Experienced Weight Gain Research Articles

The relationship between weight gain during chemotherapy and outcomes in patients with advanced non-small cell lung cancer.

This post hoc, pooled analysis examined the relationship between different weight gain categories and overall survival (OS) in patients with non-small cell lung cancer (NSCLC) receiving first-line platinum-based chemotherapy. Data were pooled from the control arms of three phase III clinical studies (NCT00596830, NCT00254891, and NCT00254904), and the maximum weight gain in the first 3months from treatment initiation was categorised as >0%, >2.5%, and >5.0%. Cox proportional hazard modelling of OS was used to estimate hazard ratios (HRs) for each category, including baseline covariates, time to weight gain, and time to confirmed objective response (RECIST Version 1.0). Of 1030 patients with advanced NSCLC (IIIB 11.5% and IV 88.5%), 453 (44.0%), 252 (24.5%), and 120 (11.7%) experienced weight gain from baseline of >0%, >2.5%, and >5.0%, respectively. The median time to weight gain was 23 (>0%), 43 (>2.5%),and 45 (>5.0%) days. After adjusting for a time-dependent confirmed objective response, the risk of death was reduced for patients with any weight gain (>0% vs. ≤0% [HR 0.71; 95% confidence interval-CI 0.61, 0.82], >2.5% vs. ≤2.5% [HR 0.76; 95% CI 0.64, 0.91] and >5.0% vs. ≤5.0% [HR 0.77; 95% CI 0.60, 0.99]). The median OS was 13.5 versus 8.6months (weight gain >0% vs. ≤0%), 14.4 versus 9.4months (weight gain >2.5% vs. ≤2.5%), and 13.4 versus 10.2months (weight gain >5.0% vs. ≤5.0%). Weight gain during treatment was associated with a reduced risk of death, independent of tumour response. The survival benefit was comparable for weight gain >0%, >2.5%, and >5.0%, suggesting that any weight gain may be an early predictor of survival with implications for the design of interventional cancer cachexia studies.

App-Based Lifestyle Intervention (PINK! Coach) in Breast Cancer Patients-A Real-World-Data Analysis.

Overweight and a lack of physical activity not only increase the risk of recurrence in breast cancer patients but also negatively impact overall and long-term survival, as well as quality of life. The results presented here are the first real-world data from the DiGA PINK! Coach examining the physical activity and BMI of app users. Based on the literature, an approximate weight gain of 10% over 6 months and a decrease in physical activity can be expected. The purpose of this study is to retrospectively investigate the effects of the PINK! Coach in a real-world setting on patients' BMI and physical activity level during acute therapies. such as chemotherapy (CHT) and antihormone therapy (AHT). The PINK! Coach app accompanies breast cancer patients during and after acute therapy to bring about a sustainable lifestyle change. The patients are encouraged to establish a healthy diet, become physically active, and make informed decisions. In this study, real-world data from the app were analyzed over 6 months from baseline to T1 (after 12 weeks) and T2 (after 24 weeks). The patients were under acute therapy or in follow-up care receiving either CHT or AHT. The analyzed data indicate that all patients were able to maintain a consistent BMI over 6 months independent of pre-defined subgroups such as AHT, CHT, or BMI subgroups. In the subgroup of patients undergoing AHT, overweight patients were even able to significantly reduce their BMI by 1-score-point over 6 months (p < 0.01). The subgroup of patients undergoing CHT also showed an significant overall reduction in BMI (p = 0.01). All patients were also able to significantly increase their daily step count as well as their physical activity minutes per day. After the first 12 weeks, 41.4% of patients experienced weight gain, 33.4% were able to maintain their weight, and 24.2% reduced their weight. The presented data provides intriguing insights into the users of the PINK! Coach app and the impact of this usage in regards to BMI and physical activity. At the current time, there are only a few effective concepts for encouraging all breast cancer patients to engage in moderate physical activity and reduce body weight. Often, these concepts apply to selected patient groups. The data presented here include all age groups, tumor stages, and therapies, providing an initial insight into a comprehensive approach. Data over an even longer period would be one way to better contextualize the results in current research.

Trajectories and Predictors for the Development of Clinically Significant Weight Gain in Children and Adolescents Prescribed Second-Generation Antipsychotics.

Background: As many as 60% of pediatric patients taking second-generation antipsychotics (SGA) experience weight gain (antipsychotic-induced weight gain). However, the subgroup that experienced substantial weight increase was poorly understood. This study aimed to identify the development and predictors of clinically significant weight gain (CSWG) among pediatric SGA recipients. Methods: A retrospective analysis of the 2016 to 2021 IQVIA Ambulatory EMR-US database was conducted. The study cohort comprised SGA-naive patients ages 5 to 19, continuously prescribed SGA for ≥90 days. CSWG was defined as a weight gain in BMI z-score >0.5. The development of CSWG was described using the group-based trajectory model approach, and multinomial logistic regression analysis was conducted to examine the risk factors associated with the CSWG trajectories. Results: Of the 16,262 SGA recipients who met the inclusion criteria, 4 distinctive CSWG trajectories were identified: (1) Rapid (14.6%), (2) Gradual (12.6%), (3) Transit (7%), and (4) no CSWG (65.8%). Factors associated with a higher likelihood of having rapid or gradual CSWG versus nonsignificant weight gain were being younger (OR [95% CI] = 12-17 vs. 5-11, Rapid, 0.727 [0.655-0.806]; Gradual, 0.776 [0.668-0.903]), male (Rapid, 1.131 [1.021-1.253]), non-Hispanic White (Black vs. White: Rapid, 0.833 [0.709-0.98]), with lower baseline BMI z-score (Rapid, 0.376 [0.361-0.392]; Gradual, 0.449 [0.424-0.476]), and receiving olanzapine as the initial SGA (Rapid, 1.38 [1.093-1.74]). The Area under the Receiver operating characteristic (ROC) Curve for the comparison of rapid and gradual CSWG with no CSWG trajectory were 0.83 and 0.80, respectively. Conclusions: SGA recipients experienced four distinctive CSWG trajectories (Rapid, Gradual, Transient, and No CSWG). The risk of CSWG could be predicted using patient characteristics at the SGA initiation. This insight highlights the importance of personalized monitoring and timely intervention strategies for at-risk individuals who experienced persistent CSWG in real practice.

A Study on the Need for Dietary Management due to Weight Changes Among Middle-aged Women in Gwangju during the COVID-19 Pandemic

This study aimed to identify the need for dietary management due to weight changes among middle-aged women in the Gwangju area during the COVID-19 pandemic. To achieve this, a survey was conducted of their eating habits, dietary and lifestyle habits, alterations in food intake, and changes in menopausal symptoms. Overall, significant differences were found between dietary and lifestyle habits (&lt;i&gt;p&lt;/i&gt; &lt;.01) depending on the frequency of eating out. Specifically, those who eating out two to three times a week exhibited a significant increase in negative habits such as ordering delivery food and consuming instant meals. In terms of food consumption changes, those who eating out two or three times a week displayed a relatively higher increase in the consumption of non-recommended food than those who eating out once a week. Regarding changes in menopausal symptoms, individuals who eating out two to three times a week experienced a greater increase in the severity of menopausal symptoms than those who eating out once a week. In terms of dietary and lifestyle habit changes, it was found that the more frequent the exercise, the greater the overall improvement in dietary and lifestyle habits (&lt;i&gt;p&lt;/i&gt; &lt;.001). Moreover, women who did not experience weight gain exhibited positive changes in their dietary and lifestyle habits compared with women who experienced weight gain. The results for food consumption changes revealed that the consumption of non-recommended foods was higher in middle-aged women who experienced weight gain, particularly the consumption of meat (&lt;i&gt;p&lt;/i&gt; &lt;.001) and noodles (&lt;i&gt;p&lt;/i&gt; &lt;.05). Finally, significant differences (&lt;i&gt;p&lt;/i&gt; &lt;.001) in menopausal symptoms due to weight changes were found.

Bone indices and body weight changes of ovariectomized rats treated with&lt;i&gt; Marantodes pumilum&lt;/i&gt; var. &lt;i&gt;Alata&lt;/i&gt;

Marantodes pumilim var. alata (MPva) is a popular female aphrodisiac and known source of phytoestrogens. It is traditionally used to manage postmenopausal crisis and preserve bone health in women. The study aims to investigate the effects of MPva on bone indices and bodyweight of post-menopausal rats. Thirty female Sprague-Dawley rats were divided into groups (n=6): Healthy control (Sham); ovariectomized control (OVXC); Estrogen treatment (ERT); plant leaf extract treatment (MPr) and plant root extract treatment (MPv) groups. All rats (except the Sham-operated group) were ovariectomized. After 2-weeks healing period, the ERT group was treated with 64.5 μg/kg estrogen while MPv and MPr groups received pre-determined optimal daily dose of MPva leaf and root extracts, respectively. Changes in bodyweight of rats were monitored through an eight-weeks treatment period after which rats were euthanized for testing of bone parameters. Both leaves and roots of MPva (20 mg/kg) were found to show optimal preservation of bone mineral density and mechanical strength. Untreated estrogen-deficient rats (OVXC) showed significant weight-gain when compared with the healthy control (Sham) (p&lt;0.05). Treatment with MPva leaf and root extracts, similar to treatment with estrogen, significantly suppressed weight-gain observed in the estrogen-deficient (OVXC) group (p&lt;0.05). In conclusion, treatment with MPva leaf and root extracts preserved bone strength. In addition, it suppressed weight gain in postmenopausal rats, an outcome that makes MPva more beneficial to postmenopausal women that may experience weight gain.

A Realist Evaluation of Social Care Practitioners' Experiences With and Understanding of Applied Healthcare Research.

Social care practitioners are often under-represented in research activity and output. Evidence-based practice enables social care practitioners to develop/engage the skills to evaluate evidence and be more actively involved in research. REalist Synthesis Of non-pharmacologicaL interVEntions for antipsychotic-induced weight gain (RESOLVE) is a NIHR-funded study where realist synthesis is used to understand and explain how, why, for whom, and in what contexts non-pharmacological interventions help service users, with severe mental illness, to manage antipsychotic-induced weight gain. Social care practitioners are a key part of the team providing care for people living with severe mental illness and therefore supporting antipsychotic-induced weight gain. The current study, RESOLVE 2, uses realist evaluation and RESOLVE as an illustrative example to help understand why and how social care practitioners engage (or not) with research. Semi-structured, audio-recorded interviews will be undertaken with a purposive sample of approximately 20 social care practitioners working with people who have severe mental illness, are treated with antipsychotics, and have experienced weight gain. Participants will be recruited from NHS Trusts and recruitment avenues such as social media and personal networks. Topics discussed during interviews will include barriers and facilitators to engagement in research, current, and past engagement as well as recommendations for researchers and other practitioners. Interview recordings will be transcribed verbatim and analyzed using realist evaluation which will allow in-depth causal explanations for research engagement. Better understanding of research engagement by social care practitioners will allow for evidence-based practice and better patient outcomes within these settings.

Hubungan Pengetahuan Ibu Tentang Pola Asupan Nutrisi Dengan Kenaikan Berat Badan Bayi 6-12 Bulan Di Puskesmas Keritang Hulu Kecamatan Kemuning Tahun 2023

Impaired growth and development can occur if nutrition in infancy and children is not fulfilled and is not treated early. Fulfillment of nutritional needs in infants, especially in infants aged 6-12 months where at this time babies are introduced to food, or termed MP-ASI, you should pay attention to several things such as the nutritional content of the ingredients used, administration according to nutritional needs, can be well received by the baby's digestion, preferably produced from local ingredients and is dense in nutrition. Knowledge about nutritional intake patterns is needed by every mother, so that the baby's nutritional needs can be optimal. The purpose of this study was to determine the relationship between maternal knowledge about nutritional intake patterns and weight gain for babies aged 6-12 months at the Keritang Hulu Health Center, Kemuning District. The results of the study showed that 29 mothers (72.5%) had good nutritional patterns and 29 mothers (100%) had weight gain. However, there were 11 mothers who had poor nutritional patterns (27.5%) and all of these mothers' babies did not experience weight gain (100%). the results of the statistical chi-square test that has been carried out show a Pvalue (&gt; 0.05), namely 0.000. The research hypothesis states that there is a relationship between maternal knowledge about nutritional intake patterns and weight gain for infants aged 6-12 months at the Keritang Hulu Health Center, Kemuning District, in 2023. Conclusion Sufficient knowledge about nutritional patterns will have an impact on infant weight gain. It is hoped that all mothers who have babies will be able to find more information about how good nutritional patterns are for babies aged 6-12 months so that they have an impact on optimal baby growth and development according to the baby's age.

Weight maintenance and gain were significantly associated with lower risk of all-cause and cancer-related mortality in Korean adults who were newly diagnosed with cancer based on the Korean NHIS-HEALS cohort.

The burden of malignant neoplasms is increasing worldwide. Healthy lifestyles such as maintaining a healthy body weight are important to improve survival rate in cancer patients. This study was aimed to test the hypothesis that weight change affects mortality in patients newly diagnosed with cancer. This study was retrospectively designed based on the National Health Insurance Service-National Health Screening Cohort. A total of 1856 subjects aged at least 40 years who received a national health checkup within 6 months before cancer diagnosis was included. Study subjects were classified into 3 categories based on weight change before and after cancer diagnosis: weight loss, maintenance, and gain. Cox proportional hazards regression models were adopted to examine the association between weight change and mortality after adjusting for confounders. Compared to those experiencing weight loss, the adjusted hazards ratios (HRs) (95% confidence intervals [CIs]) for those experiencing weight maintenance were 0.327 (0.189-0.568) for all-cause mortality and 0.431 (0.215-0.867) for cancer-related mortality. The adjusted HRs (95% CIs) for those experiencing weight gain were 0.149 (0.044-0.505) for all-cause mortality and 0.289 (0.080-1.045) for cancer-related mortality. After stratifying according to baseline body mass index (BMI), weight maintenance and gain were negatively associated with all-cause mortality (0.286 [0.138-0.592] for weight maintenance and 0.119 [0.027-0.533] for weight gain) among those with a BMI < 25 kg/m2. Weight maintenance and gain reduced the risk of all-cause mortality in patients newly diagnosed with any cancer. In addition, weight maintenance was significantly related to cancer-related mortality.

Unveiling the effects of living standards on diabetes and hypertension with the mediating role of overweight and obesity: a cross-sectional study in Bangladesh

ObjectiveThe purpose of the study was to ascertain how the standard of living is associated with the likelihood of developing diabetes and hypertension directly as well as indirectly through overweight...

The efficacy and safety of glucocorticoid stent implantation compared with oral glucocorticoid during perioperative period in chronic rhinosinusitis with nasal polyps

Objective:To compare the perioperative efficacy and safety of postoperative oral glucocorticoid and glucocorticoid stent implantation in patients with chronic rhinosinusitis with nasal polyps（CRSwNP） undergoing functional endoscopic sinus surgery（FESS）. Methods:Sixty patients with bilateral CRSwNP with similar degree of lesions were selected and divided into three groups: conventional surgical treatment group（20 cases）, glucocorticoid stent group（20 cases）, and oral glucocorticoid group（20 cases）. All three groups underwent routine FESS, patients in the sinus glucocorticoid stent group receiving sinus glucocorticoid stent placed in the ethmoid sinuses（one on each side） during surgery, and patients in the oral glucocorticoid group received postoperative oral methylprednisolone at a dose of 0.4 mg/kg per day for 7 days, followed by a tapering of 8 mg per week to 8 mg followed by maintenance therapy for 1 week, for a total of 3-4 weeks. Visual analog scale（VAS） scores were used to evaluate nasal congestion, rhinorrhea, olfaction, and facial pressure symptoms before surgery, as well as at 2, 4, 8, and 12 weeks after surgery. Nasal endoscopic Lund-Kennedy scores were recorded, and adverse reactions such as stent detachment, stent-related allergic reactions, sleep disorders, edema, gastrointestinal symptoms, rash/acne, behavioral/cognitive changes, weight gain, limb pain, and infection risk were documented. Results:The nasal congestion symptom scores at 2, 4, 8, and 12 weeks after surgery were significantly lower than those before operationin all three groups, and the differences were statistically significant（P<0.05）. The sinus glucocorticoid stent group exhibited significantly lower nasal congestion symptom scores at 4 and 8 weeks after surgery compared to the conventional surgical treatment group. The rhinorrhea symptom scores at 2, 8, and 12 weeks after surgery were significantly lower than preoperative scores in all three groups. Additionally, the sinus glucocorticoid stent group had significantly lower rhinorrhea scores than the conventional surgical treatment group at 2 weeks postoperatively. Concerning olfaction, the sinus glucocorticoid stent group showed a significant reduction in scores at 12 weeks postoperatively, while the oral glucocorticoid group exhibited significant improvement starting from 8 weeks after surgery. There were no statistically significant differences in nasal congestion, rhinorrhea, facial pressure, and olfaction scores between the sinus glucocorticoid stent and oral glucocorticoid groups at 2, 4, 8, and 12 weeks postoperatively. Nasal endoscopy scores revealed lower polyp scores and edema at 2, 4, 8, and 12 weeks postoperatively for all three groups compared to preoperative scores. The conventional surgical treatment group exhibited a significant reduction in nasal secretion scores starting from 8 weeks after surgery, while both the sinus glucocorticoid stent and oral glucocorticoid groups showed significant reductions starting from 2 weeks postoperatively, with scores significantly lower than those of the conventional surgical treatment group at 2 weeks. Scab/scar scores in the conventional surgical treatment group significantly decreased from 8 weeks after surgery, while both the sinus glucocorticoid stent and oral glucocorticoid groups exhibited significant reductions starting from 4 weeks. No statistically significant differences were observed in endoscopy scores（including polyps, edema, nasal secretion, scars, and scabs） between the sinus glucocorticoid stent and oral glucocorticoid groups at 2, 4, 8, and 12 weeks postoperatively. Regarding adverse reactions, no postoperative complications related to sinus glucocorticoid stent were observed in the sinus glucocorticoid stent group. In the oral glucocorticoid group,1 patient experienced irritability, and 1 patient experienced weight gain. Conclusion:The glucocorticoid stent implantation has comparable effects to oral glucocorticoid in improving postoperative nasal symptoms, reducing nasal mucosal edema, scar formation, and nasal secretion in patients with CRSwNP undergoing FESS, with a better safety profile.

Effect of beta-blocker therapy on weight loss outcomes after sleeve gastrectomy & Roux-en-Y gastric bypass

BackgroundPatients taking beta-blockers (BBs) commonly experience weight gain. There is limited research exploring how BBs impact weight loss after bariatric surgery. ObjectivesWe examined how BBs impact 12-month weight loss in patients undergoing sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). SettingLarge midwest health system. MethodsWe reviewed health records of SG and RYGB patients (2011-2022) and categorized them by BB usage (none, pre-, post-, or pre- and postoperative). Multivariable linear regression models examined the relation between BB use, percent total body weight loss (%TBWL), and percent excess body mass index lost (%EBMIL). ResultsA total of 889 individuals (SG, n = 485; RYGB, n = 404) had complete data. RYGB led to greater %TBWL compared to SG (31% versus 26%, P < .01) and greater %EBMIL (79% versus 64%, P < .01). BB status did not significantly affect 12-month %TBWL or %EBMIL. ConclusionsBB use may not significantly affect weight loss 12 months after bariatric surgery. This finding could enable physicians to prescribe BBs for improved blood pressure control in bariatric surgery patients with less concern of blunting weight loss. Longer term follow-up with a larger sample size would be an important next step to better characterize the relationship between BB usage and bariatric surgery.

A Rare Case of TMP-SMX Induced DRESS and Clinical TSS in a Pediatric Patient

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a rare and potentially life-threatening adverse drug reaction. We present a case of a 14-year-old girl with overlapping DRESS syndrome and Toxic Shock Syndrome (TSS) following Trimethoprim/Sulfamethoxazole treatment. The patient developed a generalized pruritic maculopapular rash, lymphadenopathy, fever, and facial swelling. Laboratory results showed leukocytosis, elevated liver enzymes, and C-reactive protein (CRP). Despite initial treatment with methylprednisolone, her condition worsened, necessitating a transfer to a higher level of care. She exhibited fever, hypotension, tachycardia, tachypnea, strawberry tongue, and perioral impetigo, consistent with TSS. Antibiotic therapy was initiated, but eosinophilia and an abdominal desquamative rash emerged, indicative of DRESS syndrome. Treatment involved discontinuing antibiotics, administering intravenous solumedrol for possible DRESS, and restarting antibiotics due to persistent TSS features. The patient’s symptoms improved, and she was discharged on tapering steroids and antibiotics. This case highlights the coexistence of DRESS and TSS in a pediatric patient and emphasizes the importance of promptly discontinuing the offending agent and appropriate management with steroids and antibiotics. Of the participants, 65.9% reported decreased activity levels, while 46.3% experienced weight gain. Notably, 64.2% of participants had an elevated risk score, signifying an increased vulnerability to T2D.

The Effects of COVID-19 Pandemic Lock Down on Body Weight and Risk Score for Diabetes Among Healthcare Students

Background: The COVID-19 pandemic necessitated widespread lockdowns, significantly altering daily routines and activity levels. This study hypothesizes that such changes might have exacerbated the health risks associated with type 2 diabetes (T2D). Objective: Given the prevalence of T2D among U.S. adults and the centrality of weight gain as a risk factor, this research aims to explore the potential ramifications of the pandemic on TGD risk. Such findings are important for preparations against future outbreaks, which might amplify T2D onset rates. Methods: Affiliates from three U.S. Touro college campuses were surveyed to assess the pandemic’s effects on dietary patterns, daily activity levels, and weight change. To gauge changes in T2D risk, a diabetes risk score was determined, comparing pre-pandemic levels to those observed during COVID-19 restrictions. The study used a survey research method and Qualtrics for data collection. The research proposal was approved by the University Institutional Review Board (M-0221). Results: Of the participants, 65.9% reported decreased activity levels, while 46.3% experienced weight gain. Notably, 64.2% of participants had an elevated risk score, signifying an increased vulnerability to T2D.

Weight gain and metabolic disturbances in people living with HIV who start antiretroviral therapy with, or switch to, bictegravir/emtricitabine/tenofovir alafenamide after 48 weeks of treatment: A real-world prospective study.

People living with HIV (PLWH) starting or switching to an integrase strand transfer inhibitor-based regimen are more likely to experience weight gain than other classes of antiretroviral regimens. The aim of this study was to evaluate the weight gain and metabolic disturbances in PLWH who start antiretroviral therapy (ART) with bictegravir/emtricitabine/tenofovir alafenamide and in individuals who switch from another ART to BIC/FTC/TAF after 48weeks. A prospective longitudinal study was conducted in an HIV clinic in Mexico. Weight and metabolic parameters were measured at baseline, 24 and 48weeks. A paired t test and Wilcoxon signed-rank test were applied to evaluate weight and metabolic changes. 160 participants completed measurements, median age was 29 (IQR 26-32) and 30 (IQR 27-34)years old for the treatment-naïve and switch group respectively. In the treatment-naïve group, mean weight change was 3.8kg (±5.8) (p < .001) and BMI increased 1.3kg/m2 (±2) (p < .001) at 48weeks. Incidence of BMI >25kg/m2 was 28% (95%CI; 18%-40%) and BMI >30kg/m2 was 7% (95%CI; 2%-16%) at 48weeks in treatment-naïve individuals. In the switch group, mean weight gain and BMI change at 48weeks was 2.8kg (±5.9) and 0.9kg/m2 (±2.0) respectively (p < .001). Incidence of BMI >25kg/m2 was 17% (95%CI; 8%-32%) and BMI >30kg/m2 12.8% (95%CI; 5%-26%) at 48weeks respectively. Weight gain should be considered when men PLWH are treated with BIC/FTC/TAF regimen. They should be informed about this possible adverse event and strategies of intervention.

Feasibility and Activity of Megestrol Acetate in Addition to Etoposide, Doxorubicin, Cisplatin, and Mitotane as First-Line Therapy in Patients with Metastatic/Unresectable Adrenocortical Carcinoma with Low Performance Status.

(1) Background: The standard first-line therapy for advanced adrenocortical carcinoma (ACC) is represented by EDP-M (etoposide, doxorubicin, cisplatin + mitotane). Progestins have shown cytotoxic activity both in vitro and in vivo on ACC; better EDP-M tolerability and efficacy have been hypnotized due to the association with progestins. (2) Methods: The feasibility and tolerability of EDP-M combined with oral megestrol acetate (EDP-MM) were tested in 24 patients (pts) affected by metastatic ACC with a low performance status (PS); the case group was compared with a 48 pts control group according to the propensity score. The secondary objectives were clinical benefit rate (CBR), progression-free survival (PFS), and overall survival (OS). (3) Results: Thirteen pts (54.2%) in the EDP-MM population experienced progestin-related toxicities; in particular, five pts experienced vaginal bleeding (20.8%); four pts experienced weight gain (16.7%); and thromboembolic events, worsening of hypertension, skin rashes, and hyperglycemia were registered in one patient each (4.2%). This led to the discontinuation of megestrol acetate in four pts (16.7%). EDP-M-related toxicities were similar in both groups. No differences in PFS and OS curves were observed; the CBR was 75.0% and 60.4%, respectively. (4) Conclusions: The association of EDP-M + megestrol acetate in ACC pts with a low PS is feasible and well tolerated; its efficacy appeared to be non-inferior to EDP-M administered to pts with a good PS.

FGF1 supports glycolytic metabolism through the estrogen receptor in endocrine-resistant and obesity-associated breast cancer

BackgroundObesity increases breast cancer risk and breast cancer-specific mortality, particularly for people with estrogen receptor (ER)-positive tumors. Body mass index (BMI) is used to define obesity, but it may not be the best predictor of breast cancer risk or prognosis on an individual level. Adult weight gain is an independent indicator of breast cancer risk. Our previous work described a murine model of obesity, ER-positive breast cancer, and weight gain and identified fibroblast growth factor receptor (FGFR) as a potential driver of tumor progression. During adipose tissue expansion, the FGF1 ligand is produced by hypertrophic adipocytes as a stimulus to stromal preadipocytes that proliferate and differentiate to provide additional lipid storage capacity. In breast adipose tissue, FGF1 production may stimulate cancer cell proliferation and tumor progression.MethodsWe explored the effects of FGF1 on ER-positive endocrine-sensitive and resistant breast cancer and compared that to the effects of the canonical ER ligand, estradiol. We used untargeted proteomics, specific immunoblot assays, gene expression profiling, and functional metabolic assessments of breast cancer cells. The results were validated in tumors from obese mice and breast cancer datasets from women with obesity.ResultsFGF1 stimulated ER phosphorylation independently of estradiol in cells that grow in obese female mice after estrogen deprivation treatment. Phospho- and total proteomic, genomic, and functional analyses of endocrine-sensitive and resistant breast cancer cells show that FGF1 promoted a cellular phenotype characterized by glycolytic metabolism. In endocrine-sensitive but not endocrine-resistant breast cancer cells, mitochondrial metabolism was also regulated by FGF1. Comparison of gene expression profiles indicated that tumors from women with obesity shared hallmarks with endocrine-resistant breast cancer cells.ConclusionsCollectively, our data suggest that one mechanism by which obesity and weight gain promote breast cancer progression is through estrogen-independent ER activation and cancer cell metabolic reprogramming, partly driven by FGF/FGFR. The first-line treatment for many patients with ER-positive breast cancer is inhibition of estrogen synthesis using aromatase inhibitors. In women with obesity who are experiencing weight gain, locally produced FGF1 may activate ER to promote cancer cell metabolic reprogramming and tumor progression independently of estrogen.

Kesesuaian Peningkatan Berat Badan Selama Kehamilan Berhubungan dengan Luaran Kehamilan

Globally, 53% of pregnant women experience unsuitable weight gain with WHO recommendations. This condition is associated with poor perinatal outcomes. Study investigates pregnancy weight gain's impact on outcomes. This study design was observational with a retrospective cohort approach. The sample size was obtained based on the difference formula of two proportions, namely, 142 mothers giving birth. Consecutive sampling technique according to inclusion criteria (mothers giving birth, willing to be respondents, complete medical record status) and exclusion extraction, namely having a history of comorbidities and/or complications The form record is used to collect data. Data analysis with SPSS 25 used the exact Fisher, Mann-Whitney, and chi-square tests. The results showed that 74% of pregnant women experienced weight gain not according to recommendations with 86.5% experienced inadequate weight gain. Appropriateness of weight gain during pregnancy was related to birth weight (p=0.024), birth length (p=0.009), amniotic fluid condition (p=0.000), and Apgar score (p=0.002). Pregnancy outcomes in the form of type of delivery (p=0.426), gestational age (p=0.84), and length of gestation (p=0.0583) were not related. Examination of pre-pregnancy BMI and education about recommendations for weight gain during pregnancy have been important since the first ANC contact.

Developing a Healthy Lifestyle Program for Recent Kidney Transplant Recipients.

Many kidney transplant recipients experience weight gain in the first year after transplantation. The objective of this research study was to assess the desires of recent kidney transplant patients about the design features of a healthy lifestyle program to counter unnecessary weight gain. In this descriptive study, recent recipients at 2 transplant centers were invited to participate in an online survey. Survey items included sociodemographic information, current medications, health conditions, weight change posttransplant, diet behaviors, physical activity participation, and desired features of a lifestyle program. Fifty-three participants, mean age 60.5 (11.2) years, primarily males, completed surveys. Forty percent gained weight posttransplantation with many indicating struggling with their diet. Physical activity levels stayed the same (17%) or decreased (40%) posttransplantation. Eighty-seven percent of participants indicated they would participate in an online lifestyle program and 76% wanted online physical activity and nutrition sessions to meet at least once weekly. Suggestions about the type of information and activities, included eating strategies (eg, how to eat healthfully at restaurants, grocery shopping tips, and recipes), resources for at-home physical activities, access to cooking classes, and apps to track both activity and food intake. Recent kidney transplant recipients would benefit from and desired to join a lifestyle program featuring tailored nutrition education and physical activity coaching. Gathered information will be used to inform and tailor a lifestyle program. Identifying features for the prevention of unnecessary weight gain with patients' input is essential for promoting and sustaining healthy behaviors.

Higher levels of serum α-Klotho are longitudinally associated with less central obesity in girls experiencing weight gain.

Klotho is an anti-aging protein that reduces adiposity and increases caloric expenditure, among others. Although associations between secreted α-Klotho levels and obesity have been described, its relationship with central obesity and visceral fat accumulation during childhood is poorly understood. Our objective was to study the longitudinal associations between serum α-Klotho concentrations and obesity-related parameters in apparently healthy children. We studied a cohort of 208 apparently healthy school-age children (107 girls and 101 boys) assessed at baseline (mean age 8.5 ± 1.8 years) and at follow-up 4 years later. Serum α-Klotho concentrations were measured at baseline in all subjects. Obesity-related parameters, such as BMI, waist circumference, body fat, visceral fat, triglyceride levels, HOMA-IR index, and C-reactive protein were studied. Boys and girls were classified into 3 groups according to weight change between baseline and follow-up visits: weight loss, stable weight, or weight gain (based on a BMI-SDS change cut-off > 0.35 SD). In girls (N=107), but not in boys, we observed negative associations of serum α-Klotho protein with BMI, waist circumference, body fat, visceral fat, HOMA IR index, and C-reactive protein at baseline and also at follow-up. The associations of α-Klotho and obesity-related parameters were more evident in girls who exhibited weight gain. In such girls, multivariate regression analyses (adjusting for age, puberty and baseline weight/height ratio) showed that α-Klotho protein was negatively associated with follow-up BMI, waist circumference, and visceral fat (p = 0.003 to 0.028). For each 1 SD-increase in baseline α-Klotho, follow-up waist circumference decreased by 4.15 cm and visceral fat by 1.38 mm. In school-age girls, serum α-Klotho concentrations are longitudinally related to a more favorable metabolic profile. In girls experiencing weight gain, α-Klotho may prove to be a protective factor against the accumulation of visceral fat.

Menopause: Nutrition and weight gain.

There remains great debate amongst health professionals, women and social media commentators about what the best menopause diet should be. There are areas of nutrition requiring specific attention in the menopause such as bone health and cardiovascular health. Many women experience weight gain during the menopause. This tool for clinicans has been written to cover current evidence based dietary advice for menopause health and provide practical tips on how to present this information to women and motivate them to make appropriate changes.