1
|
Jin Z, Li J, Thackray AE, Shen T, Deighton K, King JA, Stensel DJ. Fasting appetite-related gut hormone responses after weight loss induced by calorie restriction, exercise, or both in people with overweight or obesity: a meta-analysis. Int J Obes (Lond) 2025; 49:776-792. [PMID: 39929932 PMCID: PMC12095072 DOI: 10.1038/s41366-025-01726-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 01/06/2025] [Accepted: 01/22/2025] [Indexed: 05/23/2025]
Abstract
OBJECTIVES Altered appetite-related gut hormone concentrations may reflect a physiological adaptation facilitating weight regain after weight loss. This review investigates hormonal changes after weight loss achieved through calorie restriction (CR), exercise (EX), or both combined (CREX). METHODS A systematic search of PubMed (MEDLINE), EMBASE, SPORTDiscus, Cochrane Library, Web of Science, and ClinicalTrials.gov was conducted to identify randomised controlled trials (RCTs) and non-RCTs reporting in a fasting state either pre- and post-intervention appetite-related hormone concentrations or the changes therein after weight loss. The hormones examined were ghrelin, peptide tyrosine tyrosine (PYY), glucagon-like peptide -1 (GLP-1), and cholecystokinin (CCK), in their total and/or active form. Standardised mean differences (SMD) were extracted as the effect size. RESULTS 127 studies were identified: 19 RCTs, 108 non-RCTs, 1305 and 4725 participants, respectively. In response to weight loss induced by CR, EX or CREX, the meta-analysis revealed an increase in total ghrelin from both RCTs (SMD: 0.55, 95% CI: 0.07-1.04) and non-RCTs (SMD: 0.24, 95% CI: 0.14-0.35). A decrease in acylated ghrelin was identified for RCTs (SMD: -0.58, 95% CI: -1.09 to -0.06) but an increase was observed for non-RCTs (SMD: 0.15, 95% CI: 0.03 to 0.27). Findings also revealed a decrease in PYY (total PYY: SMD: -0.17, 95%CI: -0.28 to -0.06; PYY3-36: SMD: -0.17, 95%CI: -0.32 to -0.02) and active GLP-1 (SMD: -0.16, 95% CI: -0.28 to -0.05) from non-RCTs. Changes in hormones did not differ among the three interventions when controlling for weight loss. Meta-regression indicated that greater weight loss was associated with a greater increase in total ghrelin. CONCLUSIONS Weight loss induced by CR, EX, or CREX elicits an increase in total ghrelin, but varied responses in other appetite-related hormones. The extent of weight loss influences changes in appetite-related gut hormone concentrations.
Collapse
Affiliation(s)
- Zhuoxiu Jin
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Jiajin Li
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Alice E Thackray
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
- National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester National Health Service (NHS) Trust and the University of Leicester, Leicester, United Kingdom
| | - Tonghui Shen
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
- Department of Physical Education and Aesthetic Education, Hangzhou City University, Hangzhou, China
| | | | - James A King
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
- National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester National Health Service (NHS) Trust and the University of Leicester, Leicester, United Kingdom
| | - David J Stensel
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom.
- National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester National Health Service (NHS) Trust and the University of Leicester, Leicester, United Kingdom.
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan.
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong.
| |
Collapse
|
2
|
Huang L, Guo Z, Jiang Z, Xu Y, Huang H. Resting metabolic rate in obesity. Postgrad Med J 2025; 101:396-410. [PMID: 39561990 DOI: 10.1093/postmj/qgae153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 08/17/2024] [Indexed: 11/21/2024]
Abstract
The prevalence of obesity has continued to rise, and obesity and its attendant metabolic disorders are major global health threat factors. Among the current interventions for obesity, none have demonstrated sustained efficacy in achieving long-term outcomes. So, the identification of therapeutic targets is of paramount importance in the advancement and sustainability of obesity. Resting metabolic rate (RMR) constitutes 60%-75% of total energy expenditure and serves a crucial function in maintaining energy balance. Nevertheless, there exists considerable heterogeneity in RMR among individuals. Low RMR is associated with weight gain, elevating the susceptibility to obesity-related ailments. Hence, RMR will be the main focus of interest in the study of obesity treatment. In this review, we will elucidate the influence factors and mechanisms of action of RMR in obesity, with particular emphasis on the effects of obesity treatment on RMR and the alterations and influence factors of RMR in special types of populations with obesity.
Collapse
Affiliation(s)
- LingHong Huang
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, NO. 950 Donghai Street, Fengze District, Quanzhou 362000, Fujian, China
| | - ZhiFeng Guo
- Department of Respiratory Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, NO. 950 Donghai Street, Fengze District, Quanzhou 362000, Fujian, China
| | - ZhengRong Jiang
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, NO. 950 Donghai Street, Fengze District, Quanzhou 362000, Fujian, China
| | - YaJing Xu
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, NO. 950 Donghai Street, Fengze District, Quanzhou 362000, Fujian, China
| | - HuiBin Huang
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, NO. 950 Donghai Street, Fengze District, Quanzhou 362000, Fujian, China
| |
Collapse
|
3
|
Głębocka A, Pilis W, Żak A, Pilis A, Pilis K. Relationships Between Body Image and Body Parameters in Men Under Long-Term Fasting Conditions. Nutrients 2025; 17:1023. [PMID: 40290069 PMCID: PMC11944500 DOI: 10.3390/nu17061023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2025] [Revised: 03/11/2025] [Accepted: 03/12/2025] [Indexed: 04/30/2025] Open
Abstract
Background/Objectives: Fasting and physical exertion positively affect body mass and composition. This study aimed to examine the effects of physical changes induced by eight days of water-only fasting and a physical exertion test and their influence on body satisfaction and body image parameters in middle-aged men. Methods: Fifteen participants were assessed for physical (height, body mass, and body composition) and psychological (body satisfaction, evaluation of body parts, and body image determinants) aspects before and after the fasting intervention, both at rest and post-exercise. Correlation and concordance coefficients were calculated for the analyzed variables. Results: It was found that the fasting intervention led to a reduction in body mass and a favorable shift in body composition, while also increasing satisfaction with one's body and its specific parts. This positively impacted volunteers' self-assessment of their health status. Selected body image parameters remained at an average level for the male population and did not change following the fasting. Attitudes toward body weight control methods and their perceived effectiveness did not change either. Participants favored reducing food intake and eliminating high-calorie products from their diet, rejecting the use pathological methods typically associated with eating disorders. A few associations between physical and psychological aspects of corporeality were observed, whereas significant correlations between satisfaction with body parts and parameters and a positive body image were confirmed. Conclusions: The above suggest that physical conditions and their changes resulting from fasting and physical exertion lead to a positive influence on body satisfaction and its components but do not alter body image.
Collapse
Affiliation(s)
- Alicja Głębocka
- Institute of Health Sciences, University of Opole, 45-061 Opole, Poland;
| | - Wiesław Pilis
- Collegium Medicum, Jan Dlugosz University in Czestochowa, 42-200 Czestochowa, Poland; (W.P.); (A.P.)
| | - Alicja Żak
- Department of Economy in Opole, WSB Merito University in Wroclaw, 53-609 Wrocław, Poland;
| | - Anna Pilis
- Collegium Medicum, Jan Dlugosz University in Czestochowa, 42-200 Czestochowa, Poland; (W.P.); (A.P.)
| | - Karol Pilis
- Collegium Medicum, Jan Dlugosz University in Czestochowa, 42-200 Czestochowa, Poland; (W.P.); (A.P.)
| |
Collapse
|
4
|
Viirre E, Sittlington J, Wing D, Price R, Logue C, Moreno D, Ledford-Mills J, Knott C, le Roux CW, Grieve D, Watson S, McKeown J, McGeoch PD. Non-invasive vestibular nerve stimulation (VeNS) reduces visceral adipose tissue: results of a randomised controlled trial. Sci Rep 2025; 15:8753. [PMID: 40082596 PMCID: PMC11906803 DOI: 10.1038/s41598-025-92744-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Accepted: 03/03/2025] [Indexed: 03/16/2025] Open
Abstract
Across multiple species, chronic vestibular stimulation activates hypothalamic regions involved in energy homeostasis and reduces body fat. This first-in-human randomised controlled trial evaluated the efficacy and safety of electrical vestibular nerve stimulation (VeNS) as a means of reducing excess body weight and fat. Overweight and obese adults were randomised 1:1 to receive 60 min of daily VeNS (n = 117) or sham stimulation (n = 124) for 6 months, together with a hypocaloric diet. The primary endpoints were weight loss based. Secondary endpoints included reduction in visceral adipose tissue (VAT). It is VAT, more than subcutaneous fat depots, which is particularly associated with the risks associated with obesity. The weight loss based primary endpoints were not met. However, mean change in VAT was significantly greater in the active (- 12.6%) versus the sham (- 4.7%) group (p = 0.03). This suggests that regular VeNS may cause a clinically meaningful reduction in VAT.
Collapse
Affiliation(s)
- Erik Viirre
- Department of Neurosciences, University of California, San Diego, USA.
| | | | - David Wing
- Exercise and Physical Activity Resource Center, University of California, San Diego, USA
| | - Ruth Price
- School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Caomhan Logue
- School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Daniel Moreno
- Exercise and Physical Activity Resource Center, University of California, San Diego, USA
| | - Jeff Ledford-Mills
- Altman Clinical and Translational Research Institute, University of California, San Diego, USA
| | - Cynthia Knott
- Altman Clinical and Translational Research Institute, University of California, San Diego, USA
| | - Carel W le Roux
- School of Medicine, University College Dublin, Dublin, Republic of Ireland
| | - David Grieve
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK
| | | | - Jason McKeown
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK
- Neurovalens Ltd, Belfast, UK
- Center for Brain and Cognition, University of California, San Diego, USA
- Dept. of Neurosurgery, The Leland Stanford Junior University, Palo Alto, USA
| | - Paul D McGeoch
- Neurovalens Ltd, Belfast, UK
- Dept. of Neurosurgery, The Leland Stanford Junior University, Palo Alto, USA
| |
Collapse
|
5
|
Di Prinzio RR, Dosi A, Arnesano G, Vacca ME, Melcore G, Maimone M, Vinci MR, Camisa V, Santoro A, De Falco F, De Maio F, Dalmasso G, Di Brino E, Pieri V, Zaffina S. Effectiveness of a Food Education Program for healthcare workers: a pilot study in a Total Worker Health© approach. Front Public Health 2025; 13:1523131. [PMID: 40144992 PMCID: PMC11936905 DOI: 10.3389/fpubh.2025.1523131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2024] [Accepted: 02/24/2025] [Indexed: 03/28/2025] Open
Abstract
Introduction Obesity has been identified as a crucial cause of non-communicable diseases, especially for healthcare workers who often take a brief lunch break with high energy and micro- and macronutrients deficient food. Methods Our study aims to investigate the clinical and economic effectiveness of the "Food Education Program" (FEP) among healthcare workers having weight problems. Four questionnaires were administered before and after FEP to explore the risk of psychological injury ("Psychological Injury Risk Indicator"), mental and general health status ("Goldberg's General Health Questionnaire-12" and "Short Form-36 health survey") and eating behavior ("Eating Attitudes Test"). The Return on Investment (ROI) was calculated on the base of absenteeism reduction in the 1-year period after FEP. Results Fifty-one participants (78.4% females, mean age: 52.04 ± 8.94) were included in the study. They were mainly nurses (56.9%). 54.9% were obese and 43.1% overweight. The success rate was 32.1%; the reduction in BMI was more evident in the overweight participants than the obese subjects. A significant reduction of waist-to-hip ratio, glycosylated hemoglobin, total and LDL cholesterol, and an increase in vitamin D was observed (p-value: 0.047, 0.002, <0.001, 0.001, and 0.03). Scores on general health significantly improved (p-value <0.001 and 0.011). A mean per capita reduction of 3.70 days was observed in 1-year period after the intervention, with a ROI of 6.97. Conclusion Food Education Program represents a successful program to improve psychophysical wellbeing of healthcare workers through healthy nutritional plans, also having a notable positive impact on the organization, including its financial accounts.
Collapse
Affiliation(s)
- Reparata Rosa Di Prinzio
- Occupational Medicine Unit, Bambino Gesù Children's Hospital Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessia Dosi
- Occupational Medicine Unit, Bambino Gesù Children's Hospital Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Gabriele Arnesano
- Postgraduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Eugenia Vacca
- Postgraduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Melcore
- Postgraduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mariarita Maimone
- Postgraduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Rosaria Vinci
- Occupational Medicine Unit, Bambino Gesù Children's Hospital Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Vincenzo Camisa
- Occupational Medicine Unit, Bambino Gesù Children's Hospital Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Annapaola Santoro
- Occupational Medicine Unit, Bambino Gesù Children's Hospital Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Federica De Falco
- Occupational Medicine Unit, Bambino Gesù Children's Hospital Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Federica De Maio
- Occupational Medicine Unit, Bambino Gesù Children's Hospital Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Guendalina Dalmasso
- Health Directorate, Bambino Gesù Children's Hospital Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Eugenio Di Brino
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valerio Pieri
- Department of Business Economics, Università degli Studi Roma Tre, Rome, Italy
| | - Salvatore Zaffina
- Occupational Medicine Unit, Bambino Gesù Children's Hospital Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| |
Collapse
|
6
|
Huang L, Guo Z, Huang M, Zeng X, Huang H. Triiodothyronine (T3) promotes browning of white adipose through inhibition of the PI3K/AKT signalling pathway. Sci Rep 2024; 14:20370. [PMID: 39223267 PMCID: PMC11369215 DOI: 10.1038/s41598-024-71591-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 08/29/2024] [Indexed: 09/04/2024] Open
Abstract
Obesity arises from an imbalance between energy consumption and energy expenditure, and thyroid hormone levels serve as a determinant of energy expenditure. We conducted experiments at the animal and cellular levels and combined those findings with clinical data to elucidate the role of triiodothyronine (T3) in facilitating the browning of white adipose tissue (WAT) and its underlying mechanism. The results showed (i) the impaired metabolic function of local WAT and the compensatory elevation of systemic thermogenesis in obesity; (ii) T3 treatment of white adipocytes in vitro and local WAT in vivo induced a shift towards a morphologically "brown" phenotype, accompanied by upregulation of mRNA and protein expression of browning-related and mitochondrial function markers, which suggest that T3 intervention promotes the browning of WAT; and (iii) the aforementioned processes could be modulated through inhibition of the PI3K/AKT signalling pathway; however, whether T3 affects the PI3K/AKT signalling pathway by affecting insulin signalling remains to be studied and clarified. The results of our study indicate that T3 treatment promotes browning of WAT through inhibition of the PI3K/AKT signalling pathway; these findings offer novel perspectives regarding the potential of localised therapies for addressing WAT volume in individuals with obesity.
Collapse
Affiliation(s)
- LingHong Huang
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, Fujian, China
| | - ZhiFeng Guo
- Department of Respiratory Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, Fujian, China
| | - MingJing Huang
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, Fujian, China
| | - XiYing Zeng
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, Fujian, China
| | - HuiBin Huang
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, Fujian, China.
| |
Collapse
|
7
|
Almandoz JP, Wadden TA, Tewksbury C, Apovian CM, Fitch A, Ard JD, Li Z, Richards J, Butsch WS, Jouravskaya I, Vanderman KS, Neff LM. Nutritional considerations with antiobesity medications. Obesity (Silver Spring) 2024; 32:1613-1631. [PMID: 38853526 DOI: 10.1002/oby.24067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 04/26/2024] [Accepted: 04/29/2024] [Indexed: 06/11/2024]
Abstract
The improved efficacy and generally favorable safety profile of recently approved and emerging antiobesity medications (AOMs), which result in an average weight reduction of ≥15%, represent significant advancement in the treatment of obesity. This narrative review aims to provide practical evidence-based recommendations for nutritional assessment, management, and monitoring of patients treated with AOMs. Prior to treatment, clinicians can identify preexisting nutritional risk factors and counsel their patients on recommended intakes of protein, dietary fiber, micronutrients, and fluids. During treatment with AOMs, ongoing monitoring can facilitate early recognition and management of gastrointestinal symptoms or inadequate nutrient or fluid intake. Attention should also be paid to other factors that can impact response to treatment and quality of life, such as physical activity and social and emotional health. In the context of treatment with AOMs, clinicians can play an active role in supporting their patients with obesity to improve their health and well-being and promote optimal nutritional and medical outcomes.
Collapse
Affiliation(s)
- Jaime P Almandoz
- Division of Endocrinology, University of Texas, Southwestern Medical Center, Dallas, Texas, USA
| | - Thomas A Wadden
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Colleen Tewksbury
- Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Caroline M Apovian
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Jamy D Ard
- Department of Epidemiology and Prevention and Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Zhaoping Li
- Center for Human Nutrition, University of California Los Angeles, Los Angeles, California, USA
| | - Jesse Richards
- Department of Internal Medicine, University of Oklahoma School of Medicine, Tulsa, Oklahoma, USA
| | - W Scott Butsch
- Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | | | | | - Lisa M Neff
- Eli Lilly and Company, Indianapolis, Indiana, USA
| |
Collapse
|
8
|
Tsiga-Ahmed FI, Sulaiman SK, Musa MS, Hussein A, Ahmad SI, Jalo RI, Faris M, BaHammam AS, Javaid SF, Khan MAB. Changes in sleep, physical activity, and health behaviors among Nigerian fasting adults in Ramadan during the COVID-19 pandemic. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:300. [PMID: 39416987 PMCID: PMC11482368 DOI: 10.4103/jehp.jehp_1579_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/10/2023] [Indexed: 10/19/2024]
Abstract
BACKGROUND There is limited data on sleep, physical activity, and health-related behaviors among the general public during Ramadan, particularly during the COVID-19 pandemic. This study aimed to assess the factors associated with sleep and physical activity changes among Nigerian Muslims during Ramadan fasting. MATERIALS AND METHODS A nationwide web-based cross-sectional study was conducted among Nigerians aged ≥18 years who performed diurnal fasting during Ramadan. The target sample size was obtained using Fisher's formula, and snowball sampling was employed. Adapted versions of the International Physical Activity Questionnaire Short Form and Copenhagen Psychosocial Questionnaire II were used to evaluate sleep and physical activity. Correlates of change in physical activity and sleep quality were assessed using logistic regression analysis. RESULTS Seven hundred and seventy individuals participated in the study. During Ramadan, 39.1% (95% confidence interval (CI): 35.6%-42.6%) reported decreased physical activity, and 56.6% (95% CI; 53.0%-60.2%) stated having self-reported good sleep. The independent correlates of physical activity were female sex (adjusted odds ratio (aOR):0.5, 95% CI: 0.4-0.8), having very good sleep (aOR: 0.4, 95% CI: 0.2-0.7), and obesity (aOR: 2.0, 95% CI: 1.1-3.7). In addition, factors associated with improved self-reported sleep quality were perceived good health state (aOR: 8.8, 95% CI: 1.1-72.4), sleeping 7-9 h per day (aOR: 5.5, 95% CI: 2.6-10.3), and sleeping for over 9 h per day (aOR: 4.6, 95% CI: 2.1-14.1). CONCLUSIONS Although physical activity decreased by about a third, over half of the respondents lost weight and slept well during Ramadan. Strategies to include intermittent fasting in positive lifestyle changes could improve the health and well-being of the population.
Collapse
Affiliation(s)
| | | | - Muhammad Saleh Musa
- Department of Medicine, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | - Aminu Hussein
- Department of Family Medicine, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | - Saidu Idris Ahmad
- Department of Medicine, Murtala Muhammad Specialist Hospital, Kano, Nigeria
| | - Rabiu Ibrahim Jalo
- Department of Community Medicine, Aminu Kano Teaching Hospital, Bayero University Kano, Kano, Nigeria
| | - MoezAlIslam Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Ahmed S BaHammam
- University Sleep Disorders Center, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Syed Fahad Javaid
- Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Moien AB Khan
- Department of Family Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
| |
Collapse
|
9
|
Quetglas-Llabrés MM, Monserrat-Mesquida M, Bouzas C, García S, Mateos D, Casares M, Gómez C, Ugarriza L, Tur JA, Sureda A. Effects of a Two-Year Lifestyle Intervention on Intrahepatic Fat Reduction and Renal Health: Mitigation of Inflammation and Oxidative Stress, a Randomized Trial. Antioxidants (Basel) 2024; 13:754. [PMID: 39061823 PMCID: PMC11273830 DOI: 10.3390/antiox13070754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/18/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024] Open
Abstract
Metabolic-associated fatty liver disease (MAFLD) is the most common chronic liver disease observed in clinical practice worldwide. This disorder has been independently associated with an increased risk of developing chronic kidney disease (CKD). The aim of this study was to evaluate whether a 2-year intervention based on a Mediterranean diet (MedDiet) and physical activity focussed on reducing intrahepatic fat contents (IFC) was associated with a decreased risk of CKD. Forty adults (50% women) residing in Mallorca, aged 48 to 60 years, diagnosed with MAFLD were recruited. Participants were divided into two groups based on whether they improved IFC measured by nuclear magnetic resonance. Anthropometric and clinical parameters improved in responders, including reduced weight, body mass index (BMI), and waist circumference. Only responders showed improvements in lipid profile and liver enzymes. Haematological parameters showed favourable changes in both groups. Oxidative stress and inflammatory biomarkers differed between groups. Responders had lower plasma interleukine-18 (IL-18) levels, but higher erythrocyte malonaldehyde (MDA) levels. Non-responders showed increased erythrocyte catalase and superoxide dismutase activity. After 2 years, non-responders had higher serum creatinine, Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) levels, while responders showed reductions in these parameters together with uric acid and urine albumin-to-creatinine ratio (UACR). Positive correlations were found between changes in IFC and kidney injury biomarkers, including MDRD and serum creatinine levels. In conclusion, a healthy diet based on the Mediterranean dietary pattern and lifestyle promotes significant improvements in parameters related to cardiovascular, hepatic, and renal health.
Collapse
Affiliation(s)
- Maria Magdalena Quetglas-Llabrés
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.M.Q.-L.); (M.M.-M.); (C.B.); (S.G.); (D.M.); (L.U.); (A.S.)
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, 07120 Palma de Mallorca, Spain;
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Margalida Monserrat-Mesquida
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.M.Q.-L.); (M.M.-M.); (C.B.); (S.G.); (D.M.); (L.U.); (A.S.)
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, 07120 Palma de Mallorca, Spain;
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Cristina Bouzas
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.M.Q.-L.); (M.M.-M.); (C.B.); (S.G.); (D.M.); (L.U.); (A.S.)
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, 07120 Palma de Mallorca, Spain;
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Silvia García
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.M.Q.-L.); (M.M.-M.); (C.B.); (S.G.); (D.M.); (L.U.); (A.S.)
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, 07120 Palma de Mallorca, Spain;
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - David Mateos
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.M.Q.-L.); (M.M.-M.); (C.B.); (S.G.); (D.M.); (L.U.); (A.S.)
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, 07120 Palma de Mallorca, Spain;
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Miguel Casares
- Radiodiagnosis Service, Red Asistencial Juaneda, 07011 Palma de Mallorca, Spain;
| | - Cristina Gómez
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, 07120 Palma de Mallorca, Spain;
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Clinical Analysis Service, University Hospital Son Espases, 07198 Palma de Mallorca, Spain
| | - Lucía Ugarriza
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.M.Q.-L.); (M.M.-M.); (C.B.); (S.G.); (D.M.); (L.U.); (A.S.)
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, 07120 Palma de Mallorca, Spain;
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- C.S. Camp Redó, IBSalut, 07010 Palma de Mallorca, Spain
| | - Josep A. Tur
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.M.Q.-L.); (M.M.-M.); (C.B.); (S.G.); (D.M.); (L.U.); (A.S.)
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, 07120 Palma de Mallorca, Spain;
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Antoni Sureda
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.M.Q.-L.); (M.M.-M.); (C.B.); (S.G.); (D.M.); (L.U.); (A.S.)
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, 07120 Palma de Mallorca, Spain;
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| |
Collapse
|
10
|
Noone J, Mucinski JM, DeLany JP, Sparks LM, Goodpaster BH. Understanding the variation in exercise responses to guide personalized physical activity prescriptions. Cell Metab 2024; 36:702-724. [PMID: 38262420 DOI: 10.1016/j.cmet.2023.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 01/25/2024]
Abstract
Understanding the factors that contribute to exercise response variation is the first step in achieving the goal of developing personalized exercise prescriptions. This review discusses the key molecular and other mechanistic factors, both extrinsic and intrinsic, that influence exercise responses and health outcomes. Extrinsic characteristics include the timing and dose of exercise, circadian rhythms, sleep habits, dietary interactions, and medication use, whereas intrinsic factors such as sex, age, hormonal status, race/ethnicity, and genetics are also integral. The molecular transducers of exercise (i.e., genomic/epigenomic, proteomic/post-translational, transcriptomic, metabolic/metabolomic, and lipidomic elements) are considered with respect to variability in physiological and health outcomes. Finally, this review highlights the current challenges that impede our ability to develop effective personalized exercise prescriptions. The Molecular Transducers of Physical Activity Consortium (MoTrPAC) aims to fill significant gaps in the understanding of exercise response variability, yet further investigations are needed to address additional health outcomes across all populations.
Collapse
Affiliation(s)
- John Noone
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA
| | | | - James P DeLany
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA
| | - Lauren M Sparks
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA
| | - Bret H Goodpaster
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA.
| |
Collapse
|
11
|
Li Y, Gong X, Găman MA, Hernández-Wolters B, Velu P, Li Y. The effect of subcutaneous dulaglutide on weight loss in patients with Type 2 diabetes mellitus: Systematic review and meta-analysis of randomized controlled trials. Eur J Clin Invest 2024; 54:e14125. [PMID: 37950521 DOI: 10.1111/eci.14125] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/29/2023] [Accepted: 10/29/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Dulaglutide, a subcutaneously administered glucagon-like peptide 1 receptor agonist, has been hypothesized to lead to weight loss in patients with Type 2 diabetes mellitus (T2DM). However, the consequences of its prescription on body weight (BW) and other anthropometric indices, for example, body mass index (BMI) or waist circumference (WC), have not been completely clarified. Therefore, we aimed to assess the effects of subcutaneous dulaglutide administration on BW, BMI and WC values in T2DM subjects by means of a systematic review and meta-analysis of RCTs. METHODS We computed a literature search in five databases (PubMed/Medline, Web of Science, EMBASE, Scopus and Google Scholar) from their inception to February 2023 to identify RCTs that examined the influence of subcutaneous dulaglutide on obesity indices. We calculated effect sizes using the random-effects model (using DerSimonian-Laird method). Results were derived across weighted mean differences (WMD) and 95% confidence intervals (CI). Subgroup analyses were applied to explore possible sources of heterogeneity among the RCTs. The current systematic review and meta-analysis was conducted in compliance with The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS In total, 18 studies with 33 RCT arms (BW = 33 RCT arms, 14,612 participants, 7869 cases and 6743 controls; BMI = 10 RCT arms, 14,612 subjects, 7869 cases and 6743 controls; WC = 10 RCT arms, 1632 participants, 945 cases and 687 cases) were included in the meta-analysis. BW (WMD: -0.86 kg, 95% CI: -1.22, -0.49, p < 0.001), BMI (WMD: -0.68 kg/m2 , 95% CI: -0.88, -0.49, p < 0.001) and WC (WMD: -1.23 cm, 95% CI: -1.82, -0.63, p < 0.001) values decreased notably following subcutaneous dulaglutide administration versus placebo. BW notably decreased in RCTs lasting >18 weeks (WMD: -1.42 kg, 95% CI: -1.90, -0.94, p < 0.001), whereas notable reductions in WC were seen in RCTs lasting ≤18 weeks (WMD: -1.78 cm, 95% CI: -2.59, -0.98, p < 0.001). Dulaglutide dosages >1 mg/day significantly decreased BW (WMD: -1.94 kg, 95% CI: -2.54, -1.34, p < 0.001), BMI (WMD: -0.80 kg/m2 , 95% CI: -1.07, -0.54, p < 0.001) and WC (WMD: -1.47 cm, 95% CI: -1.80, -1.13, p < 0.001). BW decreased particularly following dulaglutide prescription in individuals with obesity (WMD: -1.05 kg, 95% CI: -1.28, -0.82, p < 0.001) versus overweight. The dose-response meta-analysis revealed that BW decreased significantly when dulaglutide was prescribed in doses ≤3 mg/day versus >3 mg/day. CONCLUSIONS Subcutaneous dulaglutide administration in T2DM reduces BW, BMI and WC. The decrease in BW and WC was influenced by the dose and the duration of dulaglutide administration. The reduction in BMI was only influenced by the dosage of dulaglutide. Moreover, T2DM patients who suffered from obesity experienced a notable decrease in BW versus T2DM subjects without obesity.
Collapse
Affiliation(s)
- Yang Li
- Department of Emergency Internal Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xingji Gong
- Department of Emergency Internal Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Department of Hematology, Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | | | - Periyannan Velu
- Galileovasan Offshore and Research and Development Pvt. Ltd., Nagapattinam, India
| | - Yushan Li
- Department of Emergency Internal Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| |
Collapse
|
12
|
Tsilingiris D, Vallianou NG, Spyrou N, Kounatidis D, Christodoulatos GS, Karampela I, Dalamaga M. Obesity and Leukemia: Biological Mechanisms, Perspectives, and Challenges. Curr Obes Rep 2024; 13:1-34. [PMID: 38159164 PMCID: PMC10933194 DOI: 10.1007/s13679-023-00542-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/06/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE OF REVIEW To examine the epidemiological data on obesity and leukemia; evaluate the effect of obesity on leukemia outcomes in childhood acute lymphoblastic leukemia (ALL) survivors; assess the potential mechanisms through which obesity may increase the risk of leukemia; and provide the effects of obesity management on leukemia. Preventive (diet, physical exercise, obesity pharmacotherapy, bariatric surgery) measures, repurposing drugs, candidate therapeutic agents targeting oncogenic pathways of obesity and insulin resistance in leukemia as well as challenges of the COVID-19 pandemic are also discussed. RECENT FINDINGS Obesity has been implicated in the development of 13 cancers, such as breast, endometrial, colon, renal, esophageal cancers, and multiple myeloma. Leukemia is estimated to account for approximately 2.5% and 3.1% of all new cancer incidence and mortality, respectively, while it represents the most frequent cancer in children younger than 5 years. Current evidence indicates that obesity may have an impact on the risk of leukemia. Increased birthweight may be associated with the development of childhood leukemia. Obesity is also associated with worse outcomes and increased mortality in leukemic patients. However, there are several limitations and challenges in meta-analyses and epidemiological studies. In addition, weight gain may occur in a substantial number of childhood ALL survivors while the majority of studies have documented an increased risk of relapse and mortality among patients with childhood ALL and obesity. The main pathophysiological pathways linking obesity to leukemia include bone marrow adipose tissue; hormones such as insulin and the insulin-like growth factor system as well as sex hormones; pro-inflammatory cytokines, such as IL-6 and TNF-α; adipocytokines, such as adiponectin, leptin, resistin, and visfatin; dyslipidemia and lipid signaling; chronic low-grade inflammation and oxidative stress; and other emerging mechanisms. Obesity represents a risk factor for leukemia, being among the only known risk factors that could be prevented or modified through weight loss, healthy diet, and physical exercise. Pharmacological interventions, repurposing drugs used for cardiometabolic comorbidities, and bariatric surgery may be recommended for leukemia and obesity-related cancer prevention.
Collapse
Affiliation(s)
- Dimitrios Tsilingiris
- First Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68100, Alexandroupolis, Greece
| | - Natalia G Vallianou
- Department of Internal Medicine, Evangelismos General Hospital, 45-47 Ipsilantou str, 10676, Athens, Greece
| | - Nikolaos Spyrou
- Tisch Cancer Institute Icahn School of Medicine at Mount Sinai, 1190 One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Dimitris Kounatidis
- Department of Internal Medicine, Evangelismos General Hospital, 45-47 Ipsilantou str, 10676, Athens, Greece
| | | | - Irene Karampela
- 2nd Department of Critical Care, Medical School, University of Athens, Attikon General University Hospital, 1 Rimini Str, 12462, Athens, Greece
| | - Maria Dalamaga
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias str, 11527, Athens, Greece.
| |
Collapse
|
13
|
Dalamaga M, Kounatidis D, Tsilingiris D, Vallianou NG, Karampela I, Psallida S, Papavassiliou AG. The Role of Endocrine Disruptors Bisphenols and Phthalates in Obesity: Current Evidence, Perspectives and Controversies. Int J Mol Sci 2024; 25:675. [PMID: 38203845 PMCID: PMC10779569 DOI: 10.3390/ijms25010675] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 12/31/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024] Open
Abstract
Excess body weight constitutes one of the major health challenges for societies and healthcare systems worldwide. Besides the type of diet, calorie intake and the lack of physical exercise, recent data have highlighted a possible association between endocrine-disrupting chemicals (EDCs), such as bisphenol A, phthalates and their analogs, and obesity. EDCs represent a heterogeneous group of chemicals that may influence the hormonal regulation of body mass and adipose tissue morphology. Based on the available data from mechanistic, animal and epidemiological studies including meta-analyses, the weight of evidence points towards the contribution of EDCs to the development of obesity, associated disorders and obesity-related adipose tissue dysfunction by (1) impacting adipogenesis; (2) modulating epigenetic pathways during development, enhancing susceptibility to obesity; (3) influencing neuroendocrine signals responsible for appetite and satiety; (4) promoting a proinflammatory milieu in adipose tissue and inducing a state of chronic subclinical inflammation; (5) dysregulating gut microbiome and immune homeostasis; and (6) inducing dysfunction in thermogenic adipose tissue. Critical periods of exposure to obesogenic EDCs are the prenatal, neonatal, pubertal and reproductive periods. Interestingly, EDCs even at low doses may promote epigenetic transgenerational inheritance of adult obesity in subsequent generations. The aim of this review is to summarize the available evidence on the role of obesogenic EDCs, specifically BPA and phthalate plasticizers, in the development of obesity, taking into account in vitro, animal and epidemiologic studies; discuss mechanisms linking EDCs to obesity; analyze the effects of EDCs on obesity in critical chronic periods of exposure; and present interesting perspectives, challenges and preventive measures in this research area.
Collapse
Affiliation(s)
- Maria Dalamaga
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Dimitrios Kounatidis
- Department of Internal Medicine, ‘Evangelismos’ General Hospital, 10676 Athens, Greece; (D.K.); (N.G.V.)
| | - Dimitrios Tsilingiris
- First Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Natalia G. Vallianou
- Department of Internal Medicine, ‘Evangelismos’ General Hospital, 10676 Athens, Greece; (D.K.); (N.G.V.)
| | - Irene Karampela
- Second Department of Critical Care, ‘Attikon’ General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Sotiria Psallida
- Department of Microbiology, ‘KAT’ General Hospital of Attica, 14561 Athens, Greece;
| | - Athanasios G. Papavassiliou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| |
Collapse
|
14
|
Macena ML, Silva Júnior AE, Melo JM, Paula DT, Praxedes DRS, Bueno NB. Estimates of Resting Energy Expenditure and Total Energy Expenditure Using Predictive Equations for Individuals After Bariatric Surgery: a Systematic Review with Meta-analysis. Obes Surg 2023; 33:3999-4006. [PMID: 37889369 DOI: 10.1007/s11695-023-06908-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/12/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
PURPOSE Patients after metabolic bariatric surgery (MBS) require attention to maintain energy balance and avoid weight regain. Predictive equations for resting energy expenditure (REE) and total energy expenditure (TEE) are needed since gold standard methods like calorimetry and doubly labeled water are rarely available in routine clinical practice. This study aimed to determine which predictive equation for REE and TEE has the lowest bias in subjects after MBS. METHODS MEDLINE, Embase, Web of Science, and CENTRAL searches were performed. Meta-analyses were performed with the data calculated by the predictive equations and measured by the gold standard methods for those equations that had at least two studies with these data. The DerSimonian and Laird random-effects model and the I2 statistic were used to quantify heterogeneity in the quantitative analyses. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist. RESULTS Seven studies were included. The present study found that the Mifflin St. Jeor (1990) equation had the lowest bias (mean difference = - 39.71 kcal [95%CI = - 128.97; 49.55]) for calculating REE in post-BS individuals. The Harris-Benedict (1919) equation also yielded satisfactory results (mean difference = - 54.60 kcal [95%CI = - 87.92; - 21.28]). CONCLUSION The predictive equation of Mifflin St. Jeor (1990) was the one that showed the lowest bias for calculating the REE of patients following MBS.
Collapse
Affiliation(s)
- Mateus L Macena
- Laboratório de Nutrição e Metabolismo (LANUM), Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, 57072-970, Brazil
- Postgraduate Program in Nutrition, Escola Paulista de Medicina, Universidade Federal de São Paulo, Maceió, SP, 04023-062, Brazil
| | - André E Silva Júnior
- Laboratório de Nutrição e Metabolismo (LANUM), Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, 57072-970, Brazil.
- Postgraduate Program in Nutrition, Escola Paulista de Medicina, Universidade Federal de São Paulo, Maceió, SP, 04023-062, Brazil.
| | - Jennifer M Melo
- Laboratório de Nutrição e Metabolismo (LANUM), Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, 57072-970, Brazil
| | - Déborah T Paula
- Laboratório de Nutrição e Metabolismo (LANUM), Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, 57072-970, Brazil
| | - Dafiny R S Praxedes
- Laboratório de Nutrição e Metabolismo (LANUM), Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, 57072-970, Brazil
- Postgraduate Program in Nutrition, Escola Paulista de Medicina, Universidade Federal de São Paulo, Maceió, SP, 04023-062, Brazil
| | - Nassib B Bueno
- Laboratório de Nutrição e Metabolismo (LANUM), Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, 57072-970, Brazil
- Postgraduate Program in Nutrition, Escola Paulista de Medicina, Universidade Federal de São Paulo, Maceió, SP, 04023-062, Brazil
| |
Collapse
|
15
|
Benato L, Miotto AV, Molinari RL, Olsson B, Carlos LDO, Thieme RD, Schiefecker MEM, Rebellato NLB, Scariot R, Klüppel LE. Body mass index and weight loss in patients submitted to orthognathic surgery: a prospective study. Dental Press J Orthod 2023; 28:e2323107. [PMID: 37970912 PMCID: PMC10637617 DOI: 10.1590/2177-6709.28.5.e2323107.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/04/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE To compare the body mass index (BMI) and the weight loss (WL) in patients with dentofacial deformities who underwent monomaxillary versus bimaxillary orthognathic surgery. MATERIALS AND METHODS This prospective longitudinal study included 69 patients with dentofacial deformities who underwent surgical orthodontic treatment. Patients were divided into two groups according to the type of orthognathic surgery: monomaxillary or bimaxillary. A preoperative nutritional assessment based on BMI was performed; the percentage of involuntary WL between the preoperative and postoperative periods was also calculated. Data were collected at preoperative and 10, 40, and 90 days postoperative (PO). Statistical analysis was performed using SPSS 17.0 (IBM Corp., Armonk, NY, USA), and data are reported with 95% confidence interval. RESULTS According to BMI, patients who underwent monomaxillary surgery presented: underweight = 2.6%, normal weight = 51.3%, overweight = 35.9%, and obese = 10.3%. The subjects who underwent bimaxillary surgery presented: normal weight = 43.3%, overweight = 36.7%, and obese = 20%. BMI was similar between the groups at all time points (preoperative, p= 0.237; 10 days PO, p= 0.325; 40 days PO, p= 0.430; and 90 days PO, p= 0.609). All patients lost weight postoperatively, and WL was similar among the PO measurements (p= 0.163). CONCLUSIONS Although both monomaxillary and bimaxillary orthognathic surgeries resulted in WL and lower BMI, there was no statistically significant difference in these metrics between the two types of surgery.
Collapse
Affiliation(s)
- Leonardo Benato
- Federal University of Paraná, School of Dentistry, Department of Oral and Maxillofacial Surgery (Curitiba/PR, Brazil)
| | - Alice Vanzela Miotto
- Federal University of Paraná, School of Dentistry, Department of Oral and Maxillofacial Surgery (Curitiba/PR, Brazil)
| | - Romulo Lazzari Molinari
- Federal University of Paraná, School of Dentistry, Department of Oral and Maxillofacial Surgery (Curitiba/PR, Brazil)
| | - Bernardo Olsson
- Federal University of Paraná, School of Dentistry, Department of Oral and Maxillofacial Surgery (Curitiba/PR, Brazil)
| | | | - Rubia Daniela Thieme
- Federal University of Paraná, Public Policy, Department of Nutrition (Curitiba/PR, Brazil)
| | | | - Nelson Luis Barbosa Rebellato
- Federal University of Paraná, School of Dentistry, Department of Oral and Maxillofacial Surgery (Curitiba/PR, Brazil)
| | - Rafaela Scariot
- Federal University of Paraná, School of Dentistry, Department of Oral and Maxillofacial Surgery (Curitiba/PR, Brazil)
| | - Leandro Eduardo Klüppel
- Federal University of Paraná, School of Dentistry, Department of Oral and Maxillofacial Surgery (Curitiba/PR, Brazil)
| |
Collapse
|
16
|
Alkhorayef N, Almutery FT, Rasheed Z, Althwab SA, Aljohani AS, Alhawday YA, Salem T, Alharbi AM, Wahaq AA, Alharbi FS, Alghanem AS, Al Abdulmonem W. Regulatory effects of ketogenic diet on the inflammatory response in obese Saudi women. J Taibah Univ Med Sci 2023; 18:1101-1107. [PMID: 37009396 PMCID: PMC10050637 DOI: 10.1016/j.jtumed.2023.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 01/07/2023] [Accepted: 03/12/2023] [Indexed: 04/04/2023] Open
Abstract
Objective In recent years, the use of a ketogenic diet (KD) against obesity has gained popularity in KSA. This study was designed to determine the impact of KD on anthropometric indices and on the abnormal regulation of inflammatory activities in obese Saudi women. Moreover, we investigated the potential of beta-hydroxybutyrate (BHB) supplementation on the inhibition of pro-inflammatory activities. Methods We enrolled 31 Saudi women (aged, 35.3 ± 8.4 years) with an average BMI of 33.96 ± 4.44 kg/m2 underwent an 8-week KD (8KD) from January to March 2021. Changes in anthropometric measurements were collected at baseline and after 4-8 weeks of intervention. Compliance with the dietary regimen was monitored weekly by plasma BHB level. Results Twenty-nine females commenced the diets and 23 completed the study (a 79% completion rate). In comparison to pre-intervention, the 8KD resulted in a significant increase in the levels of plasma BHB (P < 0.001) throughout the duration of the trial. This was accompanied by a significant reduction in weight loss (7.7 kg ± 11.3; P < 0.001), BMI, waist circumference (P < 0.001), and levels of the inflammatory cytokine IL-1β (P < 0.001). Conclusions An 8-week KD was found to be useful in producing a positive impact on anthropometric indices, biochemical and inflammatory processes. This study indicated that the intake of a KD by obese Saudi women induced the release of BHB in the blood without stimulation of an overall starvation response. This may be useful to alleviate the severity of chronic inflammatory disorders associated with obesity.
Collapse
Affiliation(s)
- Nada Alkhorayef
- Laboratory Department, College of Applied Medical Sciences, Al-Quway'iyah, Shaqra University, Riyadh, KSA
| | - Fatimah T. Almutery
- General Directorate of Health Affairs, Qassim Region, Public Health Department, KSA
| | - Zafar Rasheed
- Department of Pathology, College of Medicine, Qassim University, Buraidah, KSA
| | - Sami A. Althwab
- Department of Food Science and Human Nutrition, College of Agriculture and Veterinary Medicine, Qassim University, Buraidah, KSA
| | - Abdullah S.M. Aljohani
- Department of Veterinary Medicine, College of Agricultural and Veterinary Medicine, Qassim University, Buraidah, KSA
| | | | - Tarek Salem
- Department of Pathology, College of Medicine, Qassim University, Buraidah, KSA
| | - Abdulaziz M. Alharbi
- Department of Public Health, Directorate of Health Affairs in Al-Qassim, Buraidah, KSA
| | - Abdulrahman A.A.B. Wahaq
- Riyadh Second Health Cluster, Department of Public Health, Al-Kahleej 1 Primary Healthcare Centre, Riyadh, KSA
| | | | | | - Waleed Al Abdulmonem
- Department of Pathology, College of Medicine, Qassim University, Buraidah, KSA
- Corresponding address: Department of Pathology, College of Medicine, Qassim University, Buraidah, KSA.
| |
Collapse
|
17
|
Siedler MR, De Souza MJ, Albracht-Schulte K, Sekiguchi Y, Tinsley GM. The Influence of Energy Balance and Availability on Resting Metabolic Rate: Implications for Assessment and Future Research Directions. Sports Med 2023; 53:1507-1526. [PMID: 37213050 DOI: 10.1007/s40279-023-01856-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/23/2023]
Abstract
Resting metabolic rate (RMR) is a significant contributor to an individual's total energy expenditure. As such, RMR plays an important role in body weight regulation across populations ranging from inactive individuals to athletes. In addition, RMR may also be used to screen for low energy availability and energy deficiency in athletes, and thus may be useful in identifying individuals at risk for the deleterious consequences of chronic energy deficiency. Given its importance in both clinical and research settings within the fields of exercise physiology, dietetics, and sports medicine, the valid assessment of RMR is critical. However, factors including varying states of energy balance (both short- and long-term energy deficit or surplus), energy availability, and prior food intake or exercise may influence resulting RMR measures, potentially introducing error into observed values. The purpose of this review is to summarize the relationships between short- and long-term changes in energetic status and resulting RMR measures, consider these findings in the context of relevant recommendations for RMR assessment, and provide suggestions for future research.
Collapse
Affiliation(s)
- Madelin R Siedler
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Mary Jane De Souza
- Departments of Kinesiology and Physiology, Pennsylvania State University, University Park, PA, USA
| | | | - Yasuki Sekiguchi
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA.
| |
Collapse
|
18
|
Obesity and main urologic cancers: Current systematic evidence, novel biological mechanisms, perspectives and challenges. Semin Cancer Biol 2023; 91:70-98. [PMID: 36893965 DOI: 10.1016/j.semcancer.2023.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/06/2023] [Accepted: 03/06/2023] [Indexed: 03/09/2023]
Abstract
Urologic cancers (UC) account for 13.1% of all new cancer cases and 7.9% of all cancer-related deaths. A growing body of evidence has indicated a potential causal link between obesity and UC. The aim of the present review is to appraise in a critical and integrative manner evidence from meta-analyses and mechanistic studies on the role of obesity in four prevalent UC (kidney-KC, prostate-PC, urinary bladder-UBC, and testicular cancer-TC). Special emphasis is given on Mendelian Randomization Studies (MRS) corroborating a genetic causal association between obesity and UC, as well as on the role of classical and novel adipocytokines. Furthermore, the molecular pathways that link obesity to the development and progression of these cancers are reviewed. Available evidence indicates that obesity confers increased risk for KC, UBC, and advanced PC (20-82%, 10-19%, and 6-14%, respectively), whereas for TC adult height (5-cm increase) may increase the risk by 13%. Obese females tend to be more susceptible to UBC and KC than obese males. MRS have shown that a higher genetic-predicted BMI may be causally linked to KC and UBC but not PC and TC. Biological mechanisms that are involved in the association between excess body weight and UC include the Insulin-like Growth Factor axis, altered availability of sex hormones, chronic inflammation and oxidative stress, abnormal secretion of adipocytokines, ectopic fat deposition, dysbiosis of the gastrointestinal and urinary tract microbiomes and circadian rhythm dysregulation. Anti-hyperglycemic and non-steroidal anti-inflammatory drugs, statins, and adipokine receptor agonists/antagonists show potential as adjuvant cancer therapies. Identifying obesity as a modifiable risk factor for UC may have significant public health implications, allowing clinicians to tailor individualized prevention strategies for patients with excess body weight.
Collapse
|
19
|
Abstract
PURPOSE OF REVIEW This review aims to detail the current global research state of metabolically healthy obesogenesis with regard to metabolic factors, disease prevalence, comparisons to unhealthy obesity, and targeted interventions to reverse or delay progression from metabolically healthy to unhealthy obesity. RECENT FINDINGS As a long-term condition with increased risk of cardiovascular, metabolic, and all-cause mortality risks, obesity threatens public health on a national level. The recent discovery of metabolically healthy obesity (MHO), a transitional condition during which obese persons carry comparatively lower health risks, has added to confusion about the true effect of visceral fat and subsequent long-term health risks. In this context, the evaluation of fat loss interventions, such as bariatric surgery, lifestyle changes (diet/exercise), and hormonal therapies require re-evaluation in light of evidence that progression to high-risk stages of obesity relies on metabolic status and that strategies to protect the metabolism may be useful in the prevention of metabolically unhealthy obesity. Typical calorie-based exercise and diet interventions have failed to reduce the prevalence of unhealthy obesity. Holistic lifestyle, psychological, hormonal, and pharmacological interventions for MHO, on the other hand, may at least prevent progression to metabolically unhealthy obesity.
Collapse
Affiliation(s)
- Bryan J Mathis
- International Medical Center, University of Tsukuba Hospital, Tsukuba, Ibaraki, 305-8576, Japan.
| | - Kiyoji Tanaka
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yuji Hiramatsu
- International Medical Center, University of Tsukuba Hospital, Tsukuba, Ibaraki, 305-8576, Japan
| |
Collapse
|
20
|
The catcher in the gut: Tirzepatide, a dual incretin analog for the treatment of type 2 diabetes mellitus and obesity. Metabol Open 2022; 16:100220. [DOI: 10.1016/j.metop.2022.100220] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 12/04/2022] [Indexed: 12/11/2022] Open
|