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1.
Eur J Endocrinol ; 182(4): 447-457, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32069218

RESUMO

Context: Altered tissue-specific glucocorticoid metabolism has been described in uncomplicated obesity and type 2 diabetes. We hypothesized that weight loss induced by diet and exercise, which has previously been shown to reverse abnormal cortisol metabolism in uncomplicated obesity, also normalizes cortisol metabolism in patients with type 2 diabetes. Objective: Test the effects of a diet intervention with added exercise on glucocorticoid metabolism. Design: Two groups followed a Paleolithic diet (PD) for 12 weeks with added 180 min of structured aerobic and resistance exercise per week in one randomized group (PDEX). Setting: Umeå University Hospital. Participants: Men and women with type 2 diabetes treated with lifestyle modification ± metformin were included. Twenty-eight participants (PD, n = 15; PDEX, n = 13) completed measurements of glucocorticoid metabolism. Main outcome measures: Changes in glucocorticoid metabolite levels in 24-h urine samples, expression of HSD11B1 mRNA in s.c. adipose tissue and conversion of orally administered cortisone to cortisol measured in plasma. Body composition and insulin sensitivity were measured using a hyperinsulinemic-euglycemic clamp, and liver fat was measured by magnetic resonance spectroscopy. Results: Both groups lost weight and improved insulin sensitivity. Conversion of orally taken cortisone to plasma cortisol and the ratio of 5α-THF + 5ß-THF/THE in urine increased in both groups. Conclusions: These interventions caused weight loss and improved insulin sensitivity with concomitant increases in the conversion of cortisone to cortisol, which is an estimate of hepatic HSD11B1 activity. This suggests that dysregulation of liver glucocorticoid metabolism in these patients is a consequence rather than a cause of metabolic dysfunction.


Assuntos
Diabetes Mellitus Tipo 2/metabolismo , Dieta Redutora/métodos , Exercício/fisiologia , Glucocorticoides/metabolismo , Perda de Peso/fisiologia , Adulto , Idoso , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/terapia , Dieta Paleolítica , Terapia por Exercício/métodos , Feminino , Técnica Clamp de Glucose , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/sangue , Resistência à Insulina , Fígado/metabolismo , Espectroscopia de Ressonância Magnética , Masculino , Metformina/uso terapêutico , Pessoa de Meia-Idade , Resultado do Tratamento
3.
Rev Med Suisse ; 16(679): 199-201, 2020 Jan 29.
Artigo em Francês | MEDLINE | ID: mdl-31995303
4.
Orv Hetil ; 160(43): 1687-1697, 2019 Oct.
Artigo em Húngaro | MEDLINE | ID: mdl-31630554

RESUMO

Long-term successful weight control poses a huge challenge to people who are overweight and treat them in the obesogenic environment. After reaching a clinically significant (5-10%) weight loss, the goal is to maintain the weight loss achieved. However, this requires virtually constant resistance to temptations and requires sustained effort in terms of dietary restriction and physical activity, which requires a strong motivational base. From the point of view of behavior, motivation is the probability that the patient starts, pursues, or persistently follows a strategy that triggers change, that is, in the case of obesity, is committed to health-related behaviors that support weight management and abandons health risk behaviors that hinders weight control efforts. The present study describes the transtheoretical model of behavioral change and provides examples of practical ways to increase motivation and adherence at all stages of behavioral change. All this can contribute to the work of primary care and outpatient care professionals in supporting weight loss patients with excess weight. Orv Hetil. 2019; 160(43): 1687-1697.


Assuntos
Dieta Redutora/métodos , Exercício , Motivação , Obesidade/terapia , Sobrepeso/terapia , Cooperação do Paciente/psicologia , Perda de Peso , Comportamentos Relacionados com a Saúde , Humanos , Modelos Psicológicos , Obesidade/psicologia , Sobrepeso/psicologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-31547451

RESUMO

The purpose of this pilot study was to assess the acceptability to adolescents (11-18 years old) and their parents using a revised protein-sparing modified fast (rPSMF) for 12 months as an intervention for severe obesity in a tertiary pediatric weight management clinic (PWMC). To assess acceptability (satisfaction, confidence) with the rPSMF protocol, surveys were completed by adolescents and parents at baseline, 1, 3, 6, and 12 months, with adolescent height and weight measured. Analyses were conducted to assess differences in satisfaction and confidence based on adolescent response (weight loss) and adherence to the rPSMF. Adolescents' adherence with the rPSMF was close to 50% in the first 3 months, but dropped to 14.7% at 6 months. Adolescents were most confident with choosing low carbohydrate foods at baseline. Over 12 months, adolescents and parents reported weight loss as "the most liked" part of the rPSMF. Adolescents who were adherent were more satisfied with their weight loss than their non-adherent peers. Parents and adolescents reported lack of food variety and difficulty following the protocol as challenges with the rPSMF. Adolescents and their parents were able to follow the rPSMF protocol, with weight loss, but with decreased adherence over time.


Assuntos
Proteínas na Dieta/administração & dosagem , Jejum , Obesidade Mórbida/dietoterapia , Pais , Cooperação do Paciente , Obesidade Pediátrica/dietoterapia , Adolescente , Criança , Dieta Redutora , Feminino , Alimentos , Humanos , Masculino , Projetos Piloto , Perda de Peso
6.
BMC Endocr Disord ; 19(1): 93, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477085

RESUMO

BACKGROUND: Obese women with polycystic ovary syndrome (PCOS) may face additional barriers in achieving weight loss. We aimed to compare the effects of the hypocaloric low glycemic index (LGI) diet on anthropometric variables and insulin resistance in women with and without PCOS and investigate the effect of this diet on the clinical and hormonal features of PCOS women. METHODS: This interventional study was carried out at the Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Of 108 women invited for the purpose of the present study, 62 participants (PCOS = 28, non-PCOS = 34) followed a 24-week energy restricted LGI diet. Anthropometric, biochemical, hormonal and clinical measurements were documented at baseline, 12 weeks and 24 weeks with intervention. RESULTS: The percentages of weight loss achieved by both the PCOS and non-PCOS groups did not differ significantly (PCOS: -8.04% vs. non-PCOS: -8.09%). No significant difference in decrease of homeostatic model assessment of insulin resistance (HOMA-IR) was observed between the two groups (PCOS = - 0.83 ± 0.33, non PCOS = - 0.79 ± 0.28, P = 0.83). In PCOS women, significant reduction in total testosterone (- 0.91 ± 0.33 nmol/L, P = 0.006), FAI (- 4.47 ± 1.1, P < 0.001) and increase in SHBG (38.98 ± 11.02 nmol/L, P < 0.001) were observed. Menstrual irregularity was improved in 80% of women with PCOS and a significant decrease (32.1%) in occurrence of acne was reported. CONCLUSIONS: This diet has equally beneficial effects on anthropometric and metabolic characteristics of overweight women with and without PCOS. TRIAL REGISTRATION: This study is registered in the Iranian Randomized Clinical Trials Registry (IRCT, code: IRCT2016092129909N1 ).


Assuntos
Restrição Calórica/métodos , Dieta Redutora/métodos , Índice Glicêmico , Obesidade/terapia , Sobrepeso/terapia , Síndrome do Ovário Policístico/complicações , Adolescente , Adulto , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Resistência à Insulina , Obesidade/complicações , Sobrepeso/complicações , Prognóstico , Perda de Peso , Adulto Jovem
8.
J Bone Joint Surg Am ; 101(16): 1440-1450, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31436651

RESUMO

BACKGROUND: Many surgeons require or request weight loss among morbidly obese patients (those with a body mass index [BMI] of ≥40 kg/m) before undergoing total knee arthroplasty. We sought to determine how much weight reduction was necessary to improve operative time, length of stay, discharge to a facility, and physical function improvement. METHODS: Using a retrospective review of cohort data that were prospectively collected from 2011 to 2016 at 1 tertiary institution, we identified 203 patients who were morbidly obese at least 90 days before the surgical procedure and had their BMI measured again at the immediate preoperative visit. All heights and weights were clinically measured. We used logistic and linear regression models that adjusted for preoperative age, sex, year of the surgical procedure, bilateral status, physical function (Patient-Reported Outcomes Measurement Information System [PROMIS]-10 physical component score [PCS]), mental function (PROMIS-10 mental component score [MCS]), and the Charlson Comorbidity Index. RESULTS: Of the 203 patients in the study, 41% lost at least 5 pounds (2.27 kg) before the surgical procedure, 29% lost at least 10 pounds (4.54 kg), and 14% lost at least 20 pounds (9.07 kg). Among morbidly obese patients, losing 20 pounds before a total knee arthroplasty was associated with lower adjusted odds of discharge to a facility (odds ratio [OR], 0.28 [95% confidence interval (CI), 0.09 to 0.94]; p = 0.039), lower odds of extended length of stay of at least 4 days (OR, 0.24 [95% CI, 0.07 to 0.88]; p = 0.031), and an absolute shorter length of stay (mean difference, -0.87 day [95% CI, -1.39 to -0.36 days]; p = 0.001). There were no differences in operative time or PCS improvement. Losing 5 or 10 pounds was not associated with differences in any outcome. CONCLUSIONS: Losing at least 20 pounds before total knee arthroplasty was associated with shorter length of stay and lower odds of facility discharge for morbidly obese patients, even while most patients remained morbidly or severely obese. Although there were no differences in operative time or physical function improvement, this has considerable implications for patient burden and cost reduction. Patients and providers may want to focus on larger preoperative weight loss targets. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.


Assuntos
Artroplastia do Joelho/métodos , Índice de Massa Corporal , Obesidade Mórbida/complicações , Obesidade Mórbida/terapia , Aptidão Física , Perda de Peso , Idoso , Artroplastia do Joelho/efeitos adversos , Estudos de Coortes , Bases de Dados Factuais , Dieta Redutora/métodos , Exercício/fisiologia , Feminino , Humanos , Tempo de Internação , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/diagnóstico , Complicações Pós-Operatórias/prevenção & controle , Cuidados Pré-Operatórios/métodos , Prognóstico , Estudos Retrospectivos , Medição de Risco , Centros de Atenção Terciária , Resultado do Tratamento
9.
Nutrients ; 11(8)2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31382439

RESUMO

Dieting attempts have become popular worldwide. Dieting, however, seems to have both positive and negative health-related consequences. So far, only a few studies have focused on the determinants of dieting in detail. This study explores the association between self-report dieting attempts and intentional weight loss (IWL) during the previous year and several demographic, lifestyle, health, and psychological factors in a cross-sectional study design using data from the representative Finnish Health 2000 Survey. The sample comprised 2147 men and 2378 women, aged 30-69. Information for potential determinants was assembled via health examinations, interviews, and questionnaires. Approximately 24% of the men and 39% of the women reported dieting attempts and 10% of the men and 15% of the women reported IWL. Dieting attempts were associated with younger age, education, BMI, formerly smoking, more favourable values in lifestyle variables, and unfavorable values in serum HDL and triglycerides, a worse sense of coherence, concerns about one's appearance, and concerns about one's health. Among men, diabetics and those sleeping ≤6 h a night more frequently reported dieting attempts and those with osteoarthritis reported IWL. Moreover, the gradient between BMI and dieting attempts was significantly stronger in men than in women. Men seem to attempt dieting when they have actual health-related reasons, while such reasons are not so strongly associated with dieting in women. These findings can be used for determining subpopulations with obesity and real weight-loss needs and, alternatively, subpopulations with normal weight unnecessarily attempting dieting.


Assuntos
Dieta Redutora/psicologia , Autorrelato , Perda de Peso , Adulto , Fatores Etários , Idoso , Índice de Massa Corporal , Estudos Transversais , Escolaridade , Feminino , Finlândia , Inquéritos Epidemiológicos , Humanos , Estilo de Vida , Masculino , Saúde Mental , Pessoa de Meia-Idade , Obesidade/dietoterapia , Fatores Sexuais
10.
Clin Obes ; 9(5): e12329, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31294535

RESUMO

Obesity is a chronic disease with a significant and growing impact on Canadians. The "Awareness, Care and Treatment In Obesity MaNagement" (ACTION) Study investigated perceptions, attitudes and perceived barriers to obesity management among Canadian people with obesity (PwO), healthcare providers (HCPs) and employers. In this study adult PwO (body mass index ≥30 kg/m2 , based on self-reported height/weight), HCPs (physicians and allied HCPs managing PwO) and employers (≥20 employees; offering health insurance), completed online surveys between 3 August and 11 October 2017 in a cross-sectional design. Survey respondents (N = 2545) included 2000 PwO, 395 HCPs and 150 employers. Obesity was viewed as a "chronic medical condition" by most PwO (60%), HCPs (94%) and employers (71%) and deemed to have a large impact on overall health (74%, 78%, 81%, respectively). Many PwO (74%) believed weight management was their own responsibility. While PwO (55%) reportedly knew how to manage their weight, only 10% reported maintaining ≥10% weight reduction for >1 year. Despite low success rates, the most commonly reported effective long-term weight loss methods tried and/or recommended were "improvements in eating habits" (PwO 38%; HCP 63%) and "being more active" (PwO 39%; HCP 54%). PwO and HCPs reported very different perceptions of the quality and content of their interaction during obesity management discussions. These findings highlight the communication gaps and misunderstanding between PwO, HCPs and employers. This underscores the importance of, and need for, evidence-based management of obesity and a collaborative approach and understanding of the complex nature of this chronic disease.


Assuntos
Manejo da Obesidade/métodos , Manejo da Obesidade/estatística & dados numéricos , Adulto , Atitude Frente a Saúde , Canadá , Comunicação , Estudos Transversais , Dieta Redutora , Emprego , Exercício , Comportamento Alimentar , Feminino , Pessoal de Saúde , Nível de Saúde , Humanos , Colaboração Intersetorial , Masculino , Pessoa de Meia-Idade , Obesidade/terapia , Percepção , Inquéritos e Questionários , Resultado do Tratamento , Perda de Peso
11.
Diabetes Metab Syndr ; 13(2): 989-994, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336557

RESUMO

AIMS: Liver biopsy is currently the gold standard test for NAFLD diagnosis and staging but has many drawbacks. In addition, other tools such as transient elastography are limited to specialized research centers. To assess the usefulness of CK-18 as a non-invasive biomarker for detecting therapeutic responses in patients with liver fibrosis. MATERIALS AND METHODS: Sixty overweight and obese patients with liver fibrosis were evaluated by a dietitian and given a weight-reducing diet with a calorie deficit of 500-1000 kcal/day over a 6-month period. Controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) both were performed at the beginning and at the end of the trial to determine liver steatosis and liver fibrosis, respectively. Serum CK-18 levels were measured by enzyme linked immune sorbent assay (ELISA) at baseline and at 3 and 6 months after intervention. RESULTS: Patients experienced a rapid weight loss of -7.6 kg (8.5%) during the trial. Among all participants, liver steatosis decreased from 76.5 ±â€¯12.2% to 51.8 ±â€¯24.4% (baseline to end-point) (p < 0.001) and fibrosis score decreased from 9.9 ±â€¯3.7 to 7.2 ±â€¯2.4 (p < 0.001) (a 27.2% decrease). Serum CK-18 levels decreased from 290.2 ±â€¯98.1 U/L to 217.6 ±â€¯64.8 U/L (p < 0.001) (a 25.0% decrease). ΔCK-18 was found to be significantly associated with delta fibrosis score (r = 0.25, p = 0.05) CONCLUSIONS: This trial showed a significant positive association between changes in CK-18 levels and changes in liver fibrosis over a 6-month dietary intervention.


Assuntos
Biomarcadores/sangue , Dieta Redutora/métodos , Queratina-18/sangue , Cirrose Hepática/fisiopatologia , Obesidade/sangue , Sobrepeso/sangue , Perda de Peso , Adulto , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Obesidade/dietoterapia , Obesidade/epidemiologia , Sobrepeso/dietoterapia , Sobrepeso/epidemiologia , Prognóstico
12.
Nutrients ; 11(7)2019 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-31337035

RESUMO

Study objectives were to determine if erythrocyte omega-3 polyunsaturated fatty acids (n-3 PUFAs) increased in women participating in a dietary intervention that reduced inflammation and body weight and examine PUFA associations with markers of inflammation and quality of life (QOL). An experimental pre-post test, single group design was used. Fifteen post-menopausal women with obesity were enrolled in a 12-week pilot intervention focusing on lowering added sugars and increasing fiber and fish rich in n-3 PUFAs. Measurements included fasting blood samples, anthropometric, lifestyle and dietary data collected at baseline, end of intervention (Week 12) and follow-up (Week 24). Primary outcomes were change in erythrocyte PUFAs and associations between erythrocyte PUFAs, QOL (Short Form 12), and inflammatory markers (interleukin-6, tumor necrosis factor-α-receptor 2, and high sensitivity C-reactive protein (CRP)). Fourteen women completed all intervention visits. Mean erythrocyte docosahexaenoic acid and arachidonic acid (AA) increased at Week 12 and Week 24 (p < 0.001 for both), while eicosapentaenoic acid increased at Week 24 (p < 0.01). After adjustment for percent weight change, week 12 QOL related to physical function was significantly associated with erythrocyte linoleic acid (p < 0.05) and trended toward significant association with EPA (p = 0.051); week 24 CRP was directly associated with erythrocyte AA (p < 0.05). Erythrocyte n-3 PUFAs were not associated with inflammation.


Assuntos
Dieta Redutora , Eritrócitos/química , Ácidos Graxos Insaturados/química , Inflamação/metabolismo , Obesidade/metabolismo , Pós-Menopausa , Adulto , Feminino , Humanos , Projetos Piloto , Qualidade de Vida
13.
Eat Behav ; 34: 101312, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31351360

RESUMO

The study used self-regulation theory to elucidate the relationships between the desirability of the thin-ideal goal, dispositional worry, body checking and weight-loss dieting (WLD) in college women. We hypothesized that body checking would mediate the relationship between the desirability of the thin-ideal goal and WLD: the desire to be thin would be associated with more WLD through more frequent body checking. We also hypothesized that dispositional worry would moderate this mediation pathway, such that the mediation pathway would be stronger for those higher in worry. Finally, all effects were expected to occur when controlling for self-reported body size. A paper and pencil survey was conducted on a convenience sample of 237 college women who completed measures of: thin-ideal desirability, dispositional worry, body checking, WLD, as well as providing height and weight. A bootstrap analysis using PROCESS (Hayes, 2013) supported the hypothesized moderated mediation model. Findings add to current knowledge by elucidating the nature and function of body checking, and by so doing may provide insight into the prevention and treatment of disordered eating.


Assuntos
Imagem Corporal/psicologia , Dieta Redutora/psicologia , Comportamento Alimentar/psicologia , Metas , Adulto , Índice de Massa Corporal , Peso Corporal , Feminino , Humanos , Inquéritos e Questionários , Universidades , Adulto Jovem
14.
Nutrients ; 11(6)2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31226790

RESUMO

Intermittent energy restriction combined with a Mediterranean diet (IER+MED) has shown promise to reduce body fat and insulin resistance. In the Multiethnic Cohort Adiposity Phenotype Study, Japanese Americans had the highest visceral adipose tissue (VAT) when adjusting for total adiposity. We conducted this pilot study to demonstrate feasibility and explore efficacy of following IER+MED for 12 weeks to reduce VAT among East Asians in Hawaii. Sixty volunteers (aged 35-55, BMI 25-40 kg/m2, VAT ≥ 90 cm2 for men and ≥ 80 cm2 for women) were randomized to IER+MED (two consecutive days with 70% energy restriction and 5 days euenergetic MED) or an active comparator (euenergetic Dietary Approaches to Stop Hypertension (DASH) diet). Participants and clinic staff (except dietitians) were blinded to group assignments. IER+MED had significantly larger reductions in DXA-measured VAT and total fat mass (-22.6 ± 3.6 cm2 and -3.3 ± 0.4 kg, respectively) vs. DASH (-10.7 ± 3.5 cm2 and -1.6 ± 0.4 kg) (p = 0.02 and p = 0.005). However, after adjusting for total fat mass, change in VAT was not statistically different between groups; whereas, improvement in alanine transaminase remained significantly greater for IER+MED vs. DASH (-16.2 ± 3.8 U/L vs. -4.0 ± 3.6 U/L, respectively, p = 0.02). Attrition rate was 10%, and participants adhered well to study prescriptions with no reported major adverse effect. Results demonstrate IER+MED is acceptable, lowers visceral and total adiposity among East Asian Americans, and may improve liver function more effectively than a healthful diet pattern. ClinicalTrials.gov Identifier: NCT03639350.


Assuntos
Restrição Calórica/métodos , Dieta Mediterrânea , Dieta Redutora/métodos , Gordura Intra-Abdominal/fisiopatologia , Obesidade Abdominal/dietoterapia , Adiposidade , Adulto , Idoso , Americanos Asiáticos , Feminino , Hawaii , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/fisiopatologia , Projetos Piloto , Resultado do Tratamento
15.
Clin Obes ; 9(4): e12316, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31207126

RESUMO

Obesity worsens the age-related tendency towards cardiovascular disease and diabetes. Older adults are vulnerable to medication adverse effects. Intentional weight loss in older adults with obesity has been shown to improve cardiovascular and glycaemic markers. The effect of rapid weight loss induced by very-low-calorie diets (VLCDs) on these markers has not been evaluated in this group. In this 12-week study, participants were randomized to one of healthy eating, hypocaloric diet or VLCD, all combined with three times weekly exercise (Ex/HE, Ex/Diet, Ex/VLCD, respectively). The effects of these interventions on weight, blood pressure, lipids, glucose and HbA1c , inflammatory markers and cardiovascular and diabetes medication changes were measured. Weight loss was 3.7%, 5.1% and 11.1% in Ex/HE, Ex/Diet and Ex/VLCD, respectively. There were significant improvements in HbA1c in all groups, but by the greatest degree in Ex/VLCD (0.18 ± 0.07%, 0.18 ± 0.06% and 0.59 ± 0.13%, respectively). Similar patterns were seen in total cholesterol (0.13 ± 0.15, 0.21 ± 0.11 and 0.53 ± 0.13 mmol/L, respectively, P = .047), triglycerides (0.35 ± 0.13, 0.20 ± 0.10 and 0.51 ± 0.09 mmol/L, respectively, P = .011) and systolic blood pressure (9 ± 2, 2 ± 3 and 14 ± 3 mmHg respectively, P = .025). There were no between-group differences in fasting glucose, high-density lipoprotein (HDL) cholesterol, LDL-C and inflammatory markers. Reductions in anti-hypertensive or diabetes medication were made in 4/29, 7/36 and 16/37 participants in Ex/HE, Ex/Diet and Ex/VLCD, respectively (P = .017). Significant weight loss achieved with a VLCD gave rise to improvements in multiple cardiovascular risk markers, despite reduction in medication. Weight loss is an under-utilized method of cardiovascular risk management in this group.


Assuntos
Biomarcadores/metabolismo , Doenças Cardiovasculares/tratamento farmacológico , Diabetes Mellitus/tratamento farmacológico , Obesidade/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/análise , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Índice de Massa Corporal , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/fisiopatologia , HDL-Colesterol/metabolismo , Diabetes Mellitus/metabolismo , Diabetes Mellitus/fisiopatologia , Dieta Redutora , Feminino , Hemoglobina A Glicada/metabolismo , Humanos , Hipoglicemiantes/análise , Hipoglicemiantes/uso terapêutico , Masculino , Obesidade/dietoterapia , Obesidade/metabolismo , Triglicerídeos/metabolismo , Perda de Peso
16.
Food Funct ; 10(6): 3581-3588, 2019 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-31161182

RESUMO

The prevalence of obesity and its related metabolic syndrome (MetS) has shown an upsurge in recent years due to modified lifestyle patterns. The present study was designed to investigate the impact of a nutritionally balanced conventional meal replacement diet with modified macromolecular composition (rich in soy/pea protein and soluble fibers) and caloric restriction on Taiwanese obese subjects. Obese subjects (BMI > 27; n = 50, male 23, female 27) were recruited and requested to replace two meals per day (breakfast and lunch or dinner) with the balanced nutritional meal replacement diet (equal to 240 kcal) for 8 weeks with one regular meal and make sure that the daily target calorie limit (caloric restriction) was less than 1500 kcal day-1 for men and 1200 kcal day-1 for women. After eight weeks of intervention with a calorie-restricted balanced partial meal replacement diet, the levels of body weight, body fat, and waist circumference were significantly reduced by 4.1 kg, 2.38%, and 5.06 cm, respectively. The levels of serum total cholesterol (TC), triglycerides (TG) and low-density lipoprotein cholesterol (LDL-c) were significantly decreased (p < 0.05) with a significant increase (p < 0.05) in high-density lipoprotein cholesterol (HDL-c) levels after 8 weeks of intervention with the meal replacement diet. Moreover, the levels of insulin, homeostatic model assessment-insulin resistance (HOMA-IR), leptin, thiobarbituric acid reactive substances (TBARS) and cardiovascular risk factors were significantly attenuated (p < 0.05). To conclude, the present intervention with meal replacement and caloric restriction on obese subjects could concomitantly decrease the body weight and glycemic and cardiovascular risk factors and thereby lower the risk of various metabolic disorders.


Assuntos
Obesidade/dietoterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Restrição Calórica , Colesterol/metabolismo , LDL-Colesterol/metabolismo , Dieta Redutora , Ingestão de Energia , Feminino , Humanos , Insulina/metabolismo , Resistência à Insulina , Leptina/metabolismo , Masculino , Refeições , Pessoa de Meia-Idade , Obesidade/metabolismo , Adulto Jovem
17.
Trials ; 20(1): 315, 2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31151464

RESUMO

BACKGROUND: Taurine (Tau) is involved in many biochemical functions such as regulation of glucose and lipid metabolism, enhancement of energy expenditure, anti-inflammatory effects and appetite control. The most important effect of Tau in obesity is its direct effect on adipose tissue. Some evidence has shown an impaired FGF (fibroblast growth factor) 19 and 21 biosyntheses in obesity. Besides the effects of eicosapentaenoic acid on serum FGF concentrations, the effect of other nutrients on FGFs is not clear. Since obesity as an important health problem is rising around the world and on the other side, Tau biosynthesis is reduced by adipose-tissue-derived factors in obesity, the effects of Tau and a weight-loss diet on obesity need to be investigated further. METHODS: We will conduct an 8-week. double-blind, parallel-group, randomized controlled clinical trial to investigate the effect of Tau supplementation on fasting serum levels of FGFs, ß-Klotho co-receptor, some biochemical indices and body composition in 50 obese women aged between 18 and 49 years on a weight-loss diet. DISCUSSION: We will determine the other advantages of a weight-loss diet on new metabolic risk factors. Since Tau may regulate adipose-tissue-derived factors and a weight-loss diet can promote the useful effects of Tau supplementation; for the first time, the effects of a weight-loss diet along with Tau supplementation on these variables will be assessed. TRIAL REGISTRATION: Iran Clinical Trials Registry, ID: IRCT20131125015542N2 . Registered on 24 November 2018.


Assuntos
Composição Corporal , Dieta Redutora , Fatores de Crescimento de Fibroblastos/sangue , Proteínas de Membrana/sangue , Obesidade/dietoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Taurina/administração & dosagem , Adolescente , Adulto , Interpretação Estatística de Dados , Suplementos Nutricionais , Método Duplo-Cego , Jejum , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/metabolismo , Adulto Jovem
18.
Nutrients ; 11(6)2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31159183

RESUMO

BACKGROUND: Obesity is a widespread problem in the elderly, being associated with severe comorbidities negatively influencing life expectancy. Integrated multidisciplinary metabolic rehabilitation aimed to reduce body weight (BW) and fatigue, increase physical autonomy and introduce healthy life style changes has been proposed as a useful intervention to improve the general health status and quality of life of the obese geriatric population. METHODS: Six hundred-eighty four severely obese subjects (F/M = 592/92; age range: 61-83 years; mean body mass index, BMI ± SD: 42.6 ± 5.6 kg/m2) were admitted to take part in a three-week in-hospital BW reduction program (BWRP), entailing energy restricted diet, psychological counselling, physical rehabilitation and nutritional education. Biochemical parameters, cardiovascular risk factors (throughout the Coronary Heart Disease Risk, CHD-R), fatigue (throughout the Fatigue Severity Scale, FSS) and lower limb muscle performance (throughout the Stair Climbing Test, SCT) were evaluated before and at the end of the BWRP. RESULTS: A 4% BW reduction was achieved at the end of the BWRP. This finding was associated with a significant improvement of the metabolic homeostasis (i.e., decrease in total cholesterol and glucose) and a reduction of systolic blood pressure in both females and males, thus resulting in a reduction of CHD-R in the male group. Total FSS score and SCT time decreased in female and male obese patients. The effects of BWPR were comparable among all age-related subgroups (>60, 60-69 and >70 years), apart from ΔCHD-R, which was higher in male subgroups. Finally, age was negatively correlated with ΔBMI and ΔFSS. CONCLUSIONS: Though only a relatively limited number of outcomes were investigated, the present study shows that a 4% BW reduction in severely elderly obese patients is associated with positive multisystemic effects, particularly, muscle-skeletal and cardiometabolic benefits, which can favorably influence their general well-being and improve the autonomy level in performing more common daily activities. The maintenance of a healthy life style, including controlled food intake and regular physical activity, after a BWRP is obviously recommended in all elderly obese patients to further improve their clinical condition.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Aconselhamento , Dieta Redutora , Exercício , Fadiga , Obesidade/terapia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Perda de Peso/fisiologia
19.
J Pers Soc Psychol ; 117(4): 697-720, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31233318

RESUMO

People pursue goals throughout their lives, and many of these attempts end happily-a goal is achieved. However, what facilitates the continuation of behaviors that are aligned with the completed goal, such as continuing to monitor food intake after completing a diet program? The results of 6 studies involving over 1,600 people across cultures and samples (executives in Africa, dieters in a 7-day food diary program, exercisers in a 14-day walking program, and college students) demonstrated that construing an achieved goal as a journey one has completed (compared with an alternative metaphor of having reached a destination, or a no-metaphor control) led to a greater likelihood of people continuing behaviors aligned with this attained goal. These findings demonstrated how shifting people's focus of a metaphor (i.e., focusing on the journey vs. the destination part of a completed path) can lead to consequentially different perceptions and behaviors. We isolated a mechanism for why people would continue goal-aligned behaviors after attaining their specific goals-enhanced perceptions of personal growth. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Logro , Impulso (Psicologia) , Metas , Metáfora , Motivação , Adulto , África , Atenção , Atitude , Comparação Transcultural , Dieta Redutora/psicologia , Exercício/psicologia , Feminino , Seguimentos , Felicidade , Humanos , Masculino , Pessoa de Meia-Idade , Estudantes/psicologia , Adulto Jovem
20.
Horiz. méd. (Impresa) ; 19(2): 77-83, Jun. 2019. tab, ilus
Artigo em Espanhol | LILACS, LIPECS | ID: biblio-1007096

RESUMO

Objetivo: Investigar el cambio en la concentración de adiponectina circulante en plasma en 23 mujeres obesas premenopáusicas de la ciudad de Lima luego de la reducción de la masa corporal como resultado de un programa de actividad física aeróbica y una dieta baja en calorías.Materiales y métodos: Se llevó a cabo un estudio analítico y cuasi-experimental con el grupo de mujeres obesas. Adicionalmente, 24 mujeres se consideraron como control o de referencia de la concentración de adiponectina y otros marcadores bioquímicos. La cuantificación de adiponectina se realizó mediante la prueba de ELISA. La concentración de glucosa en ayunas en sangre, colesterol, lipoproteína de alta densidad y triglicéridos fueron cuantificados mediante análisis clínicos de rutina.Resultados: Antes del programa el grupo control mostró altos valores de adiponectina (mediana: 8,54 µg/mL; rango: 6,14 µg/mL a 13,49 µg/mL) en comparación con el grupo obesidad (mediana: 7,03 µg/mL, rango: 3;77 µg/mL a 17,23 µg/mL); sin embargo, la diferencia no fue estadísticamente significativa (P = 0.0563). Luego de la finalización del programa se observó que el grupo obesidad presentó una reducción estadísticamente significativa del índice de masa corporal (P = 5.98e-08) y de la circunferencia abdominal (P = 1.55e-08) así como un incremento estadísticamente significativo de los niveles de adiponectina (mediana, 8.79 µg/mL; rango, 5.50 µg/mL a 19.37 µg/mL) (P = 0.0127). Conclusiones: Basándonos en los resultados, concluimos que en mujeres obesas premenopáusicas la concentración de adiponectina se incrementa cuando la masa corporal se reduce como resultado de actividad física aeróbica y una dieta baja en calorías.


Objective: To investigate the changes in the plasma-circulating adiponectin concentration in 23 premenopausal obese women living in Lima after a body mass reduction as a result of an aerobic physical activity program and a low-calorie diet.Materials and methods: An analytical and quasi-experimental study was conducted in a group of obese women. In addition, another 24 women were considered as control or reference group for comparing their adiponectin concentration and other biochemical markers. The quantification of adiponectin was carried out using the ELISA test. Fasting blood glucose concentration, cholesterol, high-density lipoprotein and triglycerides levels were quantified by routine clinical analysis.Results: Before beginning the program, the control group showed high adiponectin levels (median, 8.54 µg/mL; range, 6.14 µg/mL to 13.49 µg/mL) compared to the obesity group (median, 7.03 µg/mL; range, 3.77 µg/mL to 17.23 µg/mL). However, the difference was not statistically significant (P = 0.0563). Once the program was finished, the obesity group showed a statistically significant reduction in the body mass index (P = 5.98e-08) and abdominal circumference (P = 1.55e-08), and a statistically significant increase in the adiponectin levels (median, 8.79 µg/mL; range, 5.50 µg/mL to 19.37 µg/mL) (P = 0.0127). Conclusions: Based on the results, we conclude that the adiponectin concentration in premenopausal obese women increases when the body mass is reduced as a result of aerobic physical activity and a low-calorie diet.


Assuntos
Feminino , Adiponectina , Índice de Massa Corporal , Dieta Redutora , Programas de Redução de Peso , Atividade Motora
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