Long-term Maintenance Of Body Weight Research Articles

The dietary treatment of obesity

The review article represents an analysis of sources dealing with the issues of dietary therapy of obesity. The internet resources were used such as PubMed, MedLine, The Cochrane Databases, Google Scholar, Science Direct, Web of Science, and Scopus. Obesity has reached pandemic proportions worldwide, with more than 1 billion adults overweight (at least 300 million of them are clinically obese) and is a major contributor to the global burden of chronic disease and disability. This is a complex multifactorial disease, in which the accumulated excess fat in the body leads to negative impact on health. The main cause of obesity is a long-term energy imbalance between consumed and expended calories. Lifestyle modification remains the cornerstone of obesity treatment. An indivi­dually selected diet is recommended, which allows you to achieve a state of negative energy balance and is focused on quality food for health promotion. Most often, recommended diets for the treatment of obesity use the following energy restrictions based on changes in the composition of macronutrients: a low-fat diet, a low-carbohydrate and high-fat diet, a low-carbohydrate and high-protein diet, a paleo diet (with a high protein content). Intermittent fasting is considered an alternative to calorie-restricted diets. After an initial period on a high-protein diet, a Mediterranean diet may be an attractive option for continued treatment of obesity, provided that it is given in an energy-restric­ted form. This diet has been shown to be associated with lower levels of inflammatory biomarkers and metabolic markers of cardiovascular disease risk. The results of many studies indicate successful weight loss with the help of the Mediterranean diet, not only in the short term, but also in the long term. For the majority of obese patients, a purposeful change in lifestyle with adherence to the principles of dietary nutrition and regular physical activity allows for effective weight loss, adequate control of metabolic disorders, reduced risk of concomitant di­seases, and long-term maintenance of body weight achieved in the process of losing weight.

Monogenic forms of childhood obesity: a review

Childhood obesity has become a notable health concern in the world. According to American Medical Association, obesity is defined as having a body mass index greater than 30 kg/m2. Childhood obesity is classified into three main categories, polygenic obesity, which is the most common form; followed by monogenic obesity, which is rare; and non-syndromic obesity. The management of childhood obesity is complex and requires a multidisciplinary approach. For monogenic obesity, several treatment options have been investigated. Long-term body weight maintenance is challenging. This review aimed to provide an overview of monogenic obesity, its mechanisms, evaluation, and treatment options. Monogenic forms of childhood obesity are rare. However, early diagnosis using whole-exome sequencing is needed to identify the causes of obesity and its associated anomalies for subsequent treatment. In addition, the early initiation of a multidisciplinary management approach is essential to prevent long-term morbidity and mortality. Several new treatment options have recently emerged, which could, in combination with lifestyle modifications, provide a favorable outcome for patients with non-syndromic forms of obesity.

Long-term maintenance of nutritional status with ninjinyoueito in terminal patients with chronic respiratory disease: Two case reports.

Ninjinyoeito, is a traditional herbal (Kampo) medicine which is administered to patients with debilitating diseases in North-East Asia. Ninjinyoeito has been reported to be effective against loss of physical strength, fatigue and loss of appetite in patients with wasting diseases. The present study described long-term maintenance of body weight with ninjinyoueito in 2 terminal patients with chronic respiratory diseases. The first patient was a 75-year-old with chronic obstructive pulmonary disease (COPD) who took ninjinyoueito for ≥5 years and the second patient was a 72-year-old man with metastatic lung cancer with combined pulmonary fibrosis and emphysema (CPFE) who took ninjinyoueito for ≥1 year. Both of them maintained their physique and nutritional status during the terminal stages of disease and there were no adverse effects observed in these 2 patients which could be attributed to ninjinyoueito. The results suggest that ninjinyoueito may be a supplementary treatment for the maintenance of nutritional status in patients with a chronic respiratory disease accompanied by wasting, such as COPD.

An Integrated Understanding of the Molecular Mechanisms of How Adipose Tissue Metabolism Affects Long-term Body Weight Maintenance.

Lifestyle-based weight loss interventions frequently demonstrate long-term inefficiency and weight regain. Identification of underlying mechanisms and predictors to identify subjects who will benefit from lifestyle-based weight loss strategies is urgently required. We analyzed 143 adults of the randomized Maintain trial (Maintain-Adults) after intended weight loss to identify mechanisms contributing to the regulation of body weight maintenance. Unbiased RNA sequencing of adipose and skeletal muscle biopsies revealed fatty acid metabolism as a key pathway modified by weight loss. Variability of key enzymes of this pathway, estimates of substrate oxidation, and specific serum acylcarnitine (AC) species, representing a systemic snapshot of in vivo substrate flux, predicted body weight maintenance (defined as continuous or dichotomized [< or ≥3% weight regain] variable) 18 months after intended weight loss in the entire cohort. Key results were confirmed in a similar randomized controlled trial in 137 children and adolescents (Maintain-Children), which investigated the same paradigm in a pediatric cohort. These data suggest that adaption of lipid utilization in response to negative energy balance contributes to subsequent weight maintenance. Particularly a functional role for circulating ACs, which have been suggested to reflect intracellular substrate utilization, as mediators between peripheral energy stores and control of long-term energy homeostasis was indicated.

Long-Term Body Weight Maintenance among StrongWomen-Healthy Hearts Program Participants.

Background. The repeated loss and regain of body weight, referred to as weight cycling, may be associated with negative health complications. Given today's obesity epidemic and related interventions to address obesity, it is increasingly important to understand contexts and factors associated with weight loss maintenance. This study examined BMI among individuals who had previously participated in a 12-week, evidence-based, nationally disseminated nutrition and physical activity program designed for overweight and obese middle-aged and older women. Methods. Data were collected using follow-up surveys. Complete height and weight data were available for baseline, 12-week program completion (post-program) and follow-up (approximately 3 years later) for 154 women (response rate = 27.5%; BMI characteristics did not differ between responders and nonresponders). Results. Mean BMI decreased significantly from baseline to post-program (−0.5, P < 0.001) and post-program to follow-up (−0.7, P < 0.001). Seventy-five percent of survey respondents maintained or decreased BMI post-program to follow-up. Self-efficacy and social support for healthy eating behaviors (but not physical activity) were associated with BMI maintenance or additional weight loss. Conclusions. These findings support the durability of weight loss following participation in a relatively short-term intervention.

The histone acetyltransferase MOF activates hypothalamic polysialylation to prevent diet-induced obesity in mice.

Overfeeding causes rapid synaptic remodeling in hypothalamus feeding circuits. Polysialylation of cell surface molecules is a key step in this neuronal rewiring and allows normalization of food intake. Here we examined the role of hypothalamic polysialylation in the long-term maintenance of body weight, and deciphered the molecular sequence underlying its nutritional regulation. We found that upon high fat diet (HFD), reduced hypothalamic polysialylation exacerbated the diet-induced obese phenotype in mice. Upon HFD, the histone acetyltransferase MOF was rapidly recruited on the St8sia4 polysialyltransferase-encoding gene. Mof silencing in the mediobasal hypothalamus of adult mice prevented activation of the St8sia4 gene transcription, reduced polysialylation, altered the acute homeostatic feeding response to HFD and increased the body weight gain. These findings indicate that impaired hypothalamic polysialylation contribute to the development of obesity, and establish a role for MOF in the brain control of energy balance.

Can artificial sweeteners help control body weight and prevent obesity?

The possible role played by artificial sweeteners in the long-term maintenance of body weight is considered. Although artificial sweeteners can play a role in a short-term energy-controlled diet, the evidence that they are helpful over a longer period is limited. In those in the recommended weight range there is evidence of compensation; that is, the consumption of low-energy foods is followed by an increased energy intake to make up the lost energy. Energy compensation is more likely in those not displaying dietary restraint. The desire to remove sugar from the diet reflects an assumption that its intake is associated with obesity. However, the consumption of energy-dense food, that almost entirely reflects a high fat and low water content, is the best predictor of obesity. Diets offering a high proportion of energy in the form of carbohydrate tend to contain low levels of fat. There are several reports that the use of artificial sweeteners leads to an increased consumption of fat. The weak ability of fat to satisfy hunger makes it easy to overeat fatty foods; in contrast, carbohydrates promote a feeling of 'fullness'. Various short-term studies have found that carbohydrate consumed as a liquid, rather than a solid, is more likely to result in weight gain.

The cholecystokinin-A receptor mediates inhibition of food intake yet is not essential for the maintenance of body weight.

Food intake and body weight are determined by a complex interaction of regulatory pathways. To elucidate the contribution of the endogenous peptide cholecystokinin, mice lacking functional cholecystokinin-A receptors were generated by targeted gene disruption. To explore the role of the cholecystokinin-A receptor in mediating satiety, food intake of cholecystokinin-A receptor-/- mice was compared with the corresponding intakes of wild-type animals and mice lacking the other known cholecystokinin receptor subtype, cholecystokinin-B/gastrin. Intraperitoneal administration of cholecystokinin failed to decrease food intake in mice lacking cholecystokinin-A receptors. In contrast, cholecystokinin diminished food intake by up to 90% in wild-type and cholecystokinin-B/gastrin receptor-/- mice. Together, these findings indicate that cholecystokinin-induced inhibition of food intake is mediated by the cholecystokinin-A receptor. To explore the long-term consequences of either cholecystokinin-A or cholecystokinin-B/gastrin receptor absence, body weight as a function of age was compared between freely fed wild-type and mutant animals. Both cholecystokinin-A and cholecystokinin-B/gastrin receptor-/- mice maintained normal body weight well into adult life. In addition, each of the two receptor-/- strains had normal pancreatic morphology and were normoglycemic. Our results suggest that although cholecystokinin plays a role in the short-term inhibition of food intake, this pathway is not essential for the long-term maintenance of body weight.

Energy requirement for long-term body weight maintenance in older women

The total dietary energy requirement of healthy, free-living older women was examined by determining the total energy intake (TEl) required for long-term body weight maintenance in nine women aged (mean ± SD) 67 ± 9 years (range, 56 to 78). For 14 weeks, each woman consumed defined amounts of foods and beverages prepared at a General Clinical Research Center (GCRC) to provide 0.8 g protein · kg −1 · d −1 and a nonprotein energy ratio of 40% fat to 60% carbohydrate. Adjustments to TEl were made to keep body weight within ±0.5 kg of each woman's starting body weight. All women were asked to maintain their habitual level of daily activity, and the energy cost of physical activity was estimated using the Yale Physical Activity Survey (YPAS). Resting energy expenditure (REE) was measured with each woman in the postabsorptive state just after awakening, using an indirect calorimeter at baseline and week 14. The energy requirement expressed as the ratio of TEl to REE was 1.82 ± 0.15 a value 21% higher ( P < .001) than the energy allowance of 1.5 × REE suggested for women beyond age 50 years in the 1989 Recommended Dietary Allowances (RDAs). Using the RDAs equation to predict REE from body weight (pREE), the ratio of TEl to pREE was 1.73 ± 0.18 ( P < .005, comparison with 1.50 × REE). Estimates of the energy expenditure for physical activity (EEPA) based on the energy intake-balance data and the YPAS data were similar (3.18 ± 0.92 and 3.14 ± 1.42 M J/d, respectively) for the group of women, but were more variable on an individual basis. Results of this long-term energy balance study suggest that the RDAs underestimate the dietary energy requirement of older women.