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Dahlberg J, Nylander E, Persson M, Shayesteh A. An uncertain uphill battle - experiences and consequences of living with lipedema. Int J Qual Stud Health Well-being 2024; 19:2300152. [PMID: 38159285 PMCID: PMC10763886 DOI: 10.1080/17482631.2023.2300152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 12/25/2023] [Indexed: 01/03/2024] Open
Abstract
PURPOSE To describe and analyse experiences of living with lipedema. Methods: Individual, semi-structured interviews with a purposive sample of 12 women diagnosed with lipedema and analysed by qualitative content analysis utilizing an inductive approach. RESULTS The overarching theme, "An uncertain uphill battle against a divergent body and societal ignorance", covers the experiences of living with lipedema and is based on five categories; "Captivated by a disintegrating body", "Face the impairments of a chronic condition", "Experience social exclusion", "Need emotional support to go on" and "Mull over an insecure future". The women felt entrapped within their bodies and experienced social exclusion due to the chronic symptoms and the progressive body shape alteration caused by their illness. Having experienced deficient information on the illness, varying support from other people, and a deteriorating economic situation, the women face an uncertain future. CONCLUSIONS Symptoms and restrictions caused by lipedema affect women's livelihood and future, as there are no indications for disease improvement. Preventive work aimed at reducing health deterioration should be a priority. More research is needed to raise healthcare awareness regarding difficulties experienced by patients with lipedema.
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Affiliation(s)
- Johan Dahlberg
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
| | - Elisabet Nylander
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
| | | | - Alexander Shayesteh
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
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Desmercieres S, Lardeux V, Longueville JE, Dugast E, Thiriet N, Solinas M. Effects of Highly Palatable Diet on motivation for food and resistance to punishment in rats: Role of sex and age of exposure. Appetite 2024; 198:107340. [PMID: 38582135 DOI: 10.1016/j.appet.2024.107340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 03/05/2024] [Accepted: 04/03/2024] [Indexed: 04/08/2024]
Abstract
Exposure to highly palatable food is believed to induce behavioral and neurobiological changes that may produce addiction-like behavior and increase the risks of obesity and overweight. Studies in rodents have led to conflicting results suggesting that several factors such as sex and age of exposure contribute to the development of maladaptive behaviors towards food. In addition, it is not clear whether effects of exposure to highly palatable diets (HPD) persist after their discontinuation, which would indicate long-term risks to develop addiction-like behavior. In this study, we investigated the persistent effects of an intermittent 8-week exposure to HPD in male and female rats as a function of age of exposure (adult and adolescent). We found that intermittent exposure to HPD did not alter body weight, but it affected consumption of standard food during the time of exposure in all groups. In addition, in adults, HPD produced a decrease in the initial baseline responding in FR1 schedules, an effect that persisted for 4 weeks in males but not in female rats. However, we found that exposure to HPD did not affect resistance to punishment measured by progressive shock strength break points or motivation for food as measured by progressive-ratio break points regardless of sex or age of exposure. Altogether, these results do not provide support for the hypothesis that intermittent exposure to HPD produce persistent increases in the vulnerability to develop addiction-like behaviors towards palatable food.
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Affiliation(s)
- Stevenson Desmercieres
- Université de Poitiers, INSERM, U-1084, Laboratoire des Neurosciences Expérimentales et Cliniques, Poitiers, France
| | - Virginie Lardeux
- Université de Poitiers, INSERM, U-1084, Laboratoire des Neurosciences Expérimentales et Cliniques, Poitiers, France
| | - Jean-Emmanuel Longueville
- Université de Poitiers, INSERM, U-1084, Laboratoire des Neurosciences Expérimentales et Cliniques, Poitiers, France
| | - Emilie Dugast
- Université de Poitiers, INSERM, U-1084, Laboratoire des Neurosciences Expérimentales et Cliniques, Poitiers, France; CHU de Poitiers, Poitiers, France
| | - Nathalie Thiriet
- Université de Poitiers, INSERM, U-1084, Laboratoire des Neurosciences Expérimentales et Cliniques, Poitiers, France
| | - Marcello Solinas
- Université de Poitiers, INSERM, U-1084, Laboratoire des Neurosciences Expérimentales et Cliniques, Poitiers, France.
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Takale G, Handore A, Jeyakumar A, Godbharle S. Prevalence and determinants of multiple chronic conditions (MCC) among young adults in Indian households: an analysis of NFHS-5. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:77. [PMID: 38835054 DOI: 10.1186/s41043-024-00560-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 05/03/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Multiple chronic conditions (MCC) are defined as the presence of two or more chronic conditions, that significantly impact health status, functional capacity, quality of life, and overall healthcare management. Despite the significant evidence on chronic disease burden, the co-existence of MCC within a household in low- and middle-income countries (LMICs) is less studied. This study therefore estimates the prevalence of MCC and its determinants among adults in the Indian households. METHODS Data used in this study were drawn from the fifth round of the National Family Health Survey (NFHS) conducted in 2019-21. Data sets of men (15-54 years) and women (15-49 years) were used for the study. The total sample size of adults for this analysis was N = 239,848. The outcome variable of this study was multiple chronic conditions (MCC) in adults which included a total of nine chronic conditions (hypertension, diabetes, chronic respiratory diseases, chronic kidney disorders, cancer, thyroid disorders, obesity, and heart diseases, consuming alcohol, chewing tobacco, and smoking) documented in NFHS-5. Descriptive statistics and binary logistic regression analysis were used to quantify the results. RESULTS A prevalence of 5.5% of MCC in adults emerged from our study. Logistic regression analysis identified that younger age, males (AOR 0.36 (0.33-0.39)), urban areas (AOR 1.11 (1.02-1.17)) as the place of residence, and participants representing SC (AOR 0.89 (0.81-0.97)), and ST (AOR 1.30 (1.17-1.45)), had a higher risk of MCC irrespective of level of education, type of occupation, marital status, or wealth index, and states from any category of social progress. CONCLUSION A 5% prevalence of MCC specifically obesity, substance use, and hypertension calls for integrated efforts aiming at behavior change, and regulatory efforts to prevent further increase of MCC among young adults in India.
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Affiliation(s)
- Geetanjali Takale
- Department of Health Sciences, Savitribai Phule Pune University, Ganeshkhind Road, Pune, Maharashtra, India
| | - Avantika Handore
- Department of Health Sciences, Savitribai Phule Pune University, Ganeshkhind Road, Pune, Maharashtra, India
| | - Angeline Jeyakumar
- Food Evolution Research Laboratory (FERL), School of Tourism and Hospitality Management, College of Business and Economics, University of Johannesburg, Johannesburg, South Africa
- Department of Nutrition, University of Nevada, Reno, NV, USA
| | - Swapnil Godbharle
- Department of Health Sciences, Savitribai Phule Pune University, Ganeshkhind Road, Pune, Maharashtra, India.
- Food Evolution Research Laboratory (FERL), School of Tourism and Hospitality Management, College of Business and Economics, University of Johannesburg, Johannesburg, South Africa.
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Bajaj JS, Long MD. Obesity and GI Diseases: A Major Problem Weighing on Our Guts and Minds. Am J Gastroenterol 2024; 119:999-1000. [PMID: 38832707 DOI: 10.14309/ajg.0000000000002855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Indexed: 06/05/2024]
Affiliation(s)
- Jasmohan S Bajaj
- Virginia Commonwealth University School of Medicine and Central Virginia Veterans Healthcare System, Richmond, Virginia, USA; and
| | - Millie D Long
- University of North Carolina, School of Medicine, Chapel Hill, North Carolina, USA
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5
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Nolan M, Waring JJC, Noble B, Bradley D, Olurotimi O, Fronheiser J, Sifat M, Boozary LK, McQuoid J, Kendzor DE, Alexander AC. The Association of Cultural Identification with Obesity among African Americans. J Racial Ethn Health Disparities 2024; 11:1385-1393. [PMID: 37126155 PMCID: PMC10725277 DOI: 10.1007/s40615-023-01615-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/16/2023] [Accepted: 04/22/2023] [Indexed: 05/02/2023]
Abstract
INTRODUCTION The influence of culture on body mass index (BMI) and obesity within the African American population is an underexplored area in the literature. Therefore, this study explored the extent to which cultural identity was associated with BMI and obesity among African Americans and whether the association of cultural identity with obesity differed between males and females. METHODS Participants were African Americans (n = 304) who responded to an online survey. BMI was calculated using self-reported weight and height; a BMI ≥ 30 indicated obesity. Sex assigned at birth was measured by self-report, and identification with African American culture was assessed using scores from six Black Identity Classification Scale (BICS) subscales. Primary analyses were conducted using a series of linear and logistic regression analyses. RESULTS In almost all cases, BICS was not associated with BMI and obesity among all African Americans, but moderation analyses revealed that stronger identification with certain subscales of BICS, such as Afrocentrism, Black Americanism, and Racial Salience, was associated with an increase in the odds of obesity for males and not for females. CONCLUSIONS Study findings suggest that culture may influence obesity differently among males and females. Uncovering mechanisms linking cultural identification to obesity will provide novel contributions to behavioral interventions designed to reduce obesity within the African American population.
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Affiliation(s)
- Maria Nolan
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- School of Music, The University of Oklahoma, Norman, OK, USA
| | - Joseph J C Waring
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Bishop Noble
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - David Bradley
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Oluwakemi Olurotimi
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jack Fronheiser
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Munjireen Sifat
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Laili Kharazi Boozary
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Cellular and Behavioral Neurobiology, Department of Psychology, The University of Oklahoma, Norman, OK, USA
| | - Julia McQuoid
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Darla E Kendzor
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Adam C Alexander
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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Spiga F, Davies AL, Tomlinson E, Moore TH, Dawson S, Breheny K, Savović J, Gao Y, Phillips SM, Hillier-Brown F, Hodder RK, Wolfenden L, Higgins JP, Summerbell CD. Interventions to prevent obesity in children aged 5 to 11 years old. Cochrane Database Syst Rev 2024; 5:CD015328. [PMID: 38763517 PMCID: PMC11102828 DOI: 10.1002/14651858.cd015328.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
BACKGROUND Prevention of obesity in children is an international public health priority given the prevalence of the condition (and its significant impact on health, development and well-being). Interventions that aim to prevent obesity involve behavioural change strategies that promote healthy eating or 'activity' levels (physical activity, sedentary behaviour and/or sleep) or both, and work by reducing energy intake and/or increasing energy expenditure, respectively. There is uncertainty over which approaches are more effective and numerous new studies have been published over the last five years, since the previous version of this Cochrane review. OBJECTIVES To assess the effects of interventions that aim to prevent obesity in children by modifying dietary intake or 'activity' levels, or a combination of both, on changes in BMI, zBMI score and serious adverse events. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was February 2023. SELECTION CRITERIA Randomised controlled trials in children (mean age 5 years and above but less than 12 years), comparing diet or 'activity' interventions (or both) to prevent obesity with no intervention, usual care, or with another eligible intervention, in any setting. Studies had to measure outcomes at a minimum of 12 weeks post baseline. We excluded interventions designed primarily to improve sporting performance. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our outcomes were body mass index (BMI), zBMI score and serious adverse events, assessed at short- (12 weeks to < 9 months from baseline), medium- (9 months to < 15 months) and long-term (≥ 15 months) follow-up. We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS This review includes 172 studies (189,707 participants); 149 studies (160,267 participants) were included in meta-analyses. One hundred forty-six studies were based in high-income countries. The main setting for intervention delivery was schools (111 studies), followed by the community (15 studies), the home (eight studies) and a clinical setting (seven studies); one intervention was conducted by telehealth and 31 studies were conducted in more than one setting. Eighty-six interventions were implemented for less than nine months; the shortest was conducted over one visit and the longest over four years. Non-industry funding was declared by 132 studies; 24 studies were funded in part or wholly by industry. Dietary interventions versus control Dietary interventions, compared with control, may have little to no effect on BMI at short-term follow-up (mean difference (MD) 0, 95% confidence interval (CI) -0.10 to 0.10; 5 studies, 2107 participants; low-certainty evidence) and at medium-term follow-up (MD -0.01, 95% CI -0.15 to 0.12; 9 studies, 6815 participants; low-certainty evidence) or zBMI at long-term follow-up (MD -0.05, 95% CI -0.10 to 0.01; 7 studies, 5285 participants; low-certainty evidence). Dietary interventions, compared with control, probably have little to no effect on BMI at long-term follow-up (MD -0.17, 95% CI -0.48 to 0.13; 2 studies, 945 participants; moderate-certainty evidence) and zBMI at short- or medium-term follow-up (MD -0.06, 95% CI -0.13 to 0.01; 8 studies, 3695 participants; MD -0.04, 95% CI -0.10 to 0.02; 9 studies, 7048 participants; moderate-certainty evidence). Five studies (1913 participants; very low-certainty evidence) reported data on serious adverse events: one reported serious adverse events (e.g. allergy, behavioural problems and abdominal discomfort) that may have occurred as a result of the intervention; four reported no effect. Activity interventions versus control Activity interventions, compared with control, may have little to no effect on BMI and zBMI at short-term or long-term follow-up (BMI short-term: MD -0.02, 95% CI -0.17 to 0.13; 14 studies, 4069 participants; zBMI short-term: MD -0.02, 95% CI -0.07 to 0.02; 6 studies, 3580 participants; low-certainty evidence; BMI long-term: MD -0.07, 95% CI -0.24 to 0.10; 8 studies, 8302 participants; zBMI long-term: MD -0.02, 95% CI -0.09 to 0.04; 6 studies, 6940 participants; low-certainty evidence). Activity interventions likely result in a slight reduction of BMI and zBMI at medium-term follow-up (BMI: MD -0.11, 95% CI -0.18 to -0.05; 16 studies, 21,286 participants; zBMI: MD -0.05, 95% CI -0.09 to -0.02; 13 studies, 20,600 participants; moderate-certainty evidence). Eleven studies (21,278 participants; low-certainty evidence) reported data on serious adverse events; one study reported two minor ankle sprains and one study reported the incident rate of adverse events (e.g. musculoskeletal injuries) that may have occurred as a result of the intervention; nine studies reported no effect. Dietary and activity interventions versus control Dietary and activity interventions, compared with control, may result in a slight reduction in BMI and zBMI at short-term follow-up (BMI: MD -0.11, 95% CI -0.21 to -0.01; 27 studies, 16,066 participants; zBMI: MD -0.03, 95% CI -0.06 to 0.00; 26 studies, 12,784 participants; low-certainty evidence) and likely result in a reduction of BMI and zBMI at medium-term follow-up (BMI: MD -0.11, 95% CI -0.21 to 0.00; 21 studies, 17,547 participants; zBMI: MD -0.05, 95% CI -0.07 to -0.02; 24 studies, 20,998 participants; moderate-certainty evidence). Dietary and activity interventions compared with control may result in little to no difference in BMI and zBMI at long-term follow-up (BMI: MD 0.03, 95% CI -0.11 to 0.16; 16 studies, 22,098 participants; zBMI: MD -0.02, 95% CI -0.06 to 0.01; 22 studies, 23,594 participants; low-certainty evidence). Nineteen studies (27,882 participants; low-certainty evidence) reported data on serious adverse events: four studies reported occurrence of serious adverse events (e.g. injuries, low levels of extreme dieting behaviour); 15 studies reported no effect. Heterogeneity was apparent in the results for all outcomes at the three follow-up times, which could not be explained by the main setting of the interventions (school, home, school and home, other), country income status (high-income versus non-high-income), participants' socioeconomic status (low versus mixed) and duration of the intervention. Most studies excluded children with a mental or physical disability. AUTHORS' CONCLUSIONS The body of evidence in this review demonstrates that a range of school-based 'activity' interventions, alone or in combination with dietary interventions, may have a modest beneficial effect on obesity in childhood at short- and medium-term, but not at long-term follow-up. Dietary interventions alone may result in little to no difference. Limited evidence of low quality was identified on the effect of dietary and/or activity interventions on severe adverse events and health inequalities; exploratory analyses of these data suggest no meaningful impact. We identified a dearth of evidence for home and community-based settings (e.g. delivered through local youth groups), for children living with disabilities and indicators of health inequities.
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Affiliation(s)
- Francesca Spiga
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Annabel L Davies
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Eve Tomlinson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Theresa Hm Moore
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Sarah Dawson
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jelena Savović
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Yang Gao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Sophie M Phillips
- Department of Sport and Exercise Science, Durham University, Durham, UK
- Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- Child Health and Physical Activity Laboratory, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Frances Hillier-Brown
- Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- Human Nutrition Research Centre and Population Health Sciences Institute, University of Newcastle, Newcastle, UK
| | - Rebecca K Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Julian Pt Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- NIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Carolyn D Summerbell
- Department of Sport and Exercise Science, Durham University, Durham, UK
- Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
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Spiga F, Tomlinson E, Davies AL, Moore TH, Dawson S, Breheny K, Savović J, Hodder RK, Wolfenden L, Higgins JP, Summerbell CD. Interventions to prevent obesity in children aged 12 to 18 years old. Cochrane Database Syst Rev 2024; 5:CD015330. [PMID: 38763518 PMCID: PMC11102824 DOI: 10.1002/14651858.cd015330.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
BACKGROUND Prevention of obesity in adolescents is an international public health priority. The prevalence of overweight and obesity is over 25% in North and South America, Australia, most of Europe, and the Gulf region. Interventions that aim to prevent obesity involve strategies that promote healthy diets or 'activity' levels (physical activity, sedentary behaviour and/or sleep) or both, and work by reducing energy intake and/or increasing energy expenditure, respectively. There is uncertainty over which approaches are more effective, and numerous new studies have been published over the last five years since the previous version of this Cochrane Review. OBJECTIVES To assess the effects of interventions that aim to prevent obesity in adolescents by modifying dietary intake or 'activity' levels, or a combination of both, on changes in BMI, zBMI score and serious adverse events. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was February 2023. SELECTION CRITERIA Randomised controlled trials in adolescents (mean age 12 years and above but less than 19 years), comparing diet or 'activity' interventions (or both) to prevent obesity with no intervention, usual care, or with another eligible intervention, in any setting. Studies had to measure outcomes at a minimum of 12 weeks post baseline. We excluded interventions designed primarily to improve sporting performance. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our outcomes were BMI, zBMI score and serious adverse events, assessed at short- (12 weeks to < 9 months from baseline), medium- (9 months to < 15 months) and long-term (≥ 15 months) follow-up. We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS This review includes 74 studies (83,407 participants); 54 studies (46,358 participants) were included in meta-analyses. Sixty studies were based in high-income countries. The main setting for intervention delivery was schools (57 studies), followed by home (nine studies), the community (five studies) and a primary care setting (three studies). Fifty-one interventions were implemented for less than nine months; the shortest was conducted over one visit and the longest over 28 months. Sixty-two studies declared non-industry funding; five were funded in part by industry. Dietary interventions versus control The evidence is very uncertain about the effects of dietary interventions on body mass index (BMI) at short-term follow-up (mean difference (MD) -0.18, 95% confidence interval (CI) -0.41 to 0.06; 3 studies, 605 participants), medium-term follow-up (MD -0.65, 95% CI -1.18 to -0.11; 3 studies, 900 participants), and standardised BMI (zBMI) at long-term follow-up (MD -0.14, 95% CI -0.38 to 0.10; 2 studies, 1089 participants); all very low-certainty evidence. Compared with control, dietary interventions may have little to no effect on BMI at long-term follow-up (MD -0.30, 95% CI -1.67 to 1.07; 1 study, 44 participants); zBMI at short-term (MD -0.06, 95% CI -0.12 to 0.01; 5 studies, 3154 participants); and zBMI at medium-term (MD 0.02, 95% CI -0.17 to 0.21; 1 study, 112 participants) follow-up; all low-certainty evidence. Dietary interventions may have little to no effect on serious adverse events (two studies, 377 participants; low-certainty evidence). Activity interventions versus control Compared with control, activity interventions do not reduce BMI at short-term follow-up (MD -0.64, 95% CI -1.86 to 0.58; 6 studies, 1780 participants; low-certainty evidence) and probably do not reduce zBMI at medium- (MD 0, 95% CI -0.04 to 0.05; 6 studies, 5335 participants) or long-term (MD -0.05, 95% CI -0.12 to 0.02; 1 study, 985 participants) follow-up; both moderate-certainty evidence. Activity interventions do not reduce zBMI at short-term follow-up (MD 0.02, 95% CI -0.01 to 0.05; 7 studies, 4718 participants; high-certainty evidence), but may reduce BMI slightly at medium-term (MD -0.32, 95% CI -0.53 to -0.11; 3 studies, 2143 participants) and long-term (MD -0.28, 95% CI -0.51 to -0.05; 1 study, 985 participants) follow-up; both low-certainty evidence. Seven studies (5428 participants; low-certainty evidence) reported data on serious adverse events: two reported injuries relating to the exercise component of the intervention and five reported no effect of intervention on reported serious adverse events. Dietary and activity interventions versus control Dietary and activity interventions, compared with control, do not reduce BMI at short-term follow-up (MD 0.03, 95% CI -0.07 to 0.13; 11 studies, 3429 participants; high-certainty evidence), and probably do not reduce BMI at medium-term (MD 0.01, 95% CI -0.09 to 0.11; 8 studies, 5612 participants; moderate-certainty evidence) or long-term (MD 0.06, 95% CI -0.04 to 0.16; 6 studies, 8736 participants; moderate-certainty evidence) follow-up. They may have little to no effect on zBMI in the short term, but the evidence is very uncertain (MD -0.09, 95% CI -0.2 to 0.02; 3 studies, 515 participants; very low-certainty evidence), and they may not reduce zBMI at medium-term (MD -0.05, 95% CI -0.1 to 0.01; 6 studies, 3511 participants; low-certainty evidence) or long-term (MD -0.02, 95% CI -0.05 to 0.01; 7 studies, 8430 participants; low-certainty evidence) follow-up. Four studies (2394 participants) reported data on serious adverse events (very low-certainty evidence): one reported an increase in weight concern in a few adolescents and three reported no effect. AUTHORS' CONCLUSIONS The evidence demonstrates that dietary interventions may have little to no effect on obesity in adolescents. There is low-certainty evidence that activity interventions may have a small beneficial effect on BMI at medium- and long-term follow-up. Diet plus activity interventions may result in little to no difference. Importantly, this updated review also suggests that interventions to prevent obesity in this age group may result in little to no difference in serious adverse effects. Limitations of the evidence include inconsistent results across studies, lack of methodological rigour in some studies and small sample sizes. Further research is justified to investigate the effects of diet and activity interventions to prevent childhood obesity in community settings, and in young people with disabilities, since very few ongoing studies are likely to address these. Further randomised trials to address the remaining uncertainty about the effects of diet, activity interventions, or both, to prevent childhood obesity in schools (ideally with zBMI as the measured outcome) would need to have larger samples.
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Affiliation(s)
- Francesca Spiga
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Eve Tomlinson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Annabel L Davies
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Theresa Hm Moore
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jelena Savović
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Rebecca K Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Julian Pt Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Carolyn D Summerbell
- Department of Sport and Exercise Science, Durham University, Durham, UK
- Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
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8
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Stroh C, Meyer F. [Value and Role of Obesity and Metabolic Surgery in the Study of Human Medicine, Academic Teaching and Advanced Training]. Zentralbl Chir 2024. [PMID: 38744318 DOI: 10.1055/a-2294-0672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
In teaching, obesity and metabolic surgery play only a limited role. However, due to the rapidly increasing number of surgical interventions, communication of knowledge in the study of human medicine as well as in gastroenterological and surgical residency (general and abdominal surgery) is required.Narrative review. · Currently, lectures on obesity and metabolic surgery do not belong to the current surgical curriculum of human medicine at all University Medical Schools, which needs to be absolutely established step by step - based on their topicality and importance in the clinical spectrum of clinical care.. · This rapidly developing special area of abdominal surgery is characterized by specific and diverse interdisciplinarity.. · Multimorbidity, changes in resorption mechanisms but also psychological changes have a substantial impact on the indication and patient outcome.. · The increase in endoscopic, surgical and also robotic interventions and surgical methods in this special field requires a broad knowledge of all surgical disciplines in intervention preparation, perioperative and follow-up management of obesity-associated basic diagnosis. This objective is important even in the study of human medicine and further advanced training.. The inclusion of such complex contents on obesity and metabolic surgery into surgical teaching and into residency of general and abdominal surgery is essential to be future-oriented and prepared for the development of the discipline.
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Affiliation(s)
- Christine Stroh
- Klinik für Adipositas- und metabolische Chirurgie, SRH Wald-Klinikum Gera, Gera, Deutschland
| | - Frank Meyer
- Klinik für Allgemein-, Viszeral-, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland
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9
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Bin-Abbas B, Al Sagheir A, Taher L, Elbadawi H, Al Fares A, Al Harbi M, Refaat M, Ashmawy A. ACTION Teens Saudi Arabia: Perceptions, attitudes, motivators, and barriers among adolescents living with obesity, caregivers, and healthcare professionals in Saudi Arabia. Clin Obes 2024:e12674. [PMID: 38740496 DOI: 10.1111/cob.12674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 04/08/2024] [Accepted: 04/30/2024] [Indexed: 05/16/2024]
Abstract
Obesity is predicted to affect approximately one-quarter of children/adolescents in Saudi Arabia by 2030, but there is limited evidence regarding the perceptions, attitudes, behaviours, and barriers to effective obesity care for adolescents living with obesity (ALwO), caregivers of ALwO, and healthcare professionals (HCPs). We report data from 500 ALwO (aged 12-<18 years), 500 caregivers, and 200 HCPs surveyed in Saudi Arabia as part of the global, cross-sectional ACTION Teens study (NCT05013359). Nearly all respondents recognized that obesity has a strong impact on overall health (ALwO 88%; caregivers 85%; HCPs 90%). Most ALwO and caregivers were aware of the ALwO's obesity status (95% and 99%, respectively) and worried about weight impacting the ALwO's future health (both ≥99%), and social media was their most commonly used source of weight-management information (60% and 53%, respectively). Among ALwO and caregivers who had discussed weight with an HCP in the past year, most experienced ≥1 negative feeling following their most recent discussion (61% and 59%, respectively). Although 81% of HCPs felt motivated to help their ALwO patients lose weight, 57% believed weight loss was completely the ALwO's responsibility (compared with only 37% of ALwO and 35% of caregivers). This may reflect the finding that only 24% of HCPs had received advanced training in obesity/weight management after medical school. Overall, while respondents had similar perceptions of the impact of obesity, we found HCPs' attitudes towards weight loss were not aligned with those of ALwO and caregivers, suggesting a need for improved communication and obesity education.
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Affiliation(s)
- Bassam Bin-Abbas
- Department of Pediatrics, King Faisal Specialist Hospital, Riyadh, Saudi Arabia
| | - Afaf Al Sagheir
- Department of Pediatrics, King Faisal Specialist Hospital, Riyadh, Saudi Arabia
| | - Lama Taher
- Department of Psychiatry, King Faisal Specialist Hospital, Riyadh, Saudi Arabia
| | | | - Abdulah Al Fares
- Department of Pediatrics, Endocrine Unit, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Mohammed Al Harbi
- Therapeutic Services Deputyship, Ministry of Health, Riyadh, Saudi Arabia
| | - Mohamed Refaat
- Clinical and Medical Department, Novo Nordisk, Riyadh, Saudi Arabia
| | - Ahmed Ashmawy
- Clinical and Medical Department, Novo Nordisk, Riyadh, Saudi Arabia
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Palmer T, Leiva Granados R, Draper C, Norris SA, Batura N. Cost-effectiveness of a complex continuum of care intervention targeting women and children: protocol for an economic evaluation of the Bukhali trial in South Africa. BMJ Open 2024; 14:e080166. [PMID: 38740501 PMCID: PMC11097888 DOI: 10.1136/bmjopen-2023-080166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 04/26/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION As nearly two-thirds of women presenting at their first antenatal visit are either overweight or obese in urban South Africa, the preconception period is an opportunity to optimise health and offset transgenerational risk of both obesity and non-communicable diseases. This protocol describes the planned economic evaluation of an individually randomised controlled trial of a complex continuum of care intervention targeting women and children in Soweto, South Africa (Bukhali trial). METHODS AND ANALYSIS The economic evaluation of the Bukhali trial will be conducted as a within-trial analysis from both provider and societal perspectives. Incremental costs and health outcomes of the continuum of care intervention will be compared with standard care. The economic impact on implementing agencies (programme costs), healthcare providers, participants and their households will be estimated. Incremental cost-effectiveness ratios (ICERs) will be calculated in terms of cost per case of child adiposity at age years averted. Additionally, ICERs will also be reported in terms of cost per quality-adjusted life year gained. If Bukhali demonstrates effectiveness, we will employ a decision analytical model to examine the cost-effectiveness of the intervention over a child's lifetime. A Markov model will be used to estimate long-term health benefits, healthcare costs and cost-effectiveness. Probabilistic sensitivity analyses will be conducted to explore uncertainty and ensure robust results. An analysis will be conducted to assess the equity impact of the intervention, by comparing intervention impact within quintiles of socioeconomic status. ETHICS AND DISSEMINATION The Bukhali trial economic evaluation has ethical approval from the Human Ethics Research Committee of the University of the Witwatersrand, Johannesburg, South Africa (M240162). The results of the economic evaluation will be disseminated in a peer-reviewed journal and presented at a relevant international conference. TRIAL REGISTRATION NUMBER Pan African Clinical Trials Registry (PACTR201903750173871; https://pactr.samrc.ac.za).
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Affiliation(s)
- Tom Palmer
- Institute for Global Health, University College London, London, UK
| | | | - Catherine Draper
- MRC-Wits DPHRU, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- MRC-Wits DPHRU, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Development and Health, University of Southampton, Southampton, UK
| | - Neha Batura
- Institute for Global Health, University College London, London, UK
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11
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Schluter PJ, Ahuriri-Driscoll A, Mohammed J, Singh S. COVID-19 impact on overweight and obesity rates in Aotearoa | New Zealand 4-year-old children. Pediatr Res 2024; 95:1649-1657. [PMID: 38238565 PMCID: PMC11126386 DOI: 10.1038/s41390-024-03025-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/07/2023] [Accepted: 12/15/2023] [Indexed: 05/26/2024]
Abstract
BACKGROUND COVID-19 has had profound societal impacts. This study estimated overweight, obesity, and extreme obesity rates in 4-year-old children over pre- and post-COVID-19 periods, and investigated differential changes between sex, ethnic and deprivation groups. METHODS A national screening programme of 4-year-old children undertaking B4 School Checks (B4SCs) between 1 January 2010 and 7 March 2023 was analysed. B4SCs include anthropometric measurements enabling sex-specific body mass index-for-age Z-scores (BMI z-scores) to be derived. Children with ≥85th, ≥95th, and ≥99.7th percentile BMI z-scores were classified as overweight, obese, and extremely obese. RESULTS The eligible sample included 656,038 children (48.8% girls). Overall, 210,492 (32.1%) children were overweight, 95,196 (14.5%) obese, and 19,926 (3.0%) extremely obese. While decreasing in the pre-COVID-19 period, annual prevalence estimates for overweight, obese, and extremely obese significantly (all p < 0.001) increased in the year after COVID-restrictions were implemented. However, after three years, overweight and obese prevalence estimates were no different to pre-COVID levels overall or stratified by sex for ethnicity and deprivation groups. Extreme obesity prevalence estimates also decreased but remained higher than pre-COVID levels. CONCLUSION The sharp and steep increases in prevalence estimates all dampened relatively quickly. The question remains whether these rates will continue to decrease in time. IMPACT Compared to pre-COVID-19 estimates, the prevalence of overweight, obesity and extreme obesity significantly and substantially increased for 4-year-old children in the immediate post-COVID-19 period. These post-COVID-19 prevalence estimates dampened relatively quickly, returning to pre-COVID-19 rates for overweight and obesity after 3 years. Inequities between ethnic and social deprivation groups in overweight and obesity prevalence estimates remained similar between pre- and post-COVID-19 periods.
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Affiliation(s)
- Philip J Schluter
- Te Kaupeka Oranga, Faculty of Health, Te Whare Wānanga o Waitaha, University of Canterbury, Christchurch, Aotearoa, New Zealand.
- School of Clinical Medicine, Primary Care Clinical Unit, The University of Queensland, Brisbane, QLD, Australia.
| | - Annabel Ahuriri-Driscoll
- Te Kaupeka Oranga, Faculty of Health, Te Whare Wānanga o Waitaha, University of Canterbury, Christchurch, Aotearoa, New Zealand
| | - Jalal Mohammed
- Te Kaupeka Oranga, Faculty of Health, Te Whare Wānanga o Waitaha, University of Canterbury, Christchurch, Aotearoa, New Zealand
| | - Sheetalpreet Singh
- Service Analysis and Modelling Evidence, Research and Analytics Evidence Research and Innovation, Ministry of Health, Wellington, Aotearoa, New Zealand
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12
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Klitzman R, Greenberg H. Anti-obesity Medications: Ethical, Policy, and Public Health Concerns. Hastings Cent Rep 2024; 54:6-10. [PMID: 38842904 DOI: 10.1002/hast.1588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
New anti-obesity medications (AOMs) have received widespread acclaim in medical journals and the media, but they also raise critical ethical, public health, and public policy concerns that have largely been ignored. AOMs are very costly, need to be taken by a patient in perpetuity (since significant rebound weight gain otherwise occurs), and threaten to shift resources and focus away from other crucial efforts at obesity treatment and prevention. Many people may feel less motivated to exercise or reduce their caloric consumption, if they assume that obesity is now medically treatable. Policy-makers may similarly come to feel that the solution to the obesity pandemic is simply to prescribe medications and that prevention efforts are far less necessary. These drugs raise concerns about justice (since AOMs will disproportionately benefit the wealthy), medicalization, and marketing. Policy-makers, clinicians, and others need to engage in multipronged educational and policy efforts to address these challenges.
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13
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do Carmo JM, Hall JE, Dai X, Aitkens N, Larson K, Luna-Suarez EM, Wang Z, Omoto ACM, Mouton A, Li X, Furukawa LNS, Woronik V, da Silva AA. Parental obesity predisposes offspring to kidney dysfunction and increased susceptibility to ischemia-reperfusion injury in a sex-dependent manner. Am J Physiol Renal Physiol 2024; 326:F727-F736. [PMID: 38511219 DOI: 10.1152/ajprenal.00294.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 03/05/2024] [Accepted: 03/15/2024] [Indexed: 03/22/2024] Open
Abstract
Although obesity is recognized as a risk factor for cardiorenal and metabolic diseases, the impact of parental obesity on the susceptibility of their offspring to renal injury at adulthood is unknown. We examined the impact of parental obesity on offspring kidney function, morphology, and markers of kidney damage after acute kidney injury (AKI). Offspring from normal (N) diet-fed C57BL/6J parents were fed either N (NN) or a high-fat (H) diet (NH) from weaning until adulthood. Offspring from obese H diet-fed parents were fed N (HN) or H diet (HH) after weaning. All offspring groups were submitted to bilateral AKI by clamping the left and right renal pedicles for 30 min. Compared with male NH and NN offspring from lean parents, male HH and HN offspring from obese parents exhibited higher kidney injury markers such as urinary, renal osteopontin, plasma creatinine, urinary albumin excretion, and neutrophil gelatinase-associated lipocalin (NGAL) levels, and worse histological injury score at 22 wk of age. Only albumin excretion and NGAL were elevated in female HH offspring from obese parents compared with lean and obese offspring from lean parents. We also found an increased mortality rate and worse kidney injury scores after AKI in male offspring from obese parents, regardless of the diet consumed after weaning. Female offspring were protected from major kidney injury after AKI. These results indicate that parental obesity leads to increased kidney injury in their offspring after ischemia-reperfusion in a sex-dependent manner, even when their offspring remain lean.NEW & NOTEWORTHY Offspring from obese parents are more susceptible to kidney injury and worse outcomes following an acute ischemia-reperfusion insult. Male, but not female, offspring from obese parents exhibit increased blood pressure early in life. Female offspring are partially protected against major kidney injury induced by ischemia-reperfusion.
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Affiliation(s)
- Jussara M do Carmo
- Department of Physiology and Biophysics, Mississippi Center for Obesity Research, Cardiorenal and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - John E Hall
- Department of Physiology and Biophysics, Mississippi Center for Obesity Research, Cardiorenal and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Xuemei Dai
- Department of Physiology and Biophysics, Mississippi Center for Obesity Research, Cardiorenal and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Nikaela Aitkens
- Department of Physiology and Biophysics, Mississippi Center for Obesity Research, Cardiorenal and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Kylie Larson
- Department of Physiology and Biophysics, Mississippi Center for Obesity Research, Cardiorenal and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Emilio M Luna-Suarez
- Department of Physiology and Biophysics, Mississippi Center for Obesity Research, Cardiorenal and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Zhen Wang
- Department of Physiology and Biophysics, Mississippi Center for Obesity Research, Cardiorenal and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Ana C M Omoto
- Department of Physiology and Biophysics, Mississippi Center for Obesity Research, Cardiorenal and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Alan Mouton
- Department of Physiology and Biophysics, Mississippi Center for Obesity Research, Cardiorenal and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Xuan Li
- Department of Physiology and Biophysics, Mississippi Center for Obesity Research, Cardiorenal and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Luzia N S Furukawa
- Laboratory of Renal Pathophysiology, Department of Internal Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Viktoria Woronik
- Laboratory of Renal Pathophysiology, Department of Internal Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Alexandre A da Silva
- Department of Physiology and Biophysics, Mississippi Center for Obesity Research, Cardiorenal and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, Mississippi, United States
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14
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Kral J, Benes M, Lanska V, Macinga P, Drastich P, Spicak J, Hucl T. Long-term Results of Duodeno-jejunal Bypass in the Treatment of Obesity and Type 2 Diabetes. Obes Surg 2024; 34:1407-1414. [PMID: 38436919 PMCID: PMC11031453 DOI: 10.1007/s11695-023-06979-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 11/28/2023] [Accepted: 12/06/2023] [Indexed: 03/05/2024]
Abstract
PURPOSE Obesity and its related severe comorbidities are increasing rapidly. The duodenal-jejunal bypass is an endoscopically implanted device (mimicking the Roux-en-Y gastric bypass) developed to support weight reduction and improve type 2 diabetes control. MATERIALS AND METHODS Retrospective data analysis of consecutive patients undergoing duodenal-jejunal bypass (EndoBarrier®, DJB) implantation between 2013 and 2017 was performed to evaluate safety as well as short- and long-term efficacy. RESULTS One hundred and twenty-one patients (mean BMI of 43.1 ± 7.2 kg/m2 and weight of 138.2 ± 28.6 kg) underwent DJB implantation. The mean dwelling time was 15.5 months, the mean total body weight loss (%TBWL) after explantation was 10.3% ± 7.9% (14.2 kg, p < 0.0001), and the mean BMI was 39.5 ± 7.3 kg/m2 (p < 0.0001). There was no significant weight gain 24 months after the explantation. Seventy-seven patients had type 2 diabetes mellitus (T2DM) with a mean HbA1c before implantation of 5.6% (n = 52). The mean HbA1c after explantation was 5.1% (p = 0.0001). Significant reductions in transaminase and lipid levels before and after explantation were observed. One complication occurred during implantation and another during explantation. In 16 patients, the device had to be extracted earlier than expected (7 for severe adverse events and 9 for adverse events; 13.2%). CONCLUSION Despite an evident rate of adverse events, the DJB shows promise as a weight-loss procedure. Our results show that some patients implanted with the device maintained reduced weight even 24 months after explantation, while many improved T2DM control.
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Affiliation(s)
- Jan Kral
- Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21, Prague, Czech Republic.
- Department of Internal Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Marek Benes
- Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21, Prague, Czech Republic
| | - Vera Lanska
- Department of Statistics, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21, Prague, Czech Republic
| | - Peter Macinga
- Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21, Prague, Czech Republic
| | - Pavel Drastich
- Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21, Prague, Czech Republic
| | - Julius Spicak
- Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21, Prague, Czech Republic
| | - Tomas Hucl
- Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21, Prague, Czech Republic
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Janet R, Smallwood J, Hutcherson CA, Plassmann H, Mckeown B, Tusche A. Body mass index-dependent shifts along large-scale gradients in human cortical organization explain dietary regulatory success. Proc Natl Acad Sci U S A 2024; 121:e2314224121. [PMID: 38648482 PMCID: PMC11067012 DOI: 10.1073/pnas.2314224121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 03/14/2024] [Indexed: 04/25/2024] Open
Abstract
Making healthy dietary choices is essential for keeping weight within a normal range. Yet many people struggle with dietary self-control despite good intentions. What distinguishes neural processing in those who succeed or fail to implement healthy eating goals? Does this vary by weight status? To examine these questions, we utilized an analytical framework of gradients that characterize systematic spatial patterns of large-scale neural activity, which have the advantage of considering the entire suite of processes subserving self-control and potential regulatory tactics at the whole-brain level. Using an established laboratory food task capturing brain responses in natural and regulatory conditions (N = 123), we demonstrate that regulatory changes of dietary brain states in the gradient space predict individual differences in dietary success. Better regulators required smaller shifts in brain states to achieve larger goal-consistent changes in dietary behaviors, pointing toward efficient network organization. This pattern was most pronounced in individuals with lower weight status (low-BMI, body mass index) but absent in high-BMI individuals. Consistent with prior work, regulatory goals increased activity in frontoparietal brain circuits. However, this shift in brain states alone did not predict variance in dietary success. Instead, regulatory success emerged from combined changes along multiple gradients, showcasing the interplay of different large-scale brain networks subserving dietary control and possible regulatory strategies. Our results provide insights into how the brain might solve the problem of dietary control: Dietary success may be easier for people who adopt modes of large-scale brain activation that do not require significant reconfigurations across contexts and goals.
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Affiliation(s)
- Rémi Janet
- Department of Psychology, Queen’s University, Kingston, ONK7L 3N6, Canada
| | - Jonathan Smallwood
- Department of Psychology, Queen’s University, Kingston, ONK7L 3N6, Canada
| | - Cendri A. Hutcherson
- Department of Psychology, University of Toronto, Toronto, ONM5S 2E5, Canada
- Department of Marketing, Rotman School of Management, University of Toronto, Toronto, ONM5S 3E6, Canada
| | - Hilke Plassmann
- Marketing Area, INSEAD, FontainebleauF-77300, France
- Control-Interoception-Attention Team, Paris Brain Institute (ICM), Sorbonne University, Paris75013, France
| | - Bronte Mckeown
- Department of Psychology, Queen’s University, Kingston, ONK7L 3N6, Canada
| | - Anita Tusche
- Department of Psychology, Queen’s University, Kingston, ONK7L 3N6, Canada
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA91125
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16
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Hanauer AD, Corrêa ZGD, Blazius G, Prates RC, Mastroeni MF. Direct costs for outpatient excess body weight treatment in Brazilian children and adolescents attending a public children's hospital. J Pediatr (Rio J) 2024:S0021-7557(24)00035-4. [PMID: 38608721 DOI: 10.1016/j.jped.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 04/14/2024] Open
Abstract
OBJECTIVE To estimate the direct costs of treating excess body weight in children and adolescents attending a public children's hospital. METHODS This study analyzed the costs of the disease within the Brazilian Unified Health System (SUS) for 2,221 patients with excess body weight using a microcosting approach. The costs included operational expenses, consultations, and laboratory and imaging tests obtained from medical records for the period from 2009 to 2019. Healthcare expenses were obtained from the Table of Procedures, Medications, Orthoses/Prostheses, and Special Materials of SUS and from the hospital's finance department. RESULTS Medical consultations accounted for 50.6% (R$703,503.00) of the total cost (R$1,388,449.40) of treatment over the period investigated. The cost of treating excess body weight was 11.8 times higher for children aged 5-18 years compared to children aged 2-5 years over the same period. Additionally, the cost of treating obesity was approximately 4.0 and 6.3 times higher than the cost of treating overweight children aged 2-5 and 5-18 years, respectively. CONCLUSION The average annual cost of treating excess body weight was R$138,845.00. Weight status and age influenced the cost of treating this disease, with higher costs being observed for individuals with obesity and children over 5 years of age. Additionally, the important deficit in reimbursement by SUS and the small number of other health professionals highlight the need for restructuring this treatment model to ensure its effectiveness, including a substantial increase in government investment.
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Affiliation(s)
- Aline Denise Hanauer
- Universidade da Região de Joinville (UNIVILLE), Programa de Pós-graduação em Saúde e Meio Ambiente, Joinville, SC, Brazil; Universidade da Região de Joinville (UNIVILLE), Curso de Medicina, Joinville, SC, Brazil
| | | | - Gleci Blazius
- Universidade da Região de Joinville (UNIVILLE), Curso de Enfermagem, Joinville, SC, Brazil
| | - Rodolfo Coelho Prates
- Universidade da Região de Joinville (UNIVILLE), Programa de Pós-graduação em Saúde e Meio Ambiente, Joinville, SC, Brazil
| | - Marco Fabio Mastroeni
- Universidade da Região de Joinville (UNIVILLE), Programa de Pós-graduação em Saúde e Meio Ambiente, Joinville, SC, Brazil; Universidade da Região de Joinville (UNIVILLE), Curso de Medicina, Joinville, SC, Brazil; Universidade da Região de Joinville (UNIVILLE), Curso de Enfermagem, Joinville, SC, Brazil.
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17
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Sethi V, Bassi S, Bahl D, Kumar A, Choedon T, Bhatia N, de Wagt A, Joe W, Arora M. Prevalence of overweight and obesity and associated demographic and health factors in India: Findings from Comprehensive National Nutrition Survey (CNNS). Pediatr Obes 2024; 19:e13092. [PMID: 38326947 DOI: 10.1111/ijpo.13092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 08/11/2023] [Accepted: 11/08/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Childhood obesity (5-9 years) in India is likely to contribute 11% to the global burden by 2030. METHODS Data from India's Comprehensive National Nutrition Survey (CNNS, 2016-2018) was used to assess the prevalence and key associated factors of overweight and obesity. Multivariable logistic regression models were applied to identify potential determinants associated with being overweight and obese. RESULTS Overweight prevalence (including obesity) varied from 1.6% (0-4 years) to 4.8% (10-19 years). The majority of states reported a higher proportion of adolescents overweight and obese, than younger age group 5-9 years. A significantly higher prevalence of children and adolescents with obesity was reported in higher wealth quintiles and residents of urban areas. The prevalence of overweight and obesity and associated demographic and health factors in India included: the presence of NCD risk factor (adolescents: 1.68, 95% CI [1.31-2.14]), micronutrient deficiency (5-9 years children: 1.72, 95% CI [1.30-2.28]), mother's education (5-9 years children: 4.84, 95% CI [2.92-8.03]; adolescents: 2.17, 95% CI [1.42-3.32]), wealth (adolescents: 1.92, 95% CI [1.16-3.19]), place of residence (5-9 years children: 1.68, 95% CI [1.39-2.03]; adolescents: 1.39, 95% CI [1.16-1.66]), child age (5-9 years children: 1.64, 95% CI [1.40-1.93], and screen-time (adolescents: 1.63, 95% CI [1.22-2.19]. CONCLUSION The findings set out policy and research recommendations to pave the path for curtailing the increasing prevalence of overweight and obesity and achieving the World Health Assembly's Global Nutrition target of 'no increase in childhood overweight (Target 4) by 2025'.
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Affiliation(s)
- Vani Sethi
- UNICEF-Regional Office for South Asia, Kathmandu, Nepal
| | - Shalini Bassi
- Health Promotion Division, Public Health Foundation of India (PHFI), New Delhi, India
| | - Deepika Bahl
- Health Promotion Division, Public Health Foundation of India (PHFI), New Delhi, India
| | | | | | - Neena Bhatia
- Department of Food & Nutrition, Lady Irwin College, University of Delhi, New Delhi, India
| | | | - William Joe
- Institute of Economic Growth, New Delhi, India
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India (PHFI), New Delhi, India
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Ray S, Kapoor N, Deshpande N, Chatterjee S, Kumar J, Tantia O, Goyal G, Mukherjee JJ, Singh AK. An overview of therapeutic options of obesity management in India: the Integrated Diabetes and Endocrinology Academy (IDEA) 2023 Congress update. Expert Rev Clin Pharmacol 2024; 17:349-362. [PMID: 38471973 DOI: 10.1080/17512433.2024.2330468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/11/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION With newer anti-obesity medications (AOMs) being introduced at a rapid pace, it is prudent to make a concise and updated clinical practice document that may help busy clinicians in daily clinical practice. A group of metabolic physicians, diabetologists, endocrinologists, and bariatric surgeons assembled during the Integrated Diabetes and Endocrine Academy 2023 Congress (IDEACON, July 2023, Kolkata, India) to compile an update of pharmacotherapeutic options for managing people with obesity in India. AREAS COVERED After an extensive review of the literature by experts in different domains, this update provides all available information on the management of obesity, with a special emphasis on both currently available and soon-to-be-available AOMs, in people with obesity. EXPERT OPINION Several newer AOMs have been shown to reduce body weight significantly, thus poised to make a paradigm shift in the management of obesity. While the tolerability and key adverse events associated with these AOMs appear to be acceptable in randomized controlled trials, pharmacovigilance is vital in real-world settings, given the absence of sufficiently long-term studies. The easy availability and affordability of these drugs is another area of concern, especially in developing countries like India.
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Affiliation(s)
- Subir Ray
- Department of Medicine, Division of Diabetes & Endocrinology, Apollo Multi-Speciality Hospitals, Kolkata, West Bengal, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism Christian Medical College & Hospital, Vellore, Tamil Nadu, India
- Non-Communicable disease Unit, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Neeta Deshpande
- Belgaum Diabetes Centre and CentraCare Institute of Diabetes, Obesity and Metabolic Health (CIDOM), Belgaum, Karnataka, India
| | - Sanjay Chatterjee
- Department of Medicine, Division of Diabetes & Endocrinology, Apollo Multi-Speciality Hospitals, Kolkata, West Bengal, India
| | - Janardanan Kumar
- Department of Medicine, SRM Hospital & Research Centre, SRMIST, Kattankulathur, Tamil Nadu, India
| | - Om Tantia
- Department of Minimal Access and Bariatric Surgery, ILS Hospital, Kolkata, West Bengal, India
| | - Ghanshyam Goyal
- Department of Medicine, ILS Hospital, Salt Lake, Kolkata, West Bengal, India
| | - Jagat Jyoti Mukherjee
- Department of Medicine, Division of Diabetes & Endocrinology, Apollo Multi-Speciality Hospitals, Kolkata, West Bengal, India
| | - Awadhesh Kumar Singh
- Department of Diabetes & Endocrinology, G.D Hospital & Diabetes Institute, Kolkata, West Bengal, India
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Gruneisen E, Kremer R, Duque G. Fat as a Friend or Foe of the Bone. Curr Osteoporos Rep 2024; 22:245-256. [PMID: 38416274 DOI: 10.1007/s11914-024-00864-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW The objective of this review is to summarize the literature on the prevalence and diagnosis of obesity and its metabolic profile, including bone metabolism, focusing on the main inflammatory and turnover bone mediators that better characterize metabolically healthy obesity phenotype, and to summarize the therapeutic interventions for obesity with their effects on bone health. RECENT FINDINGS Osteoporosis and fracture risk not only increase with age and menopause but also with metabolic diseases, such as diabetes mellitus. Thus, patients with high BMI may have a higher bone fragility and fracture risk. However, some obese individuals with healthy metabolic profiles seem to be less at risk of bone fracture. Obesity has become an alarming disease with growing prevalence and multiple metabolic comorbidities, resulting in a significant burden on healthcare and increased mortality. The imbalance between increased food ingestion and decreased energy expenditure leads to pathological adipose tissue distribution and function, with increased secretion of proinflammatory markers and harmful consequences for body tissues, including bone tissue. However, some obese individuals seem to have a healthy metabolic profile and may not develop cardiometabolic disease during their lives. This healthy metabolic profile also benefits bone turnover and is associated with lower fracture risk.
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Affiliation(s)
- Elodie Gruneisen
- Division of Endocrinology & Metabolism, Department of Medicine, McGill University Health Centre, Montréal, QC, Canada
| | - Richard Kremer
- Division of Endocrinology & Metabolism, Department of Medicine, McGill University Health Centre, Montréal, QC, Canada
- Bone, Muscle & Geroscience Group, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Gustavo Duque
- Bone, Muscle & Geroscience Group, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC, Canada.
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Dicken SJ, Batterham RL. Ultra-processed Food and Obesity: What Is the Evidence? Curr Nutr Rep 2024; 13:23-38. [PMID: 38294671 PMCID: PMC10924027 DOI: 10.1007/s13668-024-00517-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 02/01/2024]
Abstract
PURPOSE OF REVIEW Obesity is a growing global healthcare concern. A proposed driver is the recent increase in ultra-processed food (UPF) intake. However, disagreement surrounds the concept of UPF, the strength of evidence, and suggested mechanisms. Therefore, this review aimed to critically appraise the evidence on UPF and obesity. RECENT FINDINGS Observational studies demonstrate positive associations between UPF intake, weight gain, and overweight/obesity, more clearly in adults than children/adolescents. This is supported by high-quality clinical data. Several mechanisms are proposed, but current understanding is inconclusive. Greater UPF consumption has been a key driver of obesity. There is a need to change the obesogenic environment to support individuals to reduce their UPF intake. The UPF concept is a novel approach that is not explained with existing nutrient- and food-based frameworks. Critical analysis of methodologies provides confidence, but future observational and experimental research outputs with greater methodological rigor will strengthen findings, which are outlined.
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Affiliation(s)
- Samuel J Dicken
- Centre for Obesity Research, Department of Medicine, University College London (UCL), London, WC1E 6JF, UK
| | - Rachel L Batterham
- Centre for Obesity Research, Department of Medicine, University College London (UCL), London, WC1E 6JF, UK.
- Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital (UCLH), London, NW1 2BU, UK.
- National Institute for Health Research, Biomedical Research Centre, University College London Hospital (UCLH), London, W1T 7DN, UK.
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Xiao M, Wang Z, Li C, Zhang K, Hou Z, Sun S, Yang L. Recent advances in drug delivery systems based on natural and synthetic polymes for treating obesity. Int J Biol Macromol 2024; 260:129311. [PMID: 38218268 DOI: 10.1016/j.ijbiomac.2024.129311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/27/2023] [Accepted: 01/05/2024] [Indexed: 01/15/2024]
Abstract
Obesity stands as a pervasive global public health issue, posing a formidable threat to human well-being as its prevalence continues to surge year by year. Presently, pharmacological treatment remains the favored adjunct strategy for addressing obesity. However, conventional delivery methods suffer from low bioavailability and the potential for side effects, underscoring the pressing need for more efficient and targeted delivery approaches. Recent research has delved extensively into emerging drug delivery systems employing polymers as carriers, with numerous preclinical studies contributing to the growing body of knowledge. This review concentrates on the utilization of natural polymers as drug delivery systems for the treatment of obesity, encompassing recent advancements in both natural and synthetic polymers. The comprehensive exploration includes an analysis of the advantages and disadvantages associated with these polymer carriers. The examination of these characteristics provides valuable insights into potential future developments in the field of drug delivery for obesity treatment.
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Affiliation(s)
- Miaomiao Xiao
- Research Center for Biomedical Materials, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang 110004, PR China; College of Exercise and Health, Shenyang Sport University, Shenyang 110102, PR China
| | - Zongheng Wang
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, PR China
| | - Chang Li
- College of Sports Medicine, Wuhan Sports University, Wuhan 430079, PR China
| | - Kai Zhang
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang 110004, PR China
| | - Zhipeng Hou
- Research Center for Biomedical Materials, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang 110004, PR China.
| | - Siyu Sun
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang 110004, PR China.
| | - Liqun Yang
- Research Center for Biomedical Materials, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang 110004, PR China; Liaoning Research Institute for Eugenic Birth & Fertility, China Medical University, Shenyang, 110031, P.R.China.
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22
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Moyo P, Felix R. Nurses' obesity knowledge, attitudes and practices in private facilities in Oshana, Namibia. Health SA 2024; 29:2385. [PMID: 38445039 PMCID: PMC10913129 DOI: 10.4102/hsag.v29i0.2385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 11/28/2023] [Indexed: 03/07/2024] Open
Abstract
Background The prevalence of obesity has been rising globally, and this is leading to an increase in other non-communicable diseases. The level of obesity knowledge among nurses may have an impact on how they treat and perceive obese patients. Aim The study aimed to ascertain the knowledge, attitudes and practices of nurses regarding obesity at private healthcare facilities located in Namibia's Oshana Region. Setting A total of four private healthcare facilities in Namibia's Oshana area served as the study's sites. Methods A quantitative cross-sectional research design using proportional stratified random sampling was used to choose 250 respondents for the study. A questionnaire that respondents self-administered was used to gather the data. The reliability and validity of the questionnaire were determined during a pilot study. IBM Statistical Package for the Social Sciences (SPSS) version 27 was used for data analysis. Results Of the participants, about two-fifths had a positive attitude (n = 112; 44.8%), slightly less than two-fifths had good practices (n = 96; 38.4%) and more than one-third had good knowledge (n = 97; 39%). There were differences in knowledge mean scores based on age, occupation, sex and educational level. Conclusion The results validate the necessity for healthcare facilities to implement nurse education and mentorship initiatives, as well as to recognise and reward nurses who effectively care for patients with obesity. Contribution This study added literature on knowledge, attitudes and practices of nurses in private healthcare facilities in Namibia, as well as factors that influence knowledge levels among the nurses.
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Affiliation(s)
- Perseverance Moyo
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Rehanna Felix
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Osińska M, Sanchak Y, Śliwczyński A, Franek E, Walicka M. Comparison of pre-and postoperative medication costs in patients who underwent bariatric surgery - a nationwide data analysis. Front Public Health 2024; 12:1344040. [PMID: 38389942 PMCID: PMC10881874 DOI: 10.3389/fpubh.2024.1344040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/15/2024] [Indexed: 02/24/2024] Open
Abstract
Introduction Bariatric surgery has known health benefits and may lower the medication-related costs. This study aimed to assess the cost of medications prior to and after bariatric surgery in the Polish nationwide registry. Methods The study included 2,390 adults. The analysis was conducted separately for a 12-month pre-operative period, and a 12-month postoperative period. The total costs of medication and cost per anatomical therapeutic chemical group were assessed and the mean cost per patient in the preoperative and postoperative periods was compared. Results The study showed a significant increase in the overall medication costs and mean costs of medications per patient in the year after bariatric surgery. This increase was related mainly to low-molecular-weight heparins used in the 1st month after surgery. Alternatively, costs of medication used in the cardiovascular system diseases and anti-infectives decreased significantly. The total costs of hypoglycemic agents were reduced by 46%, antihypertensive medications by 29%, and lipid-lowering drugs by 38. Conclusions In general, medication costs are higher in the first year after surgery. The increase results from the perioperative use of low-molecular-weight heparins, whereas a significant cost reduction of glucose-, lipid-lowering, antihypertensive, and anti-infective medications was observed.
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Affiliation(s)
- Magdalena Osińska
- Department of Internal Diseases, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Yaroslav Sanchak
- Department of Internal Diseases, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Andrzej Śliwczyński
- National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Edward Franek
- Department of Internal Diseases, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
| | - Magdalena Walicka
- Department of Internal Diseases, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
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Ma G, Meyer CL, Jackson-Morris A, Chang S, Narayan A, Zhang M, Wu D, Wang Y, Yang Z, Wang H, Zhao L, Nugent R. The return on investment for the prevention and treatment of childhood and adolescent overweight and obesity in China: a modelling study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 43:100977. [PMID: 38456086 PMCID: PMC10920044 DOI: 10.1016/j.lanwpc.2023.100977] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 10/05/2023] [Accepted: 11/08/2023] [Indexed: 03/09/2024]
Abstract
Background The rapid increase in child and adolescent overweight and obesity (OAO) in China has a significant health and economic impact. This study undertook an investment case analysis to evaluate the health and economic impacts of child and adolescent OAO in China and the potential health and economic returns from implementing specific policies and interventions. Methods The analysis estimates the reduction in mortality and morbidity from implementing a set of evidence-based interventions across China between 2025 and 2092 using a deterministic Markov cohort model. Modelled interventions were identified by literature review and expert recommendation and include fiscal and regulatory policies, eHealth breastfeeding promotion, school-based interventions, and nutritional counselling by physicians. The study applies a societal costing perspective to model the economic impact on healthcare cost savings, wages, and productivity during adulthood. By projecting and comparing the costs between a status quo scenario and an intervention scenario, the study estimates the return on investment (ROI) for interventions separately and in combination. Findings Without intervention China will experience 3.3 billion disability-adjusted life years (DALYs) due its current levels of child and adolescent OAO and a lifetime economic impact of CNY 218 trillion (USD 31.6 trillion), or a lifetime CNY 2.5 million loss per affected child or adolescent (USD 350 thousand). National implementation of all five interventions would avert 179.4 million DALYs and result in CNY 13.1 trillion of benefits over the model cohort's lifetime. Implementing fiscal and regulatory policies had the strongest ROI, with benefits accruing at least 10 years after implementation. Scaling up China's current school-based interventions offers China significant health and economic gains, however, the ROI is lower than other modelled interventions. Interpretation Effective prevention and treatment of child and adolescent OAO is critical to China's health and economic development. Multiple interventions offer a comprehensive approach to address the various factors that increase risk of child and adolescent OAO. Nonetheless, fiscal and regulatory policies offer the strongest health and economic gains. Funding Funding was provided by UNICEF China.
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Affiliation(s)
- Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Christina L. Meyer
- Center for Global Noncommunicable Diseases, RTI International, Durham, NC, USA
| | | | | | | | - Man Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Daphne Wu
- Center for Global Noncommunicable Diseases, RTI International, Durham, NC, USA
| | - Youfa Wang
- International Obesity and Metabolic Disease Research Center, Global Health Institute, School of Public Health, Xi’an Jiaotong University, Xi’an, Shannxi, China
| | - Zhenyu Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Rachel Nugent
- Center for Global Noncommunicable Diseases, RTI International, Durham, NC, USA
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Park JH, Park DJ, Kim H, Park H, Nam H, Lee B, Kim J, Cho YS, Kong SH, Lee HJ, Yang HK. Long-term impact of weight loss in people with class II obesity on the overall burden of disease: evidence from the national health screening cohort in Korea. Surg Obes Relat Dis 2024:S1550-7289(24)00039-X. [PMID: 38418337 DOI: 10.1016/j.soard.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/06/2024] [Accepted: 01/21/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Obesity is known to increase overall disease burden but does obesity management actually help reduce disease burden? OBJECTIVES To investigate the effects of weight loss on disease burden in people with obesity using the National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) in Korea. SETTING Pure longitudinal observational study using Nationwide cohort database. METHODS Out of 514,866 NHIS-HEALS cohort, participants with class II obesity in Asia-Pacific region (30 ≤ body mass index [BMI] < 35) who underwent health check-up provided by NHIS during 2003-2004 (index date) were included. All final participants continued to receive a total of 5 biennial health check-ups over the next 10 years without missing. A group-based trajectory model (GBTM) was used to categorize subjects based on 10-year BMI change patterns. The changes of co-morbidities, healthcare resource utilization, and medical cost were analyzed. RESULTS The final study subjects (9857) were categorized into 3 trajectory clusters based on the pattern of BMI (kg/m2) change: maintenance (57.35%) with an average change of -.02 ± .06, loss (38.65%) with -.04 ± .08, and substantial loss (4.0%) with -.10 ± .18. The annual increases in the number of co-morbidities per subject in each cluster were .18, .18, and .16 (all P < .001), respectively. The increase of healthcare resource utilization over time was lowest for the substantial loss compared to maintenance and loss. With each passing year, the average annual total healthcare cost increased by ₩21,200 ($16.48, P = .034) and ₩10,500 ($8.16, P = .498) in the maintenance and loss, respectively, but decreased by ₩62,500 ($48.59, P = .032) in the substantial loss. CONCLUSIONS Weight loss in people with obesity was associated with a reduced burden of disease, as evidenced by lower co-morbidity, healthcare resource utilization rate, and decreased medical costs. This study highlights the potential positive long-term impact on Korean society when actively managing weight in individuals with obesity.
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Affiliation(s)
- Ji-Hyeon Park
- Department of Surgery, Seoul National University Hospital, Seoul, Korea; Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Do Joong Park
- Department of Surgery, Seoul National University Hospital, Seoul, Korea; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
| | - Hyesung Kim
- Health Economics & Market Access, Johnson & Johnson MedTech Korea, Seoul, Republic of Korea
| | - Hyejin Park
- Health Economics & Market Access, Johnson & Johnson MedTech Korea, Seoul, Republic of Korea
| | | | - Bora Lee
- RexSoft Corp., Seoul, South Korea; Institute of Health & Environment, Seoul National University, Seoul, Republic of Korea
| | - Jeesun Kim
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Yo-Seok Cho
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Seong-Ho Kong
- Department of Surgery, Seoul National University Hospital, Seoul, Korea; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyuk-Joon Lee
- Department of Surgery, Seoul National University Hospital, Seoul, Korea; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Han-Kwang Yang
- Department of Surgery, Seoul National University Hospital, Seoul, Korea; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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Shafer BM, McAuliffe KE, McHill AW. A longitudinal look at social jetlag, sex differences, and obesity risk. Sleep 2024; 47:zsad298. [PMID: 37976216 PMCID: PMC10782486 DOI: 10.1093/sleep/zsad298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Indexed: 11/19/2023] Open
Affiliation(s)
- Brooke M Shafer
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health and Science University, Portland, OR, USA
| | - Kathryn E McAuliffe
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health and Science University, Portland, OR, USA
| | - Andrew W McHill
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health and Science University, Portland, OR, USA
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, USA
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Stielke A, Ashton K, Cotter-Roberts A, Dyakova M. The social return on investment of physical activity and nutrition interventions-a scoping review. Front Sports Act Living 2024; 5:1296407. [PMID: 38260817 PMCID: PMC10801155 DOI: 10.3389/fspor.2023.1296407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Scarcity of resources and mounting pressures on health systems make it critical to evaluate new and existing public health interventions related to physical activity and nutrition. The Social Return on Investment (SROI) framework has gained prominence for capturing traditional variables such as economic costs and returns, as well as wider beneficial social and environmental outcomes. A scoping review was conducted to present the existing evidence on the SROI of physical activity and nutrition interventions, demonstrating the wider benefits of these interventions. Methodology Existing peer-reviewed evidence and grey literature was collated to identify physical activity and nutrition interventions that were evaluated using the SROI framework between January 1996 up until February 2022. Only literature published in the English language, interventions that were conducted in high-income countries were considered for inclusion. Study information and economic data was entered into a pre-prepared data extraction sheet and eligible studies were quality assessed using a 12-point quality assessment framework for SROI studies. Results This review identified a total of 21 SROI studies, with only four deriving from peer-reviewed literature sources. In total, 18 studies evaluated physical activity interventions, one study was purely focused on nutrition, whereas the two remaining studies presented a mix of physical activity and nutrition. The majority of studies derived from the United Kingdom (n = 16) with very few of the studies published prior to 2010 (n = 1). In total, four studies were classified as low quality based on the 12-point quality assessment framework used for this review. Outcomes of the relevant studies show that the benefits of these interventions have added value to families, communities and the wider environments of the target groups. Conclusion This scoping review is adding to research conducted to understand the wider value of public health interventions such as physical activity and nutrition interventions using the SROI framework. This is important so that the development and implementation of public health interventions have the greatest value to people and society, which also benefits decision-makers to effectively and sustainably allocate scarce resources.
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Affiliation(s)
- Anna Stielke
- WHO Collaborating Centre on Investment for Health and Well-Being, Public Health Wales NHS Trust, Cardiff, United Kingdom
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Althumiri NA, BinDhim NF, Aldabaeab AE, AlMousa N, Aljabbary RA, Alumran A. Comparing Lifestyle and Behavior of Post-Bariatric Surgery and Participants with Obesity: A Community-Based Cross-Sectional Study. Diabetes Metab Syndr Obes 2024; 17:31-44. [PMID: 38192495 PMCID: PMC10771717 DOI: 10.2147/dmso.s440209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/28/2023] [Indexed: 01/10/2024] Open
Abstract
Background There is a paucity of research dedicated to exploring behavioral change in patients following bariatric surgery. However, there is a need for comparison analysis of individuals with obesity who have received surgical treatment and those who have not opted for any surgical procedures for weight loss. This study is designed to scrutinize the lifestyle choices, behavioral patterns, psychological elements, and eating habits of individuals who have undergone bariatric surgery, in contrast to those with obesity who have not undergone such a procedure. Methods This study is a secondary analysis from Sharik Diet and Health National Survey (SDHNS) dataset, which is a cross-sectional investigation covering the period from 2020 to 2022. The study focused on demographic factors like age, gender, educational attainment, and monthly earnings. Furthermore, other variables such as physical activity, leisure and workplace sitting habits, smoking patterns, strategies for managing weight, and eating and consumption behaviors were also examined. Results Out of the initial 15,980 participants reached, 4,069 satisfied the study's inclusion criteria. Bariatric surgery was reported by 806 participants (19.8%). Upon comparing three obesity status groups - The participants who underwent bariatric surgery with or without obesity, those with obesity who did not opt for any surgical weight loss measure, the analysis found that the three obesity status groups were significantly different in 21 variables from a total of 26. Moreover, a logistic regression analysis revealed that 11 variables influenced persistent obesity in the post-surgery phase, as opposed to those who successfully lost weight. These variables included advanced age, limited education, being female, lower income, waterpipe smoking habits, and the consumption of carbonated drinks. Conclusion This study showed that inability to lose weight after bariatric surgery are linked to poor lifestyle choices and behavior compared to those who were able to lose weight after the surgery.
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Affiliation(s)
- Nora A Althumiri
- Scientific Department, Informed Decision Making (IDM), Riyadh, Saudi Arabia
- Scientific Department, Sharik Association for Research and Studies, Riyadh, Saudi Arabia
| | - Nasser F BinDhim
- Scientific Department, Informed Decision Making (IDM), Riyadh, Saudi Arabia
- Scientific Department, Sharik Association for Research and Studies, Riyadh, Saudi Arabia
| | - Abdulaziz E Aldabaeab
- Obesity Department, King Fahad Hospital of the Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Norah AlMousa
- Scientific Department, Sharik Association for Research and Studies, Riyadh, Saudi Arabia
| | | | - Arwa Alumran
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Coutinho W, Halpern B. Pharmacotherapy for obesity: moving towards efficacy improvement. Diabetol Metab Syndr 2024; 16:6. [PMID: 38172940 PMCID: PMC10763391 DOI: 10.1186/s13098-023-01233-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/25/2023] [Indexed: 01/05/2024] Open
Abstract
Obesity is a chronic, recurring, progressive disease and a major public health problem associated with several other diseases that lead to disability, morbidity, and mortality. The prevalence of obesity has increased at pandemic levels, along with increasing weight-related comorbidities and deaths worldwide. Lifestyle interventions alone provide clinically significant long-term weight loss in only a small proportion of individuals, and bariatric surgery is not suitable or desirable for all patients. Historically, anti-obesity medications achieved a mean efficacy with weight loss between 5 and 10%, which significantly impacted several comorbidities and risk factors, but the average efficacy of these medications remained lower than that expected by both patients and health care professionals and eventually curbed long-term use. Moreover, there is no direct evidence on the impact of anti-obesity medications on cardiovascular outcomes. Semaglutide is a newer anti-obesity medication that changes the overall landscape, as phase 3 studies show a mean weight loss near the 15% threshold and significant proportions of patients with a weight loss of greater than 20%. In this review, we focus on the currently available anti-obesity medications, discuss the results of semaglutide, and present perspectives on the future of obesity treatment after semaglutide.
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Affiliation(s)
- Walmir Coutinho
- State Institute of Diabetes and Endocrinology, Rua Moncorvo Filho, 90, Rio de Janeiro, RJ, 20211-340, Brazil.
- Department of Medicine, Pontifical Catholic University of Rio de Janeiro, Rua Marquês de São Vicente, 225, Gávea, Rio de Janeiro, RJ, 22541-041, Brazil.
| | - Bruno Halpern
- Department of Endocrinology, Obesity Unit, Hospital das Clínicas Faculdade de Medicina da Universidade de São Paulo. Av. Dr. Enéas de Carvalho Aguiar, 255, 7Th Floor, Room 7037, São Paulo, SP, 05403-000, Brazil
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Nagi MA, Ahmed H, Rezq MAA, Sangroongruangsri S, Chaikledkaew U, Almalki Z, Thavorncharoensap M. Economic costs of obesity: a systematic review. Int J Obes (Lond) 2024; 48:33-43. [PMID: 37884664 DOI: 10.1038/s41366-023-01398-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/18/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION Obesity is a growing public health problem leading to substantial economic impact. This study aimed to summarize the economic impact of obesity and to critically analyze the methods used in the cost-of-illness (COI) studies on obesity. METHODS We conducted systematic search in PubMed and Scopus from September 1, 2016, to July 22, 2022. Original COI studies estimating the economic cost of obesity and/or overweight in at least one country, published in English were included. To facilitate the comparison of estimates across countries, we converted the cost estimates of different years to 2022 purchasing power parity (PPP) values using each country's consumer price index (CPI) and PPP conversion rate. RESULTS Nineteen studies were included. All studies employed a prevalence-based approach using Population Attributable Fraction (PAF) methodology. About half of the included studies (53%) were conducted in high-income countries while the others (47%) were conducted in middle-income countries. The economic burden of obesity ranged between PPP 15 million in Brazil to PPP 126 billion in the USA, in the year 2022. Direct medical costs accounted for 0.7% to 17.8% of the health system expenditure. Furthermore, the total costs of obesity ranged from 0.05% to 2.42% of the country's gross domestic product (GDP). Of the seven studies that estimated both direct and indirect costs, indirect costs accounted for the largest portion of five studies. Nevertheless, a variety in methodology across studies was identified. The number of co-morbidities included in the analysis varied across studies. CONCLUSIONS Although there was a variety of methodologies across studies, consistent evidence indicated that the economic burden of obesity was substantial. Obesity prevention and control should be a public health priority, especially among countries with high prevalence of obesity.
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Affiliation(s)
- Mouaddh Abdulmalik Nagi
- Doctor of Philosophy Program in Social, Economic and Administrative Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Faculty of Medical Sciences, Aljanad University for Science and Technology, Taiz, Yemen
| | - Hanan Ahmed
- Faculty of Medical Sciences, Aljanad University for Science and Technology, Taiz, Yemen
- Master of Public Health, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Mustafa Ali Ali Rezq
- Master of Public Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Faculty of Pharmacy, Sana'a University, Sana'a, Yemen
| | - Sermsiri Sangroongruangsri
- Social and Administrative Pharmacy Excellence Research (SAPER) unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Usa Chaikledkaew
- Social and Administrative Pharmacy Excellence Research (SAPER) unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Ziyad Almalki
- Prince Sattam Bin Abdulaziz University, Department of Clinical Pharmacy, Al-Kharj, Riyadh, Saudi Arabia
| | - Montarat Thavorncharoensap
- Social and Administrative Pharmacy Excellence Research (SAPER) unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
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Silva-Uribe M, Máynez-López F, Denova-Gutiérrez E, Muñoz-Guerrero B, Omaña-Guzmán I, Messiah SE, Ruíz-Arroyo A, Lozano-González E, Villanueva-Ortega E, Muñoz-Aguirre P, Garibay-Nieto N. Validation of the Childhood Family Mealtime Questionnaire in Mexican Adolescents with Obesity and Their Caregivers. Nutrients 2023; 15:4937. [PMID: 38068795 PMCID: PMC10708254 DOI: 10.3390/nu15234937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Childhood obesity is a significant public health concern in Mexico, with far-reaching implications for the nation's healthcare system and economy. In light of this challenge, our study sought to validate the Childhood Family Mealtime Questionnaire (CFMQ) in Mexican adolescents living with obesity and their primary caregivers. METHODS A sample of 56 adolescents ages 13 to 17 years and their primary caregivers from one pediatric obesity clinic participated in the study. We conducted a comprehensive assessment of the CFMQ's consistency, reliability, and construct validity among all participants. Internal consistency was determined using Cronbach's α, and the questionnaire's reliability was assessed through test-retest and intraclass correlation coefficients. Construct validity was assessed through an exploratory factor analysis. RESULTS Our findings confirmed strong internal consistency and reliability for both adolescents and caregivers. Construct validity was established through exploratory factor analysis, refining the questionnaire while preserving its original seven dimensions. This validation of the CFMQ highlights its applicability in evaluating family mealtime experiences in this context, providing valuable insights into the dynamics that influence adolescent nutrition and health. CONCLUSION The CFMQ proves to be a reliable tool for assessing family mealtime experiences in Mexican adolescents living with obesity and their caregivers who seek care at third-level public hospitals.
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Affiliation(s)
- Melissa Silva-Uribe
- Pediatric Obesity Clinic and Wellness Unit, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (M.S.-U.); (F.M.-L.); (B.M.-G.); (I.O.-G.); (A.R.-A.); (E.L.-G.); (E.V.-O.)
| | - Fernanda Máynez-López
- Pediatric Obesity Clinic and Wellness Unit, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (M.S.-U.); (F.M.-L.); (B.M.-G.); (I.O.-G.); (A.R.-A.); (E.L.-G.); (E.V.-O.)
| | - Edgar Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca 62100, Mexico;
| | - Brenda Muñoz-Guerrero
- Pediatric Obesity Clinic and Wellness Unit, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (M.S.-U.); (F.M.-L.); (B.M.-G.); (I.O.-G.); (A.R.-A.); (E.L.-G.); (E.V.-O.)
| | - Isabel Omaña-Guzmán
- Pediatric Obesity Clinic and Wellness Unit, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (M.S.-U.); (F.M.-L.); (B.M.-G.); (I.O.-G.); (A.R.-A.); (E.L.-G.); (E.V.-O.)
| | - Sarah E. Messiah
- Center for Pediatric Population Health, University of Texas Health Science Center at Houston School of Public Health, Dallas, TX 75207, USA;
| | - Arturo Ruíz-Arroyo
- Pediatric Obesity Clinic and Wellness Unit, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (M.S.-U.); (F.M.-L.); (B.M.-G.); (I.O.-G.); (A.R.-A.); (E.L.-G.); (E.V.-O.)
| | - Emilia Lozano-González
- Pediatric Obesity Clinic and Wellness Unit, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (M.S.-U.); (F.M.-L.); (B.M.-G.); (I.O.-G.); (A.R.-A.); (E.L.-G.); (E.V.-O.)
| | - Eréndira Villanueva-Ortega
- Pediatric Obesity Clinic and Wellness Unit, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (M.S.-U.); (F.M.-L.); (B.M.-G.); (I.O.-G.); (A.R.-A.); (E.L.-G.); (E.V.-O.)
| | - Paloma Muñoz-Aguirre
- Consejo Nacional de Humanidades, Ciencias y Tecnologías (CONAHCYT), Mexico City 03940, Mexico;
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca 62100, Mexico
| | - Nayely Garibay-Nieto
- Pediatric Obesity Clinic and Wellness Unit, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (M.S.-U.); (F.M.-L.); (B.M.-G.); (I.O.-G.); (A.R.-A.); (E.L.-G.); (E.V.-O.)
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Nejadghaderi SA, Grieger JA, Karamzad N, Kolahi AA, Sullman MJM, Safiri S, Sabour S. Burden of diseases attributable to excess body weight in the Middle East and North Africa region, 1990-2019. Sci Rep 2023; 13:20338. [PMID: 37990049 PMCID: PMC10663478 DOI: 10.1038/s41598-023-46702-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 11/03/2023] [Indexed: 11/23/2023] Open
Abstract
High body mass index (BMI), or excess body weight (EBW), represents a significant risk factor for a range of diseases, including cardiovascular diseases and cancers. The study sought to determine the burden of diseases attributable to EBW in the Middle East and North Africa (MENA) region from 1990 and 2019. The analysis also included an exploration of this burden by age, sex, underlying cause, and sociodemographic index (SDI). We utilized publicly available data from the Global Burden of Disease (GBD) study 2019 to identify the deaths and disability-adjusted life-years (DALYs) of diseases associated with EBW in MENA, spanning the period from 1990 to 2019. The GBD estimated the mean BMI and the prevalence of EBW using hierarchical mixed-effects regression, followed by spatiotemporal Gaussian process regression to determine the most accurate BMI distribution through comparison with actual data. In 2019, there were an estimated 538.4 thousand deaths (95% UI 369.9-712.3) and 17.9 million DALYs (12.9-23.1) attributable to EBW in the region. The DALYs attributable to EBW were higher in men (9.3 million [6.5-12.4]) than in women (8.5 million [6.4-10.8]). The age-standardized death and DALY rates for the diseases associated with EBW increased by 5.1% (- 9.0-25.9) and 8.3% (- 6.5-28.8), respectively, during the study period which was not significant. Egypt had the highest age-standardized mortality rate due to EBW (217.7 [140.0, 307.8]), while Yemen (88.6 [45.9, 143.5]) had the lowest. In 2019, the highest number of DALYs occurred among individuals aged 60 to 64 years old. Furthermore, we found a positive association between a nation's SDI and the age-standardized DALY rate linked to EBW. Cardiovascular disease emerged as the leading contributor to the EBW burden in MENA. The disease burden attributable to EBW showed a non-significant increase in MENA from 1990 to 2019.
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Affiliation(s)
- Seyed Aria Nejadghaderi
- Safety Promotion and Injury Prevention Research Centre, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jessica A Grieger
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | - Nahid Karamzad
- Department of Persian Medicine, School of Traditional Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Saeid Safiri
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Siamak Sabour
- Safety Promotion and Injury Prevention Research Centre, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Kalra S, Kapoor N, Verma M, Shaikh S, Das S, Jacob J, Sahay R. Defining and Diagnosing Obesity in India: A Call for Advocacy and Action. J Obes 2023; 2023:4178121. [PMID: 38026823 PMCID: PMC10645500 DOI: 10.1155/2023/4178121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/26/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
The prevalence of overweight and obesity has more than doubled since 1980, and it is predicted that around two-thirds of the global burden of the disease will be attributed to chronic non-communicable diseases. Developing countries are experiencing a more dramatic rise in the prevalence of obesity in recent years. As per National Family Health Survey-5 (NFHS-5), one in every four Indians is now having obesity. It has been reported that being overweight and obese is a significant problem among different socioeconomic spectrums of men and women in India, especially among the elderly, people residing in urban regions, and diverse socioeconomic strata. There is an urgent need to identify obesity as a chronic disease requiring immediate attention, mandating timely screening, timely treatment, and economical ways of achieving and managing weight loss across the country. In this review, the authors have discussed various aspects of overweight and obesity and critically appraised the current status of obesity in India, its public health implications, the significance of screening, the role of BMI and other parameters in diagnosing obesity, and the need for treatment and cost-effective prescriptions.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - Madhur Verma
- Department of Community/Family Medicine, All India Institute of Medical Sciences, Bhatinda, Punjab, India
| | - Shehla Shaikh
- Prince Aly Khan Hospital, Mumbai, Maharashtra, India
| | - Sambit Das
- Department of Endocrinology, Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, Odisha, India
| | - Jubbin Jacob
- Department of Endocrinology, Christian Medical College, Ludhiana, Punjab, India
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College, Hyderabad, Telangana, India
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Alshehri FS, Alorfi NM. Saudi Adults' Understanding and Views of Weight Management Practices and Obesity. Diabetes Metab Syndr Obes 2023; 16:3513-3531. [PMID: 37954890 PMCID: PMC10637233 DOI: 10.2147/dmso.s433721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/27/2023] [Indexed: 11/14/2023] Open
Abstract
Background and Objective The rising prevalence of overweight and obesity presents a significant global challenge. This study aimed to investigate the understanding and views of weight management practices and obesity among Saudi adults. Methodology A cross-sectional online survey was conducted from October 2022 to January 2023 among adults residing in Saudi Arabia. Participants completed a self-administered 41-item questionnaire designed to assess their understanding and views regarding weight management practices and obesity. Results A total of 1066 participants completed the survey. Gender distribution showed a majority of males (55.7%). Age-wise, the majority fell below 51 years, with 37.7% (young) between 18-24, 32.7% (young adult) between 25-33, and 21.3% (adult) between 34-51. Employment was reported by one-third (n = 315) of respondents, while 22.0% (n = 234) had a history of chronic diseases. Furthermore, 77.3% (n = 824) engaged in regular physical activity.The study results revealed that participants' mean score for understanding obesity was 3.28 ± 2.37 (range 0-6), while the average views score was 28.08 ± 8.79 (range 0-34). Furthermore, females displayed a higher level of understanding compared to males. Employment status also played a significant role, with employed individuals having a better understanding of obesity than those who were unemployed. Moreover, participants with higher qualifications demonstrated a more comprehensive understanding of obesity compared to those with lower qualifications. Additionally, individuals with higher monthly income levels displayed a greater understanding of obesity compared to those with lower incomes. Lastly, participants who engaged in regular physical activity exhibited a higher level of understanding compared to those who were physically inactive. Conclusion The study indicates that factors such as being older, being female, being employed, having higher education and income, and engaging in regular physical activity are associated with increased understanding and favorable views regarding weight management practices and obesity.
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Affiliation(s)
- Fahad S Alshehri
- Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Nasser M Alorfi
- Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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Salamah HM, Marey A, Elsayed E, Hasan MT, Mahmoud A, Abualkhair KA, Abo-Elnour DE, Abdelhaleem IA, Abd-Elgawad M. Efficacy and safety of polyethylene glycol loxenatide in type 2 diabetic patients: a systematic review and meta-analysis of randomized controlled trials. Sci Rep 2023; 13:19041. [PMID: 37923756 PMCID: PMC10624877 DOI: 10.1038/s41598-023-46274-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023] Open
Abstract
Polyethylene glycol loxenatide (PEX168) is a novel glucagon-like peptide-1 receptor agonist with a longer half-life developed by modifying the chemical structure of exenatide. This study aims to assess the efficacy and safety of PEX168 and determine the best dose. We searched PubMed, Scopus, Cochrane Library, and Web of Science databases from inception to April 25, 2023, for randomized controlled trials (RCTs) comparing PEX168 therapy alone or in combination with metformin versus other therapies. We used the risk ratio (RR) for dichotomous outcomes and the mean difference (MD) for continuous outcomes, both with 95% confidence intervals (CI). Six RCTs, including 1248 participants, were included. PEX168 added to metformin was significantly better than metformin alone regarding fasting blood glucose (MD = -1.20, 95% CI (-1.78, - 0.62), p < 0.0001), HbA1c (MD = -1.01, 95% CI (-1.48, - 0.53), p < 0.0001), and postprandial glycemia (MD = -1.94, 95% CI (-2.99, - 0.90), p = 0.0003). Similarly, for glycemic control, PEX168 monotherapy was superior to placebo (P < 0.05). No significant effects were noticed in terms of triglycerides, low-density lipoprotein, or high-density lipoprotein (p > 0.05). Body weight was significantly reduced in obese diabetic patients receiving PEX168 compared to the control group (MD = -5.46, 95% CI (-7.90, - 3.01), p < 0.0001) but not in non-obese patients (MD = 0.06, 95% CI (-0.47, 0.59), p = 0.83). People who received PEX168 alone or with metformin showed more common gastrointestinal adverse effects, especially nausea and vomiting (p < 0.05). PEX168 100, 200, and 300 ug monotherapy demonstrated comparable safety and diabetes control to metformin, but when combined with metformin, PEX168 100 and 200 ug showed significant effects on diabetes control; however, only the latter showed a significantly higher incidence of nausea and vomiting (p < 0.05). PEX168 could be a viable option for treating diabetic patients whose metformin control is inadequate or who cannot tolerate metformin. PEX168 at 100 ug in combination with metformin was found to be safe and more effective compared to metformin; however, due to the small number of trials included, these findings should be interpreted with caution, and additional trials are required.
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Affiliation(s)
| | - Ahmed Marey
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Esraa Elsayed
- Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt
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Jabeen A, Afzal MS, Pathan SA. A Review of the Role of Built Environment and Temperature in the Development of Childhood Obesity. Cureus 2023; 15:e49657. [PMID: 38161805 PMCID: PMC10756253 DOI: 10.7759/cureus.49657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
The burden of obesity is rising globally and is studied widely, yet the evidence for the association of environmental factors (both built and natural) with childhood obesity remains inconsistent. A relation with temperature as a proxy for natural environmental factors for obesity has not been reviewed previously. The purpose of this review was to assimilate updated evidence on environmental factors of childhood obesity. Three databases, MEDLINE (Medical Literature Analysis and Retrieval System Online), Web of Science, and Cochrane, were searched for articles related to the effect of built environment and temperature on childhood obesity in 6-12-year-olds published in the last five years. Twelve studies were identified: four longitudinal and eight cross-sectional. The studies were appraised using the National Institute of Health Quality (NIH) Assessment Tool. A review of included studies showed that built environmental features like higher residential and population density, higher intersection density, more playgrounds, and all park features like the presence or availability of parks, high number of parks, proximity to parks, and an increased park land area, showed a protective association against childhood obesity while land use mix showed a promoting association for the development of childhood obesity. Inconclusive evidence was observed for other built environmental features. The search strategy did not retrieve any literature published in the past five years studying the association between temperature and the development of childhood obesity. Standardization of definitions of exposure and outcome measures is recommended. Further research studying the relationship between environmental temperature and the development of childhood obesity is recommended.
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Affiliation(s)
- Atika Jabeen
- Public Health, London School of Hygiene & Tropical Medicine, University of London, London, GBR
- Emergency Department, Hamad Medical Corporation, Doha, QAT
| | | | - Sameer A Pathan
- Emergency Department, Hamad Medical Corporation, Doha, QAT
- Emergency Medicine, Blizard Institute, Queen Mary University of London, London, GBR
- Emergency Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, AUS
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McNabney SM, Gletsu-Miller N, Rowland DL. Sexual Function and Satisfaction in the Context of Obesity. Curr Diab Rep 2023; 23:315-327. [PMID: 37632680 DOI: 10.1007/s11892-023-01523-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 08/28/2023]
Abstract
PURPOSE OF REVIEW Sexual dysfunction is commonly associated with overweight/obesity, but the underlying physiological and psychosocial mechanisms are not fully understood. This review contextualizes the obesity-sexual (dys)function relationship, describes recent insights from the medical and social science literature, and suggests opportunities for continued research. RECENT FINDINGS Although sexual dysfunction has been historically evaluated as a consequence/outcome of obesity, it is increasingly considered as a harbinger of future metabolic comorbidities, including type 2 diabetes and cardiovascular disease. Body image dissatisfaction is a consistent predictor for lower sexual satisfaction across BMI categories, likely mediated by cognitive distraction during partnered sex. To fully capture the relationship between obesity and sexual dysfunction, multidisciplinary research approaches are warranted. While clinically significant weight loss tends to improve sexual functioning for women and men, higher body image satisfaction may independently promote sexual function and satisfaction without concomitant weight loss.
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Affiliation(s)
- Sean M McNabney
- Department of Applied Health Science, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Nana Gletsu-Miller
- Department of Applied Health Science, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - David L Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN, USA.
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Jackson TN, Cox BP, Grinberg GG, Yenumula PR, Lim RB, Chow GS, Khorgami Z. National usage of bariatric surgery for class I obesity: an analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. Surg Obes Relat Dis 2023; 19:1255-1262. [PMID: 37438232 DOI: 10.1016/j.soard.2023.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 04/10/2023] [Accepted: 05/14/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND National and international consensus statements, as well as the National Institutes of Health (NIH), support the use of bariatric surgery for the treatment of class I obesity. Despite this, most payors within the United States limit reimbursement to the outdated 1991 NIH guidelines or a similar adaptation. OBJECTIVES This study aimed to determine the safety of bariatric surgery in patients with lower BMI compared with standard patients, as well as determine U.S. utilization of bariatric surgery in class I obesity in 2015-2019. SETTING A retrospective analysis was performed of the 2015-2019 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. METHODS Laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass patients were divided into body mass index cohorts: class I obesity (<35 kg/m2) and severe obesity (≥35 kg/m2). Differences in preoperative patient selection and postoperative outcomes were established, and frequency trends were delineated. RESULTS Analysis included 760,192 surgeries with 8129 (1%) for patients with class I obesity. The patients with class I obesity were older, more commonly female, and with lower American Society of Anesthesiologists (ASA) class, but with higher rates of type 2 diabetes, hyperlipidemia, and gastroesophageal reflux disease (P < .05). Variation was found for operative time, length of stay, 30-day readmission, and composite morbidity. Minimal annual variation was found for bariatric surgeries performed for patients with class I obesity. CONCLUSIONS The short-term safety of bariatric surgery in patients with class I obesity was corroborated by this study. Despite consensus statements and robust support, rates of bariatric surgery in patients with class I obesity have failed to increase and remain limited to 1%. This demonstrates the impact of the outdated 1991 NIH guidelines regarding access to care for these potentially life-saving surgeries.
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Affiliation(s)
- Theresa N Jackson
- Department of Bariatric Surgery, Kaiser Permanente South Sacramento Medical Center, Sacramento, California.
| | - Bradley P Cox
- Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma
| | - Gary G Grinberg
- Department of Bariatric Surgery, Kaiser Permanente South Sacramento Medical Center, Sacramento, California
| | - Panduranga R Yenumula
- Department of Bariatric Surgery, Kaiser Permanente South Sacramento Medical Center, Sacramento, California
| | - Robert B Lim
- Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma
| | - Geoffrey S Chow
- Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma
| | - Zhamak Khorgami
- Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma; Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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Nescolarde L, Orlandi C, Farina GL, Gori N, Lukaski H. Fluid-Dependent Single-Frequency Bioelectrical Impedance Fat Mass Estimates Compared to Digital Imaging and Dual X-ray Absorptiometry. Nutrients 2023; 15:4638. [PMID: 37960291 PMCID: PMC10650025 DOI: 10.3390/nu15214638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
The need for a practical method for routine determination of body fat has progressed from body mass index (BMI) to bioelectrical impedance analysis (BIA) and smartphone two-dimensional imaging. We determined agreement in fat mass (FM) estimated with 50 kHz BIA and smartphone single lateral standing digital image (SLSDI) compared to dual X-ray absorptiometry (DXA) in 188 healthy adults (69 females and 119 males). BIA underestimated (p < 0.0001) FM, whereas SLSDI FM estimates were not different from DXA values. Based on limited observations that BIA overestimated fat-free mass (FFM) in obese adults, we tested the hypothesis that expansion of the extracellular water (ECW), expressed as ECW to intracellular water (ECW/ICW), results in underestimation of BIA-dependent FM. Using a general criterion of BMI > 25 kg/m2, 54 male rugby players, compared to 40 male non-rugby players, had greater (p < 0.001) BMI and FFM but less (p < 0.001) FM and ECW/ICW. BIA underestimated (p < 0.001) FM in the non-rugby men, but SLSDI and DXA FM estimates were not different in both groups. This finding is consistent with the expansion of ECW in individuals with excess body fat due to increased adipose tissue mass and its water content. Unlike SLSDI, 50 kHz BIA predictions of FM are affected by an increased ECW/ICW associated with greater adipose tissue. These findings demonstrate the validity, practicality, and convenience of smartphone SLSDI to estimate FM, seemingly not influenced by variable hydration states, for healthcare providers in clinical and field settings.
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Affiliation(s)
- Lexa Nescolarde
- Department of Electronic Engineering, Universitat Politècnica de Catalunya, 08034 Barcelona, Spain
| | - Carmine Orlandi
- Medical Faculty, Tor Vergata University, 00133 Rome, Italy;
- Medical Center Eubion, 00135 Rome, Italy;
| | | | - Niccolo’ Gori
- Federazione Italiana Rugby—FIR, Stadio Olimpico, Foro Italico, 00135 Rome, Italy;
| | - Henry Lukaski
- Department of Kinesiology and Public Health Education, University of North Dakota, Grand Forks, ND 58201, USA;
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Salgado Hernández JC, Basto-Abreu A, Junquera-Badilla I, Moreno-Aguilar LA, Barrientos-Gutiérrez T, Colchero MA. Building upon the sugar beverage tax in Mexico: a modelling study of tax alternatives to increase benefits. BMJ Glob Health 2023; 8:e012227. [PMID: 37963607 PMCID: PMC10649495 DOI: 10.1136/bmjgh-2023-012227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 10/07/2023] [Indexed: 11/16/2023] Open
Abstract
INTRODUCTION In 2014, Mexico implemented a one peso-per-litre tax to sugar-sweetened beverage (SSB). Even though this tax reduced household purchases and predicted population health gains, the magnitude is lower compared with taxes implemented in other settings. In this study, we assessed what would happen if Mexico modified its existing tax to get higher benefits based on currently implemented taxes elsewhere. METHODS For each tax scenario, we estimated net benefits as the difference between healthcare savings and lost jobs. We created hypothetical scenarios in which the current tax doubled or would be modified based on existing tax designs around the world including specific taxes (sugar-density or volumetric) and ad-valorem taxes. RESULTS We found that the largest benefits would correspond to a tax increase of 7.4 Mexican pesos (0.45 US dollars (USD)) per SSB litre, following the current tax in Bahrain (the highest tax rate option). This tax is predicted to yield net benefits equivalent to USD 24.7 billion after 10 years of the tax redesign. We also found that sugar-density taxes can result in larger net benefits since, in addition to reductions in consumption associated with responses to prices, they induce product reformulation. Middle-income households are the most benefited group because they reported the highest baseline prevalence of obesity and the largest price elasticity. CONCLUSION Policymakers should consider pursuing a tax reform adding to the current tax, with significant increases in prices linked to a sugar-density strategy to reach a higher benefit.
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Affiliation(s)
- Juan Carlos Salgado Hernández
- National Council for Science and Technology and Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Ana Basto-Abreu
- Center for Population and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Isabel Junquera-Badilla
- Center for Population and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | | | - M Arantxa Colchero
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Mexico
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Althumiri NA, Bindhim NF, Aldabaeab AE, AlMousa N, Aljabbary R, Alumran A. Comparative analysis of lifestyle behaviors and dietary intake among obese and non-obese individuals following bariatric surgery: a secondary data analysis from 2020 to 2022. Front Nutr 2023; 10:1273164. [PMID: 37964934 PMCID: PMC10642296 DOI: 10.3389/fnut.2023.1273164] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 10/11/2023] [Indexed: 11/16/2023] Open
Abstract
Objective The aim of this research is to perform a comparative examination of lifestyle habits and dietary consumption between obese and non-obese subjects who have undergone bariatric surgery. This is done with the intent of investigating the disparities in obesity outcomes attributable to these elements. Method This study involves a secondary analysis of cross-sectional data obtained from the Sharik Diet and Health National Survey (SDHNS). To ensure a representative distribution of participants, the SDHNS employs a proportional quota sampling strategy, with stratification based on age, sex, and geographic location within Saudi Arabia's 13 administrative regions, utilizing the ZDataCloud® system for this purpose. The data, collected between 2020 and 2022 from over 15,000 participants, were screened to identify the eligible records of individuals who underwent bariatric surgery. Results Within the entire sample, a mere 5.0% (806 individuals) had undertook bariatric surgery, with females comprising 54% of this specific subgroup. The average age within this group was 38.85 years (SD 13.02) and range (18-87). Post-operative results showed that 33% of these individuals remained classified as obese. Utilizing the backward likelihood ratio regression model, it was determined that factors including age, decreased consumption of fresh juices and chicken, as well as current tobacco use, were significantly associated with persistent obesity. Conclusion The findings of this study suggest an association between the non-obese group and healthier lifestyle choices, including the consumption of high-protein diets and fresh juices, alongside a decreased prevalence of smoking. These observations underscore the significance of maintaining a healthy lifestyle for positive weight loss outcomes following bariatric surgery.
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Affiliation(s)
- Nora A. Althumiri
- Informed Decision Making (IDM), Riyadh, Saudi Arabia
- Sharik Association for Research and Studies, Riyadh, Saudi Arabia
| | - Nasser F. Bindhim
- Informed Decision Making (IDM), Riyadh, Saudi Arabia
- Sharik Association for Research and Studies, Riyadh, Saudi Arabia
- College of Medicine, Alafia University, Riyadh, Saudi Arabia
| | | | - Norah AlMousa
- Sharik Association for Research and Studies, Riyadh, Saudi Arabia
| | | | - Arwa Alumran
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Chermon D, Birk R. Predisposition of the Common MC4R rs17782313 Female Carriers to Elevated Obesity and Interaction with Eating Habits. Genes (Basel) 2023; 14:1996. [PMID: 38002939 PMCID: PMC10671328 DOI: 10.3390/genes14111996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/22/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
The global rise in obesity is attributed to genetic predisposition interaction with an obesogenic environment. Melanocortin 4 receptor (MC4R) rs17782313 polymorphism has been linked to common obesity with varying influence across different populations. MC4R is a crucial player in the leptin proopiomelanocortin pathway that regulates weight hemostasis. We aimed to study MC4R rs17782313 and its interaction with eating behaviors on obesity predisposition in the Israeli population. Adults' (n = 5785, >18 y) genotype and anthropometric and demographic data were analyzed using logistic regression models adjusting for age, sex, T1DM, and T2DM. MC4R rs17782313 significantly predisposes to elevated obesity risk under the recessive and additive models (OR = 1.38, 95% CI: 1.1-1.72, p = 0.005 and OR = 1.1, 95% CI: 1.01-1.2, p = 0.03, respectively) adjusted for confounders (age, sex, T1DM, and T2DM). Stratification by sex demonstrated that carrying the common MC4R rs17782313 is significantly associated with an elevated predisposition to obesity under the recessive model among females only (OR = 1.41, 95% CI: 1.09-1.82, p = 0.01), with an average of 0.85 BMI increment compared with wild type and one risk allele carriers. MC4R rs17782313 significantly interacted with several eating behaviors to enhance the risk of obesity. Our findings demonstrate that MC4R rs17782313 homozygous female carriers are significantly predisposed to obesity amplified by eating behaviors.
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Affiliation(s)
| | - Ruth Birk
- Nutrition Department, Health Sciences Faculty, Ariel University, Ariel 40700, Israel;
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Fabron C, Laville M, Aron-Wisnewsky J, Disse E, Gatta-Cherifi B, Jacobi D, Montastier E, Oppert JM, Gaillard L, Detournay B, Czernichow S. Out-of-Pocket Expenses in Households of People Living with Obesity in France. Obes Facts 2023; 16:606-613. [PMID: 37879296 PMCID: PMC10870127 DOI: 10.1159/000533342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/28/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND/OBJECTIVES Overweight and obesity result in a substantial economic burden in both low- and high-income countries. Moreover, this burden is often underestimated because it only partially accounts for unreimbursed out-of-pocket expenses (OOPE) related to obesity. The objective of our study was not only to evaluate OOPE incurred by people with obesity in relation to their disease with respect to direct medical expenditures and direct non-medical expenditures but also the proportion of people living with obesity who have forgone obesity-related healthcare due to the costs of such care. METHODS An observational descriptive survey was conducted among people with class II/III obesity attending six obesity treatment centers in France. Volunteer adult participants completed a written/phone questionnaire on their related expenditures over the last 6 months for current expenditures and over the last 5 years for occasional ones. The costs were expressed in 2022 EUR. RESULTS 299 people participated (age: 46 years [SD: 13.9], women: 72%, BMI ≥40 kg/m2: 62% and 48% with comorbidities). 65% had a professional activity. 83% declared that they had OOPE related to obesity representing annually EUR 2027/individual on average (5% of the household revenue), including weight loss and nutritional products, vitamins, meal programs, gym memberships, psychologists, but mainly adapted clothing, additional travel costs, and others. 15% of the respondents had to modify their professional activity due to obesity and 15% forwent some medical care in the last 12 months. CONCLUSIONS OOPE is a significant part of the economic burden of obesity. Despite some limitations due to the specificities of the participants and because some costs may be more related to social activities affected by obesity than to healthcare, it seems important to consider these expenditures in cost estimates for obesity.
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Affiliation(s)
| | - Martine Laville
- Endocrinology-Diabetology-Nutrition Department, F-CRIN-FORCE network, Lyon-Sud Hospital, Hospices Civils de Lyon, Lyon University, Pierre-Bénite, France
| | - Judith Aron-Wisnewsky
- Nutrition Department, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, France and INSERM UMRS 1269 NutriOmics, Sorbonne University, Paris, France
| | - Emmanuel Disse
- Endocrinology-Diabetology-Nutrition Department, Lyon-Sud Hospital, Hospices Civils de Lyon, Lyon University, Pierre-Bénite, France
| | - Blandine Gatta-Cherifi
- Endocrinology-Diabetology-Nutrition Department, Haut-Lévêque Hospital, Bordeaux University Hospital, France and Neurocentre Magendie, INSERMU1215, Bordeaux University, Bordeaux, France
| | - David Jacobi
- Nantes Université, CHU Nantes, CNRS, INSERM, L’institut du Thorax, Nantes, France
| | - Emilie Montastier
- Nantes University Hospital, CNRS, INSERM, L’institut du Thorax, Nantes University, Nantes, France
| | - Jean-Michel Oppert
- Nutrition Department, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, France and INSERM UMRS 1269 NutriOmics, Sorbonne University, Paris, France
| | | | | | - Sébastien Czernichow
- Nutrition Department, Georges-Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, France and Paris Cité University, Paris, France
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Arrari F, Jabri MA, Ayari A, Dakhli N, Ben Fayala C, Boubaker S, Sebai H. Chromatographic Analyses of Spirulina (Arthrospira platensis) and Mechanism of Its Protective Effects against Experimental Obesity and Hepatic Steatosis in Rats. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1823. [PMID: 37893541 PMCID: PMC10608300 DOI: 10.3390/medicina59101823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/18/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Obesity is currently a major health problem due to fatty acid accumulation and excess intake of energy, which leads to an increase in oxidative stress, particularly in the liver. The main goal of this study is to evaluate the protective effects of spirulina (SP) against cafeteria diet (CD)-induced obesity, oxidative stress, and lipotoxicity in rats. Materials and Methods: The rats were divided into four groups and received daily treatments for eight weeks as follows: control group fed a standard diet (SD 360 g/d); cafeteria diet group (CD 360 g/d); spirulina group (SP 500 mg/kg); and CD + SP group (500 mg/kg, b.w., p.o.) according to body weight (b.w.) per oral (p.o.). Results: Our results show that treatment with a CD increased the weights of the body, liver, and abdominal fat. Additionally, severe hepatic alteration, disturbances in the metabolic parameters of serum, and lipotoxicity associated with oxidative stress in response to the CD-induced obesity were observed. However, SP treatment significantly reduced the liver alteration of CD feed and lipid profile disorder associated with obesity. Conclusions: Our findings suggest that spirulina has a marked potential therapeutic effect against obesity and mitigates disturbances in liver function parameters, histological alterations, and oxidative stress status.
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Affiliation(s)
- Fatma Arrari
- Laboratory of Functional Physiology and Valorization of Bio-Resources, Higher Institute of Biotechnology of Beja, University of Jendouba, Beja 9000, Tunisia; (M.-A.J.); (H.S.)
| | - Mohamed-Amine Jabri
- Laboratory of Functional Physiology and Valorization of Bio-Resources, Higher Institute of Biotechnology of Beja, University of Jendouba, Beja 9000, Tunisia; (M.-A.J.); (H.S.)
| | - Ala Ayari
- Laboratory of Functional Physiology and Valorization of Bio-Resources, Higher Institute of Biotechnology of Beja, University of Jendouba, Beja 9000, Tunisia; (M.-A.J.); (H.S.)
| | - Nouha Dakhli
- Laboratory of Functional Physiology and Valorization of Bio-Resources, Higher Institute of Biotechnology of Beja, University of Jendouba, Beja 9000, Tunisia; (M.-A.J.); (H.S.)
| | - Chayma Ben Fayala
- Laboratory of Human and Experimental Pathological Anatomy, Pasteur Institute of Tunisia, Tunis 1002, Tunisia
| | - Samir Boubaker
- Laboratory of Human and Experimental Pathological Anatomy, Pasteur Institute of Tunisia, Tunis 1002, Tunisia
| | - Hichem Sebai
- Laboratory of Functional Physiology and Valorization of Bio-Resources, Higher Institute of Biotechnology of Beja, University of Jendouba, Beja 9000, Tunisia; (M.-A.J.); (H.S.)
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Ceddia RP, Zurawski Z, Thompson Gray A, Adegboye F, McDonald-Boyer A, Shi F, Liu D, Maldonado J, Feng J, Li Y, Alford S, Ayala JE, McGuinness OP, Collins S, Hamm HE. Gβγ-SNAP25 exocytotic brake removal enhances insulin action, promotes adipocyte browning, and protects against diet-induced obesity. J Clin Invest 2023; 133:e160617. [PMID: 37561580 PMCID: PMC10541194 DOI: 10.1172/jci160617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/08/2023] [Indexed: 08/12/2023] Open
Abstract
Negative regulation of exocytosis from secretory cells is accomplished through inhibitory signals from Gi/o GPCRs by Gβγ subunit inhibition of 2 mechanisms: decreased calcium entry and direct interaction of Gβγ with soluble N-ethylmaleimide-sensitive factor attachment protein (SNAP) receptor (SNARE) plasma membrane fusion machinery. Previously, we disabled the second mechanism with a SNAP25 truncation (SNAP25Δ3) that decreased Gβγ affinity for the SNARE complex, leaving exocytotic fusion and modulation of calcium entry intact and removing GPCR-Gβγ inhibition of SNARE-mediated exocytosis. Here, we report substantial metabolic benefit in mice carrying this mutation. Snap25Δ3/Δ3 mice exhibited enhanced insulin sensitivity and beiging of white fat. Metabolic protection was amplified in Snap25Δ3/Δ3 mice challenged with a high-fat diet. Glucose homeostasis, whole-body insulin action, and insulin-mediated glucose uptake into white adipose tissue were improved along with resistance to diet-induced obesity. Metabolic protection in Snap25Δ3/Δ3 mice occurred without compromising the physiological response to fasting or cold. All metabolic phenotypes were reversed at thermoneutrality, suggesting that basal autonomic activity was required. Direct electrode stimulation of sympathetic neuron exocytosis from Snap25Δ3/Δ3 inguinal adipose depots resulted in enhanced and prolonged norepinephrine release. Thus, the Gβγ-SNARE interaction represents a cellular mechanism that deserves further exploration as an additional avenue for combating metabolic disease.
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Affiliation(s)
- Ryan P. Ceddia
- Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Zack Zurawski
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee, USA
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, Chicago, Illinois, USA
| | | | - Feyisayo Adegboye
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee, USA
| | | | - Fubiao Shi
- Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Dianxin Liu
- Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jose Maldonado
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA
| | - Jiesi Feng
- State Key Laboratory of Membrane Biology, Peking University School of Life Sciences, Beijing, China
- PKU-IDG/McGovern Institute for Brain Research, Beijing, China
- Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Yulong Li
- State Key Laboratory of Membrane Biology, Peking University School of Life Sciences, Beijing, China
- PKU-IDG/McGovern Institute for Brain Research, Beijing, China
- Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
- Chinese Institute for Brain Research, Beijing, China
| | - Simon Alford
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Julio E. Ayala
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA
| | - Owen P. McGuinness
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA
| | - Sheila Collins
- Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA
| | - Heidi E. Hamm
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee, USA
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Skalny AV, Korobeinikova TV, Zabroda NN, Chang JS, Chao JCJ, Aschner M, Paoliello MMB, Burtseva TI, Tinkov AA. Interactive Effects of Obesity and Hypertension on Patterns of Hair Essential Trace Element and Mineral Content in Adult Women. Biol Trace Elem Res 2023; 201:4677-4687. [PMID: 36648598 DOI: 10.1007/s12011-023-03561-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/06/2023] [Indexed: 01/18/2023]
Abstract
The objective of the present study was to evaluate potential similar patterns and interactive effects of obesity and hypertension on hair essential trace element and mineral content in adult women. In this cross-sectional study, a total of 607 adult women divided into controls (n = 101), groups with obesity without hypertension (n = 199), hypertension without obesity (n = 143), and both obesity and hypertension (n = 164) were included in the study. Assessment of hair mineral and trace element levels was performed by inductively-coupled plasma mass-spectrometry. Hair Ca, Mg, Co, and Mn levels in women with obesity, hypertension, and both diseases were significantly lower, compared to controls. Hair Mg levels in women with obesity and hypertension were significantly lower, whereas hair Na and K were found to be higher when compared to other groups. Hair Fe and V content in obese patients was lower than in other groups. Obesity was associated with lower hair Cu levels, whereas patients with hypertension had higher hair Cu content. Hypertension was also associated with higher hair Cr and Se content irrespective of body weight. Hair Zn levels in obese women with and without hypertension were significantly lower than those in healthy controls and normal-weight women with hypertension. In multiple regression models hair Mg was considered as a significant negative predictor of both systolic and diastolic blood pressure values. The observed alterations in hair trace element and mineral content provide an additional link between obesity and hypertension, although further detailed studies are required.
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Affiliation(s)
- Anatoly V Skalny
- Center for Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119435, Russia
- Yaroslavl State University, Yaroslavl, 150003, Russia
| | - Tatiana V Korobeinikova
- Center for Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119435, Russia
| | - Nadezhda N Zabroda
- Center for Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119435, Russia
| | - Jung-Su Chang
- Taipei Medical University, Taipei, 11031, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, 11031, Taiwan
| | - Jane C-J Chao
- Taipei Medical University, Taipei, 11031, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, 11031, Taiwan
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Monica M B Paoliello
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | | | - Alexey A Tinkov
- Center for Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119435, Russia.
- Yaroslavl State University, Yaroslavl, 150003, Russia.
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Oppert JM, Ciangura C, Bellicha A. Physical activity and exercise for weight loss and maintenance in people living with obesity. Rev Endocr Metab Disord 2023; 24:937-949. [PMID: 37142892 DOI: 10.1007/s11154-023-09805-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/06/2023]
Abstract
Physical activity and exercise training programs are integral part of a comprehensive obesity management approach. In persons with overweight or obesity, exercise training, specifically aerobic (i.e. endurance) training, is associated with significant additional weight loss compared to the absence of training. However the magnitude of effect remains modest amounting to only 2-3 kg additional weight loss on average. Comparable effects have been observed for total fat loss. Exercise training, specifically aerobic training, is also associated with decreased abdominal visceral fat as assessed by imaging techniques, which is likely to benefit cardiometabolic health in persons with obesity. Based on data from controlled trials with randomization after prior weight loss, the evidence for weight maintenance with exercise training is as yet not conclusive, although retrospective analyses point to the value of relatively high-volume exercise in this regard. Resistance (i.e. muscle-strengthening) training is specifically advised for lean mass preservation during weight loss. Given the relatively limited effect of exercise training on weight loss as such, the changes in physical fitness brought about by exercise training cannot be overlooked as they provide major health benefits to persons with obesity. Aerobic, as well as combined aerobic and resistance training, increase cardiorespiratory fitness (VO2max) while resistance training, but not aerobic training, improves muscle strength even in the absence of a significant change in muscle mass. Regarding the overall management strategy, adherence in the long term to new lifestyle habits remains a challenging issue to be addressed by further research.
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Affiliation(s)
- Jean-Michel Oppert
- Department of Nutrition, Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, 75013, France.
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, F-93017, France.
- Department of Nutrition, Pitié-Salpêtrière hospital, 47-83 boulevard de l'Hôpital, Paris, 75013, France.
| | - Cécile Ciangura
- Department of Nutrition, Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, 75013, France
- Department of Diabetology, Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, 75013, France
| | - Alice Bellicha
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Bobigny, F-93017, France
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Gozukara Bag HG, Yagin FH, Gormez Y, González PP, Colak C, Gülü M, Badicu G, Ardigò LP. Estimation of Obesity Levels through the Proposed Predictive Approach Based on Physical Activity and Nutritional Habits. Diagnostics (Basel) 2023; 13:2949. [PMID: 37761316 PMCID: PMC10529319 DOI: 10.3390/diagnostics13182949] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Obesity is the excessive accumulation of adipose tissue in the body that leads to health risks. The study aimed to classify obesity levels using a tree-based machine-learning approach considering physical activity and nutritional habits. Methods: The current study employed an observational design, collecting data from a public dataset via a web-based survey to assess eating habits and physical activity levels. The data included gender, age, height, weight, family history of being overweight, dietary patterns, physical activity frequency, and more. Data preprocessing involved addressing class imbalance using Synthetic Minority Over-sampling TEchnique-Nominal Continuous (SMOTE-NC) and feature selection using Recursive Feature Elimination (RFE). Three classification algorithms (logistic regression (LR), random forest (RF), and Extreme Gradient Boosting (XGBoost)) were used for obesity level prediction, and Bayesian optimization was employed for hyperparameter tuning. The performance of different models was evaluated using metrics such as accuracy, recall, precision, F1-score, area under the curve (AUC), and precision-recall curve. The LR model showed the best performance across most metrics, followed by RF and XGBoost. Feature selection improved the performance of LR and RF models, while XGBoost's performance was mixed. The study contributes to the understanding of obesity classification using machine-learning techniques based on physical activity and nutritional habits. The LR model demonstrated the most robust performance, and feature selection was shown to enhance model efficiency. The findings underscore the importance of considering both physical activity and nutritional habits in addressing the obesity epidemic.
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Affiliation(s)
- Harika Gozde Gozukara Bag
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya 44280, Turkey;
| | - Fatma Hilal Yagin
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya 44280, Turkey;
| | - Yasin Gormez
- Department of Management Information Systems, Faculty of Economics and Administrative Sciences, Sivas Cumhuriyet University, Sivas 58140, Turkey;
| | - Pablo Prieto González
- Sport Sciences and Diagnostics Research Group, GSD-HPE Department, Prince Sultan University, Riyadh 11586, Saudi Arabia;
| | - Cemil Colak
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya 44280, Turkey;
| | - Mehmet Gülü
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale 71450, Turkey;
| | - Georgian Badicu
- Department of Physical Education and Special Motricity, Transilvania University of Brasov, 00152 Brasov, Romania;
| | - Luca Paolo Ardigò
- Department of Teacher Education, NLA University College, Linstows Gate 3, 0166 Oslo, Norway;
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Kemp JVA, Kumar V, Saleem A, Hashman G, Hussain M, Taylor VH. Examining Associations Between Women's Mental Health and Obesity. Psychiatr Clin North Am 2023; 46:539-549. [PMID: 37500249 DOI: 10.1016/j.psc.2023.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Obesity is a common comorbidity associated with mental illness. It is important to understand the many ways weight gain and obesity can impact the cause and course of mental illness in women, with a special focus on vulnerable life stages. Women seem disproportionally impacted by the weight gain side effects of medications, and issues such as weight gain are more likely to impact symptoms of mental illness, impacting self-esteem. This article summarizes the existing literature on the associations between women's mental health and obesity. Understanding this association will lead to better health outcomes.
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Affiliation(s)
- Jennifer V A Kemp
- Department of Psychiatry, University of Calgary, Foothills Campus, Calgary, Alberta, Canada; Matheson Centre for Mental Health Research & Education, University of Calgary, Foothills Campus, 3280 Hospital Drive Northwest, 1D-57, Calgary, Alberta T2N 4Z6, Canada
| | - Vivek Kumar
- Department of Psychiatry, University of Calgary, Foothills Campus, Calgary, Alberta, Canada; Matheson Centre for Mental Health Research & Education, University of Calgary, Foothills Campus, 3280 Hospital Drive Northwest, 1D-57, Calgary, Alberta T2N 4Z6, Canada
| | - April Saleem
- Department of Pathology and Molecular Medicine, Gastrointestinal Disease Research Unit, Queen's University, 76 Stuart Street, Sheth Lab (Floor 3), Kingston, Ontario K7L 2V7, Canada
| | - Gabrielle Hashman
- Department of Psychiatry, University of Calgary, Foothills Campus, Calgary, Alberta, Canada; Matheson Centre for Mental Health Research & Education, University of Calgary, Foothills Campus, 3280 Hospital Drive Northwest, 1D-57, Calgary, Alberta T2N 4Z6, Canada; Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Mashael Hussain
- Department of Psychiatry, University of Calgary, Foothills Campus, Calgary, Alberta, Canada; Matheson Centre for Mental Health Research & Education, University of Calgary, Foothills Campus, 3280 Hospital Drive Northwest, 1D-57, Calgary, Alberta T2N 4Z6, Canada
| | - Valerie H Taylor
- Department of Psychiatry, University of Calgary, Foothills Campus, Calgary, Alberta, Canada.
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50
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Song MK, Kim JE, Kim JT, Kang YE, Han SJ, Kim SH, Kim HJ, Ku BJ, Lee JH. GDF10 is related to obesity as an adipokine derived from subcutaneous adipose tissue. Front Endocrinol (Lausanne) 2023; 14:1159515. [PMID: 37529611 PMCID: PMC10390302 DOI: 10.3389/fendo.2023.1159515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/04/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction Adipokines are proteins that are secreted by the adipose tissue. Although they are associated with obesity-related metabolic disorders, most studies have focused on adipokines expressed by visceral adipose tissue (VAT). This study aimed to identify the adipokine potentially derived from subcutaneous adipose tissue (SAT) and its clinical significance. Methods Samples of SAT and VAT were obtained from six adult male patients who underwent laparoscopic surgery for benign gall bladder disease. Differentially expressed genes were analyzed by subjecting the samples to RNA sequencing. The serum concentration of selected proteins according to body mass index (BMI) was analyzed in 58 individuals. Results GDF10 showed significantly higher expression in the SAT, as per RNA sequencing (fold change = 5.8, adjusted P value = 0.009). Genes related to insulin response, glucose homeostasis, lipid homeostasis, and fatty acid metabolism were suppressed when GDF10 expression was high in SAT, as per genotype-tissue expression data. The serum GDF10 concentration was higher in participants with BMI ≥ 25 kg/m2 (n = 35, 2674 ± 441 pg/mL) than in those with BMI < 25 kg/m2 (n = 23, 2339 ± 639 pg/mL; P = 0.022). There was a positive correlation between BMI and serum GDF10 concentration (r = 0.308, P = 0.019). Conclusions GDF10 expression was higher in SAT than in VAT. Serum GDF10 concentration was high in patients with obesity. Therefore, GDF10 could be a SAT-derived protein related to obesity.
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Affiliation(s)
- Mi Kyung Song
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Ji Eun Kim
- Research Center for Endocrine and Metabolic Disease, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Jung Tae Kim
- Research Center for Endocrine and Metabolic Disease, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Yea Eun Kang
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
- Research Center for Endocrine and Metabolic Disease, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Sun Jong Han
- Department of General Surgery, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Seok Hwan Kim
- Department of General Surgery, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Hyun Jin Kim
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
- Research Center for Endocrine and Metabolic Disease, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Bon Jeong Ku
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
- Research Center for Endocrine and Metabolic Disease, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Ju Hee Lee
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
- Research Center for Endocrine and Metabolic Disease, Chungnam National University College of Medicine, Daejeon, Republic of Korea
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