Editor- In-Chief: Ahmad Alkhatib, PhD, FHEA, RNutr, FRSM Title proper: Obesity Research – Open Journal ISSN:2377-8385 Subject: Medical Sciences Publisher: Openventio Publishers Dates of publication: 2014 Frequency & Medium: 3 years per year , Online Language : English Country : India Indexed by : CROSSREF , ROAD , THE KEEPERS Title DOI of the Journal: http://doi.org/10.17140/issn.2377-8385
Evaluation of the Anti-Obesity Effect of a Vegan Complex Supplement (Sinetrol, Green Tea, Bergamot and Chromium Yeast) in High-Fat Diet-Induced Obese Rats
Background Obesity is a chronic inflammatory response that not only leads to metabolic diseases such as diabetes, cardiovascular diseases, and cancers but also increases the risk of death, which needs to be addressed. Citrus and green tea, polyphenol-rich plants, hold the potential for improving metabolic diseases. Therefore, this study aims to investigate the effects of a vegan complex (VC) (Sinetrol, Green tea, Bergamot and Chromium yeast) supplementation on anti-obesity. Methods Obesity was induced in Wistar rats through a high-fat diet (HFD), and they were then randomly divided into 5 groups: 1 normal diet group and 4 high-fat diet groups (interventions with VC supplementation at 0, 207, 414, 828 mg/kg), with 12 rats in each group. After 4 weeks of supplementation, growth parameters, adipose tissue weight, hepatic lipid accumulation, and blood biochemical parameters were analyzed. Results After 4 weeks of VC supplementation, obese rats exhibited a significant reduction in final body weight, weight change, feed efficiency, visceral adipose tissue weight (epididymal, perirenal, mesenteric), and body fat percentage. In hepatic lipid content, VC supplementation significantly reduced liver weight, total cholesterol (TC), and triglyceride (TG) levels. In addition, all three doses of VC supplementation significantly reduced blood levels of TC, TG, low-density lipoprotein-cholesterol (LDL-C), and nonesterified fatty acid (NEFA), with the high dose also significantly lowering fasting blood glucose levels. Conclusion VC supplementation can effectively counteract high-fat diet-induced obesity by reducing hepatic and blood lipid accumulation, making it suitable for development as an anti-obesity dietary supplement.
Mediterranean Diet Still Holds a Place in Obesity Treatment Despite the Considerable Effectiveness of the Very Low-Calorie Ketogenic Diet: A Short Communication
There has been an escalating incidence of obesity along with type 2 diabetes mellitus (T2DM), as well as other co-morbidities so much so that the term diabesity had to be coined for this worldwide epidemic. Different attempts have been done to unravel the etiology of this ever-escalating problem, however, there has been a failure to control it. All the newer combinations like Qsymia (topiramate, phentermine), Contrive (naltrexone: bupropion), liraglutide, etc., have been unsuccessful with either cost prohibitions or side effects/contraindications. Thus, attention had shifted to dietary therapies like high protein diet, the mediterranean diet (MD), and Probiotic therapy. However, none has ensured the sustenance of weight reduction. In 2018, we reviewed how the very-low-calorie ketogenic diet (VLCKD) might be successful not only in obesity therapy but also in correlated endocrine dysfunction. Recently, there has been a lot of resurgence of the use of VLCKD. The authors performed an extensive search on various platforms like PubMed; Google scholar; Web of Science; Embase; Cochrane review library utilizing the MeSH terms; “Obesity/Overweight”; “Various diets MD”; “VLCKD to assess the efficacy of which diet is better” from 1995 till date. Nevertheless, it has been seen that the efficacy of this is not seen uniformly. Thus, the group of Muscogiuri G recently observed that compliance with MD acts in the form of the anticipation of the effectiveness of VLCKD, thus the role of MD in obesity persists because of anti-inflammatory along with antioxidant actions of MD that ensures good ketosis generation.
Assessment of Eating Habits and Preconception and Gestational Nutritional Status of Women Who Attended the Prenatal Service of a Brazilian University Hospital
Introduction Adequate nutritional status should be seen as a fundamental point of prenatal care to avoid obstetric complications and promote the baby’s health. This study aimed to compare prenatal body mass index (BMI) and BMI for gestational age (GA) and lifestyle habits of high-risk and low-risk pregnant women at a Brazilian University Hospital. Methodology This is a descriptive cross-sectional study with a quantitative approach using a questionnaire. Statistical analyzes were performed using Statistical Package for Social Sciences (SPSS) version 26.0. The significance level adopted was 5% (p<0.05). Results The present research involved 78 pregnant women, 51.3% of whom were low-risk. Most pregnant women (73.1%) did not practice physical activity and, among those who did, most reported practicing between 2 and 3-hours per week of light activity. In addition, most (57.7%) interviewees reported sleeping more than 7-hours a night. The pre-pregnancy BMI was adequate in only 34.6% of the patients, while 59% were overweight (overweight or obese); at the time of the interview, BMI for gestational age was normal in only 28.2%, and 66.7% had a BMI reflecting overweight. Consumption of sweets during the week showed significant variation: the high-risk group had a higher percentage of patients who did not consume sweets during the week (44.7%) compared to the low-risk group (20%). Furthermore, while in the high-risk group, only 7.9% consumed sweets 5 to 7 times a week, 30% of the low-risk group consumed sweets 5 to 7 times a week. Conclusion The evaluated pregnant women have a prevalence of excess weight of 66.6%, higher than that of Brazilian women (53.9%). Comparison between preconception BMI and BMI for GA showed a tendency to persist in the pre-pregnancy classification; when there was a change in the distribution of the BMI classification, this occurred with a reduction in the number of underweight, eutrophic, and overweight women and an increase in the percentage of pregnant women with obesity. The diet, in general, was sufficient in terms of micronutrients and fiber, but with high consumption of sweets by low-risk pregnant women. In addition, the proportion of sedentary pregnant women is extremely high. Our study shows the importance of promoting healthy habits during prenatal care to improve pregnant women’s nutritional diagnosis.
A Case Study of Inositol and Soluble Fiber Supplementation on Glycemic Control in an Overweight Subject
Background Soluble fiber has been shown to improve glycemic control by slowing the absorptions of glucose. And inositol has been shown to improve glycemic control in type 2 diabetes (T2D) and gestational diabetes via recruiting glucose transporter type 4 (GLUT4) to cell surface. However, neither inositol supplementation nor combination of inositol and soluble fiber supplementation has been studied in overweight. Objective To investigate if supplementation of inositol improves biological markers of glycemic control overweight and obesity, and that supplementation of inositol in combination with soluble fiber have synergistic effects to further improve these markers. Design A single cohort, uncontrolled, test-retest design was planned to be implemented over 5-weeks in which the participants supplemented 2 grams of myo-inositol twice daily for 4-weeks and then 2 grams of myo-inositol plus 2 grams of soluble fiber each twice daily for 1-week in overweight and obese subjects. Only one overweight subject was able to complete both phases of supplementation due to coronavirus disease-2019 (COVID-19), therefore the study is reported as a case study. Results Supplementation of 4 grams of myo-inositol daily for 4-weeks resulted in improved glucose parameters and lipid parameters including fasting blood glucose, post-prandial blood glucose, total blood cholesterol level, blood high-density lipoprotein (HDL) cholesterol level, and blood triglyceride level. The combination of inositol and soluble fiber supplementation further improved the total blood cholesterol level. Conclusion These results indicate there is potential benefit of inositol supplementation for sub-clinical hyperglycemic, overweight subjects on glycemic control.
Effects of Garcinia Cambogia Compounded Supplements on the Formation of Body Fat Induced by a High Energy Diet in Obese Rats
Background Obesity is a public health concern in many countries. Obesity is often accompanied by other diseases and, in addition to its effects on personal health, also increases national health expenditure and medical costs. Currently, weight loss can be achieved through several medical means, such as gastric bypass surgery, liposuction, or the use of weight loss drugs. However, these options may lead to side effects or increased mortality. As such, the development of anti-obesity supplements that are natural and safe merits greater research attention. Garcinia cambogia extract, green coffee bean extract, mulberry leaf extract, chromium yeast, and wakame extract are known to have the potential to combat obesity and adjust physical constitutions; however, the effect on fat loss of these agents in a compound supplement has not been researched or discussed. Objective This study investigated the effects of a compound supplement (hereafter referred to as Garcinia cambogia compounded supplements (GC)) containing Garcinia cambogia extract, green coffee bean extract, mulberry leaf extract, chromium yeast, and wakame extract on fat accumulation induced by a high energy (HE) diet in rats. Design Six-week-old, male Sprague–Dawley rats were assigned to a control group or an experimental (HE) group. The control group comprised 12 rats who were given regular feed. The HE group comprised 36 rats who were given HE diet and were further divided according to whether they received carboxymethyl cellulose (CMC) or GC (305 and 1220 mg/kg, denoted as GC-L and GC-H, respectively) for 5-weeks. Starting from the sixth-week, the rats were tube-fed various dosages of GC. After the ninth-week, the rats’ body weight, food intake, body fat mass, serum biochemical properties, and liver fat were analyzed. Results The results demonstrated that the HE+GC-L rats had significantly lower weight and body fat mass (569.5±51.3 g; 36.6±9.6 g) than the HE+CMC rats (618.5±57.1 g; 46.3±12.2 g). Food efficiency and calorie utilization were also significantly lower in the HE+GC-L rats than in the HE+CMC group (p<0.01). Compared with the HE+CMC group, food efficiency, calorie utilization, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and concentration of free fatty acids were also significantly lower in the HE+GC-H rats (p<0.05). Conclusion The GC supplementation significantly reduced body weight, body fat mass, body fat percentage, food efficiency, and calorie utilization in rats, and it thus has potential as a natural and safe plant extract dietary supplement. Its long-term effects on the human body should be investigated in the future.
Chylous Ascites Associated with Internal Hernia Post-Roux-en-Y Gastric Bypass: A Case Report
Chyloperitoneum is a rare intra-abdominal finding in internal hernia, only a few cases reports mentioned in the literature. It presents around 0.001-0.005% of hospital admissions. The presence of chylous ascites and swirl sign in a patient is a good indication of internal hernia and the bowel’s validity.
Association of Fat Mass and Obesity Associated, Dopamine Receptor Type 2 and Ankyrin Repeat and Kinase Domain Containing 1 Genes with Pediatric Obesity and Metabolic Risk: A Case-Control Study
Background Genetic polymorphisms that affect the availability and secretion of dopamine can affect the risk of obesity. Objectives To investigate the relationship between pediatric obesity and cardiovascular risk factors (CRF) with the polymorphisms of “Fat Mass and Obesity Associated” (FTO) rs9939609, “Dopamine Receptor type 2” (DRD2) rs6277 and “Ankyrin Repeat and Kinase Domain Containing 1” (ANKK1) rs18000497 genes. Methods Case-Control study conducted with 226 pediatric patients from 5 to 16-years of age. The two main groups, Obese (O) and Eutrophic (E), were subdivided according to the value of HOMA-IR into obese with insulin resistance (ORI) or insulin sensitivity (OSI) and eutrophic resistant (ERI) or sensitive (ESI) to insulin. According to the presence of two or more CRF, they were subdivided into metabolically unhealthy or metabolically healthy groups: Obese Metabolically Unhealthy (OMU), Obese Metabolically Healthy (OMH), Eutrophic Metabolically Unhealthy (EMU) and Eutrophic Metabolically Healthy (EMH). Polymorphisms were determined by real-time Polymerase Chain Reaction (PCR) or Restriction Fragment Length Polymorphisms (PCR-RFLP). Results In the obese group, the higher the number of risk alleles of FTO and ANKK1 genes isolated and the three genes combined, the higher the mean BMI (p<0.0001). Regarding the FTO gene: the frequency of the risk allele was: 57.7%-ERI, 37.4%-ESI (p=0.048), and the homozygous wild genotype was: 29.5%-OMU, 37.5%-OMH (p=0.02). Regarding the DRD2 gene: the genotypes with the risk allele were present in 84.6%-OMU and 67.5%-OMH (p=0.031). Regarding the ANKK1 gene: the frequency of the homozygous risk genotype was current in 15.4%-ERI and 13.5%-ESI (p<0.0001) and 62.5%-EMU and 41.5%-OMH (p=0.031). Conclusion Risk alleles of FTO, DRD2 and ANKK1 genes had an additive effect on the outcome of pediatric obesity in Brazilian children and conferred a higher risk of insulin resistance (FTO and ANKK1) and CRF.
The Effect of L-Carnitine, Green Tea Extract and Lotus Leaf Extract on the Body Fat Percentage in High Energy Diet-Induced Obese Rats
Background Obesity has become a public health issue of global concern. Obesity is often associated with the occurrence of many diseases, and will also increase mortality; it not only affects personal health, but also increases healthcare costs, thus reducing social productivity and causing negative social and economic impacts. Therefore, ameliorating obesity is an issue worth attention and effort. The development of a natural and safe anti-obesity combination is worthy of further research. It is known that L-carnitine, green tea and lotus leaves have anti-obesity potential, but there is no research and discussion on this novel combination to improve body fat. Objective This study explored how the dietary supplement formula containing L-carnitine, green tea extract and lotus leaf extract (CGL) lowered the body fat accumulation in rats induced by high-energy diet. Design The test used 60 male Sprague Dawley® white rats aged 6 weeks, which were first divided into the control group (12 rats were given normal feed) and the experimental group (48 rats were given high energy diet; HE). The HE group was further divided into H2O and CGL groups (296, 593 and 1186 mg/kg, to be designated as CGL-L, CGL-M, CGL-H respectively). The rats were first fed with feed for five-weeks, and then fed with different doses of CGL by gavage starting from the sixth-week. After nine-weeks of feeding, the rats were sacrificed to obtain their body weight, feed intake, body fat, serum biochemical indices and liver lipid measurements. Results The results show that the final body weight of HE+CGL-L (578.8±41.6 g) was significantly lower than that of HE+H2O (634.9±42.2 g), and the body fat amount of HE+CGL-L (36.6±9.8 g) was significantly lower than that of HE+H2O (49.4±13.8 g). Feed efficiency and calorie efficiency of HE+CGL-L were also significantly lower than that of HE+H2O (p<0.001). HE+CGL-M and HE+CGL-H were also able to significantly reduce the final body weight, body fat amount and serum-free fatty acid concentration (p<0.05). Conclusion CGL can significantly reduce the final body weight, body fat amount, body fat ratio, feed efficiency and calorie efficiency. CGL has the potential as a new dietary supplement for weight loss. However, the significance of these results on humans taking the supplement for prolonged periods of time is unknown and should be a focus for future investigations.
The Association of Dietary Fatty Acids and Gut Microbiota Alterations in the Development of Neuropsychiatric Diseases: A Systematic Review
Aim Having reviewed earlier the role of probiotics in obesity and other associated metabolic disorders like non-alcoholic fatty liver disease (NAFLD), engineering probiotics for cholera and other neuronal diseases like Alzheimer’s, Parkinson disease with incidence of obesity and diabetes mellitus (DM) so much on the rise, Here the aim of this systematic review is to highlight the influence of dietary patterns, like fatty acids, other lipids on role of maternal stress and the neuropsychiatric disease (NPD) formation along with influence of probiotics in reverting them. Method A systematic review was carried out using the PubMed, Web of Science, Medline, Embase, Cochrane reviews, and Google Scholar, Search engine with the MeSH Terms; “Impaired lipid metabolism”; “Oxidative stress”; “inflammation”; “Gut Microbiota (GM)”; “NPD”; “Schizophrenia (SCZ)”; “Autism Spectrum Disorder (ASD)”; “Bipolar disorders (BD)”; “Gamma amino butyric acid (GABA)”; “5-hydroxy tryptamine (5HT)”; “Brain derived neutrotrophicfactor (BDNF)”; “Polyunsaturated fatty acids (PUFA)”; “Saturated (SFA)”; “Depression”; “Resolvins”; “Protectins”; “Short chain fatty acids (SCFA)”; “Probiotics”; “Fecal Transplantation” from 1990 till June 2020. Results We found a total of 900 articles under various subheadings of GM and NPD and probiotics with NPD and SCZ, ASD. One hundred ninety-two (192) articles got selected for this comprehensive review. No meta-analysis was conducted. Conclusion We observed a marked correlation among dietary habits, like utilization of Western diet (WD) with marked escalation of intake of high fat, high sugar rich diet escalated n6 PUFAS over n3 PUFAS and influence on GM that is not helpful in digestion of the nondigestible fibers in form of starch along with generation of butyrate aiding in certain beneficial effects and on formation of various neurochemicals like escalation of BDNF while increased GABA, reduced 5HT formation alteration of tryptophan metabolism is seen in these WD food and we have tried to detail the role of SCFA formation, generation of resolvins and how they work in the formation of various NPD besides maternal diet during pregnancy and how it determines infants microglial priming and later determinants of early stress.
Cross-Sectional Associations between Physical Activity and Internet Addiction among Undergraduate Students in Taiwan
Purpose Internet addiction is a major health concern among undergraduate students; however, few studies have addressed modifiable behavioral factors associated with internet addiction in the context of Taiwan. This study aimed to investigate associations between physical activity and the risk of internet addiction among undergraduate students in Taiwan. Methods In 2017, we recruited 320 undergraduate students from Northern Taiwan to participate in a cross-sectional questionnaire-based survey. Physical activity was measured by the Taiwanese short-form version of the International Physical Activity Questionnaire, which evaluates an individual’s weekly levels of vigorous-intensity aerobic physical activity (VPA) and moderate-intensity aerobic physical activity (MPA). Internet addiction was measured by the Chen Internet Addiction Scale (CIAS). Results For the 320 surveyed students, the average CIAS score was 53.3, and 18.13% of participants were at risk for internet addiction (defined as CIAS score >64). The results of the multiple regression analysis indicated that a routine of at least 150 min of MPA per week was negatively associated with risk for internet addiction (β=−4.39, 95% CI=[-8.10, -0.66]). No significant associations were observed between internet addiction and 75 min of VPA or 150 min of total physical activity per week. Among the 5 dimensions of the CIAS scale, MPA was negatively associated with tolerance symptoms, time-management problems, and interpersonal and health-related problems when a routine of 150 min per week was adopted. Conclusion A routine of 150 min of MPA per week was associated with a lower risk for internet addiction. Intervention efforts aimed at reducing undergraduate students’ problematic internet use should promote recommended levels of MPA. We also recommend longitudinal research on the effects of engaging in physical activity on the risk of internet addition.
Optimizing Cardiovascular Outcome in Type 2 Diabetes Mellitus with Better Control of Diabetes Mellitus with Empigliflozin and Hypertension with Renin Angiotensin System Inhibitors and Manidipine Preferably of the Dihydropyridones
Aim: Obesity is increasing globally by leaps and bounds and thus the incidence of type 2 diabetes mellitus (T2DM) along with it so much so that the term diabesity had to be coined. Earlier we had reviewed how to treat the both together and the role of empagliflozin to improve cardiovascular outcome trials (CVOT). Similarly T2DM and hypertension are pathophysiologically-related diseases which co-exist with a broader complex of metabolic diseases which co-exist possessing similar set of risk factors. Hence it is important to consider which antihypertensives are suitable that possess a positive effect on metabolic factors in cases of T2DM who require an antihypertensive. Method: A systematic review was carried out using the PubMed search engine with the MeSH terms: “T2DM”; “essential hypertension; “cardiovascular (CV)”; “Complications of diabetes mellitus (DM) and antihypertensive”; “Antihypertensive preferred in T2DM subjects”; “Renin-angiotensin–aldosterone system inhibitors”; “Angiotensin converting enzyme inhibitors (ACEi)”; “Angiotensin receptor blockers (ARBs)”; “Dihydropyridine calcium channel blocker”; “β2 blockers”; “Diuretics”. Discussion: Most diabetes mellitus (DM) subjects need a minimum of two antihypertensive drugs, combining a renin-angiotensinaldosterone system (RAS) inhibitor with a dihydropyridine calcium channel blocker seems to be the most indicated approach. But not all dihydropyridine calcium channel blockers have equivalent effects on metabolic parameters. Hence manidipine that causes positive effect on insulin resistance (IR) seems to be an effective option. We have reviewed how manidipine is superior to amlodipine with regards to improving IR, not seen with amlodipine, along with not causing excessive sympathetic nervous system (SNS) activation, pulse pressure and ankle edema or to much lesser extent than amlodipine. Therefore, manidipine needs to be the first addition to RAS inhibitors in case of DM’s having hypertension of the dihydropyridines calcium channel blockers. Further good blood pressure (BP) control been correlated with good CVs outcomes. Conclusion: A RAS inhibitor is the first line of choice of drugs in a subject with T2DM who needs to be treated with empagliflozin for better CVOT outcome, and when a 2nd drug has to be added it is manidipine that is preferred over amlodipine. Plant products are proving to be having a lot of beneficial effects in DM, obesity and hypertension. Thus need for developing agents from plants will prove to be more cost effective in these chronic diseases where compliance is difficult to achieve with the use of common antiDM drugs and antihypertensives with the cost factor along with their side effects.
Renin-angiotensin-aldosterone system (RAS) inhibitor
dihydropyridines calcium channel blockers
Why are Patients Reluctant to View Exercise as a Treatment Plan
As healthcare costs continue to rise worldwide, as well as cases of overweight and obese individuals, a pedagogical shift must be made towards a greater use of preventative care and exercise as treatment methods for disease management and prevention. The physical benefits of exercise are not disputed, but costs, proper exercise prescription, and program compliance remain barriers to widespread adoption of exercise as treatment for disease management and improving quality of life. Regular weekly exercise not only improves quality of life in overweight and obese individuals1 and individuals with cardiorespiratory illness or disease,2 but will also save on healthcare costs. Research has indicated seniors (age <65-years) who regularly participate in an organized exercise program spend on average $1186-2144 less than their less active or sedentary peers.3 However, the Centers for Disease Control (CDC)4 noted that only 22.9% of Americans achieved the weekly exercise recommendations of strength training two times per week, and at least 150-minutes of moderate-to-vigorous cardiovascular activity weekly.
Exercise is Medicine Credential Level II
A Couple’s Personalized-Care Intervention for Weight-Loss and Diabetes based on DNA and Gut Biome Profiles: A Case Study
Introduction The global prevalence of obesity has reached epidemic proportions. Given the negative strain that obesity and associated chronic diseases, such as type 2 diabetes, put on the healthcare system and the economy, disease management has begun evolving to help individuals change their behaviors. Obesity is often difficult to treat and even harder to maintain. Past studies have failed to show weight loss maintenance over long periods after interventions. To overcome the complexity of obesity, a multifaceted precision care treatment approach should be adopted. Aim The aim of this case study was to assess the health benefits and weight loss journey of a cohabiting Caucasian heterosexual married couple using the Digbi Health personalized obesity management program. A personalized integrative nutrition plan is created based on one’s genetic and gut microbiome obesity risk profile and incorporates daily digital tracking and lifestyle coaching. Never before has a program offered personalized data including genetic, gut microbiome and lifestyle coaching to help people understand the best plan to lose weight and keep it off long term. Method The male subject achieved a total change in weight loss of 15.94%, as well as a reduction in A1C and blood pressure levels and the female subject achieved a 13.65% change in weight loss over a period of four months. The couple have still been able to maintain their weight loss goals four months after completing the program, stating their individual and personalized approach gave them the tools long-term to maintain. Conclusion A supportive environment for cohabiting couples following a personalized weight loss program based on their genetic and gut microbiome profile may help with weight loss and long-term maintenance.
Multi-component Lifestyle Interventions for Diabetes and Associated Non-communicable Diseases: Considerations for Future Research
Diabetes prevalence is at an alarming level. It is predicted that one in ten adults will have the condition by 2030 compared with one in eleven at present.1 Despite several global calls for action to reverse such a trend, the number of people with diabetes and associated lifestyle diseases continues to rise leading to significant health burdens, morbidity and premature mortality.2 Such challenge makes it crucial to adopt immediate preventative policies which embed effective lifestyle diabetes interventions, especially those integrating multi-components interventions.3 Adopting a multi-component approach which encompasses changing behavioral and physical aspects is likely to be more effective than a single component diabetes prevention program. Lessons from large lifestyle interventions combining a variety of physical activity patterns with different healthy dietary regimes have unequivocal evidence about their joint long-term effectiveness compared with adopting a single component whether exercise, diet or medication alone.4,5 For example, the Finish diabetes study was first to show a remarkable 58% reduced rates of diabetes incidence when a longitudinal multi-component intervention (behavioral, exercise and dietary) was followed by individuals with glucose intolerance.3 Similar longitudinal diabetes risk reduction of 58% was found for those with pre-diabetes in the US diabetes prevention program when exercise and diet approaches were combined, compared with almost half (30% reduction) found when relying on insulin-sensitizing drug Metformin.5 A fifteen-year follow- up of the latter showed that medication did not elicit better risk-reduction benefits than a multi-component lifestyle intervention.
Re-evaluating the Optimal Exercise for the Critical Peri and Postmenopausal Years
Menopause is characterized by marked changes in the circulating estrogen of the female body.1 As women age, progressively declines in ovarian function lead to a gradual reduction in estrogen secretion that ultimately ceases when menopause is reached. This transitional time is termed the perimenopausal period and it occurs approximately within one year of its commencement.2 The perimenopausal years are crucial for the future health of females as the observed hormonal alterations can lead to a number of psychophysiological changes that can increase the risk of disease if not prevented early.2 Specifically, during the perimenopausal years the diminished concentrations of estrogens, reduce their protective role on health and contribute to significant physiological disturbances. 3 Adverse health effects such as reductions in fat-free mass (sarcopenia), accumulation of body fat and intra-abdominal visceral fat and associated adverse cardiovascular and metabolic impairments namely hypertension, atherosclerosis and insulin resistance are observed.1 Consequently, there is a significantly increased risk in the development of obesity and its comorbidities namely cardiovascular disease and type 2 diabetes, that can reduce the quality of life and dramatically increase the risk of mortality in older women.3 In conjunction with the aforementioned conditions, significant impairments in cognitive and mood state are observed in the peri and postmenopausal years, further increasing the risk of morbidity and mortality in older women.4-6 An increased prevalence of anxiety and depression and cognitive declines such as loss of concentration, memory and a high risk of developing dementia and Alzheimer’s disease have been noted, recognizing menopause not only as a reproductive but also as a neurological transitional state.7-9 These effects are exacerbated by the declines in physical activity participation and low exercise compliance observed in older women. The complex and multifaceted pathophysiology of the peri and postmenopausal years, makes the treatment of the aforementioned comorbidities very difficult and challenging and warrants further research on identifying the ideal treatment plan for this population. Particularly, preventive treatment plans during the perimenopausal years are deemed essential in slowing down or delaying the development of chronic mental and non-mental diseases later in life and increasing the well-being and quality of life of older women.
Relationships between Sleep, Sedentary Behavior, and Physical Activity in Young Adults
Purpose While there are some studies on sleep and physical activity, little is known regarding the associations between sleep and sedentary behavior. This study investigated the associations between sleep, sedentary behavior, and physical activity among young adults. Methods Cross-sectional data from 124 undergraduate students were included in the analysis (age=21±1 years). Both accelerometer-based and self-report assessments of sleep were included; physical activity and sedentary behavior were assessed by accelerometers. Participants were asked to fill out sleep questionnaires and wear accelerometers for 7 days. Pearson correlations, partial correlations, and analysis of covariance (ANCOVA) analyses were performed to investigate the relationships between sleep, sedentary behavior, and physical activity. Results After adjusting for age, gender, percent body fat, educational level, and monthly allowance, prolonged sedentary time was correlated with a shorter sleep onset latency (r=-0.19, p=0.04), shorter time in bed (r=-0.43, p<0.001), and shorter sleep duration (r=-0.38, p<0.001). Moderate-to-vigorous physical activity (MVPA) was positively correlated with sleep onset latency (r=0.43, p<0.001). Sedentary behavior and MVPA were not correlated with sleep quality or daytime sleepiness. After further categorizing sleep duration into three subgroups, individuals with ≤6 hours (p<0.001) of sleep spent more time being sedentary than did those with 6-7 hours (p<0.001) and ≥7 hours (p=0.007) of sleep. Individuals with 6-7 hours of sleep had a higher level of MVPA than did those with ≥7 hours of sleep. Conclusion Improving the duration of sleep may be a viable approach to help reduce sedentary behavior among young adults. Future studies with longitudinal designs are needed to further investigate the directionality of these associations and their potential mediators and moderators.
The Role of Genetics in the Pathophysiology of Obesity: A Systematic Review
Aim The obesity epidemic has been largely attributed to changes in lifestyle habits established over the past three decades. These changes are mainly attributed to excessive nutrition and decline in physical activity as well as additional factors such as reduced intestinal microbiota diversity, sleep duration, endocrine disruptors, and reduced variability of the ambient temperature. However, the obesogenic environment is not sufficient to determine the presence of obesity, it is necessary that the lifestyle becomes associated with a personal predisposition for the phenotype to emerge. In this article, we review the main forms of monogenic and syndromic obesity, as well as a historical summary of the search for the genes that add up to confer greater risk for the development of polygenic obesity. Methods We carried out a PubMed search, along with ExcerptaMedica database (EMBASE)/Cochrane library, Web Sciences for the Medical Subject Headings (MeSH) terms “obesity’’ AND “genetics” for the past 5-years. Results We found a total of 14057 articles pertaining to obesity and genetics together of which we selected 92 articles for this review after getting articles after searching cross references. Conclusion Studies with twins and adopted children show that 55 to 80% of the variation of body mass index (BMI) is attributed to genetic factors. According to the genetic criteria, obesity can be classified as A) Monogenic - when a mutated gene is responsible for the phenotype; B) Syndromic - when a set of specific symptoms are present and a small group of genes is involved; usually the term is used to describe obese patients with cognitive delay, dysmorphic features, organ-specific abnormalities, hyperphagia, and/or other signs of hypothalamic dysfunction; C) Polygenic - also called “common” obesity, present in up to 95% of cases. Many genes add up to give a greater risk to the individual, and if associated with some habits culminates in obesity. In spite of its great relevance, the search for the genes that raise the risk of obesity has not been easy. It is still a challenge for the scientific community to separate the genetic element from the environmental component in the etiology of this disease. Individuals more susceptible to excessive adiposity may carry risk variants in the genes that influence appetite control, the regulation of cellular machinery, lipid metabolism and adipogenesis, the energy expenditure, insulin signaling, and inflammation.
Importance of Simultaneous Treatment of Obesity and Diabetes Mellitus: A Sequelae to the Understanding of Diabesity-A Review
Aim With the growing epidemic of obesity in children, adolescents and adults globally, obesity has been found to be a risk factor for many non-communicable diseases like type 2 diabetes mellitus (T2DM), hypertension, dyslipidemias and many cancers. So much so that recently a term diabesity (Obesity and diabetes in the same patient, especially when the obesity had a causal influence on the diabetes) got introduced. The aim of this systematic review was to study how we can tackle together so that we can take care of the mortality caused by obesity and T2DM being responsible for more mortalities replacing malnutrition even in developing countries. Methods We carried out a PubMed search, along with Excerpta Medica dataBASE (EMBASE)/Cochrane library, web sciences for the Medical Subject Headings (MeSH) Terms “obesity’’, “diabetes mellitus (DM)’’, “lifestyle including exercise’’, “diet therapy for management of diabesity’’, pharmacotherapy including foods rich in antidiabetics like anthocyanins’’, “polyphenols’’, “walnuts’’, “monoterpenes’’ for same including “bariatric surgery (BS)’’. Results We found a total of 86,283 articles pertaining to obesity and DM together of which we selected 92 articles for this review after getting articles after searching cross references. No meta-analysis was done. Conclusion Till date body mass index (BMI) is used to classify overweight and obesity. With decreased muscle mass being common in these obese patients it is important to measure the body composition. Further, one has to monitor body composition when getting the patient to lose weight. Importantly, the criterion used for labelling obesity also varies in different geographical areas in view of different phenotype of diabetes in South Asia. Weight loss can be achieved using lifestyle interventions like diet, exercise and importance of combining natural products from food in attaining weight loss along with controlling hyperglycemia utilizing pharmacotherapies obesity and T2DM, control. Bariatric Surgery (BS) remains the last resort for morbidly obese although it might have to be resorted in individuals where diabetes is resistant to medical treatment and be needed for those with BMI greater than 35 kg/m2 or even less in case of resistant diabetics. Role of diets rich in walnuts, anthrocyanins, soyabean, chickpeas, curcumin, polyphenols and other vitamins and micronutrients including vitamin A, also needs to be considered while treating diabesity.
Obesity is defined as excessive body fat accumulated to the extent that presents a risk to health. A measure of obesity is the body mass index (BMI), a person’s weight (in kilograms) divided by the square of the person’s height (in meters). A person with a BMI of 30 or over is generally considered obese, and a BMI of 25 or over considered overweight.1 Obesity is a major risk factor for chronic diseases, including diabetes, cardiovascular diseases and cancer. Obesity also damages productivity. Obese people move slower and are sick from work more often due to complications of diabetes and other noncommunicable diseases (NCDs). Obesity was once considered a problem only in high-income countries, and now, however, it is dramatically increasing in developing countries.1 Unfortunately, at present, nearly one-third of the world’s population is obese or overweight, i.e., 2.1 billion.
Effects of Dietary Control, Exercise and Anti-Obesity Prescriptions on Weight Loss: An Interview
Obesity is a major public health problem all over the world. The objective of this work was to evaluate effectiveness of various weight management strategies. Methods A clinic interview-based study was accomplished in various nutrition clinics in Alexandria city and pursued the following data: demographic data, body mass index (BMI), lipid profile, comorbidities, with emphasize on the authenticity of the effectiveness of weight management strategies. Results The study comprised 2,240 participants following weight management strategies at nutrition clinics; 59.8% were obese (group I) and 40.2% were overweight (group II). BMI was highest among age group 30-40 years in group I and 18-20 years in group II. Weight management strategy by dietary control merely in 55.8% of group I and 59.5% of group II. 33.5% of group I implemented exercise training plan and 41.5% of group II respectively. Fourteen point seven percentage of group I responded to adjuvant antiobesity drug versus 1.5% of group II. The most commonly adopted anti-obesity prescription was Orlistat. Conclusion Participants who received anti-obesity prescriptions combined with dietary control and exercise obtained the best results when compared to other strategies, therefore anti-obesity prescriptions may be beneficial in conditions that are resistant to other weight management strategies. Comorbidities, particularly dyslipidemia; may partially impede effective.
Supplementation with Mix of Garcinia cambogia Extract, Yerba Mate Extract, and Guarana Extract Lowers Body Fat but has no Effects on High-Density Lipoprotein Cholesterol Level
Background Obesity and being overweight have become modern health problems due to energy intake being higher than expenditure. The obesity epidemic refers to the worldwide increase in excess weight according to the World Health Organization (WHO). Objective In light of the pressing need to check the progression of obesity, this study attempted to determine the effect of an herbal formula tablet, which contains Garcinia cambogia extract, yerba mate extract, and guarana extract, on weight control. Design We enrolled 30 overweight or obese subjects and randomly assigned them to a control or an intervention group. Subjects were asked to take a placebo or an herbal formula tablet twice a day for 8 weeks. Both groups had five nutrition education courses, and regular anthropometric measurements were taken. At the end of the study, we analyzed blood lipid and glycemic parameters to determine whether the herbal formula tablet had reduced lipid and glucose levels. Results Results showed that the waist and hip circumferences, weight, and body fat were significantly reduced in both groups (p<0.05); basal metabolic rates were simultaneously maintained, although there were no differences between the two groups. In addition, subjects in the intervention group had greater weight and body fat loss than did those in the control group (p<0.05). Blood analytic measurements showed that high-density lipoprotein cholesterol had significantly decreased in the control group (p<0.05). Conclusions In conclusion, the herbal formula tab.
Perceptions of Body Image and Obesity among Cross Culture: A Review
Body image inconvenience is a common issue not only in the United States but also worldwide. The perception towards body image is basically subjective. There are also culture-specific notions in physical appearance. Prevalence of obesity seems to be greater among the African-Americans and other ethnic minority populations than Whites. According to Jansen, 2008 there is a relationship between body image and eating habits across the cultures. Many studies have found that Black women are more satisfied with their bodies than White women. In the past, women always have been compared their bodies to celebrities, which could lead to depression and many negative consequences. Body image is a big concern among the individuals, especially in younger adults. Media had a high impact on dissatisfaction with physical body among the young adults. This leads to depression and many health problems. The significance of my review towards the field of dietetics could be to determine the perceptions of body image across cross-cultures and to determine the etiology of obesity. This could definitely shed some lights among the Registered Dietitians (RD) in terms of how body image is perceived by other cultures and aid in counseling them.
Hypothalamic Inflammation and Glioses as Aetiopathogenetic Factor in High Fat Diet Induced Obesity and Various Therapeutic Options to Resolve it
We reviewed the literature relating to hypothalamic inflammation (HI); gliosis in relation to high-fat diet (HFD) and that how this could be reversed with various types of therapies. We searched PubMed articles with the MeSH terms “hypothalamic inflammation”, “gliosis”, “HFD”, “obesity”, and “treatments” used. During HFD intake, we found that the ventromedial hypothalamus (VMH) astrocytes uses fatty acids (FA’s) to generate ketone bodies which are then exported to neurons where they produce excess adenosine triphosphate (ATP) and reactive oxygen species (ROS), which overrides CD36 mediated FA sensing and role of astrocytederived ketone bodies in reducing calorie intake in diet resistant but not diet-induced obese strains was emphasized. The further role of HAM-RS2-a special starch, resolvins abscisic acid, KBH1, unsaturated fatty acid receptor targeting GPR120/GPR40. Hepatic clock genes were effective in tackling obesity. We found that in rodents hypothalamic inflammation and glioses were found to occur immediately with HFD consumption before any significant weight gain. Sensitivity or resistance to diet-induced obesity in rodents also correlates with the presence or absence of hypothalamic inflammation and reactive glioses. Further functional interventions with the increase or decrease inflammation in neurons and glia alter diet associated weight gain. Various human magnetic resonance imaging (MRI) studies have found glioses and disrupted connectivity in obese humans. Various factors which can be used to tackle obesity like HAMRS2- a special starch, resolvins, abscisic acid, KBH1, unsaturated fatty acid receptors, GPR120 and GPR40 are some of the explored routes by which these pathways may be explored to prevent the further extension of the HFD and one may get newer answers for arresting obesity development.
Role of Oxidative Stress and Associated Alteration in Enzyme Activities in Obesity Comorbidities
Obesity is defined as having a body mass index (BMI) of 30 kg/m2 or above, with progressively increasing prevalence all over the world in recent years. Obesity is characterized by deposition of abnormally increased body fat, resulting from increased energy intake relative to energy expenditure. The condition is associated with several comorbidities that upsurge risk of morbidity. The purpose of this review is to describe the role of oxidative stress in release of pro-inflammatory mediators that influence fat and glucose metabolism and is associated with altered enzyme activity, which results in insulin resistance and other associated comorbidities. The main pathology is through intensified generation of reactive oxygen species (ROS) and diminution of antioxidant defense, creating a chronic inflammatory situation that is critically important in development of comorbidities. New strategies to combat resultant comorbidities concentrate on weight reduction either solely or coupled with moderately regular exercise. This policy may be sufficient to improve insulin sensitivity, regulate fatty acid metabolism together with refining antioxidant defense of the body. Other approaches encourage modulation of dietary pattern through dietary supplements as vitamins, with or without pharmaceutical antioxidants, which may provide a potential therapeutics approach in obesity comorbidities.
Obesity: Key Factor for Cardiometabolic Risk
Obesity is a chronic multifactorial desease whose increasing prevalence is associated with several comorbidities. Diabetes, cardiovascular diseases, musculoskeletal diseases, mental health problems and even certain cancers are more common among obese patients. According to World Health Organization (WHO), obesity is one of the ten responsible for more than a third of deaths, being the second cause of premature avoidable mortality after smoke. Metabolic syndrome (MS) is a clinical entity characterized by the presence of insulin resistance, compensatory hyperinsulinism, glucose intolerance, hypertension, dyslipidaemia and obesity, which increases cardiovascular risk. The prevalence of this clinical condition has increased in the last decade in the western world, being very common in Europe and in the United States (it may reach around 25% in people over 20-years-old and 50% in people over 60-years-old).1 Unlike the WHO or European Group for the study of Insulin Resistance (EGIR) group criteria, abdominal obesity/waist circumference (men >102 cm and women >88 cm) gains importance in the Adult Treatment Panel III (ATPIII) which is recognised as similar as other main criteria; not being necessary the presence of insulin resistance, diabetes or hydrocarbon intolerance. These convenience standards make useful the anthropometric and laboratory accessible tests in primary and hospital care. Overall, there are three kinds of risk factors (underlying, major and emerging) in the MS, some of them have proved relation to the obesity.2 Firstly, obesity (especially visceral or abdominal obesity) is considered one of the main underlying risk factors, along with a lack of physical activity and an atherogenic diet. Secondly, elevated blood pressure is strongly associated with obesity, more frequently with insulin resistance people, as a metabolic risk factor. Another emerging risk factor to consider is the frequent proinflammatory state in the MS, which is clinically detected by an increase of C-reactive protein (CRP) levels. One of the principal cause among the multiple mechanisms underlying of this is the obesity due to the excess adipose tissue releases inflammatory cytokines that can produce high-levels of CRP.
Adipocytokines: A Potential Link Between Obesity and CNS Disorders
The interrelationships between obesity and high fat mass with different chronic pathophysiological conditions have been taken into consideration in recent decades along with the growing prevalence of obesity. Epidemiological evidence supports the increased risk of the onset and progression of cardiovascular disease (CVD), hypertension, dyslipidemia, type 2 diabetes and some types of cancers with obesity.1 Studies in neurological disorders have also suggested the potential contribution of obesity in developing structural pathologies in the brain in different life stages.2 Obesity can induce atrophic changes in vulnerable areas of the brain including hippocampus, cingulate gyrus and frontal lobes, which in turn could be a risk factor for Alzheimer’s disease (AD).3,4 Age-related deficits such as decline in immediate memory function have also been exacerbated with higher body mass index (BMI) and abdominal obesity especially in people with AD.5 Furthermore, the risk of dementia is 2.34 to 3.60 fold higher in obese people with a waist circumference above recommended cut offs.6 Although, the exact mechanisms by which obesity could influence the CNS are not fully understood, they may involve many mediators including systemic and brain peptides and cytokines.7 In 2009, it has been confirmed that circulating inflammatory cytokines might mediate the effect of midlife obesity on brain gray matter reduction in pre- and post-menopausal women.
Real-Time Technology Video-Coding Tools for Programming Multisensory Interventions Incorporating Exotic Local Fruits and Vegetables in Early Childhood: Implications for Pediatric Obesity Prevention Research
Promoting fruit and vegetable (henceforth referred to as F&V) intake in early childhood is significant to public health now and in the future.1 One of the goals of Healthy People 2020 (i.e., Goal NSW-15) is to increase the variety and contribution of vegetables in the dietary habits of the population, including its youngest members (U.S. Department of Health and Human Services, 2014).2 Education efforts fostering the consumption of fruits and vegetables in young children serve as a catalyst for efforts to combat childhood obesity by helping promote shifts in dietary patterns with decreased intake of energy-dense foods high in fat and sugars to foods high in vitamins, minerals, and phytonutrients. In our work with the U.S. federal food assistance program, Head Start, in the New England region of Western Massachusetts,3 we found that children were not achieving the recommended F and V intake, and that overweight and obesity, as well as micronutrient deficiencies (vitamins A and C, and iron) may be prevalent.4 Although the direct correlation between F and V consumption, and lowering of obesity is yet to be established in this early life-stage, F and V, especially exotic varieties are low-calorie, low-fat sources of vitamins (vitamin C, carotenoids), minerals, and fiber and provide an array of phytonutrients and antioxidants, and anti-inflammatory benefits.5
Body Mass Index is a Strong Predictor of Vitamin D Deficiency in Multiethnic Obese Children
Background: Vitamin D deficiency is highly prevalent among obese children in the United States. Objective: The main objective of this study is to determine predictors of vitamin D deficiency in obese children. Methods: Children aged 5-14 years with body mass index z-score (BMIZ)>95% were enrolled. Data included height, weight, ethnicity, season, dietary intake, serum 25-hydroxy vitamin D test: (25(OH)D), parathyroid hormone, calcium, insulin, glucose, high sensitivity C-reactive protein (CRP), lipids, aspartate aminotransferase (AST), alanine transaminase (ALT) and waist circumference. BMIZ calculation in children was categorized into ≥2.5 (high) and <2.5 (low). Serum 25(OH)D levels were dichotomized as <20 ng/mL (deficient) or ≥20 ng/mL (sufficient). Results: Ninety-one children completed the study. Mean BMIZ was 31.3±6.3 kg/m2. Mean 25(OH)D level was 21.2±7.6 ng/mL. A base logistic regression model showed odds of a deficient 25(OH)D was more than 3-times higher in children with a high BMIZ (OR: 3.35, 95% CI: 1.07-10.43). African-American children were more likely than Caucasian children to have low 25(OH)D (OR: 6.68, 95% CI: 1.31-36.13). Children enrolled in seasons other than winter were less likely to have a low 25(OH)D. Adjustment for nutrients and serum cardiovascular disease risk markers did not significantly alter the relationship between low 25(OH)D and BMIZ. Conclusions: The risk for vitamin D deficiency increases in children with severe obesity (BMIZ≥2.5 SD) and does not significantly change by season, ethnicity, nutrient intake, or cardiovascular disease risk parameters.
Knowledge about Feeding and Practicing Physical Activity as Protective Factors of Overweight and Obesity in Students of Official Schools in the Municipality of Sopó
Objective: To establish the knowledge of students of cycle IV of official schools of the municipality of Sopó in relation to food and adequate physical activity (AF), as protective factors of overweight and obesity. Methodology: A descriptive cross-sectional study (diagnosis) was carried out through three phases, in the first phase, a conceptual reference was built on the competencies that would be expected to strengthen in students through the curriculum, in relation to food and adequate physical activity as prevention of overweight and obesity. In a second phase, the curricula of the areas of Natural Sciences and Physical Education were analyzed in order to establish whether or not they provide sufficient and necessary knowledge to the students in relation to the feeding and practice of physical activity as protective factors of overweight and obesity. Then in the last phase, a survey was applied to 469 students between the ages of 12 and 19 with questions associated with obesity, overweight, physical activity and adequate food. Results: In relation to the practice of physical activity, it was established that only 10% of the students complies with the global recommendation of 60 minutes per day, in relation to physical activity, 88% is not clear which are the components to have into account during the practice of physical activity frequency, intensity and time (Organisation mondiale de la Santé, OMS, WHO 2010). With respect to the knowledge for choosing a healthy diet, it would be essential to conclude that the knowledge is insufficient, since 63% of the students include a sweet dish and other foods that are high in sugar in their diet. Regarding the overweight and obesity prevalence, only 12% are perceived as overweight and 8% come under obese, rest of the 80% are neither of the two categories. The figure that is in contrast with the nutritional status was reported by the Nutritional Surveillance System (SISVAN) of the municipality in the recent years. Conclusions: It was possible to conclude that the curricula of the areas of Natural Sciences and Physical Education Recreation and Sports do not provide students with the necessary and sufficient knowledge when it comes to adequate diet and practice of physical activity as prevention measures of both overweight and obesity, however, they provide some guidance regarding healthy habits and lifestyles.