Magnitude Of Weight Loss Research Articles

Does adaptive thermogenesis occur after weight loss in adults? A systematic review.

Adaptive thermogenesis (AT) has been proposed to be a compensatory response that may resist weight loss (WL) and promote weight regain. This systematic review examined the existence of AT in adults after a period of negative energy balance (EB) with or without a weight stabilisation phase. Studies published until 15 May 2020 were identified from PubMed, Cochrane Library, EMBASE, MEDLINE, SCOPUS and Web of Science. Inclusion criteria included statistically significant WL, observational with follow-up or experimental studies, age > 18y, sample size ≥10 participants, intervention period ≥ 1week, published in English, objective measures of total daily energy expenditure (EE) (TDEE), resting EE (REE) and sleeping EE(SEE). The systematic review was registered at PROSPERO (2020 CRD42020165348). A total of thirty-three studies comprising 2528 participants were included. AT was observed in twenty-seven studies. Twenty-three studies showed significant values for AT for REE (82·8 %), four for TDEE (80·0 %) and two for SEE (100 %). A large heterogeneity in the methods used to quantify AT and between subjects and among studies regarding the magnitude of WL and/or of AT was reported. Well-designed studies reported lower or non-significant values for AT. These findings suggest that although WL may lead to AT in some of the EE components, these values may be small or non-statistically significant when higher-quality methodological designs are used. Furthermore, AT seems to be attenuated, or non-existent, after periods of weight stabilisation/neutral EB. More high-quality studies are warranted not only to disclose the existence of AT but also to understand its clinical implications on weight management outcomes.

Adipocytokine and appetite-regulating hormone response to weight loss in adolescents with obesity: Impact of weight loss magnitude

ObjectiveThe aim of this study was to investigate the association between the magnitude of weight loss (WL) and serum concentrations of the main adipocytokines and appetite-regulating hormones in adolescents with obesity. MethodsAfter completion of informed consent,108 adolescents with obesity (14–19 y of age; postpubertal) were submitted to clinical, nutritional, psychological, physical exercise, and physiotherapy support for 1 y. Body composition (BC) and plasma levels of neuropeptides (neuropeptide Y [NPY], agouti-related peptide [AgRP], and α-melanocyte-stimulating hormone [α-MSH]) and leptin were measured at baseline and post-intervention. ResultsAfter therapy, adolescents who lost <10% body weight and <10% body weight (were compared. Both groups presented improvements in BC and reduced leptin. The Δα-MSH, Δα-MSH/AgRP ratio, and Δα-MSH/NPY ratio were lower and AgRP and NPY variations were higher in the low weight loss group. The leptin concentration was close to normal in the high weight loss only. The ΔWeight, Δα-MSH and Δleptin were associated with body fat loss by multiple linear regressions for all samples. ConclusionWeight loss >10% seems to reverse obesity-induced hyperleptinemia while stabilizing the neuropeptides that control appetite in adolescents with obesity. We were able to produce a prognostic mathematical model to predict body fat loss using weight, leptin, and α-MSH variations.

Optimising weight-loss interventions in cancer patients-A systematic review and network meta-analysis.

BackgroundExcess weight has been associated with increased morbidity and a worse prognosis in adult patients with early-stage cancer. The optimal lifestyle interventions to optimize anthropometric measures amongst cancer patients and survivors remain inconsistent.ObjectiveTo conduct a systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing the effects of exercise and dietary interventions alone or in combination on anthropometric measures of adult cancer patients and survivors.MethodsA systematic search of Medline, Embase and the Cochrane Trials Registry was performed. Outcomes of interest included changes in weight, body mass index (BMI), and waist circumference. Screening and data collection were performed by two reviewers. Bayesian NMAs were performed.ResultsOverall, 98 RCTs were included; 75 were incorporated in NMAs (n = 12,199). Groups of intervention strategies included: 3 exercise interventions, 8 dietary interventions, 7 combination interventions of diet and exercise and standard care. Median intervention duration was 26 weeks. NMA suggested that diet alone (mean difference [MD] -2.25kg, 95% CrI -3.43 to -0.91kg) and combination strategies (MD -2.52kg, 95% CrI -3.54 to -1.62kg) were associated with more weight loss compared to standard care. All dietary interventions achieved a similar magnitude of weight loss (MD range from -2.03kg to -2.52kg). Both diet alone and combination strategies demonstrated greater BMI reductions versus standard care, and each of diet alone, exercise alone and combination strategies demonstrated greater reductions in waist circumference than standard care.ConclusionDiet and exercise alone or in combination are effective lifestyle interventions to improve anthropometric measures in cancer patients and survivors. All reputable diets appear to be similarly effective to achieve weight loss.

What the obesity epidemic does not need: A cancel culture

What the obesity epidemic does not need: A cancel culture

Investigating IGF-II and IGF2R serum markers as predictors of body weight loss following an 8-week acute weight loss intervention: PREVIEW sub-study

BackgroundWeight reduction is effective in preventing T2D however, weight reduction and maintenance is difficult to achieve on a population scale. Serum insulin-like growth factor II (IGF-II) and IGF-II receptor (IGF2R) have been associated with diabetic status and body weight in prior studies and, in addition, IGF-II has been indicated as predictive of future weight change. We measured these serum markers in participants with obesity/overweight and prediabetes from the New Zealand arm of the PREVIEW lifestyle intervention randomised trial before and after an 8-week low energy diet (LED). MethodsTotal IGF-II (n = 223) and soluble IGF2R (n = 151) were measured using commercial ELISA kits on fasted serum samples taken prior to an 8-week LED and also from participants completing the LED. ResultsIGF-II levels were not correlated with baseline body weight although mean levels did significantly decrease following the LED. Change in IGF-II serum level was correlated to fasting glucose change (p = 0.04) but not to weight change. Baseline serum IGF2R was correlated with BMI (p = 0.007) and was significantly higher in Māori compared to European Caucasian participants independent of body weight (p = 0.0016). Following LED, IGF2R change was positively associated with weight change (p = 0.02) when corrected for ethnicity. Pre-LED levels of these serum markers were not predictive of the magnitude of weight loss over the 8 weeks. ConclusionNeither marker was useful in predicting magnitude of short-term weight loss. IGF2R is positively associated with BMI and is higher in Māori compared to European Caucasian individuals.

The effect of the magnitude of weight loss on non-alcoholic fatty liver disease: A systematic review and meta-analysis

BackgroundTrials show that weight loss interventions improve biomarkers of non-alcoholic fatty liver disease (NAFLD), but it is unclear if a dose-response relationship exists. ObjectiveWe aimed to quantify the dose-response relationship between the magnitude of weight loss and improvements in NAFLD. MethodsNine databases and trial registries were searched until October 2020. Single-arm, non-randomized comparative, or randomized trials of weight loss interventions (behavioral weight loss programs [BWLPs], pharmacotherapy, or bariatric surgery) in people with NAFLD were eligible for inclusion if they reported an association between changes in weight and changes in blood, radiological, or histological biomarkers of liver disease. The review followed Cochrane methods and the risk of bias was assessed using the Newcastle-Ottawa scale. Pooled unstandardized b coefficients were calculated using random-effect meta-analyses. ResultsForty-three studies (BWMPs: 26, pharmacotherapy: 9, surgery: 8) with 2809 participants were included. The median follow-up was 6 (interquartile range: 6) months. The direction of effect was generally consistent but the estimates imprecise. Every 1 kg of weight lost was associated with a 0.83-unit (95% CI: 0.53 to 1.14, p < 0.0001, I2 = 92%, n = 18) reduction in alanine aminotransferase (U/L), a 0.56-unit (95% CI: 0.32 to 0.79, p < 0.0001, I2 = 68%, n = 11) reduction in aspartate transaminase (U/L), and a 0.77 percentage point (95% CI: 0.51 to 1.03, p < 0.0001, I2 = 72%, n = 11) reduction in steatosis assessed by radiology or histology. There was evidence of a dose-response relationship with liver inflammation, ballooning, and resolution of NAFLD or NASH, but limited evidence of a dose-response relationship with fibrosis or NAFLD activity score. On average, the risk of bias for selection and outcome was medium and low, respectively. ConclusionClinically significant improvements in NAFLD are achieved even with modest weight loss, but greater weight loss is associated with greater improvements. Embedding support for formal weight loss programs as part of the care pathway for the treatment of NAFLD could reduce the burden of disease.PROSPERO: CRD42018093676.

Factors Influencing Weight Loss Practices in Italian Boxers: A Cluster Analysis.

It is common practice in combat sports that athletes rapidly lose body weight before a match, by applying different practices—some safer and others possibly dangerous. The factors behind the choice of practices utilised have not been fully studied. This study aimed to investigate the weight loss strategies used by Italian boxers and to look at the difference between higher and lower risk practice adaptors. A modified version of a validated questionnaire has been sent to 164 amateur (88%) and professional (12%) boxers by email. A heatmap with hierarchical clustering was used to explore the presence of subgroups. Weight loss strategies were used by 88% of the athletes. Two clusters were found, defined by the severity of weight loss behaviours. Professional fighters, high-level athletes and females were more represented in Cluster 2, the one with more severe weight-loss practices. These athletes were characterised by a higher weight loss magnitude and frequency throughout the season and reported being more influenced by physicians and nutritionists, compared with the boxers in Cluster 1. Not all the weight loss practices are used with the same frequency by all boxers. The level of the athlete and the boxing style have an influence on the weight-cutting practices.

Necroptosis is dispensable for the development of inflammation-associated or sporadic colon cancer in mice.

Chronic inflammation of the large intestine is associated with an increased risk of developing colorectal cancer (CRC), the second most common cause of cancer-related deaths worldwide. Necroptosis has emerged as a form of lytic programmed cell death that, distinct from apoptosis, triggers an inflammatory response. Dysregulation of necroptosis has been linked to multiple chronic inflammatory diseases, including inflammatory bowel disease and cancer. Here, we used murine models of acute colitis, colitis-associated CRC, sporadic CRC, and spontaneous intestinal tumorigenesis to investigate the role of necroptosis in these gastrointestinal pathologies. In the Dextran Sodium Sulfate-induced acute colitis model, in some experiments, mice lacking the terminal necroptosis effector protein, MLKL, or its activator RIPK3, exhibited greater weight loss compared to wild-type mice, consistent with some earlier reports. However, the magnitude of weight loss and accompanying inflammatory pathology upon Mlkl deletion varied substantially between independent repeats. Such variation provides a possible explanation for conflicting literature reports. Furthermore, contrary to earlier reports, we observed that genetic deletion of MLKL had no impact on colon cancer development using several mouse models. Collectively, these data do not support an obligate role for necroptosis in inflammation or cancer within the gastrointestinal tract.

Quality of life after gastric bypass surgery in patients with type 2 diabetes: patients\u2019 experiences during 2\xa0years of follow-up

BackgroundTo examine the effects of gastric bypass surgery on health-related quality of life (HRQoL) in obese patients with type 2 diabetes, and to investigate their experiences of life adjustments using quantitative and qualitative methods.MethodsThirteen patients with type 2 diabetes and obesity, (body mass index, BMI > 30 kg/m2), participating in a randomized clinical trial, completed this sub-study. HRQoL was evaluated before, and at 6 months and 2 years after gastric bypass surgery, using the RAND- 36-item health survey. At 2 years, interviews for in-depth analysis of HRQoL changes were performed.ResultsSignificant improvement was observed from baseline to 6 months for 2 of the eight health concepts, general health, and emotional well-being. At 2 years, improvements were also seen in physical functioning, energy/fatigue, as well as sustained improvements in general health and emotional well-being. Multiple regression analyses showed mostly non-significant associations between the magnitude of decrease in weight, BMI, and HbA1c during follow-up and improvement in HRQoL. The analyses from qualitative interviews supported a common latent theme “Finding a balance between the experience of the new body weight and self-confidence”.ConclusionsThe improved HRQoL after gastric bypass surgery in obese patients with type 2 diabetes was not explained specifically by the magnitude of weight loss, but rather by the participants achieving a state of union between body and consciousness.Trial registration ClinicalTrials.gov Identifier NCT02729246. Date of registration 6 April 2016 – Retrospectively registered https://clinicaltrials.gov/ct2/show/NCT02729246?term=bariglykos&draw=2&rank=1

Does craniofacial morphology relate to sleep apnea severity reduction following weight loss intervention? A patient-level meta-analysis.

Obesity is a common and reversible risk factor for obstructive sleep apnea (OSA). However, there is substantial unexplained variability in the amount of OSA improvement for any given amount of weight loss. Facial photography is a simple, inexpensive, and radiation-free method for craniofacial assessment. Our aims were (1) to determine whether facial measurements can explain OSA changes, beyond weight loss magnitude and (2) whether facial morphology relates to how effective weight loss will be for OSA improvement. We combined data from three weight loss intervention trials in which participants had standardized pre-intervention facial photography (N = 91; 70.3% male, mean ± SD weight loss 10.4 ± 9.6% with 20.5 ± 51.2% apnea-hypopnea index [AHI] reduction). Three skeletal-type craniofacial measurements (mandibular length, lower face height, and maxilla-mandible relationship angle) were assessed for relationship to AHI change following weight loss intervention. Weight and AHI changes were moderately correlated (rho = 0.3, p = 0.002). In linear regression, an increased maxilla-mandible relationship angle related to AHI improvement (β [95% CI] -1.7 [-2.9, -0.5], p = 0.004). Maxilla-mandible relationship angle explained 10% in the variance in AHI over the amount predicted by weight loss amount (20%). The relationship between weight change and AHI was unaffected by the maxilla-mandible relationship angle (interaction term p > 0.05). Regardless of facial morphology, weight loss is similarly moderately predictive of OSA improvement. Increased maxilla-mandible relationship angle, suggestive of retrognathia, was weakly predictive of OSA response to weight loss. Although this is unlikely to be clinically useful, exploration in other ethnic groups may be warranted.

Trajectories of depressive symptoms and relationships with weight loss in the seven years after bariatric surgery

IntroductionWhile depression generally improves after bariatric surgery, less is known regarding heterogeneity in long-term symptom change. Given that depressive symptoms have been associated with weight change following bariatric surgery, identifying and characterizing subgroups with more severe depressive symptoms may have prognostic utility for understanding post-surgical weight loss. This study sought to characterize patterns of change in depressive symptoms and evaluate associations with weight loss in the seven years following bariatric surgery. MethodsParticipants were 2308 patients who underwent bariatric surgery as part of the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study. Depressive symptoms (measured by the Beck Depression Inventory) and weight were assessed annually following surgery. ResultsA group-based trajectory model identified six subgroups that evidenced distinct patterns of change in depressive symptoms, with the majority (87.0%) exhibiting stable low to average levels. Generalized linear mixed models indicated trajectory groups differed in percent total weight loss (%TWL), with trajectories characterized by initial decreases in depressive symptoms over the first two years (5.2% of participants) experiencing the highest %TWL (20.7% vs. 14.9–18.4% in the other trajectories at 7 years). ConclusionsFindings demonstrate meaningful heterogeneity in the pattern of changes in depressive symptoms after surgery. While most patients experience relatively low stable levels of depressive symptoms, those who have initial symptom improvement demonstrate the greatest magnitude of weight loss. Further research is necessary to explore the directionality of this association and the time-varying mechanisms by which depression and weight may mutually influence each other.

Effects of gradual weight loss v. rapid weight loss on body composition and RMR: a systematic review and meta-analysis.

This systematic review and meta-analysis compared the effects of different rates of weight loss (WL), but equivalent total WL, on body composition and RMR. Studies examining gradual v. rapid WL on body composition and RMR in participants with overweight/obesity published up to October 2019 were identified through PubMed, the Cochrane Library, Web of Science, Embase, Scopus and Ovid databases. Meta-analysis was carried out using a fixed or random effects model as appropriate. Although the magnitude of WL was similar (mean difference 0·03 kg, 95 % CI –0·65, 0·71), gradual WL promoted greater reductions in fat mass (FM) (–1 kg, 95 % CI –1·70, –0·29) and body fat percentage (BFP) (–0·83 %, 95 % CI –1·49, –0·17). Gradual WL significantly preserved RMR compared with rapid WL (407·48 kJ, 95 % CI 76·76, 118·01). However, there was no significant difference in waist and hip circumferences, waist:hip ratio and fat-free mass (FFM) between gradual and rapid WL. The present systematic review and meta-analysis indicates beneficial effects of gradual WL, as compared with rapid WL, on FM, BFP and RMR in individuals with overweight/obesity. However, FFM changes and anthropometric indices did not significantly differ following different rates of WL.

Changes in DNA Methylation and Gene Expression of Insulin and Obesity-Related Gene PIK3R1 after Roux-en-Y Gastric Bypass.

Weight regulation and the magnitude of weight loss after a Roux-en-Y gastric bypass (RYGB) can be genetically determined. DNA methylation patterns and the expression of some genes can be altered after weight loss interventions, including RYGB. The present study aimed to evaluate how the gene expression and DNA methylation of PIK3R1, an obesity and insulin-related gene, change after RYGB. Blood samples were obtained from 13 women (35.9 ± 9.2 years) with severe obesity before and six months after surgical procedure. Whole blood transcriptome and epigenomic patterns were assessed by microarray-based, genome-wide technologies. A total of 1966 differentially expressed genes were identified in the pre- and postoperative periods of RYGB. From these, we observed that genes involved in obesity and insulin pathways were upregulated after surgery. Then, the PIK3R1 gene was selected for further RT-qPCR analysis and cytosine-guanine nucleotide (CpG) sites methylation evaluation. We observed that the PI3KR1 gene was upregulated, and six DNA methylation CpG sites were differently methylated after bariatric surgery. In conclusion, we found that RYGB upregulates genes involved in obesity and insulin pathways.

Dairy Consumption and Cardiometabolic Risk Factors in Patients with Type 2 Diabetes and Overweight or Obesity during Intensive Multidisciplinary Weight Management: A Prospective Observational Study.

Dairy products are integral parts of healthy diets; however, their association with cardiometabolic (CM) health among patients with type 2 diabetes (T2D) undergoing weight management is debated. We examined the relationship between dairy consumption and CM biomarkers in 45 subjects with T2D and obesity (mean age 56 ± 9 yrs, 40% female) enrolled in a 12-week intensive multidisciplinary weight management (IMWM) program. After the IMWM program (intervention phase), subjects were followed for 12 weeks (maintenance phase). We stratified subjects based on initial average dairy consumption into infrequent (IFR), less-frequent (LFR), and frequent (FR) consumers. Outcomes were assessed at baseline, 12, and 24 weeks. There were no differences between tertiles at baseline except for higher total energy intake among FR compared with IFR. HbA1c changes showed no association with dairy consumption at 12 or 24 weeks. FR Females achieved greater weight loss at 12 weeks compared with IFR peers (−4.5 kg; 95%CI: −5.5, −3.5). There was a trend towards lower HDL-C with increasing dairy consumption during the intervention phase. In subjects with T2D and overweight or obesity, dairy consumption during weight management is not associated with HbA1c changes but with lower HDL-C and with higher magnitude of weight loss among females.

Advising Based on Self-Experimentation Assignments Increases the Magnitude of Weight Loss

Abstract Objectives Individualized Diet Improvement Program (iDip) has been developed for a sustainable diet for weight management through self-experimentation with emphasis on increasing protein and fiber and reducing caloric intake. Upon a successful feasibility test with the first study completed in 2018 (iDip 1), we hypothesized that assigning homework and advising based on response would improve weight loss along with the dietary changes. Methods Thirty adults (BMI &amp;gt;25 kg/m2) were enrolled in a 2-year study (iDip 2). The study comprised of 22 dietary sessions over 12 months, identical to iDip 1. Participants were assigned to complete a self-experimentation homework after each session and received advising based on responses. As visual feedback, weekly weight charts and dietary analyses in the form of Protein-Fiber (PF) plot were offered. Daily weights, body composition, waist circumference were collected and 24-hour dietary records were obtained. Results Six participants dropped out, leaving 24 participants (80%). Mean body weight change (n = 24) in iDip 2 at 8 months was −6.2 ± 1.5% while mean body weight change (n = 12) in iDip 1 was −5.2 ± 1.1%. Nine out of 24 participants (38%) achieved clinically meaningful weight loss (&amp;gt;5% of initial body weight) with a mean body weight change of −12.9% ± 2.8. The magnitude of weight loss of the successful group in iDip 2 was significantly greater (P &amp;lt; 0.05) than that of the successful group in iDip 1 where 5 out of 12 participants (42%) achieved &amp;gt;5% weight loss (mean body weight change: −8.9 ± 1.3%). Skeletal muscle mass was well-maintained with a mean change (n = 18) of −0.7 ± 0.2% at 6 months. Waist circumference (n = 18) was significantly decreased (P &amp;lt; 0.05) from baseline by −6.5 ± 1.3 cm. 24-hr records showed improvements in protein and fiber intake throughout the study. Although no significant differences were found in protein and fiber intake between two studies, higher mean protein and fiber intake were observed at 6 months in iDip 2. Conclusions Self-experimentation assignments followed by individualized feedback significantly increased the magnitude of weight loss over the previous study with protein intake to maintain skeletal muscle mass as evidenced by its minimal loss. The success rate of participants achieving &amp;gt;5% weight loss did not improve in this study. Funding Sources USDA NIFA ILLU-698–908; NIBIB NIH (CA).

Identifying the Factors That Hinder Sustainable Dietary Modification and Successful Weight Loss in Obese Adult

Abstract Objectives The Individualized Diet Improvement Program (iDip) is a year-long, group session-based weight loss program to help participants experiment and discover a sustainable dietary modification. We observed a large difference among participants in weight loss success. The objective is to identify factors that explain the difference in weight loss magnitude among participants. Methods 30 participants (25–70y) enrolled in an ongoing iDip study. A self-reflection survey was designed and administrated at eight months to determine the factors that could account for the differential weight loss outcome. The survey consisted of 19 dietary implementation statements and 19 behavior change statements. A degree of dietary implementation was scored from 0 (Have not tried) to 3 (Well implemented). Difficulty in a behavior change was scored from 0 (Strongly agree) to 4 (Strongly disagree). The survey scores were compared between top and bottom tertile groups in weight loss success. Two-tailed t-test was used for statistical analysis. Results 21 out of 24 remaining participants returned the survey. Mean weight loss of the top, middle, and bottom tertiles (n = 7 each) was −14.8 ± 2.9, −5.2 ± 0.6 and −1.3 ± 0.6 kg (mean ± SEM) at eight months, respectively. The sum of dietary implementation statement scores in the bottom tertile group (14.5 ± 1.2) was significantly lower (P &amp;lt; 0.05) than that of the top tertile group (17.7 ± 1.1). The score of the bottom tertile group was also significantly lower than that of the top tertile group in the following statements: exchanging protein sources for leaner options (2.00 vs.2.86), selecting higher protein and fiber density foods (1.71 vs. 2.43), making meals high in protein and fiber (1.57 vs. 2.29), and finding staple food high in protein and fiber (1.86 vs.2.57). No difference was observed in the sum of behavioral statement scores between the two groups. Only one statement, “it is demotivating when seeing others losing weight”, was found significant among individual behavioral statements (bottom and top tertile groups, 3.1 and 3.7, respectively. Conclusions The survey indicates that the main obstacles to successful weight loss are difficulty in establishing meal routine and selecting foods high in protein and fiber per energy. In addition, lack of success in weight loss is likely to decrease motivation. Funding Sources USDA NIFA; NIBIB NIH (CA).

Influence of magnitude of weight loss on Adipo/lep ratio in adolescents with obesity undergoing multicomponent therapy

Background and aimsThe expansion of adipose tissue increases leptin secretion associated with a reduction of adiponectin concentration, which negatively affects health of adolescents with obesity. This study aims to investigate the effects of non-intensive interdisciplinary therapy on cardiometabolic parameters including leptin, adiponectin and adiponectin/leptin ratio as a dependent manner on its magnitude of weight loss reduction. Methods and resultsThirty-eight adolescents (14–19 y.o) were enrolled in an interdisciplinary therapy for 20 weeks. Body composition, biochemical parameters, leptin and adiponectin were measured at baseline and after therapy. The adolescents were divided into two groups according to the magnitude of total weight loss, less than 5% (<5%-n = 18) or greater than or equal to 5% (≥5%-n = 20). Leptin decreased in whole group after therapy, while adiponectin, and adiponectin/leptin ratio increased. Additionally, body composition was improved. Only the group who lost ≥5% of body weight could reduce the inflammatory state. ConclusionThe interdisciplinary therapy contributes to improve cardiometabolic parameters that could be involved on inflammation in adolescents with obesity, this improvement occurred mainly when the weight loss is ≥5% of body weight. It could be a target for control the inflammatory process related to obesity in adolescents.

Oxidative stress does not influence weight loss induced by aerobic training in adults: randomized clinical trials.

High levels of oxidative stress promote degradation of the cell membrane impairing cellular function in fat oxidation. However, the influence of oxidative stress on exercise-induced weight-loss has not yet been investigated. Therefore, the aim of this study was to verify the influence of a lipidic peroxidation marker (malondialdehyde, MDA) and antioxidant status (total antioxidant capacity marker, TAC) on the magnitude of weight-loss by aerobic-induced exercise in previously sedentary overweight or obese individuals. Seventy-five physically inactive adults were randomized into experimental (N.=58) and control (N.=17) groups, who engaged in a 12-week program of aerobic training walking and/or running (3 to 5 days/week) or stretching (1 day/week), respectively. Body composition (DXA), aerobic capacity (ergospirometric) and blood collections for oxidative stress analysis (MDA and TAC) were determined before and after the experimental protocol. Two-way ANOVA for repeated measures or Friedman's test were used to evaluate differences in time/group interaction. Pearson correlation was used to verify the relationship between the variables of oxidative stress and of body composition. Significant reduction was found in fat body mass of experimental when compared to control group (-1.3±1.9 kg versus -0.3±1.3, P=0.04). Experimental group also altered significantly the total body mass (-1.2±4.7 kg; effect size 0.44), body mass index - BMI (-0.3±1.1 effect size 0.37), fat percentage (1.3±1.6%; effect size 0.50) and lean body mass (0.6±1.5 kg; effect size 0.32).There was increase in MDA of 2.3 μmol/L to 2.7 μmol/L (P=0.00), without changes to TAC (25.6±13.9% to 28.0±10.4%). No correlation was found between these variations in body composition with either the initial values of MDA and TAC or delta variation of these indicators of oxidative stress in response to the training program. Indicators of oxidative stress (MDA and TAC) does not influence the magnitude of weight-loss induced by aerobic training.

Weight Change and Its Association with Cardiometabolic Risk Markers in Overweight and Obese Women.

Objectives To examine the association of weight loss magnitude with changes in cardiometabolic risk markers in overweight and obese women from low socioeconomic areas engaged in a lifestyle intervention. Methods Analyses were performed on 243 women (mean body mass index 31.27 ± 4.14 kg/m2) who completed a 12-month lifestyle intervention in low socioeconomic communities in Klang Valley, Malaysia. Analysis of covariance (ANCOVA) was used to compare changes of cardiometabolic risk factors across weight change categories (2% gain, ±2% maintain, >2 to <5% loss, and 5 to 20% loss) within intervention and control group. Results A graded association for changes in waist circumference, fasting insulin, and total cholesterol (p=0.002, for all variables) across the weight change categories were observed within the intervention group at six months postintervention. Participants who lost 5 to 20% of weight had the greatest improvements in those risk markers (−5.67 cm CI: −7.98 to −3.36, −4.27 μU/mL CI: −7.35, −1.19, and −0.59 mmol/L CI: −.99, −0.19, respectively) compared to those who did not. Those who lost >2% to <5% weight reduced more waist circumference (−4.24 cm CI: −5.44 to −3.04) and fasting insulin (−0.36 μU/mL CI: −1.95 to 1.24) than those who maintained or gained weight. No significant association was detected in changes of risk markers across the weight change categories within the control group except for waist circumference and adiponectin. Conclusion Weight loss of >2 to <5% obtained through lifestyle intervention may represent a reasonable initial weight loss target for women in the low socioeconomic community as it led to improvements in selected risk markers, particularly of diabetes risk.

The effect of stoma size on the mid-term weight loss outcome of one anastomosis gastric bypass (OAGB): a single-blinded prospective randomized trial.

One anastomosis gastric bypass (OAGB) is gaining wide spread acceptance among bariatric surgeons all over the world because of its technical simplicity and documented efficacy. However, the relation between stoma size in OAGB and magnitude of weight loss has not been addressed. To evaluate the effect of stoma size on the mid-term weight loss outcome for patients with obesity after OAGB. University Hospital. This is a single-blinded prospectively randomized trial. From March 2014 to September 2016, 83 patients, eligible for bariatric surgery, were included in the study. OAGB was carried out with the same technical steps, except for the size of the gastrojejunostomy (GJ). Patients were randomly allocated into two equal groups; narrow GJ group (30mm) and wide GJ group (45mm). The percentage of total weight loss (%TWL) and the percentage of excess weight loss (%EWL) were recorded at 6, 12 and 24months after procedure. At 6months follow-up, patients with 30mm GJ had better %EWL (53.3) and %TWL (23.4) than other patients with 45mm GJ (42.6 and 18.2 respectively). However, at 12 and 24months the %TWL and %EWL difference between the two groups have disappeared. Patients with narrower stoma size (30mm) of OAGB tend initially to lose more weight than patients with wider stoma (45mm). However, this difference disappears at mid-term follow-up after 2years.