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Saraf-Bank S, Ahmadi A, Paknahad Z, Maracy M, Nourian M. Effects of curcumin on cardiovascular risk factors in obese and overweight adolescent girls: a randomized clinical trial. SAO PAULO MED J 2019; 137:414-422. [PMID: 31691723 PMCID: PMC9745817 DOI: 10.1590/1516-3180.2018.0454120419] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 04/12/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Obese adolescents are at higher risk of development of cardiovascular risk factors and obesity in later life. Dietary intake of antioxidants, particularly curcumin, as an active ingredient of turmeric extract, may have noticeable effects on obesity and its important complications such as cardiovascular risk factors. Therefore, the aim of this study was to assess the effects of curcumin supplementation on cardiovascular risk factors among overweight and obese female adolescents. DESIGN AND SETTING Randomized placebo-controlled clinical trial; Pediatric Cardiovascular Research Center, Isfahan, Iran. METHODS 60 adolescent girls (aged 13-18 years) were randomly assigned to receive either placebo or intervention. The adolescents were asked to consume one 500 mg tablet per day, containing either standardized 95% turmeric extract or placebo, and to undergo a weight maintenance or a mild weight loss diet for 10 weeks. Anthropometric and biochemical indices were assessed at the baseline and the end of the intervention. RESULTS Curcumin supplementation had beneficial effects on body mass index (P = 0.019), waist circumference (P = 0.008), hip circumference (P = 0.030), high-density lipoprotein levels (P = 0.042) and triglyceride/high-density lipoprotein ratio (P = 0.021). However, in univariate analysis of covariance, no significant differences were found between the intervention and placebo groups after 10 weeks of supplementation (P > 0.05). CONCLUSIONS Prescription of curcumin supplementation along with use of a slight weight loss diet might have beneficial effects on some cardiovascular risk factors among overweight and obese female adolescents. Larger clinical trials with higher curcumin doses and longer duration are needed to confirm the results from the current study. CLINICAL TRIAL REGISTRATION IRCT20171107037302N1.
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Affiliation(s)
- Sahar Saraf-Bank
- MSc. Doctoral Student and Dietitian, Students’ Research Committee, Isfahan University of Medical Sciences; Doctoral Student and Dietitian, Food Security Research Center, Isfahan University of Medical Sciences; and Doctoral Student and Dietitian, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Alireza Ahmadi
- MD. Associate Professor and Cardiologist, Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Zamzam Paknahad
- PhD. Full Professor and Dietitian, Food Security Research Center, Isfahan University of Medical Sciences, and Full Professor and Dietitian, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Mohammadreza Maracy
- PhD. Full Professor and Statistician, Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Mojgan Nourian
- PhD. Assistant Professor and Dietitian, Food Security Research Center, Isfahan University of Medical Sciences, and Assistant Professor and Dietitian, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Sundström J, Bruze G, Ottosson J, Marcus C, Näslund I, Neovius M. Weight Loss and Heart Failure: A Nationwide Study of Gastric Bypass Surgery Versus Intensive Lifestyle Treatment. Circulation 2017; 135:1577-1585. [PMID: 28258170 PMCID: PMC5404408 DOI: 10.1161/circulationaha.116.025629] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 02/22/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Associations of obesity with incidence of heart failure have been observed, but the causality is uncertain. We hypothesized that gastric bypass surgery leads to a lower incidence of heart failure compared with intensive lifestyle modification in obese people. METHODS We included obese people without previous heart failure from a Swedish nationwide registry of people treated with a structured intensive lifestyle program and the Scandinavian Obesity Surgery Registry. All analyses used inverse probability weights based on baseline body mass index and a propensity score estimated from baseline variables. Treatment groups were well balanced in terms of weight, body mass index, and most potential confounders. Associations of treatment with heart failure incidence, as defined in the National Patient Register, were analyzed with Cox regression. RESULTS The 25 804 gastric bypass surgery patients had on average lost 18.8 kg more weight after 1 year and 22.6 kg more after 2 years than the 13 701 lifestyle modification patients. During a median of 4.1 years, surgery patients had lower heart failure incidence than lifestyle modification patients (hazard ratio, 0.54; 95% confidence interval, 0.36-0.82). A 10-kg achieved weight loss after 1 year was related to a hazard ratio for heart failure of 0.77 (95% confidence interval, 0.60-0.97) in both treatment groups combined. Results were robust in sensitivity analyses. CONCLUSIONS Gastric bypass surgery was associated with approximately one half the incidence of heart failure compared with intensive lifestyle modification in this study of 2 large nationwide registries. We also observed a graded association between increasing weight loss and decreasing risk of heart failure.
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Affiliation(s)
- Johan Sundström
- From Department of Medical Sciences, Uppsala University, and Uppsala Clinical Research Center, Sweden (J.S.); Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden (G.B., M.N.); Department of Surgery, Faculty of Medicine and Health, Örebro University, Sweden (J.O., I.N.); and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (C.M.).
| | - Gustaf Bruze
- From Department of Medical Sciences, Uppsala University, and Uppsala Clinical Research Center, Sweden (J.S.); Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden (G.B., M.N.); Department of Surgery, Faculty of Medicine and Health, Örebro University, Sweden (J.O., I.N.); and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (C.M.)
| | - Johan Ottosson
- From Department of Medical Sciences, Uppsala University, and Uppsala Clinical Research Center, Sweden (J.S.); Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden (G.B., M.N.); Department of Surgery, Faculty of Medicine and Health, Örebro University, Sweden (J.O., I.N.); and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (C.M.)
| | - Claude Marcus
- From Department of Medical Sciences, Uppsala University, and Uppsala Clinical Research Center, Sweden (J.S.); Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden (G.B., M.N.); Department of Surgery, Faculty of Medicine and Health, Örebro University, Sweden (J.O., I.N.); and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (C.M.)
| | - Ingmar Näslund
- From Department of Medical Sciences, Uppsala University, and Uppsala Clinical Research Center, Sweden (J.S.); Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden (G.B., M.N.); Department of Surgery, Faculty of Medicine and Health, Örebro University, Sweden (J.O., I.N.); and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (C.M.)
| | - Martin Neovius
- From Department of Medical Sciences, Uppsala University, and Uppsala Clinical Research Center, Sweden (J.S.); Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden (G.B., M.N.); Department of Surgery, Faculty of Medicine and Health, Örebro University, Sweden (J.O., I.N.); and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (C.M.)
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Fernando HA, Zibellini J, Hsu MS, Seimon RV, Nguyen AD, Sainsbury A. The neuropeptide Y-ergic system: potential therapeutic target against bone loss with obesity treatments. Expert Rev Endocrinol Metab 2015; 10:177-191. [PMID: 30293515 DOI: 10.1586/17446651.2015.1001741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Obesity is no longer considered to provide protection against osteoporosis. Moreover, treatments for obesity are now suspected of reducing bone mass. With the escalating incidence of obesity, combined with increases in the frequency, duration and intensity of interventions used to combat it, we face a potential increase in health burden due to osteoporotic fractures. The neuropeptide Y-ergic system offers a potential target for the prevention and anabolic treatment of bone loss in obesity, due to its dual role in the regulation of energy homeostasis and bone mass. Although the strongest stimulation of bone mass by this system appears to occur via indirect hypothalamic pathways involving Y2 receptors (one of the five types of receptors for neuropeptide Y), Y1 receptors on osteoblasts (bone-forming cells) induce direct effects to enhance bone mass. This latter pathway may offer a suitable target for anti-osteoporotic treatment while also minimizing the risk of adverse side effects.
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Affiliation(s)
- Hamish A Fernando
- a 1 The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Camperdown NSW 2006, Australia
| | - Jessica Zibellini
- a 1 The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Camperdown NSW 2006, Australia
| | - Michelle Sh Hsu
- a 1 The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Camperdown NSW 2006, Australia
| | - Radhika V Seimon
- a 1 The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Camperdown NSW 2006, Australia
| | - Amy D Nguyen
- b 2 Neuroscience Program, Garvan Institute of Medical Research, University of New South Wales, Darlinghurst, Australia
| | - Amanda Sainsbury
- a 1 The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, The University of Sydney, Camperdown NSW 2006, Australia
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Mulrow CD, Chiquette E, Angel L, Grimm R, Cornell J, Summerbell CD, Anagnostelis BB, Brand M. WITHDRAWN: Dieting to reduce body weight for controlling hypertension in adults. Cochrane Database Syst Rev 2008; 2008:CD000484. [PMID: 18843609 PMCID: PMC10798416 DOI: 10.1002/14651858.cd000484.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND As early as the 1920's, researchers noted a relationship between caloric restriction, weight loss and a decreased incidence of hypertension (Terry 1922, Preble 1923, Bauman 1928, Master 1929). In 1988 a meta-analysis of aggregate data from 12 prospective studies, including 5 randomized controlled trials (RCTs), found that on average each 1 kilogram decrease in body weight in obese hypertensive patients was associated with a 2.4 mm Hg systolic and 1.5 mm Hg diastolic decrease in blood pressure (Staessen 1988). Blood pressure reductions were not dependent upon degree of baseline obesity.This review aims to: 1) update the work of Staessen (Staessen 1988) looking specifically at randomized controlled trials, and 2) assess whether any of the trials assess effects of weight-reducing diets on clinical outcomes such as quality of life, morbidity or mortality. OBJECTIVES Evaluate whether weight-loss diets are more effective than regular diets or other antihypertensive therapies in controlling blood pressure and preventing morbidity and mortality in hypertensive adults. SEARCH STRATEGY MEDLINE and The Cochrane Library were searched through November 1997. Trials known to experts in the field were included through June 1998. SELECTION CRITERIA For inclusion in the review, trials were required to meet each of the following criteria: 1) randomized controlled trials with one group assigned to a weight-loss diet and the other group assigned to either normal diet or antihypertensive therapy; 2) ambulatory adults with a mean blood pressure of at least 140 mm Hg systolic and/or 90 mm Hg diastolic; 3) active intervention consisting of a calorie-restricted diet intended to produce weight loss (excluded studies simultaneously implementing multiple lifestyle interventions where the effects of weight loss could not be disaggregated); and 4) outcome measures included weight loss and blood pressure. DATA COLLECTION AND ANALYSIS Studies were dual abstracted by two independent reviewers using a standardized form designed specifically for this review. The primary mode of analysis was qualitative; graphs of effect sizes for individual studies were also used. MAIN RESULTS Eighteen trials were found. Only one small study of inadequate power reported morbidity and mortality outcomes. None addressed quality of life or general well being issues. In general, participants assigned to weight-reduction groups lost weight compared to control groups.Six trials involving 361 participants assessed a weight-reducing diet versus a normal diet. The data suggested weight loss in the range of 4% to 8% of body weight was associated with a decrease in blood pressure in the range of 3 mm Hg systolic and diastolic. Three trials involving 363 participants assessed a weight-reducing diet versus treatment with antihypertensive medications. These suggested that a stepped-care approach with antihypertensive medications produced greater decreases in blood pressure (in the range of 6/5 mm Hg systolic/diastolic) than did a weight-loss diet. Trials that allowed adjustment of participants' antihypertensive regimens suggested that patients required less intensive antihypertensive drug therapy if they followed a weight-reducing diet. Data was insufficient to determine the relative efficacy of weight-reduction versus changes in sodium or potassium intake or exercise. AUTHORS' CONCLUSIONS Weight-reducing diets in overweight hypertensive persons can affect modest weight loss in the range of 3-9% of body weight and are probably associated with modest blood pressure decreases of roughly 3 mm Hg systolic and diastolic. Weight-reducing diets may decrease dosage requirements of persons taking antihypertensive medications.
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Affiliation(s)
- Cynthia D Mulrow
- Audie L Murphy Memorial Veteran HospitalGeneral Internal MedicineHealth Sciences Center at San Antonio7400 Merton Minter BlvdSan AntonioTexasUSA78284
| | - Elaine Chiquette
- The University of Texas at Austin, College of PharmacyCollege of Pharmacy, PHR 5.1121 University Station A1900A1945AustinTexasUSA78712
| | - L Angel
- Shapiro Center for Evidenced‐Based MedicineShapiro Center for Evidenced‐Based Medicine914 South Eighth St D‐2 MinneapolisMN USA55404
| | - Richard Grimm
- Shapiro Center for Evidenced‐Based Medicine914 South Eighth St D‐2MinneapolisMNUSA55404
| | - John Cornell
- 7400 Merton Minter BoulevardVA ACOS (11C6)San AntonioTXUSA78284
| | - Carolyn D Summerbell
- University of TeessideSchool of Health and Social CareParkside WestMiddlesbroughTeessideUKTS1 3BA
| | | | - M Brand
- Shapiro Center for Evidenced‐Based MedicineShapiro Center for Evidenced‐Based Medicine914 South Eighth St D‐2 MinneapolisMN USA55404
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Abstract
OBJECTIVES To assess the effects of prescribing a low-energy diet to pregnant women who are either overweight, or who exhibited high weight gain earlier in gestation, on subsequent weight gain, pre-eclampsia, and the outcome of pregnancy. SEARCH STRATEGY The Cochrane Pregnancy and Childbirth Group trials register was searched and researchers in the field were contacted. SELECTION CRITERIA All acceptably controlled comparisons of protein/energy restriction prescribed to pregnant women who meet one or both of the criteria listed above. DATA COLLECTION AND ANALYSIS Data were extracted by the author from published reports, and supplemented by additional information from trialists contacted by the author. MAIN RESULTS Three studies involving 266 women were involved. Energy/protein restriction leads to a significant reduction in weekly maternal weight gain and in birth weight but has no clear effect on either pregnancy-induced hypertension or pre-eclampsia. Other outcomes, including fetal/infant mortality and other measures of maternal morbidity (eg Caesarean section) or long-term nutritional status, have not been reported. REVIEWER'S CONCLUSIONS Protein/energy restriction of pregnant women who are overweight or exhibit high weight gain is unlikely to be beneficial and may be harmful to the developing fetus.
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Affiliation(s)
- M S Kramer
- Faculty of Medicine, McGill University, 1020 Pine Avenue West, Montreal, Quebec, CANADA, H3A 1A2.
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