Percentage Change In Body Weight Research Articles

Effectiveness of a Total Meal Replacement Program (OPTIFAST Program) on Weight Loss: Results from the OPTIWIN Study.

ObjectiveThe aim of this study was to test the effectiveness of the OPTIFAST program (OP), a total meal replacement dietary intervention, compared with a food‐based (FB) dietary plan for weight loss.MethodsParticipants with BMI 30 to 55 kg/m2, age 18 to 70 years old, were randomized to OP or FB dietary and lifestyle interventions for 26 weeks, followed by a weight‐maintenance phase. Outcomes were percent change in body weight (%WL) from baseline to weeks 26 and 52, associated changes in body composition (using dual energy x‐ray absorptiometry), and adverse events. Primary analysis used repeated‐measures multivariable linear mixed models to compare outcomes between groups in a modified intention‐to‐treat fashion (mITT).ResultsA total of 273 participants (83% of randomized; 135 OP, 138 FB) made up the mITT population. Mean age was 47.1 ± 11.2 years; 82% were female and 71% non‐Hispanic white. Baseline BMI was 38.8 ± 5.9 kg/m2. At 26 weeks, OP %WL was 12.4% ± 0.6% versus 6.0% ± 0.6% in FB (P < 0.001). At 52 weeks, OP %WL was 10.5% ± 0.6% versus 5.5% ± 0.6% in FB (P < 0.001). Fat mass loss was greater for OP; lean mass loss was proportional to total weight loss. There was no difference in serious adverse event rates between groups.ConclusionsCompared with an FB approach, OP was more effective with greater sustained weight loss.

Abstract 17193: Effect of Long Term Canagliflozin Use on Body Weight and Blood Pressure: A Systematic Review and Meta-Analysis

Introduction: Although Canagliflozin, an FDA-approved sodium-glucose cotransporter 2 inhibitor (SGLT2i), is known to reduce body weight and blood pressure (BP) in the short-term, it is unclear whether this effect persists in the long-term. Furthermore, it remains uncertain whether the reduction in BP and body weight is dose-dependent. Objective: To conduct a meta-analysis to study the effects of long term Canagliflozin use on BP and body weight in type 2 diabetes mellitus (T2DM) patients and stratify the results by dosage. Methods: MEDLINE and Scopus were queried in May 2018 for randomized controlled trials (RCTs) of Canagliflozin that had a follow-up period of at least one year and reported change in BP and percentage change in body weight. Data from included studies were pooled using a random effects model and results were presented as weighted mean differences (WMDs) with 95% confidence intervals (CIs). Subgroup analysis according to dosage (100mg/300mg) was performed. Chi-squared test was conducted to test for subgroup differences. Results: Five RCTs (N=15,230 participants) were included in the final analysis. Canagliflozin also led to significant reduction in body weight when compared to controls (WMD: -3.32% [-4.04, -2.60]; p&lt;0.001); however, this effect was not found to be dose-dependent (p=0.76). Both systolic (WMD: -4.40 mmHg [-5.18, -3.62]; p&lt;0.001) and diastolic (WMD: -1.68 mmHg [-2.14, -1.23]; p&lt;0.001) BP were significantly lower with long-term canagliflozin use, when compared to placebo (Figure 1). This effect was significantly stronger in the 300mg subgroup, when compared to the 100mg subgroup for both systolic (p=0.02) and diastolic (p=0.01) BP. There was no significant change in the risk of hypotension with the use of canagliflozin (Odds ratio: 1.59 [0.80, 3.19]; p=0.19). Conclusion: Long-term Canagliflozin is associated with reduced body weight and may be one mechanism for the beneficial BP response observed . Favorable changes in body weight and BP may be responsible for improved cardiovascular outcomes in T2DM patients with Canagliflozin.

PSY10 - Real-World Clinical Effectiveness of Liraglutide 3.0 mg for Weight Management in Canada

Real-world clinical effectiveness of liraglutide 3.0 mg, in combination with diet and exercise, was investigated at 4 and 6 months post-initiation. Changes in absolute and percent body weight, and in cardiometabolic markers, were examined from baseline. Using a database of de-identified electronic medical records from 6 Canadian weight management clinics, a cohort of liraglutide 3.0 mg initiators during 2015-2016 was identified. Post-initiation values at 4 and 6 months were compared to respective baseline values using a paired t-test. The full cohort consisted of 311 subjects, with 210 subjects in the ≥4months and 167 subjects in the ≥6months persistence groups. For all subjects, average age was 49.7 and subjects were predominantly white (77.5%) and female (83.0%). Average BMI was 40.7 kg/m2, and weight was 114.8 kg. At baseline, 74.9%, 19.9% and 5.1% of subjects had normoglycemia, prediabetes, and diabetes, respectively. Average baseline values for HbA1c and blood pressure were 5.8% and 127/77 mmHg. There was a significant change in body weight 6 months after initiation of treatment in persistent subjects (≥6months: -8.1 kg, p<0.001). Weight loss was also significant for subjects persistent on treatment for ≥4months (-6.9 kg, p<0.001) and in all subjects, regardless of persistence (-7.5 kg, p-value<0.001). Percentage change in body weight from baseline for the ≥6months group was -7.1%, with 63.4% and 35.2% of subjects having lost ≥5% and >10% body weight, respectively. Overall percentage change in body weight was also observed in the ≥4months group (-6.2%) and in all subjects (-6.6%). For the ≥6months treatment group, there was a statistically significant change in HbA1c (-0.35%, p<0.001) and SBP (-3.0 mmHg, p<0.01), but not DBP (0.1 mmHg, p=0.90). In a real-world setting, liraglutide 3.0 mg, when combined with diet and exercise, was associated with clinically meaningful weight loss and with improvements in cardiometabolic markers.

Risk Factors for Weight Loss 1 Year After Esophagectomy and Gastric Pull-up for Esophageal Cancer

BackgroundLoss of body weight is regarded as a marker of malnutrition after esophagectomy. This study investigated changes in body weight and risk factors for weight loss after esophagectomy for esophageal cancer. MethodsWe retrospectively reviewed records of 181 patients who underwent esophagectomy and gastric pull-up from 2012 to June 2016. Patients with operative mortality and recurrences were excluded. Percent change in body weight was defined as change in body weight (%)=(1-year body weight−preoperative body weight)×100/preoperative body weight. ResultsMean age of patients was 62.98±8.23 years with 164 men (90.6%). Mean preoperative body weight was 63.12±9.42 kg, and body weight at 1 year was 56.04±8.59 kg. Mean change in body weight was −10.95±7.50%, and 98 (54.1%) patients showed weight loss more than 10% compared to initial body weight. Univariable analysis showed that initial body weight, narrow gastric tube, thoracotomy, laparotomy, and postoperative vocal cord palsy (VCP) were related to more than 10% weight loss. Multivariable analysis showed that initial body weight (odds ratio [OR]=1.041, p=0.031) and postoperative VCP (OR=2.772, p=0.025) were adverse risk factors for weight loss 1 year after esophagectomy, whereas conduit type, route of reconstruction, postoperative complications, anastomotic complications, minimally invasive esophagectomy, and adjuvant therapy were not. ConclusionsInitial body weight and postoperative VCP were related to weight loss. Patients with VCP need additional nutritional monitoring and support.

S226. A STUDY COMPARING WEIGHT GAIN FROM ALKS 3831 TO OLANZAPINE IN EARLY-ILLNESS YOUNG ADULTS WITH SCHIZOPHRENIFORM, SCHIZOPHRENIA, OR BIPOLAR I DISORDER

BackgroundOptimal pharmacological efficacy is crucial in first-episode and early-episode schizophrenia and bipolar I disorder. Olanzapine (OLZ) is a highly efficacious antipsychotic indicated for the treatment of schizophrenia and bipolar I disorder. However, the clinical utility of OLZ may be limited by a propensity to cause significant weight gain and increased metabolic side effects, especially for patients early in the course of their illness. ALKS 3831 is composed of a flexible dose of olanzapine (OLZ) and a fixed dose of 10 mg of samidorphan (SAM), formulated as a bilayer tablet. ALKS 3831 has been shown in Phase 1 and Phase 2 studies to result in significantly less weight gain than OLZ while delivering equivalent antipsychotic efficacy. This Phase 3, 12-week study, is designed to evaluate the effect of ALKS 3831 on body weight in young adults early in the course of diagnosis of a serious mental illness, including a schizophreniform, schizophrenia, or bipolar I disorder diagnosis.MethodsThis is an international (Austria, Germany, Ireland, Israel, Italy, Poland, Spain, UK, and USA) two-arm, double-blind, active-comparator–controlled, multicentre study (planned N=250) that started enrollment in 2017. Key inclusion criteria are a primary diagnosis of schizophreniform disorder, schizophrenia, or bipolar I disorder; a body-mass index (BMI) of ≥18.0 and ≤27.0 kg/m2; and meeting specific criteria for duration of illness and prior antipsychotic exposure. Patients with a bipolar I diagnosis must be in the manic phase. In the US sites, men and women must be aged ≥16 to <40 years at screening, and in Europe, aged ≥18 to <40 years. Exclusion criteria include diagnosis of additional psychiatric conditions and use of prohibited drugs.ResultsPatients will be randomised 1:1 to receive either OLZ or ALKS 3831 treatment for 12 weeks. ALKS 3831 (OLZ + SAM) and matched OLZ + placebo (OLZ + PBO) will be provided as bilayer tablets to be taken by mouth once daily and doses will include ALKS 3831 (OLZ/SAM) 5/10 mg, 10/10 mg, 15/10 mg, 20/10 mg, or (OLZ/PBO) 5 mg, 10 mg, 15 mg, or 20 mg. The primary endpoint will be percent change in body weight from baseline to Week 12. Secondary and exploratory endpoints will include the proportion of patients who gain ≥7% and ≥10% of baseline body weight, metabolic parameters (change in fasting lipids and glucose), body composition measured through bioimpedance, clinical global impression, and safety, pharmacokinetic, and pharmacodynamic parameters. Patients will be offered a supportive clinical care programme during the 12-week treatment period, and also receive a daily medication-adherence monitoring and reminder system (via smartphones).DiscussionPatients who complete the study will have the option to participate in an open-label 2-year extension of ALKS 3831 (based on clinician and patient decision).EudraCT number: 2017-000497-11; ClinicalTrials.gov identifier: NCT03187769

Quantification of Biological Responses as Predictors of Cognitive Outcome after Developmental TBI.

Successful translational studies within the field of Traumatic Brain Injury (TBI) are concerned with determining reliable markers of injury outcome at chronic time points. Determination of injury severity following Fluid Percussion Injury (FPI) has long been limited to the measured atmospheric pressure associated with the delivered pulse. Duration of unresponsiveness to toe pinch (unconsciousness) was next introduced as an extra marker of injury severity. The current study is an effort to assess the utilization of acute injury-induced biological responses (duration of toe pinch unresponsiveness, percent body weight change, quantification of brain edema, and apnea duration) to predict cognitive performance at a subacute time point following developmental brain injury. Cognitive performance, when measured at a subacute phase, after developmental FPI was negatively correlated with the following variables, duration of toe pinch unresponsiveness, percent weight change, and quantified level of brain edema. These finding suggest the potential utilization of reliable severity assessment of injury-induced biological responses in determining outcome measures at subacute time points.

Effectiveness of an Interprofessional Glycemic Optimization Clinic on Preoperative Glycated Hemoglobin Levels for Adult Patients With Type 2 Diabetes Undergoing Bariatric Surgery.

Bariatric surgery is an effective treatment for patients with type 2 diabetes and refractory obesity; however, many patients have nonoptimal glycemic control preoperatively. We created an interprofessional bariatric glycemic optimization clinic. Patients were seen monthly and received weekly phone calls. We analyzed the effectiveness in assisting patients reach a preoperative glycated hemoglobin (A1C) level of <7.5%. Data were analyzed for the first 75 patients. The primary outcome measure was percentage of patients reaching target A1C levels. Mean age was 51±8.3 years; 64% were women. Mean baseline weight was 134.4±29.2 kg. Baseline body mass index was 48.2±8.3 kg/m2. Duration of diabetes was 9±7.9 years. Baseline A1C level was 9.0±1.2%. Number of antihyperglycemic agents at baseline was 2.7±0.96. Seventy-five percent reached a target A1C level of ≤7.5%, 92% reached a target of ≤8.0% and 95% reached a target of ≤8.5%; 32% had achieved A1C levels ≤7.5% at 1 month, 59% at 2 months, 70% at 3 months, 73% at 4 months and 75% at 5 months. Mean number of antihyperglycemic agents at target A1C levels was 3.6±1.1. Mean absolute decrease in A1C levels from baseline to target A1C levels was 1.7±1.2. Mean absolute change in weight was -1.9±8.0 kg. Percent change in body weight from baseline to target A1C level was -1.3±4.9%. Glycemic optimization for candidates with diabetes for bariatric surgery is possible in a short time by an interprofessional diabetes team and without weight gain. Further research is needed to determine whether better preoperative glycemic control improves bariatric surgery outcomes.

Bisphosphonates prevent age-related weight loss in Japanese postmenopausal women.

Decline of body weight with aging is a major risk factor for frailty, osteoporosis and fracture, suggesting that treatment for osteoporosis may affect body composition. Recently, we have shown that 5-year treatment with raloxifene prevented age-related weight loss, suggesting some other drugs for osteoporosis may also prevent a decrease in body weight with aging. The present study aimed to identify the relationship between bisphosphonate treatment and body composition markers. We measured bone mineral density (BMD), body composition, and bone remodeling markers in 551 Japanese postmenopausal women with bisphosphonate treatment, which included risedronate or alendronate treatment (BP-treatment group; N=193) and without treatment by any osteoporosis drug (no-treatment group; N=358) for 4-7years (mean observation periods; 5.5years) and analyzed the relationship of these with BMD, body mass index (BMI), body weight, and biochemical markers. The mean (SD) age of the participants was 68.6 (9.8)years in the BP-treatment group and 63.7 (10.6)years in the no-treatment group. Percent changes in body weight and BMI were significantly different between the BP-treatment and no-treatment groups (P<0.01 and P<0.01, respectively). In multiple linear regression analysis, bisphosphonate treatment was a significant independent determinant of percent changes in body weight and BMI (P<0.01 and P=0.01, respectively). Long-term use of bisphosphonates prevented reductions in BMI and body weight, usually observed in elderly women. Our results suggest that bisphosphonate treatment not only reduces the risk for incident osteoporotic fractures but also for frailty in the elderly.

Modulation of Human Subcutaneous Adipose Tissue MicroRNA Profile Associated with Changes in Adiposity-Related Parameters.

To analyze the effect of three calorie-restricted diets with different amount and quality of carbohydrates on subcutaneous adipose tissue (SAT) microRNA (miRNA) profile. 6-month parallel, randomized trial conducted on overweight and obese subjects randomized to: 1) low glycemic index diet (LGI), 2) high glycemic index diet (HGI), and 3) low-fat (LF). The genome-wide SAT miRNA profile was assessed in eight randomly selected participants and the most relevant changing miRNAs (n = 13) were validated in 48 subjects. None of the miRNAs showed significant changes between the intervention groups. However, changes in some of them correlated with changes in biochemical and anthropometric variables. Stratifying our population according to tertiles of percentage change in body weight (BW), we observed a significant down-regulation of miR-210 in those subjects in Tertile 1 as compared to Tertile 3. When our population was stratified by tertiles of waist circumference, miR-132, miR-29a, miR-34a, and miR-378 were found to be significantly down-regulated, in T2 compared to T3. Furthermore, when stratified by tertiles of fat mass, we also observed the significant down-regulation of miR-132 in T1. The macronutrient composition of a calorie-restricted diet does not affect the expression of the miRNAs analyzed, while changes in adiposity play a primary regulatory role.

Effect of Weight Gain and Weight Loss on In Vivo Colonocyte Proliferation Rate in People with Obesity.

ObjectiveTo evaluate the effects of diet-induced changes in energy balance and body weight on in vivo colonocyte fractional proliferation rates (FPR) in people with obesity.MethodsIn vivo colonocyte FPR was assessed in 31 men and women with obesity (BMI: 35.4±4.0 kg/m2, age: 52.6±8.9 years) before and after diet-induced weight loss, weight gain, or weight maintenance. Subjects ingested aliquots of 2H2O (heavy water) daily for 4-7 days, followed by flexible sigmoidoscopy with colon biopsies to assess the incorporation of 2H into the DNA of dividing colonocytes.ResultsColonocyte FPR averaged 12.7±3.8 % per day, and correlated directly with adipose tissue (IAAT) volume (r=0.364, P=0.044). Colonocyte FPR decreased in the weight loss group, did not change in the weight maintenance group, and increased in the weight gain group. The change in colonocyte FPR correlated directly with the percent change in body weight (r=0.409, P=0.028) and IAAT volume (r=0.598, P=0.001).ConclusionsA high-calorie diet and weight gain increase, whereas a low-calorie diet and weight loss decrease, in vivo colonocyte proliferation rate in people with obesity. These results suggest that changes in energy balance influence the risk of developing colon cancer in people with obesity by regulating colonic mucosal growth rates.

Influence of previous body mass index and sex on regional fat changes in a weight loss intervention

ABSTRACTObjectives: Men and women may lose weight in a different fashion. This study compares the changes in different anatomical regions after a well-controlled weight loss program by sex and initial BMI.Methods: A total of 180 subjects (48 overweight women, 36 overweight men, and 48 obese women and 48 obese men) were recruited to participate in a 22-week weight loss programme (diet + exercise).Results: Regarding percentage body weight change from baseline, there was no triple interaction (BMI, sex and anatomical region), but there was interaction between BMI and anatomical region (F2,840 = 34.5; p < 0.001), and between sex and anatomical region (F2,840 = 98.8; p < 0.001). Usually, the arms and legs are the regions that lose more weight in obese participants, but men lose the highest percentage of mass from the trunk. There were differences between men and women for the areas of left trunk mass (750g), right trunk mass (700g), total mass of the trunk (1400g), android mass (350g), and finally in the total mass in overweight participants (1300g), with higher values for men than for women. The region that loses more weight and fat is the trunk, followed by the legs, and then the arms, when the loss is observed in function of the total weight or fat lost.Conclusion: Both BMI and sex exert a definite influence fat loss, especially in some anatomical regions.

Effects of long-term consumption of high fructose corn syrup containing peach nectar on body weight gain in sprague dawley rats

High fructose corn syrup (HFCS) is one of the most used sweeteners in the food industry. Health concerns regarding the consumption of HFCS-containing foods have developed in parallel with the increasing amount of people who become overweight. This study was conducted to investigate whether HFCS-containing peach nectar (pn-HFCS) consumption has more detrimental effects on anthropometrical and biochemical parameters compared with sucrose-containing peach nectar (pn-sucrose). Fifty-day-old Sprague Dawley rats were divided into three groups and were fed (A) pn-HFCS + ad libitum chow, (B) pn-sucrose + ad libitum chow and (C) only ad libitum chow for 7 months. The percentage change in body weight (PCBW), body mass index (BMI), and Lee index were calculated, and serum triglyceride, glucose, insulin and leptin concentrations were measured. The PCBW, BMI, Lee index, serum triglyceride, glucose, insulin and leptin concentrations were insignificant among the three groups. We can suggest that peach nectar consumption resulted in more energy intake than the control and since pn-HFCS group consumed more chow than the pn-sucrose group. The results show that long term daily HFCS or sucrose consumption in peach nectar is not associated with weight gain and does not stimulate metabolic changes in Sprague Dawley rats.

Coadministration of Canagliflozin and Phentermine for Weight Management in Overweight and Obese Individuals Without Diabetes: A Randomized Clinical Trial.

To assess the efficacy and safety of coadministration of canagliflozin (CANA) and phentermine (PHEN) compared with placebo (PBO) and CANA or PHEN monotherapies in individuals who were overweight and obese without type 2 diabetes. This 26-week, phase 2a, randomized, double-blind, PBO-controlled, multicenter, parallel-group study enrolled individuals who were obese or overweight without type 2 diabetes (N = 335, aged 18-65 years, BMI ≥30 to <50 kg/m2 or BMI ≥27 to <50 kg/m2 with hypertension and/or dyslipidemia). Participants were randomized (1:1:1:1) to receive PBO, CANA 300 mg, PHEN 15 mg, or coadministration of CANA 300 mg and PHEN 15 mg (CANA/PHEN) orally once daily. The primary end point was percent change in body weight from baseline to week 26; key secondary end points were the proportion of participants achieving weight loss ≥5% and change from baseline in systolic blood pressure. CANA/PHEN provided statistically superior weight loss from baseline versus PBO at week 26 (least squares mean difference -6.9% [95% CI -8.6 to -5.2]; P < 0.001). CANA/PHEN also provided statistically superior achievement of weight loss ≥5% and reduction in systolic blood pressure compared with PBO. CANA/PHEN was generally well tolerated, with a safety and tolerability profile consistent with that of the individual components. CANA/PHEN produced meaningful reductions in body weight and was generally well tolerated in individuals who were overweight or obese without type 2 diabetes. Further studies are warranted to evaluate potential use of this combination for long-term weight management.

The differential effects of high-fat and high-fructose diets on physiology and behavior in male rats

Objectives: The purpose of the current study is to directly compare a diet high in fat with a diet high in fructose. This side-by-side comparison will allow us to determine the physiological and behavioral effects resulting from the consumption of a diet dominated by one macronutrient.Methods: Rats were fed pelletized food containing either 60% fat or 55% fructose diet, or control chow (5.8% kcal of fat, 44.3% kcal carb) for 9 weeks. Animals performed a classic Morris Water Maze (MWM) and a reversal MWM to assess spatial and working memory near the end of the feeding period. At termination, tissue samples were collected including trunk blood, livers, fat pads, and brain punches.Results: Animals maintained on the high-fat diet weighed more by the end of the feeding period, had a higher percent body weight change and had higher fat pad weight than the high-fructose and control group. The high-fructose group had higher serum insulin levels than the high-fat group and higher total triglycerides than control or high-fat groups. Additionally, the high-fructose group entered the target quadrant significantly less than high-fat fed animals in the reverse MWM task.Discussion: These data suggest that fat accumulation and weight gain are influenced by the high-fat component of the Western-style diet. However, insulin resistance and elevated serum triglycerides are impacted more by high levels of fructose in the diet. Comparative data between a high-fat and high-fructose diet in a single study are novel and shed light on two of the individual components of a Western-style diet.

Efficacy of pancreatic exocrine replacement therapy for patients with unresectable pancreatic cancer in a randomized trial

BackgroundWeight loss in pancreatic cancer is associated with maldigestion due to pancreatic duct obstruction. Pancreatic exocrine replacement therapy (PERT) may significantly improve fat and protein absorption. ObjectivesThis prospective, double-blind, randomized, placebo-controlled phase II trial assessed whether PERT could reduce or prevent weight loss in patients with unresectable pancreatic cancer. MethodsSixty seven patients with unresectable pancreatic cancer were randomized to receive enteric coated PERT, consisting of 6–9 capsules of pancreatin (457.7 mg/capsule), or placebo. Patients took two capsules each three times daily during main meals and one capsule each up to three times daily when having between-meal snacks. The primary endpoint was the percentage change in body weight at eight weeks. ResultsThe mean percentage change in body weight (1.49% [1.12 kg] vs. 2.99% [1.63 kg], P = 0.381) and the mean percent change in Patient-Generated Subjective Global Assessment (PG-SGA) score (8.85% vs. 15.69%, p = 0.18) did not differ significantly between the PERT and placebo groups. There was no improvement in quality of life and overall survival did not differ significantly between the PERT and placebo groups (5.84 months vs 8.13 months, p = 0.744). ConclusionsPERT did not reduce weight loss in patients with unresectable pancreatic cancer. Larger randomized trials are needed to identify those patients who may benefit from PERT.Trial registration: ClinicalTrials.gov Number NCT01587534.

One-Year Weight Loss with a Telephone-Based Lifestyle Program

Objective: Telephone-based weight loss programs are offered as an alternative to face-to-face obesity treatments, but data on the effectiveness regarding weight loss are limited. Therefore, we evaluated a telephone-based lifestyle program in a real-world setting. Methods: The telephone-based intervention consists of regular phone calls providing individualized lifestyle recommendations, and delivery of printed materials. Anthropometric and metabolic data are collected by general practitioners or are self-reported. Results: Baseline data were available from 398 participants (61% men; weight 103.12 ± 14.21 kg; BMI 33.38 ± 2.83 kg/m²) and 1-year data from 258 (65%) participants. In the completers, mean weight change was -4.25 ± 5.18 kg (p < 0.001) which corresponds to a mean percentage body weight change of -4.10 ± 4.88%. 87 participants (34%) lost more than 5% of their initial body weight, with 29 (11%) losing more than 10% of their initial body weight. 40 participants (16%) gained weight over this period. A reduction of abdominal girth of -0.59 cm (95% CI 0.34, 0.85 cm; p < 0.001) and total cholesterol of -1.55 mg/dl (95% CI 0.04, 3.05 mg/dl; p = 0.044) per kilogram weight loss was observed. Conclusions: The telephone-based lifestyle program results in a moderate weight loss after 12 months, which may be comparable to face-to-face interventions. Telephone-based weight loss support is independent of time and location and represents a tool which is also accepted by men.

Restoration of gastrointestinal motility ameliorates nutritional deficiencies and body weight loss of patients who undergo laparoscopy-assisted proximal gastrectomy.

Esophagogastrostomy after proximal gastrectomy (PG) is a simple and safe reconstruction, but it leads to a high incidence of reflux esophagitis and impairs postoperative quality of life. We have already reported gastric tube (GT) reconstruction after PG and performed it on more than 100 patients. No studies have reported long-term outcomes after PG-GT. The aim of this study was to investigate long-term outcomes, including nutrition indices, such as body weight, serum albumin, total protein, hemoglobin, and ferritin after PG, and observe recovery of upper gastrointestinal tract motility. We analyzed body weight loss and laboratory findings at our outpatient clinic at 1, 6, 12, 24, 36, 48, and 60months postoperatively. Manometric recording was carried out at 1, 2, 3, 4, and 5years after surgery. The percentage change in body weight in the PG-GT group was significantly larger than that in the PG-JI and TG-RY groups at 2.5, 3, 4, and 5years after surgery. The levels of hemoglobin and ferritin in the PG-GT and PG-JI groups were significantly higher than those in the TG-RY group at all time points except 6months after surgery. In the fasted state, the phase III originated at the gastric tube was propagated to the duodenum 3years after surgery. In the fed state, phasic contractions of the duodenum were in harmony with gastric tube contractions 3years after surgery. PG-GT is the least invasive procedure, and restoration of gastrointestinal motilities in the gastric tube and duodenum may ameliorate body weight loss and nutritional status, including anemia, in patients after PG.

Evaluation of Immunosuppressive Effects of Azathioprine and Cyclophosphamide in CD1® Mice Flow Cytometer

Introduction: Qualitative and quantitative analysis of single cells treated with immunomodulators can be done by FACS. T cells, B cells and NK cells, designated as CD cells, are the immunological biomarkers of various haematological conditions which are attributed to prognosis and diagnosis of related disorders. Azathioprine and Cyclophosphamide are immunosuppressive agents, having different mode of action and classification which are been used clinically. Here, we have compared the dose of Azathioprine and Cyclophosphamide in CD-1® mice through lymhocytes’ enumeration by FACS to compare the potency of immunosuppression. Methods: Randomly divided male and female mice were treated with AZA 20, AZA 50 and CPM 20 for four days, Body weight and feed consumption was taken on day 1 and 5. Collected blood samples were mixed with antibodies. Samples were lysed by lysing solution. Repeated washing and centrifugation yields leucocytes in each tube for estimation. Lymhocytes’ enumeration was performed for CD3, CD4, CD7, CD8, CD16, CD19 and CD45 and percent population of CD markers were evaluated. Results and Conclusion: All the animals were normal throughout treatment. No significant change in body weight, percent body weight change and food consumption was observed. No gross lesions were observed. Total lymhocytes’ counts were decreased. Double negative tregs of CD4and CD8in female mice showed potent immunosuppressive effects and sensitivity towards female gender. Azathioprine was less immunosuppressive than Cyclophosphamide at 20 mg/ kg body weight.

Carbohydrate Intake Affects Weight Loss Related Improvements in Glycemic Control: Results from a Systematic Review and Regression Analysis

ObjectiveWeight loss is shown to improve glucose control and extensive research exists on the effect of carbohydrate (CHO) intake on weight loss. However, whether or not diets varying in CHO content elicit superior improvements in glycemic control when the degree of weight loss is comparable has yet to be systematically investigated.MethodsThis systematic review and regression analysis used randomized controlled trials to assess the effects of different quantities of CHO intake during energy restriction‐induced weight loss or weight maintenance on glycemic control among overweight and obese adults. Carbohydrate intake was categorized as normal (≥45 to ≤65% of total energy intake), low (≥20 to &lt;45% of total energy intake), or restricted (utilization of a ketogenic diet, initial CHO intake &lt;50 g/d). Two researchers independently screened 1882 articles from PubMed, CINAHL, Cochrane, and Scopus databases and 44 articles (with 98 intervention groups) were included in this review. Data extracted from each intervention group included the mean percentage change of body weight and mean change of serum or plasma fasting glucose (mg/dL) and insulin (μU/mL) concentrations. A mixed model ANCOVA (SAS, version 9.3) was performed on changes in glucose or insulin separately, with percent body weight change, CHO intake level (normal, low, or restricted), and their interactions as primary predictors of interest. Other information such as mean baseline body mass index, age, percentage of female subjects, continent of study origin, study duration, and dietary fat and protein intakes were also extracted and included in the model unless multicollinearity existed among the predictors.ResultsThe mean (and range) body weight changes was −5.5% (−13 to 0%), −5.7% (−13.6 to 0.3%), and −8.5% (−12.3 to −5.9%) for the normal CHO (n=48 groups), low CHO (n=40 groups), and restricted CHO (n=10 groups) diet groups, respectively. ANCOVA analyses were only performed using results from the normal and low CHO diets. This was necessary because the range of weight change for the CHO restricted diet groups was less than half of those of the other two groups which would force extrapolation of the regression results. Among all normal and low CHO diet groups, greater energy restriction‐induced weight loss was associated with greater reductions in fasting glucose (β=0.42 mg/dL, p=0.002). Each 1% weight loss predicted a 0.42 mg/dL reduction in glucose. This association was independent of normal versus low CHO intake. The impact of weight loss on changes in insulin was dependent on dietary CHO intake. Each 1% weight loss predicted 0.21 and 0.43 μU/mL reduction of insulin in the normal and low CHO groups, respectively (p=0.04), a difference of 0.22 μU/mL.ConclusionThese findings support that for a given percentage weight loss, consuming low CHO diets predicts a greater reduction in fasting insulin concentration, consistent with improved insulin‐mediated glycemic control.Support or Funding InformationUSDA‐NIFA #2011‐38420‐20038 (WWC)

Reliability of body size measurements obtained at autopsy: impact on the pathologic assessment of the heart.

Purpose Assessment of body size at autopsy is important for interpreting organ weight measurements and in some cases body identification. The reliability of post-mortem body size measurements, the causes for perturbations in these measurements from their corresponding pre-mortem values, and the impact of such perturbations on heart weight interpretation have not been fully explored. Methods Autopsy body length and weight measurements and pre-mortem height and body weight measurements were compared in 132 autopsies. Clinical records were evaluated for peripheral edema and serum albumin levels. Causes of death, body cavity fluid collections, and heart weights were obtained from the autopsy reports. A subset of patients underwent quantitative post-mortem computed tomography assessment of anasarca. Results At autopsy, body weight differed from the pre-mortem value by 11±1%, compared with -0.2±0.3% for body length (P<0.0001). The percent change in body weight at autopsy correlated with the presence of peripheral edema (14±2% vs. 7±2%, P=0.01), serum albumin<3.0g/dL (16±2% vs. 7±2%, P=0.001), and the degree of anasarca (P=0.01). In 4% of autopsies, heart weights were abnormal based on the pre-mortem body weight, but would be classified as normal based on the elevated post-mortem body weight. Conclusions At autopsy, body weight is a less reliable parameter than body length in correlating with the corresponding pre-mortem measurement. Autopsy body weights are elevated in part due to peripheral edema/anasarca. Alterations in body weight at autopsy can confound the interpretation of organ weight measurements.