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Mingrone G, Rajagopalan H. Bariatrics and endoscopic therapies for the treatment of metabolic disease: Past, present, and future. Diabetes Res Clin Pract 2024; 211:111651. [PMID: 38580037 DOI: 10.1016/j.diabres.2024.111651] [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: 08/21/2023] [Accepted: 04/01/2024] [Indexed: 04/07/2024]
Abstract
The burden of chronic metabolic diseases such as obesity, type 2 diabetes mellitus (T2DM), and metabolic dysfunction-associated steatotic liver disease (MASLD) and the urgency of the epidemiological situation necessitate the development of therapies that enhance metabolic health and alter the trajectory of metabolic disease in society. Certain bariatric-metabolic surgeries have proven to be effective approaches for treating metabolic dysfunction, showing remission or significant improvements in obesity, T2DM, and MASLD-related outcomes, suggesting that these interventions might be able to "reset" a pathologically calibrated metabolic setpoint. However, considering the challenges and invasiveness of surgery, endoscopic bariatric metabolic therapies (EBMTs) have emerged with a primary focus to reconstruct or mimic anatomical and/or functional changes observed with bariatric surgery in a more broadly accessible manner. These innovative approaches offer a potentially promising solution to address significant unmet medical need in the large segment of society, which remains at risk for the consequences of metabolic diseases. In this review, we discuss therapeutic options within the EBMT space in the context of the metabolic setpoint intellectual model and provide a brief overview of current knowledge surrounding their mechanisms of action and impact on metabolic health. Finally, we explore future perspectives and directions in this exciting field.
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Affiliation(s)
- Geltrude Mingrone
- Division of Obesity and Metabolic Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy; Division of Diabetes & Nutritional Sciences, School of Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, United Kingdom.
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Lowe MR, Singh S, Rosenbaum M, Mayer L. Physiological, body composition, and body mass measures show that a developmental measure of weight suppression is more valid than the traditional measure. Int J Eat Disord 2024. [PMID: 38597163 DOI: 10.1002/eat.24210] [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: 09/05/2023] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE The traditional measure of weight suppression (TWS; the difference between an individual's highest past weight at adult height and current weight), has been associated with many psychological, behavioral and biological variables in those with eating disorders. A new measure of weight suppression, called developmental weight suppression (DWS), corrects two major problems in the original measure. Initial research indicates that DWS represents a superior operationalization of the construct weight suppression was originally designed to measure (Lowe [1993, Psychol Bull, 114: 100]). This study is the first to examine the relation between both WS measures and weight history, body composition and a variety of metabolic hormones. METHODS Data were collected in 91 women with bulimia nervosa (BN) or BN-spectrum disorders. RESULTS Both weight suppression indices were related to multiple hormones. However, multiple regression analyses showed that the independent effects of DWS differed from the independent effects of TWS in that only DWS was negatively related to: (1) current z-BMI, (2) body fat percentage, and (3) insulin, leptin, T3 free, and TSH. This differential pattern also occurred when results were corrected for multiple comparisons. DISCUSSION Findings provide stronger biological support for the construct validity of DWS than TWS and suggest that: (1) from the perspective of individuals with BN, high DWS embodies success at food restriction and weight loss, (2) elevated DWS may trap individuals with BN in a powerful biobehavioral bind, and (3) DWS is the preferred measure of weight suppression in future research on eating disorders. PUBLIC SIGNIFICANCE Most individuals with bulimia nervosa lose substantial weight in the process of developing their disorder. Such weight suppression is related to many characteristics of those with the eating disorder bulimia nervosa. This study shows why a new measure of weight suppression, based on an individual's growth during development, is more biologically valid than the traditional measure of weight suppression.
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Affiliation(s)
- Michael R Lowe
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Simar Singh
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Michael Rosenbaum
- Department of Pediatrics and Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Laurel Mayer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
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Alemany M. The Metabolic Syndrome, a Human Disease. Int J Mol Sci 2024; 25:2251. [PMID: 38396928 PMCID: PMC10888680 DOI: 10.3390/ijms25042251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
This review focuses on the question of metabolic syndrome (MS) being a complex, but essentially monophyletic, galaxy of associated diseases/disorders, or just a syndrome of related but rather independent pathologies. The human nature of MS (its exceptionality in Nature and its close interdependence with human action and evolution) is presented and discussed. The text also describes the close interdependence of its components, with special emphasis on the description of their interrelations (including their syndromic development and recruitment), as well as their consequences upon energy handling and partition. The main theories on MS's origin and development are presented in relation to hepatic steatosis, type 2 diabetes, and obesity, but encompass most of the MS components described so far. The differential effects of sex and its biological consequences are considered under the light of human social needs and evolution, which are also directly related to MS epidemiology, severity, and relations with senescence. The triggering and maintenance factors of MS are discussed, with especial emphasis on inflammation, a complex process affecting different levels of organization and which is a critical element for MS development. Inflammation is also related to the operation of connective tissue (including the adipose organ) and the widely studied and acknowledged influence of diet. The role of diet composition, including the transcendence of the anaplerotic maintenance of the Krebs cycle from dietary amino acid supply (and its timing), is developed in the context of testosterone and β-estradiol control of the insulin-glycaemia hepatic core system of carbohydrate-triacylglycerol energy handling. The high probability of MS acting as a unique complex biological control system (essentially monophyletic) is presented, together with additional perspectives/considerations on the treatment of this 'very' human disease.
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Affiliation(s)
- Marià Alemany
- Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Catalonia, Spain
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Marques CC, Sayal A, Crisóstomo J, Duarte JV, Castilho P, Goss K, Pereira AT, Castelo-Branco M. A neural network underlying cognitive strategies related to eating, weight and body image concerns. Front Hum Neurosci 2024; 17:1274817. [PMID: 38318273 PMCID: PMC10839062 DOI: 10.3389/fnhum.2023.1274817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/29/2023] [Indexed: 02/07/2024] Open
Abstract
Concerns about food intake, weight and body shape can trigger negatively loaded emotions, which may prompt the use of cognitive strategies to regulate these emotional states. A novel fMRI task was developed to assess the neurobehavioral correlates of cognitive strategies related to eating, weight and body image concerns, such as self-criticism, avoidance, rumination, and self-reassurance. Fourteen healthy females were presented audio sentences referring to these conditions and instructed to repeat these internally while engaging their thoughts with the content of food or body images. Participants were asked to report the elicited emotion and rate their performance. All cognitive strategies recruited a network including the inferior and superior frontal gyri, orbitofrontal and anterior cingulate cortex, insula, and dorsal striatum. These brain regions are involved in emotional, reward and inhibitory control processing. Representational similarity analysis revealed distinct patterns of neural responses for each cognitive strategy. Additionally, self-report measures showed that self-criticism was positively associated with superior frontal gyrus (SFG) activation. Self-compassion scores were negatively correlated with activations in the insula and right putamen, while self-reassurance scores were negatively associated with activity in the orbitofrontal cortex. These findings identify a neural network underlying cognitive strategies related to eating, weight and body image concerns, where neurobehavioral correlation patterns depend on the cognitive strategy.
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Affiliation(s)
- Cristiana C. Marques
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Alexandre Sayal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Siemens Healthineers, Lisbon, Portugal
| | - Joana Crisóstomo
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João V. Duarte
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Paula Castilho
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Kenneth Goss
- Coventry & Warwickshire Partnership Trust, Coventry Eating Disorder Service, Coventry, United Kingdom
| | - Ana T. Pereira
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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de Oliveira J, Stelmo IDC, Figueredo LS, de Freitas CC. Very low-calorie ketogenic diet in the treatment of adaptive thermogenesis: A case report. Nutrition 2024; 117:112252. [PMID: 37897984 DOI: 10.1016/j.nut.2023.112252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/13/2023] [Accepted: 09/27/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVES The management of the phenomenon of adaptive thermogenesis poses a challenge to the successful treatment of overweight/obesity with a nutritional intervention that minimizes the loss of muscle mass, with little cognitive restraint use and disorganization of eating behavior. On the other hand, it creates a significant calorie deficit for the reduction of body fat. The aim of this case report was to discuss the effects of a very low-calorie ketogenic diet in a woman with obesity and low resting metabolic rate. CASE DESCRIPTION A 36-y-old white woman with a history of obesity and bulimia nervosa who has had difficulty losing and maintaining weight despite numerous dietary and pharmacologic treatments. RESULTS There was a loss of 12 kg in 115 d, reaching 13.4 kg, with 11.4 kg of fat mass (FM). The resting metabolic rate showed an increase of 79% in relation to the initial rate, reaching normal levels for the predictive equations and maintaining this level in the first-year follow-up. Additionally, improvement of metabolic laboratory parameters and eating behavior traits were described. CONCLUSIONS In this specific case of bulimia nervosa resulting in hypometabolism (low resting metabolic rate/fat-free mass) and obesity, the very low-calorie ketogenic diet intervention has demonstrated a possibility of weight loss with little cognitive restraint use, thereby increasing resting metabolic rate in the short and medium terms, ultimately promoting a negative energy balance. In relation to the numeric results, it seems positive; however, more research is necessary to evaluate the effects on the overall relationship with food and its long-term repercussions.
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Affiliation(s)
| | | | - Leandro Silva Figueredo
- A Beneficência Portuguesa de São Paulo - R. Maestro Cardim, São Paulo - SP 01323-001, Brazil
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Alabduljabbar K, Bonanos E, Miras AD, le Roux CW. Mechanisms of Action of Bariatric Surgery on Body Weight Regulation. Gastroenterol Clin North Am 2023; 52:691-705. [PMID: 37919021 DOI: 10.1016/j.gtc.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Bariatric surgery is an effective treatment modality for obesity and obesity-associated complications. Weight loss after bariatric surgery was initially attributed to anatomic restriction or reduced energy absorption, but now it is understood that surgery treats obesity by influencing the subcortical areas of the brain to lower adipose tissue mass. There are three major phases of this process: initially the weight loss phase, followed by a phase where weight loss is maintained, and in a subset of patients a phase where weight is regained. These phases are characterized by altered appetitive behavior together with changes in energy expenditure. The mechanisms associated with the rearrangement of the gastrointestinal tract include central appetite control, release of gut peptides, change in microbiota and bile acids. However, the exact combination and timing of signals remain largely unknown.
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Affiliation(s)
- Khaled Alabduljabbar
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland; Department of Family Medicine and Polyclinics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
| | | | | | - Carel W le Roux
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland.
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de Lima Macena M, Tenório da Costa Paula D, da Silva Júnior AE, Rodrigues Silva Praxedes D, Bueno NB. Longitudinal estimates of resting energy expenditure using predictive equations in individuals with excess weight after weight loss: A systematic review with meta-analysis. Clin Nutr ESPEN 2023; 58:263-269. [PMID: 38057015 DOI: 10.1016/j.clnesp.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/11/2023] [Accepted: 10/06/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND & AIMS To determine which resting energy expenditure (REE) predictive equation has the lowest bias in the aggregate level in individuals with excess weight during weight loss interventions. METHODS Searches were performed in MEDLINE, Web of Science, Scopus, CENTRAL and gray literature databases. Longitudinal studies on weight loss interventions which evaluated REE by predictive equations compared to that measured by indirect calorimetry in adults with excess weight at different follow-up times were included. Meta-analyses were performed with the differences between biases of predictive equations of the REE at the different follow-up times of weight loss. RESULTS Of the total of 2178 occurrences found in the databases, only eight studies were included. The Harris-Benedict (1919) equation showed the smallest differences between bias up to the third month (MD = 103.33 kcal; 95%CI = -39.01; 245.67), in the sixth month (MD = 59.16 kcal; 95%CI = 8.74; 109.57) and at the 12th month (MD = -71.41 kcal; 95%CI = -150.38; 7.55) of weight loss follow-up. Weight loss does not seem to have an effect on bias at different follow-up times. CONCLUSION Harris-Benedict (1919) equation seems to be the most adequate to assess the REE of individuals with excess weight during weight loss. However, the finding of large estimated predictive intervals may indicate that predictive equations may not be handy tools for individuals losing and regaining weight due to changes other than body weight.
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Affiliation(s)
- Mateus de Lima Macena
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Laboratório de Nutrição e Metabolismo, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil
| | | | - André Eduardo da Silva Júnior
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Laboratório de Nutrição e Metabolismo, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil
| | - Dafiny Rodrigues Silva Praxedes
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Laboratório de Nutrição e Metabolismo, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil
| | - Nassib Bezerra Bueno
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Laboratório de Nutrição e Metabolismo, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil.
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Ortiz GU, de Freitas EC. Physical activity and batokines. Am J Physiol Endocrinol Metab 2023; 325:E610-E620. [PMID: 37819193 DOI: 10.1152/ajpendo.00160.2023] [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: 05/24/2023] [Revised: 09/28/2023] [Accepted: 10/02/2023] [Indexed: 10/13/2023]
Abstract
Brown and beige adipose tissue share similar functionality, being both tissues specialized in producing heat through nonshivering thermogenesis and also playing endocrine roles through the release of their secretion factors called batokines. This review elucidates the influence of physical exercise, and myokines released in response, on the regulation of thermogenic and secretory functions of these adipose tissues and discusses the similarity of batokines actions with physical exercise in the remodeling of adipose tissue. This adipose tissue remodeling promoted by autocrine and paracrine batokines or physical exercise seems to optimize its functionality associated with better health outcomes.
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Affiliation(s)
- Gabriela Ueta Ortiz
- Department of Health Sciences, Ribeirao Preto Medical School, University of São Paulo-FMRP USP, São Paulo, Brazil
| | - Ellen Cristini de Freitas
- Department of Health Sciences, Ribeirao Preto Medical School, University of São Paulo-FMRP USP, São Paulo, Brazil
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Liu Y, Qu Y, Cheng C, Tsai PY, Edwards K, Xue S, Pandit S, Eguchi S, Sanghera N, Barrow JJ. Nipsnap1-A regulatory factor required for long-term maintenance of non-shivering thermogenesis. Mol Metab 2023; 75:101770. [PMID: 37423391 PMCID: PMC10404556 DOI: 10.1016/j.molmet.2023.101770] [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: 02/16/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVE The activation of non-shivering thermogenesis (NST) has strong potential to combat obesity and metabolic disease. The activation of NST however is extremely temporal and the mechanisms surrounding how the benefits of NST are sustained once fully activated, remain unexplored. The objective of this study is to investigate the role of 4-Nitrophenylphosphatase Domain and Non-Neuronal SNAP25-Like 1 (Nipsnap1) in NST maintenance, which is a critical regulator identified in this study. METHODS The expression of Nipsnap1 was profiled by immunoblotting and RT-qPCR. We generated Nipsnap1 knockout mice (N1-KO) and investigated the function of Nipsnap1 in NST maintenance and whole-body metabolism using whole body respirometry analyses. We evaluate the metabolic regulatory role of Nipsnap1 using cellular and mitochondrial respiration assay. RESULTS Here, we show Nipsnap1 as a critical regulator of long-term thermogenic maintenance in brown adipose tissue (BAT). Nipsnap1 localizes to the mitochondrial matrix and increases its transcript and protein levels in response to both chronic cold and β3 adrenergic signaling. We demonstrated that these mice are unable to sustain activated energy expenditure and have significantly lower body temperature in the face of an extended cold challenge. Furthermore, when mice are exposed to the pharmacological β3 agonist CL 316, 243, the N1-KO mice exhibit significant hyperphagia and altered energy balance. Mechanistically, we demonstrate that Nipsnap1 integrates with lipid metabolism and BAT-specific ablation of Nipsnap1 leads to severe defects in beta-oxidation capacity when exposed to a cold environmental challenge. CONCLUSION Our findings identify Nipsnap1 as a potent regulator of long-term NST maintenance in BAT.
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Affiliation(s)
- Yang Liu
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14850, USA
| | - Yue Qu
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14850, USA
| | - Chloe Cheng
- Department of Veterinary Medicine, Cornell University, Ithaca, NY, 14850, USA
| | - Pei-Yin Tsai
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14850, USA
| | - Kaydine Edwards
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14850, USA
| | - Siwen Xue
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14850, USA
| | - Supriya Pandit
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14850, USA
| | - Sakura Eguchi
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14850, USA
| | - Navneet Sanghera
- Department of Biological Sciences, San Jose State University, San Jose, CA, 95192, USA
| | - Joeva J Barrow
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14850, USA.
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Pepe RB, Lottenberg AM, Fujiwara CTH, Beyruti M, Cintra DE, Machado RM, Rodrigues A, Jensen NSO, Caldas APS, Fernandes AE, Rossoni C, Mattos F, Motarelli JHF, Bressan J, Saldanha J, Beda LMM, Lavrador MSF, Del Bosco M, Cruz P, Correia PE, Maximino P, Pereira S, Faria SL, Piovacari SMF. Position statement on nutrition therapy for overweight and obesity: nutrition department of the Brazilian association for the study of obesity and metabolic syndrome (ABESO-2022). Diabetol Metab Syndr 2023; 15:124. [PMID: 37296485 DOI: 10.1186/s13098-023-01037-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 03/23/2023] [Indexed: 06/12/2023] Open
Abstract
Obesity is a chronic disease resulting from multifactorial causes mainly related to lifestyle (sedentary lifestyle, inadequate eating habits) and to other conditions such as genetic, hereditary, psychological, cultural, and ethnic factors. The weight loss process is slow and complex, and involves lifestyle changes with an emphasis on nutritional therapy, physical activity practice, psychological interventions, and pharmacological or surgical treatment. Because the management of obesity is a long-term process, it is essential that the nutritional treatment contributes to the maintenance of the individual's global health. The main diet-related causes associated with excess weight are the high consumption of ultraprocessed foods, which are high in fats, sugars, and have high energy density; increased portion sizes; and low intake of fruits, vegetables, and grains. In addition, some situations negatively interfere with the weight loss process, such as fad diets that involve the belief in superfoods, the use of teas and phytotherapics, or even the avoidance of certain food groups, as has currently been the case for foods that are sources of carbohydrates. Individuals with obesity are often exposed to fad diets and, on a recurring basis, adhere to proposals with promises of quick solutions, which are not supported by the scientific literature. The adoption of a dietary pattern combining foods such as grains, lean meats, low-fat dairy, fruits, and vegetables, associated with an energy deficit, is the nutritional treatment recommended by the main international guidelines. Moreover, an emphasis on behavioral aspects including motivational interviewing and the encouragement for the individual to develop skills will contribute to achieve and maintain a healthy weight. Therefore, this Position Statement was prepared based on the analysis of the main randomized controlled studies and meta-analyses that tested different nutrition interventions for weight loss. Topics in the frontier of knowledge such as gut microbiota, inflammation, and nutritional genomics, as well as the processes involved in weight regain, were included in this document. This Position Statement was prepared by the Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), with the collaboration of dietitians from research and clinical fields with an emphasis on strategies for weight loss.
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Affiliation(s)
- Renata Bressan Pepe
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Ana Maria Lottenberg
- Laboratório de Lipides (LIM10), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
- Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), Rua Mato Grosso 306 - cj 1711, Sao Paulo, SP, 01239-040, Brazil.
| | - Clarissa Tamie Hiwatashi Fujiwara
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Mônica Beyruti
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP, Brazil
| | - Dennys Esper Cintra
- Centro de Estudos em Lipídios e Nutrigenômica - CELN - University of Campinas, Campinas, SP, Brazil
| | - Roberta Marcondes Machado
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Alessandra Rodrigues
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP, Brazil
| | - Natália Sanchez Oliveira Jensen
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | | | - Ariana Ester Fernandes
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Carina Rossoni
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Fernanda Mattos
- Programa de Obesidade e Cirurgia Bariátrica do Hospital Universitário Clementino Fraga Filho da UFRJ, Rio de Janeiro, RJ, Brazil
| | - João Henrique Fabiano Motarelli
- Núcleo de Estudos e Extensão em Comportamento Alimentar e Obesidade (NEPOCA) da Universidade de São Paulo - FMRP/USP, Ribeirão Preto, Brazil
| | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, MG, Brazil
| | | | - Lis Mie Masuzawa Beda
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP, Brazil
| | - Maria Sílvia Ferrari Lavrador
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Mariana Del Bosco
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP, Brazil
| | - Patrícia Cruz
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | | | - Priscila Maximino
- Instituto PENSI - Fundação José Luiz Egydio Setúbal, Instituto Pensi, Fundação José Luiz Egydio Setúbal, Hospital Infantil Sabará, São Paulo, SP, Brazil
| | - Silvia Pereira
- Núcleo de Saúde Alimentar da Sociedade Brasileira de Cirurgia Bariátrica e Metabólica, São Paulo, Brazil
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Rosenbaum M. Appetite, Energy Expenditure, and the Regulation of Energy Balance. Gastroenterol Clin North Am 2023; 52:311-322. [PMID: 37197875 DOI: 10.1016/j.gtc.2023.03.004] [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: 05/19/2023]
Abstract
At usual weight, energy intake and expenditure are coupled and covary to maintain body weight (energy stores). A change in energy balance, especially weight loss, invokes discoordinated effects on energy intake and output that favor return to previous weight. These regulatory systems reflect physiological changes in systems regulating energy intake and expenditure rather than a lack of resolve. The biological and behavioral physiology of dynamic weight change are distinct from those of attempts at static weight maintenance of an altered body weight. This suggests that optimal therapeutic approaches to losing or gaining vs. sustaining weight changes are different for most individuals.
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Affiliation(s)
- Michael Rosenbaum
- Division of Molecular Genetics, Department of Pediatrics, Columbia University Irving Medical Center, 1150 St. Nicholas Avenue, 6th Floor, New York, NY 10032, USA; Department of Medicine, Columbia University Irving Medical Center, 1150 St. Nicholas Avenue, 6th Floor, New York, NY 10032, USA.
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12
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Abstract
The rising prevalence of obesity in Singapore is a harbinger for a corresponding increase in obesity-related complications such as type 2 diabetes mellitus (T2DM) and coronary heart disease. Obesity is a complex disease driven by multiple factors, and hence, treatment cannot follow a 'one-size-fits-all' approach. Lifestyle modifications involving dietary interventions, physical activity and behavioural changes remain the cornerstone of obesity management. However, similar to other chronic diseases such as T2DM and hypertension, lifestyle modifications are often insufficient on their own, hence the importance of other treatment modalities including pharmacotherapy, endoscopic bariatric therapy and metabolic-bariatric surgery. Weight loss medications currently approved in Singapore include phentermine, orlistat, liraglutide and naltrexone-bupropion. In recent years, endoscopic bariatric therapies have evolved as an effective, minimally invasive and durable therapeutic option for obesity. Metabolic-bariatric surgery remains the most effective and durable treatment for patients with severe obesity, with an average weight loss of 25%-30% after one year.
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Affiliation(s)
- Phong Ching Lee
- Department of Endocrinology, Singapore General Hospital, Singapore
| | - Chin Hong Lim
- Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, Singapore
| | - Ravishankar Asokkumar
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
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13
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Semmler G, Datz C, Trauner M. Eating, diet, and nutrition for the treatment of non-alcoholic fatty liver disease. Clin Mol Hepatol 2023; 29:S244-S260. [PMID: 36517001 PMCID: PMC10029946 DOI: 10.3350/cmh.2022.0364] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
Nutrition and dietary interventions are a central component in the pathophysiology, but also a cornerstone in the management of patients with non-alcoholic fatty liver disease (NAFLD). Summarizing our rapidly advancing understanding of how our diet influences our metabolism and focusing on specific effects on the liver, we provide a comprehensive overview of dietary concepts to counteract the increasing burden of NAFLD. Specifically, we emphasize the importance of dietary calorie restriction independently of the macronutrient composition together with adherence to a Mediterranean diet low in added fructose and processed meat that seems to exert favorable effects beyond calorie restriction. Also, we discuss intermittent fasting as a type of diet specifically tailored to decrease liver fat content and increase ketogenesis, awaiting future study results in NAFLD. Finally, personalized dietary recommendations could be powerful tools to increase the effectiveness of dietary interventions in patients with NAFLD considering the genetic background and the microbiome, among others.
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Affiliation(s)
- Georg Semmler
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Christian Datz
- Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, Oberndorf, Austria
| | - Michael Trauner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
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14
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Tham KW, Abdul Ghani R, Cua SC, Deerochanawong C, Fojas M, Hocking S, Lee J, Nam TQ, Pathan F, Saboo B, Soegondo S, Somasundaram N, Yong AML, Ashkenas J, Webster N, Oldfield B. Obesity in South and Southeast Asia-A new consensus on care and management. Obes Rev 2023; 24:e13520. [PMID: 36453081 PMCID: PMC10078503 DOI: 10.1111/obr.13520] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 12/03/2022]
Abstract
Obesity is a chronic disease in which the abnormal or excessive accumulation of body fat leads to impaired health and increased risk of mortality and chronic health complications. Prevalence of obesity is rising rapidly in South and Southeast Asia, with potentially serious consequences for local economies, healthcare systems, and quality of life. Our group of obesity specialists from Bangladesh, Brunei Darussalam, India, Indonesia, Malaysia, Philippines, Singapore, Sri Lanka, Thailand, and Viet Nam undertook to develop consensus recommendations for management and care of adults and children with obesity in South and Southeast Asia. To this end, we identified and researched 12 clinical questions related to obesity. These questions address the optimal approaches for identifying and staging obesity, treatment (lifestyle, behavioral, pharmacologic, and surgical options) and maintenance of reduced weight, as well as issues related to weight stigma and patient engagement in the clinical setting. We achieved consensus on 42 clinical recommendations that address these questions. An algorithm describing obesity care is presented, keyed to the various consensus recommendations.
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Affiliation(s)
- Kwang Wei Tham
- Singapore Association for the Study of Obesity, Singapore
| | | | - Sioksoan C Cua
- Division of Pediatric Endocrinology, Philippine General Hospital, Metro Manila, Philippines.,Department of Pediatrics, Chinese General Hospital, Cardinal Santos Medical Center, Manila Doctors Hospital, Metro Manila, Philippines
| | | | - Mia Fojas
- Department of Biochemistry and Molecular Biology, University of the Philippines College of Medicine, Manila, Philippines
| | - Samantha Hocking
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, Australia.,Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Boden Initiative, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - June Lee
- Upper Gastrointestinal and Bariatric Surgery, Department of Surgery, Changi General Hospital, Singapore
| | - Tran Quang Nam
- Department of Endocrinology, Ho Chi Minh City University Medical Center, Ho Chi Minh City, Vietnam
| | - Faruque Pathan
- Department of Endocrinology, Ibrahim Memorial Diabetes Center, Dhaka, Bangladesh
| | - Banshi Saboo
- Dia Care Diabetes Care and Hormone Clinic, Ahmedabad, Gujarat, India
| | - Sidartawan Soegondo
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.,Diabetes Connection and Care, Eka Hospitals, Jakarta, Indonesia
| | | | - Alice M L Yong
- Department of Internal Medicine, RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam
| | | | | | - Brian Oldfield
- Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, Australia
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15
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Rules for body fat interventions based on an operating point mechanism. iScience 2023; 26:106047. [PMID: 36818281 PMCID: PMC9929596 DOI: 10.1016/j.isci.2023.106047] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/15/2022] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
Interventions to reduce fat are important for human health. However, they can have opposing effects such as exercise that decreases fat but increases food intake, or coherent effects such as leptin resistance which raises both. Furthermore, some interventions show an overshoot in food intake, such as recovery from a diet, whereas others do not. To explain these properties we present a graphical framework called the operating point model, based on leptin control of feeding behavior. Steady-state fat and food intake is given by the intersection of two experimental curves - steady-state fat at a given food intake and ad libitum food intake at a given fat level. Depending on which curve an intervention shifts, it has opposing or coherent effects with or without overshoot, in excellent agreement with rodent data. The model also explains the quadratic relation between leptin and fat in humans. These concepts may guide the understanding of fat regulation disorders.
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16
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Growth hormone receptor (GHR) in AgRP neurons regulates thermogenesis in a sex-specific manner. GeroScience 2023:10.1007/s11357-023-00726-4. [PMID: 36633824 PMCID: PMC10400518 DOI: 10.1007/s11357-023-00726-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 01/03/2023] [Indexed: 01/13/2023] Open
Abstract
Evidence for hypothalamic regulation of energy homeostasis and thermoregulation in brown adipose tissue (BAT) during aging has been well recognized, yet the central molecular mediators involved in this process are poorly understood. The arcuate hypothalamus, orexigenic agouti-related peptide (AgRP) neurons control nutrient intake, energy homeostasis, and BAT thermogenesis. To determine the roles of growth hormone receptor (GHR) signaling in the AgRP neurons, we used mice with the AgRP-specific GHR deletion (AgRPΔGHR). We found that female AgRPΔGHR mice were resistant to temperature adaptation, and their body core temperature remained significantly lower when held at 10 °C, 22 °C, or 30 °C, compared to control mice. Low body core temperature in female AgRPΔGHR mice has been associated with significant reductions in Ucp1 and Pgc1α expression in the BAT. Further, neuronal activity in AgRP in response to cold exposure was blunted in AgRPΔGHR female mice, while the number of Fos+ AgRP neurons was increased in female controls exposed to cold. Global transcriptome from BAT identified increased the expression of genes related to immune responses and chemokine activity and decreased the expression of genes involved in triglyceride synthesis and metabolic pathways in AgRPΔGHR female mice. Importantly, these were the same genes that are downregulated by thermoneutrality in control mice but not in the AgRPΔGHR animals. Collectively, these data demonstrate a novel sex-specific role for GHR signaling in AgRP neurons in thermal regulation, which might be particularly relevant during aging.
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17
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Flack KD, Stults-Kolehmainen MA, Creasy SA, Khullar S, Boullosa D, Catenacci VA, King N. Altered motivation states for physical activity and 'appetite' for movement as compensatory mechanisms limiting the efficacy of exercise training for weight loss. Front Psychol 2023; 14:1098394. [PMID: 37187558 PMCID: PMC10176969 DOI: 10.3389/fpsyg.2023.1098394] [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: 11/14/2022] [Accepted: 03/23/2023] [Indexed: 05/17/2023] Open
Abstract
Weight loss is a major motive for engaging in exercise, despite substantial evidence that exercise training results in compensatory responses that inhibit significant weight loss. According to the Laws of Thermodynamics and the CICO (Calories in, Calories out) model, increased exercise-induced energy expenditure (EE), in the absence of any compensatory increase in energy intake, should result in an energy deficit leading to reductions of body mass. However, the expected negative energy balance is met with both volitional and non-volitional (metabolic and behavioral) compensatory responses. A commonly reported compensatory response to exercise is increased food intake (i.e., Calories in) due to increased hunger, increased desire for certain foods, and/or changes in health beliefs. On the other side of the CICO model, exercise training can instigate compensatory reductions in EE that resist the maintenance of an energy deficit. This may be due to decreases in non-exercise activity thermogenesis (NEAT), increases in sedentary behavior, or alterations in sleep. Related to this EE compensation, the motivational states associated with the desire to be active tend to be overlooked when considering compensatory changes in non-exercise activity. For example, exercise-induced alterations in the wanting of physical activity could be a mechanism promoting compensatory reductions in EE. Thus, one's desires, urges or cravings for movement-also known as "motivation states" or "appetence for activity"-are thought to be proximal instigators of movement. Motivation states for activity may be influenced by genetic, metabolic, and psychological drives for activity (and inactivity), and such states are susceptible to fatigue-or reward-induced responses, which may account for reductions in NEAT in response to exercise training. Further, although the current data are limited, recent investigations have demonstrated that motivation states for physical activity are dampened by exercise and increase after periods of sedentarism. Collectively, this evidence points to additional compensatory mechanisms, associated with motivational states, by which impositions in exercise-induced changes in energy balance may be met with resistance, thus resulting in attenuated weight loss.
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Affiliation(s)
- Kyle D. Flack
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY, United States
| | - Matthew A. Stults-Kolehmainen
- Division of Digestive Health, Yale New Haven Hospital, New Haven, CT, United States
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, United States
- *Correspondence: Matthew A. Stults-Kolehmainen,
| | - Seth A. Creasy
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Saumya Khullar
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Daniel Boullosa
- Faculty of Physical Activity and Sports Sciences, Universidad de León, León, Spain
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
- Graduate Program in Movement Sciences, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Victoria A. Catenacci
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Neil King
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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18
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Aragón-Vela J, Alcalá-Bejarano Carrillo J, Moreno-Racero A, Plaza-Diaz J. The Role of Molecular and Hormonal Factors in Obesity and the Effects of Physical Activity in Children. Int J Mol Sci 2022; 23:15413. [PMID: 36499740 PMCID: PMC9737554 DOI: 10.3390/ijms232315413] [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: 10/30/2022] [Revised: 11/27/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Obesity and overweight are defined as abnormal fat accumulations. Adipose tissue consists of more than merely adipocytes; each adipocyte is closely coupled with the extracellular matrix. Adipose tissue stores excess energy through expansion. Obesity is caused by the abnormal expansion of adipose tissue as a result of adipocyte hypertrophy and hyperplasia. The process of obesity is controlled by several molecules, such as integrins, kindlins, or matrix metalloproteinases. In children with obesity, metabolomics studies have provided insight into the existence of unique metabolic profiles. As a result of low-grade inflammation in the system, abnormalities were observed in several metabolites associated with lipid, carbohydrate, and amino acid pathways. In addition, obesity and related hormones, such as leptin, play an instrumental role in regulating food intake and contributing to childhood obesity. The World Health Organization states that physical activity benefits the heart, the body, and the mind. Several noncommunicable diseases, such as cardiovascular disease, cancer, and diabetes, can be prevented and managed through physical activity. In this work, we reviewed pediatric studies that examined the molecular and hormonal control of obesity and the influence of physical activity on children with obesity or overweight. The purpose of this review was to examine some orchestrators involved in this disease and how they are related to pediatric populations. A larger number of randomized clinical trials with larger sample sizes and long-term studies could lead to the discovery of new key molecules as well as the detection of significant factors in the coming years. In order to improve the health of the pediatric population, omics analyses and machine learning techniques can be combined in order to improve treatment decisions.
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Affiliation(s)
- Jerónimo Aragón-Vela
- Department of Health Sciences, Area of Physiology, Building B3, Campus s/n “Las Lagunillas”, University of Jaén, 23071 Jaén, Spain
| | - Jesús Alcalá-Bejarano Carrillo
- Department of Health, University of the Valley of Mexico, Robles 600, Tecnologico I, San Luis Potosí 78220, Mexico
- Research and Advances in Molecular and Cellular Immunology, Center of Biomedical Research, University of Granada, Avda, del Conocimiento s/n, 18016 Armilla, Spain
| | - Aurora Moreno-Racero
- Research and Advances in Molecular and Cellular Immunology, Center of Biomedical Research, University of Granada, Avda, del Conocimiento s/n, 18016 Armilla, Spain
| | - Julio Plaza-Diaz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
- Instituto de Investigación Biosanitaria IBS, Granada, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
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19
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Exenatide increases CTRP3 gene expression in adipose cells by inhibiting adipogenesis and induces apoptosis. Toxicol In Vitro 2022; 85:105479. [PMID: 36152787 DOI: 10.1016/j.tiv.2022.105479] [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: 07/14/2022] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 11/24/2022]
Abstract
Considering the rapidly increasing prevalence of obesity worldwide, the number of weight control drugs is very few. Incretin-based therapies are currently being developed to achieve weight control, and Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RA) are used in incretin-based therapies. This study aimed to investigate the cytotoxicity of exenatide, a GLP-1A, on 3T3-L1 adipocytes and the effect of exenatide on the expression of adipogenesis-related genes, insulin and glucose levels, and apoptosis. Cytotoxic activity of exenatide on 3T3-L1 adipocytes was determined by MTT method. Gene expression levels were determined by qPCR. Apoptosis studies were performed on the Muse Cell Analyzer. C1q/TNF-related protein-3 (CTRP3) expression levels were found to be higher in exenatide treated adipocyte cells than in control cells (p < 0.001). Adipocyte cells treated with exenatide were found to have lower PPAR-γ gene expression levels when compared to control adipocyte cells (p < 0.001). Intracellular insulin (p < 0.001) and glucose levels were higher in 3T3-L1 adipocytes treated with exenatide compared to control adipocyte cells. Total apoptosis increased approximately 1.5 times as a result of exenatide administration. The increase in CTRP3 gene expression, which is thought to be a new biomarker for obesity, and the decrease in PPAR-γ gene expression indicate that exenatide is a promising new pharmacotherapeutic agent in the treatment of obesity by regulating the expression of genes related to adipogenesis and lipogenesis and inducing apoptosis.
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20
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Olszewski PK, Noble EE, Paiva L, Ueta Y, Blevins JE. Oxytocin as a potential pharmacological tool to combat obesity. J Neuroendocrinol 2022; 34:e13106. [PMID: 35192207 PMCID: PMC9372234 DOI: 10.1111/jne.13106] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/06/2022] [Accepted: 02/08/2022] [Indexed: 11/30/2022]
Abstract
The neuropeptide oxytocin (OT) has emerged as an important anorexigen in the regulation of food intake and energy balance. It has been shown that the release of OT and activation of hypothalamic OT neurons coincide with food ingestion. Its effects on feeding have largely been attributed to limiting meal size through interactions in key regulatory brain regions governing the homeostatic control of food intake such as the hypothalamus and hindbrain in addition to key feeding reward areas such as the nucleus accumbens and ventral tegmental area. Furthermore, the magnitude of an anorexigenic response to OT and feeding-related activation of the brain OT circuit are modified by the composition and flavor of a diet, as well as by a social context in which a meal is consumed. OT is particularly effective in reducing consumption of carbohydrates and sweet tastants. Pharmacologic, genetic, and pair-feeding studies indicate that OT-elicited weight loss cannot be fully explained by reductions of food intake and that the overall impact of OT on energy balance is also partly a result of OT-elicited changes in lipolysis, energy expenditure, and glucose regulation. Peripheral administration of OT mimics many of its effects when it is given into the central nervous system, raising the questions of whether and to what extent circulating OT acts through peripheral OT receptors to regulate energy balance. Although OT has been found to elicit weight loss in female mice, recent studies have indicated that sex and estrous cycle may impact oxytocinergic modulation of food intake. Despite the overall promising basic research data, attempts to use OT in the clinical setting to combat obesity and overeating have generated somewhat mixed results. The focus of this mini-review is to briefly summarize the role of OT in feeding and metabolism, address gaps and inconsistencies in our knowledge, and discuss some of the limitations to the potential use of chronic OT that should help guide future research on OT as a tailor-made anti-obesity therapeutic.
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Affiliation(s)
- Pawel K Olszewski
- Faculty of Science and Engineering, University of Waikato, Waikato, New Zealand
- Department of Food Science and Nutrition, College of Food, Agricultural and Natural Resource Sciences, University of Minnesota, St Paul, Minnesota, USA
- Department of Integrative Biology and Physiology, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - Emily E Noble
- Department of Nutritional Sciences, University of Georgia, Athens, Georgia, USA
| | - Luis Paiva
- Instituto de Ciencia Animal, Facultad de Ciencias Veterinarias, Universidad Austral de Chile, Valdivia, Chile
| | - Yoichi Ueta
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - James E Blevins
- Department of Veterans Affairs Medical Center, VA Puget Sound Health Care System, Office of Research and Development Medical Research Service, Seattle, Washington, USA
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
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21
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Pileggi CA, Blondin DP, Hooks BG, Parmar G, Alecu I, Patten DA, Cuillerier A, O'Dwyer C, Thrush AB, Fullerton MD, Bennett SA, Doucet É, Haman F, Cuperlovic-Culf M, McPherson R, Dent RRM, Harper ME. Exercise training enhances muscle mitochondrial metabolism in diet-resistant obesity. EBioMedicine 2022; 83:104192. [PMID: 35965199 PMCID: PMC9482931 DOI: 10.1016/j.ebiom.2022.104192] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/05/2022] [Accepted: 07/15/2022] [Indexed: 12/14/2022] Open
Abstract
Background Current paradigms for predicting weight loss in response to energy restriction have general validity but a subset of individuals fail to respond adequately despite documented diet adherence. Patients in the bottom 20% for rate of weight loss following a hypocaloric diet (diet-resistant) have been found to have less type I muscle fibres and lower skeletal muscle mitochondrial function, leading to the hypothesis that physical exercise may be an effective treatment when diet alone is inadequate. In this study, we aimed to assess the efficacy of exercise training on mitochondrial function in women with obesity with a documented history of minimal diet-induced weight loss. Methods From over 5000 patient records, 228 files were reviewed to identify baseline characteristics of weight loss response from women with obesity who were previously classified in the top or bottom 20% quintiles based on rate of weight loss in the first 6 weeks during which a 900 kcal/day meal replacement was consumed. A subset of 20 women with obesity were identified based on diet-resistance (n=10) and diet sensitivity (n=10) to undergo a 6-week supervised, progressive, combined aerobic and resistance exercise intervention. Findings Diet-sensitive women had lower baseline adiposity, higher fasting insulin and triglycerides, and a greater number of ATP-III criteria for metabolic syndrome. Conversely in diet-resistant women, the exercise intervention improved body composition, skeletal muscle mitochondrial content and metabolism, with minimal effects in diet-sensitive women. In-depth analyses of muscle metabolomes revealed distinct group- and intervention- differences, including lower serine-associated sphingolipid synthesis in diet-resistant women following exercise training. Interpretation Exercise preferentially enhances skeletal muscle metabolism and improves body composition in women with a history of minimal diet-induced weight loss. These clinical and metabolic mechanism insights move the field towards better personalised approaches for the treatment of distinct obesity phenotypes. Funding Canadian Institutes of Health Research (CIHR-INMD and FDN-143278; CAN-163902; CIHR PJT-148634).
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Affiliation(s)
- Chantal A Pileggi
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Institute of Systems Biology, Ottawa, Ontario, Canada; National Research Council of Canada, Digital Technologies Research Centre, Ottawa, Canada
| | - Denis P Blondin
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Breana G Hooks
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Institute of Systems Biology, Ottawa, Ontario, Canada; Centre for Infection, Immunity and Inflammation, Ottawa, Ontario, Canada
| | - Gaganvir Parmar
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Institute of Systems Biology, Ottawa, Ontario, Canada
| | - Irina Alecu
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Institute of Systems Biology, Ottawa, Ontario, Canada
| | - David A Patten
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Institute of Systems Biology, Ottawa, Ontario, Canada
| | - Alexanne Cuillerier
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Conor O'Dwyer
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - A Brianne Thrush
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Morgan D Fullerton
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Centre for Infection, Immunity and Inflammation, Ottawa, Ontario, Canada; Centre for Catalysis Research and Innovation, Ottawa, Ontario, Canada
| | - Steffany Al Bennett
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Institute of Systems Biology, Ottawa, Ontario, Canada; Centre for Catalysis Research and Innovation, Ottawa, Ontario, Canada
| | - Éric Doucet
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - François Haman
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Miroslava Cuperlovic-Culf
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Institute of Systems Biology, Ottawa, Ontario, Canada; National Research Council of Canada, Digital Technologies Research Centre, Ottawa, Canada
| | - Ruth McPherson
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario Canada
| | - Robert R M Dent
- Division of Endocrinology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Mary-Ellen Harper
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Institute of Systems Biology, Ottawa, Ontario, Canada; Centre for Infection, Immunity and Inflammation, Ottawa, Ontario, Canada.
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22
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Targeting skeletal muscle mitochondrial health in obesity. Clin Sci (Lond) 2022; 136:1081-1110. [PMID: 35892309 PMCID: PMC9334731 DOI: 10.1042/cs20210506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/26/2022] [Accepted: 07/05/2022] [Indexed: 11/21/2022]
Abstract
Metabolic demands of skeletal muscle are substantial and are characterized normally as highly flexible and with a large dynamic range. Skeletal muscle composition (e.g., fiber type and mitochondrial content) and metabolism (e.g., capacity to switch between fatty acid and glucose substrates) are altered in obesity, with some changes proceeding and some following the development of the disease. Nonetheless, there are marked interindividual differences in skeletal muscle composition and metabolism in obesity, some of which have been associated with obesity risk and weight loss capacity. In this review, we discuss related molecular mechanisms and how current and novel treatment strategies may enhance weight loss capacity, particularly in diet-resistant obesity.
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23
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Martins C, BA G, Hunter GR. Metabolic adaptation after combined resistance and aerobic exercise training in older women. Obesity (Silver Spring) 2022; 30:1453-1461. [PMID: 35729736 PMCID: PMC9256770 DOI: 10.1002/oby.23450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This study investigated whether combined aerobic and resistance training in older women leads to metabolic adaptation. METHODS A total of 80 women (64 White individuals; BMI: 30.0 [4.4] kg/m2 ; age: 64.8 [3.5] years) followed 32 weeks of aerobic and resistance training. Body weight/composition (dual-energy X-ray absorptiometry) and resting metabolic rate (RMR; indirect calorimetry) were measured at baseline, week 16, and week 32. Metabolic adaptation was defined as significantly lower measured versus predicted RMR. A regression model to predict metabolic adaptation was developed that included race, age, baseline fat-free mass, RMR and respiratory quotient, and changes in net submaximal oxygen consumption after different tasks. RESULTS There was significant metabolic adaptation at week 16 (-59 [136] kcal/d, p = 0.002), following a 640-kcal/wk energy loss (-0.7 [2.6] kg of weight loss). In 53 women with complete data, metabolic adaptation was seen both at week 16 (-64 [129] kcal/d, p = 0.001) and at week 32 (-94 [127] kcal/d, p < 0.001). Metabolic adaptation at week 16 was predicted by race, age, baseline fat-free mass, RMR and respiratory quotient, and change in net oxygen consumption of walking (R2 adjusted = 0.90, p < 0.001). Similar results were seen at week 32. CONCLUSIONS In older women with overweight and obesity, a minimal energy deficit induced by aerobic and resistance exercise is associated with metabolic adaptation at the level of RMR.
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Affiliation(s)
- Catia Martins
- Department of Nutrition Sciences, University of Alabama at Birmingham, USA
| | - Gower BA
- Department of Nutrition Sciences, University of Alabama at Birmingham, USA
| | - Gary R Hunter
- Department of Nutrition Sciences, University of Alabama at Birmingham, USA
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Roser P, Bajaj SS, Stanford FC. International lack of equity in modern obesity therapy: the critical need for change in health policy. Int J Obes (Lond) 2022; 46:1571-1572. [PMID: 35778480 PMCID: PMC9395261 DOI: 10.1038/s41366-022-01176-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Pia Roser
- University Medical Center Hamburg-Eppendorf, Department of Endocrinology and Diabetes, Hamburg, Germany.
| | - Simar S Bajaj
- Harvard University, Department of the History of Science, Cambridge, MA, USA
| | - Fatima Cody Stanford
- Massachusetts General Hospital, MGH Weight Center, Department of Medicine-Division of Endocrinology-Neuroendocrine, Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Boston, MA, USA
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Freshwater M, Christensen S, Oshman L, Bays HE. Behavior, motivational interviewing, eating disorders, and obesity management technologies: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. OBESITY PILLARS (ONLINE) 2022; 2:100014. [PMID: 37990715 PMCID: PMC10661888 DOI: 10.1016/j.obpill.2022.100014] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 03/19/2022] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) is intended to provide clinicians an overview of "Behavior, Motivational Interviewing, Eating Disorders, and Obesity Management Technologies." Methods The scientific information for this CPS is based upon published scientific citations, clinical perspectives of OMA authors, and peer review by the Obesity Medicine Association leadership. Results This CPS outlines important components of behavior, motivational interviewing, eating disorders, and obesity management technologies as they relate to pre-obesity and obesity. Topics include eating behavior disorder evaluation, the motivations behind eating and physical activity behaviors (including underlying neurophysiology, eating disorders, environmental factors, and personal prioritization), motivational interviewing techniques, and technologies that may assist with pre-obesity/obesity management. Conclusions This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on "Behavior, Motivational Interviewing, Eating Disorders, and Obesity Management Technologies" is one of a series of OMA CPSs designed to assist clinicians in the care of patients with the disease of pre-obesity/obesity. Implementation of appropriate clinical practices in these areas may improve the health of patients, especially those with adverse fat mass and adiposopathic metabolic consequences.
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Affiliation(s)
- Michelle Freshwater
- Diplomate of American Board of Obesity Medicine, Idaho Weight Loss, 801 N Stilson Road, Boise, ID, 83703, USA
| | - Sandra Christensen
- Certificate of Advanced Education in Obesity Medicine, Integrative Medical Weight Management, 2611 NE 125th St, Suite 100B, Seattle, WA, 98125, USA
| | - Lauren Oshman
- Diplomate of American Board of Obesity Medicine, University of Michigan Medical School, 14700 E Old US Hwy 12, Chelsea, MI, 48118, USA
| | - Harold Edward Bays
- Diplomate of American Board of Obesity Medicine, Medical Director/President Louisville Metabolic and Atherosclerosis Research Center, Clinical Associate Professor/University of Louisville Medical School, 3288 Illinois Avenue, Louisville, KY, 40213, USA
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Castle-Kirszbaum M, Shi MDY, Goldschlager T. Quality of Life in Craniopharyngioma: A Systematic Review. World Neurosurg 2022; 164:424-435.e2. [PMID: 35580780 DOI: 10.1016/j.wneu.2022.05.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Craniopharyngiomas are morbid tumors that significantly reduce patients' quality of life (QoL). The lifelong burden of endocrine, visual, hypothalamic, and limbic dysfunction can have disastrous consequences for the physical and psychosocial health of patients. Elucidating the factors that influence QoL could guide therapeutic interventions to improve patient well-being. METHODS A systematic review was performed in accordance with the PRISMA (preferred reporting items for systematic reviews and meta-analyses) statement using the PubMed and Medline databases. Studies that had reported patient QoL using validated metrics in both adult and pediatric populations were included. Bias and methodological rigor were assessed using the MINORS (methodological index for nonrandomized studies) criteria. RESULTS A total of 25 studies, including 2025 patients, were available for review. Most studies were small, retrospective, cohort studies with a high risk of bias. The QoL of the patients with craniopharyngioma was lower than that of the general population. Hypothalamic involvement was consistently the strongest predictor of QoL. Endocrinopathy contributed to morbidity but could be ameliorated by hormone replacement therapy. Social and emotional dysregulation and a poor memory are common complaints after surgery, and iatrogenic damage to the infundibulum, hypothalamus, limbic system, and frontal lobes might underlie these concerns. Sleep-wake cycle dysfunction and hypothalamic obesity are serious consequences of hypothalamic damage. CONCLUSIONS An experienced multidisciplinary team is necessary to optimally manage the complex cases of these patients. The poor QoL of patients with craniopharyngioma is multifactorial. However, the contribution of iatrogenesis is not insubstantial. Improved surgical techniques, focusing on hypothalamic preservation, and adjuvant treatment options are required to improve the well-being of these patients.
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Affiliation(s)
- Mendel Castle-Kirszbaum
- Department of Neurosurgery, Monash Health, Melbourne, Victoria, Australia; Department of Surgery, Monash University, Melbourne, Victoria, Australia.
| | - Margaret D Y Shi
- Department of Surgery, Northern Hospital, Melbourne, Victoria, Australia
| | - Tony Goldschlager
- Department of Neurosurgery, Monash Health, Melbourne, Victoria, Australia; Department of Surgery, Monash University, Melbourne, Victoria, Australia
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Qiu Y, Deng Z, Jiang C, Wei K, Zhu L, Zhang J, Jiao C. The Associations of Meteorological and Environmental Factors with Memory Function of the Older Age in Urban Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095484. [PMID: 35564874 PMCID: PMC9105547 DOI: 10.3390/ijerph19095484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023]
Abstract
Individual, meteorological, and environmental factors are associated with cognitive function in older age. However, little is known about how meteorological and environmental factors interact with individual factors in affecting cognitive function in older adults. In the current study, we used mixed effects models to assess the association of individual, meteorological, and environmental factors with cognitive function among older adults in urban areas. Data from 2623 adults aged 60 to 91 years from 25 provinces (or autonomous regions/municipalities) from the China Family Panel Studies (CFPS) were used. We used the memory test in CFPS to measure memory function, while meteorological data from the daily climate data set of China’s surface international exchange stations, and the traffic and greening data compiled by the National Bureau of Statistics (NBS) of China, were used to assess meteorological and environmental factors. The ICC of the empty model indicated that 7.7% of the variation in memory test scores for the older adults was caused by provincial characteristics. Results showed that the temperature and relative humidity of provinces moderated the effect of gender on the memory function for the older urban adults. Specifically, in the high temperature areas, memory scores for females were higher than those of males, and in the middle humidity areas, memory scores were also higher for the females than those of males. This study explained how meteorological and environmental factors played roles in influencing demographic factors on memory function among older adults. Further research is needed to better define the role and potential mechanism of this moderation.
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Affiliation(s)
- Yuehong Qiu
- School of Psychology, Shenzhen University, Shenzhen 518060, China; (Y.Q.); (Z.D.); (K.W.); (L.Z.)
- Center for Mental Health, Shenzhen University, Shenzhen 518060, China
| | - Zeming Deng
- School of Psychology, Shenzhen University, Shenzhen 518060, China; (Y.Q.); (Z.D.); (K.W.); (L.Z.)
- Center for Mental Health, Shenzhen University, Shenzhen 518060, China
| | - Chujuan Jiang
- School of Music and Dance, Division of Arts, Shenzhen University, Shenzhen 518060, China;
| | - Kaigong Wei
- School of Psychology, Shenzhen University, Shenzhen 518060, China; (Y.Q.); (Z.D.); (K.W.); (L.Z.)
- Center for Mental Health, Shenzhen University, Shenzhen 518060, China
| | - Lijun Zhu
- School of Psychology, Shenzhen University, Shenzhen 518060, China; (Y.Q.); (Z.D.); (K.W.); (L.Z.)
- Center for Mental Health, Shenzhen University, Shenzhen 518060, China
| | - Jieting Zhang
- School of Psychology, Shenzhen University, Shenzhen 518060, China; (Y.Q.); (Z.D.); (K.W.); (L.Z.)
- Center for Mental Health, Shenzhen University, Shenzhen 518060, China
- Correspondence: (J.Z.); (C.J.)
| | - Can Jiao
- School of Psychology, Shenzhen University, Shenzhen 518060, China; (Y.Q.); (Z.D.); (K.W.); (L.Z.)
- Center for Mental Health, Shenzhen University, Shenzhen 518060, China
- Correspondence: (J.Z.); (C.J.)
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Wit M, Trujillo-Viera J, Strohmeyer A, Klingenspor M, Hankir M, Sumara G. When fat meets the gut-focus on intestinal lipid handling in metabolic health and disease. EMBO Mol Med 2022; 14:e14742. [PMID: 35437952 PMCID: PMC9081902 DOI: 10.15252/emmm.202114742] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 12/12/2022] Open
Abstract
The regular overconsumption of energy‐dense foods (rich in lipids and sugars) results in elevated intestinal nutrient absorption and consequently excessive accumulation of lipids in the liver, adipose tissue, skeletal muscles, and other organs. This can eventually lead to obesity and obesity‐associated diseases such as type 2 diabetes (T2D), non‐alcoholic fatty liver disease (NAFLD), cardiovascular disease, and certain types of cancer, as well as aggravate inflammatory bowel disease (IBD). Therefore, targeting the pathways that regulate intestinal nutrient absorption holds significant therapeutic potential. In this review, we discuss the molecular and cellular mechanisms controlling intestinal lipid handling, their relevance to the development of metabolic diseases, and emerging therapeutic strategies.
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Affiliation(s)
- Magdalena Wit
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warszawa, Poland
| | - Jonathan Trujillo-Viera
- Rudolf-Virchow-Zentrum, Center for Integrative and Translational Bioimaging, University of Würzburg, Würzburg, Germany
| | - Akim Strohmeyer
- Chair for Molecular Nutritional Medicine, Technical University of Munich, TUM School of Life Sciences Weihenstephan, Freising, Germany.,EKFZ - Else Kröner-Fresenius-Center for Nutritional Medicine, Technical University of Munich, Munich, Germany.,ZIEL - Institute for Food & Health, Technical University of Munich, Freising, Germany
| | - Martin Klingenspor
- Chair for Molecular Nutritional Medicine, Technical University of Munich, TUM School of Life Sciences Weihenstephan, Freising, Germany.,EKFZ - Else Kröner-Fresenius-Center for Nutritional Medicine, Technical University of Munich, Munich, Germany.,ZIEL - Institute for Food & Health, Technical University of Munich, Freising, Germany
| | - Mohammed Hankir
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Grzegorz Sumara
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warszawa, Poland
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Energy balance in hypothalamic obesity in response to treatment with a once-weekly GLP-1 receptor agonist. Int J Obes (Lond) 2022; 46:623-629. [PMID: 34975146 PMCID: PMC8881399 DOI: 10.1038/s41366-021-01043-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/15/2021] [Accepted: 11/25/2021] [Indexed: 11/14/2022]
Abstract
BACKGROUND/OBJECTIVES Hypothalamic obesity (HO) frequently occurs following suprasellar tumors from a combination of decreased energy expenditure and increased energy intake. Glucagon-like peptide-1 receptor agonist (GLP1RA) therapy is associated with increased satiety and energy expenditure. We hypothesized GLP1RA therapy in patients with HO would cause both lower energy intake and increased energy expenditure. SUBJECTS/METHODS Forty-two patients aged 10-26 years (median 16 years) with HO with suprasellar tumors were randomized to GLP1RA (exenatide extended release once-weekly, ExQW, n = 23) or placebo (n = 19). Thirty seven (81%) patients completed the 36-week double-blind placebo-controlled trial. Total energy expenditure (TEE) was measured with doubly labeled water, physical activity was assessed with actigraphy, and intake was estimated with ad libitum buffet meal. Results are presented as adjusted mean between-group difference. RESULTS As compared with treatment with placebo, treatment with ExQW was associated with decreased energy intake during a buffet meal (-1800 kJ (-430 kcal), 95% CI -3 184 to -418 kJ, p = 0.02). There were no significant differences in physical activity between groups. ExQW (vs. placebo) treatment was associated with a decrease in TEE (-695 kJ/day (-166 kcal/day), 95% CI -1 130 to -264 kJ/day, p < 0.01, adjusted for baseline TEE). The treatment effect was still significant after further adjustment for change in body composition (-372 kJ/day (-89 kcal/day), 95% CI -699 to -42 kJ/day, p = 0.04) or change in leptin (-695 kJ/day (-166 kcal/day), 95% CI -1 130 to -264 kJ/day, p < 0.01). This decrease in TEE occurred despite an increase in lean mass and fat mass (1.7 vs. 1.3 kg lean mass, p = 0.88 and 1.5 vs. 4.6 kg fat mass, p = 0.04, ExQW vs. placebo). CONCLUSIONS Treatment with a GLP1RA was associated with a decrease in food intake but also a decrease in TEE that was disproportionate to change in body composition.
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Asbjørnsen RA, Hjelmesæth J, Smedsrød ML, Wentzel J, Ollivier M, Clark MM, van Gemert-Pijnen JEWC, Solberg Nes L. Combining Persuasive System Design Principles and Behavior Change Techniques in Digital Interventions Supporting Long-term Weight Loss Maintenance: Design and Development of eCHANGE (Preprint). JMIR Hum Factors 2022; 9:e37372. [PMID: 35622394 PMCID: PMC9187967 DOI: 10.2196/37372] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/29/2022] [Accepted: 04/22/2022] [Indexed: 02/06/2023] Open
Abstract
Background Long-term weight maintenance after weight loss is challenging, and innovative solutions are required. Digital technologies can support behavior change and, therefore, have the potential to be an effective tool for weight loss maintenance. However, to create meaningful and effective digital behavior change interventions that support end user values and needs, a combination of persuasive system design (PSD) principles and behavior change techniques (BCTs) might be needed. Objective This study aimed to investigate how an evidence-informed digital behavior change intervention can be designed and developed by combining PSD principles and BCTs into design features to support end user values and needs for long-term weight loss maintenance. Methods This study presents a concept for how PSD principles and BCTs can be translated into design features by combining design thinking and Agile methods to develop and deliver an evidence-informed digital behavior change intervention aimed at supporting weight maintenance. Overall, 45 stakeholders participated in the systematic and iterative development process comprising co-design workshops, prototyping, Agile development, and usability testing. This included prospective end users (n=17, 38%; ie, people with obesity who had lost ≥8% of their weight), health care providers (n=9, 20%), healthy volunteers (n=4, 9%), a service designer (n=1, 2%), and stakeholders from the multidisciplinary research and development team (n=14, 31%; ie, software developers; digital designers; and eHealth, behavior change, and obesity experts). Stakeholder input on how to operationalize the design features and optimize the technology was examined through formative evaluation and qualitative analyses using rapid and in-depth analysis approaches. Results A total of 17 design features combining PSD principles and BCTs were identified as important to support end user values and needs based on stakeholder input during the design and development of eCHANGE, a digital intervention to support long-term weight loss maintenance. The design features were combined into 4 main intervention components: Week Plan, My Overview, Knowledge and Skills, and Virtual Coach and Smart Feedback System. To support a healthy lifestyle and continued behavior change to maintain weight, PSD principles such as tailoring, personalization, self-monitoring, reminders, rewards, rehearsal, praise, and suggestions were combined and implemented into the design features together with BCTs from the clusters of goals and planning, feedback and monitoring, social support, repetition and substitution, shaping knowledge, natural consequences, associations, antecedents, identity, and self-belief. Conclusions Combining and implementing PSD principles and BCTs in digital interventions aimed at supporting sustainable behavior change may contribute to the design of engaging and motivating interventions in line with end user values and needs. As such, the design and development of the eCHANGE intervention can provide valuable input for future design and tailoring of evidence-informed digital interventions, even beyond digital interventions in support of health behavior change and long-term weight loss maintenance. Trial Registration ClinicalTrials.gov NCT04537988; https://clinicaltrials.gov/ct2/show/NCT04537988
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Affiliation(s)
- Rikke Aune Asbjørnsen
- Center for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
- Research and Innovation Department, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Jøran Hjelmesæth
- Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Jobke Wentzel
- Center for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
- Research Group IT Innovations in Health Care, Windesheim University of Applied Sciences, Zwolle, Netherlands
| | - Marianne Ollivier
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Matthew M Clark
- Department of Psychiatry & Psychology, College of Medicine & Science, Mayo Clinic, Rochester, MN, United States
| | - Julia E W C van Gemert-Pijnen
- Center for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
- University of Waterloo, Waterloo, ON, Canada
| | - Lise Solberg Nes
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Department of Psychiatry & Psychology, College of Medicine & Science, Mayo Clinic, Rochester, MN, United States
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Martins C, Gower BA, Hunter GR. Metabolic adaptation delays time to reach weight loss goals. Obesity (Silver Spring) 2022; 30:400-406. [PMID: 35088553 PMCID: PMC8852805 DOI: 10.1002/oby.23333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/29/2021] [Accepted: 10/14/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of this study was to determine whether metabolic adaptation, at the level of resting metabolic rate, was associated with time to reach weight loss goals, after adjusting for confounders. METHODS A total of 65 premenopausal women with overweight (BMI: 28.6 ± 1.5 kg/m2 ; age: 36.4 ± 5.9 years; 36 were White, and 29 were Black) followed an 800-kcal/d diet until BMI ≤25 kg/m2 . Body weight and composition were measured at baseline and after weight loss. Dietary adherence was calculated from total energy expenditure, determined by double labeled water, and body composition changes. Metabolic adaptation was defined as a significantly lower measured versus predicted resting metabolic rate (from own regression model). A regression model to predict time to reach weight loss goals was developed including target weight loss, energy deficit, dietary adherence, and metabolic adaptation as predictors. RESULTS Participants lost on average 12.5 ± 3.1 kg (16.1% ± 3.4%) over 155.1 ± 49.2 days. Average dietary adherence was 63.6% ± 31.0%. There was significant metabolic adaptation after weight loss (-46 ± 113 kcal/d, p = 0.002) and this variable was a significant predictor of time to reach weight loss goals (β = -0.1, p = 0.041), even after adjusting for confounders (R2 adjusted = 0.63, p < 0.001). CONCLUSION In premenopausal women with overweight, metabolic adaptation after a 16% weight loss increases the length of time necessary to achieve weight loss goals.
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Affiliation(s)
- Catia Martins
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Centre for Obesity and Innovation (ObeCe), Clinic of Surgery, St. Olav University Hospital, Trondheim, Norway
- Department of Nutrition Sciences, University of Alabama at Birmingham, USA
| | - Barbara A Gower
- Department of Nutrition Sciences, University of Alabama at Birmingham, USA
| | - Gary R Hunter
- Department of Nutrition Sciences, University of Alabama at Birmingham, USA
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Influence of fat-free mass and resting metabolic rate on increased food reinforcement after exercise training. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-021-00876-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Purpose
Models of appetite control have been largely based on negative feedback from gut and adipose signaling to central appetite centers. However, contemporary models posit that fat-free mass (FFM) or the energy demand of FFM [i.e., resting metabolic rate (RMR)] may play a primary role in the motivational drive for food intake (i.e., food reinforcement). The relative reinforcing value of food (RRVfood) is associated with energy intake (EI) and increases with an acute energy deficit. Chronic exercise-induced energy deficits lead to alterations in fat mass (FM), FFM, and RMR and provide an opportunity to test whether change in (∆) FM, ∆FFM, ∆usual EI, or ∆RMR are associated with ∆RRVfood.
Methods
Participants (n = 29, BMI = 25–35 kg/m2) engaged in aerobic exercise expending 300 or 600 kcal, 5 days/weeks for 12 weeks. The reinforcing value of food (PMaxfood) was measured via a computer-based operant responding task and RRVfood was calculated as the reinforcing value of food relative to non-eating sedentary behaviors. RMR was determined by indirect calorimetry and body composition by DXA.
Results
Post-training FFM correlated with usual post-training EI (rs = 0.41, p < 0.05), PMaxfood (rs=0.52, p < 0.01), and RMR (rs = 0.85, p < 0.0001). ∆RMR negatively correlated with ∆PMaxfood (rs = − 0.38, p < 0.05) and with ∆RRVfood (rs = − 0.37, p < 0.05). ∆PMaxfood and ∆RRVfood were not associated with ∆FFM (p = 0.71, p = 0.57, respectively).
Conclusions
Reductions in RMR with weight loss may increase food reinforcement as means of restoring FFM and RMR to pre-weight loss amounts. Limiting reductions in RMR during weight loss may benefit weight maintenance by restricting increases in food reinforcement after weight loss.
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Perez LC, Perez LT, Nene Y, Umpierrez GE, Davis GM, Pasquel FJ. Interventions associated with brown adipose tissue activation and the impact on energy expenditure and weight loss: A systematic review. Front Endocrinol (Lausanne) 2022; 13:1037458. [PMID: 36568070 PMCID: PMC9780295 DOI: 10.3389/fendo.2022.1037458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/09/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Brown adipose tissue (BAT) plays a role in modulating energy expenditure. People with obesity have been shown to have reduced activation of BAT. Agents such as β-agonists, capsinoids, thyroid hormone, sildenafil, caffeine, or cold exposure may lead to activation of BAT in humans, potentially modulating metabolism to promote weight loss. METHODS We systematically searched electronic databases for clinical trials testing the effect of these agents and cold exposure on energy expenditure/thermogenesis and the extent to which they may impact weight loss in adults. RESULTS A total of 695 studies from PubMed, Web of Science, and Medline electronic databases were identified. After the removal of duplicates and further evaluation, 47 clinical trials were analyzed. We observed significant heterogeneity in the duration of interventions and the metrics utilized to estimate thermogenesis/energy expenditure. Changes observed in energy expenditure do not correlate with major weight changes with different interventions commonly known to stimulate thermogenesis. Even though cold exposure appears to consistently activate BAT and induce thermogenesis, studies are small, and it appears to be an unlikely sustainable therapy to combat obesity. Most studies were small and potential risks associated with known side effects of some agents such as β-agonists (tachycardia), sibutramine (hypertension, tachycardia), thyroid hormone (arrhythmias) cannot be fully evaluated from these small trials. CONCLUSION Though the impact of BAT activation and associated increases in energy expenditure on clinically meaningful weight loss is a topic of great interest, further data is needed to determine long-term feasibility and efficacy.
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Affiliation(s)
- Luis C. Perez
- Ponce Health Sciences University School of Medicine, Ponce, PR, United States
| | - Laura T. Perez
- Ponce Health Sciences University School of Medicine, Ponce, PR, United States
| | - Yash Nene
- Neurology Residency Program, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Guillermo E. Umpierrez
- Department of Endocrinology, Emory University School of Medicine, Atlanta, GA, United States
| | - Georgia M. Davis
- Department of Endocrinology, Emory University School of Medicine, Atlanta, GA, United States
| | - Francisco J. Pasquel
- Department of Endocrinology, Emory University School of Medicine, Atlanta, GA, United States
- *Correspondence: Francisco J. Pasquel,
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Branched Chain Amino Acid Supplementation to a Hypocaloric Diet Does Not Affect Resting Metabolic Rate but Increases Postprandial Fat Oxidation Response in Overweight and Obese Adults after Weight Loss Intervention. Nutrients 2021; 13:nu13124245. [PMID: 34959797 PMCID: PMC8708242 DOI: 10.3390/nu13124245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Branched chain amino acids (BCAA) supplementation is reported to aid in lean mass preservation, which may in turn minimize the reduction in resting metabolic rate (RMR) during weight loss. Our study aimed to examine the effect of BCAA supplementation to a hypocaloric diet on RMR and substrate utilization during a weight loss intervention. Methods: A total of 111 Chinese subjects comprising 55 males and 56 females aged 21 to 45 years old with BMI between 25 and 36 kg/m2 were randomized into three hypocaloric diet groups: (1) standard-protein (14%) with placebo (CT), (2) standard-protein with BCAA, and (3) high-protein (27%) with placebo. Indirect calorimetry was used to measure RMR, carbohydrate, and fat oxidation before and after 16 weeks of dietary intervention. Results: RMR was reduced from 1600 ± 270 kcal/day to 1500 ± 264 kcal/day (p < 0.0005) after weight loss, but no significant differences in the change of RMR, respiratory quotient, and percentage of fat and carbohydrate oxidation were observed among the three diet groups. Subjects with BCAA supplementation had an increased postprandial fat (p = 0.021) and decreased postprandial carbohydrate (p = 0.044) oxidation responses compared to the CT group after dietary intervention. Conclusions: BCAA-supplemented standard-protein diet did not significantly attenuate reduction of RMR compared to standard-protein and high-protein diets. However, the postprandial fat oxidation response increased after BCAA-supplemented weight loss intervention.
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Abstract
The observation that 64% of English adults are overweight or obese despite a rising prevalence in weight-loss attempts suggests our understanding of energy balance is fundamentally flawed. Weight-loss is induced through a negative energy balance; however, we typically view weight change as a static function, in that energy intake and energy expenditure are independent variables, resulting in a fixed rate of weight-loss assuming a constant energy deficit. Such static modelling provides the basis for the clinical assumption that a 14644 kJ (3500 kcal) deficit translates to a 1 lb weight-loss. However, this '3500 kcal (14644 kJ) rule' is consistently shown to significantly overestimate weight-loss. Static modelling disregards obligatory changes in energy expenditure associated with the loss of metabolically active tissue, i.e. skeletal muscle. Additionally, it disregards the presence of adaptive thermogenesis, the underfeeding-associated fall in resting energy expenditure beyond that caused by loss of fat-free mass. This metabolic manipulation of energy expenditure is observed from the onset of energy restriction to maintain weight at a genetically pre-determined set point. As a result, the observed magnitude of weight-loss is disproportionally less, followed by earlier weight plateau, despite strict compliance to a dietary intervention. By simulating dynamic changes in energy expenditure associated with underfeeding, mathematical modelling may provide a more accurate method of weight-loss prediction. However, accuracy at an individual level is limited due to difficulty estimating energy requirements, physical activity and dietary intake in free-living individuals. In the present paper, we aim to outline the contribution of dynamic changes in energy expenditure to weight-loss resistance and weight plateau.
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Rinott E, Youngster I, Meir AY, Tsaban G, Kaplan A, Zelicha H, Rubin E, Koren O, Shai I. Autologous fecal microbiota transplantation can retain the metabolic achievements of dietary interventions. Eur J Intern Med 2021; 92:17-23. [PMID: 33883079 DOI: 10.1016/j.ejim.2021.03.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND We recently reported that autologous fecal microbiota transplantation (aFMT), derived from the time of maximal weight-loss and administrated in the regain-phase, might preserve weight loss and glycemic control in moderately obese subjects, and is associated with specific microbiome signatures. Here, we sought to explore the global effect of aFMT on adipokines, inflammatory markers and blood cholesterol and on the overall gut microbiome preservation. METHODS In the DIRECT-PLUS weight-loss trial, abdominally obese participants were randomized to three distinct weight-loss diets. Following the expected weight loss phase (0-6 m), 90 participants were randomized to receive their personal frozen fecal microbiota or placebo oral capsules (ten 1 g-capsules over ten sessions-total=100 g) during the expected weight regain phase (8-14 m). RESULTS Of the 90 participants (age=52 yr; 0-6 m weight loss=-8.3 kg), 95.6% ingested at least 80/100 oral aFMT/placebo capsules over 6 months. Overall, the gut microbiome community structure was associated with plasma levels of leptin, cholesterol and interleukin-6 at baseline and after 6 m, whereas 6 m (weight loss phase) changes in specific microbiome species associated with the dynamic of leptin and inflammatory biomarkers. Following the 8-14 m aFMT administration phase, aFMT maintained decreased levels of leptin (ΔaFMT=-3.54 ng/mL vs. Δplacebo=-0.82 ng/mL;P = 0.04), C-reactive-protein (ΔaFMT=-1.45 mg/L vs. Δplacebo=-0.66 mg/L;P = 0.009), Interleukin-6 (ΔaFMT=-0.03pg/mL vs. Δplacebo=1.11pg/mL;P = 0.03) and total cholesterol (ΔaFMT=2.2 mg/dl vs. Δplacebo=13.1 mg/dl;P = 0.04) achieved in the weight loss phase. Overall, aFMT induced a significant preservatory effect on personal gut microbiome global composition (P = 0.03;Jensen-Shannon distance), as compared to placebo. CONCLUSIONS aFMT treatment in the regain phase might retain weight-loss induced metabolic benefits. These findings may suggest a novel aFMT treatment approach for personal metabolic attainment preservation.
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Affiliation(s)
- Ehud Rinott
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ilan Youngster
- Pediatric Division and Center for Microbiome Research, Shamir Medical Center, Be'er Ya'akov, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Anat Yaskolka Meir
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gal Tsaban
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Alon Kaplan
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hila Zelicha
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Elad Rubin
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Omry Koren
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Iris Shai
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Dahle JH, Ostendorf DM, Pan Z, MacLean PS, Bessesen DH, Heymsfield SB, Melanson EL, Catenacci VA. Weight and body composition changes affect resting energy expenditure predictive equations during a 12-month weight-loss intervention. Obesity (Silver Spring) 2021; 29:1596-1605. [PMID: 34431624 DOI: 10.1002/oby.23234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Mathematical equations that predict resting energy expenditure (REE) are widely used to derive calorie prescriptions during weight-loss interventions. Although such equations are known to introduce group- and individual-level error into REE prediction, their validity has largely been assessed in weight-stable populations. Therefore, this study sought to characterize how weight change affects the validity of commonly used REE predictive models throughout a 12-month weight-loss intervention. METHODS Changes in predictive error of four models (Mifflin-St-Jeor, Harris-Benedict, Owen, and World Health Organization/Food and Agriculture) were assessed at 1-, 6-, and 12-month time points in adults (n = 66, 76% female, aged 18-55 years, BMI = 27-45 kg/m2 ) enrolled in a randomized clinical weight-loss trial. RESULTS All equations experienced significant negative shifts in bias (measured - predicted REE) toward overprediction from baseline to 1 month (p < 0.05). Three equations showed reversal of bias in the positive direction (toward underprediction) from baseline to 12 months (p < 0.05). Early changes in bias were correlated with decreased fat-free mass (p ≤ 0.01). CONCLUSIONS Changes in body composition and mass during a 12-month weight-loss intervention significantly affected REE predictive error in adults with overweight and obesity. Weight history should be considered when using mathematical models to predict REE during periods of weight fluctuation.
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Affiliation(s)
- Jared H Dahle
- Integrated Physiology Program, Graduate School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Danielle M Ostendorf
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Zhaoxing Pan
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Paul S MacLean
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Daniel H Bessesen
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Edward L Melanson
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Victoria A Catenacci
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Broskey NT, Martin CK, Burton JH, Church TS, Ravussin E, Redman LM. Effect of Aerobic Exercise-induced Weight Loss on the Components of Daily Energy Expenditure. Med Sci Sports Exerc 2021; 53:2164-2172. [PMID: 34519717 PMCID: PMC8441008 DOI: 10.1249/mss.0000000000002689] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Exercise usually results in less weight loss than expected. This suggests increased energy intake and/or deceased expenditure counteract the energy deficit induced by exercise. The aim of this study was to evaluate changes in components of daily energy expenditure (doubly labeled water and room calorimetry) after 24 wk of exercise training with two doses of aerobic exercise. METHODS This was an ancillary study in 42 (29 women, 13 men) sedentary, middle-age (47.8 ± 12.5 yr) individuals with obesity (35 ± 3.7 kg·m-2) enrolled in the Examination of Mechanisms of Exercise-induced Weight Compensation study. Subjects were randomized to three groups: healthy living control group (n = 13), aerobic exercise that expended 8 kcal·kg-1 of body weight per week (8 KKW, n = 14), or aerobic exercise that expended 20 kcal per kilogram of weight per week (20 KKW, n = 15). Total daily energy expenditure (TDEE) was measured in free-living condition by doubly labeled water and in sedentary conditions in a metabolic chamber over 24 h (24EE). Energy intake was calculated over 14 d from TDEE before and after the intervention using the intake-balance method. RESULTS Significant weight loss occurred with 20 KKW (-2.1 ± 0.7 kg, P = 0.04) but was only half of expected. In the 20 KKW group free-living TDEE increased by ~4% (P = 0.03), which is attributed to the increased exercise energy expenditure (P = 0.001), while 24EE in the chamber decreased by ~4% (P = 0.04). Aerobic exercise at 8 KKW did not induce weight change, and there was no significant change in any component of EE. There was no significant change in energy intake for any group (P = 0.53). CONCLUSIONS Structured aerobic exercise at a dose of 20 KKW produced less weight loss than expected possibly due to behavioral adaptations leading to reduced 24EE in a metabolic chamber without any change in energy intake.
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Malatesta D, Favre J, Ulrich B, Hans D, Suter M, Favre L, Fernández Menéndez A. Effect of very large body mass loss on energetics, mechanics and efficiency of walking in adults with obesity: mass-driven versus behavioural adaptations. J Physiol 2021; 600:979-996. [PMID: 34505286 PMCID: PMC9293213 DOI: 10.1113/jp281710] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/26/2021] [Indexed: 11/18/2022] Open
Abstract
Abstract Understanding the mechanisms involved in the higher energy cost of walking (NCw: the energy expenditure above resting per unit distance) in adults with obesity is pivotal to optimizing the use of walking in weight management programmes. Therefore, this study aimed to investigate the mechanics, energetics and mechanical efficiency of walking after a large body mass loss induced by bariatric surgery in individuals with obesity. Nine adults (39.5 ± 8.6 year; BMI: 42.7 ± 4.6 kg m–2) walked at five fixed speeds before (baseline) and after the bariatric surgery (post 1 and post 2). Gas exchanges were measured to obtain NCw. A motion analysis system and instrumented treadmill were combined to assess total mechanical work (Wtot). Mechanical efficiency (Wtot NCw–1) was also calculated. Participants lost 25.7 ± 3.4% of their body mass at post 1 (6.6 months; P < 0.001) and 6.1 ± 4.9% more at post 2 (12 months; P = 0.014). Mass‐normalized NCw was similar between baseline and post 1 and decreased at post 2 compared to that at baseline (−6.2 ± 2.7%) and post 1 (−8.1 ± 1.9%; P ≤ 0.007). No difference was found in mass‐normalized Wtot during follow‐up (P = 0.36). Mechanical efficiency was similar at post 1 and post 2 when compared to that at baseline (P ≥ 0.19), but it was higher (+14.1 ± 4.6%) at post 2 than at post 1 (P = 0.013). These findings showed that after a very large body mass loss, individuals with obesity may reorganize their walking pattern into a gait more similar to that of lean adults, thus decreasing their NCw by making their muscles work more efficiently.
![]() Key points A higher net (above resting) energy cost of walking (lower gait economy) is observed in adults with obesity compared to lean individuals. Understanding the mechanisms (i.e. mass driven, gait pattern and behavioural changes) involved in this extra cost of walking in adults with obesity is pivotal to optimizing the use of walking to promote daily physical activity and improve health in these individuals. We found that very large weight loss induced by bariatric surgery significantly decreased the energy cost of walking per kg of body mass after 1 year with similar total mechanical work per kg of body mass, resulting in an increased mechanical efficiency of walking. Individuals with obesity may reorganize their walking pattern into a gait more similar to that of adults of normal body mass, thus decreasing their energy cost of walking by making their muscles work more efficiently.
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Affiliation(s)
- Davide Malatesta
- Institute of Sport Sciences of the University of Lausanne (ISSUL), University of Lausanne, Lausanne, Switzerland
| | - Julien Favre
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Baptiste Ulrich
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
| | - Didier Hans
- Center for Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - Michel Suter
- CHUV, Service de chirurgie viscérale, Bâtiment hospitalier du CHUV, Lausanne, Switzerland
| | - Lucie Favre
- Consultation de prévention et traitement de l'obésité, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Aitor Fernández Menéndez
- Institute of Sport Sciences of the University of Lausanne (ISSUL), University of Lausanne, Lausanne, Switzerland
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Löffler MC, Betz MJ, Blondin DP, Augustin R, Sharma AK, Tseng YH, Scheele C, Zimdahl H, Mark M, Hennige AM, Wolfrum C, Langhans W, Hamilton BS, Neubauer H. Challenges in tackling energy expenditure as obesity therapy: From preclinical models to clinical application. Mol Metab 2021; 51:101237. [PMID: 33878401 PMCID: PMC8122111 DOI: 10.1016/j.molmet.2021.101237] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/31/2021] [Accepted: 04/13/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND A chronic imbalance of energy intake and energy expenditure results in excess fat storage. The obesity often caused by this overweight is detrimental to the health of millions of people. Understanding both sides of the energy balance equation and their counter-regulatory mechanisms is critical to the development of effective therapies to treat this epidemic. SCOPE OF REVIEW Behaviors surrounding ingestion have been reviewed extensively. This review focuses more specifically on energy expenditure regarding bodyweight control, with a particular emphasis on the organs and attractive metabolic processes known to reduce bodyweight. Moreover, previous and current attempts at anti-obesity strategies focusing on energy expenditure are highlighted. Precise measurements of energy expenditure, which consist of cellular, animal, and human models, as well as measurements of their translatability, are required to provide the most effective therapies. MAJOR CONCLUSIONS A precise understanding of the components surrounding energy expenditure, including tailored approaches based on genetic, biomarker, or physical characteristics, must be integrated into future anti-obesity treatments. Further comprehensive investigations are required to define suitable treatments, especially because the complex nature of the human perspective remains poorly understood.
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Affiliation(s)
- Mona C Löffler
- Cardio Metabolic Diseases Research, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach, Germany
| | - Matthias J Betz
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland
| | - Denis P Blondin
- Department of Medicine, Division of Neurology, Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, QC, Canada
| | - Robert Augustin
- Cardio Metabolic Diseases Research, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach, Germany
| | - Anand K Sharma
- Institute of Food, Nutrition and Health, ETH Zürich, Schwerzenbach, Switzerland
| | - Yu-Hua Tseng
- Joslin Diabetes Center, Section on Integrative Physiology and Metabolism, Harvard Medical School, Boston, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Camilla Scheele
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Denmark
| | - Heike Zimdahl
- Cardio Metabolic Diseases Research, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach, Germany
| | - Michael Mark
- Cardio Metabolic Diseases Research, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach, Germany
| | - Anita M Hennige
- Therapeutic Area CardioMetabolism & Respiratory, Boehringer Ingelheim International GmbH, Biberach, Germany
| | - Christian Wolfrum
- Institute of Food, Nutrition and Health, ETH Zürich, Schwerzenbach, Switzerland
| | - Wolfgang Langhans
- Physiology and Behavior Laboratory, Department of Health Sciences and Technology, ETH Zürich, Switzerland
| | - Bradford S Hamilton
- Cardio Metabolic Diseases Research, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach, Germany
| | - Heike Neubauer
- Cardio Metabolic Diseases Research, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach, Germany.
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Serdan TDA, Masi LN, Pereira JNB, Rodrigues LE, Alecrim AL, Scervino MVM, Diniz VLS, Dos Santos AAC, Filho CPBS, Alba-Loureiro TC, Marzuca-Nassr GN, Bazotte RB, Gorjão R, Pithon-Curi TC, Curi R, Hirabara SM. Impaired brown adipose tissue is differentially modulated in insulin-resistant obese wistar and type 2 diabetic Goto-Kakizaki rats. Biomed Pharmacother 2021; 142:112019. [PMID: 34403962 DOI: 10.1016/j.biopha.2021.112019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/29/2021] [Accepted: 08/07/2021] [Indexed: 12/13/2022] Open
Abstract
Brown adipose tissue (BAT) is a potential target to treat obesity and diabetes, dissipating energy as heat. Type 2 diabetes (T2D) has been associated with obesogenic diets; however, T2D was also reported in lean individuals to be associated with genetic factors. We aimed to investigate the differences between obese and lean models of insulin resistance (IR) and elucidate the mechanism associated with BAT metabolism and dysfunction in different IR animal models: a genetic model (lean GK rats) and obese models (diet-induced obese Wistar rats) at 8 weeks of age fed a high-carbohydrate (HC), high-fat (HF) diet, or high-fat and high-sugar (HFHS) diet for 8 weeks. At 15 weeks of age, BAT glucose uptake was evaluated by 18F-FDG PET under basal (saline administration) or stimulated condition (CL316,243, a selective β3-AR agonist). After CL316, 243 administrations, GK animals showed decreased glucose uptake compared to HC animals. At 16 weeks of age, the animals were euthanized, and the interscapular BAT was dissected for analysis. Histological analyses showed lower cell density in GK rats and higher adipocyte area compared to all groups, followed by HFHS and HF compared to HC. HFHS showed a decreased batokine FGF21 protein level compared to all groups. However, GK animals showed increased expression of genes involved in fatty acid oxidation (CPT1 and CPT2), BAT metabolism (Sirt1 and Pgc1-α), and obesogenic genes (leptin and PAI-1) but decreased gene expression of glucose transporter 1 (GLUT-1) compared to other groups. Our data suggest impaired BAT function in obese Wistar and GK rats, with evidence of a whitening process in these animals.
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Affiliation(s)
| | - Laureane Nunes Masi
- Interdisciplinary Postgraduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | | | - Luiz Eduardo Rodrigues
- Interdisciplinary Postgraduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Amanda Lins Alecrim
- Interdisciplinary Postgraduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | | | | | | | | | | | | | | | - Renata Gorjão
- Interdisciplinary Postgraduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Tania Cristina Pithon-Curi
- Interdisciplinary Postgraduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Rui Curi
- Interdisciplinary Postgraduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Sandro Massao Hirabara
- Interdisciplinary Postgraduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo, Brazil
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Obesity-induced taste dysfunction, and its implications for dietary intake. Int J Obes (Lond) 2021; 45:1644-1655. [PMID: 34031530 DOI: 10.1038/s41366-021-00855-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 04/21/2021] [Accepted: 04/30/2021] [Indexed: 02/06/2023]
Abstract
The incidence of obesity has dramatically increased in recent years, and poses a public health challenge for which an effective and scalable intervention strategy is yet to be found. Our food choices are one of the primary drivers of obesity, where the overconsumption of energy from foods high in fat and sugar can be particularly problematic. Unfortunately, these same foods also tend to be highly palatable. We select foods more on their sensory properties than on any other factor, such as price, convenience, or healthfulness. Previous evidence from human sensory studies has suggested a depressed sense of taste in panelists with obesity. Evidence from animal models also demonstrates a clear deficiency in taste buds occurring with obesity, suggesting that damage to the taste system may result from an obese state. In this review only taste, as opposed to smell, will be examined. Here we seek to bring together evidence from a diverse array of human and animal studies into taste response, dietary intake, and physiology, to better understand changes in taste with obesity, with the goal of understanding whether taste may provide a novel target for intervention in the treatment of obesity.
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Whytock KL, Corbin KD, Parsons SA, Pachori A, Bock CP, Jones KP, Smith JS, Yi F, Xie H, Petucci CJ, Gardell SJ, Smith SR. Metabolic adaptation characterizes short-term resistance to weight loss induced by a low-calorie diet in overweight/obese individuals. Am J Clin Nutr 2021; 114:267-280. [PMID: 33826697 DOI: 10.1093/ajcn/nqab027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 01/28/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Low-calorie diet (LCD)-induced weight loss demonstrates response heterogeneity. Physiologically, a decrease in energy expenditure lower than what is predicted based on body composition (metabolic adaptation) and/or an impaired capacity to increase fat oxidation may hinder weight loss. Understanding the metabolic components that characterize weight loss success is important for optimizing weight loss strategies. OBJECTIVES We tested the hypothesis that overweight/obese individuals who had lower than expected weight loss in response to a 28-d LCD would be characterized by 1) impaired fat oxidation and 2) whole-body metabolic adaptation. We also characterized the molecular mechanisms associated with weight loss success/failure. METHODS This was a retrospective comparison of participants who met their predicted weight loss targets [overweight/obese diet sensitive (ODS), n = 23, females = 21, males = 2] and those that did not [overweight/obese diet resistant (ODR), n = 14, females = 12, males = 2] after a 28-d LCD (900-1000 kcal/d). We used whole-body (energy expenditure and fat oxidation) and tissue-specific measurements (metabolic proteins in skeletal muscle, gene expression in adipose tissue, and metabolites in serum) to detect metabolic properties and biomarkers associated with weight loss success. RESULTS The ODR group had greater mean ± SD metabolic adaptation (-175 ± 149 kcal/d; +119%) than the ODS group (-80 ± 108 kcal/d) after the LCD (P = 0.030). Mean ± SD fat oxidation increased similarly for both groups from baseline (0.0701 ± 0.0206 g/min) to day 28 (0.0869 ± 0.0269 g/min; P < 0.001). A principal component analysis factor comprised of serum 3-hydroxybutyric acid, citrate, leucine/isoleucine, acetyl-carnitine, and 3-hydroxylbutyrlcarnitine was associated with weight loss success at day 28 (std. β = 0.674, R2 = 0.479, P < 0.001). CONCLUSIONS Individuals who achieved predicted weight loss targets after a 28-d LCD were characterized by reduced metabolic adaptation. Accumulation of metabolites associated with acetyl-CoA excess and enhanced ketogenesis was identified in the ODS group.This trial was registered at clinicaltrials.gov as NCT01616082.
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Affiliation(s)
- Katie L Whytock
- Translational Research Institute, AdventHealth, Orlando, FL, USA
| | - Karen D Corbin
- Translational Research Institute, AdventHealth, Orlando, FL, USA
| | | | - Alok Pachori
- Translational Research Institute, AdventHealth, Orlando, FL, USA
| | | | - Karen P Jones
- Translational Research Institute, AdventHealth, Orlando, FL, USA
| | - Joshua S Smith
- Translational Research Institute, AdventHealth, Orlando, FL, USA
| | - Fanchao Yi
- Translational Research Institute, AdventHealth, Orlando, FL, USA
| | - Hui Xie
- Translational Research Institute, AdventHealth, Orlando, FL, USA
| | - Christopher J Petucci
- Translational Research Institute, AdventHealth, Orlando, FL, USA.,Cardiovascular Institute and Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Steven R Smith
- Translational Research Institute, AdventHealth, Orlando, FL, USA
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Arianti R, Vinnai BÁ, Tóth BB, Shaw A, Csősz É, Vámos A, Győry F, Fischer-Posovszky P, Wabitsch M, Kristóf E, Fésüs L. ASC-1 transporter-dependent amino acid uptake is required for the efficient thermogenic response of human adipocytes to adrenergic stimulation. FEBS Lett 2021; 595:2085-2098. [PMID: 34197627 DOI: 10.1002/1873-3468.14155] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/16/2021] [Accepted: 06/28/2021] [Indexed: 11/09/2022]
Abstract
Brown and beige adipocytes dissipate energy by uncoupling protein 1 (UCP1)-dependent and UCP1-independent thermogenesis, which may be utilized to develop treatments against obesity. We have found that mRNA and protein expression of the alanine/serine/cysteine transporter-1 (ASC-1) was induced during adipocyte differentiation of human brown-prone deep neck and beige-competent subcutaneous neck progenitors, and SGBS preadipocytes. cAMP stimulation of differentiated adipocytes led to elevated uptake of serine, cysteine, and glycine, in parallel with increased oxygen consumption, augmented UCP1-dependent proton leak, increased creatine-driven substrate cycle-coupled respiration, and upregulation of thermogenesis marker genes and several respiratory complex subunits; these outcomes were impeded in the presence of the specific ASC-1 inhibitor, BMS-466442. Our data suggest that ASC-1-dependent consumption of serine, cysteine, and glycine is required for efficient thermogenic stimulation of human adipocytes.
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Affiliation(s)
- Rini Arianti
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Hungary.,Doctoral School of Molecular Cell and Immune Biology, University of Debrecen, Hungary
| | - Boglárka Ágnes Vinnai
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Hungary
| | - Beáta B Tóth
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Hungary
| | - Abhirup Shaw
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Hungary.,Doctoral School of Molecular Cell and Immune Biology, University of Debrecen, Hungary
| | - Éva Csősz
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Hungary
| | - Attila Vámos
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Hungary.,Doctoral School of Molecular Cell and Immune Biology, University of Debrecen, Hungary
| | - Ferenc Győry
- Department of Surgery, Faculty of Medicine, University of Debrecen, Hungary
| | | | - Martin Wabitsch
- Division of Pediatric Endocrinology and Diabetes, University Medical Center Ulm, Germany
| | - Endre Kristóf
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Hungary
| | - László Fésüs
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Hungary
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45
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Turner RT, Wong CP, Fosse KM, Branscum AJ, Iwaniec UT. Caloric Restriction and Hypothalamic Leptin Gene Therapy Have Differential Effects on Energy Partitioning in Adult Female Rats. Int J Mol Sci 2021; 22:ijms22136789. [PMID: 34202651 PMCID: PMC8269114 DOI: 10.3390/ijms22136789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 06/04/2021] [Accepted: 06/18/2021] [Indexed: 12/14/2022] Open
Abstract
Dieting is a common but often ineffective long-term strategy for preventing weight gain. Similar to humans, adult rats exhibit progressive weight gain. The adipokine leptin regulates appetite and energy expenditure but hyperleptinemia is associated with leptin resistance. Here, we compared the effects of increasing leptin levels in the hypothalamus using gene therapy with conventional caloric restriction on weight gain, food consumption, serum leptin and adiponectin levels, white adipose tissue, marrow adipose tissue, and bone in nine-month-old female Sprague-Dawley rats. Rats (n = 16) were implanted with a cannula in the 3rd ventricle of the hypothalamus and injected with a recombinant adeno-associated virus, encoding the rat gene for leptin (rAAV-Lep), and maintained on standard rat chow for 18 weeks. A second group (n = 15) was calorically-restricted to match the weight of the rAAV-Lep group. Both approaches prevented weight gain, and no differences in bone were detected. However, calorically-restricted rats consumed 15% less food and had lower brown adipose tissue Ucp-1 mRNA expression than rAAV-Lep rats. Additionally, calorically-restricted rats had higher abdominal white adipose tissue mass, higher serum leptin and adiponectin levels, and higher marrow adiposity. Caloric restriction and hypothalamic leptin gene therapy, while equally effective in preventing weight gain, differ in their effects on energy intake, energy expenditure, adipokine levels, and body composition.
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Affiliation(s)
- Russell T. Turner
- Skeletal Biology Laboratory, School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA; (R.T.T.); (C.P.W.); (K.M.F.)
| | - Carmen P. Wong
- Skeletal Biology Laboratory, School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA; (R.T.T.); (C.P.W.); (K.M.F.)
| | - Kristina M. Fosse
- Skeletal Biology Laboratory, School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA; (R.T.T.); (C.P.W.); (K.M.F.)
| | - Adam J. Branscum
- Biostatistics Program, School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA;
| | - Urszula T. Iwaniec
- Skeletal Biology Laboratory, School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA; (R.T.T.); (C.P.W.); (K.M.F.)
- Correspondence:
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46
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Martins C, Roekenes J, Gower BA, Hunter GR. Metabolic adaptation is associated with less weight and fat mass loss in response to low-energy diets. Nutr Metab (Lond) 2021; 18:60. [PMID: 34116675 PMCID: PMC8196522 DOI: 10.1186/s12986-021-00587-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/03/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The practical relevance of metabolic adaptation remains a controversial issue. To the best of our knowledge, no study has properly evaluated the role of metabolic adaptation in modulating weight loss outcomes. Therefore, the aim of this study was to determine the association between metabolic adaptation, at the level of resting metabolic rate (RMR), and weight and fat mass (FM) loss after low-energy diets (LED), after adjusting for dietary adherence and other confounders. METHODS 71 individuals with obesity (BMI: 34.6 ± 3.4 kg/m2; age: 45.4 ± 8.2 years; 33 males) were randomized to one of three 1000 kcal/day diets for 8 weeks. Body weight, FM and fat-free mass (FFM) (air displacement plethysmography), RMR (indirect calorimetry) and physical activity level (PAL) (armbands) were measured at baseline and at week 9. Metabolic adaptation at week 9 was defined as measured RMR minus predicted RMR at week 9. An equation to predict RMR was derived from baseline data of all participants that were part of this analysis and included age, sex, FM and FFM as predictors. Dietary adherence was calculated from RMR, PAL and body composition changes. Linear regression was used to assess the potential role of metabolic adaptation in predicting weight and FM loss after adjusting for dietary adherence, average PAL, sex, baseline FM and FFM and randomization group. RESULTS Participants lost on average 14 ± 4 kg of body weight (13 ± 3%) and presented with metabolic adaptation (-92 ± 110 kcal/day, P < 0.001). Metabolic adaptation was a significant predictor of both weight (β = -0.009, P < 0.001) and FM loss (β = -0.008, P < 0.001), even after adjusting for confounders (R2 = 0.88, 0.93, respectively, P < 0.001 for both). On average, an increase in metabolic adaptation of 50 kcal/day was associated with a 0.5 kg lower weight and FM loss in response to the LED. CONCLUSION In individuals with obesity, metabolic adaptation at the level of RMR is associated with less weight and FM loss in response to LED. Trial registration ID: NCT02944253.
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Affiliation(s)
- Catia Martins
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Forsyningssenteret, Prinsesse Kristinas Gate 5, 7030, Trondheim, Norway.
- Centre for Obesity and Innovation (ObeCe), Clinic of Surgery, St. Olav University Hospital, Trondheim, Norway.
- Department of Nutrition Sciences, University of Alabama At Birmingham, Birmingham, USA.
| | - Jessica Roekenes
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Forsyningssenteret, Prinsesse Kristinas Gate 5, 7030, Trondheim, Norway
| | - Barbara A Gower
- Department of Nutrition Sciences, University of Alabama At Birmingham, Birmingham, USA
| | - Gary R Hunter
- Department of Nutrition Sciences, University of Alabama At Birmingham, Birmingham, USA
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47
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Davis AE, Smyers ME, Beltz L, Mehta DM, Britton SL, Koch LG, Novak CM. Differential weight loss with intermittent fasting or daily calorie restriction in low- and high-fitness phenotypes. Exp Physiol 2021; 106:1731-1742. [PMID: 34086376 DOI: 10.1113/ep089434] [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: 01/26/2021] [Accepted: 06/02/2021] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? How does intrinsic aerobic capacity impact weight loss with 50% daily caloric restriction and alternate-day fasting? What is the main finding and its importance? Intermittent fasting is effective for weight loss in rats with low fitness, which highlights the importance of how intermittent fasting interacts with aerobic fitness. ABSTRACT Recent interest has focused on the benefits of time-restricted feeding strategies, including intermittent fasting, for weight loss. It is not yet known whether intermittent fasting is more effective than daily caloric restriction at stimulating weight loss and how each is subject to individual differences. Here, rat models of leanness and obesity, artificially selected for intrinsically high (HCR) and low (LCR) aerobic capacity, were subjected to intermittent fasting and 50% calorie restrictive diets in two separate experiments using male rats. The lean, high-fitness HCR and obesity-prone, low-fitness LCR rats underwent 50% caloric restriction while body weight and composition were monitored. The low-fitness LCR rats were better able to retain lean mass than the high-fitness HCR rats, without significantly different proportional loss of weight or fat. In a separate experiment using intermittent fasting in male HCR and LCR rats, alternate-day fasting induced significantly greater loss of weight and fat mass in LCR compared with HCR rats, although the HCR rats had a more marked reduction in ad libitum daily food intake. Altogether, this suggests that intermittent fasting is an effective weight-loss strategy for those with low intrinsic aerobic fitness; however, direct comparison of caloric restriction and intermittent fasting is warranted to determine any differential effects on energy expenditure in lean and obesity-prone phenotypes.
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Affiliation(s)
- Ashley E Davis
- School of Biomedical Sciences, Kent State University, Kent, Ohio, USA
| | - Mark E Smyers
- School of Biomedical Sciences, Kent State University, Kent, Ohio, USA
| | - Lisa Beltz
- Department of Biological Sciences, Kent State University, Kent, Ohio, USA
| | - Devanshi M Mehta
- Department of Biological Sciences, Kent State University, Kent, Ohio, USA
| | - Steven L Britton
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA.,Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Lauren G Koch
- Department of Physiology and Pharmacology, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA
| | - Colleen M Novak
- School of Biomedical Sciences, Kent State University, Kent, Ohio, USA.,Department of Biological Sciences, Kent State University, Kent, Ohio, USA
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48
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Verboven K, Hansen D. Critical Reappraisal of the Role and Importance of Exercise Intervention in the Treatment of Obesity in Adults. Sports Med 2021; 51:379-389. [PMID: 33332014 DOI: 10.1007/s40279-020-01392-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In the treatment of obesity in adults, exercise intervention is recommended and some people with obesity even prefer exercise above dietary intervention as a single weight-loss strategy. However, evidence is accumulating that the long-term body weight and adipose tissue mass loss as a result of exercise intervention in these individuals is disappointingly small. Although this could be related to various clinical reasons, more recent evidence reveals that also (patho)physiological abnormalities are involved which cannot be remediated by exercise intervention, especially in metabolically compromised patients. As a result, the role and importance of exercise intervention in the treatment of obesity deserve significant reconsideration to avoid confusion and disappointment amongst clinicians, patients and society. Hence, to reduce adipose tissue mass and body weight, dietary intervention is much more effective than exercise intervention, and is, therefore, of key importance in this endeavour. However, dietary interventions must be supplemented by exercise training to induce clinically relevant changes in specific cardiovascular or metabolic risk factors like blood pressure, blood triglycerides and high-density lipoprotein cholesterol concentrations, as well as visceral adipose tissue mass, physical fitness, muscle mass and strength, quality of life and life expectancy. This allows individuals with obesity to preserve their cardiometabolic health or to shift from a metabolically unhealthy phenotype to a metabolically healthy phenotype. Signifying the true clinical value of exercise interventions might lead to a better understanding and appreciation of the goals and associated effects when implemented in the multidisciplinary treatment of obesity, for which a proper tailoring of exercise prescription is required.
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Affiliation(s)
- Kenneth Verboven
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Building A, 3590, AgoralaanDiepenbeek, Belgium. .,BIOMED-Biomedical Research Center, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
| | - Dominique Hansen
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Building A, 3590, AgoralaanDiepenbeek, Belgium.,BIOMED-Biomedical Research Center, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium
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49
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Call CC, D'Adamo L, Butryn ML, Stice E. Examining weight suppression as a predictor and moderator of intervention outcomes in an eating disorder and obesity prevention trial: A replication and extension study. Behav Res Ther 2021; 141:103850. [PMID: 33839586 DOI: 10.1016/j.brat.2021.103850] [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: 08/11/2020] [Revised: 02/16/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
Weight suppression (WS) predicts future weight gain and increases in eating disorder symptoms in community and clinical samples but has received minimal attention in obesity and eating disorder prevention programs. In a sample of emerging adults (N = 364) in a randomized controlled trial evaluating two obesity and eating disorder prevention interventions versus a control condition, this study aimed to replicate the findings that WS and its interaction with baseline BMI predict increases in weight and eating disorder symptoms and test a novel hypothesis that WS would moderate the effects of the interventions on change in weight and eating disorder symptoms. Participants completed assessments at baseline, post-intervention, 6-, 12-, and 24-months. WS was calculated as the difference between highest lifetime weight and baseline weight. WS interacted with baseline BMI to predict greater weight gain over 24-months, such that those with high WS and lower baseline BMI gained weight most rapidly. WS did not predict eating disorder symptom change and did not moderate the effects of the prevention programs. Given that individuals with WS are at increased risk for weight gain, expressly targeting this high-risk population with evidence-based obesity prevention programs may be useful. CLINICALTRIALS.GOV REGISTRATION: NCT01680224.
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Affiliation(s)
- Christine C Call
- Department of Psychology, Drexel University, Stratton Hall Suite 119, 3141 Chestnut St, Philadelphia, PA, 19104, USA; Center for Weight, Eating and Lifestyle Science, Drexel University, Stratton Hall Second Floor, 3201 Chestnut St, Philadelphia, PA, 19104, USA.
| | - Laura D'Adamo
- Department of Psychology, Drexel University, Stratton Hall Suite 119, 3141 Chestnut St, Philadelphia, PA, 19104, USA; Center for Weight, Eating and Lifestyle Science, Drexel University, Stratton Hall Second Floor, 3201 Chestnut St, Philadelphia, PA, 19104, USA.
| | - Meghan L Butryn
- Department of Psychology, Drexel University, Stratton Hall Suite 119, 3141 Chestnut St, Philadelphia, PA, 19104, USA; Center for Weight, Eating and Lifestyle Science, Drexel University, Stratton Hall Second Floor, 3201 Chestnut St, Philadelphia, PA, 19104, USA.
| | - Eric Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5101, USA.
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50
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Abstract
Adaptive thermogenesis (AT) has been proposed to be a compensatory response that may resist weight loss (WL) and promote weight regain. This systematic review examined the existence of AT in adults after a period of negative energy balance (EB) with or without a weight stabilisation phase. Studies published until 15 May 2020 were identified from PubMed, Cochrane Library, EMBASE, MEDLINE, SCOPUS and Web of Science. Inclusion criteria included statistically significant WL, observational with follow-up or experimental studies, age > 18y, sample size ≥10 participants, intervention period ≥ 1week, published in English, objective measures of total daily energy expenditure (EE) (TDEE), resting EE (REE) and sleeping EE(SEE). The systematic review was registered at PROSPERO (2020 CRD42020165348). A total of thirty-three studies comprising 2528 participants were included. AT was observed in twenty-seven studies. Twenty-three studies showed significant values for AT for REE (82·8 %), four for TDEE (80·0 %) and two for SEE (100 %). A large heterogeneity in the methods used to quantify AT and between subjects and among studies regarding the magnitude of WL and/or of AT was reported. Well-designed studies reported lower or non-significant values for AT. These findings suggest that although WL may lead to AT in some of the EE components, these values may be small or non-statistically significant when higher-quality methodological designs are used. Furthermore, AT seems to be attenuated, or non-existent, after periods of weight stabilisation/neutral EB. More high-quality studies are warranted not only to disclose the existence of AT but also to understand its clinical implications on weight management outcomes.
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