Completeness of intervention reporting of nutrition-focused weight management interventions adjunct to metabolic and bariatric surgery: effect of the TIDieR checklist.

Nutrition-focused interventions are essential to optimize the bariatric care process and improve health and weight outcomes over time. Clear and detailed reporting of these interventions in research reports is crucial for understanding and applying the findings effectively in clinical practice and research replication. Given the importance of reporting transparency in research, this study aimed to use the Template for Intervention Description and Replication (TIDieR) checklist to evaluate the completeness of intervention reporting in nutritional weight management interventions adjunct to metabolic and bariatric surgery (MBS). The secondary aim was to examine the factors associated with better reporting. A literature search in PubMed, PsychINFO, EMBASE, Scopus, and the Cochrane Controlled Register of Trials was conducted to include randomized controlled trials (RCT), quasi-RCTs and parallel group trials. A total of 22 trials were included in the final analysis. Among the TIDieR 12 items, 6.6 ± 1.9 items were fully reported by all studies. None of the studies completely reported all intervention descriptors. The main areas where reporting required improvement were providing adequate details of the materials and procedures of the interventions, intervention personalization, and intervention modifications during the study. The quality of intervention reporting remained the same after vs. before the release of the TIDieR guidelines. Receiving funds from industrial organizations (p = 0.02) and having the study recorded within a registry platform (p = 0.08) were associated with better intervention reporting. Nutritional weight management interventions in MBS care are still below the desirable standards for reporting. The present study highlights the need to improve adequate reporting of such interventions, which would allow for greater replicability, evaluation through evidence synthesis studies, and transferability into clinical practice.

Food Addiction and Binge Eating Disorder in Relation to Dietary Patterns and Anthropometric Measurements: A Descriptive-Analytic Cross-Sectional Study in Iranian Adults with Obesity.

Obesity is associated with maladaptive eating behaviors, including food addiction (FA) and binge eating disorder (BED). However, the key factors influencing the development of maladaptive eating behaviors remain unknown. Adherence to specified dietary patterns has been suspected of making indirect impacts. This study investigates the association of FA and BED with dietary patterns and anthropometric measurements among 400 Iranian adults (aged 18-60; 66.25% women) living with obesity (body mass index [BMI] ≥ 30 kg/m2). The Binge Eating Scale and Yale Food Addiction Scale were used to measure BED and FA. A validated 147-item semi-quantitative food frequency questionnaire underwent principal component analysis and identified three major dietary patterns: mixed, unhealthy, and healthy dietary pattern. After adjusting for confounders, higher adherence to unhealthy dietary patterns was associated with an increased risk of FA, while higher adherence to healthy dietary patterns was associated with a lower risk of FA. Also, those within obesity class III had a significantly higher risk of FA and BED than those in obesity class I. This study suggests that adherence to an unhealthy dietary pattern may be associated with a higher risk of FA. It also highlights the link between higher BMI and maladaptive eating behaviors.

Grape seed extract supplementation along with a restricted-calorie diet improves cardiovascular risk factors in obese or overweight adult individuals: A randomized, placebo-controlled trial.

Grape seed extract (GSE) is a flavonoid-rich supplement, recently discussed as a potential moderator of inflammation and obesity. In this study, we aimed to investigate the effects of GSE supplementation along with a restricted-calorie diet (RCD), on changes in blood lipid profile, visceral adiposity index (VAI), and atherogenic index of plasma (AIP). We designed a randomized, double-blinded, placebo-controlled clinical trial. Forty obese or overweight individuals (25 ≤ body mass index < 40 kg/m2 ) were randomly assigned to receive GSE (300 mg/day) or placebo, plus RCD, for 12 weeks. We studied the anthropometric measures, biochemical biomarkers and dietary intake within the study timelines. Levels of high-density lipoprotein cholesterol (HDL-C) and HDL-C/low-density lipoprotein cholesterol (LDL-C) significantly increased in the GSE group as compared with the placebo group at week 12 (p = .03 and .008, respectively, adjusted for age, sex, energy and saturated fatty acid intake). We also observed a significant reduction in LDL-C following GSE supplementation in comparison to placebo (adjusted for age, sex and energy intake, p = .04). VAI, AIP, total cholesterol and triglyceride significantly decreased in the GSE group compared with the baseline (p = .04, .02, .01, and .02, respectively). GSE supplementation may have a modulatory role in improving blood lipid profile in obese or overweight individuals, when accompanied by RCD.

The effects of grape seed extract (Vitis vinifera) supplement on inflammatory markers, neuropeptide Y, anthropometric measures, and appetite in obese or overweight individuals: A randomized clinical trial.

BACKGROUND: Grape seed extract (GSE) is a natural supplement known for its various health benefits, including anti-inflammatory effect. This study aimed to evaluate the effects of GSE supplementation on inflammatory markers, neuropeptide Y, anthropometric measurements, and appetite in obese or overweight individuals. METHODS AND MATERIALS: A randomized, double-blind clinical trial was performed on 40 obese or overweight subjects who were randomly assigned to receive GSE (300 mg/day) or placebo for a period of 12-weeks. Both groups were under a restricted calorie diet (RCD)(~250 kcal lower than the estimated energy requirement). Anthropometric measurements, biochemical biomarkers and dietary intakes were determined during the study period. RESULTS: The reductions of body weight, body mass index, waist circumference, and waist to hip ratio were significantly higher in the GSE group compared to the placebo group (P = 0.045, 0.033, 0.029, and 0.021, respectively). Lower levels of neuropeptide Y, tumor necrosis factor alpha, and high sensitivity C-reactive protein were observed in the GSE group in comparison with the placebo group (P = 0.041, 0.001, and 0.034, respectively). CONCLUSION: GSE supplement with a RCD has favorable effects in reducing anthropometric measurements and inflammatory markers in obese or overweight individuals, and may play an effective role in the treatment of obesity.

Advanced glycation end products and risk of hypertension in Iranian adults: Tehran lipid and glucose study.

BACKGROUND: Elevated blood pressure is still one of the major risk factors for diseases and disabilities and also a public health challenge worldwide. In the present longitudinal study, we aimed to evaluate the association between risk of hypertension and dietary advanced glycation end products (AGEs) as a recently discussed potential risk factor. MATERIALS AND METHODS: Dietary assessment of 1775 participants in the third phase of Tehran lipid and glucose study to obtain dietary intake of AGEs was performed using a validated semi-quantitative food frequency questionnaire, and they were followed up for a mean duration of approximately 6 years. To determine the incidence of hypertension across quartiles of AGEs intake, logistic regression models with adjustment for potential confounding variables were used. All statistical analyses were conducted using SPSS, and P < 0.05 was considered statistically significant. RESULTS: Higher hypertension occurrence risk was generally attributed to higher AGEs intake quartiles after adjusting for age in men (odds ratio [OR] = 1.48, 95% confidence interval [CI] = 1.11-1.52, P = 0.038) and additional adjustment for smoking, drugs, and physical activity in women (OR = 1.38%-95% CI = 1.09-1.42, P = 0.042). Moreover, across the increasing trend of dietary AGEs intake, the percentage of fat intake increased and that of carbohydrate significantly decreased (P < 0.0001). CONCLUSION: In conclusion, it is highly recommended to limit dietary AGEs consumption to prevent and manage hypertension and its complications.

Coconstruction of adjunct behavioral interventions to bariatric surgery: The INTER-Change program.

OBJECTIVE: The INTER-Change program aims to use systematic frameworks to develop adjunct behavioral interventions to enhance long-term behavior change and improve outcomes in patients undergoing bariatric surgery (BS). This paper details the program strategies and how engagement of interested parties is shaping the research. METHOD: The core elements of this work include: (a) A living systematic review of behavioral weight management (BWM) interventions adjunct to BS; (b) Focus groups of interested parties, including patients, healthcare professionals, and administrators, on different aspects of designing and implementing adjunct behavioral interventions; (c) A patient-generated survey to assess needs for behavioral interventions to support BWM; (d) An international eDelphi study involving interested parties to prioritize intervention components and delivery structures; and (e) An international consensus meeting to construct testing intervention protocol(s). RESULTS: The systematic review revealed that delivering BWM interventions during the postoperative period resulted in better weight maintenance; however, most interventions reviewed were poorly developed, and none included interested parties. Initial themes from ongoing focus groups highlighted nonweight-related outcomes as being key goals of adjunct behavior change interventions, with a strong emphasis on psychological well-being and health-related behaviors. The patient survey will add patients' feedback on current interventions and expectations. Finally, the eDelphi process and international consensus meeting will integrate all the findings to develop more efficient behavioral interventions and appropriate testing protocol(s). CONCLUSIONS: This integrated knowledge translation approach will help ensure that the behavioral adjunct interventions are relevant to interested parties' needs, well-designed, effective, and more likely to be implemented successfully. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Understanding the impact of radical changes in diet and the gut microbiota on brain function and structure: rationale and design of the EMBRACE study.

BACKGROUND: Bariatric surgery leads to profound changes in gut microbiota and dietary patterns, both of which may interact to impact gut-brain communication. Though cognitive function improves postsurgery, there is a large variability in outcomes. How bariatric surgery-induced modifications in the gut microbiota and dietary patterns influence the variability in cognitive function is still unclear. OBJECTIVES: To elucidate the associations between bariatric surgery-induced changes in dietary and gut microbiota patterns with cognition and brain structure. SETTING: University hospital. METHODS: A total of 120 adult patients (≥30 years) scheduled to undergo a primary bariatric surgery along with 60 age-, sex-, and body mass index-matched patients on the surgery waitlist will undergo assessments 3-months presurgery and 6- and 12-month postsurgery (or an equivalent time for the waitlist group). Additionally, 60 age-and sex-matched nonbariatric surgery eligible individuals will complete the presurgical assessments only. Evaluations will include sociodemographic and health behavior questionnaires, physiological assessments (anthropometrics, blood-, urine-, and fecal-based measures), neuropsychological cognitive tests, and structural magnetic resonance imaging. Cluster analyses of the dietary and gut microbiota changes will define the various dietary patterns and microbiota profiles, then using repeated measures mixed models, their associations with global cognitive and structural brain alterations will be explored. RESULTS: The coordinating study site (Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, QC, Canada), provided the primary ethical approval (Research Ethics Board#: MP-32-2022-2412). CONCLUSIONS: The insights generated from this study can be used to develop individually-targeted neurodegenerative disease prevention strategies, as well as providing critical mechanistic information.

Fabrication of the macro and micro-scale microbial fuel cells to monitor oxalate biodegradation in human urine.

This study presented the fabrication of macro and micro-scale microbial fuel cells (MFCs) to generate bioelectricity from oxalate solution and monitor the biodegradation in a micro-scale MFC for the first time. The maximum generated power density of 44.16 W m-3 in the micro-scale MFC elucidated its application as a micro-sized power generator for implantable medical devices (IMDs). It is also worthwhile noting that for the macro-scale MFC, the significant amounts of open circuit voltage, oxalate removal, and coulombic efficiency were about 935 mV, 99%, and 44.2%, respectively. These values compared to previously published studies indicate successful oxalate biodegradation in the macro-scale MFC. Regarding critical challenges to determine the substrate concentration in microfluidic outlets, sample collection in a suitable time and online data reporting, an analogy was made between macro and micro-scale MFCs to elicit correlations defining the output current density as the inlet and the outlet oxalate concentration. Another use of the system as an IMD is to be a platform to identify urolithiasis and hyperoxaluria diseases. As a versatile device for power generation and oxalate biodegradation monitoring, the use of facile and cheap materials (< $1.5 per device) and utilization of human excreta are exceptional features of the manufactured micro-scale MFC.

Anthropometric and Biochemical Measures in Bariatric Surgery Candidates: What Is the Role of Inflammatory Potential of Diet?

BACKGROUND: The present study aimed to assess dietary total antioxidant capacity (TAC), dietary phytochemical intake (PI), and dietary inflammatory index (DII) in patients with morbid obesity who are candidates of bariatric surgery and their association with anthropometric and biochemical parameters. METHODS AND MATERIALS: One hundred seventy patients with morbid obesity who were referred to surgery clinic of Firoozgar Hospital were enrolled in the study. Ideal body weight and adjusted ideal body weight were calculated. The dietary data were collected using a food frequency questionnaire. Anthropometrics and biochemical parameters were assessed. A p-value of <0.05 was considered significant. RESULTS: The strongest correlations of DII with dietary intakes and anthropometric and biochemical biomarkers were found for iron (p<0.0001). Significant association was also observed for ferritin (p=0.02) and transferrin (p=0.02). In terms of PI, The strongest associations were also found for iron (p<0.0001). Additionally, the value of body mass index (BMI) showed significant correlation with PI (p=0.04). The correlations of dietary total antioxidant indices with dietary intakes and anthropometric and biochemical biomarkers were assessed. Non-significant correlation was found between fasting blood sugar (FBS), hemoglobin A1C (HbA1C), vitamin B12, and vitamin D3 with ORAC index. Significant strong correlation showed for the value of iron in both ferric reducing ability of plasma (FRAP) and Oxygen Radical Absorbance Capacity (ORAC) indices (p<0.0001). CONCLUSION: We find statistical significance correlation for dietary PI and BMI. The inflammatory and antioxidant properties of diet were not related to biochemical markers associated with obesity. Graphical abstract.

The effects of Spirulina supplementation on metabolic syndrome components, its liver manifestation and related inflammatory markers: A systematic review.

AIMS: The aim of this systematic review was to assess the effects of Spirulina supplementation on metabolic syndrome components, its liver manifestation and related inflammatory markers. METHODS: We searched PubMed and Scopus (up to August 2017) to identify relevant studies. English randomized controlled trials (RCTs) investigating the effects of Spirulina supplementation on factors associated with metabolic syndrome in human models, were included in the review. RESULTS: Among 720 articles related to Spirulina in the primary search, 22 of them were eligible human RCTs and finally 18 of them were included in the review. The systematic review revealed that oral dosage range of 1-19gr/day for 0.5-6 months of Spirulina supplementation have positive effects on metabolic syndrome components. CONCLUSION: Spirulina can be possibly administered as a safe and efficient supplementation in the case of metabolic syndrome components, although determining the optimal dosage and period of supplementation still needs further investigations.

Zinc supplementation improves body weight management, inflammatory biomarkers and insulin resistance in individuals with obesity: a randomized, placebo-controlled, double-blind trial.

BACKGROUND: The present study was designed to determine whether zinc supplementation would increase the effects of restricted calorie diet (RCD) on obesity. METHODS AND MATERIALS: A randomized, double-blind clinical trial was performed on 40 obese subjects who were randomly assigned to receive zinc supplements (30 mg/day) or placebo for a period of 15-weeks. Both groups were under a restricted calorie diet (~ 300 kcal lower than the estimated energy requirement). Anthropometric measurements, biochemical markers, appetite, and dietary intakes were determined during the study period. RESULTS: The reductions of body weight, body mass index, waist circumference, and hip circumference were significantly higher in the zinc group compared to the placebo group (P = 0.032, 0.025, 0.003, and 0.0001, respectively). Lower levels of high sensitivity C-reactive protein, apelin, homeostatic model assessment of insulin resistance (HOMA-IR), and appetite score were observed in the zinc group in comparison with the placebo group (P = 0.0001, 0.001, 0.031 and 0.001 respectively). CONCLUSION: This study indicates that Zn supplementation with a restricted calorie diet has favorable effects in reducing anthropometric measurements, inflammatory markers, insulin resistance and appetite in individuals with obesity, and may play an effective role in the treatment of obesity.Trial registration This clinical trial was registered at clinicaltrials.gov at the U.S. National Library of Medicine (NCT02516475).

Dietary Intakes and Biochemical Parameters of Morbidly Obese Patients Prior to Bariatric Surgery.

BACKGROUND: Patients with morbid obesity appear to have adequate nutritional intake, but some studies suggest deficiencies in the micronutrient intake in these patients. Present study aimed to determine dietary intakes and their associated biochemical parameters in an Iranian population of patients with morbid obesity prior to bariatric surgery. METHODS: One hundred seventy patients with morbid obesity who have referred to surgery clinic of Firoozgar Hospital were enrolled in the study. Ideal Body Weight (IBW) and Adjusted Ideal Body Weight (AIBW) were calculated. The dietary data were collected using a Food Frequency Questionnaire (FFQ). Anthropometrics and biochemical parameters were assessed. All the statistical analyses were done using the SPSS with an alpha of 0.05. RESULTS: Mean age of participants was 37.4 ± 10.17 years. The mean and standard deviation (SD) of the BMI and EBW values was 45.75 ± 6.49 kg/m and 47.6 ± 13.74 kg, respectively. All the micro- and macro-nutrient intakes are significantly different from the recommended values, except for vitamin A in the men and calcium in the 51-70-year-old women. 47.1% and 17.1% of the participants were classified as patients with diabetes and pre-diabetes, respectively. Majority of participants had lower serum iron levels than the reference values. Almost all the participants (97%) had normal albumin levels. CONCLUSIONS: Despite their excess intakes of energy, patients with obesity usually suffer from micronutrient deficiencies, such as vitamin D, iron, and vitamin B12, which can be accompanied by complicated biochemical disorders like impaired glucose metabolism and dyslipidemia. Therefore, bariatric surgery candidates require close nutritional monitoring before and after their surgical operations.

Spirulina platensis effectively ameliorates anthropometric measurements and obesity-related metabolic disorders in obese or overweight healthy individuals: A randomized controlled trial.

AIMS: Novel alternative treatments such as food supplements may be an effective approach to weight management. The aim of the present study was to investigate the possible effects of Spirulina Platensis (SP) on anthropometric measures, appetite and metabolic parameters in obese or overweight individuals. MATERIAL AND METHODS: A total of fifty-two obese and overweight subjects (25 kg/m2 ≤ body mass index (BMI) <40 kg/m2) were randomly selected to be allocated to SP (4 × 500 mg daily tablets along with restricted calorie diet (RCD)) or placebo (placebo tablets along with RCD) for 12 weeks of intervention. Anthropometric measurements and appetite score were assessed at baseline, weeks 6 and 12. Biochemical assessments were performed at baseline and week 12. RESULTS: Thirty-eight participants completed the intervention. Body weight, waist circumference, body fat and BMI significantly reduced in the SP group compared to the placebo group (p < 0.001, p = 0.049, p = 0.049 and p = 0.02, respectively). In the SP group, the reduction triglycerides (TG) and high sensitivity C-reactive protein levels was considerably significant compared to the placebo group (p = 0.03, p = 0.02, respectively). Appetite score was significantly reduced in the SP group compared to the baseline (p < 0.001). CONCLUSIONS: This study suggests that spirulina platensis, as a complementary therapy may have beneficial effects on adherence to RCD, management of weight loss and also reduction in TG levels through possible modulatory effects on anti-inflammatory pathways.