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Guo L, Yokoyama W, Chen L, Chen M, Zhong F. Dynamic Hydration and Viscosity Control of Konjac Glucomannan Enhance Long-Term Antiobesity Effects by Reducing Food Intake in High-Fat-Diet-Fed Mice. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2024; 72:24561-24575. [PMID: 39441122 DOI: 10.1021/acs.jafc.4c07730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2024]
Abstract
The purpose of this study was to investigate the necessity and importance of dynamic hydration rate and ultimate viscosity control of konjac glucomannan (KGM) for long-term antiobesity effects in C57BL/6J mice on high-fat (HF) diets. KGM supplementation effectively attenuated HF-diet-induced increases in body and tissue weights. The hydration rate and viscosity changes of KGM in the digestive tract were found to have marked impacts on antiobesity effects. KGM with medium hydration and viscosity slowed gastric emptying and intestinal transit, leading to prolonged presence in the lower ileum, increased satiety-related hormones (GLP-1 and PYY), and an 18.27% reduction in daily food intake over 10 weeks (p < 0.05). This resulted in the greatest reduction in weight gain among HF-fed mice. In contrast, KGM with faster hydration and higher viscosity provided only short-term satiety due to rapid dilution. Furthermore, KGM improved metabolic health and altered glycolipid metabolism gene transcription while enriching beneficial gut bacteria; however, no significant differences were observed among the KGM groups in these effects. These findings highlight that synchronizing KGM's hydration rate and viscosity with digestive processes is crucial for regulating satiety and achieving long-term weight loss.
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Affiliation(s)
- Liping Guo
- Science Center for Future Foods, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- College of Food Science and Engineering/Collaborative Innovation Center for Modern Grain Circulation and Safety, Key Laboratory of Grains and Oils Quality Control and Processing, Nanjing University of Finance and Economics, No. 3 Wenyuan Road, Nanjing, Jiangsu 210023, China
| | - Wallace Yokoyama
- Western Regional Research Center, ARS, USDA, Albany, California 94710, United States
| | - Ling Chen
- Science Center for Future Foods, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
| | - Maoshen Chen
- Science Center for Future Foods, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
| | - Fang Zhong
- Science Center for Future Foods, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
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Creasy SA, Rosenberg RC, Ostendorf DM, Browning R, Melanson EL, Pan Z, Catenacci VA. Walking economy and exercise efficiency in successful weight loss maintainers. Physiol Behav 2024; 288:114730. [PMID: 39505080 DOI: 10.1016/j.physbeh.2024.114730] [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: 07/10/2024] [Revised: 10/15/2024] [Accepted: 11/03/2024] [Indexed: 11/08/2024]
Abstract
PURPOSE Following short-term weight loss, the energetic cost of transport decreases and exercise efficiency increases. Whether changes persist during long-term weight maintenance is unknown. METHODS We compared walking economy and exercise efficiency in weight loss maintainers (WLM, maintaining ≥13.6 kg weight loss for ≥1 year), controls without obesity (NC, BMI similar to current BMI of WLM), and controls with overweight/obesity (OC, BMI similar to pre-weight loss BMI of WLM). Energy expenditure (EE) and respiratory quotient were measured using indirect calorimetry at rest, while standing, and during treadmill walking. Gross and net energetic cost of transport (J/kg/m) was measured during level treadmill walking at 0.75, 1.12, and 1.52 m/s. Gross, net, and delta efficiency (%) were measured during inclined treadmill walking (2 %, 4 %, and 6 % grade) and a constant speed (1.12 m/s). RESULTS WLM (n = 32, BMI: 23.8 ± 2.3 kg/m2) and NC (n = 28, BMI: 22.7 ± 1.6 kg/m2) had significantly lower EE (kJ/min) compared to OC (n = 26, BMI: 33.0 ± 4.5 kg/m2) during rest, standing, and walking (p < 0.01). Net energetic cost of transport was significantly lower in WLM compared to OC at 1.12 and 1.52 m/s (p < 0.05). Net efficiency was significantly greater in WLM compared to OC while walking (p ≤ 0.05). There were no significant differences between WLM and NC for any measures of economy or efficiency. CONCLUSION WLM had lower walking economy and greater walking efficiency compared to OC, but there were no differences between WLM and NC. Thus, individuals maintaining significant weight loss may be successful with long-term weight loss, in part, due to resistance against adaptive reductions in walking energetics.
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Affiliation(s)
- Seth A Creasy
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Anschutz Health & Wellness Center at the University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
| | - Rebecca C Rosenberg
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Danielle M Ostendorf
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Anschutz Health & Wellness Center at the University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Ray Browning
- Department of Health and Exercise Science, Colorado State University, Ft. Collins, CO, USA
| | - Edward L Melanson
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Eastern Colorado VA Geriatric Research, Education, and Clinical Center, Aurora, CO, USA
| | - Zhaoxing Pan
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Victoria A Catenacci
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Anschutz Health & Wellness Center at the University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
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Gerstenberg MK, Andersen DB, Torz L, Castorena CM, Bookout AL, Hartmann B, Rehfeld JF, Petersen N, Holst JJ, Kuhre RE. Weight loss by calorie restriction does not alter appetite-regulating gut hormone responses from perfused rat small intestine. Acta Physiol (Oxf) 2023; 238:e13947. [PMID: 36755506 DOI: 10.1111/apha.13947] [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: 07/27/2022] [Revised: 01/27/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023]
Abstract
AIM Postprandial secretion of the appetite-inhibiting hormones, glucagon-like peptide-1 (GLP-1), and peptide YY are reduced with obesity. It is unclear if the reduced secretion persists following weight loss (WL), if other appetite-inhibiting hormones are also reduced, and if so whether reduced secretion results from intrinsic changes in the gut. METHODS To address whether WL may restore secretion of GLP-1 and other appetite-inhibiting hormones, we performed a gut perfusion study of the small intestine in diet-induced obese (DIO) rats after WL. A 20% weight loss (means ± SEM (g): 916 ± 53 vs. 703 ± 35, p < 0.01, n = 7) was induced by calorie restriction, and maintained stable for ≥7 days prior to gut perfusion to allow for complete renewal of enteroendocrine cells. Age-matched DIO rats were used as comparator. Several gut hormones were analyzed from the venous effluent, and gene expression was performed on gut tissue along the entire length of the intestine. RESULTS Secretion of cholecystokinin, gastrin, glucose-dependent insulinotropic peptide, GLP-1, neurotensin, and somatostatin was not affected by WL during basal conditions (p ≥ 0.25) or in response to macronutrients and bile acids (p ≥ 0.14). Glucose absorption was indistinguishable following WL. The expression of genes encoding the studied peptides, macronutrient transporters (glucose, fructose, and di-/tripeptides) and bile acid receptors did also not differ between DIO and WL groups. CONCLUSIONS These data suggest that the attenuated postprandial responses of GLP-1, as well as reduced responses of other appetite-inhibiting gut hormones, in people living with obesity may persist after weight loss and may contribute to their susceptibility for weight regain.
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Affiliation(s)
| | - Daniel B Andersen
- Department of Biomedical Sciences, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.,Novo Nordisk Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Lola Torz
- Global Drug Discovery, Novo Nordisk A/S, Måløv, Denmark
| | | | - Angie L Bookout
- Global Drug Discovery, Novo Nordisk A/S, Seattle, Washington, USA
| | - Bolette Hartmann
- Department of Biomedical Sciences, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.,Novo Nordisk Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Jens F Rehfeld
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Jens J Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.,Novo Nordisk Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Rune E Kuhre
- Department of Biomedical Sciences, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.,Global Drug Discovery, Novo Nordisk A/S, Måløv, Denmark
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Athesh K, Agnel Arul John N, Sridharan G, Brindha P, Alanazi AM, Rengasamy KRR, Balamuralikrishnan B, Liu WC, Vijaya Anand A. Protective Effect of Dolichos biflorus Seed Extract on 3T3‐L1 Preadipocyte Differentiation and High‐Fat Diet‐Induced Obesity in Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2023; 2023. [DOI: 10.1155/2023/6251200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 01/18/2023] [Indexed: 11/29/2023]
Abstract
Obesity is known to be one of the severe health issues worldwide, as its prevalence continues to rise as well as its association with other chronic diseases worsens. Even though various approaches have been underway to prevent or treat obesity, alternative approaches are in need to combat this chronic condition because of the unsatisfactory effectiveness and adverse side effects of the existing approaches. Dolichos biflorus L. seeds have been employed as a weight‐loss treatment in folk medicine. Considering the necessity to develop a safe alternative remedy to rising obesity, the current investigation has been set up to assess the antiobesity potential and the mode of action of the aqueous seed extract of D. biflorus (ASEDB) in a cell line (3T3‐L1) and high‐fat diet (HFD)‐induced rats. For in-vitro studies, 3T3‐L1 cell lines were cultured in Dulbecco’s modified Eagle medium (DMEM) augmented with adipogenic‐inducing medium and the influence of the extract (10 µg/mL–500 µg/mL) on 3T3‐L1 adipocyte viability, adipogenesis, and lipolysis was assessed. An in-vitro study revealed maintenance of cell viability, reduced triglycerides (TG) accumulation, and promoted lipolysis in 3T3‐L1 cells by ASEDB. Following in-vitro analysis, the HFD‐induced obese rats were treated with ASEDB at different concentrations (100 mg/kg, 200 mg/kg, and 300 mg/kg) for 60 days and the effect was evaluated through various anthropometric and biochemical parameters. The findings revealed a significant decrement in total body weight, organ weights, fat pad weights, and restoration of abnormal levels of glucose, leptin, insulin, lipid markers, and antioxidant system to normal by ASEDB treatment. Also, pancreatic lipase inhibition analysis of ASEDB revealed a modest level of inhibition with an IC50 value of 213.3 µg/mL. All these findings exposed that ASEDB possesses pronounced antiobesity potential and exhibits its protective effect by suppressing food intake, reducing fat digestion and absorption, limiting adipogenesis, enhancing lipolysis, and alleviating oxidative stress.
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Effect of sleep on weight loss and adherence to diet and physical activity recommendations during an 18-month behavioral weight loss intervention. Int J Obes (Lond) 2022; 46:1510-1517. [PMID: 35577898 PMCID: PMC9850430 DOI: 10.1038/s41366-022-01141-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND/OBJECTIVES To examine the association between indices of sleep quantity and quality with dietary adherence, physical activity adherence, and weight loss during a behavioral weight loss intervention. METHODS Adults (n = 156) with overweight and obesity (40 ± 9 years, 84% female, BMI: 34.4 ± 4.2 kg/m2) participated in an 18-month behavioral weight loss intervention which prescribed a reduced calorie diet (1200-1800 kcal/d) and increased physical activity (300 min/wk). Body weight, indices of sleep (SenseWear armband; SWA), energy intake (EI, 3-day food records), and moderate-to-vigorous physical activity (SWA) were measured at baseline, 6, 12, and 18 months. Linear mixed effects models examined the association between sleep and weight change over time. Additional models were adjusted for covariates including age, BMI, sex, race, ethnicity, study completion, randomization, EI, and physical activity. Secondary analyses examined the association between sleep and adherence to diet and physical activity recommendations. RESULTS Mean weight loss was 7.7 ± 5.4, 8.4 ± 7.9, and 7.1 ± 9.0 kg at 6, 12, and 18 months, respectively. Lower sleep efficiency, higher wake after sleep onset (WASO), more awakenings, and higher sleep onset latency (SOL) were significantly associated with attenuated weight loss (p < 0.05). Lower sleep efficiency, more awakenings, and higher SOL remained significantly associated with blunted weight loss after adjustment for covariates (p < 0.05). Later waketime, longer time in bed, longer sleep duration, higher WASO, more awakenings, and higher SOL were associated with lower odds of achieving ≥300 min/wk of moderate-to-vigorous physical activity, adjusted for covariates (FDR p < 0.05). CONCLUSIONS Future studies should evaluate whether incorporating strategies to improve sleep health within a behavioral weight loss intervention leads to improved adherence to diet and physical activity recommendations and enhanced weight loss. CLINICAL TRIALS IDENTIFIER NCT01985568.
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Kim HJ, Lim S, Chung S, Lee S, Choi E, Yang KH, Hwang JT, Chung MY. Barley Sprout Water Extract and Saponarin Mitigate Triacylglycerol Accumulation in 3T3-L1 Adipocytes. J Med Food 2022; 25:79-88. [PMID: 35029509 DOI: 10.1089/jmf.2021.k.0092] [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] [Indexed: 01/05/2023] Open
Abstract
The mechanisms of action responsible for the reported hypolipidemic activity of barley sprouts have yet to be elucidated. The objective of this study was to compare the content of saponarin (the sole flavonoid present in barley sprout leaves), hypolipidemic activity between barley sprout water extract (BSW) and barley sprout ethanol extract (BSE), and the associated relevance to hypolipidemic activity in 3T3-L1 preadipocytes. BSW elicited superior antiadipogenic effects when compared with BSE in MDI mixture [IBMX 0.5 mM + dexamethasone 1 μM + insulin 1 μg/mL]-treated 3T3-L1 preadipocytes. BSW attenuated MDI-mediated triacylglycerol (TAG) accumulation by inhibiting fatty acid synthase (FAS). FAS protein expression was markedly and dose dependently attenuated by BSW, with higher doses suppressing expression to a level equivalent to the controls. BSW also significantly attenuated MDI-mediated increases in the expression of genes involved in TAG synthesis as well as FAS in 3T3-L1 preadipocytes. High-performance liquid chromatography analysis indicated that BSW contains more than four times more saponarin than BSE. Further investigation of saponarin-mediated hypotriacylglycerolemic activity and related gene expression revealed that saponarin significantly inhibited TAG accumulation, which was attributed to reductions in TAG synthesis-related gene expression. Taken together, these findings provide a basis for further development of barley sprout extract for functional health food purposes.
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Affiliation(s)
- Hyo-Jin Kim
- Korea Food Research Institute, Wanju-gun, Korea.,Department of Food Biotechnology, University of Science & Technology, Daejeon, Korea
| | - Sol Lim
- Korea Food Research Institute, Wanju-gun, Korea
| | | | - Sohee Lee
- Department of Food and Nutrition, Sookmyung Women's University, Seoul, Korea
| | - Eunji Choi
- Department of Food and Nutrition, Sookmyung Women's University, Seoul, Korea
| | | | - Jin-Taek Hwang
- Korea Food Research Institute, Wanju-gun, Korea.,Department of Food Biotechnology, University of Science & Technology, Daejeon, Korea
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Petersen N, Greiner TU, Torz L, Bookout A, Gerstenberg MK, Castorena CM, Kuhre RE. Targeting the Gut in Obesity: Signals from the Inner Surface. Metabolites 2022; 12:metabo12010039. [PMID: 35050161 PMCID: PMC8778595 DOI: 10.3390/metabo12010039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/26/2021] [Accepted: 12/31/2021] [Indexed: 12/17/2022] Open
Abstract
Obesity is caused by prolonged energy surplus. Current anti-obesity medications are mostly centralized around the energy input part of the energy balance equation by increasing satiety and reducing appetite. Our gastrointestinal tract is a key organ for regulation of food intake and supplies a tremendous number of circulating signals that modulate the activity of appetite-regulating areas of the brain by either direct interaction or through the vagus nerve. Intestinally derived messengers are manifold and include absorbed nutrients, microbial metabolites, gut hormones and other enterokines, collectively comprising a fine-tuned signalling system to the brain. After a meal, nutrients directly interact with appetite-inhibiting areas of the brain and induce satiety. However, overall feeding behaviour also depends on secretion of gut hormones produced by highly specialized and sensitive enteroendocrine cells. Moreover, circulating microbial metabolites and their interactions with enteroendocrine cells further contribute to the regulation of feeding patterns. Current therapies exploiting the appetite-regulating properties of the gut are based on chemically modified versions of the gut hormone, glucagon-like peptide-1 (GLP-1) or on inhibitors of the primary GLP-1 inactivating enzyme, dipeptidyl peptidase-4 (DPP-4). The effectiveness of these approaches shows that that the gut is a promising target for therapeutic interventions to achieve significant weigh loss. We believe that increasing understanding of the functionality of the intestinal epithelium and new delivery systems will help develop selective and safe gut-based therapeutic strategies for improved obesity treatment in the future. Here, we provide an overview of the major homeostatic appetite-regulating signals generated by the intestinal epithelial cells and how these signals may be harnessed to treat obesity by pharmacological means.
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Affiliation(s)
- Natalia Petersen
- Global Obesity and Liver Disease Research, Global Drug Discovery, Novo Nordisk A/S, Novo Park 1, 2670 Måløv, Denmark; (L.T.); (M.K.G.); (R.E.K.)
- Correspondence:
| | - Thomas U. Greiner
- The Wallenberg Laboratory and Sahlgrenska Center for Cardiovascular and Metabolic Research, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, 405 30 Gothenburg, Sweden;
| | - Lola Torz
- Global Obesity and Liver Disease Research, Global Drug Discovery, Novo Nordisk A/S, Novo Park 1, 2670 Måløv, Denmark; (L.T.); (M.K.G.); (R.E.K.)
- Department of Veterinary and Animal Science, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Angie Bookout
- Global Obesity and Liver Disease Research, Global Drug Discovery, Novo Nordisk Research Center, Seattle, WA 98109, USA; (A.B.); (C.M.C.)
| | - Marina Kjærgaard Gerstenberg
- Global Obesity and Liver Disease Research, Global Drug Discovery, Novo Nordisk A/S, Novo Park 1, 2670 Måløv, Denmark; (L.T.); (M.K.G.); (R.E.K.)
| | - Carlos M. Castorena
- Global Obesity and Liver Disease Research, Global Drug Discovery, Novo Nordisk Research Center, Seattle, WA 98109, USA; (A.B.); (C.M.C.)
| | - Rune Ehrenreich Kuhre
- Global Obesity and Liver Disease Research, Global Drug Discovery, Novo Nordisk A/S, Novo Park 1, 2670 Måløv, Denmark; (L.T.); (M.K.G.); (R.E.K.)
- Department of Veterinary and Animal Science, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
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Pirchio R, Graziadio C, Colao A, Pivonello R, Auriemma RS. Metabolic effects of prolactin. Front Endocrinol (Lausanne) 2022; 13:1015520. [PMID: 36237192 PMCID: PMC9552666 DOI: 10.3389/fendo.2022.1015520] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/05/2022] [Indexed: 11/23/2022] Open
Abstract
Over the last years, the metabolic role of PRL has emerged. PRL excess is known to promote weight gain, obesity, metabolic syndrome, and impairment in gluco-insulinemic and lipid profiles, likely due to the suppression of physiologic dopaminergic tone. Prolactin receptors and dopamine receptors type 2 have been demonstrated to be expressed on both human pancreatic β- cell and adipocytes, supporting a key role of prolactin and dopamine in peripheral metabolic regulation. Medical treatment with the dopamine agonists bromocriptine and cabergoline has been demonstrated to decrease the prevalence of metabolic syndrome and obesity, and significantly improve gluco-insulinemic and lipid profiles. In hyperprolactinemic men with concomitant hypogonadism, correction of hyperprolactinaemia and testosterone replacement has been proven to restore metabolic impairment. In turn, low prolactin levels have also been demonstrated to exert a detrimental effect on weight gain, glucose and lipid metabolism, thus leading to an increased prevalence of metabolic syndrome. Therefore, PRL values ranging from 25 to 100 mg/L, in absence of other recognizable pathological causes, have been proposed to represent a physiological response to the request for an increase in metabolic activity, and nowadays classify the so-called HomeoFIT- PRL as a promoter of metabolic homeostasis. The current review focuses mainly on the effects of hyperprolactinemia and its control by medical treatment with DAs on the modulation of food intake, body weight, gluco-insulinemic and lipid profile. Furthermore, it provides the latest knowledge about the metabolic impact of hypoprolactinemia.
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Affiliation(s)
- Rosa Pirchio
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, University of Naples Federico II, Naples, Italy
| | - Chiara Graziadio
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, University of Naples Federico II, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, University of Naples Federico II, Naples, Italy
- Unesco Chair for Health Education and Sustainable Development, “Federico II” University, Naples, Italy
| | - Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, University of Naples Federico II, Naples, Italy
- Unesco Chair for Health Education and Sustainable Development, “Federico II” University, Naples, Italy
| | - Renata S. Auriemma
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, University of Naples Federico II, Naples, Italy
- *Correspondence: Renata S. Auriemma,
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Seoudy AK, Beckmann A, Wietzke-Braun P, Settgast U, Ziegenbruch U, Türk K, Hartmann K, Brandes J, Schulte DM, Wehkamp K, Trettow M, Schreiber S, Laudes M. Tagesklinische Versorgungsstruktur zur Komplextherapie der Adipositas III°. DIABETOL STOFFWECHS 2021. [DOI: 10.1055/a-1482-8115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Zusammenfassung
Hintergrund Die konservativen Behandlungsmöglichkeiten der Adipositas III° (BMI ≥ 40 kg/m2) sind limitiert, da flächendeckend eine adäquate Versorgungsstruktur nicht vorgehalten wird. Am Universitätsklinikum Schleswig-Holstein, Campus Kiel, wurde 2018 eine Tagesklinik zur Komplextherapie der Adipositas III° eingerichtet mit Sicherung der Finanzierung durch die Kostenträger über Tagessätze gemäß Krankenhausentgeltgesetz.
Methode Von 201 Adipositaspatienten, die sich von Juni 2018 bis Mai 2020 vorstellten, wurde die Tagesklinikbehandlung analysiert und zusätzlich wurde das Körpergewicht ein Jahr später ausgewertet.
Ergebnisse Die Komplextherapie fand in wöchentlichen Behandlungseinheiten über 26 Wochen statt. 170 von 201 Patienten haben die Behandlung komplettiert, entsprechend einer Adhärenzquote von 84,6 %. Das mediane Alter betrug 46 Jahre. Die Mehrheit der Patienten war weiblichen Geschlechts (64,7 %). In der Gruppe der Responder (≥ 10 % Gewichtsreduktion) betrug die absolute Gewichtsabnahme 27,1 kg entsprechend etwa 20 %. Auch die Non-Responder (< 10 %) konnten ihr Körpergewicht um 8,8 kg reduzieren; in dieser Gruppe fand sich ein signifikant höherer Frauenanteil (81,3 % vs. 60,9 %, p = 0,039). Responder und Non-Responder unterschieden sich hinsichtlich des Bauch- und Hüftumfangs sowie der Fettmasse (p-Wert jeweils < 0,001). Am Therapieende wiesen die Responder niedrigere Triglyzerid- (p = 0,019) und HbA1c-Konzentrationen (p = 0,030) auf. Ein Jahr nach Beginn der Komplextherapie imponierte eine stabile Gewichtsreduktion in beiden Gruppen.
Schlussfolgerung Die teilstationäre Adipositas-Komplextherapie in einer internistischen Tagesklinik stellt eine effektive Methode zur anhaltenden Gewichtsreduktion von Patienten mit Adipositas III° dar.
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Affiliation(s)
| | - Alexia Beckmann
- Medizinische Klinik 1, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | | | - Ute Settgast
- Medizinische Klinik 1, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Ursula Ziegenbruch
- Medizinische Klinik 1, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Kathrin Türk
- Medizinische Klinik 1, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Katharina Hartmann
- Medizinische Klinik 1, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Juliane Brandes
- Medizinische Klinik 1, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | | | - Kai Wehkamp
- Medizinische Klinik 1, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Marc Trettow
- Medizinische Klinik 1, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Stefan Schreiber
- Medizinische Klinik 1, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Matthias Laudes
- Medizinische Klinik 1, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
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Remde A, DeTurk SN, Almardini A, Steiner L, Wojda T. Plant-predominant eating patterns - how effective are they for treating obesity and related cardiometabolic health outcomes? - a systematic review. Nutr Rev 2021; 80:1094-1104. [PMID: 34498070 DOI: 10.1093/nutrit/nuab060] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
CONTEXT The obesity epidemic is a main driver of the chronic disease epidemic; however, present treatment approaches have suboptimal efficacy. OBJECTIVES To assess the efficacy of plant-predominant (vegan, vegetarian, plant-based whole foods [PBWFs]) diets in treating obesity and its main cardiometabolic sequelae: hyperlipidemia (HLD); indices of insulin resistance, glycemic control, and diabetes mellitus type 2 (DM2); and cardiovascular disease (CVD), including hypertension (HTN). DATA SOURCES A systematic search of multiple databases was conducted for articles published between November 2019 and February 2020; databases searched included: PubMed, Medline (Ovid), Cochrane, CENTRAL, and CINAHL. DATA EXTRACTION AND ANALYSIS All interventional trials (randomized controlled trials [RCTs] and trials of non-randomized experimental design) that met the inclusion criteria (English language, duration of at least 4 weeks, primary end point congruent with above objectives, no major flaws in research design that would prevent interpretation) were included in the review. A total of 3135 articles were scanned and 84 were selected. The articles were collated and summarized in 2 evidence tables. Risk of bias for RCTs was assessed using the Cochrane Risk-of-Bias tool 2 as a guide. For non-randomized trials, higher risk of bias was assumed, and the JBI Critical Appraisal tool was used as a guide to determine inclusion. RESULTS Plant-based diets, in general, demonstrated improved weight control and cardiometabolic outcomes related to lipids, cardiovascular end points, blood pressure, insulin sensitivity, A1C, and fasting glucose, and a lower risk of diabetes compared with usual diets and in some cases standard health-oriented diets such as the American Heart Association (AHA), American Diabetic Association (ADA), and Mediterranean diets. Preliminary studies suggest plant-predominant diets practiced as part of healthy lifestyle interventions may stabilize or even reverse DM 2 and CVD. The acceptability and sustainability of plant-predominant diets where measured were generally similar to other health-oriented diets. CONCLUSION Plant-predominant diets can play a major role in reversing the obesity and chronic disease epidemics. In the setting of sustained lifestyle intervention programs, they may arrest or even reverse DM2 and CVD. Further higher-level RCTs are needed to confirm and expand on these findings.
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Affiliation(s)
- Alan Remde
- A. Remde is with Research and Curriculum, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. S.N. DeTurk is with PGY2 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. A. Almardini is with PGY1 Family Medicine, SLUHN Family Medicine Residency-Miners Campus, Tamaqua, Pennsylvania, USA. L. Steiner is with Biomedical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA. T. Wojda is with PGY3 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA
| | - Stephen N DeTurk
- A. Remde is with Research and Curriculum, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. S.N. DeTurk is with PGY2 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. A. Almardini is with PGY1 Family Medicine, SLUHN Family Medicine Residency-Miners Campus, Tamaqua, Pennsylvania, USA. L. Steiner is with Biomedical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA. T. Wojda is with PGY3 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA
| | - A Almardini
- A. Remde is with Research and Curriculum, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. S.N. DeTurk is with PGY2 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. A. Almardini is with PGY1 Family Medicine, SLUHN Family Medicine Residency-Miners Campus, Tamaqua, Pennsylvania, USA. L. Steiner is with Biomedical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA. T. Wojda is with PGY3 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA
| | - Lauren Steiner
- A. Remde is with Research and Curriculum, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. S.N. DeTurk is with PGY2 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. A. Almardini is with PGY1 Family Medicine, SLUHN Family Medicine Residency-Miners Campus, Tamaqua, Pennsylvania, USA. L. Steiner is with Biomedical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA. T. Wojda is with PGY3 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA
| | - Thomas Wojda
- A. Remde is with Research and Curriculum, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. S.N. DeTurk is with PGY2 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. A. Almardini is with PGY1 Family Medicine, SLUHN Family Medicine Residency-Miners Campus, Tamaqua, Pennsylvania, USA. L. Steiner is with Biomedical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA. T. Wojda is with PGY3 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA
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Intuitive eating longitudinally predicts better psychological health and lower use of disordered eating behaviors: findings from EAT 2010-2018. Eat Weight Disord 2021; 26:287-294. [PMID: 32006391 PMCID: PMC7392799 DOI: 10.1007/s40519-020-00852-4] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 01/18/2020] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To examine longitudinal associations of intuitive eating (IE), defined as eating according to internal hunger and satiety cues, with psychological health outcomes and disordered eating behaviors. METHODS Data from a diverse sample of 1491 participants (54.1% female, 19.7% non-Hispanic white) followed from adolescence (baseline; Mage = 14.5 years) into young adulthood (follow-up; Mage = 22.2 years) came from the population-based EAT 2010-2018 (Eating and Activity over Time) study. Logistic regression models predicting psychological health outcomes and disordered eating behaviors at follow-up simultaneously included baseline IE and change in IE from baseline to follow-up as predictors, adjusting for demographic covariates, body mass index, and outcome at baseline. RESULTS Greater baseline IE and increases in IE from baseline to follow-up were both associated with lower odds of high depressive symptoms, low self-esteem, high body dissatisfaction, unhealthy weight control behaviors (e.g., fasting, skipping meals), extreme weight control behaviors (e.g., taking diet pills, vomiting), and binge eating at 8-year follow-up. Particularly strong protective associations were observed for binge eating, such that a one-point higher IE score at baseline was associated with 74% lower odds of binge eating at follow-up, and a one-point higher increase in IE score from baseline to follow-up was associated with 71% lower odds of binge eating at follow-up. CONCLUSIONS These results indicate that IE longitudinally predicts better psychological and behavioral health across a range of outcomes and suggest that IE may be a valuable intervention target for improving psychological health and reducing disordered eating behaviors, particularly binge eating. LEVEL OF EVIDENCE Level III, cohort study.
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12
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Psychological predictors of poor weight loss following LSG: relevance of general psychopathology and impulsivity. Eat Weight Disord 2020; 25:1621-1629. [PMID: 31728923 DOI: 10.1007/s40519-019-00800-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 10/17/2019] [Indexed: 12/15/2022] Open
Abstract
PURPOSE After bariatric surgery (BS) a significant minority of patients do not reach successful weight loss or tend to regain weight. In recent years, interest for the psychological factors that predict post-surgical weight loss has increased with the objective of developing interventions aimed to ameliorate post-surgical outcomes. In the present study, predictive models of successful or poor weight loss 12 months after BS were investigated considering pre-surgery level of psychopathological symptoms, dysfunctional eating behaviors and trait impulsivity at baseline (pre-surgery). METHODS Sixty-nine patients with morbid obesity canditates for laparoscopic sleeve gastrectomy were assessed regarding metabolic and psychological dimensions. Successful post-surgery weight loss was defined as losing at least 50% of excess body weight (%EWL). RESULTS Logistic models adjusted for patient sex, age and presence of metabolic diseases showed that the baseline presence of intense psychopathological symptoms and low attentional impulsivity predict poor %EWL (< 50%), as assessed 12-month post-surgery. CONCLUSIONS The present findings suggest that intensity of general psychopathology and impulsivity, among other psychological factors, might affect post-surgery %EWL. Conducting adequate psychological assessment at baseline of patients candidates for BS seems to be crucial to orient specific therapeutic interventions. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Dey P, Olmstead BD, Sasaki GY, Vodovotz Y, Yu Z, Bruno RS. Epigallocatechin gallate but not catechin prevents nonalcoholic steatohepatitis in mice similar to green tea extract while differentially affecting the gut microbiota. J Nutr Biochem 2020; 84:108455. [PMID: 32688217 DOI: 10.1016/j.jnutbio.2020.108455] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 05/15/2020] [Accepted: 06/14/2020] [Indexed: 02/06/2023]
Abstract
Catechin-rich green tea extract (GTE) protects against nonalcoholic steatohepatitis (NASH) by alleviating gut-derived endotoxin translocation and hepatic Toll-like receptor-4 (TLR4)-nuclear factor κB (NFκB) inflammation. We hypothesized that intact GTE would attenuate NASH-associated responses along the gut-liver axis to a greater extent than purified (-)-epigallocatechin gallate (EGCG) or (+)-catechin (CAT). Male C57BL/6J mice were fed a low-fat diet, a high-fat (HF) diet, or the HF diet with 2% GTE, 0.3% EGCG or 0.3% CAT for 8 weeks prior to assessing NASH relative to endotoxemia, hepatic and intestinal inflammation, intestinal tight junction proteins (TJPs) and gut microbial ecology. GTE prevented HF-induced obesity to a greater extent than EGCG and CAT, whereas GTE and EGCG more favorably attenuated insulin resistance. GTE, EGCG and CAT similarly attenuated serum alanine aminotransferase and serum endotoxin, but only GTE and EGCG fully alleviated HF-induced NASH. However, hepatic TLR4/NFκB inflammatory responses that were otherwise increased in HF mice were similarly attenuated by GTE, EGCG and CAT. Each treatment also similarly prevented the HF-induced loss in expression of intestinal TJPs and hypoxia inducible factor-1α and the otherwise increased levels of ileal and colonic TNFα mRNA and fecal calprotectin protein concentrations. Gut microbial diversity that was otherwise lowered in HF mice was maintained by GTE and CAT only. Further, microbial metabolic functions were more similar between GTE and CAT. Collectively, GTE catechins similarly protect against endotoxin-TLR4-NFκB inflammation in NASH, but EGCG and CAT exert differential prebiotic and antimicrobial activities suggesting that catechin-mediated shifts in microbiota composition are not entirely responsible for their benefits along the gut-liver axis.
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Affiliation(s)
- Priyankar Dey
- Human Nutrition Program, The Ohio State University, Columbus, OH, USA; Department of Biotechnology, Thapar Institute of Engineering and Technology, Patiala, Punjab, India
| | - Bryan D Olmstead
- Human Nutrition Program, The Ohio State University, Columbus, OH, USA
| | - Geoffrey Y Sasaki
- Human Nutrition Program, The Ohio State University, Columbus, OH, USA
| | - Yael Vodovotz
- Department of Food Science and Technology, The Ohio State University, Columbus, OH, USA
| | - Zhongtang Yu
- Department of Animal Sciences, The Ohio State University, Columbus, OH, USA
| | - Richard S Bruno
- Human Nutrition Program, The Ohio State University, Columbus, OH, USA.
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Pedroso JAB, Wasinski F, Donato J. Prolonged fasting induces long-lasting metabolic consequences in mice. J Nutr Biochem 2020; 84:108457. [PMID: 32738733 DOI: 10.1016/j.jnutbio.2020.108457] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 12/11/2022]
Abstract
To endure prolonged fasting, animals undergo important acute physiological adjustments. However, whether severe fasting also leads to long-term metabolic adaptations is largely unknown. Forty-eight-hour fasting caused a pronounced weight loss in adult C57BL/6 male mice. Seven days of refeeding increased body adiposity to levels above baseline, whereas fasting-induced reductions in lean body mass and energy expenditure were not fully recovered. Respiratory exchange ratio and locomotor activity also remained altered. A fasting/refeeding cycle led to persistent suppression of Pomc mRNA levels and significant changes in the expression of histone deacetylases and DNA methyltransferases in the hypothalamus. Additionally, histone acetylation in the ventromedial nucleus of the hypothalamus was reduced by prolonged fasting and remained suppressed after refeeding. Mice subjected to 48-h fasting 30 days earlier exhibited higher body weight and fat mass compared to aged-matched animals that were never food-deprived. Furthermore, a previous fasting experience altered the changes in body weight, lean mass, energy expenditure and locomotor activity induced by a second cycle of fasting and refeeding. Notably, when acutely exposed to high-palatable/high-fat diet, mice that went through cumulative fasting episodes presented higher calorie intake and reduced energy expenditure and fat oxidation, compared to mice that had never been subjected to fasting. When chronically exposed to high-fat diet, mice that experienced cumulative fasting episodes showed higher gain of body and fat mass and reduced energy expenditure and calorie intake. In summary, cumulative episodes of prolonged fasting lead to hypothalamic epigenetic changes and long-lasting metabolic adaptations in mice.
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Affiliation(s)
- João A B Pedroso
- Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Fisiologia e Biofísica, São Paulo, 05508-000, Brazil
| | - Frederick Wasinski
- Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Fisiologia e Biofísica, São Paulo, 05508-000, Brazil
| | - Jose Donato
- Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Fisiologia e Biofísica, São Paulo, 05508-000, Brazil.
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Hernandez Roman J, Patel S. Why Do Lifestyle Recommendations Fail in Most Patients with Nonalcoholic Fatty Liver Disease? Gastroenterol Clin North Am 2020; 49:95-104. [PMID: 32033766 DOI: 10.1016/j.gtc.2019.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Nonalcoholic fatty liver disease has been recognized as a major health burden. The efficacy and safety profile of pharmacotherapy in the treatment of nonalcoholic fatty liver disease remains uncertain; therefore, lifestyle modification is the first line of treatment. Based on available data, patients should optimally achieve at least a 5% to 10% weight reduction for histologic improvement. There is no clear consensus on the optimal diet or exercise regimen. Sustainability of any intervention is key to success; however, compliance has been a major issue in clinical trials. This finding underscores the importance of multidisciplinary strategies to achieve targeted weigh loss.
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Affiliation(s)
- Jose Hernandez Roman
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Samarth Patel
- Division of Gastroenterology and Hepatology, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA; Division of Gastroenterology and Hepatology, Virginia Commonwealth University, 1200 E Broad St, Richmond, VA 23298-0342, USA.
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Abstract
PURPOSE OF REVIEW We seek to characterize the impact of bariatric surgery on diabetes mellitus by recalling its history, examining the clinical data, exploring the putative mechanisms of action, and anticipating its future. RECENT FINDINGS Results of clinical trials reveal that bariatric surgery induces remission of diabetes in 33-90% of individuals at 1-year post-treatment versus 0-39% of medically managed. Remission rates decrease over time but remain higher in surgically treated individuals. Investigations have revealed numerous actions of surgery including effects on intestinal physiology, neuronal signaling, incretin hormone secretion, bile acid metabolism, and microbiome changes. Bariatric surgery improves control of diabetes through both weight-dependent and weight-independent actions. These various mechanisms help explain the difference between individuals treated surgically vs. medically. They also explain differing effects of various bariatric surgery procedure types. Understanding how surgery affects diabetes will help optimize utilization of the therapy for both disease prevention and treatment.
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Affiliation(s)
- Alison H Affinati
- Division of Metabolism, Endocrinology and Diabetes (MEND), Department of Internal Medicine, Michigan Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Lobby G, Suite 1500, Ann Arbor, MI, 48106-0482, USA
| | - Nazanene H Esfandiari
- Division of Metabolism, Endocrinology and Diabetes (MEND), Department of Internal Medicine, Michigan Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Lobby G, Suite 1500, Ann Arbor, MI, 48106-0482, USA
| | - Elif A Oral
- Division of Metabolism, Endocrinology and Diabetes (MEND), Department of Internal Medicine, Michigan Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Lobby G, Suite 1500, Ann Arbor, MI, 48106-0482, USA
| | - Andrew T Kraftson
- Division of Metabolism, Endocrinology and Diabetes (MEND), Department of Internal Medicine, Michigan Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Lobby G, Suite 1500, Ann Arbor, MI, 48106-0482, USA.
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Cassanye A, Martín-Gari M, Portero-Otin M, Serrano JCE. Adipose Tissue Mitochondrial Factors Profile after Dietary Bioactive Compound Weight Reduction Treatments in a Mice Obesity Model. Int J Mol Sci 2019; 20:E5870. [PMID: 31771102 PMCID: PMC6928597 DOI: 10.3390/ijms20235870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/14/2019] [Accepted: 11/19/2019] [Indexed: 01/02/2023] Open
Abstract
Prolonged caloric intake above energy needs disturbs the body's ability to store and manage the excess of energy intake, leading to the onset of chronic degenerative diseases. This study aimed to compare the effect of three foods, which contain demonstrated bioactive compounds in the treatment of obesity and as an adjuvant in obesity energy restriction treatments. In a mice obesity model induced through a high-fat diet; fish oil, soluble fibre, and soy were incorporated to evaluate its capacity to modulate metabolic factors in adipose tissue during a continued fat intake or weight reduction through a normocaloric diet. As a result, fish oil improved mitochondrial related, adipose tissue hormone expression, and oxidation products when high-fat diets are consumed; while soluble fibre improved glucose and inflammation pathways during high-fat diet intake. In weight reduction treatments few differential features, as a treatment adjuvant, were observed for fish oil and soy; while soluble fibre was able to improve the weight reduction effects induced by a normocaloric diet. As a conclusion, soluble fibre supplementation compared to an energy reduction program, was the only treatment able to induce a significant additional effect in the improvement of weight loss and adipose tissue metabolism.
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Affiliation(s)
| | | | | | - José CE Serrano
- Department of Experimental Medicine, NUTREN-Nutrigenomics, University of Lleida, 25198 Lleida, Spain; (A.C.); (M.M.-G.); (M.P.-O.)
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Kim SH, Chung JH, Kim TH, Lim SH, Kim Y, Eun YM, Lee YA. The effects of repetitive transcranial magnetic stimulation on body weight and food consumption in obese adults: A randomized controlled study. Brain Stimul 2019; 12:1556-1564. [DOI: 10.1016/j.brs.2019.07.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 07/14/2019] [Accepted: 07/23/2019] [Indexed: 12/24/2022] Open
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Houghton D, Wilcox MD, Brownlee IA, Chater PI, Seal CJ, Pearson JP. Acceptability of alginate enriched bread and its effect on fat digestion in humans. Food Hydrocoll 2019; 93:395-401. [PMID: 32226189 PMCID: PMC7086458 DOI: 10.1016/j.foodhyd.2019.02.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Lifestyle interventions and physical activity remain the cornerstone of obesity management, as pharmacological therapies (orlistat) are associated with gastrointestinal (GI) side effects. Combining orlistat with fibers can reduce side effects, improving compliance. Therefore, a fiber that inhibits lipase without side effects could help treat obesity. The aims of the present work were to assess whether alginate enriched bread could inhibit fat digestion, and assess the acceptability of alginate bread and its effect on GI wellbeing. A double-blind, randomised, controlled cross-over pilot study (NCT03350958) assessed the impact of an alginate bread meal on; lipid content in ileal effluent and circulating triacylglycerol levels. This was compared against the same meal with non-enriched (control) bread. GI wellbeing and acceptability of alginate bread was compared to control bread through daily wellbeing questionnaires and food diaries (NCT03477981). Control bread followed by alginate bread were consumed for two weeks respectively. Consumption of alginate bread reduced circulating triacylglycerol compared to control (2% reduction in AUC) and significantly increased lipid content in ileal effluent (3.8 g ± 1.6 after 210 min). There were no significant changes to GI wellbeing when comparing alginate bread to control bread. A significant increase in the feeling of fullness occurred with alginate bread compared to baseline and the first week of control bread consumption. This study showed that sustained consumption of alginate enriched bread does not alter GI wellbeing and can decrease lipolysis, increasing lipid leaving the small intestine. Further studies are required to demonstrate that reduced fat digestion through the action of alginate can reduce fat mass or body weight. Alginate can be incorporated into a highly acceptable loaf at 4%. Sustained (two weeks) consumption of alginate bread did not affect GI wellbeing. Consumption of alginate bread decreases circulating triglyceride after the meal. Consumption of alginate bread increases lipid leaving the ileum after the meal.
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Affiliation(s)
- David Houghton
- Institute for Cell and Molecular Biosciences, Newcastle University, Medical School, Framlington Place, Newcastle upon Tyne, UK
| | - Matthew D Wilcox
- Institute for Cell and Molecular Biosciences, Newcastle University, Medical School, Framlington Place, Newcastle upon Tyne, UK
| | - Iain A Brownlee
- Institute for Cell and Molecular Biosciences, Newcastle University, Medical School, Framlington Place, Newcastle upon Tyne, UK
| | - Peter I Chater
- Institute for Cell and Molecular Biosciences, Newcastle University, Medical School, Framlington Place, Newcastle upon Tyne, UK
| | - Chris J Seal
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, M2.054 Leech Building, Newcastle upon Tyne, NE2 4HH, UK
| | - Jeffrey P Pearson
- Institute for Cell and Molecular Biosciences, Newcastle University, Medical School, Framlington Place, Newcastle upon Tyne, UK
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Vable AM, Nguyen TT, Rehkopf D, Glymour MM, Hamad R. Differential associations between state-level educational quality and cardiovascular health by race: Early-life exposures and late-life health. SSM Popul Health 2019; 8:100418. [PMID: 31249857 PMCID: PMC6586990 DOI: 10.1016/j.ssmph.2019.100418] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/20/2019] [Accepted: 05/24/2019] [Indexed: 01/13/2023] Open
Abstract
Cardiovascular diseases (CVD) are patterned by educational attainment but educational quality is rarely examined. Educational quality differences may help explain racial disparities. Health and Retirement Study respondent data (1992-2014; born 1900-1951) were linked to state- and year-specific educational quality measures when the respondent was 6 years old. State-level educational quality was a composite of state-level school term length, student-to-teacher ratio, and per-pupil expenditure. CVD-related outcomes were self-reported (N = 24,339) obesity, heart disease, stroke, ever-smoking, high blood pressure, diabetes and objectively measured (N = 10,704) uncontrolled blood pressure, uncontrolled blood sugar, total cholesterol, high-density lipoprotein cholesterol (HDL), and C-reactive protein. Race/ethnicity was classified as White, Black, or Latino. Cox models fit for dichotomous time-to-event outcomes and generalized estimating equations for continuous outcomes were adjusted for individual and state-level confounders. Heterogeneities by race were evaluated using state-level educational quality by race interaction terms; race-pooled, race by educational quality interaction, and race-specific estimates were calculated. In race-pooled analyses, higher state-level educational quality was protective for obesity (HR = 0.92; 95%CI(0.87,0.98)). In race-specific estimates for White Americans, state-level educational quality was protective for high blood pressure (HR = 0.95; 95%CI(0.91,0.99). Differential relationships among Black compared to White Americans were observed for obesity, heart disease, stroke, smoking, high blood pressure, and HDL cholesterol. In race-specific estimates for Black Americans, higher state-level educational quality was protective for obesity (HR = 0.88; 95%CI(0.84,0.93)), but predictive of heart disease (HR = 1.07; 95%CI(1.01,1.12)), stroke (HR = 1.20; 95%CI(1.08,1.32)), and smoking (HR = 1.05; 95%CI(1.02,1.08)). Race-specific hazard ratios for Latino and Black Americans were similar for obesity, stroke, and smoking. Better state-level educational quality had differential associations with CVD by race. Among minorities, better state-level educational quality was predominately associated with poorer CVD outcomes. Results evaluate the 1900-1951 birth cohorts; secular changes in the racial integration of schools since the 1950s, means results may not generalize to younger cohorts.
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Affiliation(s)
- Anusha M. Vable
- Department of Family and Community Medicine, University of California, San Francisco, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Thu T. Nguyen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - David Rehkopf
- Center for Population Health Sciences, Stanford University, USA
- Department of Medicine, Division of Primary Care and Population Health, Stanford University, USA
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
- Department of Social and Behavioral Health, Harvard T.H. Chan School of Public Health, Harvard University, USA
| | - Rita Hamad
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, USA
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Pedroso JAB, Ramos-Lobo AM, Donato J. SOCS3 as a future target to treat metabolic disorders. Hormones (Athens) 2019; 18:127-136. [PMID: 30414080 DOI: 10.1007/s42000-018-0078-5] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/29/2018] [Indexed: 12/20/2022]
Abstract
The suppressors of cytokine signaling (SOCS) are a group of eight proteins responsible for preventing excessive cytokine signaling. Among this protein family, SOCS3 has received special attention. SOCS3 expression is important to control certain allergy autoimmune diseases. Furthermore, SOCS3 expression is elevated in obesity and it is involved in the inhibition of leptin and insulin signaling, two important hormones involved in the control of energy metabolism. Therefore, increased SOCS3 expression in obese individuals is associated with several metabolic disorders, including reduced energy expenditure, increased food intake and adiposity, and insulin and leptin resistance. In addition, recent studies found that SOCS3 expression regulates energy and glucose homeostasis in several metabolic conditions, such as pregnancy, caloric restriction, and refeeding. Importantly, attenuation of SOCS3 expression in most cases improves leptin and insulin sensitivity, leading to beneficial metabolic effects. This review aims to discuss the role of SOCS3 in the control of blood glucose levels as well as in energy homeostasis. The development of pharmacological compounds to inhibit SOCS3 activity and/or expression may represent a promising therapeutic approach to treat type 2 diabetes mellitus, obesity, and other metabolic imbalances.
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Affiliation(s)
- João A B Pedroso
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1524, São Paulo, 05508-000, Brazil.
| | - Angela M Ramos-Lobo
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1524, São Paulo, 05508-000, Brazil
| | - Jose Donato
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1524, São Paulo, 05508-000, Brazil
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Dey P, Sasaki GY, Wei P, Li J, Wang L, Zhu J, McTigue D, Yu Z, Bruno RS. Green tea extract prevents obesity in male mice by alleviating gut dysbiosis in association with improved intestinal barrier function that limits endotoxin translocation and adipose inflammation. J Nutr Biochem 2019; 67:78-89. [PMID: 30856467 DOI: 10.1016/j.jnutbio.2019.01.017] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 01/03/2019] [Accepted: 01/29/2019] [Indexed: 01/03/2023]
Abstract
Gut-derived endotoxin translocation provokes obesity by inducing TLR4/NFκB inflammation. We hypothesized that catechin-rich green tea extract (GTE) would protect against obesity-associated TLR4/NFκB inflammation by alleviating gut dysbiosis and limiting endotoxin translocation. Male C57BL/6J mice were fed a low-fat (LF) or high-fat (HF) diet containing 0% or 2% GTE for 8 weeks. At Week 7, fluorescein isothiocyanate (FITC)-dextran was administered by oral gavage before assessing its serum concentrations as a gut permeability marker. HF-feeding increased (P<.05) adipose mass and adipose expression of genes involved in TLR4/NFκB-dependent inflammation and macrophage activation. GTE attenuated HF-induced obesity and pro-inflammatory gene expression. GTE in HF mice decreased serum FITC-dextran, and attenuated portal vein and circulating endotoxin concentrations. GTE in HF mice also prevented HF-induced decreases in the expression of intestinal tight junction proteins (TJPs) and hypoxia inducible factor-1α while preventing increases in TLR4/NFκB-dependent inflammatory genes. Gut microbial diversity was increased, and the Firmicutes:Bacteroidetes ratio was decreased, in HF mice fed GTE compared with HF controls. GTE in LF mice did not attenuate adiposity but decreased endotoxin and favorably altered several gut bacterial populations. Serum FITC-dextran was correlated with portal vein endotoxin (P<.001; rP=0.66) and inversely correlated with colonic mRNA levels of TJPs (P<.05; rP=-0.38 to -0.48). Colonic TJPs mRNA were inversely correlated with portal endotoxin (P<.05; rP=-0.33 to -0.39). These data suggest that GTE protects against diet-induced obesity consistent with a mechanism involving the gut-adipose axis that limits endotoxin translocation and consequent adipose TLR4/NFκB inflammation by improving gut barrier function.
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Affiliation(s)
- Priyankar Dey
- Human Nutrition Program, The Ohio State University, Columbus, OH, USA
| | - Geoffrey Y Sasaki
- Human Nutrition Program, The Ohio State University, Columbus, OH, USA
| | - Ping Wei
- Department of Neuroscience and Center for Brain and Spinal Cord Repair, The Ohio State University, Columbus, OH, USA
| | - Jinhui Li
- Human Nutrition Program, The Ohio State University, Columbus, OH, USA
| | - Lingling Wang
- Department of Animal Sciences, The Ohio State University, Columbus, OH, USA
| | - Jiangjiang Zhu
- Department of Chemistry and Biochemistry, Miami University, Oxford, OH, USA
| | - Dana McTigue
- Department of Neuroscience and Center for Brain and Spinal Cord Repair, The Ohio State University, Columbus, OH, USA
| | - Zhongtang Yu
- Department of Animal Sciences, The Ohio State University, Columbus, OH, USA
| | - Richard S Bruno
- Human Nutrition Program, The Ohio State University, Columbus, OH, USA.
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Natsis M, Antza C, Doundoulakis I, Stabouli S, Kotsis V. Hypertension in Obesity: Novel Insights. Curr Hypertens Rev 2019; 16:30-36. [PMID: 30987571 DOI: 10.2174/1573402115666190415154603] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND The relationship between obesity and hypertension has been established in both adults and children. The combination of obesity, hypertension and other cardiovascular risk factors significantly increases the likelihood of adverse cardiovascular effects and raises concerns about aggressive treatment strategies. OBJECTIVE Despite the impressive elements which indicate an important role for excessive weight gain in increasing blood pressure, not all obese patients are hypertensive. A subgroup of obese people may not develop hypertension. Furthermore, masked hypertension occurs more common among obese patients, and body fat distribution has a major role in the development of hypertension. METHOD We conducted a research of the relevant literature regarding obesity-induced hypertension and possible treatment strategies. RESULTS Successful weight loss is correlated with blood pressure reduction and requires a multidisciplinary approach that includes personalized dietary interventions combined with regular exercise and cognitive behavioral therapy. CONCLUSION Pharmacological therapy may be considered as part of a comprehensive obesity management strategy. More research and new treatment therapies are required in this field.
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Affiliation(s)
- Michail Natsis
- 3rd Department of Internal Medicine, Hypertension-24h ABPM ESH Center of Excellence, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christina Antza
- 3rd Department of Internal Medicine, Hypertension-24h ABPM ESH Center of Excellence, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Doundoulakis
- 3rd Department of Internal Medicine, Hypertension-24h ABPM ESH Center of Excellence, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stella Stabouli
- 1st Department of Pediatrics, Hippokration Hospital, Thessaloniki, Greece
| | - Vasilios Kotsis
- 3rd Department of Internal Medicine, Hypertension-24h ABPM ESH Center of Excellence, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Enö Persson J, Bohman B, Tynelius P, Rasmussen F, Ghaderi A. Prevention of Childhood Obesity in Child Health Services: Follow-Up of the PRIMROSE Trial. Child Obes 2019; 14:99-105. [PMID: 29232526 DOI: 10.1089/chi.2017.0117] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Childhood obesity is an urgent public health concern, and there's a need for long-term, high-quality, primary prevention trials targeting parents of young children. The aim of the current study was to evaluate the long-term effect of a parental support program based on motivational interviewing (MI). METHODS A cluster randomized controlled trial was carried out in eight Swedish counties. Participating families (N = 1355) were enrolled when the child was 9 months old, and participated in nine sessions during ∼39 months. The aim was to pomote healthy food and physical activity (PA) habits using MI and principles from cognitive behavioral therapy. Nurses in Swedish child health services delivered the intervention, and the control group received usual healthcare. The current study was a 1-year follow-up of effects on children's weight-related measures. Regression analyses were conducted using generalized estimating equations, including analyses to investigate potential parental moderators of the effect. RESULTS There were no statistically significant intervention effects at follow-up [BMI difference = -0.13, p = 0.29, overweight relative risk (RR) = 0.96, p = 0.78, obesity RR = 0.57, p = 0.20]. Maternal waist circumference and unhealthy eating and paternal PA moderated the effect, but effects were small and failed to reach statistical significance after correction for multiple comparisons. CONCLUSIONS A parent-focused primary prevention intervention based on MI delivered within child health services did not result in effects at 1-year follow-up. The results were in line with those obtained at post-assessment and indicated no late onset of effect. Further studies exploring individual and contextual factors influencing the outcome are called for.
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Affiliation(s)
- Johanna Enö Persson
- 1 Department of Clinical Neuroscience, Karolinska Institutet , Stockholm, Sweden
| | - Benjamin Bohman
- 1 Department of Clinical Neuroscience, Karolinska Institutet , Stockholm, Sweden .,2 Centre for Psychiatry Research , Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Per Tynelius
- 3 Child and Adolescent Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet , Stockholm, Sweden .,4 Centre for Epidemiology and Community Medicine, Stockholm County Council, Health Care Services , Stockholm, Sweden
| | - Finn Rasmussen
- 5 Department of Health Sciences, Lund University , Lund, Sweden
| | - Ata Ghaderi
- 1 Department of Clinical Neuroscience, Karolinska Institutet , Stockholm, Sweden
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Abstract
Since the renaissance of microbiome research in the past decade, much insight has accumulated in comprehending forces shaping the architecture and functionality of resident microorganisms in the human gut. Of the multiple host-endogenous and host-exogenous factors involved, diet emerges as a pivotal determinant of gut microbiota community structure and function. By introducing dietary signals into the nexus between the host and its microbiota, nutrition sustains homeostasis or contributes to disease susceptibility. Herein, we summarize major concepts related to the effect of dietary constituents on the gut microbiota, highlighting chief principles in the diet-microbiota crosstalk. We then discuss the health benefits and detrimental consequences that the interactions between dietary and microbial factors elicit in the host. Finally, we present the promises and challenges that arise when seeking to incorporate microbiome data in dietary planning and portray the anticipated revolution that the field of nutrition is facing upon adopting these novel concepts.
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Affiliation(s)
- Niv Zmora
- Immunology Department, Weizmann Institute of Science, Rehovot, Israel.,Gastroenterology Unit, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jotham Suez
- Immunology Department, Weizmann Institute of Science, Rehovot, Israel
| | - Eran Elinav
- Immunology Department, Weizmann Institute of Science, Rehovot, Israel.
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Talepasand S, Golzari M. Attention Control in Presence of Food Cues in Restrained and Unrestrained Eaters. Noro Psikiyatr Ars 2018; 55:301-306. [PMID: 30622384 PMCID: PMC6300831 DOI: 10.5152/npa.2017.19323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 09/13/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION This research tries to study the relation between dietary restraint and attention control in females admitted to diet therapy clinics in Kerman County. METHODS Participants were all female subjects who had been admitted to diet therapy clinics in Kerman County. The sample size included 80 women between ages of 15 to 50 years. Participants were selected through convenience sampling. All participants were asked to fill out the Dutch Eating Behavior Questionnaire and respond to Stroop task software. RESULTS The restrained eaters' reaction time towards food stimuli was higher than that of unrestrained eaters. The reaction time in Stroop effect condition in restrained eaters was higher than that of unrestrained eaters. In restrained eaters, the reaction time in presence of food stimuli was higher than the condition in which non-food stimuli were presented. In presence of food stimuli, the reaction time in Stroop effect condition was higher than non-Stroop effect. Finally, it was determined that in non-Stroop conditions compared to Stroop conditions, strained eaters had a higher reaction time in presence of food stimuli than the condition in which non-food stimuli were presented. CONCLUSION These findings verify the role of attention bias in reaction to food stimuli in restrained eaters and they suggest that diet success relies on avoiding interactions related to food.
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Jeong JN. Effect of Pre-meal Water Consumption on Energy Intake and Satiety in Non-obese Young Adults. Clin Nutr Res 2018; 7:291-296. [PMID: 30406058 PMCID: PMC6209729 DOI: 10.7762/cnr.2018.7.4.291] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 09/30/2018] [Accepted: 10/03/2018] [Indexed: 11/19/2022] Open
Abstract
I determined whether water consumption reduces energy intake and affects satiety in non-obese young adults. The final subjects consisted of 15 individuals (8 women and 7 men) with average ages of 26.4 and 23.5 years for women and men, respectively. When subjects drank water before eating a test meal, they ate a lower amount of the test meal compared to eating test meals under waterless and postload water conditions (preload water: 123.3 g vs. waterless: 161.7 g or postload water: 163.3 g, p < 0.05). Water consumption after eating a test meal did not affect energy intake. When the subjects drank water before eating a test meal, despite consuming a lower amount, the subjects did not feel significantly less satiety than eating meals under waterless or postload water conditions. The finding that pre-meal water consumption led to a significant reduction in meal energy intake in young adults suggests that pre-meal water consumption may be an effective weight control strategy, although the mechanism of action is unknown.
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Affiliation(s)
- Ji Na Jeong
- Department of of Health Management, Jeonju University, Jeonju 55069, Korea
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28
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Romer AL, Su Kang M, Nikolova YS, Gearhardt AN, Hariri AR. Dopamine genetic risk is related to food addiction and body mass through reduced reward-related ventral striatum activity. Appetite 2018; 133:24-31. [PMID: 30296504 DOI: 10.1016/j.appet.2018.09.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 08/22/2018] [Accepted: 09/10/2018] [Indexed: 12/29/2022]
Abstract
The prevalence rate of obesity continues to rise in the U.S., but effective treatment options remain elusive resulting in increased emphasis on prevention. One such area of prevention research capitalizes on the relatively novel behavioral construct of food addiction, which has been implicated in obesity. Food addiction reflects an individual's propensity for compulsive eating despite negative consequences, and shares not only symptoms with both eating and substance use disorders but also genetic and neural correlates within neural reward-circuitry modulated by dopamine. Here, we examined associations between food addiction scores, body mass index (BMI), reward-related ventral striatum activity, and a polygenic score approximating dopamine signaling in 115 non-Hispanic Caucasian young adult university students. As predicted, polygenic dopamine scores were related to ventral striatum activity, which in turn was associated with higher food addiction scores. In addition, food addiction was related to BMI. An exploratory post-hoc path analysis further indicated that polygenic scores were indirectly related to both food addiction and BMI, in part, through ventral striatum activity. Collectively, our results provide evidence supporting the utility of food addiction in weight gain prevention research by establishing links with known risk-related neural and genetic biomarkers.
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Affiliation(s)
| | - Min Su Kang
- University of Pennsylvania, Philadelphia, PA, USA
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29
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Zhang L, Pagoto S, Olendzki B, Persuitte G, Churchill L, Oleski J, Ma Y. A nonrestrictive, weight loss diet focused on fiber and lean protein increase. Nutrition 2018; 54:12-18. [DOI: 10.1016/j.nut.2018.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/22/2017] [Accepted: 02/04/2018] [Indexed: 01/21/2023]
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Coutinho SR, Halset EH, Gåsbakk S, Rehfeld JF, Kulseng B, Truby H, Martins C. Compensatory mechanisms activated with intermittent energy restriction: A randomized control trial. Clin Nutr 2018; 37:815-823. [DOI: 10.1016/j.clnu.2017.04.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Revised: 03/22/2017] [Accepted: 04/03/2017] [Indexed: 12/19/2022]
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Kim SH, Chung JH, Kim TH, Lim SH, Kim Y, Lee YA, Song SW. The effects of repetitive transcranial magnetic stimulation on eating behaviors and body weight in obesity: A randomized controlled study. Brain Stimul 2018; 11:528-535. [DOI: 10.1016/j.brs.2017.11.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 11/22/2017] [Accepted: 11/28/2017] [Indexed: 11/29/2022] Open
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Li J, Sasaki GY, Dey P, Chitchumroonchokchai C, Labyk AN, McDonald JD, Kim JB, Bruno RS. Green tea extract protects against hepatic NFκB activation along the gut-liver axis in diet-induced obese mice with nonalcoholic steatohepatitis by reducing endotoxin and TLR4/MyD88 signaling. J Nutr Biochem 2018; 53:58-65. [PMID: 29190550 DOI: 10.1016/j.jnutbio.2017.10.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 10/12/2017] [Accepted: 10/25/2017] [Indexed: 12/12/2022]
Abstract
Green tea extract (GTE) reduces NFκB-mediated inflammation during nonalcoholic steatohepatitis (NASH). We hypothesized that its anti-inflammatory activities would be mediated in a Toll-like receptor 4 (TLR4)-dependent manner. Wild-type (WT) and loss-of-function TLR4-mutant (TLR4m) mice were fed a high-fat diet containing GTE at 0 or 2% for 8 weeks before assessing NASH, NFκB-mediated inflammation, TLR4 and its adaptor proteins MyD88 and TRIF, circulating endotoxin, and intestinal tight junction protein mRNA expression. TLR4m mice had lower (P<.05) body mass compared with WT mice but similar adiposity, whereas body mass and adiposity were lowered by GTE regardless of genotype. Liver steatosis, serum alanine aminotransferase, and hepatic lipid peroxidation were also lowered by GTE in WT mice, and were similarly lowered in TLR4m mice regardless of GTE. Phosphorylation of the NFκB p65 subunit and pro-inflammatory genes (TNFα, iNOS, MCP-1, MPO) were lowered by GTE in WT mice, and did not differ from the lowered levels in TLR4m mice regardless of GTE. TLR4m mice had lower TLR4 mRNA, which was also lowered by GTE in both genotypes. TRIF expression was unaffected by genotype and GTE, whereas MyD88 was lower in mice fed GTE regardless of genotype. Serum endotoxin was similarly lowered by GTE regardless of genotype. Tight junction protein mRNA levels were unaffected by genotype. However, GTE similarly increased claudin-1 mRNA in the duodenum and jejunum and mRNA levels of occludin and zonula occluden-1 in the jejunum and ileum. Thus, GTE protects against inflammation during NASH, likely by limiting gut-derived endotoxin translocation and TLR4/MyD88/NFκB activation.
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Affiliation(s)
- Jinhui Li
- Human Nutrition Program, The Ohio State University, Columbus, OH 43210, USA
| | - Geoffrey Y Sasaki
- Human Nutrition Program, The Ohio State University, Columbus, OH 43210, USA
| | - Priyankar Dey
- Human Nutrition Program, The Ohio State University, Columbus, OH 43210, USA
| | | | - Allison N Labyk
- Human Nutrition Program, The Ohio State University, Columbus, OH 43210, USA
| | - Joshua D McDonald
- Human Nutrition Program, The Ohio State University, Columbus, OH 43210, USA
| | - Joshua B Kim
- Human Nutrition Program, The Ohio State University, Columbus, OH 43210, USA
| | - Richard S Bruno
- Human Nutrition Program, The Ohio State University, Columbus, OH 43210, USA.
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Auriemma RS, De Alcubierre D, Pirchio R, Pivonello R, Colao A. The effects of hyperprolactinemia and its control on metabolic diseases. Expert Rev Endocrinol Metab 2018; 13:99-106. [PMID: 30058862 DOI: 10.1080/17446651.2018.1434412] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Hyperprolactinaemia has been implicated in the pathogenesis of obesity and glucose intolerance and is reportedly associated with impaired metabolic profile and metabolic syndrome in approximately one third of patients. AREAS COVERED Suppression of dopaminergic tone has been proposed as a potential mechanism responsible for weight gain and metabolic abnormalities in such patients. Dopamine receptor type 2 (D2R) is abundantly expressed on human pancreatic β-cell and adipocytes, suggesting a regulatory role for peripheral dopamine in insulin and adipose functions. Medical treatment with the dopamine-agonists bromocriptine and cabergoline has been shown to significantly improve gluco-insulinemic and lipid profile, also reducing the prevalence of metabolic syndrome. In patients with concomitant hypogonadism, simultaneous correction of both PRL excess and testosterone deficiency is mandatory to improve insulin resistance and metabolic abnormalities. EXPERT COMMENTARY Hyperprolactinemia promotes metabolic alterations. Control of PRL excess by dopamine agonists is mandatory to induce weight loss and to improve metabolic profile, and replacement treatment for concomitant hypogonadism effectively ameliorates insulin resistance and metabolic syndrome.
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Affiliation(s)
- Renata S Auriemma
- a Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia , University of Naples Federico II , Naples , Italy
| | - Dario De Alcubierre
- a Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia , University of Naples Federico II , Naples , Italy
| | - Rosa Pirchio
- a Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia , University of Naples Federico II , Naples , Italy
| | - Rosario Pivonello
- a Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia , University of Naples Federico II , Naples , Italy
| | - Annamaria Colao
- a Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia , University of Naples Federico II , Naples , Italy
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Ludwig RG, Rocha AL, Mori MA. Circulating molecules that control brown/beige adipocyte differentiation and thermogenic capacity. Cell Biol Int 2018; 42:701-710. [PMID: 29384242 DOI: 10.1002/cbin.10946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/27/2018] [Indexed: 12/18/2022]
Abstract
Obesity may be counteracted by increased energy expenditure. Circulating molecules act in the adipose tissue to influence brown and beige adipocyte function, differentiation, and thermogenic capacity, which in turn affects substrate utilization and impacts energy balance at the organismal level. These molecules have been envisioned as biomarkers and potential candidates for pharmacological interventions to treat obesity. Here we summarize studies that demonstrate the roles of endogenous circulating molecules of a wide variety in regulating the thermogenic potential of brown and beige fat cells. This review describes the state-of-the-art in the field and helps researchers to prioritize their targets in future studies.
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Affiliation(s)
- Raissa G Ludwig
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, Brazil
- Program in Genetics and Molecular Biology, Institute of Biology, University of Campinas, Campinas, Brazil
| | - Andréa L Rocha
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, Brazil
- Program in Genetics and Molecular Biology, Institute of Biology, University of Campinas, Campinas, Brazil
| | - Marcelo A Mori
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, Campinas, Brazil
- Program in Genetics and Molecular Biology, Institute of Biology, University of Campinas, Campinas, Brazil
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Austin C, Stewart D, Allwood JW, McDougall GJ. Extracts from the edible seaweed, Ascophyllum nodosum, inhibit lipase activity in vitro: contributions of phenolic and polysaccharide components. Food Funct 2018; 9:502-510. [PMID: 29243753 DOI: 10.1039/c7fo01690e] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A polyphenol-rich extract (PRE) from the edible seaweed, Ascophyllum nodosum, inhibited pancreatic lipase activity in an oil-based turbidimetric assay with an IC50 of 200 μg gallic acid equivalents (GAE) perassay) [∼230 μg DW] whereas the known inhibitor, Orlistat, gave an IC50 at 0.4 μg per assay. A phlorotannin-enriched fraction (TRF) purified from the PRE was more potent with an IC50 = 60 μg GAE per assay (∼65 μg DW). When the assay was started by the addition of lipase, both Orlistat and TRF were much less effective which suggests that pre-incubation of enzyme and inhibitor improved inhibition. Based on phenol content, water extracts from Ascophyllum were more potent lipase inhibitors than PRE (IC50 ∼ 150 μg GAE per assay). However, this was equivalent to ∼580 μg DW and these extracts contained polysaccharides (e.g. alginate content = 110 μg mL-1) which may also contribute to inhibition. Indeed, a polysaccharide-enriched fraction obtained by ethanol precipitation gave an IC50 of 1000 μg DW which was equivalent to 130 μg GAE and 420 μg alginate per assay. Therefore a >3 fold increase in alginate content did not markedly improve inhibition. Re-precipitation increased alginate content and reduced polyphenol content but lipase inhibition was markedly reduced (i.e. IC50 at ∼1100 μg DW per assay, 700 μg alginate and 25 μg GAE). Purifying the polysaccharide fraction by ion exchange removed all phenolics but the IC50 increased to >2500 μg DW, equivalent to >1970 μg alginate per assay. In conclusion, polysaccharides and phlorotannins may inhibit lipase in an additive fashion, with phlorotannins apparently more effective in vitro. However, interactions between these components may be important when food products containing this edible seaweed are consumed.
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Affiliation(s)
- Ceri Austin
- Environmental and Biochemical Sciences Group, The James Hutton Institute, Invergowrie, Dundee DD2 5DA, UK.
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36
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Devine CM, Barnhill A. The Ethical and Public Health Importance of Unintended Consequences: the Case of Behavioral Weight Loss Interventions. Public Health Ethics 2017. [DOI: 10.1093/phe/phx026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tharakan G, Behary P, Wewer Albrechtsen NJ, Chahal H, Kenkre J, Miras AD, Ahmed AR, Holst JJ, Bloom SR, Tan T. Roles of increased glycaemic variability, GLP-1 and glucagon in hypoglycaemia after Roux-en-Y gastric bypass. Eur J Endocrinol 2017; 177:455-464. [PMID: 28855269 PMCID: PMC5642268 DOI: 10.1530/eje-17-0446] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/14/2017] [Accepted: 08/30/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Roux-en-Y gastric bypass (RYGB) surgery is currently the most effective treatment for diabetes and obesity. An increasingly recognized and highly disabling complication of RYGB is postprandial hypoglycaemia (PPH). The pathophysiology of PPH remains unclear with multiple mechanisms suggested including nesidioblastosis, altered insulin clearance and increased glucagon-like peptide-1 (GLP-1) secretion. Whilst many PPH patients respond to dietary modification, some have severely disabling symptoms. Multiple treatments are proposed, including dietary modification, GLP-1 antagonism, GLP-1 analogues and even surgical reversal, with none showing a more decided advantage over the others. A greater understanding of the pathophysiology of PPH could guide the development of new therapeutic strategies. METHODS We studied a cohort of PPH patients at the Imperial Weight Center. We performed continuous glucose monitoring to characterize their altered glycaemic variability. We also performed a mixed meal test (MMT) and measured gut hormone concentrations. RESULTS We found increased glycaemic variability in our cohort of PPH patients, specifically a higher mean amplitude glucose excursion (MAGE) score of 4.9. We observed significantly greater and earlier increases in insulin, GLP-1 and glucagon in patients who had hypoglycaemia in response to an MMT (MMT Hypo) relative to those that did not (MMT Non-Hypo). No significant differences in oxyntomodulin, GIP or peptide YY secretion were seen between these two groups. CONCLUSION An early peak in GLP-1 and glucagon may together trigger an exaggerated insulinotropic response to eating and consequent hypoglycaemia in patients with PPH.
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Affiliation(s)
- George Tharakan
- Division of DiabetesEndocrinology and Metabolism, Imperial College London, London, UK
| | - Preeshila Behary
- Division of DiabetesEndocrinology and Metabolism, Imperial College London, London, UK
| | - Nicolai J Wewer Albrechtsen
- NNF Center for Basic Metabolic Research and Department of Biomedical SciencesFaculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Harvinder Chahal
- Division of DiabetesEndocrinology and Metabolism, Imperial College London, London, UK
| | - Julia Kenkre
- Division of DiabetesEndocrinology and Metabolism, Imperial College London, London, UK
| | - Alexander D Miras
- Division of DiabetesEndocrinology and Metabolism, Imperial College London, London, UK
| | - Ahmed R Ahmed
- Department of SurgeryImperial College Healthcare NHS Trust, London, UK
| | - Jens J Holst
- NNF Center for Basic Metabolic Research and Department of Biomedical SciencesFaculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stephen R Bloom
- Division of DiabetesEndocrinology and Metabolism, Imperial College London, London, UK
| | - Tricia Tan
- Division of DiabetesEndocrinology and Metabolism, Imperial College London, London, UK
- Correspondence should be addressed to T Tan;
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Reverri EJ, Randolph JM, Kappagoda CT, Park E, Edirisinghe I, Burton-Freeman BM. Assessing beans as a source of intrinsic fiber on satiety in men and women with metabolic syndrome. Appetite 2017; 118:75-81. [DOI: 10.1016/j.appet.2017.07.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 07/10/2017] [Accepted: 07/12/2017] [Indexed: 12/23/2022]
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Huang X, Xu M, Shirahata T, Li W, Koike K, Kojima-Yuasa A, Yuasa I, Kobayashi Y. Anti-steatosis compounds from leaves of Mallotus furetianus. Nat Prod Res 2017; 32:1459-1462. [PMID: 28693358 DOI: 10.1080/14786419.2017.1350664] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
There is no drug administration-approved therapy for non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). In this study, eight compounds, gallic acid (1), methyl gallate (2), corilagin (3), 3,4,8,9,10-pentahydroxydibenzo[b,d]pyran-6-one (4), repandinin B (5), (Z)-3-hexenyl-β-D-glucopyranoside (6), (+)-lyoniresinol-3α-O-α-L-rhamnopyranoside (7) and mallophenol A (8) were isolated from the active fractions of Mallotus furetianus. Three compounds, (6, 7 and 8) revealed potent anti-steatosis activity in the oleic acid (OA)-induced steatosis cell model, with the minimum effective concentration of 0.05 (6), 0.0005 (7) and 0.0005 (8) μg/mL, which were much lower than the control compound, fibrate (72.4 μg/mL).
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Affiliation(s)
- Xuedan Huang
- a School of Pharmaceutical Sciences , Kitasato University , Tokyo , Japan
| | - Mingzhu Xu
- a School of Pharmaceutical Sciences , Kitasato University , Tokyo , Japan
| | - Tatsuya Shirahata
- a School of Pharmaceutical Sciences , Kitasato University , Tokyo , Japan
| | - Wei Li
- b Faculty of Pharmaceutical Science , Toho University , Funabashi , Japan
| | - Kazuo Koike
- b Faculty of Pharmaceutical Science , Toho University , Funabashi , Japan
| | - Akiko Kojima-Yuasa
- c Department of Food and Human Health Sciences, Graduate School of Human Life Science , Osaka City University , Osaka , Japan
| | - Isao Yuasa
- c Department of Food and Human Health Sciences, Graduate School of Human Life Science , Osaka City University , Osaka , Japan
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Coutinho SR, With E, Rehfeld JF, Kulseng B, Truby H, Martins C. The impact of rate of weight loss on body composition and compensatory mechanisms during weight reduction: A randomized control trial. Clin Nutr 2017; 37:1154-1162. [PMID: 28479016 DOI: 10.1016/j.clnu.2017.04.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/29/2017] [Accepted: 04/10/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND & AIMS Rapid weight loss (WL) has been associated with a larger loss of fat free mass and a disproportional reduction in resting metabolic rate (RMR), but the evidence is inconclusive. We aimed to evaluate the impact of WL rate on body composition and compensatory mechanisms activated with WL (reduced RMR, increased exercise efficiency (ExEff) and appetite), both during negative and neutral energy balance (EB). METHODS Thirty-five participants with obesity were randomized to lose a similar weight rapidly (4 weeks) or gradually (8 weeks), and afterwards to maintain it (4 weeks). Body weight and composition, RMR, ExEff (10, 25 and 50 W), appetite feelings and appetite-regulating hormones (active ghrelin, cholecystokinin, total peptide YY (PYY), active glucagon-like peptide-1 and insulin), in fasting and every 30 min up to 2.5 h, were measured at baseline and after each phase. RESULTS Changes in body weight (≈9%) and composition were similar in both groups. With WL, RMR decreased and ExEff at 10 W increased significantly in the rapid WL group only. However, fasting hunger increased significantly with gradual WL only, while fasting and postprandial prospective food consumption, and postprandial hunger decreased (and postprandial fullness increased) significantly with rapid WL only. Basal total PYY, and basal and postprandial insulin decreased significantly, and similarly in both groups. After weight stabilization and no ketosis no differences between groups were found. CONCLUSIONS Despite differences while under negative EB, WL rate does not seem to have a significant impact on body composition or on compensatory mechanisms, once EB is reestablished. CLINICAL TRIAL REGISTRATION NUMBER NCT01912742 (the study was registered in clinicaltrial.gov).
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Affiliation(s)
- Sílvia Ribeiro Coutinho
- Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Emilie With
- Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jens F Rehfeld
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bård Kulseng
- Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Centre for Obesity, Department of Surgery, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Helen Truby
- Department of Food, Nutrition and Dietetics, Monash University, Melbourne, Australia
| | - Cátia Martins
- Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Centre for Obesity, Department of Surgery, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
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Tay TR, Lee J, Radhakrishna N, Hore-Lacy F, Stirling R, Hoy R, Dabscheck E, O'Hehir R, Hew M. A Structured Approach to Specialist-referred Difficult Asthma Patients Improves Control of Comorbidities and Enhances Asthma Outcomes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2017; 5:956-964.e3. [PMID: 28284780 DOI: 10.1016/j.jaip.2016.12.030] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 12/05/2016] [Accepted: 12/20/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Systematic evaluation is advocated for difficult asthma, but how best to deliver such care is unclear and outcome data are scarce. OBJECTIVE We describe our institution's structured approach to difficult asthma management and report on the outcomes of such an approach. METHODS Eighty-two consecutive patients with difficult asthma referred to our clinic from respiratory specialists were evaluated in 3 key areas: diagnostic confirmation, comorbidity detection, and inflammatory phenotyping. We then optimized treatment including relevant comorbidity interventions. The outpatient protocol was supported by comorbidity questionnaires, an electronic clinic template, and standardized panel discussion. Asthma outcomes were assessed at 6 months. RESULTS Sixty-eight patients completed follow-up. Asthma diagnosis was refuted in 3 patients and the remaining 65 patients were included in the study analysis. There was no overall escalation of inhaled or oral corticosteroids. Patients had a median of 3 comorbidities, and a median of 3 comorbidity interventions. Control of chronic rhinosinusitis and dysfunctional breathing improved among patients with these diagnoses (22-item Sino-Nasal Outcome Test score from 47 ± 20 to 37 ± 22, P = .017; Nijmegen score from 32 ± 6 to 25 ± 9, P = .003). There were overall improvements in the Asthma Control Test score (from 14 ± 5 to 16 ± 6, P < .001), the Asthma Quality of Life Questionnaire (from 4.29 ± 1.4 to 4.65 ± 1.5, P = .073), and the frequency of exacerbations over 6 months (from 2 [interquartile range, 0-4] to 0 [interquartile range, 0-2], P < .001). CONCLUSIONS In patients referred with difficult asthma from respiratory specialists, a structured approach coupled with targeted comorbidity interventions improved control of key comorbidities and enhanced asthma outcomes.
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Affiliation(s)
- Tunn Ren Tay
- Allergy, Asthma and Clinical Immunology Service, The Alfred Hospital, Melbourne, Victoria, Australia.
| | - Joy Lee
- Allergy, Asthma and Clinical Immunology Service, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Naghmeh Radhakrishna
- Allergy, Asthma and Clinical Immunology Service, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Fiona Hore-Lacy
- Allergy, Asthma and Clinical Immunology Service, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Robert Stirling
- Allergy, Asthma and Clinical Immunology Service, The Alfred Hospital, Melbourne, Victoria, Australia; Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ryan Hoy
- Allergy, Asthma and Clinical Immunology Service, The Alfred Hospital, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Eli Dabscheck
- Allergy, Asthma and Clinical Immunology Service, The Alfred Hospital, Melbourne, Victoria, Australia; Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Robyn O'Hehir
- Allergy, Asthma and Clinical Immunology Service, The Alfred Hospital, Melbourne, Victoria, Australia; Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mark Hew
- Allergy, Asthma and Clinical Immunology Service, The Alfred Hospital, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Balog JE. Public Health, Historical and Moral Lessons for the Preparation of School Health Educators: The Case of Childhood Obesity and the Need for Social Responsibility. AMERICAN JOURNAL OF HEALTH EDUCATION 2016. [DOI: 10.1080/19325037.2016.1219683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Joseph E. Balog
- The College at Brockport, State University of New York, Public Health & Health Education
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Donnadieu-Rigole H, Olive L, Nalpas B, Duny Y, Nocca D, Perney P. Prevalence of Psychoactive Substance Consumption in People With Obesity. Subst Use Misuse 2016; 51:1649-1654. [PMID: 27486825 DOI: 10.1080/10826084.2016.1191514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the prevalence and the kind of psychoactive substances consumed by people with obesity. METHODS Patients were included at their first visit for bariatric surgery. Socio-demographic characteristics, anxiety, depressive disorders and psychoactive substance consumption were assessed. The prevalence of psychoactive substance consumption was compared to that of the general population reported by the French National Institute of Prevention and Health Education. RESULTS One hundred (100) patients were consecutively recruited: 60 women (mean age 41 ± 14 years) and 40 men (mean age 46 ± 13 years). Sixty-seven percent of subjects consumed alcohol. Consumption rates of cannabis (21% vs. 10%), cocaine (7.0% vs. 0.8%) and amphetamine (6.0% vs. 0.3%) were significantly (p < .0001) higher in people with obesity than in the general population. CONCLUSIONS People with obesity have an excess risk of amphetamine, cocaine and cannabis consumption. This consumption may increase the risk of cardiovascular and psychiatric morbidity and should therefore be detected before surgery.
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Affiliation(s)
- Hélène Donnadieu-Rigole
- a Department of Internal Medicine and Addiction Treatment , Hôpital Saint Eloi , University Hospital of Montpellier , Montpellier , France.,b University of Medicine of Montpellier (UM1) , Montpellier , France.,c INSERM U844 , Hôpital Saint Eloi , Montpellier , France
| | - Laetitia Olive
- a Department of Internal Medicine and Addiction Treatment , Hôpital Saint Eloi , University Hospital of Montpellier , Montpellier , France
| | - Bertrand Nalpas
- d INSERM Department of Information and Scientific Communication , Paris , France.,e Department of Addiction Treatment , Hôpital Caremeau , Nîmes , France
| | - Yohan Duny
- f Department of Information , University Hospital of Montpellier , Montpellier , France
| | - David Nocca
- b University of Medicine of Montpellier (UM1) , Montpellier , France.,g Department of Visceral Surgery , Hôpital Saint Eloi , University Hospital of Montpellier , Montpellier , France
| | - Pascal Perney
- b University of Medicine of Montpellier (UM1) , Montpellier , France.,e Department of Addiction Treatment , Hôpital Caremeau , Nîmes , France
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Pedroso JAB, Silveira MA, Lima LB, Furigo IC, Zampieri TT, Ramos-Lobo AM, Buonfiglio DC, Teixeira PDS, Frazão R, Donato J. Changes in Leptin Signaling by SOCS3 Modulate Fasting-Induced Hyperphagia and Weight Regain in Mice. Endocrinology 2016; 157:3901-3914. [PMID: 27471877 DOI: 10.1210/en.2016-1038] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Weight regain frequently follows interventions that reduce body weight, leading to a failure in long-term obesity treatment. Inhibitory proteins of the leptin signaling pathway, such as the suppressor of cytokine signaling 3 (SOCS3), have been studied in conditions that predispose animals to obesity. However, whether SOCS3 modulates postrestriction hyperphagia and weight regain remains unknown. Mice lacking SOCS3 protein specifically in leptin receptor (LepR)-expressing cells (LepR SOCS3 knockout [KO]) were generated and studied in fasting and refeeding conditions. LepR SOCS3 KO mice exhibited increased leptin sensitivity in the hypothalamus. Notably, LepR SOCS3 KO males and females showed attenuated food intake and weight regain after 48 hours of fasting. Postrestriction hyperleptinemia was also prevented in LepR SOCS3 KO mice. Next, we studied possible mechanisms and neural circuits involved in the SOCS3 effects. SOCS3 deletion did not prevent fasting- or refeeding-induced c-Fos expression in the arcuate nucleus of the hypothalamus (ARH) nor fasting-induced increased excitability of ARH LepR-expressing cells. On the other hand, SOCS3 ablation reduced the mRNA levels of hypothalamic orexigenic neuropeptides during fasting (neuropeptide Y, agouti-related protein, orexin, and melanin-concentrating hormone). In summary, our findings suggest that increased leptin sensitivity contributes to the maintenance of a reduced body weight after food deprivation. In addition, the attenuated postrestriction food intake observed in mutant mice was not explained by fasting-induced changes in the activity of ARH neurons but exclusively by a lower transcription of orexigenic neuropeptides during fasting. These results indicate a partial dissociation between the regulation of neuronal activity and gene expression in ARH LepR-expressing cells.
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Affiliation(s)
- João A B Pedroso
- Department of Physiology and Biophysics (J.A.B.P., L.B.L., I.C.F., T.T.Z., A.M.R.-L., D.C.B., P.D.S.T., J.D.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-000 Brazil; and Department of Anatomy (M.A.S., R.F.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-900 Brazil
| | - Marina A Silveira
- Department of Physiology and Biophysics (J.A.B.P., L.B.L., I.C.F., T.T.Z., A.M.R.-L., D.C.B., P.D.S.T., J.D.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-000 Brazil; and Department of Anatomy (M.A.S., R.F.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-900 Brazil
| | - Leandro B Lima
- Department of Physiology and Biophysics (J.A.B.P., L.B.L., I.C.F., T.T.Z., A.M.R.-L., D.C.B., P.D.S.T., J.D.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-000 Brazil; and Department of Anatomy (M.A.S., R.F.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-900 Brazil
| | - Isadora C Furigo
- Department of Physiology and Biophysics (J.A.B.P., L.B.L., I.C.F., T.T.Z., A.M.R.-L., D.C.B., P.D.S.T., J.D.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-000 Brazil; and Department of Anatomy (M.A.S., R.F.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-900 Brazil
| | - Thais T Zampieri
- Department of Physiology and Biophysics (J.A.B.P., L.B.L., I.C.F., T.T.Z., A.M.R.-L., D.C.B., P.D.S.T., J.D.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-000 Brazil; and Department of Anatomy (M.A.S., R.F.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-900 Brazil
| | - Angela M Ramos-Lobo
- Department of Physiology and Biophysics (J.A.B.P., L.B.L., I.C.F., T.T.Z., A.M.R.-L., D.C.B., P.D.S.T., J.D.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-000 Brazil; and Department of Anatomy (M.A.S., R.F.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-900 Brazil
| | - Daniella C Buonfiglio
- Department of Physiology and Biophysics (J.A.B.P., L.B.L., I.C.F., T.T.Z., A.M.R.-L., D.C.B., P.D.S.T., J.D.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-000 Brazil; and Department of Anatomy (M.A.S., R.F.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-900 Brazil
| | - Pryscila D S Teixeira
- Department of Physiology and Biophysics (J.A.B.P., L.B.L., I.C.F., T.T.Z., A.M.R.-L., D.C.B., P.D.S.T., J.D.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-000 Brazil; and Department of Anatomy (M.A.S., R.F.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-900 Brazil
| | - Renata Frazão
- Department of Physiology and Biophysics (J.A.B.P., L.B.L., I.C.F., T.T.Z., A.M.R.-L., D.C.B., P.D.S.T., J.D.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-000 Brazil; and Department of Anatomy (M.A.S., R.F.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-900 Brazil
| | - Jose Donato
- Department of Physiology and Biophysics (J.A.B.P., L.B.L., I.C.F., T.T.Z., A.M.R.-L., D.C.B., P.D.S.T., J.D.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-000 Brazil; and Department of Anatomy (M.A.S., R.F.), Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-900 Brazil
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Abstract
Excess weight gain is an increasing burden on individuals, societies and healthcare providers. The role of very low calorie diets (VLCD) in the treatment of overweight and obese people with diabetes is considered within the framework of a partnership between healthcare providers, a commercial organisation and the patient.
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Affiliation(s)
- Peggy Bennett
- Cambridge Health & Weight Plan, Berkeley House, Hunts Rise, South Marston Park, Swindon, Wilts, SN3 4TG, UK,
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Mohammad S, Ahmad J. Management of obesity in patients with type 2 diabetes mellitus in primary care. Diabetes Metab Syndr 2016; 10:171-181. [PMID: 27117509 DOI: 10.1016/j.dsx.2016.01.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 01/09/2016] [Indexed: 01/06/2023]
Abstract
AIMS Obesity and being overweight is the most powerful risk factor accounting for 80-90% of patients with type 2 diabetes mellitus (T2DM). The epidemic of obesity is driving the diabetes epidemic to alarming levels and primary care is becoming an important setting for obesity management in T2DM in India. Yet many primary care providers feel ill-equipped or inadequately supported to address obesity in patients with diabetes. This article reviews the most recent and strongest evidence-based strategies that may aid physicians in management of obesity in patients with T2DM in primary care. MATERIAL AND METHODS A systematic literature search of MEDLINE using the search terms Obesity, Obesity in T2DM, weight loss and Primary Care was conducted. The American Diabetes Association, National Institute for Health, National Institute of Health and Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN) and World Health Organization websites were also searched. Most studies in this area are observational in design with few randomized controlled trials (RCTs). Articles and studies involving meta-analysis or RCTs were preferred over other types. RESULTS AND CONCLUSION Effective weight management treatment in T2DM patient can be implemented in the primary care setting. Evidence based individualized lifestyle and pharmacologic measures supported by behavioral intervention and counseling with appropriate and informed surgical referrals has the potential to improve the success of weight management within primary care.
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Affiliation(s)
| | - Jamal Ahmad
- Centre for Diabetes & Endocrinology, Faculty of Medicine, J. N. Medical College Hospital, A.M.U, Aligarh 202 002, India.
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Beaulac J, Sandre D. Critical review of bariatric surgery, medically supervised diets, and behavioural interventions for weight management in adults. Perspect Public Health 2016; 137:162-172. [PMID: 27354536 DOI: 10.1177/1757913916653425] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AIMS Patient selection of weight management treatment option is often guided by a variety of factors. Currently, there is no comprehensive tool to facilitate informed decision-making for patients and clinicians. This article aims to synthesise evidence on the treatment effectiveness, health benefits, risks, and patient experiences of treatment options presently available at the Weight Management Clinic at The Ottawa Hospital (TOH), as a first step towards developing a decision aid. METHODS Narrative and systematic reviews published in English between 1999 and 2014 were included that focused on one or more of the following weight management treatments in adults aged 18 years and over: roux-en-y gastric bypass (RYGB), sleeve gastrectomy (SG), medically supervised meal replacement, and behavioural or lifestyle intervention. RESULTS Overall, bariatric surgeries have received the greatest research attention and have been associated not only with greater weight loss and health benefit but also with greater risks, complications, and financial cost. Dietary programmes demonstrated weight loss and health benefits to a lesser extent than with surgery but were associated with lower and shorter-term risks and complications. Behavioural and lifestyle interventions have been studied less yet have shown significant, albeit small, weight loss outcomes alone and in combination with dietary or surgical options; they also appear to be the lowest risk interventions. Patient experiences of weight management options are mixed and not well understood. CONCLUSION Further research is needed; however, this review identified some general trends related to weight loss outcomes, benefits, risks, and barriers for weight management options that have implications for shared treatment decision-making.
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Affiliation(s)
- Julie Beaulac
- Psychology Department, The Ottawa Hospital, Ottawa, Canada; The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Daniella Sandre
- Psychology Department, The Ottawa Hospital, Ottawa, ON, Canada
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Loria-Kohen V, Espinosa-Salinas I, Marcos-Pasero H, Lourenço-Nogueira T, Herranz J, Molina S, Reglero G, Ramirez de Molina A. Polymorphism in the CLOCK gene may influence the effect of fat intake reduction on weight loss. Nutrition 2016; 32:453-60. [DOI: 10.1016/j.nut.2015.10.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 10/04/2015] [Accepted: 10/17/2015] [Indexed: 11/30/2022]
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49
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Ho AL, Sussman ES, Pendharkar AV, Azagury DE, Bohon C, Halpern CH. Deep brain stimulation for obesity: rationale and approach to trial design. Neurosurg Focus 2016; 38:E8. [PMID: 26030708 DOI: 10.3171/2015.3.focus1538] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Obesity is one of the most serious public health concerns in the US. While bariatric surgery has been shown to be successful for treatment of morbid obesity for those who have undergone unsuccessful behavioral modification, its associated risks and rates of relapse are not insignificant. There exists a neurological basis for the binge-like feeding behavior observed in morbid obesity that is believed to be due to dysregulation of the reward circuitry. The authors present a review of the evidence of the neuroanatomical basis for obesity, the potential neural targets for deep brain stimulation (DBS), as well as a rationale for DBS and future trial design. Identification of an appropriate patient population that would most likely benefit from this type of therapy is essential. There are also significant cost and ethical considerations for such a neuromodulatory intervention designed to alter maladaptive behavior. Finally, the authors present a consolidated set of inclusion criteria and study end points that should serve as the basis for any trial of DBS for obesity.
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Affiliation(s)
| | | | | | | | - Cara Bohon
- 3Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Casey H Halpern
- 1Departments of Neurosurgery.,3Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
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50
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Thomas EA, Mcnair B, Bechtell JL, Ferland A, Cornier MA, Eckel RH. Greater hunger and less restraint predict weight loss success with phentermine treatment. Obesity (Silver Spring) 2016; 24:37-43. [PMID: 26584649 PMCID: PMC4688167 DOI: 10.1002/oby.21244] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 07/07/2015] [Accepted: 07/13/2015] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Phentermine is thought to cause weight loss through a reduction in hunger. It was hypothesized that higher hunger ratings would predict greater weight loss with phentermine. METHODS This is an observational pilot study in which all subjects were treated with phentermine for 8 weeks and appetite and eating behaviors were measured at baseline and week 8. Outcomes were compared in subjects with ≥5% vs. <5% weight loss, and linear regression was used to identify predictors of percent weight loss. RESULTS Twenty-seven subjects (37 ± 4.5 years, 93.8 ± 12.1 kg, BMI 33.8 ± 3.1 kg m(-2) ) completed the study, with mean weight loss of -5.4 ± 3.3 kg (-5.7% ± 3.2%). Subjects with ≥5% weight loss had higher baseline pre-breakfast hunger (P = 0.017), desire to eat (P =0.003), and prospective food consumption (0.006) and lower baseline cognitive restraint (P = 0.01). In addition, higher baseline home prospective food consumption (P = 0.002) and lower baseline cognitive restraint (P < 0.001) were found to be predictors of weight loss. CONCLUSIONS These results suggest that individuals reporting greater hunger and less restraint are more likely to achieve significant weight loss with phentermine. This information can be used clinically to determine who might benefit most from phentermine treatment.
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Affiliation(s)
- Elizabeth A Thomas
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Bryan Mcnair
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jamie L Bechtell
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Annie Ferland
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Marc-Andre Cornier
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Robert H Eckel
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA
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