Prevent Weight Gain Research Articles

Effects of Therapeutic Alliance in Interpersonal Psychotherapy Among Adolescent Girls With Loss-of-Control Eating.

Interpersonal psychotherapy (IPT) has been proposed for prevention of excess weight gain among adolescents with loss-of-control (LOC) eating. Mixed findings from a trial testing this conjecture warrant elucidation of potential outcome predictors. The therapeutic alliance (adolescent-facilitator emotional bond and task collaboration) may be important for IPT but has received little attention in weight-related interventions. This study evaluated associations of adolescent-reported therapeutic alliance during IPT with weight- and eating-related outcomes. Secondary analyses of a randomized controlled trial were conducted to compare group IPT to health education (HE) for preventing excess weight gain among 113 girls (ages 12-17) with body mass index (BMI) at the 75th to 97th percentile and LOC eating. BMI and LOC eating were measured at baseline, 12 weeks (postintervention), and 1 year. Multilevel modeling was used to test associations between change in therapeutic alliance (from session 1 to session 12) and changes in weight- and eating-related outcomes (from postintervention to 1 year). Analyses were controlled for therapeutic alliance after session 1 and for baseline and postintervention outcome values; group assignment (IPT vs. HE) was a moderator. Increases in emotional bond were associated with decreased weight and with greater decreases in number of LOC eating episodes at 1 year in the IPT group (p<0.05) and with weight gain in the HE group (p<0.05). Greater task collaboration was related to greater weight gain at 1-year follow-up, regardless of group assignment (p<0.05). The association of therapeutic alliance during IPT with weight and LOC eating outcomes among adolescent girls merits further investigation.

The evolution of nutritional care in children and young people with acute lymphoblastic leukaemia: a narrative review.

Acute lymphoblastic leukaemia (ALL) is the most common paediatric malignancy in the world. Advances in treatment protocols have resulted in survival rates of >80% in most high-income countries (HIC); however, children and young people (CYP) with ALL continue to face significant nutrition-related challenges during treatment. This narrative review outlines the changing landscape of treatment and survivorship for CYP with ALL and the advances in nutrition knowledge that call for changes to clinical nutrition practice. The incidence of ALL has remained stable in HIC; however, there have been significant advances in survival over the past 30 years. Overweight and obesity are increasingly prevalent in CYP with ALL at diagnosis, during treatment and in survivorship. Coupled with poor diet quality, high-energy and saturated fat intakes, altered eating behaviours and inactivity, this necessitates the need for a shift in nutrition intervention. Undernutrition remains a concern for CYP with high-risk treatment protocols where oral or enteral nutrition support remains a cornerstone of maintaining nutrition status. With improved treatment protocols and high survival rates, a shift to focusing on diet quality, prevention of excessive weight gain and obesity during treatment and survivorship is necessary.

Impact of changes in commuting mode on body weight among Japanese workers: a longitudinal study.

The health benefits of active commuting have been reported. However, few studies have assessed commuting modes using objective methods. This study clarified the association between changes in objectively measured commuting modes and body weight among Japanese workers. This longitudinal study used data from the annual health examinations and personnel records of a company with branches in all prefectures of Japan. Data from 2018 and 2019 were used as the baseline and follow-up data, respectively. The commuting mode was assessed using the commuting mode code included in the personnel records and classified into three types: walking, public transport, and car or motorcycle. The participants were classified into nine categories based on the combination of their commuting modes in 2018 and 2019. Body weight was measured objectively during health examinations. The 1-year changes in body weight were calculated for the nine categories and assessed using an analysis of covariance with adjustments for covariates. The analysis included 6,551 workers (men: 86.8%; mean age: 42.8 years). Overall, body weights tended to increase (+0.40 kg/year). The participants who switched to more active commuting, such as from car or motorcycle to walking (-0.13 kg/year), from car or motorcycle to public transport (+0.10 kg/year), and from public transport to walking (-0.07 kg/year), exhibited small weight gains or losses. A similar trend was observed even after adjustment. Changing to a more active commuting mode may prevent weight gain among workers.

Preventive effects of a nutraceutical mixture of berberine, citrus and apple extracts on metabolic disturbances in Zucker fatty rats.

The prevention of obesity represents a major health and socio-economic challenge. Nutraceuticals are regularly highlighted for their beneficial effects in preventing the metabolic disturbances associated with obesity. However, few studies have described the combined action of nutraceutical mixtures combining polyphenols with alkaloids. The aim of this study was to evaluate the effects of long-term dietary supplementation with a mixture of Berberine, Citrus and Apple extracts (BCA) in the primary prevention of obesity and its metabolic and vascular complications in the obese Zucker rat, a spontaneous model of genetic obesity and insulin resistance. Sixteen 8-week-old obese Zucker male rats were randomly divided into two groups: all rats received oral gavage daily either with water, untreated obese (U-ObZ) or BCA (BCA-ObZ) mixture for thirteen weeks. Morphological and metabolic parameters were measured along the study. Cumulative concentration-response curves to insulin, acetylcholine and phenylephrine were determined on isolated thoracic aorta. Colon permeability measurements were performed using the Ussing chamber technique. Fecal samples collected at the beginning and the end of the protocol were used as a template for amplification of the V3-V4 region of the 16S rDNA genes. BCA supplementation reduced weight gain (p<0.05) and food intake (p<0.05) in the BCA-ObZ group rats compared to the U-ObZ group rats. It also improved glucose tolerance (p<0.001) and decreased fasting insulin and Homeostasis model assessment index (p<0.05). Through ex vivo experiments, the BCA mixture enhanced significantly aortic insulin relaxation (p<0.01), reduced α1-adrenoceptor-mediated vasoconstriction (p<0.01), and decreased distal colon permeability. Moreover, short-chain fatty acid producers such as Bacteroides, Blautia, and Akkermansia were found to be increased by the BCA mixture supplementation. The results showed that a 13-week-supplementation with BCA mixture prevented weight gain and improved glucose metabolism in obese Zucker rats. We also demonstrated that BCA supplementation improved vascular function, colonic barrier permeability and gut microbiota profile.

Glucosinolate extract from radish (Raphanus sativus L.) seed attenuates high-fat diet-induced obesity: insights into gut microbiota and fecal metabolites.

Radish seed is a functional food with many beneficial health effects. Glucosinolates are characteristic components in radish seed that can be transformed into bioactive isothiocyanates by gut microbiota. The present study aims to assess anti-obesity efficacy of radish seed glucosinolates (RSGs) and explored the underlying mechanisms with a focus on gut microbiota and fecal metabolome. High-fat diet-induced obese mice were supplemented with different doses of RSGs extract for 8 weeks. Changes in body weight, serum lipid, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels; and pathological changes in the liver and adipose tissue were examined. Fecal metabolome and 16S rRNA gene sequencing were used to analyze alterations in fecal metabolite abundance and the gut microbiota, respectively. Results showed that RSG extract prevented weight gain and decreased serum lipid, ALT, AST levels and lipid deposition in liver and epididymal adipocytes in obese mice. Treatment with RSG extract also increased gut microbiota diversity and altered the dominant bacteria genera in the gut microbiota, decreasing the abundance of Faecalibaculum and increasing the abundance of Allobaculum, Romboutsia, Turicibacter, and Akkermansia. Fecal metabolome results identified 570 differentially abundant metabolites, of which glucosinolate degradation products, such as sulforaphene and 7-methylsulfinylheptyl isothiocyanate, were significantly upregulated after RSG extract intervention. Furthermore, enrichment analysis of metabolic pathways showed that the anti-obesity effects of RSG extract may be mediated by alterations in bile secretion, fat digestion and absorption, and biosynthesis of plant secondary metabolites. Overall, RSG extract can inhibit the development of obesity, and the obesity-alleviating effects of RSG are related to alternative regulation of the gut microbiota and glucosinolate metabolites.

Weight Change at 12 Months among Hormonal Contraceptive Users at Nur Sejahtera Clinics of National Population and Family Development Board (LPPKN): A Retrospective Study

Introduction: Weight gain was among the most common side effects that caused women to discontinue using hormonal contraception. However, previous literature had reported inconsistent findings of the association between hormonal contraception and weight change. This study aimed to determine the impact of hormonal contraceptive use on weight gain and factors associated with weight gain among the hormonal contraceptive users. Methods: A retrospective cohort study was conducted in four Nur Sejahtera Clinics using universal sampling method between September to November 2021. This study recruited women that had been using the hormonal contraception continuously for at least 12 months and had their weight measure at baseline and 12 months. Sociodemographic and clinical characteristic of the participant, weight measurement at baseline and 12 months and the type of hormonal contraception used were retrieved from the records. Multiple logistic regression was used to examine the factors associated with &gt;5% weight gain. Results: A total of 366 samples were recruited. About one-third (33.6%) of hormonal contraceptive users had their weight gain more than 5% from their baseline weight. The risk factor for weight gain more than 5% were women with aged less than 40 years (AOR=2.09; 95% CI:1.26,3.45) and Etonogestrel (ENG) implant user (AOR = 7.91; 95% CI:2.69,23.24). Conclusion: One third of the hormonal contraception users had their weight gain greater than 5%. Lifestyle intervention to prevent weight gain could be targeted at high-risk users who are less than 40 years old and those on ENG implant.

Natural History of Reproductive Complications (Menstruation, Including Cancer, and Menopause)

A lifelong reproductive health plan is recommended for women with PCOS, with a focus on preconception risk factors including prevention of weight gain and optimisation of fertility. Metabolic risk factors, diabetes, cardiovascular disease, and sleep disorders are all increased in PCOS and screening and management is recommended. PCOS should be considered a high-risk condition in pregnancy with women identified and monitored. An increased premenopausal risk of endometrial cancer should be recognised. Depressive and anxiety symptoms are significantly increased and should be screened for in all women with PCOS, with psychological assessment and therapy as indicated. Shared decision making, self-empowerment and integrated models of care should be developed, funded, and evaluated. Supported healthy lifestyle remains vital throughout the lifespan in PCOS, with a strong focus on overall health, prevention of weight gain and if required on weight management. Combined oral contraceptive pills are first line pharmacological treatment for menstrual irregularity and hyperandrogenism, with no specific recommended preparation, and a preference for lower dose preparations and those with less side-effects. Metformin is recommended primarily for metabolic, although it is not routinely recommended for use in pregnant women with PCOS.

A Systematic Review of Butterfly Pea Flowers (Clitoria ternatea L.) in Reducing Body Weight and Improving Lipid Profile in Rodents with Obesity

Background: Butterfly pea flowers (Clitoria ternatea L.) are edible plants found in Asian countries that have several phytochemical compounds thathave potential anti-obesity and anti-dyslipidemia. From several in vivo studies, the administration of various extracts of butterfly pea flowers has different effects to reduce body weight (BW) or body mass index (BMI), and lipid profiles. Objectives: To analyze systematically the effects of butterfly pea flowers on BW or BMI and lipid profiles in rodents with or without obesity. Methods: This study used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and bias risk using the Systematic Review Centre for Laboratory Animal Experimentation (SyRCLEs).Original articles were from Google Scholar, PubMed, ResearchGate, and Science-Direct with criteria: randomized control trial (RCT), published from 2019 to 2023, rodents, and research outcomes (BW and lipid profiles). Results: Four original articles met the research criteria. Giving 1,000 mg/kg BW of the aqueous extract of butterfly pea flower for seven days reduced BW. Another study reported that giving 130 mg/kg BW butterfly pea flowers kombucha inhibited weight gain. Doses of 0.25 and 0.50% of the aqueous extracts of butterfly pea flowers for 15 weeks did not affect BW butthe dose of 2% prevented weight gain. Conclusions: Butterfly pea flowers have beneficial effects on reducing BW and improving lipid profiles in rodents with severaldiets although vary in animal models, diet types, extraction methods, and research design. This study becomes important evidence for further study.

Subdermal Progestin Implant and an Oral Combined Hormonal Contraceptive in Youth with Type 1 Diabetes

Study ObjectiveTo determine the metabolic effects of the subcutaneous etonogestrel implant compared to an oral contraceptive in adolescents and young adults (AYA) with T1D on body weight, body composition, glucose, lipids, and C-reactive protein levels (CRP). MethodsNon-randomized, interventional, prospective study. Thirty-nine AYA with T1D participated; twenty used the implant (Implant-T1D), and nineteen used an oral combined contraceptive (OC-T1D). Body composition, HbA1c, intermittent continuous glucose monitoring (CGM), lipids, and high sensitivity C-reactive protein (hsCRP) levels were evaluated. ResultsAll participants were followed for at least 12 months, and twenty-six completed the 24-month follow-up. No women discontinued the intervention due to side effects. Body weight increased by 0.8 ± 3.5 kg and 1 ± 2.9 kg in the OC-T1D and the Implant-T1D group at 12 months and by 2.6 ± 3.9 kg and 3.3 ± 3.6 kg at 24 months, respectively. OC-T1D and Implant-T1D had similar HbA1c, mean interstitial glucose levels, and time in range throughout the study; no significant difference over time was observed. hsCRP levels increased in both groups and were associated with BMI and HbA1c (p<0.001 for both variables). Women in the OC-T1D group had higher total cholesterol, HDL-C, and triglyceride levels compared with the Implant-T1D. ConclusionGlucose levels were similar in youth using the subdermal progestin implant and an OC. However, both AYA groups showed increased BMI, fat mass, and subclinical inflammation. Changes in lipid levels were associated with the OC method. These data highlight the importance of weight gain prevention in young women with T1D using hormonal contraception.

Hyperleptinemia contributes to antipsychotic drug-associated obesity and metabolic disorders.

Despite their high degree of effectiveness in the management of psychiatric conditions, exposure to antipsychotic drugs, including olanzapine and risperidone, is frequently associated with substantial weight gain and the development of diabetes. Even before weight gain, a rapid rise in circulating leptin concentrations can be observed in most patients taking antipsychotic drugs. To date, the contribution of this hyperleptinemia to weight gain and metabolic deterioration has not been defined. Here, with an established mouse model that recapitulates antipsychotic drug-induced obesity and insulin resistance, we not only confirm that hyperleptinemia occurs before weight gain but also demonstrate that hyperleptinemia contributes directly to the development of obesity and associated metabolic disorders. By suppressing the rise in leptin through the use of a monoclonal leptin-neutralizing antibody, we effectively prevented weight gain, restored glucose tolerance, and preserved adipose tissue and liver function in antipsychotic drug-treated mice. Mechanistically, suppressing excess leptin resolved local tissue and systemic inflammation typically associated with antipsychotic drug treatment. We conclude that hyperleptinemia is a key contributor to antipsychotic drug-associated weight gain and metabolic deterioration. Leptin suppression may be an effective approach to reducing the undesirable side effects of antipsychotic drugs.

Fat-Proofing Halloween, Thanksgiving, and Christmas: Exploring Behavioral Solutions to Holiday Weight Gain

People overeat during the holidays and gain on average 1.1 pounds from Thanksgiving to New Year’s Eve. Participant observers compiled over 100 different insights on factors cause people to overeat during the holiday season. Each trap that was identified was paired with some advice from that insider on how to prevent the overeating. Insights were categorized based the social aspects of the meal, the influence of proximate others, and the layout of the food. These indulgent insights will be useful to help prevent people from overeating during the holiday season and has the potential to prevent weight gain and health decreases that are paired with the winter months.

Effect of combined administration of Acyl-CoA: Cholesterol acyltransferase 1 inhibitor and glucagon-like peptide 1 receptor agonist on a rodent model of diet-induced obesity

A glucagon-like peptide 1 receptor agonist (GLP-1 RA) semaglutide was approved for the treatment of obesity by the Food and Drug Administration. However, it can cause gastrointestinal events at high doses, limiting its broader use. Combining drugs with multiple mechanisms of action could enhance the weight-reducing effects while minimizing side effects. To this end, we investigated the combined effects of semaglutide and avasimibe, an acyl-CoA:cholesterol acyltransferase 1 (ACAT1) inhibitor, on weight reduction in diet-induced obesity mice. Two cohorts of mice were used: In cohort 1, mice were fed a high-fat (HF) diet for 12 weeks and then randomly assigned to the vehicle, avasimibe [10 mg/kg body weight (BW)], semaglutide (0.4 mg/kg BW), or combination groups. The drugs were administered via subcutaneous (sc) injections on a daily basis. In cohort 2, mice were fed an HF diet for 8 weeks and randomly assigned to the same four groups, but avasimibe was administered at a dose of 20 mg/kg BW, and the drugs were administered every 3 days. In cohort 1, semaglutide initially reduced food intake initially, but this effect was diminished with prolonged administration. Avasimibe, on the other hand, did not affect food intake but prevented weight gain to a lesser extent than semaglutide. Importantly, the combination treatment resulted in the greatest percentage of body weight reduction, along with lower plasma glucose and leptin levels compared to the semaglutide single-treatment group. Cohort 2 confirmed that the superior weight loss in the combination group compared to the other three groups was largely due to a significant reduction in fat mass. Histological analysis of inguinal adipose tissue showed smaller adipocyte size across all treatment groups compared to the vehicle group, with no significant differences among the treatment groups. Collectively, these findings suggest combining semaglutide and avasimibe could be an effective approach to weight management.

Trends in weight change patterns across life course among US adults, 1988–2018: population-based study

BackgroundTo examine trends in weight change patterns from young adulthood through midlife to late adulthood and their sex and racial/ethnic disparities among US adults from 1988 to 2018.MethodsA total of 48,969 participants from the National Health and Nutrition Examination Survey 1988–1994 and 2001–2018 were included.ResultsThe age-adjusted prevalence of stable non-obesity between young adulthood and midlife declined significantly from 84.1% (95 CI, 82.9-85.3%) in 1988–1994 to 68.7% (67.1-70.2%) in 2013–2018, and between midlife and late adulthood from 71.2% (69.2-73.1%) to 52.4% (50.5-54.2%). The magnitude of increase in the prevalence of weight gain from young adulthood to midlife (from 10.8% [9.9-11.6%] in 1988–1994 to 21.2% [20-22.3%] in 2013–2018; P < 0.001 for trend) was greater than that from midlife to late adulthood (from 14.1% [12.9-15.3%] to 17.2% [16.2-18.1%]; P = 0.002 for trend). The magnitude of increase in the prevalence of stable obesity from young adulthood to midlife (from 3.9% [3.1-4.8%] in 1988–1994 to 9.2% [8.2-10.3%] in 2013–2018; P < 0.001 for trend) was smaller than that from midlife to late adulthood (from 11.2% [10.1-12.2%] to 24.8% [23.3-26.3%]; P < 0.001 for trend). The declining trends in the prevalence of stable non-obesity and increasing trends in the prevalence of weight gain and stable obesity from young adulthood through midlife to late adulthood were also observed for all sex and race/ethnicity subgroups. The magnitude of decrease in the prevalence of stable non-obesity, and the magnitude of increase in the prevalence of weight gain from young adulthood through midlife to late adulthood were greater in men than in women (all P for interaction < 0.01). Weight gain patterns for those aged ≥ 65 years were substantially different from the younger age groups.ConclusionsMore young people born in later years are encountering obesity and accumulate greater obesity exposure across their lives than young people born in earlier years.

A randomised controlled trial to investigate the feasibility and acceptability of a small change approach to prevent weight gain

A weight gain prevention strategy showing merit is a small change approach (increase energy expenditure and/or decrease energy intake by 100–200 kcal/day). Studies have tested a small change approach in intensive interventions involving multiple contacts, unsuitable for delivery at scale. The aim here was to assess the feasibility and acceptability of a remote small change weight gain prevention intervention. A randomised controlled trial of 122 participants was conducted. The intervention was a remote 12-week small change weight gain prevention programme (targeting dietary and/or physical activity behaviours). The comparator group received a healthy lifestyle leaflet. Data were collected at baseline and 12-weeks. The primary outcome was the feasibility and acceptability, assessed against three stop–go traffic light criteria: retention, number of participants randomised per month and adherence to a small change approach. Participants’ opinions of a small change approach and weight change were also measured. The traffic light stop–go criteria results were green for recruitment (122 participants recruited in three months) and retention (91%) and red for intervention adherence. Most participants (62%) found a small change approach helpful for weight management and the mean difference in weight was − 1.1 kg (95% CI − 1.7, − 0.4), favouring the intervention group. Excluding intervention adherence, the trial was feasible and acceptable to participants. Despite adherence being lower than expected, participants found a small change approach useful for weight management and gained less weight than comparators. With refinement to increase intervention adherence, progress to an effectiveness trial is warranted.ISRCTN18309466: 12/04/2022 (retrospectively registered).

The effect of high-dose vitamin D supplementation and an exercise program to lose weight on some biochemical variables of overweight women

Background and Study Aim. In recent years, there has been a technological revolution and development in all fields, particularly the sports field. This has imposed on man a lifestyle characterized by comfort at the expense of a significant portion of his movement and activities. The problem of obesity has expanded beyond the inconsistency of the body to include its direct effect of increasing the proportion of fat and the negative impact on the work of vital organs. This disruption alters the body's internal environment and causes numerous diseases. The purpose of this study is to determine the effect of a sports program on taking vitamin D to lose weight and on some biochemical variables in young adults aged 30 to 35 years old. Materials and Methods. The study involved 10 overweight women aged 30-35 years, selected through intentional sampling. Inclusion criteria required consent, good health, and no ongoing vitamin D or exercise programs. The research employed a Randomized Controlled Trial (RCT) design. Primary outcome measures encompassed body weight, body composition, lipid profile, and vitamin D status. Anthropometric measurements included age, height, weight, and training age. Biochemical measurements involved blood tests for cholesterol, triglycerides, and vitamin D levels. The experimental group received vitamin D tablets and a proposed aerobic exercise program for 12 weeks. Results. The proposed aerobic sports program with vitamin D intake improved biochemical variables, such as total fat, total cholesterol, triglyceride, high-density cholesterol, low-density cholesterol, OH, and Vitamin D-025 for the sample under investigation. The application of the aerobic program with vitamin D led to weight loss among the study's female participants. The aerobic program with vitamin D intake has a positive effect on the general health status of the sample. Conclusions. Based on the study's findings, it is recommended to consider the positive effects of Vitamin D on the overall functional state of the body, making it essential to incorporate an aerobic sports program across various age groups. Regular medical tests are crucial for monitoring and maintaining overall health. Emphasizing the importance of regular exercise is vital in preventing weight gain and reducing the risk of certain chronic diseases. By implementing these recommendations, individuals can enhance their overall well-being and lead a healthier lifestyle. To further validate these outcomes, similar studies should be conducted on different age groups and diverse samples.

A literature review of evidence for primary prevention of overweight and obesity in healthy weight children and adolescents: A report produced by a working group of the Danish Council on Health and Disease Prevention.

Primary prevention targets development of overweight in individuals with healthy weight and is a great challenge. This paper summarizes the main findings of a working group of the Danish Council on Health and Disease Prevention that reviewed the literature on primary prevention of overweight and obesity among children and adolescents. The results were presented in a Danish report, in which a 2019 Cochrane review on childhood obesity prevention was complemented by searches in PubMed to include all relevant subsequent studies published from January 2018 until March 2020. In this paper, the review was updated until June 2023. Numerous childhood overweight prevention interventions have been developed during the past decades, primarily targeting diet and/or physical activity. Several of these interventions showed positive effects on diet and physical activity level but did not show effects on risk of developing overweight. The evidence foundation is inconsistent as four out of five interventions did not show positive effects. Previously observed intervention effects may not reflect excessive weight gain prevention among children with healthy weight but rather bodyweight reduction among those with overweight or obesity. We do not have sufficient knowledge about how to prevent children with healthy weight from developing overweight, and creative solutions are urgently needed.

Assessment of body mass index in patients with chronic hepatitis C who received an effective antiviral therapy

To evaluate the body mass index (BMI) in patients with chronic hepatitis C (CHC) with different stages of liver fibrosis and steatosis who received effective antiviral therapy (AVT). The study included 278 CHC patients with a sustained virologic response (SVR) at the end of treatment. In addition to assessing the investigational data to determine the clinical status of the patient, we calculated BMI (following the World Health Organization guidelines) and determined the severity of liver fibrosis (F) and steatosis (S) using transient elastography. The patients were assessed at the start of antiviral therapy, after ≥6 months from the moment SVR was confirmed, and then every 12 to 24 months. By the end of the study, the mean patient age was 49 years, 53% of them were men, and 34% of the patients were obese. Excessive weight gain was registered in 17% (n=48) of the cases, with 60% newly diagnosed with Class 1 to 2 obesity. Both before the start of AVT and years after reaching SVR, the mean BMI corresponded to the reference pre-obesity values, the liver steatosis was significantly more often absent in normal BMI; on the contrary, fatty liver (predominantly S2 to S3) was registered in individuals with elevated BMI (p<0.0001). After the long-term period following a successful therapy, Stage F4 liver fibrosis patients were mainly diagnosed with obesity (80% versus 44% before AVT; p=0.0010). The high proportion of patients with elevated BMI and liver steatosis seen years after a successful CHC therapy indicates a continued risk of progression of chronic liver disease. Such patients should be advised on how important it is to change their lifestyle to reduce overweight and prevent weight gain. We also need long-term assessments of how liver steatosis changes over time and what are the outcomes associated with post-SVR increase in BMI.

Dietary Patterns in Pregnancy and the Postpartum Period and the Relationship with Maternal Weight up to One Year after Pregnancy Complicated by Gestational Diabetes.

This multicentric cohort study aimed to describe changes in dietary patterns during pregnancy and postpartum and the association with BMI variation at six and twelve months postpartum in women with gestational diabetes mellitus (GDM). Between 2014 and 2018, we enrolled women with GDM in prenatal clinics of the Brazilian National Health System and followed them for one year postpartum. The dietary patterns during pregnancy and the postpartum period were obtained by factorial analysis. The relationship between these patterns and variation in postpartum BMI was evaluated by Poisson regression with robust variance adjusted for confounders. We identified three dietary patterns in 584 women, two healthy (generally healthy and Dash type), which were associated with less weight gain (RR 0.77 CI 95% 0.62-0.96 and RR 0.71 CI 95% 0.57-0.88, respectively). The high-risk pattern (based on ultra-processed, high-calorie foods and sweetened drinks) was associated with weight gain (RR 1.31 CI 95% 1.07-1.61 and RR 1.26 CI 95% 1.01-1.59) in six and twelve months postpartum, respectively. Although the participants learned about healthy dieting during pregnancy, dietary habits worsened from pregnancy to postpartum, especially, with lower consumption of fruits and dairy and higher consumption of sweetened beverages, with consequent weight gain postpartum. Postpartum support is needed to prevent weight gain and obesity.

Aerobic Exercise Ameliorates Liver Injury in Db/Db Mice by Attenuating Oxidative Stress, Apoptosis and Inflammation Through the Nrf2 and JAK2/STAT3 Signalling Pathways.

Diabetes mellitus (DM) implicates oxidative stress, apoptosis, and inflammation, all of which may contribute liver injury. Aerobic exercise is assured to positively regulate metabolism in the liver. This project was designed to investigate whether and how aerobic exercise improves DM-induced liver injury. Seven-week-old male db/db mice and age-matched m/m mice were randomly divided into a rest control group or a group that received 12 weeks of aerobic exercise by treadmill training (10 m/min). Haematoxylin and eosin (HE) staining, electron microscopy, Oil Red O staining and TUNEL assays were used to evaluate the histopathological changes in mouse liver. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TRIG), cholesterol (CHOL) were analyzed by serum biochemical analysis. Interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), and tissue levels of malondialdehyde (MDA) and superoxide dismutase (SOD) were analyzed via ELISA. Nuclear factor E2-associated factor-2 (Nrf2), nuclear factor κB (NF-κB) and JAK2/STAT3 pathway-related proteins were measured by immunofluorescence, Western blotting and q-PCR. F4/80 expression in liver tissues was assessed by immunohistochemistry. In diabetic mice, exercise training significantly decreased the levels of serum TRIG, CHOL, IL-6, TNF-α, ALT and AST; prevented weight gain, hyperglycaemia, and impaired glucose and insulin tolerance. Morphologically, exercise mitigated the diabetes-induced increase in liver tissue microvesicles, inflammatory cells, F4/80 (macrophage marker) levels, and TUNEL-positive cells. In addition, exercise reduced the apoptosis index, which is consistent with the results for caspase-3 and Bax. Additionally, exercise significantly increased SOD activity, decreased MDA levels, activated Nrf2 and decreased the expression of NF-kB, phosphorylated JAK2 and STAT3 proteins in the livers of diabetic mice. This study demonstrated that aerobic exercise reversed liver dysfunction in db/db mice with T2DM by reducing oxidative stress, apoptosis and inflammation, possibly by enhancing Nrf2 expression and inhibiting the JAK2/STAT3 cascade response.

Time-restricted feeding combined with resistance exercise prevents obesity and improves lipid metabolism in the liver of mice fed a high-fat diet.

Nonalcoholic fatty liver disease (NAFLD), a condition characterized by the accumulation of fat in the liver, is estimated to be the most common liver disease worldwide. Obesity is a major risk factor and contributor, and, accordingly, weight loss can improve NAFLD. Previous studies in preclinical models of diet-induced obesity and fatty liver disease have shown the independent benefits of resistance exercise training (RT) and time-restricted feeding (TRF) in preventing weight gain and hepatic build-up of fat. Here, we tested the combined effect of TRF and RT on obesity and NAFLD in mice fed a high-fat diet. Our results showed that both TRF-8-h food access in the active phase-and RT-consisting of three weekly sessions of ladder climbing-attenuated body weight gain, improved glycemic homeostasis, and decreased the accumulation of lipids in the liver. TRF combined with RT improved the respiratory exchange rate, energy expenditure, and mitochondrial respiration in the liver. Furthermore, gene expression analysis in the liver revealed lower mRNA expression of lipogenesis and inflammation genes along with increased mRNA of fatty acid oxidation genes in the TRF + RT group. Importantly, combined TRF + RT was shown to be more efficient in preventing obesity and metabolic disorders. In conclusion, TRF and RT exert complementary actions compared with isolated interventions, with significant effects on metabolic disorders and NAFLD in mice.NEW & NOTEWORTHY Whether time-restricted feeding (TRF) combined with resistance exercise training (RT) may be more efficient compared with these interventions alone is still unclear. We show that when combined with RT, TRF provided additional benefits, being more effective in increasing energy expenditure, preventing weight gain, and regulating glycemic homeostasis than each intervention alone. Thus, our results demonstrate that TRF and RT have complementary actions on some synergistic pathways that prevented obesity and hepatic liver accumulation.