Reduction In Waist Circumference Research Articles

Effectiveness of high-intensity interval training and moderate-intensity continuous training on cardiometabolic health in university labourers

Abstract Background: The prevalence of obesity continues to drive the growth of chronic, non-communicable diseases in sub-Saharan African countries. Little evidence is available to prevent the spread of chronic diseases in vulnerable African communities and amongst workers living in these settings. This study aimed to compare and evaluate the effectiveness of a 12-week high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on cardiometabolic health in a cohort of African workers. Methods: Forty-three Black South African university professional workers employed at the University of the Witwatersrand were randomized into 3 groups: HIIT (n = 17), a MICT (n = 15) and a control group (n = 11). The HIIT performed progressive supervised exercise on a cycle ergometer, the MICT performed continuous aerobic activity and the control group maintained their usual routines. Changes in body composition, blood glucose, blood pressure and VO2max outcomes were measured at baseline and at 3-month follow-up. Results: Compared to controls both HIIT and MICT significantly reduced waist circumference (−5.3 and −4.0 cm), BMI (−2.4 and −1.9), and blood pressure (systolic & diastolic - moderate to large effects) (p ♯αμπ;λτ; 0.05). Similarly, blood glucose levels dropped in both intervention groups (−1.9 and −2.0 mmol/L−1) (p ♯αμπ;λτ; 0.05). Notably, both interventions significantly improved VO2max (+7.5 and +7.0 mL.kg−1.min−1) (p ♯αμπ;λτ; 0.05). Conclusions: These findings suggest both HIIT and MICT effectively improve key health markers. In the context of a growing chronic diseases crisis, our study provides important formative data for developing feasible workplace interventions to improve health outcomes.

The effect of bariatric-metabolic surgery on selected components of metabolic syndrome and visceral adipose tissue - the pilot study.

The aim of this study was to monitor changes in the components of the metabolic syndrome defined by Adult Treatment Panel III and the risk of adipose tissue. The study population consisted of 45 patients (30 women, 15 men) who underwent one bariatric procedure - partial jejuno-ileal derivation (n=17), sleeve resection (n=14) or laparoscopic gastric - plication (n=14). Components of metabolic syndrome such as waist circumference, morning glycemia/antihypertension, TAG, HDL cholesterol and blood pressure (BP)/antihypertension were monitored in probands. In addition, Dual Energy X-Ray Absorciometry measurements were performed. Parameters were monitored over the course of one year. The study shows that it is an effective method of weight reduction for the study population with metabolic effects in the risk components of metabolic syndrome - fasting glycemia, increase in HDL cholesterol and reduction in triacylglycerols in the blood, reduction in waist circumference and BP or direct disappearance of metabolic syndrome. Significantly, of the entire cohort, 68.9 % of the probands studied showed signs of metabolic syndrome when measured before the intervention. At the end of follow-up, only 22.2 % of probands showed metabolic syndrome. It was also found that if the amount of visceral fat was reduced, the overall risk of metabolic syndrome was also reduced. The study demonstrates a significant positive effect of bariatric surgery on parameters of metabolic syndrome. The study also showed a positive effect of reduced visceral fat volume on the components of metabolic syndrome.

Comparison between the effect of Empagliflozin and Pioglitazone added to metformin in patients with type 2 diabetes and nonalcoholic fatty liver disease

Background/aimsNon-alcoholic fatty liver disease (NAFLD), defined as the accumulation of >5% fat in the liver, is the most frequently co-exist disease with diabetics up to 70%. Current study was conducted to compare efficacy of combination therapy of empagliflozin (EMPA) or pioglitazone (PGZ) with metformin (MET) in patients with T2DM and NAFLD. MethodsIn this open label, prospective clinical trial, sixty patients were randomly assigned to receive EMPA 10 mg/day or PGZ 30 mg/day in combination Metformin (at least 1500 mg) for six months. NAFLD grade and liver stiffness were defined and measured at the beginning and after 6 months. As the secondary outcomes, anthropometric characteristics, lipid profile, plasma glucose test, and liver enzymes test were measured at the baseline and endpoint. ResultsThe results showed that both combination therapy with EMPA+ MET or PGZ+MET significantly reversed fibrosis stage of NAFLD (P<0.05). Significant reduction in lipid profile test, and liver enzymes test were seen in both groups (P<0.05). However, the greater reduction in waist circumference was observed in EMPA groups compared to PGZ (-4.4 ± 2.39 vs -2.05±1.28, p<0.001), meanwhile weight and BMI decreased significantly only in the patients receiving EMPA (-5.78 ± 3.6 kg vs 0.93 ± 0.33 kg and -2.01± 3.19 kg/m2 vs 0.33 ± 0.12 kg/m2, respectively, P<0.001). Conclusioncombination of EMPA or PGZ with metformin equally improved liver fibrosis stage and stiffness in T2DM patients with NAFLD. The improvements of laboratory tests were observed in the both groups, while, regarding weight reduction, only the regimen containing EMPA was effective.

“Light through Life”– an inter-disciplinary long-term integrated health promotion programme for overweight and obese people

Introduction/Background: In 2019, around half of the Austrian adult population was overweight or obese, and this has only worsened during the COVID-19 pandemic. While research is clear that sustainable weight loss needs a long-term and holistic approach to support lifestyle changes and address the underlying causes of overweight and obesity, most weight loss programmes offer only short-term and single intervention solutions, with a focus on either raising physical activity or changing nutritional habits. To raise the potential for success and translate research into practice, the Austrian Social Insurance Fund for Public Service, Railway and Mining Industries developed “Light through Life”, a long-term integrated health promotion programme, which started in January 2022.&#x0D; Who is it for? The programme was developed by an interdisciplinary team of the social insurance fund and is offered to their adult insurees, who are overweight or obese. They can register themselves, be transferred by their GP or continue after other health promotion and rehabilitation programmes offered by the social insurance fund. The programme itself consists of three phases, which are designed to progressively enable participants to not only manage their weight, but self-sufficiently design their own healthy lifestyle. Regular monitoring, participant feedback and an independent evaluation ensure that a continuous improvement process takes into account the needs of the participants and adjust the programme accordingly.&#x0D; What did you do? “Light through Life” aims to strengthen health literacy and self-management skills of the participants by focussing on four themes: clinical aspects, physical activity, nutrition, and mental health. In addition they receive ongoing support through prevention coordinators. The first phase is a 6-months intensive basic programme, which combines face to face lectures with practical classes covering the four topics. The focus is on creating an understanding of what influences their health and thus their weight and how to manage it differently. The participants learn in groups to create a community of practice. The programme encourages participants to set their own goals and monitor them. In the second phase, the year- long “Pro” programme the support offered changes to coaching and more person-focussed training. In this phase, participants should be able to manage themselves, with thematic workshops and trainings reinforcing the learned content or addressing specific needs. Participation throughout the programme is voluntary.&#x0D; What results did you get? What impact did you have? The programme was introduced with an independent evaluation in place. The evaluation uses a mixed methods approach, analysing both process and outcome measures for participants and professionals. The comprehensive quantitative data collected through regular clinical examinations and an extensive lifestyle questionnaire will enable a better understanding of which elements work and which need improvement. A first, preliminary analysis of the baseline data and after 6 months shows weight and waist circumference reductions in all groups safe obese men (above BMI of 36). More detailed analyses also including mental health and e.g. the urban-rural divide will be available for the conference.&#x0D; With a comprehensive analysis of the first year of the programme, recommendations will be formulated.&#x0D; &#x0D; &#x0D;

The Comparison of Anthropometry and Cognitive Function Before and During Ramadhan Fasting among Overweight and Obese Adults in Kuala Nerus, Terengganu, Malaysia

Ramadhan fasting is one of the five pillars in Islam. During these 29-30 days of holistic and spiritual days, Muslims abstain from drinking and eating from dawn to sunset. This alteration of dietary behavior could affect not only on anthropometry but also cognitive function. This prospective observational study aimed to determine the effect of Ramadhan fasting on anthropometry and cognitive function and its correlation overweight and obese adult populations. This study recruited adults aged between 19 to 65 years old with a BMI of ≥23.0 kg/m2 live in Kuala Nerus. Sociodemographic, anthropometry, and cognitive function data were assessed twice; Before Ramadhan (two weeks prior to Ramadhan) and During Ramadhan (week 3 and 4 during Ramadhan). Anthropometry data including body weight, height, body mass index (BMI), waist circumference, body fat percentage, muscle mass, and total body water were measured using a weighing scale, stadiometer, measuring tape, and bioelectrical impedance analysis (BIA) while the cognitive function was assessed using the Malay Version of the Auditory Verbal Learning Test (MAVLT), Trail Making Test (TMT) A and B, and Stroop Task. A total of 146 participants were recruited with old 54.8% were male while 45.2% were female. The mean age of participants was 42.6±19.4 years. Analysis on the anthropometry data showed that weight, BMI, waist circumference, and body fat percentage were significantly reduced during Ramadhan with p&lt;0.001. Meanwhile, the cognitive function data showed that the completion time for Stroop Congruent and Incongruent Test, and TMT B were significantly reduced during Ramadhan with p&lt;0.001 signifying a better executive performance. The MAVLT learning and recognition scores were significantly increased during Ramadhan (p&lt;0.001) indicating an improvement in memory. The correlational analysis showed the negative correlation between the changes in waist circumference and MAVLT learning during Ramadhan (p=0.031) indicating that reduced waist circumference results in increased MAVLT learning score during Ramadhan. This study’s limitation includes the number of participants that did not reach the required sample size. In conclusion, the current study showed the significant potential of Ramadhan fasting to improve anthropometry outcomes and cognitive function among overweight and obese adults.

Weight reduction and dietary improvements in a cluster-randomised controlled trial for adults with intellectual disabilities.

People with intellectual disabilities (IDs) have an increased risk of obesity and health concerns related to their nutritional status and dietary intake. To assess the effectiveness of a multi-component intervention on weight, waist circumference (WC), clinical health parameters and dietary habits in a group of overweight and obese adults with mild-to-moderate ID. A 7-month cluster-randomised trial and a 7-month follow-up of the intervention group after the end of intervention when the group received usual care. The intervention consisted of monthly dietary-group courses tailored to the participants' cognitive abilities and practical skills, monthly nutritional courses for staff, use of behaviour change techniques and nudging. The control group received usual care during the intervention. There were 32 participants aged 22-61 years: 15 in the intervention group and 17 in the control group. After 7 months, a non-significant weight difference (median difference = -1.25 kg; 95% confidence interval [CI] = -2.00; 0.95 vs. +1.00 kg; CI = -1.15; 3.00, P = 0.08) and a significant WC difference were observed between the intervention and control groups (median difference = -3.75 cm; CI: -7.68; 0.11 vs. 0 cm; CI = -3.99; 1.00, P = 0.03), respectively. The median reduction in WC continued in the intervention group during the 7-month follow-up (median difference = -7.50 cm; CI: -13.57; -3.16, P = 0.002). A significant difference in frequency intake of fruit (P = 0.03) and berries (P = 0.004) was observed between the groups after 7 months, supported by a significant increase in measured serum-carotenoid levels in the intervention group after 7 months (median difference = 0.26 mmol/L; CI: -0.12; 0.52, P = 0.007). A significant difference in WC was observed between the groups, accompanied by changes in blood parameters and dietary habits.

Outcomes of a Remote Cardiac Rehabilitation Program for Patients Undergoing Atrial Fibrillation Ablation: Pilot Study.

Risk factor modification, in particular exercise and weight loss, has been shown to improve outcomes for patients with atrial fibrillation (AF). However, access to structured supporting programs is limited. Barriers include the distance from appropriate facilities, insurance coverage, work or home responsibilities, and transportation. Digital health technology offers an opportunity to address this gap and offer scalable interventions for risk factor modification. This study aims to assess the feasibility and effectiveness of a 12-week asynchronous remotely supervised exercise and patient education program, modeled on cardiac rehabilitation programs, in patients with AF. A total of 12 patients undergoing catheter ablation of AF were enrolled in this pilot study. Participants met with an exercise physiologist for a supervised exercise session to generate a personalized exercise plan to be implemented over the subsequent 12-week program. Disease-specific education was also provided as well as instruction in areas such as blood pressure and weight measurement. A digital health toolkit for self-tracking was provided to facilitate monitoring of exercise time, blood pressure, weight, and cardiac rhythm. The exercise physiologist remotely monitored participants and completed weekly check-ins to titrate exercise targets and provide further education. The primary end point was program completion. Secondary end points included change in self-tracking adherence, weight, 6-minute walk test (6MWT), waist circumference, AF symptom score, and program satisfaction. The median participant age was 67.5 years, with a mean BMI of 33.8 kg/m2 and CHADs2VASC (Congestive Heart Failure, Hypertension, Age [≥75 years], Diabetes, Stroke/Transient Ischemic Attack, Vascular Disease, Age [65-74 years], Sex [Female]) of 1.5. A total of 11/12 (92%) participants completed the program, with 94% of expected check-ins completed and 2.9 exercise sessions per week. Adherence to electrocardiogram and blood pressure tracking was fair at 81% and 47%, respectively. Significant reductions in weight, waist circumference, and BMI were observed with improvements in 6MWT and AF symptom scores (P<.05) at the completion of the program. For program management, a mean of 2 hours per week or 0.5 hours per patient per week was required, inclusive of time for follow-up and intake visits. Participants rated the program highly (>8 on a 10-point Likert scale) in terms of the impact on health and wellness, educational value, and sustainability of the personal exercise program. An asynchronous remotely supervised exercise program augmented with AF-specific educational components for patients with AF was feasible and well received in this pilot study. While improvements in patient metrics like BMI and 6MWT are encouraging, they should be viewed as hypothesis generating. Based on insights gained, future program iterations will include particular attention to improved technology for data aggregation, adjustment of self-monitoring targets based on observed adherence, and protocol-driven exercise titration. The study design will need to incorporate strategies to facilitate the recruitment of a diverse and representative participant cohort.

Effect of different bariatric surgery methods on metabolic syndrome in patients with severe obesity.

Bariatric surgery (BS) has been as a currently developed treatment of choice for metabolic syndrome (MetS). Which, in turn, is well-known as serious public health concern. Therefore, this study assessed the outcomes of different procedures of BS and possible predictors for improving MetS. This single-center retrospective cohort analysis included bariatric candidates between 2009 and 2017. The operational approach was chosen based on the patient's condition, as well as the patient's metabolic profile and the surgeon's experience. All desired information was evaluated at baseline and 6, 12, and 24months after the operation. Of the 1111 patients included, 918 (82.6%) were female. There was no considerable trend in the improvement of MetS over the follow-up period of each surgery group. After 6 to 24months of follow-up, waist circumference reduction was significant in all three types of surgery, and sleeve gastrectomy resulted in the best (but not significant) improvement rates after 24months (P = 0.079). One anastomosis gastric bypass had highest decrease in percentage of excess weight loss than other procedures (P < 0.001). Each year increase in age was associated with a 4% decrease in MetS remission. In addition, the male gender, was correlated with MetS improvement positively (P = 0.049). Each one-unit increase in hemoglobin A1c (HbA1c) reduced the MetS remission rate by 40%. All three methods of BS were similarly effective in MetS. Consider the predictive value of age, gender, and HbA1c before determining the optimum procedure for each patient is recommended.

Liraglutide for the treatment of obesity among patients with hidradenitis suppurativa

Background and aimsHidradenitis suppurativa (HS) is associated with obesity. Weight loss is frequently reflected in an amelioration in the severity of the lesions. Case reports have suggested that liraglutide might improve not only weight but also skin. We aimed to study the effects of liraglutide 3mg in patients with obesity and HS on metabolic and dermatological parameters. Methods14 patients started treatment with liraglutide for 3 months. Severity of the lesions was evaluated using the Hurley Staging System and quality of life with the DLQI (Dermatology Quality Index). ResultsThere was a significant reduction in BMI (39.3±6.2 vs 35.6±5.8; p=0.002), waist circumference (121.3±19.2 vs 110.6±18.1cm; p=0.01), CRP (4.5±2.2 vs 3±2.1mg/L; p=0.04), homocysteine (16.2±2.9 vs 13.3±3μmol/L; p=0.005) and plasma cortisol (15.9±4.8 vs 12.6±4.5μg/dL; p=0.007). Hurley (2.6±0.5 vs 1.1±0.3; p=0.002) and DLQI (12.3±2.8 vs 9.7±6.9; p=0.04) improved significantly. In multiple regression analysis, weight loss did not correlate with any inflammatory parameter or Hurley. ConclusionsLiraglutide 3mg is effective and safe among patients with HS and obesity. Long-term studies are mandatory to assess the effects of liraglutide on skin lesions and inflammatory markers among subjects with HS beyond weight loss.

The relationship of pre-pregnancy body mass index with maternal anthropometric indices, weight retention and the baby’s weight and nutrition in the first 6 months post-partum

PurposePre-pregnancy body fat mass is one of the important indicators of the mother's and the infant's health. Therefore, the purpose of this study was to investigate relationship of pre-pregnancy body mass index (PPBMI) with maternal anthropometric indices and weight retention as well as the baby's weight and nutrition in the first 6 months post-partum.Materials and methodsThis is a prospective cohort study including 397 mothers giving birth to healthy babies and referring to health centers in Ahvaz (southwest of Iran) in 2022. The following data were extracted from the participants' electronic record: body mass index (BMI) before or at the beginning of pregnancy, gestational weight gain, and weight at the time of delivery. In addition to demographic information, the following data were also evaluated: maternal anthropometric indices including weight, hip and waist circumference, and conicity index during the first 10 days post-partum, along with the weight and nutrition pattern of the baby 2, 4 and 6 months post-partum.ResultsThe mean age of the mothers was 29.96±5.7 years. The frequency of mothers according to BMI classification (i.e., underweight, normal, overweight, and obese) was 4.3%, 38.5%, 37%, and 20.3%, respectively. In this study, PPBMI had a significant relationship with decreasive changes of weight, waist and hip circumferen and conicity index after child birth, 2, 4 and 6 months post-partum (P<0.05) but the mean reduction of these anthropoemetric indices at 6th month postpartum were not related to PPBMI (P>0.05). However, this relationship was not significant when it came to the weight of the baby (P > .05). The lowest reduction in weight, waist and hip circumference and conicity index belonged to overweight mothers but the highest frequency of mothers with excesive gestational weight gain, the lowest frequency of breastfeeding until 6 months and also the lowest values of postpartum weight retention were observed in obese mothers (P<0.05).ConclusionAccording to the findings of this study, the decrease in anthropometric indices up to 6 months after delivery in overweight mothers is less than other BMI groups, but the consequences related to weight and nutrition in infants of obese mothers need special attention. Also, the results re-emphasize the importance of focusing on provision of educational and counseling services to mothers in order to improve their nutrition and weight, especially before pregnancy.

Network meta-analysis of three different forms of intermittent energy restrictions for overweight or obese adults.

This network meta-analysis aimed to compare the efficacy of three forms of intermittent energy restriction (IER), including alternate-day fasting (ADF), the 5:2 diet, and time-restricted feeding (TRF), in overweight or obese adults. A literature search was conducted in PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure (CNKI) to find relevant randomized controlled trials (RCTs) until August 10, 2022. The modified Cochrane risk of bias assessment tool was applied to assess the methodological quality of eligible studies. Random network meta-analysis was conducted using STATA 14.0. Sixteen RCTs were included, with 1228 patients. Overall, the methodological quality ranged from low to moderate. ADF was superior to CER and 5:2 diet in reducing waist circumference, whereas 5:2 diet was superior to CER in reducing BMI. Regarding fat mass and drop-out, all forms of IER were comparable. Sensitivity analyses indicated that the type of individuals had no influence on the pooled results; nevertheless, ADF significantly reduced weight compared to CER and achieved significant waist circumference reduction compared to CER, 5:2 diet, and TRF. ADF may be preferentially prescribed for overweight or obese adults. More large-scale and high-quality studies are required, however, to investigate the effect of TRF on overweight and obesity.

The Effects of Breastfeeding and Gestational Diabetes Mellitus on Body Mass Composition and the Levels of Selected Hormones after Childbirth.

The study group included 42 women with a singleton pregnancy, diagnosed with GDM between the 24th and 28th week of gestation. The control group consisted of 28 non-diabetic women with a singleton pregnancy. This study was carried out at 6-8 weeks as well as at 1 year postpartum. The women were subjected to body weight measurements and body composition analysis performed using a professional body composition analyzer TANITA DC-430 S MA. Waist circumference and subcutaneous fat was measured. Blood for laboratory tests was taken in the morning, on an empty stomach. It was shown that, regardless of diabetes, exclusive breastfeeding had a significant impact on weight loss at 6-8 weeks postpartum (p = 0.014785) and lower insulin levels (p = 0.047). However, there was no effect of breastfeeding on the women's anthropometric measurements or hormone levels one year after delivery, except for the thickness of subcutaneous adipose tissue, which was significantly lower in breastfeeding women (p = 0.03). One year after delivery, breastfeeding women had a lower BMI (p = 0.0014), less-thick subcutaneous adipose tissue (p < 0.001), and a lower risk of obesity (p = 0.016). There were also higher insulin and ghrelin levels in both breastfeeding and non-breastfeeding women (p < 0.001), and lower resistin levels in non-breastfeeding women (p = 0.004). Women who had diabetes during pregnancy had a significantly reduced waist circumference and subcutaneous fat thickness after one year (p < 0.001 and p = 0.05, respectively). Having diabetes during pregnancy did not significantly affect the results of anthropometric measurements and hormone levels noted at 6-8 weeks after delivery (the only exception was the thickness of subcutaneous fat tissue, which was greater in women without GDM). This may indicate normalization of carbohydrate metabolism after childbirth; however, the observation period is too short to elucidate long-term metabolic effects. This suggests the need for further research related to GDM and breastfeeding.

Efficacy of pranic healing for inch-loss

Pranic Healing is an ancient science and art of healing that uses Prana or Life force to heal the whole physical body. It is a no-drug, no-touch energy healing modality taught by Master Choa Kok Sui since 1987. The study aimed to assess if a single session of Pranic Healing can lead to inch loss.An interventional study was conducted with 49 volunteers who desired waist circumference reduction. Baseline waist circumference measurements were collected from all participants. This was followed by a single 60-minute session of Distant Pranic Healing administered by a Certified Practitioner.Waist circumference measurements were recorded immediately after the healing session. The data analysis showed that post-intervention there was a statistically significant reduction in the measured waist circumference for the study group for over 90% of the study participants. These results prove that Pranic Healing can aid as a modality for inch loss. It is remarkable to note that a reduction of waist circumference was achieved in a 60-minute Pranic Healing session without using any drugs, gadgets, or physical contact.

Effect of Short Bouts of Vigorous Stair Climbing on Cardiorespiratory Fitness in Women with Overweight and Obesity: A Pilot Feasibility Study.

We examined the effect of 4 weeks of a brief vigorous stair climbing exercise on cardiorespiratory fitness (CRF) and body composition in women with overweight or obesity. Twenty-six participants (age, 25.4±4.9 years; body mass index [BMI], 25.3±1.8 kg/m2) were randomly assigned to either a stair climbing exercise group (n=13) or a non-exercising control group (n=13). The stair climbing exercise group performed 20 sessions (supervised, five sessions/week over 4 weeks) of brief intermittent stair climbing exercise consisting of a 3-minute warm-up followed by three bouts of 20 seconds of stair climbing (≥80% of age-predicted maximum heart rate) interspersed with 2-minute recovery periods (total exercise duration=10 minutes/session). Peak oxygen uptake (VO2peak) was measured using a graded maximal treadmill test with the use of a standard open-circuit spirometry technique. Body composition was assessed with bioelectrical impedance analysis. All participants, except one who dropped out due to coronavirus disease 2019 (COVID-19) infection, completed the study with 100% attendance rates. There were significant interaction effects (group×time) on body weight, BMI, waist circumference, and CRF such that the stair climbing exercise group had significant (P≤0.01) reductions in body weight (66.5±4.6 to 65.2±4.6 kg), BMI (24.8±1.2 to 24.4±1.1 kg/m2), and waist circumference (78.0±3.7 to 76.5±4.1 cm) and improvements in VO2peak (31.6±2.5 to 34.9±2.6 mL/kg/min) compared with controls. Short bouts of vigorous stair climbing is a feasible and time-efficient exercise strategy for improving CRF in previously sedentary, young women with overweight and obesity.

The effect of subcutaneous dulaglutide on weight loss in patients with Type 2 diabetes mellitus: Systematic review and meta-analysis of randomized controlled trials.

Dulaglutide, a subcutaneously administered glucagon-like peptide 1 receptor agonist, has been hypothesized to lead to weight loss in patients with Type 2 diabetes mellitus (T2DM). However, the consequences of its prescription on body weight (BW) and other anthropometric indices, for example, body mass index (BMI) or waist circumference (WC), have not been completely clarified. Therefore, we aimed to assess the effects of subcutaneous dulaglutide administration on BW, BMI and WC values in T2DM subjects by means of a systematic review and meta-analysis of RCTs. We computed a literature search in five databases (PubMed/Medline, Web of Science, EMBASE, Scopus and Google Scholar) from their inception to February 2023 to identify RCTs that examined the influence of subcutaneous dulaglutide on obesity indices. We calculated effect sizes using the random-effects model (using DerSimonian-Laird method). Results were derived across weighted mean differences (WMD) and 95% confidence intervals (CI). Subgroup analyses were applied to explore possible sources of heterogeneity among the RCTs. The current systematic review and meta-analysis was conducted in compliance with The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. In total, 18 studies with 33 RCT arms (BW = 33 RCT arms, 14,612 participants, 7869 cases and 6743 controls; BMI = 10 RCT arms, 14,612 subjects, 7869 cases and 6743 controls; WC = 10 RCT arms, 1632 participants, 945 cases and 687 cases) were included in the meta-analysis. BW (WMD: -0.86 kg, 95% CI: -1.22, -0.49, p < 0.001), BMI (WMD: -0.68 kg/m2 , 95% CI: -0.88, -0.49, p < 0.001) and WC (WMD: -1.23 cm, 95% CI: -1.82, -0.63, p < 0.001) values decreased notably following subcutaneous dulaglutide administration versus placebo. BW notably decreased in RCTs lasting >18 weeks (WMD: -1.42 kg, 95% CI: -1.90, -0.94, p < 0.001), whereas notable reductions in WC were seen in RCTs lasting ≤18 weeks (WMD: -1.78 cm, 95% CI: -2.59, -0.98, p < 0.001). Dulaglutide dosages >1 mg/day significantly decreased BW (WMD: -1.94 kg, 95% CI: -2.54, -1.34, p < 0.001), BMI (WMD: -0.80 kg/m2 , 95% CI: -1.07, -0.54, p < 0.001) and WC (WMD: -1.47 cm, 95% CI: -1.80, -1.13, p < 0.001). BW decreased particularly following dulaglutide prescription in individuals with obesity (WMD: -1.05 kg, 95% CI: -1.28, -0.82, p < 0.001) versus overweight. The dose-response meta-analysis revealed that BW decreased significantly when dulaglutide was prescribed in doses ≤3 mg/day versus >3 mg/day. Subcutaneous dulaglutide administration in T2DM reduces BW, BMI and WC. The decrease in BW and WC was influenced by the dose and the duration of dulaglutide administration. The reduction in BMI was only influenced by the dosage of dulaglutide. Moreover, T2DM patients who suffered from obesity experienced a notable decrease in BW versus T2DM subjects without obesity.

Effectiveness of a hybrid technology enabled care model as measured by ICHOM standard set on established and managed type 2 diabetes already using medications: A RWE retrospective study

AimsDiabetes is a pressing global health issue, demanding innovative strategies for improved treatment. However, traditional care often falls short of patient goals. To address this, digital health solutions, including smartphone apps and remote monitoring, have emerged as crucial in diabetes management. This study aims to assess a comprehensive intervention, combining remote continuous data monitoring (RCDM) with in-clinic care, for enhancing diabetes-related outcomes. Additionally, it seeks to evaluate the effectiveness of the digital RCDM component by comparing adherent and non-adherent patients. MethodsConducted in the United Arab Emirates, a retrospective study involved 89 patients primarily on anti-diabetic medications. They were split into two groups based on adherence to RCDM. Over time, significant improvements were observed across various parameters. ResultsNotably, patients exhibited weight loss (−4.0 ± 5.3, p < 0.001), reduced waist circumference (−4.74 ± 7.8, p < 0.001), lowered HbA1c levels (−1.00 ± 1.3, p < 0.001), decreased systolic BP (−3.1 ± 13.1, p = 0.035), and diminished diastolic BP (−3.4 ± 9.9, p = 0.002) annually. Furthermore, patients adhering to the GluCare model demonstrated substantial HbA1c reductions (−1.53 ± 1.5, p < 0.001), improved lipid profiles, notably decreased total Cholesterol (−16.6 ± 50.3, p = 0.034), and lowered LDL levels (−18.65 ± 42.6, p = 0.006). ConclusionsThe intervention model effectively managed T2D patients through a comprehensive approach, yielding notable improvements in HbA1c levels and other outcomes within a year. The study underscores the limitations of traditional care and reliance simply on pharmacotherapy, and emphasizes the need for a hyper-personalized, and continuous approach for T2D management.

Effect of Ramadan intermittent fasting on renal and liver function markers among healthy overweight and obese males: A prospective cohort study

Intermittent fasting (IF) has garnered attention for its potential to promote health and combat chronic diseases. This study focused on the effects of Ramadan fasting, a form of IF observed by Muslims, on renal and liver function markers, anthropometric measurements, and dietary intake in healthy overweight and obese men. The study involved 60 participants from Hargeisa, Somaliland, with an average age of 40.01 ± 7.99 years. Results revealed significant reductions in body weight (P ≤ 0.001), waist circumference (P ≤ 0.001), and body mass index (P ≤ 0.001) after Ramadan fasting. Urea levels decreased significantly (P = 0.003), and though creatinine levels showed a non-significant decrease, uric acid levels increased significantly within the normal range (P ≤ 0.001). Serum glutamate oxaloacetate transaminase (GOT) levels decreased significantly (P ≤ 0.001), while glutamate pyruvate transaminase (GPT) and alkaline phosphatase (ALP) levels remained stable. Dietary analysis indicated a significant decrease in total carbohydrates (P = 0.023), proteins (P = 0.006), and dietary cholesterol intake (P ≤ 0.001). These findings suggest that Ramadan fasting positively impacts anthropometric and renal-liver function markers in healthy overweight and obese men. The study contributes to the expanding understanding of intermittent fasting's potential health benefits, emphasizing the importance of considering Ramadan fasting as a preventive approach for metabolic disorders. Further research should explore long-term effects, mechanistic insights, and personalized clinical applications, while public health initiatives could educate individuals about safe and informed fasting practices.

Abstract 15452: Using a Commercial Virtual Health Platform to Effectively Treat Obesity and Improve Cardiometabolic Risk Factors at Scale

Introduction: Obesity is a critical risk factor for cardiometabolic disease, yet effective treatment has not been available at scale for the &amp;gt;200 million Americans who meet criteria for obesity treatment. To improve access to evidence-based treatment, we established a virtual metabolic health company to provide medically supervised obesity treatment at scale. Research Questions: This real-world evaluation examines the impact of a virtual health program on weight and related cardiometabolic markers as well as self-reported assessment of key health behaviors in food, exercise, sleep, and emotional health. Methods: Data were analyzed for individuals who completed at least 12 months in the core program. Obesity treatment involved GLP-1 receptor agonist medications combined with a proprietary intensive lifestyle intervention delivered with virtual coaching. Weights were submitted via cellular connected scale. Waist circumference, metabolic labs, and patient questionnaires were also analyzed at baseline and 12 months. Results: The cohort includes 2,643 patients who completed at least 12 months. Average weight loss at 12, 15, and 18 months was 15.58% (n=2,397), 15.97% (n=1,319), and 15.82% (n=569). Improvement was observed for all collected metabolic markers: waist circumference, AST/ALT, lipids, HbA1c, insulin, hs-CRP. Specifically for cardiovascular labs, 12 month endpoints showed improvement in HDL in 51% (n= 1180), in LDL for 61% (n=1174), in hs-CRP for 81% (n=956). Of n=303 with abnormal A1c at baseline, 72.9% achieve A1c &amp;lt;5.7%. Average reduction in waist circumference was 5.95 inches (n=1,507). Positive changes were also seen for patient-reported outcomes. Discussion: Given limited access to effective obesity treatment as a pathway to better cardiometabolic disease management, novel approaches must be developed. Results from 2,643 enrollees in a virtual metabolic health program demonstrate clinically significant and sustained weight loss through 18 months, with improvement in associated key cardiometabolic risk markers, health behaviors, and patient-reported outcomes. This commercial program demonstrates promising results in cardiometabolic risk improvement through medically managed weight loss delivered virtually.

Abstract 17793: Remotely Delivered Weight Loss and Exercise Intervention to Improve Cardiovascular Risk in Older Patients With Rheumatoid Arthritis

Background: Persons with rheumatoid arthritis (RA) face two-fold increases in CVD, due to traditional risk factors - e.g., hypertension, dyslipidemia, obesity, and physical inactivity - and RA systemic inflammation. Despite improvements in pharmacologic management of inflammatory disease activity, the increased prevalence of RA CVD persists. Thus, developing innovative, non-pharmacologic interventions to improve clinical care is critical. The goal of the SWET-RA trial was to identify the effects of a 16-wk remotely supervised weight loss and exercise training (SWET) intervention on metabolic syndrome in older persons (60-80 years) with RA and overweight/obesity (BMI 28-40 kg/m 2 ). Methods: Participants were randomized to SWET (n =10) or a counseling health as treatment (CHAT) control group (n=10). Using video conference and mobile applications, the SWET group completed aerobic training (150 min/wk moderate-to-vigorous), resistance training (2 days/wk), and a hypocaloric diet (7% weight loss goal). The CHAT group completed two counseling visits for diet and exercise followed by monthly check-ins. Metabolic syndrome z -scores (MSSc) were derived from fasting glucose, triglycerides (TG), HDL-cholesterol (HDL-C), waist circumference (WC), and mean arterial pressure. Within groups, Wilcoxon signed rank tests assessed significance of post- minus pre-intervention change scores (p&lt;0.05). Between group comparisons were assessed using regression modeling controlling for baseline. Results: Following the intervention, the SWET group significantly improved TG and WC, yet reduced HDL-C; the CHAT group did not improve individual score components. Both groups significantly improved MSSc, with no between group differences. Conclusion: Results from this trial support the use of a remotely delivered program for older persons with RA and overweight/obesity. Both SWET and CHAT elicited improvements in a composite measure of CVD risk. Although SWET exceeded CHAT for reductions in TG and WC, HDL-C was reduced in SWET - possibly due to the hypocaloric diet - and increased in CHAT, likely accounting for the lack of MSSc group difference. More research is needed to distinguish the specific effects of exercise versus diet and weight loss for improving RA CVD risk.

Effects of green tea catechin on the blood pressure and lipids in overweight and obese population-a meta-analysis

BackgroundOverweight and obesity as main health problems harm human beings worldwide. The number of people diagnosed with overweight and obese is gradually increasing. Green tea catechin has been reported to effectively help control body weight in overweight and obese population, and is protectively against the blood pressure and lipids in people with type 2 diabetes and metabolic syndrome. MethodsWe retrieved 4 English databases (PubMed, Web of science, Cochrane, Scoups) from inception to April 20, 2023. Two reviewers independently determined eligibility, assessed the reporting quality of included studies, and extracted the data. Data were extracted from eleven studies. The results were presented with the weighted mean differences (WMDs), and the confidence intervals (CIs) was 95 %. The random-effects or fixed-effects model was applied according to the heterogeneity. The subgroup analysis was used to identify the source of heterogeneity. Publication bias was evaluated using funnel plots, Egger's test, and Begg's test. ResultsEleven randomized controlled trials (RCTs) inclusion studies were screened from 3072 literature articles, involving 613 overweight and obese patients. After combining all studies, it was found that in overweight and obese people green tea catechin could reduce waist circumference (WC) (pooled WMD = −1.37 cm, 95 % CI: −2.52 to −0.22 cm, p = 0.019), and triglyceride (TG) (pooled WMD = −0.18 mmol/L, 95 % CI: −0.35 to −0.02 mmol/L, p = 0.032), and increase high density lipoprotein cholesterol (HDL-c) (pooled WMD = 0.07 mmol/L, 95 % CI: 0.01–0.14 mmol/L, p = 0.031). ConclusionGreen tea catechin supplement effectively reduced WC and TG levels and improved HDL-c levels. However, it did not show the significant effect on the blood pressure in overweight and obese people. The present meta-analysis showed a moderate benefit of green tea catechin supplementation on lipid profiles in overweight and obese people.