Weight Reduction Program Research Articles

Impact of baseline dietary quality on the efficacy of a dietitian-guided weight reduction program.

This pre-post intervention study aimed to assess the relationship between baseline dietary quality and the efficacy of a dietitian-guided weight reduction program, which has not been thoroughly documented to date. Ninety-two consecutive obese or overweight patients visiting a tertiary center clinic for weight reduction were enrolled in this study. Participants received a dietitian-guided weight reduction education program aimed at reducing daily caloric intake by 500kcal and improving adherence to the Mediterranean diet for 3 months. Baseline dietary quality was assessed using the 14-item Taiwanese Mediterranean Diet Adherence Screener (T-MEDAS), where a higher T-MEDAS score reflects greater adherence to the Mediterranean diet. Additional covariates, including dietary behaviors, lifestyle factors, and comorbidities were also recorded. The primary outcome was the percentage of weight reduction at 3 months, analyzed using restricted cubic spline models and generalized estimating equations (GEE) to account for the correlation between weight change and the baseline T-MEDAS scores. Thirty-nine participants were excluded due to major illnesses, use of anti-obesity medications, or loss to follow-up. Among the remaining 53 participants (mean age 41.2 ± 12.8 years, 56.6% female), the average weight reduction was 3.9 ± 3.3% from a baseline weight of 98.5 ± 12.8kg. Participants who did not achieve a weight reduction of more than 5% had higher baseline T-MEDAS scores compared to those who did (5.4 ± 1.7 vs. 4.1 ± 1.8, p = 0.026). A restricted cubic spline model, adjusted for covariates including age, gender, diabetes mellitus (DM), dyslipidemia, and smoking, revealed a significant inverse relationship between higher baseline T-MEDAS scores and weight loss. After controlling for various confounders, GEE analysis demonstrated that higher baseline T-MEDAS scores were significantly associated with less weight loss (beta: -4.1, 95% CI: -5.6 to -2.6, p < 0.001). Higher baseline dietary quality was associated with reduced effectiveness of a dietitian-guided weight reduction program. This suggests that additional strategies may be required to improve the success of weight loss interventions in individuals with higher baseline dietary quality.

Obesity medicine provider-directed health coaching in a commercial weight loss program: Proof of concept

BackgroundObesity remains a leading serious chronic disease and cause of death in the U.S. Despite previous research in diets (i.e., caloric restriction), physical activity levels, and biochemical markers, no studies to date have investigated the combination of an obesity medicine physician with a health coach alongside a commercial program for reducing body weight. As a result, this pilot study aims to assess the relationship between a commercial diet program and health and wellness coaching (HWC) for weight reduction outcomes when delivered in conjunction with an obesity medicine physician chronic disease care model, as a proof-of-concept study. MethodsThis 24-week proof-of-concept study was pragmatic, being an unblinded, unrandomized, uncontrolled, longitudinal, observational study. Its purpose was to assess participant weight reduction from a commercial weight reduction program using a pre-packaged portion-controlled reduced-calorie diet while meeting with a health coach and obesity medicine physician for counseling and support. Participants in the sample underwent a commercial weight reduction program through dietary control while meeting with an HWC. A repeated measures ANOVA was conducted to determine the weight reduction trends across a 24-week program. ResultsThis study included n = 53 participants; a majority were white females (n = 45; 85 %), with an average (SD) age of 50.3 (12.2) years. There was a significant improvement in weight reduction (21.8 ± 9.4 lbs. WL) seen throughout the 24-week program (F (7, 364) = 33.129, p < 0.001), with a large effect (η2 = 0.922). ConclusionThis proof-of-concept project found that Obesity Medicine Physician-directed, portion-controlled meals and HWC can improve weight reduction across a 24-week program using portioned-controlled meals. Confirmation of these findings and their clinical significance requires a follow-up randomized, controlled clinical trial using validated assessment tools.

A Qualitative Exploration of Participants' Experiences in a Randomized Controlled Trial of Weight Reduction Through a Nurse-Led Intervention.

Background Obesity presents a significant global health challenge, increasing the risk of various health complications. Nurse-led interventions offer a promising, patient-centered approach to weight reduction. However, qualitative research on participants' experiences in nurse-led weight reduction programs is limited. Objective The objective of this study was to explore the lived experiences of participants in a nurse-led weight reduction program over a period of 12 months. Methods Following a randomized controlled trial within a sequential mixed-methods study, in-depth interviews were conducted with 13 volunteers who successfully reduced their weight by at least 5% through a nurse-led intervention (NLI). The data were analyzed using interpretative phenomenological analysis, with careful attention to ensuring both data credibility and participant confidentiality. Results Participants reported positive health improvements over 12 months, including reductions in weight, BMI, waist circumference, blood pressure, and glucose levels. Four primary themes that surfaced were nutritional choices and habits, active lifestyle, support system and motivation, insights, and strategies from health journey participants. Participants adapted to healthier eating habits, incorporating protein-rich foods, millets, and seasonal fruits and vegetables. Walking and yoga were primary physical activities, with participants emphasizing their importance and strategies to overcome barriers. Family support, healthcare guidance, and work-life balance played crucial roles in participants' weight loss journeys. Conclusion The study highlights the effectiveness of NLIs in promoting sustainable weight loss and improving metabolic health. Insights from participants' experiences underscore the importance of dietary modifications, regular physical activity, and social support in successful weight management. Further research is needed to validate these findings and develop tailored interventions.

Searching for the Scale-Able Weight Loss Intervention: Can One Size Fit All? Lessons to Be Learned from the EQUAL Trial.

Overweight and obesity affect 71.2% of adults in the United States, with cancer survivors not far behind at 70.3%. Subgroups such as those diagnosed with acute lymphoblastic leukemia (ALL) face even greater challenges. The Exercise and Quality Diet after Leukemia (EQUAL) trial sought to address weight management issues among ALL survivors by implementing a remotely delivered weight loss intervention, leveraging the previously proven Practice-based Opportunities for Weight Reduction (POWER) program. Despite a strong foundation and design, the EQUAL trial yielded null results. Key differences in study populations and intervention contexts between the EQUAL and POWER trials, such as the lack of primary care physician involvement in EQUAL, contributed to these outcomes. EQUAL's failure to meet its accrual target and poor adherence among participants highlighted challenges in engaging this unique population. Contrary to EQUAL's conclusions, evidence from other studies supports the efficacy of remote interventions for weight loss among cancer survivors. The lack of qualitative assessment among ALL survivors and key integration to inform intervention adaptations undermined EQUAL's impact. However, EQUAL's impressive retention rate offers valuable insights. Lessons from EQUAL underscore the need for well-fitted, remotely delivered interventions and the importance of thoughtfully adapted and tailored approaches to specific survivor populations. See related article by Fiedmann et al., p. 1158.

Effects of Melatonin on Exercise-Induced Oxidative Stress in Adults with Obesity Undergoing a Multidisciplinary Body Weight Reduction Program.

Background: Obesity is characterized by increased oxidative stress, which, in a vicious circle, promotes chronic low-grade inflammation. Melatonin, a well-documented antioxidant, might be useful as a supplement to enhance the cardiometabolic benefits of any body weight reduction program (BWRP). Objectives/Methods: The present study aimed to evaluate the post-exercise oxidative stress and inflammation in a group of subjects with obesity treated with melatonin (2 mg/die) or placebo, undergoing a 2-week BWRP, with the administration of a single bout of acute exercise at the start and the end of the protocol (G1-G15). Results: Eighteen adults with obesity were enrolled and distributed to the two arms of the study: the melatonin group (F/M: 7/2; age: 27.8 ± 5.6 years; body mass index [BMI]: 43.0 ± 4.9 kg/m2) and the placebo group (F/M: 6/3; age: 28.8 ± 5.0 years; BMI: 42.8 ± 4.0 kg/m2). BWRP induced a decrease in BMI and waist circumference (WC) in both groups; plasma glucose, blood glycated hemoglobin (HbA1c), and neutrophil to lymphocyte ratio (NLR) were reduced only in the placebo group. Importantly, plasma biological antioxidant potential (BAP) increased throughout BWRP. Paradoxically, melatonin enhanced post-exercise production of plasma derivatives of reactive oxygen metabolites (d-ROMs) and erythrocytic glutathionyl-Hb (HbSSG) (at G1 and G15). Finally, differently from the placebo group, melatonin-treated subjects did not exhibit the BWRP-induced decrease in plasma levels of interleukin-6 (IL-6), before and after exercise, at the end of two weeks (G15). Conclusions: Melatonin is presumably an antioxidant with "conditional" prooxidant actions. The use of melatonin as a supplement in subjects with obesity might be deleterious due to the abolishment of BWRP-induced cardiometabolic benefits.

An Intermittent Fasting Intervention for Black Adults Can Be Feasibly Implemented in Black Churches: A Cluster Randomized Controlled Pilot Study

BackgroundIntensive lifestyle interventions, including modest reductions in daily caloric intake (ie, continuous calorie energy reduction [CER]), are recommended by US national professional health organizations (eg, American Heart Association). However, they are less effective in Black communities. A burgeoning literature has reported the promise of intermittent fasting (IF) as an alternative strategy for weight loss. However, IF studies have been conducted with White participants predominately and provided participant resources not readily available in real-world situations. ObjectiveWeight-loss and weight-related outcomes of a scalable (ie, able to be widely disseminated and implemented) IF intervention developed with and for Black adults were compared with a CER intervention for the purpose of determining IF’s feasibility (ie, initial effectiveness, adherence, and acceptance) in a Black community. DesignA cluster randomized controlled pilot study was conducted. Participants/settingA total of 42 Black adults with a body mass index (calculated as kg / m2) ≥25 were recruited from 5 Black churches (3 IF and 2 CER) in Western New York State from September 2021 to May 2022. Participants were free of medical conditions that might have contraindicated participation in a weight-reduction program and other factors that might affect weight loss. InterventionsCommunity health workers delivered the 6-month, 16-session, faith-based IF and CER interventions. Main outcome measuresThe primary outcome was feasibility, consisting of initial effectiveness on body weight (ie, percent body weight lost from baseline to 6-month follow-up), adherence, and acceptability. Statistical analyses performedDescriptive statistics and linear mixed models accounting for within-church clustering were used. A baseline covariate corresponding to the outcome variable was included in the model. Intent-to-treat analysis was used. ResultsThere was statistically significant weight loss within both arms (IF: –3.5 kg; 95% CI –6 to –0.9 kg, CER: –2.9 kg; 95% CI –5.1 to –0.8 kg) from baseline to 6-month follow-up. Compared with CER, IF led to significantly lower daily energy intake (414.2 kcal; 95% CI 55.2 to 773.2 kcal) and fat intake (16.1 g; 95% CI 2.4 to 29.8 g). IF may result in lower fruit and vegetable intake (–103.2 g; 95% CI –200.9 to –5.5 g) and fiber intake –5.4 g; 95% CI –8.7 to –2 g) compared with CER. Participants in the IF arm completed a mean (SE) of 3.8 (1.4) more self-monitoring booklets compared with those in the CER arm (P = .02). Participants reported high levels of satisfaction with the program. ConclusionsAn IF intervention developed with and for Black adults can be feasibly implemented in Black churches. Larger studies need to be conducted to ascertain the extent IF can serve as a viable weight-loss alternative to CER interventions in Black communities.

Long-term cost-effectiveness analysis of rugby fans in training–New Zealand: a body weight reduction programme for males

ObjectivesWe sought to extrapolate the long-term costs and clinical impacts attributed to the rugby fans in training–New Zealand (RUFIT-NZ) trial in Aotearoa, New Zealand.DesignA modelled cost-effectiveness analysis using efficacy data...

Effects of Lacticaseibacillus rhamnosus HA-114 probiotic supplementation on circulating IGFBP-2 levels during a calorie-restricted diet in overweight humans

Background and aimGut microbiota influences energy homeostasis in part through circulating hormones. Insulin-like growth factor-binding protein (IGFBP)-2 is a biomarker whose increase in systemic circulation is associated with positive effects on body weight and metabolism. In a recent clinical trial, probiotic Lacticaseibacillus rhamnosus HA-114 supplementation showed positive effects on eating behaviors and insulin resistance in overweight participants undergoing a weight-loss intervention. In this context, this ancillary study aimed at assessing the impact of L. rhamnosus HA-114 supplementation on plasma IGFBP-2 levels in these individuals, and whether this modulation correlated with changes in fat mass, energy metabolism, and eating behaviors. MethodsFasting plasma IGFBP-2 concentrations were quantified in 100 overweight or obese men and women enrolled in a 12-week diet-based weight reduction program (−500 kcal/day), in combination with probiotic L. rhamnosus HA-114 or placebo supplementation. Baseline and changes in circulating IGFBP-2 concentrations were correlated with anthropometric parameter, glucose and lipid metabolism, cardiorespiratory function and eating behaviors. ResultsOn average, the intervention reduced BMI by 4.6 % and increased IGFBP-2 by 13 %, regardless of supplementation group. Individuals who presented an increase in IGFBP-2 levels had significantly greater reductions in BMI. Changes in IGFBP-2 levels were correlated with loss in fat mass (r = 0.2, p < 0.001) in the probiotic-supplemented group, but not with other metabolic parameters or eating behaviors. Baseline IGFBP-2 levels were not associated with weight loss or improvements in cardiometabolic parameters. ConclusionProbiotic supplementation with L. rhamnosus HA-114 did not modulate plasma IGFBP-2 levels. Changes in IGFBP-2 levels were correlated with greater reductions in BMI, but not with other metabolic parameters or eating behaviors, indicating that the benefits of HA-114 on eating behaviors are likely independent of IGFBP-2. Additional changes in microbiota might be required to modulate IGFBP-2 and observe its associations with eating behaviors and cardiometabolic improvements.

Procedural and outcome impact of body mass index on pulsed field ablation of atrial fibrillation: insights from the EU-PORIA Registry

Abstract Introduction Pulsed field ablation (PFA) is a "single-shot" non thermal ablation modality for atrial fibrillation (AF). In general, obesity is associated with increased risk of AF recurrence after catheter ablation with thermal energy sources. Purpose We aimed to assess the impact of body mass index (BMI) on procedural characteristics, safety, acute efficacy and long-term outcomes of PFA for symptomatic AF. Methods Of 1233 subjects enrolled in the EU-PORIA registry, in our subanalysis we included 1055 patients undergoing de novo pulmonary vein isolation (PVI)-only ablation procedure for symptomatic AF using the pentaspline PFA catheter from March 2021 until May 2022 at seven high-volume European centers. Patients were divided into two groups based on BMI: normal weight (nW, &amp;lt; 25 kg/m2) and overweight (oW, ≥ 25 kg/m2). Overweight patients were further categorized into three subgroups: pre-obesity (pOb, 25-29.9 kg/m2), obesity (Ob, 30-34.9 kg/m2) and severe obesity (sOb, ≥ 35 kg/m2). Clinical and procedural characteristics, complications and follow up data were collected. Results A total of 1055 patients (39% female, mean age 65,7±10,9 years, 65% paroxysmal AF) were enrolled. 32% of patients were normal weight (nW) and 68% overweight (oW). Among oW group, 438 subjects (41%) were assigned to pOb group, 204 (19%) to Ob, and 71 (7%) to sOb. Acute PVI was achieved in 100% of cases. The median skin-to-skin procedure and the median fluoroscopy time were similar between nW and oW and in all investigational subgroups, but radiation exposure increased in line with BMI (p&amp;lt;0.001). Periprocedural complications were 5% in nW, 1.6% in pOb, 3.9% in Ob, and 2.8% in sOb (p=0.06). The Kaplan-Meier estimate of arrhythmia-free survival was 80.2% in nW and 71.9% in oW (p=0.017). Each unit increment in BMI was associated with 4.2% increase in risk of AF/AT recurrence. Severe obese patients presented the highest 1-year AT/AF recurrence rate (37.2%). In the sOb group the rate of recurrence was not influenced by the type of AF (PAF 65.7% vs. pers AF 59.4%; p=0.484). Conclusion Overweight patients seem to experience more AF recurrences even after PFA PVI, mainly driven by a higher recurrence rate for BMI ≥ 35 kg/m2. Weight reduction programs remain crucial, nevertheless, reduced procedural times, good safety profile and acceptable 1-year observed AF/AT freedom make PFA a feasible strategy for AF rhythm control in patients with BMI ≥ 25 kg/m2.Freedom from AF/AT recurrence

Emotional and Behavioral Impairment and Comorbid Eating Disorder Symptoms in Adolescents with Obesity: A Cross-Sectional Study.

Background: The current study aims to assess the psychological conditions of Italian adolescents with obesity seeking an in-hospital multidisciplinary body weight reduction program, by exploring their psychological adjustment, emotional states, and co-occurring eating disorder symptoms. Methods: The study involved ninety-two consecutive Italian adolescents with obesity (31 males, 61 females), with a mean age ± SD: 16.4 ± 1.1 years and body mass index (BMI): 38.3 ± 6.04 kg/m2). The Strengths and Difficulties Questionnaire (SDQ), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Eating Attitude Test-26 (EAT-26) were used for the evaluations. Differences between genders, degrees of obesity (Group 1 = BMI SDS 2-2.99 and Group 2: BMI SDS > 3), and those with or without eating disorder symptoms (Group 1: EAT-26 ≤ 20 and Group 2: EAT-26 > 20) were explored. Results: The results showed that females reported higher scores on the Emotional Symptoms, Prosocial Behaviors, Total Difficulties, and Total Impact subscales of the SDQ, the BDI, both subscales of the STAI, and the Bulimia subscales of the EAT-26 than males, independently from the degrees of obesity. Participants with eating disorder symptoms (Group 2: EAT-26 > 20) showed higher scores on the Emotional Symptoms and Total Difficulties subscales of the SDQ, the BDI, and both subscales of the STAI than those of Group 1 (EAT-26 ≤ 20). Conclusions: The study explores the psychological conditions of adolescents with obesity. The results can inform appropriate treatment approaches for the management of obesity in developmental age groups, which not only take into account the medical and physical aspects of obesity, but also the behavioral, emotional, and social difficulties expressed by adolescents, in addition to specific eating disorder symptoms.

Composición de la microbiota intestinal en población pediátrica con obesidad: una revisión sistemática

The increasing prevalence of obesity among children and adolescent’s wide is a public health problem, resulting from the interaction of genetic, environmental and lifestyle factors. Obesity can lead to dysbiosis of the gut microbiota. This systematic review aims to gather scientific information available on the composition of gut microbiota in children/ adolescents with overweight/obesity. Research studies were identified through a scientific database (PubMed). The key words used were “Obese” OR “Overweight” AND “adolescent” OR “children” AND “microbiota”. Observational and intervention studies in children/adolescents having either overweight or obesity were included in this review, belonging to the last ten years – from December 2012 to October 2022. The initial search resulted in 409 references, 379 of them were excluded because the participants had major pathologies other than obesity or overweight. From the remaining articles, others were excluded due to not providing information on the number of participants, or not including data on microbiota composition. A total of 16 articles were selected: 12 observational studies and 4 intervention studies. Among the observational studies that compared overweight/obesity vs. normal weight or metabolically unhealthy obese vs. metabolically healthy obese children/adolescents, at least two studies found higher levels of Firmicutes, Proteobacteria, Bacteroidales, Adlercreutzia, Bifidobacterium, Escherichia coli, and Clostridium. Moreover, lower abundances of Bacteroidetes, Verrucomicrobia, Bacteroides, and Akkermansia were observed. Regarding intervention studies consisting of supplementation of oligofructose- enriched inulin and a weight reduction program, higher proportions of Actinobacteria were observed after the intervention. Clostridia was also found in higher abundances after interventions that used a combined strength and endurance training program and a weight reduction program. The findings suggest that obesity decreased microbiota diversity and increases species associated with inflammation. The results are consistent with previous studies in adults. This information will be useful for designing dietary interventions to prevent or reverse dysbiosis in individuals with obesity. Keywords: Obese; Overweight; Adolescents; Children; Microbiota; Intervention studies; Observational studies

The psychosocial functioning in adolescents with severe obesity evaluated throughout the strengths and difficulties questionnaire (SDQ): a preliminary report.

Childhood obesity is associated with poor psychological adjustment. Severely impacts the psychological adjustment of young patients. To assess the psychological functioning of children and adolescents, several questionnaires have been proposed so far. Although the Strengths and Difficulties Questionnaire (SDQ) is one of the most well-used tools, its application in obesity research is scarce. The study is aimed at assessing the psychological profile of a sample of Italian children and adolescents seeking an in-hospital multidisciplinary body weight reduction program for obesity, via SDQ. One hundred and fourteen consecutive Italian children and adolescents with obesity (43 males/71 females, age range: 11-17 years, mean age ± SD: 15.1 ± 1.66, body mass index-BMI ± SD: 37.4 ± 6.13 kg/m2), were recruited at the Division of Auxology, Istituto Auxologico Italiano IRCCS, Piancavallo (VB). Obese Females reported worse conditions of emotional symptoms (t = 5.48; p < 0.001) and peer problems (t = 2.34; p = 0.021), as well as higher which were associated with greater scores of pro-social behaviors than obese males (t = 3.07; p = 0.003). The total difficulties score (t = 4.00; p < 0.001) and the total impact score (t = 4.53; p < 0.001) were significantly higher in females than males. No statistically significant differences in SDQ variables were found in relation to the degree of obesity (BMI SDS: 2-2.99; BMI SDS: > 3). These findings can contribute to understand the psychological condition of adolescents with obesity in a better way and also to develop effective interventions for the treatment of pediatric obesity which not only take into account the medical and physical aspects but also the emotional and social difficulties expressed by adolescents with obesity.

Behavioral and Emotional Problems in Children and Adolescents with Obesity: A Preliminary Report.

Parent-child agreement regarding emotional and behavioral problems in adolescents with obesity was measured. One hundred Italian adolescents with obesity (36 males, 64 females, mean age ± SD: 15.3 ± 1.61 years, mean body mass index, BMI: 37.9 ± 5.48 kg/m2), hospitalized for a 3-week multidisciplinary body weight reduction program at Istituto Auxologico Italiano, Piancavallo-Verbania, Italy, and one of their parents (n = 100, 40 fathers, 60 mothers) participated in the study. Achenbach's Child Behavior Checklist (CBCL) for parents and the Youth Self Report (YSR) for teens were administered. Most of the CBCL and YSR scores were normal, with more borderline and clinical scores being found in CBCL (29% of borderline scores in attention problems, 28% in affective problems, and 26% in ADHD; 32% of clinical scores in affective problems, 23% in withdrawn/depressed, and 22% in anxiety problems and somatic complains subscales) than in YSR (19% of borderline scores in affective behaviors and 17% in somatic complains; 15% of clinical scores in anxiety problems and 17% in withdrawn/depressed subscale). Young females reported greater anxiety problems (p = 0.009), oppositional defiant problems (p = 0.029), anxiety/depressed (p = 0.030), and internalizing problems (p = 0.045) than males. Pearson's coefficients ranged between 0.273 to 0.517. This study provides information on the cross-informant evaluation of psychological profiles with CBCL and YSR in a clinical sample of adolescents with obesity and their parents.

Basal metabolic rate using indirect calorimetry among individuals living with overweight or obesity: The accuracy of predictive equations for basal metabolic rate

Weight reduction programs in people with overweight or obesity can be informed by indirect calorimetry (IC) which is the gold standard to measure basal metabolic rate (BMR). Since IC is labor intensive and expensive, predictive equations are often used as an alternative. In this study the accuracy rate was assessed and bias statistics of predictive equations were compared to IC among subjects with overweight or obesity. Secondly, differences in clinical features between individuals with over-, accurate or underestimation of their BMR were evaluated. This cross sectional study included 731 subjects from the outpatient obesity clinic of the Antwerp University Hospital, Belgium. Fourteen equations were evaluated. Overestimation and underestimation was defined as >10 % and <10 % of measured BMR. In the total population, mean age was 43±13 years, mean BMI 35.6±5.8kg/m2 and 79.5% were female. The highest accuracy rates were reached by the Henry (73%), Ravussin (73%) and Mifflin St. Jeor (73%) equations. In the total population, the Mifflin St. Jeor and Henry equation were unbiased. The Akern, Livingston and Ravussin equations were biased to underestimation. All other equations were biased to overestimation. Subjects with an underestimation of BMR had significantly higher waist-hip ratio (1.02±0.13 vs 0.91±0.11; P<0.001), higher visceral adipose tissue (239±96 vs 162±93; P<0.001), lower fat free mass (kg) (67.6 (45.4-95.9) vs 54.0 (39.6-95.5); P<0.001) and a higher prevalence of the Metabolic Syndrome (24 (77.4) vs 112 (37.5); P<0.001). Individuals with an overestimation of BMR had significantly higher subcutaneous adipose tissue (545±149 vs 612±149; P<0.05), lower fasting plasma insulin (81 (10-2019) vs 67 (27-253); P<0.001) and lower 2-h plasma glucose (132 (30-430) vs 116 (43-193); P<0.001) during OGTT. In this study, the Henry and Mifflin St. Jeor equations have the highest accuracy and lowest bias to estimate the basal metabolic rate in a Caucasian, predominantly female, population living with overweight or obesity. Visceral and subcutaneous adipose tissue and presence of metabolic syndrome were significantly different in individuals with over- or underestimation of BMR.

Analysis of sarcopenic obesity prevalence and diagnostic agreement according to the 2022 ESPEN and EASO Consensus in hospitalized older adults with severe obesity.

Sarcopenic obesity (SO) is a clinical disorder characterized by increased adiposity and decreased muscle mass and function, commonly observed in older adults. However, most of the studies that investigated SO prevalence rates were not based on current standardized diagnostic methods. Thus, this study aims to estimate the prevalence rates of SO and their level of agreement using different instruments proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) Consensus, in a sample of hospitalized older adults with severe obesity. A cross-sectional study with 90 older adults (≥ 60 years) with severe obesity (body mass index ≥ 35 kg/m/²) seeking an in-hospital multidisciplinary body weight reduction program. Skeletal muscle function was assessed using the five-repetition Sit-Stand test (5-SSt) and Handgrip Strength (HGS). Body composition was evaluated by high percentages of fat mass (FM), low appendicular lean mass (ALM/W), and skeletal muscle mass (SMM/W), adjusted to body weight. The stage of SO was assessed on the presence of at least one comorbidity and specific cut-offs were adopted for each step. All analyses were performed according to gender and age range. The prevalence rates of SO in the total sample were 23.3%, 25.5%, 31.1%, and 40.0% considering altered values of 5-SSt+FM+ALM/W, HGS+FM+ALM/W, 5-SSt+FMSSM/W, and HGS+FM+SSM/W, respectively. Higher prevalence rates were observed among female and old elderly subgroups, regardless of the diagnostic combination. There were weak agreements between the muscle function tests (5-SSt versus HGS) using both muscle mass indexes in the total sample and all subgroups. Moderate agreements were observed between muscle mass indexes (SMM/W versus ALM/W) in the total sample, male and younger older adults (using 5-SSt), and strong agreements for men and younger older adults (using HGS). The discrepancies observed between the prevalence rates and their levels of agreement reinforce the need for new studies in similar populations aiming for better standardization of SO assessment.

Short-term weight reduction program in potential donors with severe steatosis can reduce liver volume significantly that changes clinical decision in living donor transplantation

Short-term weight reduction program in potential donors with severe steatosis can reduce liver volume significantly that changes clinical decision in living donor transplantation

Changes in Plasma Carotenoid Concentrations during the AntioxObesity Weight Reduction Program among Adults with Excessive Body Weight

Changes in Plasma Carotenoid Concentrations during the AntioxObesity Weight Reduction Program among Adults with Excessive Body Weight

Daily breakfast: will skipping a morning meal become a new prognostic marker?

The increase in the prevalence of dietary risk factors and non-communicable diseases over the past decades has led to the search for new predictors, one of which is skipping breakfast. The article examines the potential of using the "daily breakfast"/"skipping breakfast" criterion as a prognostic marker. The results of studies on the correlation of daily breakfast with dietary risk factors (obesity and hypertension), type 2 diabetes, cardiovascular diseases and the risk of cardiovascular death are presented and analyzed. The effect of breakfast on the depression risk, which is an independent marker of cardiovascular diseases, is being studied. Also, possible pathogenetic mechanisms linking skipping breakfast with increased blood pressure are discussed. Research data is provided confirming the importance of morning meals for health. The article presents data on the prevalence of daily breakfast in the Russian population and in the populations of other countries with developed economies. Information is provided on the history of studying the effect of daily breakfast on health. Also, controversial scientific data is provided on the effect of skipping breakfast on body weight and its effective control. The role of morning meals in weight reduction programs is fully discussed. The issues of connection between the morning meal and daily calorie intake, the nutritional value of consumption of total protein, vitamins and minerals, as well as the uniform meal distribution across the day are considered. Data from a scientific discussion on the criteria for an "ideal" breakfast are presented, and general recommendations on the energy and nutritional value of a morning meal and the optimal composition of food are outlined.

Weight stigma is associated with body mass index among college students in Taiwan: the mediated role of internalized weight stigma

BackgroundWeight stigma is an issue often studied in Western countries; however, such information is scarce in Asian studies.MethodsThis study aimed to examine the role of internalized weight stigma as a mediator in the relationship between perceived weight stigma and changes in body mass index (BMI). The data were collected through a longitudinal online survey with two phases (n = 974; Phase 1: August and September 2021; Phase 2: November and December 2021). The Perceived Weight Stigma Scale (PWSS), Weight Self-Stigma Questionnaire (WSSQ), and Depression, Anxiety, Stress Scale − 21 (DASS-21) were administered to assess perceived weight stigma, internalized weight stigma, and psychological distress. Hierarchical regressions were used to examine the proposed model, and Hayes’ Process Macro was used to test a mediation model.ResultsThe changes in perceived weight stigma and internalized weight stigma were significantly and positively associated with changes in BMI. There were significant and positive associations between perceived weight stigma, internalized weight stigma and psychological distress over time. Change in internalized weight stigma was found to be a significant mediator in the association of change in perceived weight stigma with change in BMI for the entire sample (unstandardized coefficient = 0.04; 95% CI = 0.02, 0.06), female subgroup (unstandardized coefficient = 0.05; 95% CI = 0.02, 0.08), and male subgroup (unstandardized coefficient = 0.03; 95% CI = 0.01, 0.06). Change in perceived weight stigma also had significant effects on change in BMI for the entire sample and the female subgroup, but not for the male subgroup.ConclusionBecause perceived weight stigma may significantly impact changes in BMI through internalized weight stigma, treatment strategies to ameliorate self-stigma may enhance the results of weight-reduction programs. Such treatment strategies should be considered for inclusion in weight-loss interventions.

Weight loss induced alleviation of sleep-disordered breathing is associated with improvement of non-alcoholic fatty liver disease

IntroductionSleep-disordered breathing (SDB) and non-alcoholic fatty liver disease (NAFLD) are both common comorbidities in obese patients. Structured weight loss programs are effective and can reduce the incidence and severity of obesity-related comorbidities. The objective of the present analysis is to test whether weight loss induced alleviation of SDB is a predictor for improvement of NAFLD. MethodsObese participants underwent a standardized non-surgical 3 months weight reduction program (800 kilocalories per day with low carbohydrate and fat content). Abdominal sonography for NAFLD (grade 0 to 3) and monitoring for SDB (defined as apnea-hypopnea index [AHI] ≥ 15/h) were performed at baseline and after 3 months. Alleviation of SDB was defined as a shift from AHI≥ 15/h to <15/h. Results48 patients (48% female, age 42 ± 12 years, body-mass index 40.3 ± 8.1 kg/m2, AHI 14 ± 17/h, 85% NAFLD grade ≥1) participated in the weight loss program. In contrast to the no SDB group, in patients with SDB weight loss of 27.1 ±0 .9 kg (8.4 ± 2.8 kg/m2) after three months was paralleled by a reduction in AHI (-22 ± 17/h), prevalence of SDB (from 31% to 13%), and oxidized low-density lipoprotein (-13 ± 11 U/l). In individuals with preexisting SDB NAFLD grade improved more (2 versus 1, p<0.001) and was at a lower degree at 3 months than in those without SDB (0 versus 1, p = 0.015). In multivariable analysis models, SDB at baseline was associated with improvement of NAFLD grade (B 0.908; 95% CI 0.125, 1.691; p = 0.024), independently of age, sex, and BMI (each p>0.05, respectively). Decreasing BMI (B 0.16 [95%-CI 0.08; 0.23], p<0.001) and alleviation of SDB (B 0.90 [95%-CI 0.21; 1.58], p = 0.012) were independently associated with improvement of NAFLD grade. ConclusionPreexisting SDB and weight loss induced alleviation of SDB are predictors for improvement in NAFLD grade, independent of the extent of weight loss. SDB may contribute to the pathogenesis of NAFLD via SDB-induced oxidative stress and inflammation, but the causal mechanism remains unclear.