Non-invasive Body Contouring Technologies: An Updated Narrative Review.

INTRODUCTION: Nowadays, a lot of body contouring devices and methods are introduced all over the world. The object of the present narrative review was to update and classify existing evidence on these methods and devices. METHODS: We searched databases including PubMed, Cochrane, and Google Scholar for 11 essential keywords, including cryolipolysis, high-intensity focused ultrasound (HIFU), shock wave, low-level laser therapy (LLLT), radiofrequency (RF), capacitive resistive electrical transfer (TECAR), high-intensity focused electromagnetic (HIFEM), electromyostimulation (EMS), carboxytherapy, mesotherapy, and acupuncture and their abbreviations, in addition to obesity, overweight, cellulite, subcutaneous fat, and body contouring. RESULTS: Totally 193 references were used in 11 main topics. CONCLUSION: In order to help physicians with finding the best evidence in different methods, the data were summarised in 11 topics. Furthermore, FDA-approved devices, side effects and common protocols were described in each section. LEVEL OF EVIDENCE I: This journal requires that authors 39 assign a level of evidence to each article. For a full 40 description of these Evidence-Based Medicine ratings, 41 please refer to the Table of Contents or the online 42 Instructions to Authors www.springer.com/00266 .

Translation and validation of the Persian version of Godin Leisure-Time Exercise Questionnaire in patients with multiple sclerosis.

STUDY DESIGN: Psychometric study. OBJECTIVE: The purpose of this study is to translate, culturally adapt and evaluate the validity and reliability of the Persian (Farsi) version of GLTEQ in patients with multiple sclerosis. METHODS: This study had three phases, including translation of the questionnaire into Persian and making cultural adaptation, evaluation of pre-final version of questionnaire's comprehensibility in a pilot study, and investigation of reliability and validity of the final version of the translated questionnaire. Content validity, and convergent validity (correlations among the Persian version of GLTEQ and Global physical activity questionnaire (GPAQ), and international physical activity questionnaire (IPAQ)) and after all test-retest reliability were studied. RESULTS: The subjects were 87 MS patients. The Persian version demonstrated moderate to good convergent validity; the correlation coefficient between the Persian version and GPAQ was r=0.64 (p<0.001), and between the Persian version and IPAQ was r=0.59 (p<0.001). The test-retest reliability was strong (Intra-class Correlation (ICC) value ranged between 0.908 and 0.992). Besides, its face validity and content validity were acceptable. CONCLUSIONS: The Persian version of GLTEQ is a valid and reliable instrument to assess physical activity in patients with MS. This questionnaire can be a step toward standardization of physical activity measurement in patients with MS. Also, in research, it provides the possibilities to carry on a comparative study across cultures using the same outcome measure.

A Randomized Controlled Trial Investigating the Impact of a Low-Calorie Dietary Approach to Stop Hypertension (DASH) on Anthropometric and Glycemic Measures in Patients Experiencing Weight Regain 2 Years Post Sleeve Surgery.

PURPOSE: To evaluate the effect of a low-calorie dietary approach to stop hypertension (DASH) compared to a low-calorie diet on weight control, body composition and glycemic measures in post sleeve patients with weight regain. MATERIALS AND METHODS: Participants were randomly allocated to either the low-calorie DASH diet group (intervention) or the low-calorie diet group (control) for a duration of 16 weeks. Both groups had a prescribed caloric intake of 1000-1200 calories. The DASH diet group made dietary adjustments in accordance with the DASH pattern. RESULTS: At the end of the study, both interventions significantly reduced anthropometric and body composition parameters (P-value < 0.001), with a greater decrease observed in the low-calorie DASH diet group (P-value < 0.001). Insulin levels and homeostatic model assessment for insulin resistance (HOMA-IR) decreased significantly in both groups, but the magnitude of these changes was not statistically different between the two groups. After adjusting for confounders, a significant difference was observed in post-intervention values and changes in weight, body mass index, and fat mass and fat-free mass. CONCLUSION: In summary, adhering to a calorie-restricted DASH diet for 16 weeks improved weight loss, body mass index, and fat mass reduction in post-bariatric patients who experienced weight regain 2 years after surgery, compared to a calorie-restricted control diet. However, there was no significant difference in the effect on blood glucose, insulin, and HOMA-IR between the two diets.

Nutrition, Physical Activity, and Prescription of Supplements in Pre- and Post-bariatric Surgery Patients: An Updated Comprehensive Practical Guideline.

Only in the USA, 315 billion dollars are spent annually on the medical cost of obesity in adult patients. Till now, bariatric surgery is the most effective method for treating obesity and can play an essential role in reducing the direct and indirect costs of obesity treatment. Nonetheless, there are few comprehensive guidelines which include nutrition, physical activity, and supplements, before and after surgery. The purpose of the present narrative review is to provide an updated and comprehensive practical guideline to help multidisciplinary teams. The core keywords include nutrition, diet, physical activity, exercise, supplements, macronutrients, micronutrients, weight reduction, bariatric surgery, Roux-en-Y Gastric Bypass, Sleeve Gastrostomy, Laparoscopic Adjustable Gastric Banding, and Biliopancreatic diversion with duodenal switch which were searched in databases including PubMed/Medline, Cochrane, and some other sources such as Google Scholar. We answered questions in five important areas: (a) nutritional strategies before bariatric surgery, (b) nutrition after bariatric surgery, (c) physical activity before and after bariatric surgery, (d) weight regain after bariatric surgery, and (e) micronutrient assessments and recommendations before and after bariatric surgery. Some new items were added in this updated guideline including "weight regain" and "pregnancy after bariatric surgery." Other fields were updated based on new evidence and guidelines.

Dietary Macronutrient Composition and Quality, Diet Quality, and Eating Behaviors at Different Times Since Laparoscopic Sleeve Gastrectomy.

PURPOSE: This study aimed to compare energy, macronutrients (quantity and quality), the overall dietary quality, and eating behaviors of patients undergoing laparoscopic sleeve gastrectomy (LSG) at different times since surgery. MATERIALS AND METHODS: This cross-sectional study included 184 adults at least 1 year post-LSG. Dietary intakes were assessed by a 147-item food frequency questionnaire. Macronutrient quality was assessed by computing the macronutrient quality index (MQI), carbohydrate quality index, fat quality index, and healthy plate protein quality index (HPPQI). The Healthy Eating Index (HEI)-2015 was used to assess diet quality. The Dutch Eating Behavior Questionnaire was used to assess eating behaviors. Based on the time since LSG, the time at which eating data were also collected, participants were categorized into three groups: 1-2 years (group 1), 2-3 years (group 2), and 3-5 years (group 3). RESULTS: Group 3 consumed significantly more energy and absolute carbohydrates than group 1. The MQI and HPPQI scores of group 3 were significantly lower than those of group 1. The HEI score was significantly lower in group 3 compared to group 1, with a mean difference of 8.1 points. Compared to patients with 1-2 years following LSG, those with 2-3 and 3-5 years consumed more refined grains. Eating behavior scores did not differ between groups. CONCLUSION: Patients at 3-5 years post-LSG consumed more energy and carbohydrates than those at 1-2 years after the surgery. Protein quality, overall macronutrient quality, and overall diet quality decreased as time passed following surgery.

Relationship between physical activity, healthy lifestyle and COVID-19 disease severity; a cross-sectional study.

Aim: The COVID-19 pandemic is a global health emergency, and therefore the prevention and treatment of this disease is an important priority of world health. In the present study, some risk factors, including unhealthy nutrition, obesity, and physical inactivity, were assessed in patients infected with SARS-CoV-2, and their effects on the severity and duration of disease were evaluated. Subject and methods: The present study was a cross-sectional study. Data was collected from all patients who visited the respiratory emergency department from March 20, 2020 to April 24, 2020 in the University Hospital. The outcome measures were body mass index, diet quality that was evaluated with a 16-item food intake questionnaire, and physical activity level that was assessed by the global physical activity questionnaire. Results: Two hundred and six patients' data was analyzed. The results investigated that patients with lower levels of physical activity or lower MET.min/week were affected by a more severe form of the disease (p = 0.05 and p = 0.03, respectively). We found that patients with a healthier dietary pattern were affected by lower severity of illness (p < 0.05). Conclusion: It seems that increasing levels of physical activity may partly reduce the severity of COVID-19 disease. Some dietary patterns such as increasing fruit and poultry consumption as well as drinking less tea were correlated significantly with a less severe form of the disease. The results did not confirm previous concerns regarding a potentially harmful effect of smoking on the severity or duration of symptoms.

Effect of endurance training on cardiopulmonary fitness in people with multiple sclerosis.

INTRODUCTION: Disturbances associated with Multiple Sclerosis (MS) can be due to the pathologic process of the disease or insufficient physical fitness. The benefits of exercise in improving cardiopulmonary fitness have been demonstrated in animal studies and also clinical trials on cardiovascular patients and healthy human cases; however, its effectiveness in people with MS(pwMS) is still unknown. people with MS often engage in rehabilitation programs for exercise tolerance improvement. Therefore, it is necessary to investigate the effect of this specific intervention on cardiopulmonary fitness of these patients. The present study intended to illustrate the etiology of exercise intolerance in pwMS and also the effects of exercise on these etiological factors. METHODS AND RESULTS: The present interventional study included 21 female patients suffering from Relapsing-Remitting MS (RR-MS) who had a mean age of 35 ± 5.18 years and the Expanded Disability Status Scale (EDSS) scores of 1 to 4. All the participants underwent Cardiopulmonary Exercise Testing (CPET) on an ergometer pre- and post-intervention. The intervention included 18 sessions of endurance training using a stationary bicycle with an intensity of 70% of the peak Heart Rate (HR) or 60% of the peak VO2 (Volume of oxygen consumption) under the supervision and cardiac monitoring. A total of 24 variables, including the parameters cardiopulmonary fitness (aerobic fitness), were investigated. Also, all the maximal variables were analyzed in the same RER(Respiratory Exchange Ration) (a mean RER of 0.92) pre- and post-intervention. According to the results, a total of 17 variables out of 24 study variables had significant changes (P < 0.05). CONCLUSION: The present study showed that even a short, 6-week course of aerobic exercise could change the peak HR and VO2, improving the cardio pulmonary fitness in these patients. This indicates the adaptation of the cardiopulmonary system to exercise in pwMS. In other words, these cardiopulmonary fitness variables improvement due to exercise demonstrates that this pathology is not merely caused by the MS-induced Central Nervous System (CNS) involvement and can be improved by improving cardiopulmonary fitness.

The impact of bariatric surgery procedures on the modulation of cardiometabolic risk factors in patients with severe obesity: a 12-month follow-up.

OBJECTIVE: To evaluate the effects of one anastomosis gastric bypass (OAGB), Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG) on cardiometabolic risk factors (CMRFs) in patients with severe obesity. METHODS: This retrospective cohort study included patients with severe obesity who had undergone OAGB, RYGB, or SG between 2015 and 2017 and follow-up assessments over 12-months. RESULTS: Among 485 included patients, anthropometric measurements, body composition, fasting blood glucose (FBG), lipid profile, and comorbidities were significantly improved for all three procedures throughout the follow-up period. Weight, % total weight loss (%TWL), body mass index, fat mass and fat mass to fat-free mass ratio improvements were higher with RYGB and OAGB than SG. There were no significant differences between procedures in all other variables. A significant trend toward remission rate of dyslipidemia and type 2 diabetes mellitus was observed with all three procedures, with no significant difference between the three groups. %TWL statistically correlated with fat mass, FBG, and triglycerides. CONCLUSIONS: OAGB, RYGB, and SG had a beneficial impact on CMRFs and comorbidities during 12 months of follow-up. Of note, RYGB and OAGB may result in better outcomes, particularly anthropometric and body composition indices. Further large-sample, long-term follow-up studies are required to expand on the present findings.

Food Addiction Disorder 2 Years After Sleeve Gastrectomy; Association with Physical Activity, Body Composition, and Weight Loss Outcomes.

PURPOSE: Food addiction (FA) following bariatric surgery (BS) has received a burst of attention in recent years due to its important contribution to obesity. Therefore, this study was conducted to explore the prevalence of FA disorder and its predictors 2 years after laparoscopic sleeve gastrectomy (LSG) and assess its relationship with physical activity (PA), body composition, and weight outcomes. MATERIALS AND METHODS: Four hundred fifty individuals who had undergone LSG 2 years prior to the study were enrolled. FA was diagnosed using the Yale Food Addiction Scale (YFAS). The collected data included body composition (fat mass (FM), fat-free mass (FFM)), PA, and nutritional intakes. RESULTS: Eighty-nine subjects (about 20%) met the criteria for FA disorder. FA patients had significantly lower PA (p = 0.04) and higher weight (p < 0.001), BMI (p < 0.001), FM, and FFM (p = 0.01) compared to those without FA. Regarding weight and body composition changes, the finding reveals that FA patients (vs. non-FA) had a significantly less excess weight loss (EWL%) (p < 0.001) and total weight loss (TWL%) (p = 0.05) as well as a higher FFM loss (kg) (p = 0.04) (linear regression analysis). A younger age (p trend = 0.01), higher BMI (p trend = 0.04), and more excess weight (p trend = 0.03) were related to higher odds of FA disorder at second year after LSG (logistic regression analysis). CONCLUSION: The results showed that FA was highly prevalent 2 years after LSG. In addition, FA disorder was associated with negative long-term outcomes following LSG. Younger individuals with more excess weight and higher BMI at baseline are more vulnerable to FA.

Correction to: Nutrition, Physical Activity, and Prescription of Supplements in Pre- and Post-bariatric Surgery Patients: a Practical Guideline.

In Table 7 the following corrections are required.

Nutrition, Physical Activity, and Prescription of Supplements in Pre- and Post-bariatric Surgery Patients: a Practical Guideline.

According to ASMBS, the rate of bariatric surgery increased from 158,000 in 2011 to 196,000 in 2015. Nevertheless, this growth in invasive techniques does not eliminate unhealthy habits, so lifestyle modification such as healthy nutrition and correct physical activity programs may improve surgical results. The objective of the present narrative review was to categorize the guidelines related to nutrition, physical activity, and supplement prescription before and after bariatric surgery. The main key words including nutrition, diet, physical activity, exercise, supplements, macronutrients, micronutrients, weight reduction, bariatric surgery, Roux-en-Y gastric bypass, sleeve gastrostomy, laparoscopic adjustable gastric banding, and biliopancreatic diversion with duodenal switch were searched in databases including PubMed/Medline, Cochrane, and some other sources such as Google scholar. The recommendations are classified based on the type of surgery. The indications for surgery and the type of bariatric surgery are not included in this review. This review helps medical teams, including bariatric surgeons, nutritionists, and sports medicine specialists, with proper management before and after bariatric surgery.