1
|
Uprety LP, Lee CG, Oh KI, Jeong H, Yeo S, Yong Y, Seong JK, Kim IY, Go H, Park E, Jeong SY. Anti-obesity effects of Celosia cristata flower extract in vitro and in vivo. Biomed Pharmacother 2024; 176:116799. [PMID: 38805969 DOI: 10.1016/j.biopha.2024.116799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND The overstoring of surplus calories in mature adipocytes causes obesity and abnormal metabolic activity. The anti-obesity effect of a Celosia cristata (CC) total flower extract was assessed in vitro, using 3T3-L1 pre-adipocytes and mouse adipose-derived stem cells (ADSCs), and in vivo, using high-fat diet (HFD)-treated C57BL/6 male mice. METHODS CC extract was co-incubated during adipogenesis in both 3T3-L1 cells and ADSCs. After differentiation, lipid droplets were assessed by oil red O staining, adipogenesis and lipolytic factors were evaluated, and intracellular triglyceride and glycerol concentrations were analyzed. For in vivo experiments, histomorphological analysis, mRNA expression levels of adipogenic and lipolytic factors in adipose tissue, blood plasma analysis, metabolic profiles were investigated. RESULTS CC treatment significantly prevented adipocyte differentiation and lipid droplet accumulation, reducing adipogenesis-related factors and increasing lipolysis-related factors. Consequently, the intracellular triacylglycerol content was diminished, whereas the glycerol concentration in the cell supernatant increased. Mice fed an HFD supplemented with the CC extract exhibited decreased HFD-induced weight gain with metabolic abnormalities such as intrahepatic lipid accumulation and adipocyte hypertrophy. Improved glucose utilization and insulin sensitivity were observed, accompanied by the amelioration of metabolic disturbances, including alterations in liver enzymes and lipid profiles, in CC-treated mice. Moreover, the CC extract helped restore the disrupted energy metabolism induced by the HFD, based on a metabolic animal monitoring system. CONCLUSION This study suggests that CC total flower extract is a potential natural herbal supplement for the prevention and management of obesity.
Collapse
Affiliation(s)
- Laxmi Prasad Uprety
- Department of Medical Genetics, Ajou University School of Medicine, Suwon 16499, South Korea; Department of Biomedical Sciences, Ajou University School of Medicine, Suwon 16499, South Korea
| | - Chang-Gun Lee
- Department of Biomedical Laboratory Science, College of Software and Digital Healthcare Convergence, Yonsei University MIRAE Campus, Wonju 26493, South Korea
| | - Kang-Il Oh
- Department of Medical Genetics, Ajou University School of Medicine, Suwon 16499, South Korea; Department of Biomedical Sciences, Ajou University School of Medicine, Suwon 16499, South Korea
| | | | - Subin Yeo
- Nine B Co., Ltd., Daejeon 34121, South Korea
| | | | - Je Kyung Seong
- College of Veterinary Medicine, Seoul National University, Seoul 08826, South Korea; Korea Mouse Phenotyping Center (KMPC), Seoul National University, Seoul 08826, South Korea
| | - Il Yong Kim
- College of Veterinary Medicine, Seoul National University, Seoul 08826, South Korea; Korea Mouse Phenotyping Center (KMPC), Seoul National University, Seoul 08826, South Korea
| | - Hyesun Go
- College of Veterinary Medicine, Seoul National University, Seoul 08826, South Korea; Korea Mouse Phenotyping Center (KMPC), Seoul National University, Seoul 08826, South Korea
| | - Eunkuk Park
- Department of Medical Genetics, Ajou University School of Medicine, Suwon 16499, South Korea; Department of Biomedical Sciences, Ajou University School of Medicine, Suwon 16499, South Korea.
| | - Seon-Yong Jeong
- Department of Medical Genetics, Ajou University School of Medicine, Suwon 16499, South Korea; Department of Biomedical Sciences, Ajou University School of Medicine, Suwon 16499, South Korea.
| |
Collapse
|
2
|
Smith DL, Yang Y, Mestre LM, Henschel B, Parker E, Dickinson S, Patki A, Allison DB, Nagy TR. Impact of sustained calorie restriction and weight cycling on body composition in high-fat diet-fed male and female C57BL/6J mice. Obesity (Silver Spring) 2024; 32:959-968. [PMID: 38600047 PMCID: PMC11145641 DOI: 10.1002/oby.24015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/18/2024] [Accepted: 01/31/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE The objective of this study was to investigate body composition changes with weight cycling (WC) among adult C57BL/6J mice with diet-induced obesity. METHODS A total of 555 single-housed mice were fed a high-fat diet ad libitum (AL) from 8 to 43 weeks of age. The 200 heaviest mice of each sex were randomized to the following four groups: ever obese (EO, continued AL feeding); obese weight loser (OWL, calorie-restricted); obese weight loser moderate (OWLM, body weight halfway between EO and OWL); and WC (diet restricted to OWL followed by AL refeeding cycles). Body weight and composition data were collected. Linear regression was used to calculate residuals between predicted and observed fat mass. Linear mixed models were used to compare diet groups. RESULTS Although weight loss and regain resulted in changes in body weight and composition, fat mass, body weight, and relative body fat were not significantly greater for the WC group compared with the EO group. During long-term calorie restriction, males (but not females) in the OWLM group remained relatively fatter than the EO group. CONCLUSIONS WC did not increase body weight or relative fat mass for middle-aged, high-fat diet-fed adult mice. However, long-term moderate calorie restriction resulted in lower body weight but greater "relative" fat in male mice.
Collapse
Affiliation(s)
- Daniel L. Smith
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Diabetes Research Center, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Nathan Shock Center of Excellence in the Basic Biology of Aging, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Yongbin Yang
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Luis M. Mestre
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington IN, USA
| | - Beate Henschel
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington IN, USA
| | - Erik Parker
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington IN, USA
| | - Stephanie Dickinson
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington IN, USA
| | - Amit Patki
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - David B. Allison
- Nathan Shock Center of Excellence in the Basic Biology of Aging, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington IN, USA
| | - Tim R. Nagy
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Diabetes Research Center, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Nathan Shock Center of Excellence in the Basic Biology of Aging, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| |
Collapse
|
3
|
Shiu WC, Liu ZS, Chen BY, Ku YW, Chen PW. Evaluation of a Standard Dietary Regimen Combined with Heat-Inactivated Lactobacillus gasseri HM1, Lactoferrin-Producing HM1, and Their Sonication-Inactivated Variants in the Management of Metabolic Disorders in an Obesity Mouse Model. Foods 2024; 13:1079. [PMID: 38611383 PMCID: PMC11011380 DOI: 10.3390/foods13071079] [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: 02/06/2024] [Revised: 03/19/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
This study investigated the impact of incorporating various inactivated probiotic formulations, with or without recombinant lactoferrin (LF) expression, into a standard chow diet on metabolic-related disorders in obese mice. After inducing obesity through a 13-week high-fat diet followed by a standard chow diet, mice received daily oral administrations of different probiotics for 6 weeks using the oral gavage approach. These probiotic formulations consisted of a placebo (MRS), heat-inactivated Lactobacillus gasseri HM1 (HK-HM1), heat-killed LF-expression HM1 (HK-HM1/LF), sonication-killed HM1 (SK-HM1), and sonication-killed LF-expression HM1 (SK-HM1/LF). The study successfully induced obesity, resulting in worsened glucose tolerance and insulin sensitivity. Interestingly, the regular diet alone improved glucose tolerance, and the addition of inactivated probiotics further enhanced this effect, with SK-HM1/LF demonstrating the most noticeable improvement. However, while regular dietary intervention alone improved insulin sensitivity, probiotic supplementation did not provide additional benefits in this aspect. Inflammation in perirenal and epididymal fat tissues was partially alleviated by the regular diet and further improved by probiotics, particularly by SK-HM1, which showed the most significant reduction. Additionally, HK-HM1 and HK-HM1/LF supplements could contribute to the improvement of serum total triglycerides or total cholesterol, respectively. Overall, incorporating inactivated probiotics into a regular diet may enhance metabolic indices, and recombinant LF may offer potential benefits for improving glucose tolerance.
Collapse
Affiliation(s)
- Wei-Chen Shiu
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung 402202, Taiwan; (W.-C.S.); (B.-Y.C.); (Y.-W.K.)
| | - Zhen-Shu Liu
- Department of Safety, Health and Environmental Engineering, Ming Chi University of Technology, New Taipei City 24301, Taiwan;
- Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, Chiayi 61363, Taiwan
- Center for Sustainability and Energy Technologies, Chang Gung University, Taoyuan 33302, Taiwan
| | - Bo-Yuan Chen
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung 402202, Taiwan; (W.-C.S.); (B.-Y.C.); (Y.-W.K.)
| | - Yu-We Ku
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung 402202, Taiwan; (W.-C.S.); (B.-Y.C.); (Y.-W.K.)
- Animal and Plant Disease Control Center Yilan County, Wujie Township, Yilan County 268015, Taiwan
| | - Po-Wen Chen
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung 402202, Taiwan; (W.-C.S.); (B.-Y.C.); (Y.-W.K.)
| |
Collapse
|
4
|
Voils C, Shaw R, Gavin K, Hetzel S, Lewis M, Pabich S, Johnson H, Elwert F, Mao L, Gray K, Yuroff A, Garza K, Yancy W, Porter L. Primary outcomes from Partner2Lose: A randomized controlled trial to evaluate partner involvement on long-term weight loss. RESEARCH SQUARE 2024:rs.3.rs-4001003. [PMID: 38559225 PMCID: PMC10980155 DOI: 10.21203/rs.3.rs-4001003/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background Partner support is associated with better weight loss outcomes in observational studies, but randomized trials show mixed results for including partners. Unclear is whether teaching communication skills to couples will improve weight loss in index participants. Purpose To compare the efficacy of a partner-assisted intervention versus participant-only weight management program on long-term weight loss. Methods This community-based study took place in Madison, WI. Index participants were eligible if they met obesity guideline criteria to receive weight loss counseling, were aged 74 years or younger, lived with a partner, and had no medical contraindications to weight loss; partners were aged 74 years or younger and not underweight. Couples were randomized 1:1 to a partner-assisted or participant-only intervention. Index participants in both arms received an evidence-based weight management program. In the partner-assisted arm, partners attended half of the intervention sessions, and couples were trained in communication skills. The primary outcome was index participant weight at 24 months, assessed by masked personnel; secondary outcomes were 24-month self-reported caloric intake and average daily steps assessed by an activity tracker. General linear mixed models were used to compare group differences in these outcomes following intent-to-treat principles. Results Among couples assigned to partner-assisted (n=115) or participant-only intervention (n=116), most index participants identified as female (67%) and non-Hispanic White (87%). Average baseline age was 47.27 years (SD 11.51 years) and weight was 106.55 kg (SD 19.41 kg). The estimated mean 24-month weight loss was similar in the partner-assisted (2.66 kg) and participant-only arms (2.89 kg) (estimated mean difference, 0.23 kg [95% CI, -1.58, 2.04 kg]). There were no differences in 24-month average daily caloric intake (50 cal [95% CI: -233, 132 cal]) or steps (806 steps [95% CI: -1675, 64 steps]). The percentage of participants reporting an adverse event with at least possible attribution to the intervention did not differ by arm (partner-assisted: 9%, participant-only, 3%, p=0.11). Conclusions Partner-assisted and individual weight management interventions led to similar outcomes in index participants. Trial registration Clinicaltrials.gov NCT03801174.
Collapse
Affiliation(s)
- Corrine Voils
- University of Wisconsin-Madison School of Medicine & Public Health
| | | | | | - Scott Hetzel
- University of Wisconsin-Madison School of Medicine & Public Health
| | | | - Samantha Pabich
- University of Wisconsin-Madison School of Medicine & Public Health
| | - Heather Johnson
- Baptist Health South Florida/Charles E. Schmidt College of Medicine, Florida Atlantic University
| | | | - Lu Mao
- University of Wisconsin School of Medicine and Public Health
| | | | - Alice Yuroff
- University of Wisconsin-Madison School of Medicine & Public Health
| | - Katya Garza
- University of Wisconsin-Madison School of Medicine & Public Health
| | | | | |
Collapse
|
5
|
Domènech E, Ciudin A, Balibrea JM, Espinet-Coll E, Cañete F, Flores L, Ferrer-Márquez M, Turró R, Hernández-Camba A, Zabana Y, Gutiérrez A. Recommendations on the management of severe obesity in patients with inflammatory bowel disease of the Spanish Group on Crohn's Disease and Ulcerative Colitis (GETECCU), Spanish Society of Obesity (SEEDO), Spanish Association of Surgery (AEC) and Spanish Society of Digestive Endoscopy (SEED). GASTROENTEROLOGIA Y HEPATOLOGIA 2024:S0210-5705(23)00502-2. [PMID: 38290648 DOI: 10.1016/j.gastrohep.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 02/01/2024]
Abstract
Obesity is a multifactorial, chronic, progressive and recurrent disease considered a public health issue worldwide and an important determinant of disability and death. In Spain, its current prevalence in the adult population is about 24% and an estimated prevalence in 2035 of 37%. Obesity increases the probability of several diseases linked to higher mortality such as diabetes, cardiovascular disease, hyperlipidemia, arterial hypertension, non-alcoholic fatty liver disease, several types of cancer, or obstructive sleep apnea. On the other hand, although the incidence of inflammatory bowel disease (IBD) is stabilizing in Western countries, its prevalence already exceeds 0.3%. Paralleling to general population, the current prevalence of obesity in adult patients with IBD is estimated at 15-40%. Obesity in patients with IBD could entail, in addition to its already known impact on disability and mortality, a worse evolution of the IBD itself and a worse response to treatments. The aim of this document, performed in collaboration by four scientific societies involved in the clinical care of severe obesity and IBD, is to establish clear and concise recommendations on the therapeutic possibilities of severe or typeIII obesity in patients with IBD. The document establishes general recommendations on dietary, pharmacological, endoscopic, and surgical treatment of severe obesity in patients with IBD, as well as pre- and post-treatment evaluation.
Collapse
Affiliation(s)
- Eugeni Domènech
- Servicio de Aparato Digestivo, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD); Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España.
| | - Andreea Ciudin
- Departament de Fisiologia i Immunologia, Universitat Autònoma de Barcelona, Barcelona, España; Servicio de Endocrinología y Nutrición, Hospital Universitari Vall d'Hebron, Barcelona, España; Diabetes and Metabolism Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - José María Balibrea
- Servicio de Cirugía General y Digestiva, Hospital Universitari Germans Trias i Pujol; Departamento de Cirugía, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - Eduard Espinet-Coll
- Unidad de Endoscopia Bariátrica, Hospital Universitario Dexeus y Clínica Diagonal, Barcelona, España
| | - Fiorella Cañete
- Servicio de Aparato Digestivo, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD)
| | - Lilliam Flores
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM); Unidad de Obesidad, Servicio de Endocrinología y Nutrición, Hospital Clínic, Barcelona, España
| | - Manuel Ferrer-Márquez
- Servicio de Cirugía General y Digestiva, Hospital Universitario Torrecárdenas, Almería, España
| | - Román Turró
- Unidad de Endoscopia Digestiva, Bariátrica y Metabólica, Servicio de Aparato Digestivo, Centro Médico Teknon y Hospital Quirón, Barcelona, España
| | - Alejandro Hernández-Camba
- Servicio de Aparato Digestivo, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - Yamile Zabana
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD); Servicio de Aparato Digestivo, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, España
| | - Ana Gutiérrez
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD); Servicio de Aparato Digestivo, Hospital General Universitario Dr. Balmis, ISABIAL, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante, España
| |
Collapse
|
6
|
Russell HA. Is It Time to Say Goodbye to BMI? A Commentary. FAMILY & COMMUNITY HEALTH 2024; 47:16-19. [PMID: 37882447 DOI: 10.1097/fch.0000000000000391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
The linkage between weight and health is complicated and our current body of evidence is inconsistent. We cannot have a discussion about weight without understanding the larger context of our antifat society and the influence of the diet industrial complex. Weight bias and a focus on weight in health care produce known harms. Additionally, clinicians often recommend losing weight without a nuanced discussion of the evidence showing that most people are unlikely to be successful with sustained weight loss. In this piece, I argue that using our precious time with patients and health care dollars to focus on health behaviors with indisputable evidence such as increasing physical activity and promoting smoking cessation is a more effective use of resources and more closely aligns with our ethical obligation to "do no harm."
Collapse
Affiliation(s)
- Holly Ann Russell
- Department of Family Medicine, Center for Community Health and Prevention, University of Rochester School of Medicine and Dentistry, Rochester, New York
| |
Collapse
|
7
|
Okada M, Pehlivan MJ, Miskovic-Wheatley J, Barakat S, Griffiths KR, Touyz SW, Simpson SJ, Maguire S, Holmes AJ. My Diet Study: protocol for a two-part observational, longitudinal, psycho-biological study of dieting in Australian youth. Front Public Health 2023; 11:1281855. [PMID: 38155880 PMCID: PMC10752999 DOI: 10.3389/fpubh.2023.1281855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/14/2023] [Indexed: 12/30/2023] Open
Abstract
Introduction Self-directed dieting (i.e., unsupervised) is very common among adolescents and young adults but has had almost no direct research. This paper describes the protocol for the My Diet Study, a two-arm observational investigation of the natural progression of dieting among young people over a period of 6-months. The study aims to examine the links between self-directed dieting, general physiological and psychological metrics of wellbeing (e.g., depressive symptoms) and biomarkers of gut-brain axis functions (e.g., microbiome and hormones) that are predicted to influence diet adherence through appetite, mood and metabolism regulation. Methods Young people aged 16-25, intending to start a diet will be invited to participate in this observational study. For Part 1 (psychological arm), participants will be asked to complete a set of questionnaires and diaries at the beginning of every month for 6 months, to assess overall mental (e.g., psychological distress, disordered eating) and physical (e.g., weight) health, perceived diet success, food intake and gastrointestinal movements. For Part 2 (biological arm), a subsample of 50 participants will be asked to provide feces, blood and saliva for bio-sampling each month for the first 3-months of their participation in Part 1. Discussion The My Diet Study will be the first longitudinal, observational study of dieting in young people combining in-depth psychological and biological data. It is anticipated that the findings will yield psychological & biological information about the impacts and effectiveness of self-directed dieting in young people, inform a framework for advice on safety in dieting among young people and help to establish the potential for biomarkers for risk management and improvement of diet-based lifestyle interventions.
Collapse
Affiliation(s)
- Mirei Okada
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- School of Life and Environmental Sciences, The University of Sydney, Camperdown, NSW, Australia
| | - Melissa J. Pehlivan
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- InsideOut Institute for Eating Disorders, The University of Sydney and Sydney Local Health District, Camperdown, NSW, Australia
| | - Jane Miskovic-Wheatley
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- InsideOut Institute for Eating Disorders, The University of Sydney and Sydney Local Health District, Camperdown, NSW, Australia
| | - Sarah Barakat
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- InsideOut Institute for Eating Disorders, The University of Sydney and Sydney Local Health District, Camperdown, NSW, Australia
| | - Kristi R. Griffiths
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- InsideOut Institute for Eating Disorders, The University of Sydney and Sydney Local Health District, Camperdown, NSW, Australia
| | - Stephen W. Touyz
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- InsideOut Institute for Eating Disorders, The University of Sydney and Sydney Local Health District, Camperdown, NSW, Australia
| | - Stephen J. Simpson
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- School of Life and Environmental Sciences, The University of Sydney, Camperdown, NSW, Australia
| | - Sarah Maguire
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- InsideOut Institute for Eating Disorders, The University of Sydney and Sydney Local Health District, Camperdown, NSW, Australia
| | - Andrew J. Holmes
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- School of Life and Environmental Sciences, The University of Sydney, Camperdown, NSW, Australia
| |
Collapse
|
8
|
Patomella AH, Guidetti S, Hagströmer M, Olsson CB, Jakobsson E, Nilsson GH, Åkesson E, Asaba E. Make My Day: primary prevention of stroke using engaging everyday activities as a mediator of sustainable health - a randomised controlled trial and process evaluation protocol. BMJ Open 2023; 13:e072037. [PMID: 38056945 PMCID: PMC10711911 DOI: 10.1136/bmjopen-2023-072037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 11/15/2023] [Indexed: 12/08/2023] Open
Abstract
INTRODUCTION The individual, societal and economic benefits of stroke prevention are high. Even though most risk factors can be reduced by changes to lifestyle habits, maintaining new and healthy activity patterns has been shown to be challenging.The aim of the study is to evaluate the impact of an interdisciplinary team-based, mHealth-supported prevention intervention on persons at risk for stroke. The intervention is mediated by engaging everyday activities that promote health. An additional aim is to describe a process evaluation that serves to increase knowledge about how the programme leads to potential change by studying the implementation process and mechanisms of impact. METHODS AND ANALYSIS The study will be a randomised controlled trial including 104 persons at risk for stroke. Persons at risk of stroke (n=52) will be randomised to an mHealth-supported stroke prevention programme. Controls will have ordinary primary healthcare (PHC) services. The 10-week programme will be conducted at PHC clinics, combining group meetings and online resources to support self-management of lifestyle change using engaging everyday activities as a mediator. Primary outcomes are stroke risk, lifestyle habits and participation in health-promoting activities. Assessments will be performed at baseline and at follow-up (11 weeks and 12 months). The effects of the programme will be analysed using inferential statistics. Implementation will be analysed using qualitative and quantitative methods. ETHICS AND DISSEMINATION The study has been approved by the Swedish Ethical Review Authority. Study results will be disseminated in peer-reviewed journals and at regional and international conferences targeting mixed audiences. TRIAL REGISTRATION NUMBER NCT05279508.
Collapse
Affiliation(s)
- Ann-Helen Patomella
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Health Care Centre, Stockholm, Sweden
| | - Susanne Guidetti
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital, Stockholm, Sweden
| | - Maria Hagströmer
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Health Care Centre, Stockholm, Sweden
| | - Christina Birgitta Olsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Health Care Centre, Stockholm, Sweden
| | - Elin Jakobsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Gunnar H Nilsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Health Care Centre, Stockholm, Sweden
| | - Elisabet Åkesson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Stockholms Sjukhem R&D, Stockholm, Sweden
| | - Eric Asaba
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Stockholms Sjukhem R&D, Stockholm, Sweden
| |
Collapse
|
9
|
Bauman D. Impact of obesity on female puberty and pubertal disorders. Best Pract Res Clin Obstet Gynaecol 2023; 91:102400. [PMID: 37708835 DOI: 10.1016/j.bpobgyn.2023.102400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 09/16/2023]
Abstract
The worldwide epidemic of obesity appears to be one of the crucial health problems. One-third of children and adolescents in the United States are classified as either overweight or obese and 6% of adolescents are severely obese. With the development of high technology, children, and adolescents, spend more time in sedentary life. Together with the availability of consuming fast caloric food, it is almost unavoidable to get an imbalance between caloric intake and caloric expenditure of energy, resulting in the accumulation of fat-energy stores. Obesity has an enormous impact on physical and psychological health and is associated with more than 29 adverse health consequences previously identified in the adult population only, such as type 2 diabetes mellitus, hypertension, metabolic syndrome, postmenopausal breast cancer, and others. In addition, excess adiposity may exert a harmful effect on the reproductive system, resulting in precocious puberty, irregular menstrual cycle, polycystic ovary syndrome, and high-risk sexual behavior. Intervention programs for healthy lifestyle modification, consisting of caloric restriction together with physical activity did not gain the expected efficacy. Other approaches as medical and surgical therapies are currently not evidence-based for the young population. The obesity crisis in children and adolescents requires a better understanding of etiology, pathophysiology, and management of obesity in this unique population. Researchers and physicians must "turn over every stone" to find a solution for deviating obesity ascent.
Collapse
Affiliation(s)
- Dvora Bauman
- Bat-Ami Center, Pediatric & Adolescent Gynecology Division, Obstetrics and Gynecology Department, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, P.O.B 12000, Jerusalem 91120, Israel.
| |
Collapse
|
10
|
Cicuttini FM, Proietto J, Lim YZ. Our biology working against us in obesity: A narrative review on implications for management of osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100407. [PMID: 37744021 PMCID: PMC10514453 DOI: 10.1016/j.ocarto.2023.100407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 09/26/2023] Open
Abstract
Obesity is the major modifiable risk factor for osteoarthritis (OA). A major focus of management in OA is weight loss. Although we live in an obesogenic environment, obesity has a predominantly genetic and epigenetic basis. This explains a person's weight set point which is defended by biological mechanisms making weight loss difficult to achieve and maintain long term, regardless of the methods used. Significant weight regain occurs after weight loss, with weight tending to return to pre-treatment levels after cessation of interventions including the glucagon-like peptide-1 (GLP-1) agonists. An area that has received little attention is the slow, insidious weight creep of 0.5-1 kg/year over adulthood that sees individuals relentlessly increase weight. There is evidence that low intensity, personalised lifestyle interventions can prevent this weight creep, providing patients with achievable goals. In this narrative review, we examine the evidence for weight loss in OA, the biological mechanisms that make weight loss difficult to achieve and maintain and the potential negative impacts on patients. We review the evidence for preventing weight gain, the improvement in patient outcomes and the potential for significant healthcare savings through reduced knee replacements. We propose a combined approach of weight loss when indicated, together with targeting weight creep across adult years and the potential role of metformin. Implementing these combined approaches is likely to be more effective in improving patient related outcomes, reducing joint damage and healthcare costs, than our current focus on achieving weight loss in OA.
Collapse
Affiliation(s)
- Flavia M. Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Joseph Proietto
- Department of Medicine, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Yuan Z. Lim
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| |
Collapse
|
11
|
Thompson D, Miranda J, Callender C, Dave JM, Appiah G, Musaad SMA. See Me, Hear Me, Know Me: Perspectives on Diet and Physical Activity Influences among Teens Living in Rural Texas Communities. Nutrients 2023; 15:4695. [PMID: 37960349 PMCID: PMC10650212 DOI: 10.3390/nu15214695] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/27/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
Teens in rural communities are at greater risk of obesity than teens in urban areas. Diet and physical activity influence obesity risk. Understanding their perspectives is an important step in intervention design. This qualitative investigation explored teen perspectives on how living in a rural community influenced their diet and physical activity choices. Forty parent-teen pairs were recruited. Data collection included surveys and telephone interviews. This paper reports teen perspectives identified in the first interview. Thematic analysis was used to code and analyze the data. Findings revealed that the primary factor driving teens' diet and physical activity behaviors was the teens themselves. They clearly understood their role in the choices they made, although they acknowledged not always making the healthiest choice. This belief was driven by their motivation to engage in healthy behaviors, which was influenced by the perceived benefits derived from making healthy choices and from the synergistic relationship between diet and physical activity. Diet and physical activity, in turn, were influenced by the environment, particularly the home, social, and community environments. Family and friends were particularly influential, as well as resource availability. These findings can serve as a foundation for designing interventions tailored to this population.
Collapse
Affiliation(s)
- Debbe Thompson
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA; (J.M.); (C.C.); (J.M.D.); (G.A.); (S.M.A.M.)
| | | | | | | | | | | |
Collapse
|
12
|
Lee HJ, Jin BY, Park MR, Kim NH, Seo KS, Jeong YT, Wada T, Lee JS, Choi SH, Kim DH. Inhibition of adipose tissue angiogenesis prevents rebound weight gain after caloric restriction in mice fed a high-fat diet. Life Sci 2023; 332:122101. [PMID: 37730110 DOI: 10.1016/j.lfs.2023.122101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 08/30/2023] [Accepted: 09/15/2023] [Indexed: 09/22/2023]
Abstract
AIMS We investigated whether modulation of white adipose tissue (WAT) vasculature regulates rebound weight gain (RWG) after caloric restriction (CR) in mice fed a high-fat diet (HFD). MAIN METHODS We compared changes in energy balance, hypothalamic neuropeptide gene expression, and characteristics of WAT by RT-qPCR, ELISA, immunohistochemistry, and adipose-derived stromal vascular fraction spheroid sprouting assay in obese mice fed a HFD ad libitum (HFD-AL), mice under 40 % CR for 3 or 4 weeks, mice fed HFD-AL for 3 days after CR (CRAL), and CRAL mice treated with TNP-470, an angiogenic inhibitor. KEY FINDINGS WAT angiogenic genes were expressed at low levels, but WAT vascular density was maintained in the CR group compared to that in the HFD-AL group. The CRAL group showed RWG, fat regain, and hyperphagia with higher expression of angiogenic genes and reduced pericyte coverage of the endothelium in WAT on day 3 after CR compared to the CR group, indicating rapidly increased angiogenic activity after CR. Administration of TNP-470 suppressed RWG, fat regain, and hyperphagia only after CR compared to the CRAL group. Changes in circulating leptin levels and hypothalamic neuropeptide gene expression were correlated with changes in weight and fat mass, suggesting that TNP-470 suppressed hyperphagia independently of the hypothalamic melanocortin system. Additionally, TNP-470 increased gene expression related to thermogenesis, fuel utilization, and browning in brown adipose tissue (BAT) and WAT, indicating TNP-470-induced increase in thermogenesis. SIGNIFICANCE Modulation of the WAT vasculature attenuates RWG after CR by suppressing hyperphagia and increasing BAT thermogenesis and WAT browning.
Collapse
Affiliation(s)
- Hye-Jin Lee
- Department of Pharmacology, Korea University College of Medicine, Seoul 02841, Republic of Korea; BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Bo-Yeong Jin
- Department of Pharmacology, Korea University College of Medicine, Seoul 02841, Republic of Korea; BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Mi-Rae Park
- Department of Pharmacology, Korea University College of Medicine, Seoul 02841, Republic of Korea; BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Kwan Sik Seo
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Yong Taek Jeong
- Department of Pharmacology, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Tsutomu Wada
- Department of Clinical Pharmacology, University of Toyama, Toyama 930-0194, Japan
| | - Jun-Seok Lee
- Department of Pharmacology, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Sang-Hyun Choi
- Department of Pharmacology, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Dong-Hoon Kim
- Department of Pharmacology, Korea University College of Medicine, Seoul 02841, Republic of Korea; BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Republic of Korea.
| |
Collapse
|
13
|
Zavros A, Andreou E, Aphamis G, Bogdanis GC, Sakkas GK, Roupa Z, Giannaki CD. The Effects of Zinc and Selenium Co-Supplementation on Resting Metabolic Rate, Thyroid Function, Physical Fitness, and Functional Capacity in Overweight and Obese People under a Hypocaloric Diet: A Randomized, Double-Blind, and Placebo-Controlled Trial. Nutrients 2023; 15:3133. [PMID: 37513551 PMCID: PMC10386647 DOI: 10.3390/nu15143133] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Evidence of the effectiveness of zinc (Zn) and selenium (Se) on resting metabolic rate (RMR) and physical function parameters in people with overweight and obesity is scarce, while the effects of zinc and selenium on thyroid function and body composition are still a topic of debate and controversy. The aim of this randomized, double-blind, and placebo-controlled trial was to examine the effects of a hypocaloric diet and Se-Zn co-supplementation on RMR, thyroid function, body composition, physical fitness, and functional capacity in overweight or obese individuals. Twenty-eight overweight-obese participants (mean BMI: 29.4 ± 4.7) were randomly allocated (1:1) to the supplementation group (n = 14, 31.1 ± 5.5 yrs, 9 females) and the placebo group (n = 14, 32.1 ± 4.8 yrs, 6 females). The participants received Zn (25 mg of zinc gluconate/day) and Se (200 mcg of L-selenomethionine/day) or placebo tablets containing starch for eight weeks. The participants of both groups followed a hypocaloric diet during the intervention. RMR, thyroid function, body composition, cardiorespiratory fitness (VO2max), and functional capacity (sit-to-stand tests, timed up-and-go test, and handgrip strength) were assessed before and after the intervention. A significant interaction was found between supplementation and time on RMR (p = 0.045), with the intervention group's RMR increasing from 1923 ± 440 to 2364 ± 410 kcal/day. On the other hand, no interaction between supplementation and time on the thyroid function was found (p > 0.05). Regarding the effects of Zn/Se co-administration on Se levels, a significant interaction between supplementation and time on Se levels was detected (p = 0.004). Specifically, the intervention group's Se serum levels were increased from 83.04 ± 13.59 to 119.40 ± 23.93 μg/L. However, Zn serum levels did not change over time (90.61 ± 23.23 to 89.58 ± 10.61 umol/L). Even though all body composition outcomes improved in the intervention group more than placebo at the second measurement, no supplement × time interaction was detected on body composition (p > 0.05). Cardiorespiratory fitness did not change over the intervention. Yet, a main effect of time was found for some functional capacity tests, with both groups improving similarly over the eight-week intervention period (p < 0.05). In contrast, a supplement x group interaction was found in the performance of the timed up-and-go test (TUG) (p = 0.010), with the supplementation group improving more. In conclusion, an eight-week intervention with Zn/Se co-supplementation combined with a hypocaloric diet increased the RMR, TUG performance, and Se levels in overweight and obese people. However, thyroid function, Zn levels, body composition, and the remaining outcomes of exercise performance remained unchanged.
Collapse
Affiliation(s)
- Antonis Zavros
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
| | - Eleni Andreou
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
| | - George Aphamis
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
| | - Gregory C Bogdanis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | - Giorgos K Sakkas
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Zoe Roupa
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
| | - Christoforos D Giannaki
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
| |
Collapse
|
14
|
Thompson D, Mirabile Y, Islam N, Callender C, Musaad SMA, Miranda J, Moreno JP, Dave JM, Baranowski T. Diet Quality among Pre-Adolescent African American Girls in a Randomized Controlled Obesity Prevention Intervention Trial. Nutrients 2023; 15:2716. [PMID: 37375620 DOI: 10.3390/nu15122716] [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: 05/15/2023] [Revised: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Consuming an unhealthy diet increases health risks. This study assessed the impact of a culturally adapted behaviorally innovative obesity prevention intervention (The Butterfly Girls and the Quest for Founder's Rock) on diet quality in pre-adolescent non-Hispanic Black/African American girls. The RCT consisted of three groups (experimental, comparison, and waitlist control); block randomization allocated participants to each group. The two treatment groups varied in terms of whether or not they set goals. Data were collected at baseline (prior to receiving the intervention), post 1 (3 months post-baseline), and post 2 (6 months post-baseline). Two dietitian-assisted 24 h dietary recalls were collected at each timepoint. Healthy Eating Index 2015 (HEI-2015) was used to determine diet quality. A total of 361 families were recruited; 342 completed baseline data collection. No significant differences in overall HEI score or component scores were observed. To attain more equitable health outcomes, future efforts to promote dietary intake change among at-risk children should explore other behavior change procedures and employ more child-friendly dietary assessment methods.
Collapse
Affiliation(s)
- Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Yiming Mirabile
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Noemi Islam
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Chishinga Callender
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Salma M A Musaad
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Julie Miranda
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Jennette P Moreno
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Jayna M Dave
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| |
Collapse
|
15
|
Marquez B, Lebensohn-Chialvo F, Huang X, Zhang X, Allison M. Improving Relational Functioning in Mother-Daughter Dyads With Obesity. FAMILY & COMMUNITY HEALTH 2023; 46:103-111. [PMID: 36799943 PMCID: PMC10959269 DOI: 10.1097/fch.0000000000000359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Family-level interventions have the potential to address intergenerational obesity among Mexican American women. Given that poor family functioning is associated with worse weight loss outcomes, this study tested a weight management program aimed at improving relational functioning in mothers and daughters with obesity. Mexican American mothers and their adult daughters were randomly assigned to participate in a 16-week group-based standard behavioral (SB) weight loss program without or with relationship skills training (SRT). Relational functioning was assessed via observational behavioral coding using the Global Structural Family Rating Scale. General relational functioning and specifically positive alliance patterns and conflict avoidance improved significantly more in the SRT group than in the SB group. Average weight changes included percent weight loss of -5.6% in the SRT group versus -3.9% in the SB group and body mass index reduction of -2.2 kg/m2 in the SRT group versus -1.2 kg/m2 in the SB group. More participants in the SRT group (75%) than in the SB group (40%) tended to achieve at least 3% weight loss. Greater changes in positive alliance patterns increased the likelihood of losing 3% of body weight. Improving relational functioning in mother-daughter dyads may promote favorable outcomes in a behavioral weight loss intervention.
Collapse
Affiliation(s)
- Becky Marquez
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, La Jolla, California, United States of America
| | - Florencia Lebensohn-Chialvo
- Department of Counseling & Marital and Family Therapy Program, University of San Diego, San Diego, United States of America
| | - Xinyi Huang
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, La Jolla, California, United States of America
| | - Xinlian Zhang
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, La Jolla, California, United States of America
| | - Matthew Allison
- Department of Family Medicine, University of California San Diego, La Jolla, California, United States of America
| |
Collapse
|
16
|
Halliday TM, McFadden M, Cedillo M, Barone Gibbs B, Hess R, Bryce C, Fischer GS, Huber K, McTigue KM, Conroy MB. Lifestyle strategies after intentional weight loss: results from the MAINTAIN-pc randomized trial. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2023; 8:e000220. [PMID: 37458000 PMCID: PMC10348773 DOI: 10.1249/tjx.0000000000000220] [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] [Indexed: 02/16/2023]
Abstract
Introduction/Purpose Weight maintenance following intentional weight loss is challenging and often unsuccessful. Physical activity and self-monitoring are strategies associated with successful weight loss maintenance. However, less is known about the type and number of lifestyle strategies used following intentional weight loss. The purpose of this study was to determine the types and amounts of strategies associated with successful long-term weight loss maintenance. Methods Data from the 24-month Maintaining Activity and Nutrition Through Technology-Assisted Innovation in Primary Care (MAINTAIN-pc) trial were analyzed. MAINTAIN-pc recruited adults (n=194; 53.4±12.2 years of age, body mass index (BMI): 30.4±5.9 kg/m2, 74% female) with recent intentional weight loss of ≥5%, randomized to tracking tools plus coaching (i.e., coaching group) or tracking tools without coaching (i.e., tracking-only group). At baseline, 6, 12, and 24 months, participants reported lifestyle strategies used in the past 6 months, including self-monitoring, group support, behavioral skills, and professional support. General linear models evaluated changes in the number of strategies over time between groups and the consistency of strategies used over the 24-month intervention. Results At baseline, 100% used behavioral skills, 73% used group support, 69% used self-monitoring, and 68% used professional support in the past 6 months; at 24 months, these rates were 98%, 60%, 75%, and 61%, respectively. While the number of participants utilizing individual strategies did not change significantly over time, the overall number of strategies participants reported decreased. More strategies were used at baseline and 6 months compared to 12- and 24-month follow-ups. The coaching group used more strategies at months 6 and 12 than the tracking-only group. Consistent use of professional support strategies over the 24-month study period was associated with less weight regain. Conclusion Weight loss maintenance interventions that incorporate continued follow-up and support from healthcare professionals are likely to prevent weight regain after intentional weight loss.
Collapse
Affiliation(s)
- Tanya M. Halliday
- Department of Health and Kinesiology, College of Health, University of Utah, Salt Lake City, UT, USA
| | - Molly McFadden
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Maribel Cedillo
- Division of General Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Bethany Barone Gibbs
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rachel Hess
- Division of Health System Innovation and Research, Departments of Population Health Sciences and Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Cindy Bryce
- Department of Health Policy & Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh PA, USA
| | - Gary S. Fischer
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kimberly Huber
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathleen M. McTigue
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Molly B. Conroy
- Division of General Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
17
|
Forman EM, Berry MP, Butryn ML, Hagerman CJ, Huang Z, Juarascio AS, LaFata EM, Ontañón S, Tilford JM, Zhang F. Using artificial intelligence to optimize delivery of weight loss treatment: Protocol for an efficacy and cost-effectiveness trial. Contemp Clin Trials 2023; 124:107029. [PMID: 36435427 PMCID: PMC9839592 DOI: 10.1016/j.cct.2022.107029] [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: 08/30/2022] [Revised: 11/09/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022]
Abstract
Gold standard behavioral weight loss (BWL) is limited by the availability of expert clinicians and high cost of delivery. The artificial intelligence (AI) technique of reinforcement learning (RL) is an optimization solution that tracks outcomes associated with specific actions and, over time, learns which actions yield a desired outcome. RL is increasingly utilized to optimize medical treatments (e.g., chemotherapy dosages), and has very recently started to be utilized by behavioral treatments. For example, we previously demonstrated that RL successfully optimized BWL by dynamically choosing between treatments of varying cost/intensity each week for each participant based on automatic monitoring of digital data (e.g., weight change). In that preliminary work, participants randomized to the AI condition required one-third the amount of coaching contact as those randomized to the gold standard condition but had nearly identical weight losses. The current protocol extends our pilot work and will be the first full-scale randomized controlled trial of a RL system for weight control. The primary aim is to evaluate the hypothesis that a RL-based 12-month BWL program will produce non-inferior weight losses to standard BWL treatment, but at lower costs. Secondary aims include testing mechanistic targets (calorie intake, physical activity) and predictors (depression, binge eating). As such, adults with overweight/obesity (N = 336) will be randomized to either a gold standard condition (12 months of weekly BWL groups) or AI-optimized weekly interventions that represent a combination of expert-led group, expert-led call, paraprofessional-led call, and automated message). Participants will be assessed at 0, 1, 6 and 12 months.
Collapse
Affiliation(s)
- Evan M Forman
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA 19104, United States; Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA 19104, United States.
| | - Michael P Berry
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA 19104, United States; Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA 19104, United States
| | - Meghan L Butryn
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA 19104, United States; Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA 19104, United States
| | - Charlotte J Hagerman
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA 19104, United States
| | - Zhuoran Huang
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA 19104, United States
| | - Adrienne S Juarascio
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA 19104, United States; Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA 19104, United States
| | - Erica M LaFata
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA 19104, United States
| | - Santiago Ontañón
- Department of Computer Science, Drexel University, 3675 Market St 10th floor, Philadelphia, PA 19104, United States; Google Research, 1600 Amphitheatre Parkway, Mountain View, CA 94043, United States
| | - J Mick Tilford
- College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, United States
| | - Fengqing Zhang
- Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Stratton Hall, Philadelphia, PA 19104, United States
| |
Collapse
|
18
|
The impact of exercise and cumulative physical activity on energy intake and diet quality in adults enrolled in the Midwest Exercise Trial for the Prevention of Weight Regain. Br J Nutr 2022; 128:2498-2509. [PMID: 35249561 PMCID: PMC9448821 DOI: 10.1017/s0007114521005122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The purpose of this study was to assess impact of different volumes of exercise as well as cumulative moderate to vigorous physical activity (MVPA) on energy intake (EI) and diet quality, as assessed by the Healthy Eating Index-2010(HEI-2010), across a 12-month weight maintenance intervention. Participants were asked to attend group behavioural sessions, eat a diet designed for weight maintenance and exercise either 150, 225 or 300 min/week. Dietary intake was assessed by 3-d food records, and MVPA was assessed by accelerometry. Two hundred and twenty-four participants (42·5 years of age, 82 % female) provided valid dietary data for at least one time point. There was no evidence of group differences in EI, total HEI-2010 score or any of the HEI-2010 component scores (all P > 0·05). After adjusting for age, sex, time, group and group-by-time interactions, there was an effect of cumulative MVPA on EI (1·08, P = 0·04), total HEI-2010 scores (-0·02, P = 0·003), Na (-0·006, P = 0·002) and empty energy scores (-0·007, P = 0·004. There was evidence of a small relationship between cumulative daily EI and weight (β: 0·00187, 95 % CI 0·001, P = 0·003). However, there was no evidence for a relationship between HEI total score (β: -0·006, 95 % CI 0·07, 0·06) or component scores (all P > 0·05) and change in weight across time. The results of this study suggest that increased cumulative MVPA is associated with clinically insignificant increases in EI and decreases in HEI.
Collapse
|
19
|
Park KY, Nam GE, Han K, Hwang HS. Body weight variability and the risk of dementia in patients with type 2 diabetes mellitus: A nationwide cohort study in Korea. Diabetes Res Clin Pract 2022; 190:110015. [PMID: 35907508 DOI: 10.1016/j.diabres.2022.110015] [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: 03/01/2022] [Revised: 07/08/2022] [Accepted: 07/18/2022] [Indexed: 11/03/2022]
Abstract
AIMS This study aimed to examine the association between body weight variability and dementia risk using a large-scale cohort data of Korean patients with type 2 diabetes mellitus (T2DM). METHODS A population-based cohort of 1,206,764 individuals with T2DM aged ≥ 40 years who underwent ≥ 3 Korean national health screenings were followed up until the end of 2019. Body weight variability was assessed using variability independent of the mean (VIM). A multivariate Cox proportional hazard regression was performed with calculating hazard ratios (HRs) with 95 % confidence intervals (CIs) of dementia incidence. RESULTS During a median follow-up of 7.9 years, 162,615 (13.4 %) individuals developed dementia. Individuals with greater body weight variability tended to be associated with higher risk of all types of dementia (P for trend < 0.001). Individuals in the highest quartile of VIM showed 26 % (HR: 1.26, 95 % CI: 1.24-1.28), 33 % (HR: 1.33, 95 % CI: 1.30-1.36) and 28 % (HR: 1.28, 95 % CI: 1.23-1.33) higher risk for all-cause dementia, Alzheimer's disease, and vascular dementia, compared with those in the lowest quartile. These associations persisted in all body mass index categories (P for trend < 0.001). CONCLUSIONS Maintaining an appropriate body weight may help mitigate dementia risk in patients with T2DM.
Collapse
Affiliation(s)
- Kye-Yeung Park
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, South Korea.
| | - Ga Eun Nam
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea.
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea.
| | - Hwan-Sik Hwang
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, South Korea.
| |
Collapse
|
20
|
Mauldin K, May M, Clifford D. The consequences of a weight-centric approach to healthcare: A case for a paradigm shift in how clinicians address body weight. Nutr Clin Pract 2022; 37:1291-1306. [PMID: 35819360 DOI: 10.1002/ncp.10885] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/27/2022] [Accepted: 05/14/2022] [Indexed: 11/10/2022] Open
Abstract
Current healthcare is weight-centric, equating weight and health. This approach to healthcare has negative consequences on patient well-being. The aim of this article is to make a case for a paradigm shift in how clinicians view and address body weight. In this review, we (1) address common flawed assumptions in the weight-centric approach to healthcare, (2) review the weight science literature and provide evidence for the negative consequences of promoting dieting and weight loss, and (3) provide practice recommendations for weight-inclusive care.
Collapse
Affiliation(s)
- Kasuen Mauldin
- Department of Nutrition, Food Science, and Packaging, San José State University, San José, California, USA.,Department of Clinical Nutrition, Stanford Health Care, Stanford, California, USA
| | - Michelle May
- Am I Hungry? Mindful Eating Programs and Training, USA.,Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Dawn Clifford
- Department of Health Sciences, Northern Arizona University, Flagstaff, Arizona, USA
| |
Collapse
|
21
|
Solomon S, Shank LM, Lavender JM, Higgins Neyland MK, Gallager-Teske J, Markos B, Haynes H, Repke H, Rice AJ, Sbrocco T, Wilfley DE, Schvey NA, Jorgensen S, Ford B, Ford CB, Haigney M, Klein DA, Quinlan J, Tanofsky‐Kraff M. The Relationship Between Anxiety, Coping, and Disordered-Eating Attitudes in Adolescent Military-Dependents at High-Risk for Excess Weight Gain. MILITARY PSYCHOLOGY 2022; 35:95-106. [PMID: 36968637 PMCID: PMC10012895 DOI: 10.1080/08995605.2022.2083448] [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: 10/22/2021] [Accepted: 05/23/2022] [Indexed: 10/18/2022]
Abstract
Adolescent military-dependents are an understudied population who face unique stressors due to their parents' careers. Research suggests that adolescent military-dependents report more anxiety and disordered-eating than their civilian counterparts. While anxiety symptoms predict the onset and worsening of disordered-eating attitudes, the mechanisms underlying this relationship remain unclear. One factor that may underlie this relationship, and be particularly relevant for military-dependent youth, is coping. Therefore, we examined adolescent military-dependents (N=136; 14.5±1.5 years; 59.6% female; BMI-z: 1.9±0.4) who were at-risk for adult obesity and binge-eating disorder due to an age- and sex-adjusted BMI ≥ 85th percentile and loss-of-control eating and/or elevated anxiety. Participants completed an interview assessing disordered-eating attitudes and questionnaires on anxiety symptoms and coping strategies at a single time point. Bootstrapping models were conducted to examine the indirect paths between anxiety symptoms and disordered-eating attitudes through five coping subscales (aggression, distraction, endurance, self-distraction, and stress-recognition). Adjusting for relevant covariates, no significant indirect paths through the coping subscales (ps > .05) were found in any models. General coping, non-specific to eating, may not be a pathway between anxiety symptoms and disordered-eating attitudes among adolescents. Future research should examine other potential mediators of this relationship.
Collapse
Affiliation(s)
- Senait Solomon
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, USA
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, Maryland, USA
- Metis Foundation, San Antonio, Texas, USA
| | - Lisa M. Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, USA
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, Maryland, USA
- Metis Foundation, San Antonio, Texas, USA
- Department of Medicine, USU, Bethesda, Maryland, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland, USA
| | - Jason M. Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, Maryland, USA
- Metis Foundation, San Antonio, Texas, USA
- Department of Medicine, USU, Bethesda, Maryland, USA
| | - M. K. Higgins Neyland
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, Maryland, USA
- Metis Foundation, San Antonio, Texas, USA
- Department of Medicine, USU, Bethesda, Maryland, USA
| | - Julia Gallager-Teske
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, Maryland, USA
- Metis Foundation, San Antonio, Texas, USA
- Department of Medicine, USU, Bethesda, Maryland, USA
| | - Bethelhem Markos
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, Maryland, USA
- Metis Foundation, San Antonio, Texas, USA
- Department of Medicine, USU, Bethesda, Maryland, USA
| | - Hannah Haynes
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, Maryland, USA
- Metis Foundation, San Antonio, Texas, USA
- Department of Medicine, USU, Bethesda, Maryland, USA
| | - Hannah Repke
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, Maryland, USA
- Metis Foundation, San Antonio, Texas, USA
- Department of Medicine, USU, Bethesda, Maryland, USA
| | - Alexander J. Rice
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, Maryland, USA
- Metis Foundation, San Antonio, Texas, USA
- Department of Medicine, USU, Bethesda, Maryland, USA
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, USA
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Natasha A. Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland, USA
| | - Sarah Jorgensen
- Department of Family Medicine, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
| | - Brian Ford
- Department of Family Medicine, USU, Bethesda, Maryland, USA
| | - Caitlin B. Ford
- Department of Family Medicine, Fort Belvoir Community Hospital, Fort Belvoir, Virginia, USA
| | - Mark Haigney
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, Maryland, USA
- Department of Medicine, USU, Bethesda, Maryland, USA
| | - David A. Klein
- Department of Family Medicine, USU, Bethesda, Maryland, USA
- Department of Pediatrics, USU, Bethesda, Maryland, USA
| | - Jeffrey Quinlan
- Department of Family Medicine, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
| | - Marian Tanofsky‐Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, USA
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, Maryland, USA
- Department of Medicine, USU, Bethesda, Maryland, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland, USA
| |
Collapse
|
22
|
Ng CH, Xiao J, Lim WH, Chin YH, Yong JN, Tan DJH, Tay P, Syn N, Foo R, Chan M, Chew N, Tan EX, Huang DQ, Dan YY, Tamaki N, Siddiqui MS, Sanyal AJ, Loomba R, Noureddin M, Muthiah MD. Placebo effect on progression and regression in NASH: Evidence from a meta-analysis. Hepatology 2022; 75:1647-1661. [PMID: 34990037 DOI: 10.1002/hep.32315] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/26/2021] [Accepted: 01/03/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS The evaluation of the natural history of NASH has been limited. Currently, liver biopsy remains the gold standard in the assessment of NASH. Placebo-controlled trials represent a controlled environment with paired biopsies for the evaluation of NASH. This meta-analysis thus seeks to quantify the change severity of NASH over time, with patients on placebo arms from randomized controlled trials (RCTs) to examine the natural history of NASH. METHODS A search was conducted to include NASH RCTs with placebo treatment arms. Primary outcomes were (1) the resolution of NASH without worsening of fibrosis, (2) two-point reduction in NAFLD activity score without worsening of fibrosis, and (3) at least one-point reduction in fibrosis. Generalized linear mix model was used to estimate pooled proportion and mean differences. RESULTS This meta-analysis of 43 RCTs included 2649 placebo-treated patients. The pooled estimate of NASH resolution and two-point NAFLD activity score reduction without worsening of fibrosis was 11.65% (95% CI: 7.98-16.71) and 21.11% (95% CI: 17.24-25.57). The rate of ≥1 stage reduction and progression of fibrosis was 18.82% (95% CI: 15.65-22.47) and 22.74% (CI: 19.63-26.17), respectively. Older age and African American ethnicity was associated with lower NASH resolution rate in placebo-treated patients. CONCLUSIONS Despite the absence of any pharmacological interventions, a significant proportion of patients in the placebo arm demonstrated improvements in liver histology, highlighting the possibility that NASH is a disease that can not only progress but regress spontaneously over time. Additionally, histologic response in placebo-treated patients is helpful in future design of phase 2B and phase 3 trials.
Collapse
Affiliation(s)
- Cheng Han Ng
- Yong Loo Lin School of MedicineNational University of SingaporeSingapore
| | - Jieling Xiao
- Yong Loo Lin School of MedicineNational University of SingaporeSingapore
| | - Wen Hui Lim
- Yong Loo Lin School of MedicineNational University of SingaporeSingapore
| | - Yip Han Chin
- Yong Loo Lin School of MedicineNational University of SingaporeSingapore
| | - Jie Ning Yong
- Yong Loo Lin School of MedicineNational University of SingaporeSingapore
| | - Darren Jun Hao Tan
- Yong Loo Lin School of MedicineNational University of SingaporeSingapore
| | - Phoebe Tay
- Yong Loo Lin School of MedicineNational University of SingaporeSingapore
| | - Nicholas Syn
- Yong Loo Lin School of MedicineNational University of SingaporeSingapore
| | - Roger Foo
- Yong Loo Lin School of MedicineNational University of SingaporeSingapore
- Department of CardiologyNational University Heart CentreNational University HospitalSingapore
| | - Mark Chan
- Yong Loo Lin School of MedicineNational University of SingaporeSingapore
- Department of CardiologyNational University Heart CentreNational University HospitalSingapore
| | - Nicholas Chew
- Yong Loo Lin School of MedicineNational University of SingaporeSingapore
- Department of CardiologyNational University Heart CentreNational University HospitalSingapore
| | - Eunice Xx Tan
- Yong Loo Lin School of MedicineNational University of SingaporeSingapore
- Division of Gastroenterology and HepatologyDepartment of MedicineNational University HospitalSingaporeSingapore
- National University Center for Organ TransplantationNational University Health SystemSingapore
| | - Daniel Q Huang
- Yong Loo Lin School of MedicineNational University of SingaporeSingapore
- Division of Gastroenterology and HepatologyDepartment of MedicineNational University HospitalSingaporeSingapore
- National University Center for Organ TransplantationNational University Health SystemSingapore
| | - Yock Young Dan
- Yong Loo Lin School of MedicineNational University of SingaporeSingapore
- Division of Gastroenterology and HepatologyDepartment of MedicineNational University HospitalSingaporeSingapore
- National University Center for Organ TransplantationNational University Health SystemSingapore
| | - Nobuharu Tamaki
- NAFLD Research CenterDivision of Gastroenterology and HepatologyDepartment of MedicineUniversity of California at San DiegoSan DiegoCaliforniaUSA
| | - Mohammad Shadab Siddiqui
- Cedars-Sinai Fatty Liver ProgramDivision of Digestive and Liver DiseasesDepartment of MedicineComprehensive Transplant CenterCedars-Sinai Medical CentreLos AngelesCaliforniaUSA
| | - Arun J Sanyal
- Department of Internal MedicineDivision of Gastroenterology, Hepatology and NutritionVirginia Commonwealth UniversityRichmondVirginiaUSA
- Division of Gastroenterology, Hepatology and NutritionDepartment of Internal MedicineVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Rohit Loomba
- NAFLD Research CenterDivision of Gastroenterology and HepatologyDepartment of MedicineUniversity of California at San DiegoSan DiegoCaliforniaUSA
| | - Mazen Noureddin
- Cedars-Sinai Fatty Liver ProgramDivision of Digestive and Liver DiseasesDepartment of MedicineComprehensive Transplant CenterCedars-Sinai Medical CentreLos AngelesCaliforniaUSA
| | - Mark D Muthiah
- Yong Loo Lin School of MedicineNational University of SingaporeSingapore
- Division of Gastroenterology and HepatologyDepartment of MedicineNational University HospitalSingaporeSingapore
- National University Center for Organ TransplantationNational University Health SystemSingapore
| |
Collapse
|
23
|
Beier UH, Baker DJ, Baur JA. Thermogenic T cells: a cell therapy for obesity? Am J Physiol Cell Physiol 2022; 322:C1085-C1094. [PMID: 35476503 PMCID: PMC9169824 DOI: 10.1152/ajpcell.00034.2022] [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: 01/26/2022] [Revised: 04/20/2022] [Accepted: 04/22/2022] [Indexed: 11/22/2022]
Abstract
Obesity is a widespread public health problem with profound medical consequences and its burden is increasing worldwide. Obesity causes significant morbidity and mortality and is associated with conditions including cardiovascular disease and diabetes mellitus. Conventional treatment options are insufficient, or in the case of bariatric surgery, quite invasive. The etiology of obesity is complex, but at its core is often a caloric imbalance with an inability to burn off enough calories to exceed caloric intake, resulting in storage. Interventions such as dieting often lead to decreased resting energy expenditure (REE), with a rebound in weight ("yo-yo effect" or weight cycling). Strategies that increase REE are attractive treatment options. Brown fat tissue engages in nonshivering thermogenesis whereby mitochondrial respiration is uncoupled from ATP production, increasing REE. Medications that replicate brown fat metabolism by mitochondrial uncoupling (e.g., 2,4-dinitrophenol) effectively promote weight loss but are limited by toxicity to a narrow therapeutic range. This review explores the possibility of a new therapeutic approach to engineer autologous T cells into acquiring a thermogenic phenotype like brown fat. Engineered autologous T cells have been used successfully for years in the treatment of cancers (chimeric antigen receptor T cells), and the principle of engineering T cells ex vivo and transferring them back to the patient is established. Engineering T cells to acquire a brown fat-like metabolism could increase REE without the risks of pharmacological mitochondrial uncoupling. These thermogenic T cells may increase basal metabolic rate and are therefore a potentially novel therapeutic strategy for obesity.
Collapse
Affiliation(s)
- Ulf H Beier
- Janssen Research and Development, Spring House, Pennsylvania
| | - Daniel J Baker
- Center for Cellular Immunotherapies, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Parker Institute for Cancer Immunotherapy at University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Medicine, Perelman School of Medicine, Cardiovascular Institute and Institute of Diabetes, Obesity, and Metabolism, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph A Baur
- Department of Physiology, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
24
|
Estimating the benefits of obesity prevention on productivity: an Australian perspective. Int J Obes (Lond) 2022; 46:1463-1469. [PMID: 35546611 PMCID: PMC9092329 DOI: 10.1038/s41366-022-01133-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 11/16/2022]
Abstract
Background/objectives Obesity poses one of the biggest public health challenges globally. In addition to the high costs of obesity to the healthcare system, obesity also impacts work productivity. We aimed to estimate the benefits of preventing obesity in terms of years of life, productivity-adjusted life years (PALYs) and associated costs over 10 years. Subjects/methods Dynamic life table models were constructed to estimate years of life and PALYs saved if all new cases of obesity were prevented among Australians aged 20–69 years from 2021 to 2030. Life tables were sex specific and the population was classified into normal weight, overweight and obese. The model simulation was first undertaken assuming currently observed age-specific incidences of obesity, and then repeated assuming all new cases of obesity were reduced by 2 and 5%. The differences in outcomes (years of life, PALYs, and costs) between the two modelled outputs reflected the potential benefits that could be achieved through obesity prevention. All outcomes were discounted by 5% per annum. Results Over the next 10 years, 132 million years of life and 81 million PALYs would be lived by Australians aged 20–69 years, contributing AU$17.0 trillion to the Australian economy in terms of GDP. A 5% reduction in new cases of obesity led to a gain of 663 years of life and 1229 PALYs, equivalent to AU$262 million in GDP. Conclusions Prevention of obesity is projected to result in substantial economic gains due to improved health and productivity. This further emphasises the need for public health prevention strategies to reduce this growing epidemic.
Collapse
|
25
|
Comprehensive Review and Updates on Holistic Approach Towards Non-Alcoholic Fatty Liver Disease Management with Cardiovascular Disease. Curr Atheroscler Rep 2022; 24:515-532. [PMID: 35507280 DOI: 10.1007/s11883-022-01027-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW The global prevalence of non-alcoholic fatty liver disease (NAFLD) presents an unmet need in treating these, often asymptomatic, individuals. In this review, we summarised NAFLD management and described recent developments in non-alcoholic steatohepatitis (NASH) therapeutics that can shape the future of NAFLD. RECENT FINDINGS A multi-disciplinary effort in promoting sustainable lifestyle measures is paramount, with the goal of either limiting energy surplus alone or in combination with targeting downstream pathways of inflammation and fibrosis. Several antidiabetic medications like PPAR-γ agonist and glucagon-like peptide receptor agonists have beneficial effects on the metabolic profile as well as NASH histology. Vitamin E has shown promise in specific groups of patients with the haptoglobin2 allele protein. Newer drugs have demonstrated promising results in NASH resolution and fibrosis improvement such as obeticholic acid, resmetirom, aramchol, efruxifermin, aldafermin and lanifibranor. Apart from discussing the results of late stage clinical trials and the possible challenges in managing these patients with limited approved therapies, we also discussed the specific management of comorbidities (diabetes, hypertension, hyperlipidaemia, cardiovascular diseases) in NAFLD patients. Treatment strategy needs to target improvements in liver-related outcomes and cardiometabolic profile.
Collapse
|
26
|
Gut microbiota-bile acid crosstalk contributes to the rebound weight gain after calorie restriction in mice. Nat Commun 2022; 13:2060. [PMID: 35440584 PMCID: PMC9018700 DOI: 10.1038/s41467-022-29589-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/24/2022] [Indexed: 12/13/2022] Open
Abstract
Calorie restriction (CR) and fasting are common approaches to weight reduction, but the maintenance is difficult after resuming food consumption. Meanwhile, the gut microbiome associated with energy harvest alters dramatically in response to nutrient deprivation. Here, we reported that CR and high-fat diet (HFD) both remodeled the gut microbiota with similar microbial composition, Parabacteroides distasonis was most significantly decreased after CR or HFD. CR altered microbiota and reprogramed metabolism, resulting in a distinct serum bile acid profile characterized by depleting the proportion of non-12α-hydroxylated bile acids, ursodeoxycholic acid and lithocholic acid. Downregulation of UCP1 expression in brown adipose tissue and decreased serum GLP-1 were observed in the weight-rebound mice. Moreover, treatment with Parabacteroides distasonis or non-12α-hydroxylated bile acids ameliorated weight regain via increased thermogenesis. Our results highlighted the gut microbiota-bile acid crosstalk in rebound weight gain and Parabacteroides distasonis as a potential probiotic to prevent rapid post-CR weight gain. Caloric restriction is a common approach to weight reduction, however, weight regain is common. Here the authors report that caloric restriction reduces the abundance of Parabacteroides distasonis in the gut and alters serum bile acid (BA) profile, which contribute to weight regain in mice.
Collapse
|
27
|
Christoffersen BØ, Sanchez‐Delgado G, John LM, Ryan DH, Raun K, Ravussin E. Beyond appetite regulation: Targeting energy expenditure, fat oxidation, and lean mass preservation for sustainable weight loss. Obesity (Silver Spring) 2022; 30:841-857. [PMID: 35333444 PMCID: PMC9310705 DOI: 10.1002/oby.23374] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/09/2021] [Accepted: 12/10/2021] [Indexed: 12/17/2022]
Abstract
New appetite-regulating antiobesity treatments such as semaglutide and agents under investigation such as tirzepatide show promise in achieving weight loss of 15% or more. Energy expenditure, fat oxidation, and lean mass preservation are important determinants of weight loss and weight-loss maintenance beyond appetite regulation. This review discusses prior failures in clinical development of weight-loss drugs targeting energy expenditure and explores novel strategies for targeting energy expenditure: mitochondrial proton leak, uncoupling, dynamics, and biogenesis; futile calcium and substrate cycling; leptin for weight maintenance; increased sympathetic nervous system activity; and browning of white fat. Relevant targets for preserving lean mass are also reviewed: growth hormone, activin type II receptor inhibition, and urocortin 2 and 3. We endorse moderate modulation of energy expenditure and preservation of lean mass in combination with efficient appetite reduction as a means of obtaining a significant, safe, and long-lasting weight loss. Furthermore, we suggest that the regulatory guidelines should be revisited to focus more on the quality of weight loss and its maintenance rather than the absolute weight loss. Commitment to this research focus both from a scientific and from a regulatory point of view could signal the beginning of the next era in obesity therapies.
Collapse
Affiliation(s)
| | | | - Linu Mary John
- Global Obesity and Liver Disease ResearchGlobal Drug DiscoveryNovo Nordisk A/SMåløvDenmark
| | - Donna H. Ryan
- Pennington Biomedical Research CenterLouisiana State UniversityBaton RougeLouisianaUSA
| | - Kirsten Raun
- Global Obesity and Liver Disease ResearchGlobal Drug DiscoveryNovo Nordisk A/SMåløvDenmark
| | - Eric Ravussin
- Pennington Biomedical Research CenterLouisiana State UniversityBaton RougeLouisianaUSA
| |
Collapse
|
28
|
Paisey R, Daniels C, Howitt W, Greatorex D, Campbell C, Paisey C, Paisey R, Frost J, Bromige R. Body weight, diabetes incidence vascular events and survival 15 years after very low calorie diet in community medical clinics in the UK. BMJ Nutr Prev Health 2022; 5:55-61. [PMID: 35814720 PMCID: PMC9237870 DOI: 10.1136/bmjnph-2021-000363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 02/20/2022] [Indexed: 01/09/2023] Open
Abstract
Objective To assess weight loss maintenance, diabetes status, mortality and morbidity 15 years after a very low calorie diet programme (VLCD) in patients with obesity. Design General practice data bases were interrogated for subjects coded for group therapy with VLCD in the 1990s. Causes of death, occurrence of vascular disease and remission or development of diabetes were ascertained from patient records and national stroke and cardiovascular disease data bases. Results 325 subjects engaged in the programme and had sufficient data for analysis. Baseline characteristics were: age 47.8±12. 8 years; body mass index (BMI) 36.1±6.8 kg/m2; 79.1% female/20.9% male; 13.5% had type 2 diabetes. After 15±4 years weight had changed from 97.9±19 kg at baseline to 100±20.8 kg. 10 with diabetes at baseline were in remission at 3 months, but only two remained in remission at 5 years. 50 new cases of type 2 diabetes and 11 of impaired fasting glucose developed during follow-up. Only 5.9% who remained healthy at follow-up had maintained >10% body weight reduction. Neither diabetes incidence nor diabetes free survival were related to percentage body weight lost during VLCD. Only baseline BMI was related to development of new impaired fasting glucose or diabetes by 15 years (p=0.007). 37 subjects had a cardiovascular event. Age (p=0.000002) and degree of weight loss after VLCD (p=0.03) were significantly associated with subsequent vascular events. Conclusion Long-term maintenance of weight loss after VLCD was rare in this single centre retrospective study 15 years later. Glucose intolerance developed in 21.4%. Lasting remission of type 2 diabetes or prevention of later glucose intolerance were not achieved. Vascular events were more frequent in those who lost most weight. Risk management during weight regain should be studied in future to assess potential for reduction in adverse cardiovascular outcomes.
Collapse
Affiliation(s)
- Richard Paisey
- Diabetic Department, Torbay and South Devon NHS Foundation Trust, Torquay, UK
| | - Charles Daniels
- General Practice, Chilcote Surgery Dewerstone Practice, Torquay, UK
| | - Will Howitt
- General Practice, Pembroke House Surgery, Paignton, UK
| | - Derek Greatorex
- General Practice, Kingsteignton Medical Practice, Newton Abbot, UK
| | - Claire Campbell
- Diabetic Department, Torbay and South Devon NHS Foundation Trust, Torquay, UK
| | - Christopher Paisey
- Diabetes, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Rosamund Paisey
- Diabetes Research, Torbay and South Devon NHS Foundation Trust, Torquay, UK
| | - Julie Frost
- Practice Nursing, Catherine House Surgery, Totnes, UK
| | - Robert Bromige
- General Practice, Compass House Medical Centres, Brixham, UK
| |
Collapse
|
29
|
Phelan S, Roake J, Alarcon N, Ng SM, Glanz H, Cardel MI, Foster GD. In their own words: Topic analysis of the motivations and strategies of over 6,000 long-term weight-loss maintainers. Obesity (Silver Spring) 2022; 30:751-761. [PMID: 35137557 PMCID: PMC9305441 DOI: 10.1002/oby.23372] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This study aimed to identify major themes of a large cohort experiencing long-term weight-loss maintenance who answered open-ended questions about weight-loss triggers, current motivations, strategies, and experiences. METHODS Machine learning and topic modeling were used to analyze responses to six open-ended questions among 6,139 WW International, Inc., (formerly Weight Watchers) members with weight-loss maintenance; inclusion criteria included ≥9.1-kg loss with weight-loss maintenance for ≥1 year. RESULTS Participants (mean age = 53.6 years; 94.3% White; mean BMI = 27.8 kg/m2 ) had lost 24.5 kg and maintained the loss for 3.4 years. Descriptions of factors triggering weight loss coalesced into five topics: medical status, appearance, mobility, social prompts, and change needed. Factors currently motivating weight-loss maintenance yielded two topics: looking back at experiences at higher weight and health/appearance concerns. Advice for others to succeed in weight-loss maintenance coalesced on two recommendations: perseverance in the face of setbacks and consistency in tracking. Rewards for weight management included improved confidence, pain, mobility, fitness, body image, medical status, and affect. Two thematic negative consequences were clothing costs and sagging skin. CONCLUSIONS Future weight-maintenance research should include more diverse populations and investigate weight-loss maintenance as a journey with highs and lows, perseverance in the face of setbacks, sustained tracking, and making changes in medical status more salient during the weight-maintenance journey.
Collapse
Affiliation(s)
- Suzanne Phelan
- Department of Kinesiology and Public HealthCenter for Health ResearchCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUSA
| | - James Roake
- Department of Kinesiology and Public HealthCenter for Health ResearchCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUSA
| | - Noemi Alarcon
- Department of Kinesiology and Public HealthCenter for Health ResearchCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUSA
| | - Sarah M. Ng
- Department of Kinesiology and Public HealthCenter for Health ResearchCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUSA
| | - Hunter Glanz
- Department of StatisticsCenter for Health ResearchCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUSA
| | - Michelle I. Cardel
- WW International, Inc.New YorkNew YorkUSA
- Department of Health Outcomes and Biomedical InformaticsUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Gary D. Foster
- WW International, Inc.New YorkNew YorkUSA
- Center for Weight and Eating DisordersPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| |
Collapse
|
30
|
Discriminative stimulus effects of an imidazolidine-derived appetite suppressant. Med Chem Res 2022. [DOI: 10.1007/s00044-022-02853-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
31
|
Muthiah MD, Cheng Han N, Sanyal AJ. A clinical overview of non-alcoholic fatty liver disease: A guide to diagnosis, the clinical features, and complications-What the non-specialist needs to know. Diabetes Obes Metab 2022; 24 Suppl 2:3-14. [PMID: 34387409 DOI: 10.1111/dom.14521] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/31/2021] [Accepted: 08/04/2021] [Indexed: 11/29/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) has a rapidly rising prevalence worldwide and is the most common cause of liver disease in developed countries. In this article, we discuss the spectrum of disease of NAFLD with a focus on the earlier spectrum of the disease that is commonly encountered by non-specialists, as well as the hepatic and extra-hepatic associations of the disease. We discuss in detail the two common presentations of NAFLD, incidentally detected hepatic steatosis and asymptomatic raised liver enzymes, and provide an algorithm for management and continued to follow up for these patients. Considerations for the management of cardiovascular comorbidities in these patients are also discussed. Finally, we cover the topic of screening for NAFLD in high-risk populations.
Collapse
Affiliation(s)
- Mark D Muthiah
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Gastroenterology and Hepatology, National University Hospital, National University Health System, Singapore, Singapore
| | - Ng Cheng Han
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Arun J Sanyal
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| |
Collapse
|
32
|
Kim MN, Han K, Yoo J, Ha Y, Chon YE, Lee JH, Hwang SG. Changes in general and central fatness are associated with hepatocellular carcinoma: A Korean nationwide longitudinal study. Int J Cancer 2021; 150:1587-1598. [PMID: 34957574 DOI: 10.1002/ijc.33920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 11/11/2022]
Abstract
We investigated the impact of short-term changes in general and central fatness on the risk of hepatocellular carcinoma (HCC) in a large, population-based cohort. We screened 7,221,479 subjects who underwent health examinations provided by the National Health Insurance Service of South Korea in 2009 and 2011. In total, 6,789,472 subjects were included in the final analysis. General fatness was defined as a body mass index (BMI) ≥25 kg/m2 , and central fatness was defined as a waist circumference (WC) ≥90 cm in men and ≥85 cm in women. Subjects were classified according to the change in body fatness between 2009 and 2011, as follows: 1) persistent no fatness as no fatness in both 2009 and 2011, 2) reversed fatness as fatness in 2009, but no fatness in 2011, 3) incident fatness as no fatness in 2009, but fatness in 2011, or 4) persistent fatness as fatness in both 2009 and 2011. During a median 6.4-year follow-up, we documented 9,952 HCC cases. Compared to subjects with a persistent no general fatness, the risk of HCC significantly increased in those with incident (adjusted hazard ratio [aHR]=1.10, 95% confidence interval [CI]=1.01-1.20) and persistent (aHR=1.28, 95% CI=1.23-1.34) general fatness. Compared to subjects with persistent no central fatness, those with incident and persistent central fatness showed a significantly increased risk of HCC (aHR=1.19, 95% CI=1.11-1.27, and aHR=1.33, 95% CI=1.26-1.40, respectively). Taken together, these findings indicate the importance of strategies for preventing and reversing body fatness to reduce the incidence of HCC. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Mi Na Kim
- Division of Gastroenterology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.,Clinical and Translational Hepatology Laboratory, Seongnam, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Juhwan Yoo
- Department of Biomedicine & Health Science, the Catholic University of Korea, Seoul, Korea
| | - Yeonjung Ha
- Division of Gastroenterology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Young Eun Chon
- Division of Gastroenterology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Ju Ho Lee
- Division of Gastroenterology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Seong Gyu Hwang
- Division of Gastroenterology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| |
Collapse
|
33
|
Pearl RL, Puhl RM, Himmelstein MS, Pinto AM, Foster GD. Weight Stigma and Weight-Related Health: Associations of Self-Report Measures Among Adults in Weight Management. Ann Behav Med 2021; 54:904-914. [PMID: 32333673 DOI: 10.1093/abm/kaaa026] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Weight stigma impairs health. Few studies have disentangled the associations of experienced versus internalized stigma with weight-related outcomes. PURPOSE To examine weight and health variables associated with weight stigma experiences and internalization in the largest-to-date sample of adults in weight management. METHODS WW (formerly Weight Watchers) members (N = 18,769, 94.6% female, 91.1% white) completed an online survey from 2017 to 2018. Participants reported whether they had experienced weight stigma and, if so, the onset, past-year frequency and distress, and interpersonal sources of stigma. Participants completed the Modified Weight Bias Internalization Scale (WBIS-M) and self-reported: past-year weight and lifetime weight cycles; current self-monitoring behaviors; eating self-efficacy; physical activity; perceived stress; eating to cope; body image; and mental and physical health-related quality-of-life (HRQOL). Participants reported their demographic characteristics, including height and weight to compute body mass index. RESULTS In logistic and linear regression analyses (controlling for participant characteristics), WBIS-M scores were negatively associated with weight loss, self-monitoring, eating self-efficacy, body image, and mental HRQOL and positively associated with weight gain, weight cycling, perceived stress, and eating to cope (p < .001). Experiencing weight stigma was associated with greater weight loss and less weight gain, although associations with other variables had small effect sizes (absolute β values < 0.10). WBIS-M scores remained significantly associated with all variables when including stigma onset, frequency/distress, and sources. CONCLUSIONS Internalized, but not experienced, weight stigma was consistently associated with adverse weight and health factors. Developing and testing interventions targeting internalized stigma in the context of weight management should be a research priority.
Collapse
Affiliation(s)
- Rebecca L Pearl
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca M Puhl
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA.,Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
| | - Mary S Himmelstein
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA.,Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Angela M Pinto
- Science Department, WW (formerly Weight Watchers) International, Inc., New York, NY, USA.,Department of Psychology, Baruch College, City University of New York, New York, NY, USA
| | - Gary D Foster
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Science Department, WW (formerly Weight Watchers) International, Inc., New York, NY, USA
| |
Collapse
|
34
|
Johnson NA, Sultana RN, Brown WJ, Bauman AE, Gill T. Physical activity in the management of obesity in adults: A position statement from Exercise and Sport Science Australia. J Sci Med Sport 2021; 24:1245-1254. [PMID: 34531124 DOI: 10.1016/j.jsams.2021.07.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 07/05/2021] [Accepted: 07/18/2021] [Indexed: 12/12/2022]
Abstract
This Position Statement examines the evidence for physical activity in weight and adiposity loss, prevention of weight and adiposity gain, and in weight regain in adults, and provides guidance on implications for exercise practitioners. Research evidence indicates that >150 min but preferably 300 min per week of aerobic activity of at least moderate intensity is required to prevent weight and adiposity gain, and at least the upper end of this range of activity to prevent weight regain after weight loss. For meaningful weight and total adiposity loss, a minimum of 300-420 min per week of aerobic activity of at least moderate intensity is required. The evidence around the volume of aerobic physical activity required to reduce central adiposity is emerging, and research suggests that it may be substantially less than that required for weight loss. The impact of high-intensity physical activity and resistance exercise for weight management is uncertain. During consultations for weight management, exercise practitioners should advise that metabolic and cardiovascular health benefits can be achieved with physical activity at any weight, and irrespective of weight change.
Collapse
Affiliation(s)
- Nathan A Johnson
- Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Sydney University, Australia; Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Sydney University, Australia.
| | - Rachelle N Sultana
- Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Sydney University, Australia; Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Sydney University, Australia
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, Australia
| | - Adrian E Bauman
- Prevention Research Collaboration, School of Public Health, Sydney University, Australia
| | - Tim Gill
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Sydney University, Australia
| |
Collapse
|
35
|
The Relationship between Sarcopenic Obesity, Weight-Loss and Maintenance Outcomes during Obesity Management: Are Additional Strategies Required? Clin Pract 2021; 11:525-531. [PMID: 34449572 PMCID: PMC8395568 DOI: 10.3390/clinpract11030069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/05/2021] [Accepted: 08/13/2021] [Indexed: 02/05/2023] Open
Abstract
The lack of long-term maintenance of the weight loss achieved during weight-management programs is the major cause of failure in obesity treatments. The identification of factors related to this outcome has clinical implications. Therefore, we aimed to assess the relationship between sarcopenic obesity (SO) and the weight-loss percentage (WL%). The WL% was measured at the six-month follow-up and after more than 12 months, in 46 adult participants with obesity, during an individualized weight-management program where participants were categorized as having or not having SO at the baseline. At the six-month follow-up, participants with SO did not display a significant difference in terms of WL%, when compared to those without SO (-10.49 ± 5.75% vs. -12.73 ± 4.30%; p = 0.148). However, after a longer term (i.e., >12 months), the WL% appeared to be significantly lower in the former (SO vs. non-SO) (-7.34 ± 6.29% vs. -11.43 ± 4.31%; p = 0.024). In fact, partial correlation analysis revealed a relationship between SO at the baseline and a lower WL% after more than 12 months (ρ = -0.425, p = 0.009), after controlling for age, sex, and body mass index (BMI). Participants with SO appeared to face more difficulties in maintaining the achieved WL over a longer term (>12 months follow-up) by comparison with their counterparts (i.e., non-SO). Should this finding be replicated in larger-sample studies, new strategies should be adopted for these patients in order to improve this clinical outcome, especially during the weight-maintenance phase.
Collapse
|
36
|
Engagement in Everyday Activities for Prevention of Stroke: Feasibility of an mHealth-Supported Program for People with TIA. Healthcare (Basel) 2021; 9:healthcare9080968. [PMID: 34442105 PMCID: PMC8393226 DOI: 10.3390/healthcare9080968] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/21/2021] [Accepted: 07/26/2021] [Indexed: 11/24/2022] Open
Abstract
Most of the risk factors for stroke are modifiable, yet incorporating and sustaining healthy lifestyle habits in daily life that reduce these risk factors is a major challenge. Engaging everyday activities (EEAs) are meaningful activities that are regularly performed that have the potential to contribute to the sustainability of healthy lifestyle habits and reduce risk factors for stroke. The aims of this study were (1) to investigate the feasibility and acceptability of a digitally supported lifestyle program called “Make My Day” (MMD) for people at risk for stroke following a transient ischemic attack, and (2) to describe participants’ stroke risk and lifestyle habits pre- and post-intervention. A multiple case study design using mixed methods was utilized (n = 6). Qualitative and self-reported quantitative data were gathered at baseline, post-intervention, and 12 months post-baseline. The results indicate that MMD can support lifestyle change and self-management for persons at risk for stroke following a TIA. The findings indicate a high acceptability and usability of MMD, as well as a demand for digital support provided via a mobile phone application. Self-management with digital support has the potential to increase participation in EEAs for persons at risk for stroke following a TIA.
Collapse
|
37
|
Exploratory Analysis of Racial/Ethnic and Educational Differences in a Randomized Controlled Trial of a Mindfulness-Based Weight Loss Intervention. Psychosom Med 2021; 83:503-514. [PMID: 33214537 DOI: 10.1097/psy.0000000000000859] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE People of color and lower socioeconomic groups have higher obesity prevalence, lose less weight compared with Whites and higher socioeconomic groups, and are underrepresented in randomized controlled trials of mindfulness-based interventions. We examined whether mindfulness approaches reduce disparities in weight loss interventions. METHODS We analyzed data from a randomized controlled trial of 194 participants with obesity (41% participants of color, 36% without college degree) comparing a 5.5-month mindfulness-based weight loss intervention to an active-control with identical diet-exercise guidelines. We assessed attendance, 18-month attrition, and weight change at 6, 12, and 18 months by race/ethnicity and education level using linear mixed models, adjusting for baseline body mass index, age, and education or race/ethnicity, respectively. RESULTS Participants without versus with a college degree attended fewer sessions and had higher attrition across interventions. Participants of color attended fewer intervention sessions in the mindfulness compared with the control intervention. Overall, participants of color lost significantly less weight at 12 and 18 months compared with Whites. However, during the 6- to 18-month maintenance period, we found an interaction of intervention arm, race/ethnicity, and time (p = .035), indicating that participants of color compared with Whites regained more weight in the control (0.33 kg/mo; p = .005) but not mindfulness intervention (0.06 kg/mo; p = .62). Participants without a college degree had greater initial weight loss in the mindfulness compared to control intervention from 0 to 6 months (-0.46 kg/mo; p = .039). CONCLUSIONS Although disparities persist, mindfulness approaches may mitigate some racial/ethnic and socioeconomic differences in weight loss compared with conventional diet-exercise programs.Trial Registration: Clinicaltrials.gov registration: NCT00960414.
Collapse
|
38
|
Reinka MA, Quinn DM, Puhl RM. Examining the relationship between weight controllability beliefs and eating behaviors: The role of internalized weight stigma and BMI. Appetite 2021; 164:105257. [PMID: 33864861 DOI: 10.1016/j.appet.2021.105257] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/18/2021] [Accepted: 04/06/2021] [Indexed: 01/31/2023]
Abstract
Body weight is often viewed as personally controllable. This belief, however, ignores the complex etiology of body weight. While such attributions of personal willpower may help some individuals regulate their eating patterns, they have also been associated with increased internalized weight stigma which, itself, is associated with more disinhibited eating. The current investigation aimed to examine how internalized weight stigma, along with BMI, may explain the effect of weight controllability beliefs on disparate dietary behaviors. A community sample of 2702 U.S. adults completed an online survey about their weight controllability beliefs, eating behaviors, and internalized weight stigma, as well as demographic items and self-reported BMI. Results showed that greater weight controllability beliefs were positively related to both more restricted eating, β = 0.135, p < .001, and more disinhibited eating, β = 0.123, p < .001. This ironic effect was partially explained by increased internalized weight stigma. Moreover, BMI moderated the relationship, such that individuals with lower weights demonstrated stronger effects for two of the three eating outcomes than those with higher weights. These findings advance our understanding of the relationship between attributions of personal control for body weight and subsequent health behaviors, and further underscore the need to target internalized weight stigma in dietary interventions.
Collapse
Affiliation(s)
- Mora A Reinka
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Rd., Unit 1020, Storrs, CT, 06269-1020, USA; Department of Psychology, Ursinus College, 601 E. Main St., P.O. Box 1000, Collegeville, PA, 19426-1000, USA.
| | - Diane M Quinn
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Rd., Unit 1020, Storrs, CT, 06269-1020, USA
| | - Rebecca M Puhl
- University of Connecticut Rudd Center for Food Policy & Obesity; Department of Human Development and Family Sciences, University of Connecticut, One Constitution Plaza, Suite 600, Hartford, CT, 06103, USA
| |
Collapse
|
39
|
Do Gut Hormones Contribute to Weight Loss and Glycaemic Outcomes after Bariatric Surgery? Nutrients 2021; 13:nu13030762. [PMID: 33652862 PMCID: PMC7996890 DOI: 10.3390/nu13030762] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/18/2021] [Accepted: 02/20/2021] [Indexed: 02/07/2023] Open
Abstract
Bariatric surgery is an effective intervention for management of obesity through treating dysregulated appetite and achieving long-term weight loss maintenance. Moreover, significant changes in glucose homeostasis are observed after bariatric surgery including, in some cases, type 2 diabetes remission from the early postoperative period and postprandial hypoglycaemia. Levels of a number of gut hormones are dramatically increased from the early period after Roux-en-Y gastric bypass and sleeve gastrectomy—the two most commonly performed bariatric procedures—and they have been suggested as important mediators of the observed changes in eating behaviour and glucose homeostasis postoperatively. In this review, we summarise the current evidence from human studies on the alterations of gut hormones after bariatric surgery and their impact on clinical outcomes postoperatively. Studies which assess the role of gut hormones after bariatric surgery on food intake, hunger, satiety and glucose homeostasis through octreotide use (a non-specific inhibitor of gut hormone secretion) as well as with exendin 9–39 (a specific glucagon-like peptide-1 receptor antagonist) are reviewed. The potential use of gut hormones as biomarkers of successful outcomes of bariatric surgery is also evaluated.
Collapse
|
40
|
Mundi MS, Hurt RT, Phelan SM, Bradley D, Haller IV, Bauer KW, Bradley SM, Schroeder DR, Clark MM, Croghan IT. Associations Between Experience of Early Childhood Trauma and Impact on Obesity Status, Health, as Well as Perceptions of Obesity-Related Health Care. Mayo Clin Proc 2021; 96:408-419. [PMID: 33549259 DOI: 10.1016/j.mayocp.2020.05.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 05/10/2020] [Accepted: 05/27/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the association between obesity and history of childhood trauma in an effort to define implications for the provider-patient relationship and possible causes of failure of obesity treatment. METHODS Multisite survey developed by the Patient-Centered Outcomes Research Institute Learning Health Systems Obesity Cohort Workgroup consisting of 49 questions with 2 questions focusing on history of being a victim of childhood physical and/or sexual abuse was mailed to 19,964 overweight or obese patients. Data collection for this survey occurred from October 27, 2017, through March 1, 2018. RESULTS Among the 2211 surveys included in analysis, respondents reporting being a victim of childhood abuse increased significantly with obesity (23.6%, 26.0%, 29.1%, and 36.8% for overweight, class I, class II, and class III obesity, respectively; P<.001). A higher percentage of those who reported being a victim of childhood abuse noted that their weight issues began at an earlier age (P=.002) and were more likely to have weight-related comorbidities (P<.001), even after controlling for body mass index. Impacting physician counseling on weight loss, patients who were childhood victims of abuse reported lower self-esteem (P<.001), were more likely to feel judged by their health care providers (P=.009), and less likely to feel being treated with respect (P=.045). CONCLUSION Overall, being a victim of childhood abuse was significantly associated with obesity, lower self-esteem and negative experiences interacting with health care providers. Health care providers should receive training to ensure open and nonjudgmental visits with obese patients and consider the role of trauma survivorship issues in patients' development of obesity and health care experiences.
Collapse
Affiliation(s)
- Manpreet S Mundi
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN.
| | - Ryan T Hurt
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN; Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
| | - Sean M Phelan
- Robert D. and Patricia E. Kern Center of Science and Health Care Delivery, Mayo Clinic, Rochester, MN
| | - David Bradley
- Diabetes and Metabolism Research Center, Division of Endocrinology, Diabetes & Metabolism, Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - Irina V Haller
- Department of Psychiatry and Psychology, Essentia Institute of Rural Health, Essential Health, Duluth, MN
| | - Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Steven M Bradley
- Center for Healthcare Delivery Innovation, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation Minneapolis, MN
| | - Darrell R Schroeder
- Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, Rochester, MN
| | - Matthew M Clark
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Ivana T Croghan
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN; Robert D. and Patricia E. Kern Center of Science and Health Care Delivery, Mayo Clinic, Rochester, MN; Division of Community Internal Medicine, Mayo Clinic, Rochester, MN; Division of Epidemiology, Department of Health Science Research, Mayo Clinic, Rochester, MN
| |
Collapse
|
41
|
Baheeg M, Tag El-Din M, Labib MF, Elgohary SA, Hasan A. Long-term durability of weight loss after bariatric surgery; a retrospective study. INTERNATIONAL JOURNAL OF SURGERY OPEN 2021. [DOI: 10.1016/j.ijso.2020.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
42
|
Washburn RA, Szabo-Reed AN, Gorczyca AM, Sullivan DK, Honas JJ, Mayo MS, Krebill R, Goetz J, Ptomey LT, Lee J, Donnelly JE. A Randomized Trial Evaluating Exercise for the Prevention of Weight Regain. Obesity (Silver Spring) 2021; 29:62-70. [PMID: 34494375 PMCID: PMC9260853 DOI: 10.1002/oby.23022] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of three levels of exercise on weight regain subsequent to clinically meaningful weight loss (WL). METHODS Adults with overweight or obesity (n = 298) initiated a 3-month behavioral WL intervention, which included reduced energy intake, increased exercise, and weekly behavioral counseling. Participants achieving ≥5% WL (n = 235) began a 12-month behavioral WL maintenance intervention and were randomized to 150 min/wk (n = 76), 225 min/wk (n = 80), or 300 min/wk (n = 79) of partially supervised moderate-to-vigorous-intensity exercise. RESULTS Participants randomized to 150, 225, and 300 minutes of exercise completed 129 ± 30, 153 ± 49 and 179 ± 62 min/wk of exercise (supervised + unsupervised), respectively. Mean WL at 3 months (9.5 ± 3.1 kg) was similar across randomized groups (P = 0.68). Weight change across 12 months was 1.1 ± 6.5 kg, 3.2 ± 5.7 kg, and 2.8 ± 6.9 kg in the 150, 225, and 300 min/wk groups, respectively. Intent-to-treat analysis revealed no significant overall trend across the three treatment groups (P = 0.09), effects for group (P = 0.08), or sex (P = 0.21). CONCLUSIONS This study found no evidence for an association between the volume of moderate-to-vigorous-intensity exercise and weight regain across 12 months following clinically relevant WL. Further, results suggest that exercise volumes lower than those currently recommended for WL maintenance, when completed in conjunction with a behavioral weight-maintenance intervention, may minimize weight regain over 12 months.
Collapse
Affiliation(s)
- Richard A. Washburn
- Department of Internal Medicine, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Amanda N. Szabo-Reed
- Department of Internal Medicine, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Anna M. Gorczyca
- Department of Internal Medicine, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Debra K. Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Jeffery J. Honas
- Department of Internal Medicine, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Matthew S. Mayo
- Department of Biostatistics & Data Science, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Ronald Krebill
- Department of Biostatistics & Data Science, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Jeannine Goetz
- Department of Dietetics and Nutrition, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Lauren T. Ptomey
- Department of Internal Medicine, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Jaehoon Lee
- Department of Educational Psychology and Leadership, Texas Tech University, Lubbock, Texas, USA
| | - Joseph E. Donnelly
- Department of Internal Medicine, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| |
Collapse
|
43
|
Early changes in appetite and energy expenditure are not associated to body weight and fat losses in pre-menopausal women living with overweight/obesity. Physiol Behav 2021; 228:113201. [PMID: 33039382 DOI: 10.1016/j.physbeh.2020.113201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/02/2020] [Accepted: 10/07/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND The aim of the study was to investigate whether early changes (1-week) in energy balance-related measures would predict changes in body weight (BW) and fat losses in women living with overweight/obesity. METHODS BW, body composition (DXA), resting energy expenditure (REE)(indirect calorimetry), olfactory performance (Sniffin' Sticks), appetite and palatability (visual analogue scale) were measured at baseline, after a 1-week of caloric restriction as well as post-intervention (at 10 and 20 weeks) in a group of 30 women living with overweight/obesity. RESULTS A significant decrease in REE (p = 0.033) was noted after 1 week. Fasting desire to eat (p = 0.004), hunger (p = 0.001) and prospective food consumption (p = 0.001) all increased after 1 week. Similarly, significant increases in AUC SQ for desire to eat (p = 0.01), hunger (p = 0.005) and prospective food consumption (p = 0.001) were noted after 1 week. However, these early changes were not associated to final BW or FM losses at the end of the weight loss intervention. CONCLUSION Despite significant changes in REE and appetite soon after the onset of a BW loss intervention, these early changes do not seem to predict final BW or FM losses at the end of the program in women living with overweight/obesity.
Collapse
|
44
|
Aviram-Friedman R, Kafri L, Baz G, Alyagon U, Zangen A. Prisoners of Addictive Cues: Biobehavioral Markers of Overweight and Obese Adults with Food Addiction. Nutrients 2020; 12:nu12113563. [PMID: 33233720 PMCID: PMC7699916 DOI: 10.3390/nu12113563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity is associated with food and eating addiction (FA), but the biobehavioral markers of this condition are poorly understood. To characterize FA, we recruited 18 healthy controls and overweight/obese adults with (n = 31) and without (n = 17) FA (H-C, FAOB, NFAOB, respectively) to assess alpha brain asymmetry at rest using electroencephalogram; event-related potentials following exposure to high-calorie food (HCF), low-calorie food (LCF), and nonfood (NF) images in a Stroop paradigm; reaction time reflective of the Stroop bias; and symptoms of depression and disordered eating behavior. The FAOB group had the greatest emotional and uncontrollable eating, depressive, and binge-eating symptoms. The FAOB group displayed lower resting left alpha brain asymmetry than that of the NFAOB group. Differently from the other groups, the FAOB group presented attenuated Stroop bias following exposure to HCF relative to NF images, as well as a lower late positive potential component (LPPb; 450-495 ms) in both frontal and occipital regions. In the total cohort, a correlation was found between the Stroop bias and the LPPb amplitude. These results point to biobehavioral hypervigilance in response to addictive food triggers in overweight/obese adults with FA. This resembles other addictive disorders but is absent in overweight/obesity without FA.
Collapse
Affiliation(s)
- Roni Aviram-Friedman
- Correspondence: (R.A.-F.); (A.Z.); Tel.: +972-52-6066876 or +972-8-6472646 (R.A.-F. & A.Z.)
| | | | | | | | - Abraham Zangen
- Correspondence: (R.A.-F.); (A.Z.); Tel.: +972-52-6066876 or +972-8-6472646 (R.A.-F. & A.Z.)
| |
Collapse
|
45
|
Dougherty JA, Guirguis E, Thornby KA. A Systematic Review of Newer Antidiabetic Agents in the Treatment of Nonalcoholic Fatty Liver Disease. Ann Pharmacother 2020; 55:65-79. [PMID: 32571083 DOI: 10.1177/1060028020935105] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To evaluate glucagon-like peptide 1 receptor agonists (GLP-1 RAs), dipeptidyl-peptidase IV (DPP-4) inhibitors, and sodium-glucose cotransporter 2 (SGLT) inhibitors to treat nondiabetic and type 2 diabetes mellitus (T2DM) nonalcoholic fatty liver disease (NAFLD) as it relates to improvement in hepatosteatosis (HS) or steatohepatitis (SH). DATA SOURCES MEDLINE and CINAHL were searched from inception through May 1, 2020. Search terms included nonalcoholic steatohepatitis, nonalcoholic fatty liver disease, fatty liver, dipeptidyl-peptidase IV inhibitors, glucagon-like peptide-1 receptor agonists, and sodium-glucose transporter 2 inhibitors. STUDY SELECTION AND DATA EXTRACTION Full-text observational and randomized controlled studies in English were included. Patients diagnosed with NAFLD, treated with GLP-1 RAs, DPP-4 inhibitors, and SGLT2 inhibitors, with measures to evaluate HS or SH were evaluated. DATA SYNTHESIS Eight GLP-1 RA trials were reviewed; 7 GLP-1 RA trials showed improvement in HS. Two studies demonstrated improvement in liver histology in patients with SH. Seven SGLT2 inhibitor studies were reviewed; 6 studies demonstrated improvements in NAFLD. Five studies showed improvements in HS, whereas 1 displayed improvement in liver histology in NASH. Six studies that included DPP-4 inhibitors were evaluated, and only 2 demonstrated improvement in NASH. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE Based on evidence reviewed, GLP-1 RAs and SGLT2 inhibitors decreased HS and SH in NAFLD patients, whereas DPP-4 inhibitor therapy was not effective for patients with HS. CONCLUSIONS Based on study data utilizing imaging studies and biopsy results, GLP-1 RAs or SGLT2 inhibitors can benefit NAFLD T2DM patients. Clinical trials with larger patient populations may augment these results.
Collapse
Affiliation(s)
- John A Dougherty
- Palm Beach Atlantic University: Lloyd L. Gregory School of Pharmacy, West Palm Beach, FL, USA
| | - Erenie Guirguis
- Palm Beach Atlantic University: Lloyd L. Gregory School of Pharmacy, West Palm Beach, FL, USA
| | - Krisy-Ann Thornby
- Palm Beach Atlantic University: Lloyd L. Gregory School of Pharmacy, West Palm Beach, FL, USA
| |
Collapse
|
46
|
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] [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.
Collapse
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
| |
Collapse
|
47
|
Annesi JJ. Contrasting Personal Characteristics and Psychosocial Correlates of Exercise and Eating Behavior Changes in Women Successful vs. Unsuccessful with Weight Loss and Maintenance. Appl Psychol Health Well Being 2020; 12:703-723. [PMID: 32421909 DOI: 10.1111/aphw.12203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/03/2020] [Accepted: 04/17/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is great variability in individuals' responses to behavioral weight-loss treatments. Beyond attaining meaningful weight loss in the initial several weeks, little is known of the characteristics of participants successful vs. unsuccessful with short- and long-term weight loss. METHODS Separate samples of women with obesity enrolled in cognitive-behavioral weight-loss treatments were assessed over 6 months (Study 1: successful weight-loss group, n = 83; unsuccessful group, n = 158), and over 24 months (Study 2: sustained initially lost weight, n = 25; regained weight, n = 19), on personal characteristics and theory-driven psychosocial variables. RESULTS In Study 1, significantly older age and greater eating self-regulation at baseline were found in the successful group. Significantly greater improvements in exercise- and eating-related self-regulation, mood, exercise- and eating-related self-efficacy, physical self-concept, and body satisfaction were found in the successful group. In Study 2, the sustainer group had significantly more favorable changes over 2 years in exercise- and eating-related self-regulation, and mood. During Months 6-24, the psychosocial correlates of both exercise and eating behaviors regressed, with more pronounced reversions in the regainer group. CONCLUSION Increasing the magnitude of treatment-associated improvement in each of the tested theory-based psychosocial factors is warranted to increase probabilities for success with attaining and maintaining meaningful weight loss.
Collapse
Affiliation(s)
- James J Annesi
- YMCA of Metro Atlanta, Atlanta, GA, USA.,University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
48
|
Psychological Factors of Long-Term Dietary and Physical Activity Adherence among Chinese Adults with Overweight and Obesity in a Community-Based Lifestyle Modification Program: A Mixed-Method Study. Nutrients 2020; 12:nu12051379. [PMID: 32408509 PMCID: PMC7284498 DOI: 10.3390/nu12051379] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/04/2020] [Accepted: 05/08/2020] [Indexed: 12/19/2022] Open
Abstract
There is a paucity of research on factors influencing long-term adherence to lifestyle modification. We conducted a mixed-method study to explore the psychological factors of dietary and physical activity (PA) adherence among Chinese adults with overweight and obesity at 10 months after enrollment of a community-based lifestyle modification program in Hong Kong. We recruited Chinese adults newly enrolled in a culturally adapted lifestyle modification program and followed them for 10 months. For the quantitative study, primary outcomes were dietary and PA adherence scores while secondary outcomes included knowledge, self-efficacy, motivation and stage of change. For the qualitative study, data were collected using semi-structured interviews and observation. A total of 140 participants completed the 10-month follow-up. They reported moderate level of dietary adherence but low level of PA adherence at 10 months. Multivariable regression analyses revealed that greater improvement in nutrition knowledge and diet stage of change predicted higher dietary adherence while greater improvement in PA self-efficacy and PA stage of change predicted higher PA adherence. Qualitative data on 26 participants suggest that participants' knowledge and self-efficacy but not motivation were enhanced during the program. The findings of this study enhanced our understanding on factors influencing long-term adherence to lifestyle changes.
Collapse
|
49
|
Kakinami L, Knäuper B, Brunet J. Weight cycling is associated with adverse cardiometabolic markers in a cross-sectional representative US sample. J Epidemiol Community Health 2020; 74:662-667. [PMID: 32366587 PMCID: PMC7320743 DOI: 10.1136/jech-2019-213419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/27/2020] [Accepted: 04/14/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Whether weight cycling (repeated weight loss and regain) is associated with cardiometabolic health is unclear. Study objective was to examine whether weight cycling since young adulthood (ie, 25 years of age) was associated with cardiometabolic markers. METHODS Data from a nationally representative cross-sectional US sample (National Health and Nutrition Examination Survey, 1999-2014) were used. Weight history was based on self-reported weight at age 25, 10 years prior and 1 year prior to the survey (n=4190, 51% male). Using current self-reported weight as the anchor, participants were classified as (1) stable weight , (2) weight losers, (3) weight gainers and (4) weight cyclers. Cardiometabolic markers included fasting lipids, insulin sensitivity and blood pressure. Multiple linear regressions were used to analyse weight history (reference: stable weight) and adjusted for covariates. Analyses incorporated the sampling design and survey weights and were stratified by sex or weight status. RESULTS Compared with females with stable weight, female weight cyclers had worse lipids and homeostasis model assessment for insulin resistance (HOMA-IR) (all ps<0.05). Compared with males with stable weight, male weight cyclers had worse high-density lipoprotein cholesterol (HDL) and HOMA-IR (ps<0.05). Weight cyclers with normal weight had worse HDL and low-density lipoprotein cholesterol (ps<0.05), and weight cyclers with overweight or obesity had worse HOMA-IR (p=0.05). Blood pressure was not associated. CONCLUSION Weight cycling is adversely associated with cardiometabolic markers but associations differ by sex and weight status. While weight cycling is consistently associated with worse cardiometabolic markers among females, results are mixed among males. Weight cycling is associated with worse lipid measures for normal weight persons, and marginally worse insulin sensitivity for those with overweight/obesity.
Collapse
Affiliation(s)
- Lisa Kakinami
- Mathematics and Statistics, Concordia University, Montreal, Quebec, Canada
- PERFORM Centre, Montreal, Canada
| | | | | |
Collapse
|
50
|
Paixão C, Dias CM, Jorge R, Carraça EV, Yannakoulia M, de Zwaan M, Soini S, Hill JO, Teixeira PJ, Santos I. Successful weight loss maintenance: A systematic review of weight control registries. Obes Rev 2020; 21:e13003. [PMID: 32048787 PMCID: PMC9105823 DOI: 10.1111/obr.13003] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 12/25/2022]
Abstract
Weight loss maintenance is a major challenge for obesity treatment. Weight control registries can be useful in identifying psychological and behavioural factors that could contribute to better long-term success. The objective of this study is to describe the existing weight control registries and their participants and identify correlates of weight loss maintenance. A comprehensive search of peer-reviewed articles published until November 2018 was conducted in PubMed, Web of Science, and Scopus. Studies that reported results from weight control registries were considered. Fifty-two articles, corresponding to five registries (the United States, Portugal, Germany, Finland, and Greece), were included. Registries differed in inclusion criteria and procedures. Of 51 identified weight loss and maintenance strategies, grouped in 14 domains of the Oxford Food and Activity Behaviors taxonomy, the following were the most frequently reported: having healthy foods available at home, regular breakfast intake, increasing vegetable consumption, decreasing sugary and fatty foods, limiting certain foods, and reducing fat in meals. Increased physical activity was the most consistent positive correlate of weight loss maintenance. To our knowledge, this is the first systematic review of information about successful weight loss maintenance obtained from weight control registries. Key common influential characteristics of success were identified, which can inform future prospective studies and weight management initiatives.
Collapse
Affiliation(s)
- Catarina Paixão
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - Carlos M Dias
- Centro de Investigação em Saúde Pública (CISP), NOVA-Escola Nacional de Saúde Pública, Lisbon, Portugal.,Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Rui Jorge
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal.,Unidade de Investigação do Instituto Politécnico de Santarém, Escola Superior Agrária, Instituto Politécnico de Santarém, Santarém, Portugal
| | - Eliana V Carraça
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Sirpa Soini
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - James O Hill
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Pedro J Teixeira
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - Inês Santos
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal.,Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| |
Collapse
|