Impact of a short-term low calorie diet alone or with interval exercise on quality of life and oxidized phospholipids in obese females

Higher calorie intake with adequate exercise is associated with reduced mortality compared with low-calorie diet with equivalent exercise: An observational study from NHANES based on the 2020-2025 Dietary Guidelines for Americans

OBJECT

To explore the effects of different combinations of calorie intake and exercise on all-cause, cardiovascular and cancer mortality.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) were analyzed. Weighted multivariate cox regression analyses were performed to assess the association between different combinations of calorie intake and exercise and mortality. Interaction effects were evaluated using the relative excess risk of interaction (RERI), attributable proportion of interaction (API), and synergy index (SI). Subgroup and sensitivity analyses were also conducted.

RESULTS

A total of 21,618 participants (51 % female) were included, with 1957 all-cause deaths, 568 cardiovascular deaths, and 508 cancer deaths over a median follow-up of 6.75 years. Both higher- and low-calorie diet were associated with reduced all-cause mortality as long as the participants engaged in adequate exercise, with greater benefits in the former group (Higher-calorie diet: Hazard ratio (HR) [95%CI] 0.59 [0.48, 0.71]; low-calorie diet: 0.69 [0.56, 0.84]; both P < 0.001). Only higher-calorie diet with adequate exercise was associated with reduced cardiovascular mortality (HR 0.64 [0.43, 0.94], P = 0.022, P for trend = 0.085). No significant association about cancer mortality was observed (P > 0.05). There was no additive interaction between low-calorie diet and adequate exercise in reducing mortality (all P > 0.05). Subgroup and sensitivity analyses remained stable.

CONCLUSION

Adequate exercise with either higher- or low-calorie diet was associated with reduced all-cause mortality, with greater benefits in the former group. Moreover, only the former was associated with a reduction in cardiovascular mortality.

Aerobic Exercise Program Management Enhances Mental and Physical Health in Overweight/Obese Adolescents With Depression: Insights From a Retrospective Study

BACKGROUND

Overweight/obese adolescents show higher rates of depression. This study aims to explore the effect of aerobic exercise program management on overweight/obese adolescents with depression.

METHODS

This retrospective study analyzed clinical data of overweight/obese adolescents with depression at Wuhan Mental Health Center, from June 2019 to June 2022. Propensity score matching (PSM), t-tests, and chi-square tests were applied. Observation indexes including Hamilton Anxiety Scale (HAMA), Hamilton Depression Rating Scale 17 (HAMD-17), Simplified Coping Style Questionnaire (SCSQ), body mass index (BMI), waist-hip ratio (WHR), nursing effectiveness, and Generic Quality of Life Inventory-74.

RESULTS

A total of 229 depressed overweight/obese adolescents were divided into two groups: the control group (n = 108) receiving routine care only, and the observation group (n = 121) receiving routine care along with aerobic exercise. After 1:1 PSM (caliper 0.02), groups (each group comprised 104 patients) showed no baseline differences. No significant differences were found in HAMA, HAMD-17, SCSQ, quality of life scores, BMI, and WHR pre-exercise (p > 0.05). Post-nursing care, the observation group exhibited significantly lower HAMA (t = 3.589, p = 0.001), HAMD-17 (t = 3.554, p = 0.001), SCSQ negative scores (t = 3.584, p = 0.001), BMI (t = 3.051, p = 0.003), and waist-to-hip ratio (t = 3.379, p = 0.001), with higher SCSQ positive (t = 3.443, p = 0.001) and quality of life in material life (t = 3.385, p = 0.001), physical function (t = 3.834, p < 0.001), social function (t = 3.485, p = 0.001), psychological function (t = 3.178, p = 0.002) compared to the control group.

CONCLUSION

The aerobic exercise program care for overweight/obese adolescents with depression, which is advocated and has a high nursing effect, can effectively improve the anxiety and depression of patients.

Oxidised phosphatidylcholine induces sarcolemmal ceramide accumulation and insulin resistance in skeletal muscle

AIMS/HYPOTHESIS

Intracellular ceramide accumulation in specific cellular compartments is a potential mechanism explaining muscle insulin resistance in the pathogenesis of type 2 diabetes. Muscle sarcolemmal ceramide accumulation negatively impacts insulin sensitivity in humans, but the mechanism explaining this localised accumulation is unknown. Previous reports revealed that circulating oxidised LDL is elevated in serum of individuals with obesity and type 2 diabetes. Oxidised phosphatidylcholine, which is present in oxidised LDL, has previously been linked to ceramide pathway activation, and could contribute to localised ceramide accumulation in skeletal muscle. We hypothesised that oxidised phosphatidylcholine inversely correlates with insulin sensitivity in serum, and induces sarcolemmal ceramide accumulation and decreases insulin sensitivity in muscle.

METHODS

We used LC-MS/MS to quantify specific oxidised phosphatidylcholine species in serum from a cross-sectional study of 58 well-characterised individuals spanning the physiological range of insulin sensitivity. We also performed in vitro experiments in rat L6 myotubes interrogating the role of specific oxidised phosphatidylcholine species in promoting sarcolemmal ceramide accumulation, inflammation and insulin resistance in skeletal muscle cells.

RESULTS

Human serum oxidised phosphatidylcholine levels are elevated in individuals with obesity and type 2 diabetes, inversely correlated with insulin sensitivity, and positively correlated with sarcolemmal C18:0 ceramide levels in skeletal muscle. Specific oxidised phosphatidylcholine species, particularly 1-palmitoyl-2-(5-oxovaleroyl)-sn-glycero-3-phosphocholine (POVPC), increase total ceramide and dihydroceramide and decrease total sphingomyelin in the sarcolemma of L6 myotubes by de novo ceramide synthesis and sphingomyelinase activation. POVPC also increases inflammatory signalling and causes insulin resistance in L6 myotubes.

CONCLUSIONS/INTERPRETATION

These data suggest that circulating oxidised phosphatidylcholine species promote ceramide accumulation and decrease insulin sensitivity in muscle, help explain localised sphingolipid accumulation and muscle inflammatory response, and highlight oxidised phosphatidylcholine species as potential targets to combat insulin resistance.

Effect of physical activity on anxiety, depression and obesity index in children and adolescents with obesity: A meta-analysis

FOR FULL-LENGTH ARTICLES

This study systematically identified the effects of physical activity (PA) on depression, anxiety and weight-related outcomes among children and adolescents with overweight/obesity. EMBASE, The Cochrane Library, Web of Science, and PubMed were searched from January 1, 2000 to August 1, 2022 for peer-reviewed papers. Meta-analyses were conducted to ascertain the effect of physical activity on symptoms of anxiety, depression and weight-related outcomes in overweight/obese children and adolescents. Twenty-five studies representing 2188 participants, with median age 12.08 years old (8.3 to 18.44 years) were included. Depressive and anxiety symptoms, BMI, BMI z-scores, weight, waist circumference and height were evaluated. After incorporating the effects of PA interventions on children and adolescents with overweight/obesity, PA could improve depressive and anxiety symptoms, but not obesity indexes except waist circumference. While, PA combined with other interventions have a significant effect both on anxiety symptoms and BMI compared to pure PA intervention. In terms of intervention duration, we observed that durations falling within the range of 8 to 24 weeks exhibited the most positive effects on reducing depressive symptoms.

FOR SHORT COMMUNICATIONS

We included 25 articles on the effects of physical activity on psychological states such as depression and anxiety, weight, BMI and other weight-related indicators in children and adolescents with overweight/obesity. We attempted to determine the most appropriate type of physical activity intervention for children and adolescents with overweight/obesity, as well as the most appropriate population characteristics and duration by combining the outcome data from each article. This has a great enlightening effect for health workers to carry out corresponding strategies in the future.

Dietary patterns and cardiometabolic health: Clinical evidence and mechanism

For centuries, the search for nutritional interventions to underpin cardiovascular treatment and prevention guidelines has contributed to the rapid development of the field of dietary patterns and cardiometabolic disease (CMD). Numerous studies have demonstrated that healthy dietary patterns with emphasis on food-based recommendations are the gold standard for extending lifespan and reducing the risks of CMD and mortality. Healthy dietary patterns include various permutations of energy restriction, macronutrients, and food intake patterns such as calorie restriction, intermittent fasting, Mediterranean diet, plant-based diets, etc. Early implementation of healthy dietary patterns in patients with CMD is encouraged, but an understanding of the mechanisms by which these patterns trigger cardiometabolic benefits remains incomplete. Hence, this review examined several dietary patterns that may improve cardiometabolic health, including restrictive dietary patterns, regional dietary patterns, and diets based on controlled macronutrients and food groups, summarizing cutting-edge evidence and potential mechanisms for CMD prevention and treatment. Particularly, considering individual differences in responses to dietary composition and nutritional changes in organ tissue diversity, we highlighted the critical role of individual gut microbiota in the crosstalk between diet and CMD and recommend a more precise and dynamic nutritional strategy for CMD by developing dietary patterns based on individual gut microbiota profiles.