Function In Obese Adults Research Articles

Pulmonary and chest wall function in obese adults

Obesity is frequently associated with breathing disorders. To investigate if and how the highest levels of obesity impact respiratory function, 17 subjects with obesity (median age: 49 years; BMI: 39.7 kg/m2, 8 females) and 10 normal-weighted subjects (49 years; 23.9 kg/m2, 5 females) were studied. The abdominal volume occupied 41% in the obese group, being higher (p < 0.001) than the normal-weighted group (31%), indicating accumulation of abdominal fat. Restrictive lung defect was present in 17% of subjects with obesity. At rest in the supine position, subjects with obesity breathed with higher minute ventilation (11.9 L/min) and lower ribcage contribution (5.7%) than normal weighted subjects (7.5 L/min, p = 0.001 and 31.1%, p = 0.003, respectively), thus indicating thoracic restriction. Otherwise healthy obesity might not be characterized by a systematic restrictive lung pattern. Despite this, another sign of restriction could be poor thoracic expansion at rest in the supine position, resulting in increased ventilation. Class 3 obesity made respiratory rate further increased. Opto-electronic plethysmography and its thoraco-abdominal analysis of awake breathing add viable and interesting information in subjects with obesity that were complementary to pulmonary function tests. In addition, OEP is able to localize the restrictive effect of obesity.

Comments on "Probiotic Bifidobacterium strains and galactooligosaccharides improve intestinal barrier function in obese adults but show no synergism when used together as synbiotics".

Comments on "Probiotic Bifidobacterium strains and galactooligosaccharides improve intestinal barrier function in obese adults but show no synergism when used together as synbiotics".

P03-003-23 Influence of Dark Sweet Cherry (DSC) Supplementation on the Fecal Microbiota and Biomarkers of Intestinal Barrier Function in Obese Adults

P03-003-23 Influence of Dark Sweet Cherry (DSC) Supplementation on the Fecal Microbiota and Biomarkers of Intestinal Barrier Function in Obese Adults

The effect of DASH diet on atherogenic indices, pro-oxidant-antioxidant balance, and liver steatosis in obese adults with non-alcoholic fatty liver disease: A double-blind controlled randomized clinical trial.

Background: The present clinical trial aimed to examine whether adherence to Dietary Approaches to Stop Hypertension (DASH) diet could improve lipid profile, the Pro-oxidant-antioxidant balance (PAB) as well as liver function in obese adults with non-alcoholic fatty liver disease (NAFLD). Methods: Sixty two patients with NAFLD were equally allocated into either DASH or low-calorie diet (LCD) group for 8 weeks. The primary and secondary outcomes were determined before and after the trial. Results: Forty patients completed the trial. Significant within group differences were found in dietary saturated fat, selenium, vitamins A and E as well as body weight and body mass index (BMI) and waist circumference (WC) after the intervention (P<0.05). DASH diet showed greater significant change in systolic and diastolic blood pressure without significant differences between the groups after 8 weeks. Apart from serum high-density lipoprotein cholesterol (HDL-C) and triglyceride/HDL-C, greater reductions were found not only in serum lipids and atherogenic indices (P<0.05) but also in serum aspartate aminotransferase (AST), AST to platelet ratio index (APRI) and lipid accumulation product (LAP) in DASH group in comparison to control group (P=0.008, P=0.019 and P=0.003, respectively). Nevertheless, there was not any difference in PAB level between the groups. Furthermore, adherence to DASH diet was more effective in alleviating liver steatosis compared with usual LCD (P=0.012). Conclusion: Adherence to DASH diet appears to be more effective in improving obesity, atherogenic and liver steatosis biomarkers but not oxidative stress (OS) than usual LCD.

β-hydroxy-β-methylbutyrate-enriched nutritional supplements for obese adults during weight loss: study protocol of a randomised, double-blind, placebo-controlled clinical trial

IntroductionObesity is a public health challenge worldwide. To maintain a healthy weight, dieting and lifestyle changes are the first-line interventions; however, these interventions are of poor compliance and may cause...

Utilization of Mid-Thigh Magnetic Resonance Imaging to Predict Lean Body Mass and Knee Extensor Strength in Obese Adults.

Purpose:To train and test a machine learning model to automatically measure mid-thigh muscle cross-sectional area (CSA) to provide rapid estimation of appendicular lean mass (ALM) and predict knee extensor torque of obese adults.Methods:Obese adults [body mass index (BMI) = 30–40 kg/m2, age = 30–50 years] were enrolled for this study. Participants received full-body dual-energy X-ray absorptiometry (DXA), mid-thigh MRI, and completed knee extensor and flexor torque assessments via isokinetic dynamometer. Manual segmentation of mid-thigh CSA was completed for all MRI scans. A convolutional neural network (CNN) was created based on the manual segmentation to develop automated quantification of mid-thigh CSA. Relationships were established between the automated CNN values to the manual CSA segmentation, ALM via DXA, knee extensor, and flexor torque.Results:A total of 47 obese patients were enrolled in this study. Agreement between the CNN-automated measures and manual segmentation of mid-thigh CSA was high (>0.90). Automated measures of mid-thigh CSA were strongly related to the leg lean mass (r = 0.86, p < 0.001) and ALM (r = 0.87, p < 0.001). Additionally, mid-thigh CSA was strongly related to knee extensor strength (r = 0.76, p < 0.001) and moderately related to knee flexor strength (r = 0.48, p = 0.002).Conclusion:CNN-measured mid-thigh CSA was accurate compared to the manual segmented values from the mid-thigh. These values were strongly predictive of clinical measures of ALM and knee extensor torque. Mid-thigh MRI may be utilized to accurately estimate clinical measures of lean mass and function in obese adults.

Dark Sweet Cherry (DSC) Intake and Cognitive Function in Obese Adults: A Human Clinical Pilot Trial

Dark Sweet Cherry (DSC) Intake and Cognitive Function in Obese Adults: A Human Clinical Pilot Trial

Dark Sweet Cherry (DSC) Juice Consumption for Obesity-Related Inflammation and Cognitive Function in Obese Adults: A Human Clinical Pilot Trial

ObjectivesTo assess the effects of DSC juice on biomarkers of obesity-related metabolic disorders, inflammation, and cognitive performance. MethodsEligible participants (>18, body-mass index (BMI) = 30–40 kg/m2, no history of chronic disease and/or medication/antibiotics), were assigned to cherry or placebo groups following a single-blind randomized design after a 2-week run-in period. Participants were asked to drink 200 mL cherry juice supplemented with 3 g DSC powder (n = 11) or placebo drink (n = 10) twice a day for 30 days. Wellness check, anthropometric measurements, cognitive function/psychological assessments, and fasting blood samples were collected at study days 1 and 30. ResultsBaseline data showed no differences in anthropometric measurements between experimental groups. Results from blood markers of liver and metabolic disorders showed no difference between end point and baseline values for both cherry and placebo groups. However, median (25%, 75% interquartile) values for erythrocyte sedimentation rate (ESR) and reactive oxygen species (ROS) at day 30 (ESR = 6 (4, 13), ROS = 29 (13, 53) showed improvement compared to day 1 (ESR = 7 (2, 16), ROS = 33 (21, 65)) in cherry group, while in placebo group values showed less or no improvement (ESR = 12 (8, 24), ROS = 30 (20, 72) at day 30), vs (ESR = 10 (7, 18), ROS = 37 (29, 75) at day 1). These results suggest an anti-inflammatory cherry juice action and may be correlated with a trend for improvement in all of the cognitive tasks and physiological assessments in cherry group. The trail making tests (A and B), which assess executive functioning, improved (P = 0.0273 and P = 0.0342, respectively) as well as the Digit Span Forward task (DSF) (P = 0.0137), which examines short-term memory storage and executive control processes. The Digit Symbol Substitution test (DSST) used to assess processing speed, sustained attention and working memory showed improvement for cherry group, although non-significant (P = 0.0527). ConclusionsThese preliminary findings suggest that consumption of DSC juice rich in anthocyanins and other phytochemicals over 4 weeks may improve cognitive function in obese participants with possible link to lowered inflammation. Funding SourcesThis work was supported by the Northwest Cherry Growers.

245-LB: Aberrant DNA Methylation as a Contributor to Obesity-Associated Vascular Dysfunction

Obesity is a major risk factor for cardiovascular disease. We previously demonstrated an impaired vascular function in obese adults (OB). We now hypothesize a role of obesity-associated hypoxia in disturbing the methylation of genes involved in inflammation and vascular dysfunction and propose a mediating role of the hypoxia-inducible factor, HIF1α and the DNA hydroxymethylase, TET1. Methods: We obtained subcutaneous and visceral adipose tissue (AT) biopsies from bariatric patients (n=60; age: 36±7 yrs; BMI: 50.7±8.7 kg/m2) and non-obese (NOB) adults having elective surgeries (n=36; age: 36±2 yrs; BMI: 25.8±1 kg/m2). AT-isolated arterioles were tested for vasoreactivity in response to increasing pressure gradients. Arteriolar nitric oxide (NO) and reactive oxygen species (ROS) were measured. Protein expression of HIF1α and TET1 and promoter methylation/gene expression of leptin, IL1β, IL6, IL8, IL17, CXCL5, TNF-α, and IFNɣ were measured in the AT biopsy. Brachial artery flow-mediated dilation (FMD) was measured via doppler ultrasound. Results: Flow-induced dilation (FID) was 40-50% higher in NOB than OB adults across all pressure gradients (p&amp;lt;0.05). NO production was higher, and ROS generation was lower in the OB arterioles compared to NOB. HIF1α and TET1 proteins were 2 to 4-fold higher in OB compared to NOB adults and correlated negatively with arteriolar FID and NO and brachial artery FMD (r=0.82, 0.64, 0.91, respectively; p&amp;lt;0.001) and positively with arteriolar ROS production (r=-0.71, p&amp;lt;0.01). Global hydroxymethylation was observed in OB compared to NOB as well as DNA promoter hypomethylation and increased gene expression of the targeted adipocytokines. Conclusion: Our results suggest that vascular dysfunction in OB adults may be attributed to aberrant DNA methylation and increased expression of adipocytokines in the hypoxic AT. A downstream target for this pathway could reside in endothelial cells of nearby arterioles and remote arteries resulting in vascular dysfunction. Disclosure M.M. Ali: None. C. Hassan: None. M. Masrur: None. F. Bianco: Consultant; Self; Intuitive, Medtronic. S.A. Phillips: None. A.M. Mahmoud: None. Funding National Institutes of Health (4R00HL140049, 031K99, HL14004901)

Obesity‐associated Hypoxia Contributes to Aberrant Methylation of Genes Implicated in Inflammation and vascular Function

IntroductionObesity is a major risk factor for cardiovascular disease. We previously demonstrated an impaired vascular function in obese adults (OB). We now hypothesize a role of obesity‐associated hypoxia in disturbing the methylation/expression of genes involved in inflammation/vascular function. We also propose a mediating role of the hypoxia‐inducible factor, HIF1α and the DNA hydroxymethylase, TET1.MethodsWe obtained subcutaneous and visceral adipose tissue (AT) biopsies from bariatric patients (n=60; age: 36±7 yrs; BMI: 50.7±8.7 kg/m2) and non‐obese (NOB) adults having elective surgeries (n=30; age: 36±2 yrs; BMI: 25.8±1 kg/m2). AT‐isolated arterioles were tested for vasoreactivity in response to pressure gradients of Δ10‐Δ100 cmH2O. Arteriolar nitric oxide (NO) and reactive oxygen species (ROS) were measured. Protein expression of HIF1α and TET1 and methylation/expression of leptin, IL1β, IL6, IL8, IL17, CXCL5, TNF‐α, and IFNγ were measured in the AT.ResultsFlow‐induced dilation (FID) was 40–50% higher in NOB than OB adults across all pressure gradients (p&lt;0.05). NO production was higher, and ROS generation was lower in OB arterioles compared to NOB. HIF1α and TET1 proteins were 2–4‐fold higher in OB compared to NOB adults and correlated negatively with arteriolar FID, NO, and brachial artery FID (r=0.82, 0.64, 0.91, respectively; p&lt;0.001) and positively with ROS (r=−0.71, p&lt;0.01). Global hydroxymethylation and adipocytokine promoter hypomethylation and increased expression were observed in OB compared to NOB.ConclusionOur results suggest that vascular dysfunction in OB adults may be attributed to aberrant DNA methylation and increased expression of adipocytokines. This conclusion was also supported by invitro mechanistic studies.Support or Funding InformationThis research was funded by the National Heart, Lung, and Blood Institute (NHLBI), grants K99HL140049 and 4 R00 HL140049‐03 (AM) and HL095701 (S.P.)

Clapping jumping jacks to improve endothelial function in obese adults: if you're happy and you NO it, clap your hands.

Clapping jumping jacks to improve endothelial function in obese adults: if you're happy and you NO it, clap your hands.

Evaluation of Thyroid Function in Obese Adults with Non-Alcoholic Fatty Liver Disease Attending Tanta University Hospital

AbstractBackground: Non-Alcoholic Fatty Liver Disease (NAFLD) is considered, most common cause of end stage Liver disorder needing liver transplantation worldwide. NAFLD is considered the hepatic presentation of metabolic syndrome. The associa-tion between thyroid dysfunction and NAFLD has increasingly become a focus of research.Aim of Study: Evaluation of thyroid function in obese adults with non-alcoholic fatty liver disease attending at Tanta University Hospitals from July 2017 to February 2018.Patients and Method: In our study patients were classified into 2 groups first included 60 obese with Non-Alcoholic Fatty Liver (NAFLD) patients, second group included 60 obese non NAFLD patients recruited from endocrinology, diabetology and metabolism outpatient clinics and inpatient wards, Internal Medicine Department at Tanta University Hospitals. Serum Thyroid Stimulating Hormone (TSH), Free Thyroxine (FT4), Free Tri-iodiothyronine (FT3) by ELISA, Anti thyroid peroxidase (ANTI-TPO), Anti thyroglobulin (Tg Ab) and thyroid ultrasound were done for both groups for evaluation of thyroid function in obese adults with non-alcoholic fatty liver disease attending at Tanta University Hospitals from July 2017 to February 2018.Results: TSH levels showed statistically significant dif-ference being higher within obese NAFLD group p=0.001 with mean values 2.72±0.77 in obese NAFLD group, 1.93± 0.66 in obese non-NAFLD group. Also FT4 levels showed statistically significant difference lower in obese NAFLD group p=0.006 with mean values 1.08±0.22 in obese NAFLD group, 1.25±0.42 in obese non-NAFLD group. As regard FT3 levels, ANTI-TPO levels, Tg Ab levels and thyroid ultrasound characters did not show statistically significant difference between the two groups.Conclusion: We concluded that there was elevation in levels of TSH within the normal range in obese NAFLD group over obese non-NAFLD group. Also FT4 results was within normal range 0.8-1.8ng/dl with lower levels in obese NAFLD group than obese non-NAFLD we still need further research on large scale.

CEST MRI reveals a correlation between visceral fat mass and reduced myocardial creatine in obese individuals despite preserved ventricular structure and function.

Systolic cardiac function is typically preserved in obese adults, potentially masking underlying declines in cardiomyocyte metabolism that may contribute to heart failure. We used chemical exchange saturation transfer (CEST) MRI, a sensitive method for measurement of myocardial creatine, to examine whether myocardial creatine levels correlate with cardiac structure, contractile function, or visceral fat mass in obese adults. In this study, obese (body mass index, BMI>30, n=20) and healthy (BMI<25, n=11) adults were examined with dual-energy x-ray absorptiometry to quantify fat masses. Cine MRI and myocardial tagging were performed at 1.5T to measure ventricular structure and global function. CEST imaging with offsets in the range of ±10 parts per million (ppm) were performed in one mid-ventricular slice, where creatine CEST contrast was calculated at 1.8ppm following field homogeneity correction. Ventricular structure, global function (ejection fraction 69.4±4.3% healthy versus 69.6±9.3% obese, NS), and circumferential strain (-17.0±2.3% healthy versus -16.5±1.5% obese, NS) and strain rate were preserved in obese adults. However, creatine CEST contrast was significantly reduced in obese adults (6.8±1.3% healthy versus 4.1±2.7% obese, p=0.001). Creatine CEST contrast was inversely correlated with total body fat% (ρ=-0.45, p=0.011), visceral fat mass (ρ=-0.58, p=0.001), and septal wall thickness (ρ=-0.44, p=0.013), but uncorrelated to ventricular function or contractile function. In conclusion, creatine CEST-MRI reveals a strong correlation between heightened body and visceral fat masses and reduced myocardial metabolic function that is independent of ventricular structure and global function in obese adults.

Evaluation of thyroid function in obese adults with non-alcoholic fatty liver disease attending at Tanta university hospitals

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Probiotic Bifidobacterium strains and galactooligosaccharides improve intestinal barrier function in obese adults but show no synergism when used together as synbiotics

BackgroundOne way to improve both the ecological performance and functionality of probiotic bacteria is by combining them with a prebiotic in the form of a synbiotic. However, the degree to which such synbiotic formulations improve probiotic strain functionality in humans has not been tested systematically. Our goal was to use a randomized, double-blind, placebo-controlled, parallel-arm clinical trial in obese humans to compare the ecological and physiological impact of the prebiotic galactooligosaccharides (GOS) and the probiotic strains Bifidobacterium adolescentis IVS-1 (autochthonous and selected via in vivo selection) and Bifidobacterium lactis BB-12 (commercial probiotic allochthonous to the human gut) when used on their own or as synbiotic combinations. After 3 weeks of consumption, strain-specific quantitative real-time PCR and 16S rRNA gene sequencing were performed on fecal samples to assess changes in the microbiota. Intestinal permeability was determined by measuring sugar recovery in urine by GC after consumption of a sugar mixture. Serum-based endotoxin exposure was also assessed.ResultsIVS-1 reached significantly higher cell numbers in fecal samples than BB-12 (P < 0.01) and, remarkably, its administration induced an increase in total bifidobacteria that was comparable to that of GOS. Although GOS showed a clear bifidogenic effect on the resident gut microbiota, both probiotic strains showed only a non-significant trend of higher fecal cell numbers when administered with GOS. Post-aspirin sucralose:lactulose ratios were reduced in groups IVS-1 (P = 0.050), IVS-1 + GOS (P = 0.022), and GOS (P = 0.010), while sucralose excretion was reduced with BB-12 (P = 0.002) and GOS (P = 0.020), indicating improvements in colonic permeability but no synergistic effects. No changes in markers of endotoxemia were observed.ConclusionThis study demonstrated that “autochthony” of the probiotic strain has a larger effect on ecological performance than the provision of a prebiotic substrate, likely due to competitive interactions with members of the resident microbiota. Although the synbiotic combinations tested in this study did not demonstrate functional synergism, our findings clearly showed that the pro- and prebiotic components by themselves improved markers of colonic permeability, providing a rational for their use in pathologies with an underlying leakiness of the gut.

Combining Short-Term Interval Training with Caloric Restriction Improves ß-Cell Function in Obese Adults.

Although low-calorie diets (LCD) improve glucose regulation, it is unclear if interval exercise (INT) is additive. We examined the impact of an LCD versus LCD + INT training on ß-cell function in relation to glucose tolerance in obese adults. Twenty-six adults (Age: 46 ± 12 year; BMI 38 ± 6 kg/m2) were randomized to 2-week of LCD (~1200 kcal/day) or energy-matched LCD + INT (60 min/day alternating 3 min at 90 and 50% HRpeak). A 2 h 75 g oral glucose tolerance test (OGTT) was performed. Insulin secretion rates (ISR) were determined by deconvolution modeling to assess glucose-stimulated insulin secretion ([GSIS: ISR/glucose total area under the curve (tAUC)]) and ß-cell function (Disposition Index [DI: GSIS/IR]) relative to skeletal muscle (Matsuda Index), hepatic (HOMA-IR) and adipose (Adipose-IRfasting) insulin resistance (IR). LCD + INT, but not LCD alone, reduced glucose and total-phase ISR tAUC (Interactions: p = 0.04 and p = 0.05, respectively). Both interventions improved skeletal muscle IR by 16% (p = 0.04) and skeletal muscle and hepatic DI (Time: p < 0.05). Improved skeletal muscle DI was associated with lower glucose tAUC (r = −0.57, p < 0.01). Thus, LCD + INT improved glucose tolerance more than LCD in obese adults, and these findings relate to ß-cell function. These data support LCD + INT for preserving pancreatic function for type 2 diabetes prevention.

Combining Short-Term Interval Training With Caloric-Restriction Improves ß-Cell Function In Obese Adults

BACKGROUND: Obese adults have an increased risk of type 2 diabetes (T2D). Although insulin resistance is a key etiological factor, the progressive loss of ß-cell function causes T2D. Lifestyle therapies, such as caloric-restriction and interval exercise training (INT) have separately been shown to improve insulin secretion; however, the impact of these therapies combined on ß-cell function prior to meaningful weight loss is unknown. PURPOSE: To examine the impact of a low-calorie diet (LCD), with and without INT, on ß-cell function in obese adults. METHODS: Twenty-two, middle-aged obese (Age: 46±12 y; BMI 38±6 kg/m2) adults were randomized to either 2-wks of a LCD (~1200 kcal/day) or an energy matched LCD+INT intervention (supervised: 60-min/d alternating 3-min at 90 and 50% HRpeak). VO2peak and body fat were assessed before and after interventions. After an overnight fast, a 120-min 75g oral glucose tolerance test (OGTT) with blood samples every 30-min was performed, and glucose, insulin, and C-peptide were used to define glucose- stimulated insulin secretion ([GSIS: [INCREMENT]insulin/[INCREMENT]glucose]), hepatic clearance (HC: AUCinsulin/AUCc-peptide), and ß-cell function (Disposition Index [DI: IGI x Matsuda Index]) for early- (0-30-min) and total-phase (0-120-min) responses. GLP-1active was also measured during 0, 30 and 60-min of the OGTT to assess incretin effects. RESULTS: Neither intervention altered body fat % (Time: P=0.74), and only LCD+INT increased VO2peak (Interaction: P=0.03). LCD+INT reduced glucose total area under the curve (tAUC) when compared with LCD (Interaction: P<0.05). While both interventions increased insulin sensitivity by ~13% (Time: P=0.04), only LCD+INT elevated early-phase GSIS (Interaction: P=0.05) with no change in HC (Time: P=0.11). LCD+INT tended to increase early-, but not total-phase, ß-cell function to a greater extent when compared with LCD (Interaction: P=0.06). GLP-1active tAUC increased similarly after LCD+INT and LCD (Time: P<0.05) by ~28%. CONCLUSIONS: Independent of insulin sensitivity and GLP-1, INT combined with LCD improved early-phase pancreatic function in obese adults when compared to an energy matched diet. Additional work is required to elucidate the mechanism(s) by which INT improves insulin secretion during weight loss to optimize diabetes prevention.

Combined moderate and high intensity exercise with dietary restriction improves cardiac autonomic function associated with a reduction in central and systemic arterial stiffness in obese adults: a clinical trial.

ObjectiveThe present study aimed to assess the effects of exercise with dietary restriction on cardiac autonomic activity, arterial stiffness, and cardiovascular biomarkers in obese individuals.MethodsSeventeen obese adults completed an 8-week exercise and dietary program. Anthropometry, body composition, and multiple biochemical markers were measured. We used carotid-femoral pulse wave velocity (cfPWV), brachial-ankle pulse wave velocity (baPWV), central blood pressure, and augmentation index (AIx) to assess arterial stiffness. To determine cardiac autonomic activity, heart rate variability (HRV) was analyzed by standard deviation of normal-to-normal intervals (SDNN), square root of the mean squared differences of successive normal-to-normal intervals (RMSSD), total power (TF), low-frequency power in normalized units (LFnu), high-frequency power in normalized units (HFnu), and low-frequency power/high-frequency power (LF/HF).ResultsFollowing the exercise and diet intervention, obese subjects had significant reductions in body weight, body mass index, body fat percentage, brachial systolic blood pressure, and resting heart rate, and they had shown improvements in blood chemistry markers such as lipid profiles, insulin, and high-sensitivity C-reactive protein. There was a significant reduction in both cfPWV and baPWV following the intervention when compared to baseline levels. Moreover, the AIx and aortic systolic blood pressure were significantly reduced after the intervention. The diet and exercise intervention significantly increased cardiac autonomic modulation (determined by improved SDNN, RMSSD, TP LF, HF, and LF/HF), which was partly due to changes in heart rate, insulin resistance, and the inflammatory pattern. Furthermore, we observed a correlation between enhanced cardiac autonomic modulation (LF/HF) and decreased arterial stiffness, as measured by central cfPWV and systemic baPWV.DiscussionAn 8-week combined intervention of diet and exercise is effective in improving cardiac autonomic function in obese adults, with an associated decrease in central and systemic arterial stiffness.

High-Protein, Intermittent-Fasting Intervention is Effective in Weight Loss and Improving Arterial Function in Obese Adults

Weight loss (WL) interventions have been shown to benefit fat mass loss. However, adverse cardiovascular complications may be associated with WL. PURPOSE: To examine the effects of a high-protein, intermittent-fasting, low-calorie (HP-IF-LC) diet on blood lipids and arterial function during WL and weight-loss maintenance (WL-M). METHODS: Forty obese men (n = 21) and women (n = 19) participated in this study. This experiment was split into two consecutive phases: (a) 12-week HP-IF-LC diet (WL, Phase 1); (b) a 1-year WL maintenance comparing HP-IF with a heart healthy (HH) diet (WL-M, Phase 2). We assessed body mass index (BMI), waist circumference, circulating lipids, and arterial function at baseline (week 0), post-Phase 1 (week 12), post-Phase 2 (week 64). Two way ANOVA with repeated measures was used to determine the main effects and Post hoc test was performed if there was an interaction. RESULTS: Body composition, arterial function, blood lipids were all significantly improved following 12-week WL phase (BMI: 37.5 ± 0.9 vs. 33.7 ± 0.8 kg/m2; waist circumference: 116.3 ± 2.3 vs. 100.8 ± 2.0 cm, p < 0.001); (LDL: 145.9 ± 11.5 vs. 96.6 ± 7.0 mg/dL; total cholesterol: 116.9 ± 4.6 vs. 102.7 ± 4.2 mg/dL, p < 0.01); (HR: 64.9 ± 1.6 vs. 60.4 ± 1.5 bpm, p < 0.01; systolic BP: 125.2 ± 1.7 vs. 116.1 ± 1.8 mmHg; diastolic BP: 79.5 ± 1.8 vs. 70.3 ± 1.2 mmHg, p < 0.001), respectively. For Phase 2, HP-IF diet group showed less weight gain relapse and enhanced arterial function compared to the HH diet. CONCLUSION: A 12 week HP-IF-LC WL diet effectively improved body composition, lipid profile, and arterial function in obese men and women. Furthermore, HP-IF diet demonstrated an advantage in minimizing weight relapse and improvement of cardiovascular health compared to HH diet during 1 year WL-M.Funding was provided to PJA from Isagenix International LLC (#1307-347)

Adolescent weight history and adult cognition: before and after bariatric surgery

BackgroundCognitive deficits occur in a subset of individuals with obesity. Deficits can be reversed with bariatric surgery, though cognitive recovery is not equally exhibited across patients. Recent work has found that obesity during adolescence portends medical complications in adulthood; it is unknown if obesity in adolescence predicts adult cognition or cognitive recovery after weight loss surgery. ObjectivesThe present study examines the relationship between weight history and cognitive function in obese adults undergoing bariatric surgery. SettingAcademic medical centers with bariatric care services. MethodsSeventy-eight bariatric surgery patients (mean age = 43.2 years) enrolled in an ancillary study to the Longitudinal Assessment of Bariatric Surgery (LABS) project completed a questionnaire recalling weight history at age 18. Cognitive testing was completed preoperatively and at 12-month follow-up. ResultsWeight status at age 18 was linked to performance in several aspects of cognition. Higher body mass index at age 18 predicted poorer preoperative verbal fluency (B = –.26, P = .045) as well as postoperative cognitive recovery in attention (B = –.30, P = .01) at 12-month follow-up. ConclusionHigher body mass index at age 18 predicts verbal fluency performance in adults with obesity, as well as postoperative recovery of attention after bariatric surgery. The mechanisms underlying this connection are not fully clear, though findings may reflect effects of obesity on the brain during a crucial period of neural maturation or duration of obesity and cumulative impact of co-morbidities on cognition. Future work examining possible causal factors involved in these relationships is needed.