Reduced Fat Mass Research Articles

A Higher Adherence to the ALINFA Nutritional Intervention Is Effective for Improving Dietary Patterns in Children

Food patterns are deteriorating and, consequently, not meeting nutritional recommendations. Learning about the adherence to a diet is crucial for understanding children’s dietary habits. The objective of the present analysis was to assess the degree of compliance with the ALINFA nutritional intervention and the effectiveness of adherence groups, and to evaluate potential baseline factors predicting a higher adherence to the intervention. A total of 44 children aged 6 to 12 years-old participated in the eight-week intervention. A two-week dietary plan was specifically designed, providing participants with food products, ready-to-eat dishes, and recipes. An intake of 75% of calories of the prescribed diet was defined to divide the participants into high- and low-adherence groups (HA/LA, respectively). From the 44 participants, 24 showed a LA to the intervention, whereas 20 of them were in the HA group. Diet quality improved in both groups (p < 0.001), mainly by increasing cereals and nuts, and reducing pastries. A decrease in BMI z-score was observed (LA: p < 0.001; HA: p = 0.021). Fat mass (p = 0.002), LDL-c (p = 0.036), and CRP (p = 0.023) reductions were only achieved in the HA group, whereas leptin decreased only in the LA group (p = 0.046). All participants ameliorated their dietary habits, but those with better diet quality at baseline experienced greater enhancements in their nutritional status.

Role of Na/K-ATPase α1 Caveolin-Binding Motif in Adipogenesis.

Deficiencies in mice and in humans have brought to the fore the importance of the caveolar network in key aspects of adipocyte biology. The conserved N-terminal caveolin-binding motif (CBM) of the ubiquitous Na/K-ATPase (NKA) α1 isoform, which allows NKA/caveolin-1 (Cav1) interaction, influences NKA signaling and caveolar distribution. It has been shown to be critical for animal development and ontogenesis, as well as lineage-specific differentiation of human induced pluripotent stem cells (hiPSC). However, its role in postnatal adipogenesis has not been fully examined. Using a genetic approach to alter CBM in hiPSC-derived adipocytes (iAdi-mCBM) and in mice (mCBM), we investigated the regulatory function of NKA CBM signaling in adipogenesis. Seahorse XF cell metabolism analyses revealed impaired glycolysis and decreased ATP synthesis-coupled respiration in iAdi-mCBM. These metabolic dysfunctions were accompanied by evidence of extensive remodeling of the extracellular matrix (ECM), including increased collagen staining, overexpression of ECM marker genes, and heightened TGF-β signaling uncovered by RNAseq analysis. Rescue of mCBM by lentiviral delivery of WT NKA α1 or treatment of mCBM hiPSC with the TGF-β inhibitor SB431542 normalized ECM, suggesting that NKA CBM signaling integrity is required for adequate control of TGF-β signaling and ECM stiffness during adipogenesis. The physiological impact was revealed in mCBM male mice with reduced fat mass accompanied by histological and transcriptional evidence of elevated adipose fibrosis and decreased adipocyte size. Based on these findings, we propose that the genetic alteration of the NKA/Cav1 regulatory path uncovered in human iAdi leads to lipodystrophy in mice.

Fat loss and muscle gain: the possible role of cortical glutamate in determining the efficacy of physical exercise

BackgroundPhysical exercise is widely acknowledged for its health benefits, but its effectiveness in treating obesity remains contentious due to variability in response. Owing to the roles of glutamate in appetite regulation, food addiction, and impulsivity, this observational cohort-study evaluated medial prefrontal cortex (mPFC) glutamate as a predictor of variability in exercise response, specifically in terms of fat loss and muscle gain. MethodsHealthy non-exercising adult men (n = 21) underwent an 8-week supervised exercise program. Baseline glutamate levels in the mPFC were measured through magnetic resonance spectroscopy. For exercise-dependent changes in body composition (fat and muscle mass), basal metabolic rate (BMR), and blood metabolic biomarkers related to lipid and glucose metabolism, measurements were obtained through bioelectrical impedance and blood sample analyses, respectively. ResultsThe exercise program resulted in significant improvements in body composition, including reductions in percentage body fat mass, body fat mass, and waist-to-hip ratio and an increase in mean muscle mass. Furthermore, BMR and metabolic indicators linked to glucose and lipids exhibited significant changes. Notably, lower baseline glutamate levels were associated with greater loss in percentage body fat mass (r = 0.482, p = 0.027), body fat mass (r = 0.441, p = 0.045), and increase in muscle mass (r = -0.409, p = 0.066, marginal) following the exercise program. ConclusionThese preliminary findings contribute to our understanding of the neurobiology of obesity and emphasize the significance of glutamate in regulating body composition. The results also highlight cortical glutamate as a potential predictor of exercise-induced fat loss and muscle gain.

Is there a beneficial effect of a high-protein diet on body composition and strength capacity in physical active middle-aged individuals?—An eight-week randomized controlled trial

IntroductionDemographic changes are resulting in a continual increase in the proportion of individuals over 65 years old. Simultaneously, muscle mass (MM) tends to decrease with age, with a decline noticeable from the middle of the fourth decade of life. While physical activity is considered a modulator for maintaining MM, the interaction with nutrient uptake, especially protein intake, is getting more into focus. Due to a lack of data on the effect of a high-protein diet on middle-aged individuals (40–65 years), this study aimed to investigate the influence of a high-protein diet in middle-aged physically active persons on body composition and performance.MethodsUsing stratified randomization, participants were allocated to either a high-protein group (>2.3 g/kg FFM/day) (n = 12, age = 57.83 ± 7.74 years, height = 170.42 cm ± 11.04 cm, BMI = 30.26 ± 4.46, MM = 31.71 ± 6.89 kg) or a control group (<2.3 g/kg/FFM/day) (n = 14, age = 58.21 ± 6.44 years, height = 170.57 cm ± 8.28 cm, BMI = 26.31 ± 5.59, MM = 29.67 ± 8.08 kg). Body composition [fat-free mass (FFM), fat mass (FM), MM] and strength were assessed at baseline (T0), after four weeks (T1) and after eight weeks (T2). Exercise habits were not changed over the entire period and dietary habits were recorded using FDDB Explorer. Statistical analysis was performed using the current version of R and linear mixed models.ResultsNo significant differences in energy intake were found between the groups (p = .974). In macronutrient distribution, a significantly higher consumption of protein was found in the high-protein group (p < .0001, d = 2.22) [140 ± 70 g/day (HPG) vs. 79 ± 40 g/day (CG)]. A trivial reduction in FM over time in both groups (p = .046, d = 0.04, Δt=−.83±1.60kg) was observed. No significant differences were detected in FFM (p = .887) and MM (p = .711). Trivial interaction effects (time*group) were observed for upper (p = .007, d = 0.12, ΔHPG = 4.38 ± 3.25 kg) and lower body strength (p = .0507, d = 0.07, ΔHPG = 3.33 ± 2.36 kg).DiscussionOur results indicate no to only trivial effects of adding a high-protein diet to otherwise physically active middle-aged individuals. Trivial effects could be seen for an increase in muscle strength after this eight-week intervention. However, MM and FFM were not significantly affected. Based on the small effect sizes we observed in our results we do not see a benefit of a high-protein diet on body composition and strength capacity without altering the exercise habits.

The effect of obesity and subsequent weight reduction on cardiac morphology and function in cats

BackgroundIn people, obesity is a risk factor for cardiovascular disease, associated with systemic hypertension, cardiac remodelling and systolic and diastolic dysfunction. Weight reduction can reverse myocardial remodelling and reduce risk of subsequent cardiovascular disease. In cats, far less is known regarding the effects of obesity and subsequent weight reduction on cardiovascular morphology and function. This prospective study aimed to assess cardiac morphology and function, heart rate variability, cardiac biomarkers and body composition before and after controlled weight reduction in cats with obesity. Body composition analysis (by dual energy x-ray absorptiometry, DEXA) and cardiovascular assessment (echocardiography, systemic arterial systolic blood pressure, electrocardiography, plasma cardiac biomarkers) were performed prior to weight management in twenty cats with obesity. These investigations were repeated in eleven cats that reached target weight.ResultsAt baseline, systemic hypertension was not documented, but the majority of cats with obesity (15 out of 19) showed echocardiographic evidence of diastolic dysfunction. Eleven of 20 cats had increased maximal end-diastolic septal or left ventricular free wall thickness (≥ 6.0 mm) at baseline. Median (interquartile range) percentage of weight lost in the cats reaching target weight was 26% (17–29%), with a median reduction in body fat mass of 45% (26–64%). Both the end-diastolic left ventricular free wall (median magnitude of change -0.85 mm, IQR -0.05 mm to -1.55 mm, P = 0.019; median percentage reduction 14.0%) and end-diastolic interventricular septum (median magnitude of change -0.5 mm, IQR -0.2 mm to -1.225 mm, P = 0.047; median percentage reduction 7.9%) thickness decreased after weight reduction. Following weight reduction, pulsed wave tissue Doppler imaging of the left ventricular free wall was consistent with improved diastolic function in 4 out of 8 cats, however there was no significant difference in overall diastolic function class. Further, there was no change in heart rate variability or cardiac biomarkers with weight reduction.ConclusionAn increase in left ventricular wall thickness and diastolic dysfunction were common echocardiographic features in cats with obesity within our study and may be reversible with successful weight and fat mass loss. Further studies are required to clarify the clinical consequences of these findings.

Development of intestine-targeted microcapsules for enhanced delivery of fucoxanthin: A strategy to mitigate lipid accumulation in vitro and in vivo

The development of intestine-targeted microcapsules using spray drying without maltodextrin is still a challenge. Herein, intestine-targeted fucoxanthin-loaded microcapsules (Fx-MIC) were developed using the spray drying method. The microcapsules were formed by homogenizing fucoxanthin/conjugated linoleic acid (Fx/CLA) and whey protein isolate/Arabic gum (WPI/AG) mixture, followed by spray drying without maltodextrin. The effect of the ratio of Fx/CLA to WPI/AG in Fx-MIC on their morphology and encapsulation efficiency was evaluated. An Fx/CLA-to-WPI/AG ratio of 1:3 yielded a uniform particle size and the highest encapsulation efficiency (91.11%). In vitro simulated digestion demonstrated that Fx-MIC effectively protected Fx from premature release in the stomach and exhibited a release efficiency of 66.08% in the intestine. The digestion product of Fx-MIC effectively inhibited 3T3-L1 cell differentiation and lipid accumulation, demonstrating its ability to reduce lipid accumulation in vitro. Moreover, in high-fat diet (HFD)-induced obesity mice, Fx-MIC exhibited significant reductions in body weight, liver weight, and fat mass. Additionally, Fx-MIC demonstrated notable effects on lowering blood lipid levels and mitigating liver damage. In conclusion, the use of Fx-MIC facilitated the targeted release of Fx, thereby enhancing its anti-obesity effects. This promising result suggests potential applications of Fx-MIC in the food industry.

Effectiveness of a hybrid approach in integrating GLP-1 agonists and lifestyle guidance for obesity and pre-diabetes management: RWE retrospective study

AimEmerging anti-obesity pharmacotherapy provides an option to correct maladaptive physiological and hormonal changes associated with obesity. One of the widely used medications in this context is glucagon-like peptide 1 (GLP-1) agonists. However, the misuse of these medications without any guidance and monitoring of lifestyle modifications can lead to unfavorable outcomes. The study aims to evaluate the effectiveness of a hybrid care model, incorporating GLP-1 and GLP-1/GIP agonist therapies, in managing obese patients with/without pre-diabetes. This study showcases the midway results of a 6-month program, which includes a multidisciplinary care team and digital technology for continuous engagement and monitoring of patients, both in-clinic and remotely. MethodsIn a retrospective observational study, 115 participants were treated with GLP-1s (semaglutide, tirzepatide, and liraglutide). Physicians, dietitians, and coaches worked together to support behavioral changes using a dedicated app provided to patients. At the care team end, an integrated portal enabled continuous data flow allowing for the care team to provide personalized care via chat at regular intervals. Data collected included food logs, continuous glucose monitoring (CGM), and digital biomarkers such as sleep and activity. ResultsAt the midpoint of the program, participants exhibited statistically significant improvements in various metabolic parameters. Mean weight reduction was 8 %, with significant reductions in BMI, fat mass, and cholesterol levels. 24 (20.9 %) of patients lost ≥5 % of body weight, 55 (47.8 %) patients lost ≥10 % weight, and 36 (31.3 %) patients lost ≥15 % weight. Sub-analysis of pre-diabetic patients (n=36) demonstrated substantial improvements, including control of pre-diabetes in 80.6 % of cases and reduced HbA1c levels back to normoglycemia (5.39 ± 0.27). ConclusionThe Zone.Health's program, which combines pharmacotherapy with continuous engagement and monitoring to enable sustainable lifestyle modifications, demonstrated significant improvements in weight, body composition, and metabolic markers. Pre-diabetes was also effectively addressed. It is necessary to conduct further research to assess the long-term sustainability and optimal adoption of such care models into clinical practice.

Transgenic Overexpression of HDAC9 Promotes Adipocyte Hypertrophy, Insulin Resistance and Hepatic Steatosis in Aging Mice.

Histone deacetylase (HDAC) 9 is a negative regulator of adipogenic differentiation, which is required for maintenance of healthy adipose tissues. We reported that HDAC9 expression is upregulated in adipose tissues during obesity, in conjunction with impaired adipogenic differentiation, adipocyte hypertrophy, insulin resistance, and hepatic steatosis, all of which were alleviated by global genetic deletion of Hdac9. Here, we developed a novel transgenic (TG) mouse model to test whether overexpression of Hdac9 is sufficient to induce adipocyte hypertrophy, insulin resistance, and hepatic steatosis in the absence of obesity. HDAC9 TG mice gained less body weight than wild-type (WT) mice when fed a standard laboratory diet for up to 40 weeks, which was attributed to reduced fat mass (primarily inguinal adipose tissue). There was no difference in insulin sensitivity or glucose tolerance in 18-week-old WT and HDAC9 TG mice; however, at 40 weeks of age, HDAC9 TG mice exhibited impaired insulin sensitivity and glucose intolerance. Tissue histology demonstrated adipocyte hypertrophy, along with reduced numbers of mature adipocytes and stromovascular cells, in the HDAC9 TG mouse adipose tissue. Moreover, increased lipids were detected in the livers of aging HDAC9 TG mice, as evaluated by oil red O staining. In conclusion, the experimental aging HDAC9 TG mice developed adipocyte hypertrophy, insulin resistance, and hepatic steatosis, independent of obesity. This novel mouse model may be useful in the investigation of the impact of Hdac9 overexpression associated with metabolic and aging-related diseases.

Positive interplay between FFAR4/GPR120, DPP-IV inhibition and GLP-1 in beta cell proliferation and glucose homeostasis in obese high fat fed mice

G-protein coupled receptor-120 (GPR120; FFAR4) is a free fatty acid receptor, widely researched for its glucoregulatory and insulin release activities. This study aimed to investigate the metabolic advantage of FFAR4/GPR120activation using combination therapy. C57BL/6 mice, fed a High Fat Diet (HFD) for 120 days to induce obesity-diabetes, were subsequently treated with a single daily oral dose of FFAR4/GPR120 agonist Compound A (CpdA) (0.1μmol/kg) alone or in combination with sitagliptin (50mg/kg) for 21 days. After 21-days, glucose homeostasis, islet morphology, plasma hormones and lipids, tissue genes (qPCR) and protein expression (immunocytochemistry) were assessed. Oral administration of CpdA improved glucose tolerance (34% p<0.001) and increased circulating insulin (38% p<0.001). Addition of CpdA with the dipeptidyl peptidase-IV (DPP-IV) inhibitor, sitagliptin, further improved insulin release (44%) compared to sitagliptin alone and reduced fat mass (p<0.05). CpdA alone (50%) and in combination with sitagliptin (89%) induced marked reductions in LDL-cholesterol, with greater effects in combination (p<0.05). All treatment regimens restored pancreatic islet and beta-cell area and mass, complemented with significantly elevated beta-cell proliferation rates. A marked increase in circulating GLP-1 (53%) was observed, with further increases in combination (38%). With treatment, mice presented with increased Gcg (proglucagon) gene expression in the jejunum (130% increase) and ileum (120% increase), indicative of GLP-1 synthesis and secretion. These data highlight the therapeutic promise of FFAR4/GPR120 activation and the potential for combined benefit with incretin enhancing DPP-IV inhibitors in the regulation of beta cell proliferation and diabetes.

A systematic review of the effects of robotic exoskeleton training on energy expenditure and body composition in adults with spinal cord injury.

Metabolic diseases disproportionately affect people with spinal cord injury (SCI). Increasing energy expenditure and remodeling body composition may offset deleterious consequences of SCI to improve cardiometabolic health. Evidence is emerging that robotic exoskeleton use increases physical activity in SCI, but little is known about its effects on energy expenditure and body composition. This study therefore aimed to evaluate the impact of robotic exoskeleton training on body composition and energy expenditure in adults with SCI. A systematic literature review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Five databases were searched to retrieve studies meeting pre-set eligibility criteria: adults with SCI, interventions evaluating the effects of robotic exoskeleton devices on body composition or energy expenditure. The PEDro scale guided quality assessments with findings described narratively. Of 2163 records, 10 studies were included. Robotic exoskeleton training does not significantly improve energy expenditure compared to other exercise interventions. Significant changes (P < 0.05) in body composition, particularly reduced fat mass, however, were reported. High variability seen with the interventions was coupled with poor quality of the studies. While robotic exoskeleton interventions may propose modest cardiometabolic benefits in adults with SCI, further robust trials in larger samples are needed to strengthen these findings.

Effects of repeated weight cycling on non-alcoholic steatohepatitis in diet-induced obese mice.

Lifestyle interventions remain the treatment of choice for patients with obesity and metabolic complications, yet are difficult to maintain and often lead to cycles of weight loss and regain (weight cycling). Literature on weight cycling remains controversial and we therefore investigated the association between weight cycling and metabolic complications using preexistent obese mice. Ldlr-/-.Leiden mice received a high-fat diet (HFD) for 20 weeks to induce obesity. Subsequently, weight-cycled mice were switched between the healthy chow diet and HFD for four 2-week periods and compared to mice that received HFD for the total study period. Repeated weight cycling tended to decrease body weight and significantly reduced fat mass, whereas adipose tissue inflammation was similar relative to HFD controls. Weight cycling did not significantly affect blood glucose or plasma insulin levels yet significantly reduced plasma free fatty acid and alanine transaminase/aspartate transaminase levels. Hepatic macrovesicular steatosis was similar and microvesicular steatosis tended to be increased upon weight cycling. Weight cycling resulted in a robust decrease in hepatic inflammation compared to HFD controls while hepatic fibrosis and atherosclerosis development were not affected. These results argue against the postulate that repeated weight cycling leads to unfavorable metabolic effects, when compared to a continuous unhealthy lifestyle, and in fact revealed beneficial effects on hepatic inflammation, an important hallmark of non-alcoholic steatohepatitis.

Intermittent fasting and health outcomes: an umbrella review of systematic reviews and meta-analyses of randomised controlled trials

Benefits of Intermittent fasting (IF) on health-related outcomes have been found in a range of randomised controlled trials (RCTs). Our umbrella review aimed to systematically analyze and synthesize the available causal evidence on IF and its impact on specific health-related outcomes while evaluating its evidence quality. We comprehensively searched the PubMed, Embase, Web of Science, and Cochrane databases (from inception up to 8 January 2024) to identify related systematic reviews and meta-analyses of RCTs investigating the association between IF and human health outcomes. We recalculated the effect sizes for each meta-analysis as mean difference (MD) or standardized mean difference (SMD) with corresponding 95% confidence intervals (CIs). Subgroup analyses were performed for populations based on three specific status: diabetes, overweight or obesity, and metabolic syndrome. The quality of systematic reviews was evaluated using A Measurement Tool to Assess Systematic Reviews (AMSTAR), and the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system. This study is registered with PROSPERO (CRD42023382004). A total of 351 associations from 23 meta-analyses with 34 health outcomes were included in the study. A wide range of outcomes were investigated, including anthropometric measures (n=155), lipid profiles (n=83), glycemic profiles (n=57), circulatory system index (n=41), appetite (n=9), and others (n=6). Twenty-one (91%) meta-analyses with 346 associations were rated as high confidence according to the AMSTAR criteria. The summary effects estimates were significant at p<0.05 in 103 associations, of which 10 (10%) were supported by high certainty of evidence according to GRADE. Specifically, compared with non-intervention diet in adults with overweight or obesity, IF reduced waist circumference (WC) (MD=-1.02cm; 95% CI:-1.99 to-0.06; p=0.038), fat mass (MD=-0.72kg; 95% CI:-1.32 to-0.12; p=0.019), fasting insulin (SMD=-0.21; 95% CI:-0.40 to-0.02; p=0.030), low-density lipoprotein cholesterol (LDL-C) (SMD=-0.20; 95% CI:-0.38 to-0.02; p=0.027), total cholesterol (TC) (SMD=-0.29; 95% CI:-0.48 to-0.10; p=0.003), and triacylglycerols (TG) (SMD=-0.23; 95% CI:-0.39 to-0.06; p=0.007), but increased fat free mass (FFM) (MD=0.98kg; 95% CI: 0.18-1.78; p=0.016). Of note, compared with the non-intervention diet, modified alternate-day fasting (MADF) reduced fat mass (MD=-0.70kg; 95% CI:-1.38 to-0.02; p=0.044). In people with overweight or obesity, and type 2 diabetes, IF increases high-density lipoprotein cholesterol (HDL-C) levels compared to continuous energy restriction (CER) (MD=0.03mmol/L; 95% CI: 0.01-0.05; p=0.010). However, IF was less effective at reducing systolic blood pressure (SBP) than a CER diet in adults with overweight or obesity (SMD=0.21; 95% CI: 0.05-0.36; p=0.008). Our findings suggest that IF may have beneficial effects on a range of health outcomes for adults with overweight or obesity, compared to CER or non-intervention diet. Specifically, IF may decreased WC, fat mass, LDL-C, TG, TC, fasting insulin, and SBP, while increasing HDL-C and FFM. Notably, it is worth noting that the SBP lowering effect of IF appears to be weaker than that of CER. This work was supported by the National Key Research and Development Program of China (Q-JW), the Natural Science Foundation of China (Q-JW and T-TG), Outstanding Scientific Fund of Shengjing Hospital of China Medical University (Q-JW), and 345 Talent Project of Shengjing Hospital of China Medical University (T-TG).

EFFETS DE LASSOCIATION DE LEXERCICE PHYSIQUE ET DU MASSAGE SUEDOIS SUR LA SCIATALGIE CHEZ LES FEMMES DE YAOUNDE (CAMEROUN)

Background: Sciatica is a common chronic musculoskeletal disorder among women in developing countries. However, management strategies for this condition in these regions are often inadequate. Objective: The aim of this study was to evaluate the effectiveness of a therapeutic programme combining Swedish massage and physical exercise on the symptoms of sciatica in women in the city of Yaounde in Cameroun. Methodology : This was a cross-sectional study of 30 women suffering from sciatica. The women were divided equally into three groups. The first (G1) was made up of women who only took physical exercise, the second (G2) of those who only received Swedish massage sessions and the third (G3) of those who received both physical exercise and Swedish massage. Results : The results show an overall decrease in anthropometric parameters. This decline was most marked in G3 (ΔG3 = -3.21%) and G1 (ΔG1 = -10.10%), for body mass and bone mass respectively. G2 showed the greatest reductions in water mass (ΔG2 = -16.97%), fat mass (ΔG2 = -21.19%) and muscle mass (ΔG2 = -8.76%). The results then show an overall improvement in pain parameters. This observation was more marked in G2, irrespective of the parameter considered. On the other hand, G1 showed the best result for pain at the present time (ΔG1 = -73.57%), while G2 showed the greatest improvements for usual pain (ΔG3 = -52.24%) and most intense pain (ΔG3 = -64.06%). Finally, the results indicate an overall reduction in the consequences of pain. This reduction was more marked in G2, but G3 showed the best results in terms of social relationships. Conclusion : In conclusion, physical exercise and Swedish massage promoted remission of most of the symptoms of sciatica in the subjects studied, especially when these two methods were combined.

Ketogenic Keys to Body Composition: Nutritional Insights and Comparative Dietary Effects

Background: The ketogenic diet, characterized by high fat, low carbohydrate intake, has garnered significant interest for its impact on body composition. Despite its popularity, the mechanisms and long-term effects of the diet remain subjects of ongoing research and debate within the medical and nutritional science communities.&#x0D; Methods: This review systematically examines peer-reviewed clinical trials, observational studies, and comparative analyses conducted from 2004 to 2024. Studies were selected based on their relevance to the ketogenic diet's effects on body composition, adherence to rigorous methodological standards, and the provision of clear outcome measures related to fat mass, lean muscle mass, and overall weight changes.&#x0D; Results: The review synthesizes findings to elucidate the diet's mechanisms, effects, and comparative performance against other dietary interventions. The ketogenic diet induces metabolic adaptations conducive to fat loss while potentially preserving lean muscle mass, mediated through ketosis and associated hormonal shifts. Comparative analyses suggest that the ketogenic diet may offer distinct advantages in fat reduction compared to low-fat and Mediterranean diets, attributed to its profound effects on metabolic pathways and satiety regulation. However, individual responses vary significantly, influenced by factors such as exercise, diet duration, macronutrient composition, and genetic predispositions.&#x0D; Conclusion: The ketogenic diet emerges as a potent intervention for altering body composition, particularly effective in reducing fat mass. Its unique metabolic and hormonal effects distinguish it from other dietary approaches. Nevertheless, considerations regarding the diet's long-term sustainability, potential risks, and individual variability underscore the need for personalized dietary planning and further research.

Risk Factors for Long-term Body Weight Loss After Proximal Gastrectomy: A Retrospective Analysis.

Proximal gastrectomy (PG) is a therapy for early-stage proximal gastric cancer and offers advantages such as the preservation of food storage capacity and less body weight loss (BWL). Nevertheless, significant BWL following PG may occur, affecting the patient's well-being and survival. In this study, we aimed to identify the relevant factors for BWL following PG by analyzing an institutional database of patients. We enrolled 58 consecutive patients who underwent PG for gastric or esophagogastric junction cancer at our institution between April 2004 and March 2021. Based on BWL at 12 months postoperatively, we retrospectively compared and examined patient characteristics, surgical details, and nutritional markers. The mean BWL of the 58 patients included in this analysis was 14.0±7.2%. When the patients were divided into BWL-moderate (n=29) and BWL-severe (n=29) groups using a cutoff value of 15.7%, the latter experienced early BWL within 1 month postoperatively, primarily due to body fat mass reduction, with no recovery during the 60 months of follow up. In contrast, gradual recovery was observed among patients in the BWL-moderate group after experiencing the lowest body weight 24 months postoperatively. A greater decrease in body fat mass than in muscle mass was observed in both groups. Blood hemoglobin levels did not recover in the BWL-severe group. The BWL-severe group after proximal gastrectomy demonstrated significantly greater early postoperative BWL, primarily attributed to a reduction in body fat mass, with hardly any recovery. Early postoperative nutritional intervention might be proposed to prevent long-term BWL.

Nutrition to Enhance Metabolic-Bariatric Surgery Outcomes.

Gender-specific post-surgical goals for 12-month percent body fat (%BF) based on World Health Organization (WHO) obesity thresholds and for lean mass-sparing were published as preliminary body composition (BC) guidelines to address a knowledge gap in metabolic-bariatric surgery (MBS). Other studies' %BF outcomes inconsistently fell below obesity thresholds; none described nutrition practices. To help practitioners positively influence patients' BC and weight changes, this study describes the team-supported process of conducting serial body composition analysis (sBCA) concomitantly with the evidence-based nutrition practices applied to generate the preliminary guidelines. Guidelines were generated using the cumulative outcomes of separate, original research board-approved Roux-en-Y Gastric Bypass and Sleeve Gastrectomy studies. One dietitian assessed BC using the same bioimpedance machine, educated patients, and collected data from patients aged 18 and older in a 532-bed nonprofit acute-care institution in Northeast Ohio, USA, from May, 2007, through November, 2016. Essential to pre- and postoperative education was the "Nutrition Goal Checklist," an evidence-based synopsis of imperative practices. Body composition was assessed on initial visit, presurgically, and postoperative months 3, 6, and 12, generating individual patient handouts of progressive weight and BC changes with coordinating %BF graphs. Serial assessment enabled intervention toward meeting BC goals. For genders in both surgeries, the described process influenced highly significant fat mass reduction, transitioning %BF below obesity thresholds. Lean mass-sparing outcomes supported the suggested preliminary guidelines. Utilizing sBCA with evidence-based nutrition practices consistently generated outcomes to formulate preliminary BC guidelines following MBS. Further research is needed to solidify formal guidelines.

Abstract 5933: Identifying MC4R-targeted small molecule to investigate MC4R impact on cachexia progression

Abstract Background: The melanocortin system participates in energy homeostasis and appetiteregulation. This metabolic system is primarily located in the central nervous system,specifically in the hypothalamus and brainstem region. Within the melanocortin system,there are five established melanocortin receptors (MCR). MCRs are g-protein-coupledreceptors (GPCRs) and when these receptors are activated, they can increase neuronexcitation, regulate neurotransmitter release, regulate synaptic input, and alterconnection and strength. When Melanocortin-4 Receptor (MC4R) plays a critical role inthe progression of multiple metabolic diseases including cachexia. Cachexia is definedas the reduction of fat and lean mass, which is caused not just by lack of appetite, but byinflammatory impact. Cachexia is a symptom seen in numerous chronic diseases fromcancer to mitochondrial dysfunction to autoimmune inflictions. This makes MC4R apotentially strong therapeutic target. Method: In-silico and high-throughput methods were used to identify small moleculesthat target and inhibit MC4R. For high-throughput screen, Hek293 cells withconstitutively active MC4R tagged with a nanoluciferase were used to identify molecules,specifically with inhibitory qualities. cAMP accumulation and β-arrestin recruitmentassay were used to determine the impact on MC4R functionality. Results: 4738 small molecules were screened using high-throughput methods. Using a60% cutoff, 21 small molecules were identified as potential MC4R inhibitors. 17 arecurrently under investigation to confirm high-throughput results and identify functionalimpact. Several of these molecules have shown promising potential in vitro and will likelymove forward into in vivo studies. Conclusion: This study identifies prospective small molecule inhibitors that targetMC4R and may be used as a probe to explore MC4R biology. Citation Format: Julia Stokes, Dhanir Taylor, Marie Foss, Benedikt Grau, Sanjay Malhotra. Identifying MC4R-targeted small molecule to investigate MC4R impact on cachexia progression [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5933.

Effect of Vitamin D3 on Changes in Muscle Mass in the Elderly in Nursing Homes: Double-Blind Controlled Randomized Trial

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p&gt;&lt;em&gt;The decline in muscle mass and strength begins at the age of 30 years by 40% within 30 years, then will decrease by 40% every ten years after the age of 60 years. Loss of muscle mass and strength in older people causes weakness and reduced muscle function, which can lead to a decrease in the ability to perform activities of daily living and an increased risk of falls. In addition, older people are prone to malnutrition; this condition will be accompanied by micronutrient deficiencies both in older people who are undernourished and overnourished. Giving vitamin D3 to increase muscle mass and ability and reduce fat mass in older people also has pros and cons. So, this study aims to explore the effect of giving Vitamin D3 on changes in muscle mass in older adults. The study will also examine changes in upper arm muscle strength and evaluate the impact of Vitamin D3 on changes in muscle mass. This research is a study with an Experimental Randomised Control Trial (RCT) research design. The population was elderly who were deficient in vitamin D, while the study sample amounted to 26 control subjects and 26 action subjects. Samples are taken by consecutive sampling technique. Based on research findings, most older adults (60–69 years) suffer from vitamin D deficiency and deficiency. However, vitamin D3 supplementation increases&lt;/em&gt;&lt;em&gt; the muscle mass of older adults in nursing homes, especially in the muscles of the upper and lower extremities&lt;/em&gt;&lt;em&gt;. However, the supplement weakens muscle mass and causes bruising and bleeding but does not weaken arm muscle mass.&lt;/em&gt;&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;strong&gt;&lt;em&gt;Keywords: Elderly,  Muscle Mass,  Panti Werdha, Vitamin D3&lt;/em&gt;&lt;/strong&gt;

Moderate-Intensity Combined Training Induces Lipidomic Changes in Individuals with Obesity and Type 2 Diabetes.

Alterations in the lipid metabolism are linked to metabolic disorders such as insulin resistance (IR), obesity and type 2 diabetes (T2D). Regular exercise, particularly combined training (CT), is a well-known non-pharmacological treatment that combines aerobic (AT) and resistance (RT) training benefits. However, it is unclear whether moderate-intensity exercise without dietary intervention induces changes in lipid metabolism to promote a 'healthy lipidome'. The study aimed to investigate the effect of 16 weeks of CT on plasma and white adipose tissue in both sexes, middle-aged subjects with normal weight, obesity and T2D using an ultra-high performance liquid chromatography-mass spectrometry (UHPLC-MS) untargeted lipidomics approach. Body composition, maximum oxygen consumption (VO2 max), strength, and biochemical markers were evaluated before and after the control/training period and correlated with lipid changes. CT consisted of 8 to 10 RT exercises, followed by 35 min of AT (45 -70% VO2 max), 3 times a week for 16 weeks. The CT significantly reduced the levels of saturated and monounsaturated fatty acid side-chains (SFA/MUFA) in sphingolipids, glycerolipids (GL) and glycerophospholipids (GP) as well as reducing fat mass, circumferences and IR. Increased levels of polyunsaturated fatty acids in GPs, and GLs were also observed, along with increased fat-free mass, VO2 max, and strength (all p < 0.05) after training. Our study stated that 16 weeks of moderate-intensity CT remodelled the lipid metabolism in OB, and T2D individuals, even without dietary intervention, establishing a link between exercise-modulated lipid markers and mechanisms that reduce IR and obesity-related comorbidities.

Improving multidisciplinary management of patients living with obesity: The evaluation of seated bioimpedance measures and relationship to functional performance following targeted intervention.

Management of obesity requires a multidisciplinary approach including physical activity interventions, which have significant impacts on overall health outcomes. Greater levels of lean muscle mass are significantly associated with improved health and reduced risk of comorbidities and should be preserved where possible when undertaking rapid weight loss. This article reports on the physical and functional outcomes achieved during a 12-week intensive multidisciplinary intervention targeting obesity and evaluates correlations between body composition and functional outcomes. We additionally aimed to investigate the test-retest reliability and levels of agreement in body composition measurements using bioimpedance spectroscopy between seated and standing positions. Of the 35 participants included in analysis, significant differences were observed between baseline and post-intervention measures. These included weight loss of 12.6 kg, waist circumference reduction of 10.5 cm, fat mass reduction by 2.9%, muscle mass increase by 1.6%, 54.5 m improvement in the 6-minute walk test and 3.8 rep improvement in the 30-second sit-to-stand test. No significant correlations were observed between physical and functional outcome measures. Excellent test re-test reliability was observed in bioimpedance spectroscopy seated measurements (ICC >.9). Significant differences were observed between seated and standing bioimpedance spectroscopy measurements, however they are regarded as small differences in a clinical setting.