasting). There is some evidence in adults with overweight or obesity showing that maintenance of a lower weight may attenuate (completely or partially) some of the adaptive responses to energy restriction that oppose ongoing weight loss. Other studies show some adaptive responses persist unabated for years after weight loss. Only five randomized controlled trials in adults with overweight or obesity have compared CER with IER interventions that achieved energy balance (or absence of energy restriction) during refeeding phases. Two reported greater weight loss than CER, whereas three reported similar weight loss between interventions. While inconclusive, it is possible that achieving energy balance (i.e. avoiding energy restriction or energy excess) during refeeding phases may be important in realizing the potential of IER.
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Affiliation(s)
- A Sainsbury
- Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, NSW, Australia
| | - R E Wood
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - R V Seimon
- Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, NSW, Australia
| | - A P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - N A King
- School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - A A Gibson
- Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, NSW, Australia
| | - N M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
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Peos JJ, Helms ER, Fournier PA, Sainsbury A. Continuous versus intermittent moderate energy restriction for increased fat mass loss and fat free mass retention in adult athletes: protocol for a randomised controlled trial-the ICECAP trial (Intermittent versus Continuous Energy restriction Compared in an Athlete Population). BMJ Open Sport Exerc Med 2018; 4:e000423. [PMID: 30364484 PMCID: PMC6196972 DOI: 10.1136/bmjsem-2018-000423] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2018] [Indexed: 01/20/2023] Open
Abstract
Introduction Reducing fat mass (FM) while retaining fat free mass (FFM) is a common goal of athletes. Evidence suggests that some-but not all-forms of intermittent energy restriction (IER) may be superior to the conventional method of continuous energy restriction (CER) for people with excess body fat that are sedentary, by reducing some of the adaptive responses to ER. However, it is yet to be established whether this dietary approach is effective for athletes. Methods and analysis A single-blind, parallel group, randomised controlled trial with a 1:1 allocation ratio is proposed. Sixty healthy athletes aged ≥18 years will be recruited from local sporting facilities and randomised to an intervention of either moderate CER (mCER) or moderate IER (mIER). Both interventions will consist of 12 weeks of moderate ER, plus 3 weeks in energy balance (EB). The mCER intervention will entail 12 weeks of continuous moderate ER, followed by 3 weeks in EB. The mIER intervention will entail 12 weeks of moderate ER, administered as 4×3 week blocks of moderate ER, interspersed with 3×1 week blocks of EB. The co-primary outcomes are changes in FM and FFM after 12 weeks of moderate ER. Secondary outcomes will be changes in FM and FFM at 15 weeks after intervention commencement, as well as muscle performance, physical activity, sleep quality, changes in resting energy expenditure, subjective drive to eat, circulating concentrations of appetite-regulating hormones, mood states and diet acceptability. Trial registration ACTRN12618000638235p.
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Affiliation(s)
- Jackson J Peos
- School of Human Sciences, The University of Western Australia (UWA), Crawley, Western Australia, Australia
| | - Eric R Helms
- Sports Performance Institute New Zealand (SPRINZ), Auckland University of Technology, at AUT Millennium, Auckland, New Zealand
| | - Paul A Fournier
- School of Human Sciences, The University of Western Australia (UWA), Crawley, Western Australia, Australia
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia
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da Luz FQ, Sainsbury A, Mannan H, Touyz S, Mitchison D, Girosi F, Hay P. An investigation of relationships between disordered eating behaviors, weight/shape overvaluation and mood in the general population. Appetite 2018; 129:19-24. [DOI: 10.1016/j.appet.2018.06.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/23/2018] [Accepted: 06/20/2018] [Indexed: 11/30/2022]
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Harper C, Maher J, Grunseit A, Seimon RV, Sainsbury A. Experiences of using very low energy diets for weight loss by people with overweight or obesity: a review of qualitative research. Obes Rev 2018; 19:1412-1423. [PMID: 30144269 DOI: 10.1111/obr.12715] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 04/18/2018] [Accepted: 04/30/2018] [Indexed: 12/13/2022]
Abstract
Although very low energy diets (VLEDs) are the most successful non-surgical, non-pharmacological treatment for obesity, they are underutilized, and little is known about experiences of people using VLEDs for weight loss. This systematic review synthesizes qualitative studies investigating participants' experiences of undertaking a VLED composed of total meal replacement products to lose weight. Of the 4,911 articles screened, three studies met criteria for inclusion. Thematic synthesis was used to analyse the study findings. Health and appearance were the main motivators to use a VLED for weight loss. Adherence was facilitated by group support meetings, rapid weight loss and ease of use of the diet. Being part of a clinical trial gave a sense of accountability and further reason to adhere to a VLED, and the VLED itself was well accepted by users. Barriers to adherence, such as temptations and social occasions, were overcome by avoidance and distraction strategies. In conclusion, this qualitative synthesis of users' experiences of VLEDs shows that VLEDs are well accepted and positively viewed by users. More in-depth research could facilitate understanding of how this weight loss strategy influences the weight maintenance period, in order to facilitate better long-term results.
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Affiliation(s)
- C Harper
- Faculty of Medicine and Health, The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, The University of Sydney, Charles Perkins Centre, Sydney, NSW, Australia
| | - J Maher
- Faculty of Science, Health, Education and Engineering, School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - A Grunseit
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Charles Perkins Centre, Sydney, NSW, Australia
| | - R V Seimon
- Faculty of Medicine and Health, The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, The University of Sydney, Charles Perkins Centre, Sydney, NSW, Australia
| | - A Sainsbury
- Faculty of Medicine and Health, The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, The University of Sydney, Charles Perkins Centre, Sydney, NSW, Australia
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Cheng HL, Sainsbury A, Garden F, Sritharan M, Paxton K, Luscombe G, Hawke C, Steinbeck K. Ghrelin and Peptide YY Change During Puberty: Relationships With Adolescent Growth, Development, and Obesity. J Clin Endocrinol Metab 2018; 103:2851-2860. [PMID: 29860506 DOI: 10.1210/jc.2017-01825] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 05/25/2018] [Indexed: 12/25/2022]
Abstract
CONTEXT Pubertal adolescents show strong appetites. How this is mediated is unclear, but ghrelin and peptide YY (PYY) play potentially important roles. OBJECTIVE To measure ghrelin and PYY change in relation to pubertal growth. DESIGN Three-year prospective cohort study. SETTING Australian regional community. PARTICIPANTS Eighty healthy adolescents (26 girls; 54 boys) recruited at 10 to 13 years. MAIN OUTCOME MEASURES Fasting circulating total ghrelin, total PYY, IGF-1, insulin, leptin (via radioimmunoassay), estradiol and testosterone (via mass spectrometry), anthropometry, and body composition (via bioelectrical impedance). RESULTS Adolescents exhibited normal developmental change. Mixed models revealed positive associations for ghrelin to age2 (both sexes: P < 0.05), indicating a U-shaped trend over time. Ghrelin was also inversely associated with IGF-1 (both sexes: P < 0.05), leptin in girls (P < 0.01), and insulin in boys (P < 0.05) and negatively correlated with annual height and weight velocity (both sexes: P ≤ 0.01). PYY showed no age-related change in either sex. Neither ghrelin nor PYY were associated with Tanner stage. Weight subgroup analyses showed significant ghrelin associations with age2 in healthy-weight but not overweight and obese adolescents (7 girls; 18 boys). CONCLUSIONS Adolescents showed a U-shaped change in ghrelin corresponding to physical and biochemical markers of growth, and no change in PYY. The overweight and obesity subgroup exhibited an apparent loss of the U-shaped ghrelin trend, but this finding may be attributed to greater maturity and its clinical significance is unclear. Further research on weight-related ghrelin and PYY trends at puberty is needed to understand how these peptides influence growth and long-term metabolic risk.
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Affiliation(s)
- Hoi Lun Cheng
- The Children's Hospital at Westmead, Academic Department of Adolescent Medicine, Westmead, New South Wales, Australia
- The University of Sydney, Faculty of Medicine and Health, Sydney Medical School, Discipline of Child and Adolescent Health, Westmead, New South Wales, Australia
| | - Amanda Sainsbury
- The University of Sydney, Faculty of Medicine and Health, The Boden Institute of Obesity, Nutrition, Exercise, and Eating Disorders, Charles Perkins Centre, Camperdown, New South Wales, Australia
| | - Frances Garden
- University of New South Wales, South Western Sydney Clinical School, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Myuran Sritharan
- The Children's Hospital at Westmead, Academic Department of Adolescent Medicine, Westmead, New South Wales, Australia
- The University of Sydney, Faculty of Medicine and Health, Sydney Medical School, Discipline of Child and Adolescent Health, Westmead, New South Wales, Australia
| | - Karen Paxton
- The University of Sydney, Faculty of Medicine and Health, School of Rural Health, Dubbo, New South Wales, Australia
| | - Georgina Luscombe
- The University of Sydney, Faculty of Medicine and Health, School of Rural Health, Orange, New South Wales, Australia
| | - Catherine Hawke
- The University of Sydney, Faculty of Medicine and Health, School of Rural Health, Orange, New South Wales, Australia
| | - Katharine Steinbeck
- The Children's Hospital at Westmead, Academic Department of Adolescent Medicine, Westmead, New South Wales, Australia
- The University of Sydney, Faculty of Medicine and Health, Sydney Medical School, Discipline of Child and Adolescent Health, Westmead, New South Wales, Australia
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Hsu MSH, Harper C, Gibson AA, Sweeting AN, McBride J, Markovic TP, Caterson ID, Byrne NM, Sainsbury A, Seimon RV. Recruitment Strategies for a Randomised Controlled Trial Comparing Fast Versus Slow Weight Loss in Postmenopausal Women with Obesity-The TEMPO Diet Trial. Healthcare (Basel) 2018; 6:healthcare6030076. [PMID: 29986398 PMCID: PMC6163885 DOI: 10.3390/healthcare6030076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/02/2018] [Accepted: 07/03/2018] [Indexed: 12/12/2022] Open
Abstract
Current research around effective recruitment strategies for clinical trials of dietary obesity treatments have largely focused on younger adults, and thus may not be applicable to older populations. The TEMPO Diet Trial (Type of Energy Manipulation for Promoting optimal metabolic health and body composition in Obesity) is a randomised controlled trial comparing the long-term effects of fast versus slow weight loss on body composition and cardio-metabolic health in postmenopausal women with obesity. This paper addresses the recruitment strategies used to enrol participants into this trial and evaluates their relative effectiveness. 101 post-menopausal women aged 45–65 years, with a body mass index of 30–40 kg/m2 were recruited and randomised to either fast or slow weight loss. Multiple strategies were used to recruit participants. The total time cost (labour) and monetary cost per randomised participant from each recruitment strategy was estimated, with lower values indicating greater cost-effectiveness and higher values indicating poorer cost-effectiveness. The most cost-effective recruitment strategy was word of mouth, followed (at equal second place) by free publicity on TV and radio, and printed advertorials, albeit these avenues only yielded 26/101 participants. Intermediate cost-effective recruitment strategies were flyer distribution at community events, hospitals and a local tertiary education campus, internet-based strategies, and clinical trial databases and intranets, which recruited a further 40/101 participants. The least cost-effective recruitment strategy was flyer distribution to local health service centres and residential mailboxes, and referrals from healthcare professionals were not effective. Recruiting for clinical trials involving postmenopausal women could benefit from a combination of recruitment strategies, with an emphasis on word of mouth and free publicity via radio, TV, and print media, as well as strategic placement of flyers, supplemented with internet-based strategies, databases and intranets if a greater yield of participants is needed.
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Affiliation(s)
- Michelle S H Hsu
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Claudia Harper
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Alice A Gibson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Arianne N Sweeting
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
| | - John McBride
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Tania P Markovic
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
| | - Ian D Caterson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia.
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Radhika V Seimon
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
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da Luz FQ, Hay P, Touyz S, Sainsbury A. Obesity with Comorbid Eating Disorders: Associated Health Risks and Treatment Approaches. Nutrients 2018; 10:E829. [PMID: 29954056 PMCID: PMC6073367 DOI: 10.3390/nu10070829] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/20/2018] [Accepted: 06/25/2018] [Indexed: 12/29/2022] Open
Abstract
Obesity and eating disorders are each associated with severe physical and mental health consequences, and individuals with obesity as well as comorbid eating disorders are at higher risk of these than individuals with either condition alone. Moreover, obesity can contribute to eating disorder behaviors and vice-versa. Here, we comment on the health complications and treatment options for individuals with obesity and comorbid eating disorder behaviors. It appears that in order to improve the healthcare provided to these individuals, there is a need for greater exchange of experiences and specialized knowledge between healthcare professionals working in the obesity field with those working in the field of eating disorders, and vice-versa. Additionally, nutritional and/or behavioral interventions simultaneously addressing weight management and reduction of eating disorder behaviors in individuals with obesity and comorbid eating disorders may be required. Future research investigating the effects of integrated medical, psychological and nutritional treatment programs addressing weight management and eating disorder psychopathology in individuals with obesity and comorbid eating disorder behaviors—such as binge eating—is necessary.
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Affiliation(s)
- Felipe Q da Luz
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
- Faculty of Science, School of Psychology, the University of Sydney, Camperdown, NSW 2006, Australia.
- CAPES Foundation, Ministry of Education of Brazil, Brasília, DF 70040-020, Brazil.
| | - Phillipa Hay
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Stephen Touyz
- Faculty of Science, School of Psychology, the University of Sydney, Camperdown, NSW 2006, Australia.
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
- Faculty of Science, School of Psychology, the University of Sydney, Camperdown, NSW 2006, Australia.
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Fuller NR, Sainsbury A, Caterson ID, Denyer G, Fong M, Gerofi J, Leung C, Lau NS, Williams KH, Januszewski AS, Jenkins AJ, Markovic TP. Effect of a high-egg diet on cardiometabolic risk factors in people with type 2 diabetes: the Diabetes and Egg (DIABEGG) Study-randomized weight-loss and follow-up phase. Am J Clin Nutr 2018; 107:921-931. [PMID: 29741558 DOI: 10.1093/ajcn/nqy048] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 02/23/2018] [Indexed: 12/15/2022] Open
Abstract
Background Some country guidelines recommend that people with type 2 diabetes (T2D) limit their consumption of eggs and cholesterol. Our previously published 3-mo weight-maintenance study showed that a high-egg (≥12 eggs/wk) diet compared with a low-egg diet (<2 eggs/wk) did not have adverse effects on cardiometabolic risk factors in adults with T2D. Objective The current study follows the previously published 3-mo weight-maintenance study and assessed the effects of the high-egg compared with the low-egg diets as part of a 3-mo weight-loss period, followed by a 6-mo follow-up period for a total duration of 12 mo. Design Participants with prediabetes or T2D (n = 128) were prescribed a 3-mo daily energy restriction of 2.1 MJ and a macronutrient-matched diet and instructed on specific types and quantities of foods to be consumed, with an emphasis on replacing saturated fats with monounsaturated and polyunsaturated fats. Participants were followed up at the 9- and 12-mo visits. Results From 3 to 12 mo, the weight loss was similar (high-egg compared with low-egg diets: -3.1 ± 6.3 compared with -3.1 ± 5.2 kg; P = 0.48). There were no differences between groups in glycemia (plasma glucose, glycated hemoglobin, 1,5-anhydroglucitol), traditional serum lipids, markers of inflammation (high-sensitivity C-reactive protein, interleukin 6, soluble E-selectin), oxidative stress (F2-isoprostanes), or adiponectin from 3 to 12 mo or from 0 to 12 mo. Conclusions People with prediabetes or T2D who consumed a 3-mo high-egg weight-loss diet with a 6-mo follow-up exhibited no adverse changes in cardiometabolic markers compared with those who consumed a low-egg weight-loss diet. A healthy diet based on population guidelines and including more eggs than currently recommended by some countries may be safely consumed. This trial is registered at http://www.anzctr.org.au/ as ACTRN12612001266853.
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Affiliation(s)
- Nicholas R Fuller
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Amanda Sainsbury
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Ian D Caterson
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia.,Metabolism and Obesity Services, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Gareth Denyer
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia.,School of Molecular Bioscience, University of Sydney, Sydney, Australia
| | - Mackenzie Fong
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - James Gerofi
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Chloris Leung
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Namson S Lau
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Kathryn H Williams
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Andrzej S Januszewski
- National Health and Medical Research Council Clinical Trials Center, University of Sydney, Sydney, Australia
| | - Alicia J Jenkins
- National Health and Medical Research Council Clinical Trials Center, University of Sydney, Sydney, Australia
| | - Tania P Markovic
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia.,Metabolism and Obesity Services, Royal Prince Alfred Hospital, Camperdown, Australia
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Seimon RV, Wild-Taylor AL, Gibson AA, Harper C, McClintock S, Fernando HA, Hsu MSH, da Luz FQ, Keating SE, Johnson NA, Grieve SM, Markovic TP, Caterson ID, Byrne NM, Sainsbury A. Less Waste on Waist Measurements: Determination of Optimal Waist Circumference Measurement Site to Predict Visceral Adipose Tissue in Postmenopausal Women with Obesity. Nutrients 2018; 10:nu10020239. [PMID: 29461494 PMCID: PMC5852815 DOI: 10.3390/nu10020239] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/01/2018] [Accepted: 02/14/2018] [Indexed: 11/16/2022] Open
Abstract
With obesity being a leading cause of preventable death, it is vital to understand how best to identify individuals with greater risk of metabolic disease, especially those with high visceral adipose tissue (VAT). This study aimed to determine whether three commonly used waist circumference (WC) measurement sites could provide accurate estimations of VAT, as determined by magnetic resonance imaging (MRI), which is a gold standard for measuring VAT, in postmenopausal women with obesity. VAT volume was measured by MRI of the total abdomen in 97 women aged 57.7 ± 0.4 years (mean ± SEM), mean body mass index 34.5 ± 0.2 kg/m2. WC was measured at the midpoint between the lowest rib and the iliac crest (WCmid), the narrowest point of the torso (WCnarrow), and at the level of the umbilicus (WCumbilicus). WC differed significantly according to measurement site, with WCnarrow (102.1 ± 0.7 cm) < WCmid (108.3 ± 0.7 cm) < WCumbilicus (115.7 ± 0.8 cm) (p < 0.001). WCmid, WCnarrow and WCumbilicus were all significantly correlated with VAT, as measured by MRI (r = 0.581, 0.563 and 0.390, respectively; p < 0.001 for all), but the relationships between WCmid or WCnarrow and VAT determined by MRI were stronger than for WCumbilicus. Measurement of either WCmid or WCnarrow provides valid estimates of VAT in postmenopausal women with obesity, with WCnarrow being favoured in light of its greater ease and speed of measurement in this population.
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Affiliation(s)
- Radhika V. Seimon
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- Correspondence: ; Tel.: +61-2-8627-1918; Fax: +61-2-8627-0141
| | - Anthony L. Wild-Taylor
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Alice A. Gibson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Claudia Harper
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Sally McClintock
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Hamish A. Fernando
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Michelle S. H. Hsu
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Felipe Q. da Luz
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- School of Psychology, Faculty of Science, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Shelley E. Keating
- School of Human Movement and Nutrition Sciences, Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, Brisbane, QLD 4072, Australia;
| | - Nathan A. Johnson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW 2050, Australia
| | - Stuart M. Grieve
- Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia;
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Tania P. Markovic
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Ian D. Caterson
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
| | - Nuala M. Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia;
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2050, Australia; (A.L.W.-T.); (A.A.G.); (C.H.); (S.M.); (H.A.F.); (M.S.H.H.); (F.Q.d.L.); (N.A.J.); (T.P.M.); (I.D.C.); (A.S.)
- School of Psychology, Faculty of Science, The University of Sydney, Camperdown, NSW 2050, Australia
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Nguyen AD, Lee NJ, Wee NKY, Zhang L, Enriquez RF, Khor EC, Nie T, Wu D, Sainsbury A, Baldock PA, Herzog H. Uncoupling protein-1 is protective of bone mass under mild cold stress conditions. Bone 2018; 106:167-178. [PMID: 26055106 DOI: 10.1016/j.bone.2015.05.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 05/25/2015] [Accepted: 05/27/2015] [Indexed: 12/16/2022]
Abstract
Brown adipose tissue (BAT), largely controlled by the sympathetic nervous system (SNS), has the ability to dissipate energy in the form of heat through the actions of uncoupling protein-1 (UCP-1), thereby critically influencing energy expenditure. Besides BAT, the SNS also strongly influences bone, and recent studies have demonstrated a positive correlation between BAT activity and bone mass, albeit the interactions between BAT and bone remain unclear. Here we show that UCP-1 is critical for protecting bone mass in mice under conditions of permanent mild cold stress for this species (22°C). UCP-1-/- mice housed at 22°C showed significantly lower cancellous bone mass, with lower trabecular number and thickness, a lower bone formation rate and mineralising surface, but unaltered osteoclast number, compared to wild type mice housed at the same temperature. UCP-1-/- mice also displayed shorter femurs than wild types, with smaller cortical periosteal and endocortical perimeters. Importantly, these altered bone phenotypes were not observed when UCP-1-/- and wild type mice were housed in thermo-neutral conditions (29°C), indicating a UCP-1 dependent support of bone mass and bone formation at the lower temperature. Furthermore, at 22°C UCP-1-/- mice showed elevated hypothalamic expression of neuropeptide Y (NPY) relative to wild type, which is consistent with the lower bone formation and mass of UCP-1-/- mice at 22°C caused by the catabolic effects of hypothalamic NPY-induced SNS modulation. The results from this study suggest that during mild cold stress, when BAT-dependent thermogenesis is required, UCP-1 activity exerts a protective effect on bone mass possibly through alterations in central NPY pathways known to regulate SNS activity.
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Affiliation(s)
- Amy D Nguyen
- Neuroscience Division, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia
| | - Nicola J Lee
- Neuroscience Division, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia
| | - Natalie K Y Wee
- Osteoporosis and Bone Biology Division, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia
| | - Lei Zhang
- Neuroscience Division, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia
| | - Ronaldo F Enriquez
- Osteoporosis and Bone Biology Division, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia
| | - Ee Cheng Khor
- Osteoporosis and Bone Biology Division, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia
| | - Tao Nie
- Key Laboratory of Regenerative Biology, Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou 510663, China
| | - Donghai Wu
- Key Laboratory of Regenerative Biology, Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou 510663, China
| | - Amanda Sainsbury
- Neuroscience Division, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia; The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia
| | - Paul A Baldock
- Osteoporosis and Bone Biology Division, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia
| | - Herbert Herzog
- Neuroscience Division, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia; Faculty of Medicine, University of NSW, Kensington, Sydney, NSW 2052, Australia.
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48
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Fuller NR, Burns J, Sainsbury A, Horsfield S, da Luz F, Zhang S, Denyer G, Markovic TP, Caterson ID. Examining the association between depression and obesity during a weight management programme. Clin Obes 2017; 7:354-359. [PMID: 28801940 DOI: 10.1111/cob.12208] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 06/30/2017] [Accepted: 07/04/2017] [Indexed: 12/19/2022]
Abstract
The prevalence of depression in those with obesity is reported to be as high as double that in individuals of normal weight. There is potentially a bi-directional relationship between obesity and depression. Some research has suggested that depression results in weight gain and obesity, and other studies have suggested that those with obesity are more likely to develop depression at a later stage. The aim of this study was to investigate the association of depression symptoms with weight change over a 12-month study. Seventy participants undertook a 3-month lifestyle (diet and exercise) weight loss intervention, and were followed up as part of a 12-month study. Participants completed the Beck Depression Inventory-II (BDI-II) and had their body weight measured throughout the study. Baseline body mass index (BMI) of participants (mean ± standard deviation [SD]) was 31.1 ± 3.9 kg m-2 , body weight was 89.4 ± 16.1 kg, and age was 45.4 ± 11.1 years; 63% of the cohort were female. The mean weight change from baseline to 3 months was -5.2% (±SD 4.3%), and from baseline to 12 months was -4.2% (±SD 6.1%). There was a significant decrease in BDI-II scores over the 12-month study, and a 1-unit decrease in BDI-II score was associated with a further decrease in body weight of -0.4%. The current study indicated that weight loss was associated with improvements in mood for non-clinically depressed individuals with obesity, and these improvements persisted during a period of 3-12 months of follow-up.
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Affiliation(s)
- N R Fuller
- The Boden Institute, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - J Burns
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - A Sainsbury
- The Boden Institute, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - S Horsfield
- The Boden Institute, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - F da Luz
- The Boden Institute, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - S Zhang
- The Boden Institute, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - G Denyer
- The Boden Institute, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - T P Markovic
- The Boden Institute, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - I D Caterson
- The Boden Institute, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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49
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Byrne NM, Sainsbury A, King NA, Hills AP, Wood RE. Intermittent energy restriction improves weight loss efficiency in obese men: the MATADOR study. Int J Obes (Lond) 2017; 42:129-138. [PMID: 28925405 PMCID: PMC5803575 DOI: 10.1038/ijo.2017.206] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/02/2017] [Accepted: 08/06/2017] [Indexed: 11/09/2022]
Abstract
Background/Objectives: The MATADOR (Minimising Adaptive Thermogenesis And Deactivating Obesity Rebound) study examined whether intermittent energy restriction (ER) improved weight loss efficiency compared with continuous ER and, if so, whether intermittent ER attenuated compensatory responses associated with ER. Subjects/Methods: Fifty-one men with obesity were randomised to 16 weeks of either: (1) continuous (CON), or (2) intermittent (INT) ER completed as 8 × 2-week blocks of ER alternating with 7 × 2-week blocks of energy balance (30 weeks total). Forty-seven participants completed a 4-week baseline phase and commenced the intervention (CON: N=23, 39.4±6.8 years, 111.1±9.1 kg, 34.3±3.0 kg m−2; INT: N=24, 39.8±9.5 years, 110.2±13.8 kg, 34.1±4.0 kg m−2). During ER, energy intake was equivalent to 67% of weight maintenance requirements in both groups. Body weight, fat mass (FM), fat-free mass (FFM) and resting energy expenditure (REE) were measured throughout the study. Results: For the N=19 CON and N=17 INT who completed the intervention per protocol, weight loss was greater for INT (14.1±5.6 vs 9.1±2.9 kg; P<0.001). INT had greater FM loss (12.3±4.8 vs 8.0±4.2 kg; P<0.01), but FFM loss was similar (INT: 1.8±1.6 vs CON: 1.2±2.5 kg; P=0.4). Mean weight change during the 7 × 2-week INT energy balance blocks was minimal (0.0±0.3 kg). While reduction in absolute REE did not differ between groups (INT: -502±481 vs CON: −624±557 kJ d−1; P=0.5), after adjusting for changes in body composition, it was significantly lower in INT (INT: −360±502 vs CON: −749±498 kJ d−1; P<0.05). Conclusions: Greater weight and fat loss was achieved with intermittent ER. Interrupting ER with energy balance ‘rest periods’ may reduce compensatory metabolic responses and, in turn, improve weight loss efficiency.
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Affiliation(s)
- N M Byrne
- School of Health Sciences, Faculty of Health, University of Tasmania, Launceston, Tasmania, Australia.,Queensland University of Technology, School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Brisbane, Queensland, Australia
| | - A Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, The University of Sydney, Camperdown New South Wales, Australia
| | - N A King
- Queensland University of Technology, School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Brisbane, Queensland, Australia
| | - A P Hills
- School of Health Sciences, Faculty of Health, University of Tasmania, Launceston, Tasmania, Australia.,Queensland University of Technology, School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Brisbane, Queensland, Australia
| | - R E Wood
- School of Health Sciences, Faculty of Health, University of Tasmania, Launceston, Tasmania, Australia.,Queensland University of Technology, School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Brisbane, Queensland, Australia
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50
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Keating SE, Hackett DA, Parker HM, Way KL, O'Connor HT, Sainsbury A, Baker MK, Chuter VH, Caterson ID, George J, Johnson NA. Effect of resistance training on liver fat and visceral adiposity in adults with obesity: A randomized controlled trial. Hepatol Res 2017; 47:622-631. [PMID: 27480242 DOI: 10.1111/hepr.12781] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/23/2016] [Accepted: 07/26/2016] [Indexed: 02/08/2023]
Abstract
AIM Regular aerobic exercise reduces visceral adipose tissue (VAT) and liver fat, however, not all individuals are able to adopt and adhere to such programs. Progressive resistance training (PRT) may be an alternative therapy, but there is limited available evidence. We examined the efficacy of PRT as per current exercise guidelines, compared with sham exercise placebo on liver fat and VAT. METHODS Twenty-nine inactive and overweight/obese (body mass index ≥25 kg/m2 ) adults (age 29-59) were randomized to receive 8 weeks of PRT (n = 15, 10 exercises per session, 8-12 repetitions, 2-3 sets per exercise at 80-85% of one-repetition maximum, 3 days per week) or a sham exercise placebo control (CON) (n = 14). Change in liver fat, VAT, and abdominal s.c. adipose tissue (SAT) were assessed by magnetic resonance spectroscopy and imaging). RESULTS There were no significant group by time interactions for change in liver fat in PRT versus CON groups (-0.07 ± 0.31% vs. 0.55 ± 0.77%, respectively, P = 0.19), VAT (-175 ± 85 cm3 vs. 10 ± 64 cm3 , respectively, P = 0.11), or abdominal SAT (-436 ± 245 cm3 vs. 127.29 ± 182 cm3 , respectively, P = 0.10) despite a significant increase in muscle volume (55 ± 78 cm3 vs. -0.04 ± 8 cm3 , respectively, P = 0.03). CONCLUSION Traditional PRT is not effective for reducing liver fat in overweight/obese adults compared with placebo control. Although PRT has known metabolic benefits, an adequate volume of aerobic exercise should be promoted if liver fat is the therapeutic target.
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Affiliation(s)
- Shelley E Keating
- Discipline of Exercise and Sport Science, University of Sydney, Sydney, Australia.,Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Daniel A Hackett
- Discipline of Exercise and Sport Science, University of Sydney, Sydney, Australia
| | - Helen M Parker
- Discipline of Exercise and Sport Science, University of Sydney, Sydney, Australia
| | - Kimberley L Way
- Discipline of Exercise and Sport Science, University of Sydney, Sydney, Australia
| | - Helen T O'Connor
- Discipline of Exercise and Sport Science, University of Sydney, Sydney, Australia
| | - Amanda Sainsbury
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Michael K Baker
- School of Exercise Science, Australian Catholic University, Sydney, New South Wales, Australia
| | - Vivienne H Chuter
- School of Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Ian D Caterson
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Jacob George
- Storr Liver Centre, Westmead Millennium Institute and Westmead Hospital, University of Sydney, Sydney, Australia
| | - Nathan A Johnson
- Discipline of Exercise and Sport Science, University of Sydney, Sydney, Australia.,Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, University of Sydney, Sydney, Australia
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