Guideline Recommendations for Obesity Management

Experiences and expectations of patients with obesity 3 months after metabolic and bariatric surgery: a qualitative study

Article

Full-text available

Mar 2025

Objectives Patients experience significant physical and psychological changes within the first 3 months post-surgery, yet few studies focus on patient experiences during the early postoperative period. This study aimed to explore the patient experiences and expectations for nursing follow-up during the home recovery period following metabolic and bariatric surgery. Design A qualitative descriptive study design was used. Participants were selected using a purposive sampling method, and semi-structured interviews were conducted to collect data, which then were analysed using the content analysis method. Setting The study was conducted in a tertiary hospital in eastern China. Participants 21 patients (8 men and 13 women; aged 18–51 years) who received metabolic and bariatric surgery were included, with 16 within 3 months post-surgery and 5 beyond 3 months. Results Four themes emerged: (1) Physical and psychological rehabilitation: patients were enthusiastic and motivated about their physical recovery and mental well-being. (2) Stress and challenges: patients encountered various pressures and challenges, especially in dietary transitions and emotional management. (3) Adjustment and adaptation: patients were committed to managing discomfort and developing healthy dieting strategies through personal effort and diverse support. (4) Expectations for comprehensive support: patients desire comprehensive support and services from healthcare providers. Conclusions Healthcare providers should focus on the early postoperative experiences of patients and deliver personalised health education and emotional support to help them navigate the postoperative adaptation and ultimately achieve long-term health goals.

Micronutrient deficiencies in post-bariatric patients – an undervalued consequence

Article

Jan 2024

Comparison of Weight Loss Induced by Dietary and Pharmaceuticals in Individuals with Overweight and Obesity: A Case Control Study

Preprint

Full-text available

May 2024

Objective This study aims to evaluate the impact of low-carbohydrate diet, balanced dietary guidance, and pharmacotherapy on weight loss among individuals with overweight or obesity over a period of three months. Methods The study involves 339 individuals with overweight or obesity and received weight loss treatment at the Department of Clinical Nutrition at the Second Affiliated Hospital of Zhejiang University, School of Medicine, between January 1st, 2020 and December 31st, 2023. The primary outcome is the percentage weight loss. Results Among the studied patients, the majority chose low-carbohydrate diet as their primary treatment (168 [49.56%]), followed by balanced dietary guidance (139[41.00%]) and pharmacotherapy (32 [9.44%]). The total percentage weight loss for patients who were followed up for 1 month, 2 months, and 3 months was 4.98 (3.04,6.29) %,7.93 (5.42, 7.93) % and 10.71 (7.74,13.83) %, respectively. Multivariable logistic regression analysis identified low-carbohydrate diet as an independent factor associated with percentage weight loss of ≥ 3% and ≥ 5% at 1 month (OR [odds ratio] = 0.461, P<0.05; OR = 0.349, P<0.001). Conclusion The results showed that a low-carbohydrate diet was an effective weight loss strategy in the short term. However, its long-term effects were comparable to those observed with balanced dietary guidance and pharmacotherapy.

The Effect of Exercise-Oriented Training on Physical Activity Level and Exercise Awareness in Overweight and Obese Women: A Randomized-Controlled Trial

Article

Full-text available

Apr 2024

Obesity, exercise, education

Visceral adiposity index, premature mortality, and life expectancy in US adults

Article

Full-text available

Apr 2025
LIPIDS HEALTH DIS

Importance Visceral adiposity index (VAI) vividly reflects body fat distribution through comprehensively integrating body mass index, sex, waist circumference, triglycerides, and high-density lipoprotein cholesterol. While VAI is an established predictor of various clinical outcomes, its relationship with premature mortality and life expectancy remains unclear. Objective To explore the association between VAI and premature mortality or life expectancy in a nationally representative cohort of US adults. Methods This study included adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, linked to the National Death Index through December 31, 2019. Data were analyzed from August to October, 2024. VAI was categorized into quartiles from the lowest Q1 to the highest Q4. Primary endpoints were premature mortality (death before 80 years of age) and life expectancy. Results A total of 43,672 participants (women: 22,164; men: 21,508) aged > 20 years were included. Over a median follow-up of 9.2 years (IQR: 4.9–13.8), 3,187 premature deaths were documented. Higher VAI quartiles were significantly associated with increased multi-adjusted premature mortality risk compared to Q1 (Q3 vs. Q1: hazard ratio [HR], 95% confidence interval [CI]: 1.30, 1.05 to 1.61; Q4 vs. Q1: 1.68, 1.34 to 2.11). This association was particularly pronounced in women (Q3 vs. Q1: 1.53, 1.01 to 2.30; Q4 vs. Q1: 2.36, 1.52 to 3.68), with significant linear trends (P < 0.001). Estimated life expectancy at age 40 years was 41.45 (95% CI: 41.24 to 41.66), 41.32 (41.11 to 41.53), 40.55 (40.35 to 40.75), and 39.26 (39.08 to 39.45) years in Q1, Q2, Q3, and Q4 of VAI, respectively. By sex, estimated life expectancy at age 40 in Q4 was reduced by 3.33 years in women and 1.24 years in men, compared to Q1. By race and ethnicity, it was shortened by 3.90 years in Black participants and 1.68 years in White participants in Q4 group, compared to Q1. Conclusions In this nationwide cohort study, higher VAI was significantly associated with an increased risk of premature mortality and reduced life expectancy at age 40 among US adults. These associations we heterogeneous by sex, race and ethnicity, more pronounced in women and Black participants.

Sex-differences in Mediterranean diet: a key piece to explain sex-related cardiovascular risk in obesity? A cross-sectional study

Article

Full-text available

Jan 2024
J TRANSL MED

Background Mediterranean Diet (MD) has many health benefits, particularly in reducing cardiovascular risk (CVR). However, it is still little known if there are any sex differences in following this nutritional pattern and, thus, the potential sex-related repercussions on CVR in obesity. The study aimed to characterize sex-related adherence to MD and its association with CVR factors in subjects with obesity. Methods A total of 968 females (33.81 ± 11.06 years; BMI 34.14 ± 7.43 kg/m²) and 680 males (aged 34.77 ± 11.31years; BMI 33.77 ± 8.13 kg/m²) were included in a cross-sectional observational study. Lifestyle habits, anthropometric parameters, high sensitivity C-reactive protein (hs-CRP), and adherence to MD were evaluated. Results Females had significantly higher adherence to MD and lower hs-CRP levels than males (p < 0.001). Additionally, females consumed significantly more vegetables, fruits, legumes, fish/seafood, nuts, and sofrito sauce and less quantity of olive oil, butter, cream, margarine, red/processed meats, soda drinks (p = 0.001), red wine, and commercial sweets and confectionery than their counterparts. A PREDIMED score of ≤ 6 was associated with a significantly increased CVR in both sexes. Conclusions Females had higher adherence to MD, lower CVR, and different food preferences than males. Although the same PREDIMED threshold has been identified as a spy of CVR, the sex-related preference of individual foods included in the MD could explain the different impact of this nutritional pattern on CVR in both sexes. Graphical Abstract

Lower incidence of diabetic retinopathy and worsening events after phentermine assisted weight loss across a large U.S. cohort

Article

Full-text available

May 2025

Background/Objectives Medication assisted weight loss for treatment of obesity has rapidly increased. The effect of this treatment with phentermine on diabetic retinopathy (DR) is underexplored. Subjects/Methods Retrospective cohort study. The U.S. Collaborative Network of the TriNetX platform was queried for patients diagnosed with overweight and obesity and prescription of phentermine. Patients were propensity score matched across baseline demographics and systemic risk factors at the time of medication initiation and compared to those diagnosed with overweight and obesity without usage of weight loss medications, identifying 26,611 patients per cohort after propensity score matching. Risk ratios (RR) of incident DR and related diagnoses or procedural codes found after the medication initiation date for pertinent disease worsening and treatment metrics were assessed. Results Phentermine usage was found to be associated with reduced future risk of a new diagnosis of DR with macular oedema (RR 0.462; (95% CI 0.372–0.573), P < 0.001), mild non-proliferative diabetic retinopathy (NPDR) (RR 0.621 (0.508, 0.760), P < 0.001), moderate NPDR (RR 0.567 (0.402, 0.799), P < 0.001), severe NPDR (RR 0.477 (0.233, 0.981), P = 0.003), proliferative diabetic retinopathy (PDR) (RR 0.451 (0.323, 0.629), P < 0.001), vitreous haemorrhage (RR 0.347 (0.200, 0.602), P < 0.001), need for intravitreal anti-VEGF injection (RR: 0.530 (0.354, 0.793), P < 0.001). Conclusion The present analysis suggests that phentermine usage is associated with a decreased risk of diabetic macular oedema, NPDR, PDR, and worsening events.

The Landscape of Obesity Education Worldwide — Are We Doing Enough? Scoping Review of Content of Obesity Educational Interventions in Medical Schools and Residency Programs

Article

Full-text available

Mar 2025
OBES SURG

No study appraised the curricular content of published obesity education interventions (OEI) delivered to medical students, residents, or fellows. This scoping review identified and described the curricular content of published OEI, examined the specific obesity-related domains addressed, and proposed potential directions for future intervention development. We searched PubMed and Web of Science databases. Original articles on OEI delivered to medical students, residents, or fellows were included. Data extraction was guided by the Obesity Medicine Education Collaborative’s framework and the Accreditation Council for Graduate Medical Education-International (ACGME-I) competencies framework. The curricular content of OEI was categorized and visually mapped to identify trends and gaps. A total of 490 studies were identified, and 60 were included. Conceptually, twelve obesity domains emerged: epidemiology, health policy, prevention; basic sciences; nutrition; physical activity; behavioral aspects; counseling; pharmacotherapy; metabolic/bariatric surgery (MBS); weight stigma; ethics/professionalism; health literacy; and practice guidelines. Geographically, most OEI (88.3%) were implemented in North America. Three-quarters of OEI were for medical students, less OEI were for residents, and none for fellows. Content-wise, the OEI for medical students and for residents exhibited strikingly limited coverage of all obesity domains, although those for residency programs had more limited coverage than those for medical schools. Across medical schools, the most common domains addressed were basic sciences (48.3%), counseling, and nutrition (45% each); the least included were pharmacotherapy (13.3%), ethics/professionalism (3.3%), and health literacy (1.6%). For residency programs, the most common domains addressed were basic sciences and counseling (21.6% for each); the least were pharmacotherapy and MBS (6.6% each), weight stigma (5%), ethics/professionalism (3.3%) and health literacy (1.6%). Many critical domains of obesity remain inadequately addressed in the education provided in medical schools and residency programs. Future OEI should incorporate these to equip future physicians with knowledge, skills, and attitudes to care for patients with obesity.

Comparison of GLP-1RAs vs Other Pharmacotherapy for Obesity: A Clinical Review

Article

Full-text available

Feb 2025

Background: The Centers for Disease Control and Prevention (CDC) reports that 42% of adults in the United States (US) are obese, and 10% are severely obese. Obesity has many known associated health risks, and successful treatment decreases those risks. Management always includes diet and lifestyle changes and drug therapy can improve weight loss. The current United States Food and Drug Administration (FDA) approved pharmaceutical therapy choices for long-term use include a combination of phentermine-topiramate, combination bupropion-naltrexone, orlistat, glucagon-like peptide-1 receptor agonists (GLP-1RAs), and dual action GLP-1RAs and gastric inhibitory peptide agonists (GIP). Objectives: This review will summarize evidence comparing the safety and efficacy of GLP-1RAs or GLP-1RAs/GIP agonists with other pharmacologic treatments to achieve and maintain weight loss, improve quality of life, and reduce morbidity in obese adults. Methods: We completed a literature review of multiple databases, including PubMed, Embase, Google Scholar, and Cochrane databases, to identify studies about pharmacologic treatment for overweight or obese adults with or without T2DM and reporting outcomes of mean percentage body weight loss. An emphasis was placed on choosing meta-analyses and primary studies in patients without T2DM. We excluded articles older than 5 years or published in a language other than English. 19 meta-analyses and 2 randomized controlled trials (RCTs) were chosen, and 13 meta-analyses were excluded based on not meeting the inclusion criteria. 6 meta-analyses and 2 RCTs were included. Results: The literature showed that over 52 weeks, liraglutide reduced mean body weight percentage by 4.81% (95% CI: 4.23%-5.39%). Between a 12-68 week period in patients receiving semaglutide, three meta-analyses reported reduced weight by 12.57% [97% CI 10.35%-14.80%,) 10.55% (95% CI 6.96%-14.13%,) and 10.09% (95% CI: 8.33%-11.84%.) Tirzepatide, a novel GLP-1RA and GIP agonist, recently completed a phase-3 RCT, which showed that over 72 weeks, the mean weight percentage decrease was 18.4% (95% CI: 18.5%-23.2%) vs a 3.1% weight gain with placebo, a change of 21.8%. Each of the GLP-1RA agents (including tirzepatide) improved cardiometabolic risk factors. Phentermine-topiramate reduced mean body weight percentage by 8.45% (95% CI, 7.89%–9.01%) after 52-56 weeks. Bupropion-naltrexone reduced mean body weight percentage by 3.01% (95% CI, 2.47%–3.54%) over 56 weeks. Finally, orlistat reduced mean body weight percentage by 2.78% (95% CI, 2.36%–3.20%) after 1-4 years. Semaglutide is a well-established drug with weight loss, but tirzepatide shows the most promise in being the superior agent. Conclusion: It is well known that pharmacotherapy with diet and exercise is more effective than diet and exercise alone in achieving weight loss. The GLP-1RAs are effective for weight loss, with semaglutide more effective than phentermine-topiramate, bupropion-naltrexone, orlistat, and liraglutide. Tirzepatide shows promise as a superior agent, but more comprehensive studies need to be done. When choosing pharmacotherapy, utilizing a GLP-1RA (semaglutide) or a dual GLP-1RA/GIP agonist (tirzepatide) can improve cardiometabolic risk factors and quality of life and is more effective than any other FDA-approved agent. ?

Early pregnancy loss: the influence of endogenous risk factors

Article

Full-text available

Dec 2024

Due to the progressive decrease in the number of women of childbearing age, as well as children and adolescents in the Russian Federation, the primary medical and social task at the present stage is to preserve the reproductive health and life of women by preserving each desired preg-nancy. It is known that in more than 40% of observations the genesis of reproductive losses re-mains unclear. In Russia, the rate of miscarriage is 15—23%, in UK — 2.8%, in the USA — 15%. The share of non-developing (missed) pregnancy in the structure of early losses is up to 10—20%, while its frequency in our country increases annually. Missed abortion, as a rule, is the result of the combined effect of several factors of exogenous and endogenous origins. Exogenous factors are difficult to analyze and predict, can have a tera-togenic effect, leading to the occurrence of chromosomal abnormalities and the formation of an abnormal embryo. Endogenous factors are due to the characteristics of the female body, creating unfavorable conditions for the normal development of the embryo: anatomical, endocrine, immu-nological, infectious, etc. At the stage of pregnancy planning, endogenous factors are available for analysis and are considered conditionally controllable. Against the background of declining birth rates, the problem of non-developing pregnancy is becoming especially relevant and requires a serious analysis of the causes of its occurrence, as well as the development of possible methods of forecasting and prevention. The review article is devoted to a detailed analysis of foreign and domestic sources of literature concerning the role of maternal factors in the genesis of non-developing pregnancy as an important resource in reducing the frequency of miscarriage.

Dietary Recommendations for the Management of Gastrointestinal Symptoms in Patients Treated with GLP-1 Receptor Agonist

Article

Full-text available

Dec 2024

GLP-1 receptor agonist (GLP-1RA) have been developed to address the global burden of obesity and are renowned for their safety and efficacy. These medications influence hunger and satiety, reducing energy intake and promoting weight loss. Despite their benefits, GLP-1RAmay cause a slowed gastric emptying, leading to gastrointestinal symptoms. This study examines how food properties and meal composition affect these symptoms. Dietary recommendations are provided, particularly for evening meals, focusing on how different foods and nutrients can influence the rate of gastric emptying, to improve patient compliance and prevent interruption in weight loss.

Review on obesity management: diet, exercise and pharmacotherapy

Article

Full-text available

Nov 2024

Currently, obesity is one of the largest risk factors for cardiometabolic disease in North American adults. Over the past few years, the prevalence of this disease has been steadily increasing. This article is the second article in a three-part series of reviews exploring current clinical guidelines and management strategies used in practice to mitigate the spread of obesity. Guidelines to help physicians manage patients with obesity have been released in Canada and Europe. They outline proper management and treatment for overweight and obese patients. Examples include changes in diet and exercise, behavioural therapy and the administration of antiobesity medications as first-line and second-line treatments. Management of obesity takes on a tiered approach, where first-line therapies include lifestyle changes such as diet and exercise and second-line therapies include the use of antiobesity medications.

Quantitative analysis of the caloric restriction versus isocaloric diets models based on macronutrients composition: impacts on body weight regulation, anthropometric, and bioimpedance parameters in women with obesity

Article

Full-text available

Dec 2024

Introduction Obesity is a growing public health issue, especially among young adults, with long-term management strategies still under debate. This prospective study compares the effects of caloric restriction and isocaloric diets with different macronutrient distributions on body composition and anthropometric parameters in obese women during a 12-week weight loss program, aiming to identify the most effective dietary strategies for managing obesity-related health outcomes. Methods A certified clinical nutritionist assigned specific diets over a 12-week period to 150 participants, distributed as follows: hypocaloric diets—low-energy diet (LED, 31 subjects) and very low-energy diet (VLED, 13 subjects); isocaloric diets with macronutrient distribution—low-carbohydrate diet (LCD, 48 subjects), ketogenic diet (KD, 23 subjects), and high-protein diet (HPD, 24 subjects); and isocaloric diet without macronutrient distribution—time-restricted eating (TRE, 11 subjects). Participants were dynamically monitored using anthropometric parameters: body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and bioelectrical impedance analysis (BIA) using the TANITA Body Composition Analyzer BC-418 MA III (T5896, Tokyo, Japan) at three key intervals—baseline, 6 weeks, and 12 weeks. The following parameters were evaluated: body weight, basal metabolic rate (BMR), percentage of total body fat, trunk fat, muscle mass, fat-free mass, and hydration status. Results All diets led to weight loss, but differences emerged over time. The TRE model resulted in significantly less weight loss compared to LED at the final follow-up (6.30 kg, p < 0.001), similar to the VLED (4.69 kg, p < 0.001). Isocaloric diets with varied macronutrient distributions showed significant weight loss compared to LED (p < 0.001). The KD reduced waist circumference at both 6 and 12 weeks (−4.08 cm, p < 0.001), while significant differences in waist-to-hip ratio reduction were observed across diet groups at 12 weeks (p = 0.01). Post-hoc analysis revealed significant fat mass differences at 12 weeks, with HPD outperforming IF (p = 0.01) and VLED (p = 0.003). LCD reduced trunk fat at 6 weeks (−2.36%, p = 0.001) and 12 weeks (−3.79%, p < 0.001). HPD increased muscle mass at 12 weeks (2.95%, p = 0.001), while VLED decreased it (−2.02%, p = 0.031). TRE showed a smaller BMR reduction at 12 weeks compared to LED. Conclusion This study highlights the superior long-term benefits of isocaloric diets with macronutrients distribution over calorie-restrictive diets in optimizing weight, BMI, body composition, and central adiposity.

A Review of Etiological Biomarkers for Fibromyalgia and Their Therapeutic Implications

Article

Full-text available

Nov 2024
Pain Physician

Background: Fibromyalgia is a complex condition that has long puzzled the medical community. Hypotheses to explain the chronic widespread pain associated with the disease have evolved significantly over the years. However, research efforts to identify disease-specific biomarkers and develop effective treatments have been largely unsuccessful. Objectives: The goals of this study were to review potential etiological biomarkers for fibromyalgia, focusing on micro-inflammation and metabolic syndrome, and to discuss the clinical implications of the review findings. Study design: A narrative review. Methods: Relevant literature was obtained via Medline/PubMed, using the following search terms: fibromyalgia[ti] ("metabolic syndrome" OR "metabolic disease" OR biomarker*[ti] OR micro-inflammation OR sub-inflammation OR "low-level inflammation" OR "low-grade inflammation"). Results were filtered for the English language and screened for inclusion in the review. Results: Articles included in the review covered the topics of pain, immune response/inflammation, micro-inflammation, metabolic syndrome, gut dysbiosis, oxidative stress, and stress response. Various molecules have been proposed as pain biomarkers for fibromyalgia, including neurotransmitters, neuropeptides, growth factors, and cytokines with possible etiological relevance. Recent genome-wide expression profiling suggests connections among low-level inflammation, termed "micro-inflammation," and the upregulation of genes involved in antibacterial and innate immune system response as well as those involved in clinical features, including high body mass index (BMI) and comorbid depression, in a subgroup of fibromyalgia patients. A set of 5 differentially expressed inflammatory genes have been identified as potential biomarkers of a micro-inflammation fibromyalgia subtype. Proposed triggers of micro-inflammation include bacterial disease and gut dysbiosis. Metabolic syndrome may be causative or consequential, while comorbid depression may be associated with dysbiosis and/or micro-inflammation through the gut-immune-brain axis. A potential new treatment approach based on this information has been proposed. Limitations: External validation of potential etiological biomarkers is needed. Further investigations to ascertain the involvement of metabolic syndrome and gut dysbiosis and support the proposed treatment paradigm are warranted. Conclusion: Fibromyalgia is likely the result of multiple causative factors, genetic and environmental. To date, no clear, reliable etiological biomarker for fibromyalgia has been identified. The considerable variability among patients suggests the presence of multiple disease subtypes with different pathophysiological mechanisms. Effective treatment therefore requires a multimodal, multidisciplinary approach that targets each individual patient's pathophysiological features. The proposed treatment paradigm attempts to address multiple factors that have been implicated more recently in the development and maintenance of fibromyalgia, such as micro-inflammation, metabolic syndrome, and gut dysbiosis.

Body composition does not interfere with urinary incontinence in adult women with grade III obesity.

Article

Full-text available

Oct 2024

Objetivo. Investigar a composição corporal de mulheres adultas com obesidade grau III com e sem incontinência urinária. Métodos. Foram avaliadas mulheres com obesidade grau III do serviço ambulatorial de preparo para cirurgia bariátrica pertencente à um Hospital Universitário. Além da coleta de dados clínicos, foi realizada a mensuração da circunferência abdominal e avaliação da composição corporal por meio do exame de impedância bioelétrica tetrapolar. Para avaliar a presença de incontinência urinária nas pacientes foi utilizado o questionário International Consultation of Incontinence Questionnaire - Short Form. Foi realizada uma análise de subgrupo, com comparação das médias entre os grupos Obesas Com Perda de Urina x Obesas Sem Perda de Urina (SPU); e Controle X SPU. O grupo controle foi composto por mulheres com IMC normal, sem perda urinária. Resultados. Foram avaliadas 56 mulheres com obesidade grau III. A idade média da amostra foi de 37(±8,2) anos e o IMC 43,9 (±7,5). As variáveis de composição corporal do grupo de obesas grau III mostraram diferenças significativas quando comparadas ao grupo controle. Não foram observadas diferenças estatisticamente significativas entre os subgrupos SPU e PU para os desfechos avaliados pela impedância bioelétrica tetrapolar. Conclusão. Foi observada alta prevalência de incontinência mesmo sendo a amostra composta por mulheres adultas jovens. Não foram observadas diferenças estatisticamente significativas na comparação da composição corporal entre mulheres obesas com e sem perda de urina. A composição corporal, quando avaliada de maneira independente de outros aspectos, parece não influenciar na ocorrência de incontinência urinária nas mulheres obesas grau III.

A Guideline-Directed Approach to Obesity Treatment

Article

Nov 2024
Diabetes Spectrum

This article summarizes and compares 18 sets of guidelines for adult obesity treatment, highlighting key recommendations for patient evaluation, lifestyle intervention, anti-obesity medications (AOMs), and metabolic and bariatric surgery. Guidelines are consistent in many regards, although there is divergence regarding preferred AOMs. Metabolic and bariatric surgery is still recognized as the most durable form of obesity treatment, and newer guidelines suggest these procedures at lower BMI thresholds for people with uncontrolled type 2 diabetes. Overall, guidelines for obesity treatment show a high degree of agreement, although updates are needed to incorporate new treatment innovations.

The alteration of lipid metabolism and its correlation with glycometabolism following laparoscopic sleeve gastrectomy: A meta-analysis

Article

Full-text available

Nov 2024

Background The LSG has been shown to be effective in consistently reducing the body weight and improve the metabolism of patients with excessive obesity. However, its long-term effect in lipid metabolism and the correlation with glycometabolism have not been well summarized and analyzed. Objective The aims of this meta-analysis were to establish the panorama of lipid metabolism following LSG, study its correlation with glycometabolism, and provide evidence for therapeutic response assessment and prognosis prediction. Methods The meta-analysis identified all available studies reporting the lipid metabolism alterations following LSG from January, 2011, to March, 2023. Using relevant key words, articles were searched from the MEDLINE, PubMed, and EMBASE databases and screened following the PRISMA guideline. A total of 46 studies reporting the levels of several lipid markers across time points up to 24 months following LSG were included in the final analysis. Results Significant level decrease was found with FBG, FBI, HbA1C, HOMA-IR, and TG, in parallel with the drop of BMI following LSG up to 24 months, and significant level increase was observed in HDL. In contrast, no significant level changes were observed with TC and LDL. FBI and HOMA-IR exhibited the earliest (3–7 days) significant alterations even before BMI changed, and they also showed the biggest percentage decrease in all markers, while HDL exhibited the biggest percentage increase. All markers except LDL showed significant linear correlation with BMI, and TC and TG showed significant correlation with individual glycometabolism markers. TC, TG, and HDL showed significant correlation with each other, while LDL showed no significant correlation with other lipid markers except TC. Conclusions Insulin-related markers, HDL and TG, could be early response markers for LSG. Good correlation was found between BMI change and glyco- or lipid markers, while only TC and TG appeared to correlate with glycomarkers.

The Impact of Calories Information Displayed on Menus on Fast Food Consumption Among Teachers in Riyadh, Saudi Arabia

Article

Full-text available

Nov 2024

Background The Saudi population's dietary habits and nutritional patterns have shifted significantly due to rapid industrialization, technological advances, and cultural changes. Fast food, high in calories, saturated fats, and sodium, has become prevalent, contributing to rising rates of obesity and associated metabolic diseases such as type 2 diabetes. To combat this, the Saudi Food and Drug Authority (SFDA) introduced a mandatory menu calorie labeling policy in 2018 to improve public awareness and promote healthier eating choices. However, the impact of this policy on dietary behavior remains mixed and poorly understood. Methods This descriptive-analytical study involved 316 male and female teachers in the Riyadh region, selected using stratified random sampling from public and private schools. The study utilized a questionnaire to assess participants' knowledge, attitudes, and practices regarding menu calorie labeling and barriers to its usage. The data were statistically analyzed to explore the association between awareness of calorie labeling and demographic variables. Results Most participants (n = 288 (91.2%)) had sufficient knowledge about calorie content in macronutrients, and 234 (74%) found menu calorie information easy to understand. However, misconceptions persisted, with 159 (50.3%) participants unaware that vitamins and minerals do not contain calories. While 175 (55.4%) participants believed that calorie labeling met daily energy requirements, it had a limited impact on weight management or medical condition-related food choices. Females were twice as likely as males to be aware of calorie information (OR: 2.32, p = 0.026). Participants who visited restaurants less frequently were more conscious of menu calorie information (p = 0.009). Conclusion While the SFDA’s calorie labeling policy has increased public awareness, its influence on actual dietary choices remains inconsistent. Many individuals, particularly female teachers, demonstrate awareness of calorie content but do not always incorporate this information into healthier eating practices. The study highlights the need for further educational initiatives to improve understanding and utilization of calorie labeling, especially for individuals with health conditions.

Inter-relação entre qualidade do carboidrato da dieta e estado nutricional de uma comunidade de assentados do município de Limoeiro do Norte, CearáInterrelation between dietary carbohydrate quality and nutritional status of a community of settlers in the municipality of Limoeiro do Norte, Ceará, Brazil

Article

Full-text available

Oct 2024

Objetivo: Avaliar o índice glicêmico (IG) e a carga glicêmica (CG) da dieta de uma comunidade de assentados no município de Limoeiro do Norte/Ceará, Brasil e verificar se existe relação entre essas variáveis e o estado nutricional desses indivíduos. Método: Estudo transversal com amostra composta por 77 indivíduos adultos. O estado nutricional foi avaliado através de circunferência da cintura (CC), A Body Shape Index (ABSI) e Body Roundness Index (BRI). Recordatórios alimentares de 24 horas (R24h) foram aplicados e o índice glicêmico (IG) e a carga glicêmica (CG) foram calculados. A investigação de correlações de índice glicêmico com as variáveis antropométricas BRI e CC foi realizada por meio da utilização de teste de correlação de Pearson. A avaliação de correlação entre a carga glicêmica e a variável antropométrica ABSI foi feita através do teste de correlação de Spearman. As variáveis foram avaliadas quanto à associação através do teste Qui-quadrado. Resultado: Na população do estudo, predominaram as inadequações de IG (60,38±2,65), CG (139,46±53,45) e CC (94,23±10,99) com valores mais elevados entre os homens. Houve maior adequação para os marcadores mais recentes ABSI (0,0755±0,0040) e BRI (3,411±0,8593), que apresentaram valores proeminentes entre as mulheres. A análise estatística demonstrou ausência de correlação ou associação entre as variáveis cruzadas. Conclusão: Infere-se que os marcadores dietéticos inadequados prevaleceram entre os homens, enquanto as mulheres apresentaram mais marcadores antropométricos inadequados. IG e CG não se associaram com os marcadores CC, ABSI e BRI.

Nurses’ Knowledge about Bariatric Surgery at Surgical Wards in Al-Diwaniya Teaching Hospital

Article

Full-text available

Aug 2024

Bahaa Mirza Skal

Background: Bariatric surgery is the only type of therapy that demonstrates both efficacy and for a long-time impact on weight reduction and the amelioration of obesity-related morbidity. A nurse performs a crucial role in the following surgery by providing high-quality nursing care, preventing or minimizing problems, and facilitating the healing process. Objectives: The aims of the study to evaluate the nurses' understanding of bariatric surgery and determine the correlation between their knowledge and demographic factors such as age, gender, education level, and extensive years of expertise. Methods: An "descriptive cross-sectional study" was carried out to assess the nurses' proficiency in understanding the bariatric procedure in the surgical departments of Al-Diweniya Training Hospital. The duration of the study was prolonged from May 1st, 2024 to August 5th, 2024. A purposive (not-probability) representative sample (40) nurses employed in the surgical wards was selected. A survey was created to gather information on the demographic features of nurses and their comprehension of bariatric surgery. cross-sectional study was conducted to evaluate the nurses' level of knowledge regarding bariatric surgery in the surgical wards of Al-Diwaniya Teaching Hospital. The study was extended from May 1st, 2024 until August 5th, 2024. A deliberate "(non-probability) sample of (40) nurses" employed in the surgical wards was chosen. A survey was devised to collect data on the nurses' demographic characteristics and their understanding of bariatric surgery. Results: The findings of the research indicate that a more of the nurses, precisely 81%, lack sufficient knowledge about postoperative care. In addition, 19% of the nurses shown a moderate degree of understanding, while none of them displayed a high level of awareness. Conclusion: The current study determined that nurse prossess low knowledge regarding bariatric surgery. Recommendations: The study proposes that nurse employed on surgical wards need to attend specialized training courses.

Efficacy of antiobesity medications among breast cancer survivors taking aromatase inhibitors

Article

Full-text available

Jul 2024
BREAST CANCER RES TR

Purpose Aromatase inhibitors (AI) block estrogen synthesis and are used as long-term adjuvant treatment for breast cancer in postmenopausal women. AI use can be associated with weight gain that can lead to increased cardiometabolic risk. The response to anti-obesity medications (AOM) in patients using AI has yet to be studied. We sought to investigate weight loss outcomes of AOM in patients taking AI for breast cancer treatment. Methods This is a matched retrospective cohort study of breast cancer survivors on AI using AOM (AOM/AI group). We compared their weight loss outcomes with a group of female patients with obesity, without a history of breast cancer or AI use, on AOM (AOM group). The primary endpoint was total body weight loss percentage (TBWL %) at the last follow-up. We performed mixed linear regression models, including diabetes status at baseline, to assess associations between use of AOM with/without AI with total body weight loss percentage (TBWL%). Results We included 124 patients: 62 in the AOM/AI group (63.6 ± 10 years, body mass index [BMI] 34.3 ± 7.1 kg/m²) and 62 in the AOM group (62.8 ± 9.9 years, BMI 34.6 ± 6.5 kg/m²). The mean time of follow up was 9.3 ± 3.5 months, with no differences among the two groups. The AOM/AI group had a lower TBWL% compared to the AOM group at the last follow-up −5.3 ± 5.0 vs. −8.2 ± 6.3 (p = 0.005). The results remained significant after adjusting for diabetes status (p = 0.0002). At 12 months, the AOM/AI group had a lower TBWL% compared to the AOM group 6.4 ± 0.8% vs. 9.8 ± 0.9% (p = 0.04). The percentage of patients achieving ≥ 5%, ≥ 10%, and ≥ 15% of weight loss at 12 months was greater in the AOM compared to the AOM/AI group. Although the weight loss response was suboptimal, patients in the AOM/AI group had improvement in fasting glucose, glycated hemoglobin, systolic blood pressure, and low-density lipoprotein cholesterol. Conclusions The use of AI in breast cancer survivors is associated with less weight loss response to AOM compared to patients without breast cancer history and who do not take AI. Studies are needed to assess the mechanisms behind the differential weight loss response to AOM in women taking AI.

Poor Eating Habits and Low Physical Activity Contribute to Weight Excess and Increase Cardiometabolic Risk in Adolescents Practicing Soccer as a Recreational Sport

Article

Full-text available

Jul 2024

Background: Monitoring anthropometry, dietary intake, and physical activity (PA) is essential to prevent/counteract childhood obesity. This study examined dietary intake, PA, and anthropometric characteristics in young boys practicing soccer as a recreational sport. Methods: A cross-sectional study included 226 boys aged 8 to 13 years participating in soccer as a recreational activity in football academies located in Tunis, Tunisia. Anthropometric measures allowed the calculation of body mass index, fat mass, and peak height velocity as markers of biological maturity. A three-day food record and a food frequency questionnaire estimated nutrient intake and eating habits. The International Physical Activity Questionnaire (IPAQ) was used to estimate the PA level of the participants. Results: It was found that a high percentage of the children had excess weight (54%) and excess fat mass (47%). The total energy, carbohydrate, and saturated fat intake of the children exceeded the recommended levels by approximately 10%, 15%, and 30%, respectively. However, the intake of unsaturated fat was below the estimated requirements, particularly in obese children. In addition to the unbalanced macronutrient intake, the children also showed an insufficient intake of many essential micronutrients. Around 60% to 70% of the children in all three groups had a low intake of magnesium, n-3 polyunsaturated fatty acids (PUFA), and vitamins B9, B12, and D. Moreover, 20% to 35% of the children in the three groups had an insufficient intake of vitamins A and C. Insufficient vitamin E intake was found in 63% of obese children and 35% of non-obese children. It was observed that the PA level was lower in the overweight/obese group compared to the normal-weight group (p < 0.005). More than three-quarters of overweight/obese children had low PA levels, about 20% were moderately active, and only 1 to 2% were highly active. Conversely, normal-weight children showed moderate to high PA levels. Conclusions: Poor eating behavior, an unbalanced diet, and a low PA level are prevalent in Tunisian boys practicing recreational sports. Such a combination is responsible for a disparity between energy intake and expenditure, contributing to weight excess and increased cardiometabolic risk. The study findings provide meaningful information for practitioners and authorities on applying a balanced diet and adequate PA to prevent and fight against obesity and improve cardiometabolic health in youth.

Effect of Early Time-Restricted Eating on Metabolic Markers and Body Composition in Individuals with Overweight or Obesity

Article

Full-text available

Jul 2024

This study aimed to evaluate the effect of early time-restricted eating (eTRE) on metabolic markers and body composition in individuals with overweight or obesity. Seventeen subjects completed a randomized, crossover, and controlled clinical trial. Twelve women and five men participated, with a mean age of 25.8 ± 10.0 years and a BMI of 32.0 ± 6.3 kg/m². The eTRE intervention included 16 h of fasting (3:00 pm to 7:00 am) and 8 h of ad libitum eating (7:00 am to 03:00 pm) (16:8). The trial included four weeks of interventions followed by a four-week washout period. Body weight, waist and hip circumferences, and body composition measurements were taken. Additionally, a venous blood sample was collected for biochemical determinations. In a before–after analysis, eTRE induced a reduction in BW and BMI in women but this was not significant when compared to the control group. eTRE did not modify any other anthropometric measurements, fasting biochemical parameters, glycemic and insulinemic responses, blood pressure, or subjective appetite. In conclusion, eTRE did not induce beneficial effects on the glycemic and lipid metabolisms, body composition, subjective appetite, or blood pressure. These findings may be attributed to the special characteristics of the population and the short intervention period.

Analyzing Obesity Trends in American Children and Adolescents: Comprehensive Examination Using the National Center for Health Statistics (NCHS) Database

Article

Full-text available

Jun 2024

Background In the USA, obesity in children and adolescents has become a major public health concern. Childhood obesity has been linked to various cardiometabolic comorbidities all through one’s life. Owing to the significant increment in childhood obesity rates, there has been an urgent need for the identification of the correlates and antecedents of adiposity and the cardiometabolic risk to enable early prevention of obesity. As such, the objective of this study is to analyze obesity trends in American children and adolescents from 1999 to 2018 using the National Center for Health Statistics (NCHS) database, as this will enable the identification of various risk factors and early prevention of childhood obesity. Objective This study aimed to comprehensively examine demographic factors impacting obesity prevalence, including gender, age groups (two to five, six to 11, and 12-19 years), race/ethnicity, and poverty level. Methods The study conducted a retrospective analysis using the NCHS database from 1999 to 2018. Utilizing NCHS data, we examined the evolution of obesity prevalence among children and adolescents. The analysis focused on demographic variations, including gender, age, race/ethnicity, and percentage of poverty level. SPSS version 24, a statistical software by IBM Corp. (Chicago, IL, USA), was used for database summarization, graphical representation, and presenting prevalence trends across all participants. Results Temporal trends in obesity prevalence exhibited notable fluctuations from 1999 to 2018. Utilizing NCHS data, the study revealed demographic disparities in age groups, genders, race/ethnicities, and socioeconomic status categories. Gender-based obesity variations persist, with boys consistently surpassing girls in prevalence (17.5% vs. 16%, p = 0.0231). Varied age group patterns emerged, peaking at 18.7% in 12-19 years, 17.7% in six to 11 years, and 11.2% in two to five years. Racially, Hispanic individuals had the highest prevalence (22.8%), followed by Mexican (22.0%) and Black or African American-only individuals (20.6%). White-only individuals showed 14.4%, and Asian-only individuals exhibited the lowest (9.4%). Lower socioeconomic brackets correlate with higher obesity instances, particularly below the 100% poverty level (20%). The 100-199%, 200-399%, and 400% or more categories contributed 18.6%, 16.6%, and 11.6%, respectively. Conclusion Our extensive examination of obesity trends among American children and adolescents from 1999 to 2018, utilizing the NCHS database, provides valuable insights into the complex interplay of demographic factors influencing this public health concern. The study reveals age-specific variations, emphasizing unique challenges during adolescence. Gender disparities, socioeconomic influences, and racial/ethnic impacts are evident, underscoring the need for further study. Our findings present several policy implications regarding the development of interventions aimed at reducing childhood obesity rates in the USA. For instance, the findings indicate the need for policymakers to develop policy interventions aimed at enabling the prevention of obesity during early infancy stages. The findings highlight the need for interventions aimed at reducing the obesity disparities observed between genders and races/ethnic groups. Developing and executing the interventions is prone to considerably reduce the obesity prevalence rates among children and adolescents in the USA.

Cost-effectiveness of semaglutide 2.4 mg in chronic weight management in Portugal

Article

Full-text available

Apr 2024

Background Obesity and overweight are a significant public health concern. Subcutaneous semaglutide 2.4 mg injection is a glucagon-like peptide-1 (GLP-1) analogue approved by the European Medicines Agency as an adjunct to a reduced calorie diet and increased physical activity (diet and exercise, D&E) for the treatment obesity and overweight in the presence of at least one weight related comorbidity. This study aimed to assess the cost-effectiveness of semaglutide 2.4 mg in combination with D&E compared to D&E alone for the Portuguese setting. Methods Analysis were conducted using the Core Obesity Model (COM) version 18, a Markov state transition cohort model, to predict the health outcomes and costs of weight related complications based on changes in surrogate endpoints. Efficacy and safety data were sourced from the STEP trials (Body Mass Index, systolic blood pressure and glycemic status) from a cohort of adults aged on average 48 years with obesity (BMI ≥ 30 kg/m2) and ≥ 1 obesity-related comorbidities, over a time horizon of 40 years. Costs were estimated from the perspective of the Portuguese National Health Service. Sensitivity analyses were conducted to test the robustness of results across a range of assumptions. Results On a patient level, Semaglutide 2.4 mg in addition to D&E compared to D&E alone, improved QALYs by 0.098 and yielded higher costs by 1,325 EUR over a 40-year time horizon, with an ICER of 13,459 EUR per QALY gained and 100% probability of cost-effectiveness at the given WTP. Semaglutide 2.4 mg remained cost-effective across all different scenarios and sensitivity analysis at a WTP of 20,000 EUR per QALY. Among the subpopulations examined, Semaglutide 2.4 mg yielded ICERs of 18,459 EUR for patients with BMI ≥ 30 kg/m2 and of 22,657 EUR for patients with BMI ≥ 35 kg/m2. Conclusions Semaglutide 2.4 mg was cost-effective compared to D&E alone for patients with obesity (BMI ≥ 30 kg/m2) and weight related comorbidities in Portugal, over a 40-year time horizon.

Lifestyle Interventions in a Patient Identified as Super-Super Obese With a Body Mass Index of 90.5

Article

Full-text available

Apr 2024

Obesity is a growing global health concern. Saudi Arabia is experiencing a higher prevalence of obesity compared to the globe. This case report focuses on a 38-year-old female with a body mass index (BMI) of 90.5 kg/m², prediabetes, and obstructive sleep apnea who successfully underwent a lifestyle modification process resulting in remarkable weight loss. The patient’s past unsuccessful attempts at weight loss had left her with a reluctance to try again initially. A multidisciplinary team collaborated to develop a management plan starting with an intensive lifestyle intervention. Lifestyle was assessed, then a structured personalized lifestyle intervention based on a plant-based diet and a gradual increase in physical activity was implemented. Over 6 months, the patient succeeded in losing 23 kg, a percent weight loss of 11.9%. An additional 5 kg was lost when liraglutide “Saxenda” was added. This case report represents the effectiveness of intensive lifestyle interventions in patients with super-super obesity for weight loss and long-term health improvement. Additional research is required to determine if the positive outcomes seen in treating a single patient can be applied to a larger population with super-super obesity. This brings up the question of whether pharmacotherapy or surgical interventions should be the primary approaches for addressing these cases, considering that surgical interventions usually involve lifestyle changes. What we already know about such cases: patients with super-super obesity often require interventions such as surgery or medication to aid in weight reduction, as they typically do not respond to lifestyle interventions alone. What this case report adds to existing knowledge: the use of lifestyle interventions proved effective in such cases as super-super obesity and delayed the need for surgical intervention even without weight reduction medications.

Application of Object Detection Algorithm Based on Fiber Optic Sensors in Checking Body Fat Rate during Home Exercise

Preprint

Full-text available

Jan 2024

Wu Jing

With the increasing popularity of home fitness, people's attention to exercise effectiveness and physical health is also increasing. Body fat percentage directly reflects the body's fat content, and compared to obesity evaluation indicators such as weight or BMI, it can more scientifically and accurately evaluate the degree of obesity in the human body. In order to address the limitations of traditional body fat detection methods, this study chose fiber optic sensors as the means of body fat detection. The fiber optic sensors were in contact with the detected object, and the signals perceived by the fiber optic sensors during the motion process were converted into electrical signals. The signals were then digitized and algorithmic calculated. Using object detection algorithms to process the converted electrical signals, analyzing and extracting useful features from complex electrical signals, and accurately calculating the body fat percentage of the detected object. The results show that the algorithm proposed in this paper can accurately detect body fat percentage during home exercise, providing a convenient and fast monitoring method for sports enthusiasts, which helps improve fitness effectiveness and maintain physical health.

Association of metabolic syndrome, its components, and obesity with bone mineral density in the female population: evidence from NHANES

Preprint

Full-text available

Dec 2023

Objective We investigated the association of metabolic syndrome (MetS) and obesity with low bone mineral density (LBMD) in women and different menopausal status groups. Methods Based on the five NHANES 2-year cycles data, 1662 female participants aged 40 to 79 with BMD data of the lumbar spine and femoral neck were enrolled. Multivariate logistic regression analysis was used to estimate the association between MetS, its components, and obesity with the risk of LBMD in overall participants and premenopausal and postmenopausal subgroups. Results MetS was negatively associated with the risk of LBMD in the femoral neck but with no significant association in the lumbar spine. Among the components of MetS, waist circumference, and blood glucose showed negative associations with the LBMD risk. Overweight and obese were negatively associated with the LBMD risk in both femoral necks and lumbar spine. In contrast to the premenopausal participants, MetS was negatively associated with the femoral neck LBMD risk in the postmenopausal population. Conclusion Our study found no association or negative association between MetS and the risk of LBMD in the female population. Overweight/obese were negatively associated with the risk of LBMD. These associations may be more pronounced in the postmenopausal population than in the premenopausal population.

The relation between serum irisin levels with the anthropometric and metabolic parameters in obese and non-obese patients with type 2 diabetes mellitus

Article

Oct 2023

Visceral Adiposity Index, Premature Mortality, and Life Expectancy in US Adults

Preprint

Full-text available

Feb 2025

Importance Visceral adiposity index (VAI) vividly reflects body fat distribution through comprehensively integrating body mass index, sex, waist circumference, triglycerides, and high-density lipoprotein cholesterol. While VAI is an established predictor of various clinical outcomes, its relationship with premature mortality and life expectancy remains unclear. Objective To explore the association between VAI and premature mortality or life expectancy in a nationally representative cohort of US adults. Methods This study included adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, linked to the National Death Index through December 31, 2019. Data were analyzed from August to October, 2024. VAI was categorized into quartiles from the lowest Q1 to the highest Q4. Primary endpoints were premature mortality (death before 80 years of age) and life expectancy. Results A total of 43,672 participants (women: 22,164; men: 21,508) aged > 20 years were included. Over a median follow-up of 9.2 years (IQR: 4.9–13.8), 3,187 premature deaths were documented. Higher VAI quartiles were significantly associated with increased multi-adjusted premature mortality risk compared to Q1 (Q3 vs. Q1: hazard ratio [HR], 95% confidence interval [CI]: 1.30, 1.05 to 1.61; Q4 vs. Q1: 1.68, 1.34 to 2.11). This association was particularly pronounced in women (Q3 vs. Q1: 1.53, 1.01 to 2.30; Q4 vs. Q1: 2.36, 1.52 to 3.68), with significant linear trends ( P < 0.001). Estimated life expectancy at age 40 years was 41.45 (95% CI: 41.24 to 41.66), 41.32 (41.11 to 41.53), 40.55 (40.35 to 40.75), and 39.26 (39.08 to 39.45) years in Q1, Q2, Q3, and Q4 of VAI, respectively. By sex, estimated life expectancy at age 40 in Q4 was reduced by 3.33 years in women and 1.24 years in men, compared to Q1. By race and ethnicity, it was shortened by 3.90 years in Black participants and 1.68 years in White participants in Q4 group, compared to Q1. Conclusions In this nationwide cohort study, higher VAI was significantly associated with an increased risk of premature mortality and reduced life expectancy at age 40 among US adults. These associations we heterogeneous by sex, race and ethnicity, more pronounced in women and Black participants.

Characterization of Serum Electrolytes Levels and Lipid Profile among Young Obese Saudi Females

Article

Mar 2025
Niger J Clin Pract

Background A higher prevalence of electrolyte imbalance is observed among individuals who are obese when compared to the general population. It has been observed that obesity contributes to electrolyte imbalance, which is one of the conspicuous consequences of this physiological dysfunction. Aim This study aims to evaluate serum electrolytes and lipid profiles among young obese Saudi females. Methods The study was cross-sectional at Taibah University, Madinah, Saudi Arabia. The research included 350 obese females aged 20–25 with a body mass index (BMI) ≥30 kg/m ² . The study included students and employees aged 20–25 with a high BMI of 116 ≥30 kg/m ² . A total of three hundred fifty people volunteered to take part in this study. Volunteers received self-administered screening questionnaires to remove individuals who did not match the eligibility requirements. Participants were chosen using a random selection approach, with the additional criteria of having no pre-existing medical issues and a BMI ≥30 kg/m ² based on submitted information. Results The mean age of the females with obesity was 21 ± 10.3 years who had body mass index (BMI ≥30 kg/m ² ). Approximately 28.57% of subjects had hypernatremia, 2.9% hyponatremia ( P = 0.03), 28.57% hypokalemia, 2.8% hyperkalemia ( P < 0.001), 30% hypomagnesemia, and 2.9% hypermagnesemia ( P < 0.001), 2.3% hypochloremia, 10.8% hyperchloremia. ( P > 0.05) Notably, these individuals also exhibited elevated levels of cholesterol ( P = 0.04) and triglycerides ( P < 0.001). There exists a correlation between BMI levels and the levels of fasting blood glucose, total cholesterol, and triglycerides ( r = 0.53, P = 0.04, r = 0.56, P = 0.04, r = 0.55, 181 P = 0.02, respectively). The levels of Na ⁺ exhibit a positive correlation with BMI ( r = 54, P = 0.03), whereas the levels of K ⁺ and Mg ²⁺ demonstrate a negative correlation ( r = −0.53, P = 0.02, r = −0.54, P = 0.04, respectively). Conclusion Young females in Saudi Arabia who are obese may have greater levels of sodium (Na ⁺ ), decreased levels of potassium (K ⁺ ), and elevated levels of triglycerides and cholesterol Addressing these imbalances through targeted dietary and lifestyle interventions may be crucial for improving the health outcomes of these individuals.

AZƏRBAYCAN RESPUBLİKASI SƏHİYYƏ NAZİRLİYİ МИНИСТЕРСТВО ЗДРАВООХРАНЕНИЯ АЗЕРБАЙДЖАНСКОЙ РЕСПУБЛИКИ

Article

Full-text available

Feb 2025

Gulnara İbrahimova Hilal

Diabetes mellitus has been one of the important problems of modern medicine for many years, and researchers around the world are carefully studying this pathology. In diabetes mellitus, coagulation disorders are also observed. From this point of view, the study of many indicators of blood clotting disorders in patients with diabetes mellitus is of particular importance. Although these parameters have been studied in the blood, they have not been fully studied in the lymph. The aim of our study was a comparative study of changes in the blood and lymph coagulation system in experimental alloxan diabetes mellitus in rabbits, the determination of the rate of lymph flow, and the correction of the identified changes with Semax and Sulodexide. To create a model of diabetes mellitus, rabbits were injected with a 5% solution of alloxan monohydrate at a dose of 100 mg/kg into the abdominal cavity. In the control group, the concentration of fibrinogen in the blood and lymph, thrombin and prothrombin time were studied before the injection of alloxan and after 30, 60, and 90 days. In addition, the rate of lymph flow was also determined. After the appearance of diabetic symptoms in the experimental group of the study, the animals were injected intramuscularly with Semax at a dose of 100 μg/kg for 10 days and Sulodexide 30 evl into the stomach. Changes in blood and lymph coagulation system against the background of modeled alloxan diabetes were accompanied by a violation of lymph flow rate. The appointment of Semax and Sulodexide had a positive effect on the normalization of the identified changes.

Application of intelligent devices based on indoor thermal energy cycle in detecting body fat percentage during home exercise

Article

Dec 2024

Wu Jing

Serum autotaxin positively associates with hypertension in postmenopausal women: a single center study in China

Article

Oct 2024

Aim Autotaxin is an adipokine involved in metabolic disorders. The aim of the current study was to evaluate serum autotaxin levels in hypertensive postmenopausal women and establish a relationship between autotaxin and other comorbidities in this special group. Methods This single-center study included postmenopausal women who received annual health examinations at the First Affiliated Hospital, College of Medicine, Zhejiang University in Zhejiang, China. The metabolic and demographic characteristics of the subjects, including age, sex, height, weight, blood pressure, and biochemical indices, were collected. The serum autotaxin level was measured via ELISA. The Kolmogorov-Smirnov test, Student's t test, Mann–Whitney U test, χ ² test, receiver operating characteristic (ROC) curve analysis, Spearman correlation analysis and multivariate logistic regression analysis were adopted for statistical analysis. Results This pilot observational study included 25 hypertensive postmenopausal women and 25 age-matched normotensive controls. Hypertensive patients presented significant metabolic disturbances with greater comorbidities such as nonalcoholic fatty liver disease, obesity, overweight, diabetes, hypertriglyceridemia and hyperuricemia ( P < 0.05), impaired renal health with higher uric acid levels ( P < 0.001), and slightly elevated creatinine levels ( P = 0.156) with lower estimated glomerular filtration rates (eGFRs) ( P = 0.195). The serum autotaxin level was markedly greater in the hypertensive group (239.0±59.6 ng/ml vs. 192.7 ± 49.0 ng/ml; P < 0.01) and was positively associated with systolic blood pressure; diastolic blood pressure; and alanine transaminase, triglycerides (TG), creatinine, and uric acid levels and inversely associated with the eGFR ( P < 0.05) among postmenopausal women. Serum autotaxin levels positively predicted hypertension, with an AU-ROC of 0.750 [95% confidence interval (CI): 0.613–0.888] and a Youden index of 0.480 at a cutoff of 225 ng/ml. In the multivariate logistic regression analysis, after adjustment for demographic and metabolic parameters (including age, BMI, ALT, TB, uric acid, FBG, TG, LDL and creatinine), autotaxin (ATX) remained independently positively correlated with the risk of hypertension [odds ratio: 1.016, 95% CI 1.001–1.031; P < 0.05). Conclusions Among postmenopausal women, the serum autotaxin level is significantly elevated in the hypertensive group compared with age-matched normotensive controls. ATX is related to multiple metabolic disorders and renal health, suggesting that autotaxin has potential as a multiorgan therapeutic target for cardiovascular-metabolic-renal disorders.

Mental Health Implications of Weight Loss Medications: A Narrative Review

Article

Nov 2024
J Nurse Pract

Shari Harding

Bölüm 4 İrisin ve Metabolik Etkileri

Chapter

Full-text available

Jan 2022

Unusual and incredible weight loss after intragastric balloon: A case report

Article

Apr 2024

Mohamed S. EL Shahawy

The intragastric balloon system is a minimally invasive weight loss measure for people with obesity. Intra Gastric balloons oblige the patient to eat less food, by occupying space in the stomach, creating a feeling of constant satiety. We report a rare case of a 19-year-old Saudi man who presented with morbid obesity. At the time of presentation, the patients weight was 143 kg and BMI 49.48 kg/m ² intragastric balloon insertion done using 6 months END BALL intragastric balloon system at Almana Tertiary Referral Hospital, Dammam, Saudi Arabia. surprisingly, and after 10 months duration of gastric balloon procedure, the patient incredibly lost about 77 kg and his weight become 66 kg and BMI 22.83 kg/m ² and this considered an unusual weight loss after intragastric balloon not previously reported worldwide as loss of about 7% to 15% of body weight is typical during the 6 months after intragastric balloon placement however, in our case the patient lost 53.84% of body weight.

Total bilirubin modified the association between diabetes and stroke: a cross-sectional study from NHANES 2011–2016

Article

Sep 2024

Background Total bilirubin (TBIL) has antioxidant and anti-inflammatory properties. This study aimed to determine whether elevated TBIL could modify the association between diabetes and stroke. Method Data were obtained from the National Health and Nutrition Examination Survey 2011–2016. TBIL was stratified by median (10.3 µmol/L). The association between diabetes and stroke was quantified using multivariable logistic regression models. The cut-off concentration for the presence of TBIL modification effects was identified by Johnson-Neyman analyses. Mediation analyses were performed to determine the influence of TBIL on mediating factors that mediate the relationship between diabetes and stroke. Results This cross-sectional study included 16 130 participants, with the mean age of 46.8±0.4 years and 48.5% of men. Diabetes was associated with the presence of stroke at TBIL <10.3 µmol/L (OR=2.19, 95% CI 1.58 to 3.05) but not at TBIL ≥10.3 µmol/L (OR=1.27, 95% CI 0.85 to 1.88) after adjustment for confounders. Above associations were significantly different between the two TBIL concentrations ( P for interaction=0.03). Moreover, the modification effect of TBIL specifically occurred in men ( P for interaction=0.02) rather than in women ( P for interaction=0.08). The cut-off concentration for the presence of TBIL modification effects was 17.05 µmol/L. Additionally, the TBIL of ≥10.3 µmol/L inhibited mediating effects of hypersensitive C reactive protein (mediating effect=0.03, 95% CI −0.15 to 0.22, P =0.72) and systemic immune-inflammation index (mediating effect=0.01, 95% CI −0.01 to 0.04, P =0.29) as compared with the TBIL of <10.3 µmol/L. Conclusions Elevated TBIL modified the association between diabetes and stroke through inhibiting mediating effects of inflammatory factors.

Predictive factors of weight loss in obese patients referred to an obesity specialized centre

Article

Aug 2024

Eligibility for obesity management in Peru: Analysis of National Health Surveys from 2014 to 2022

Article

Aug 2024

Background The prevalence of overweight and obesity has increased fastest in low- and middle-income countries in the last decades. Together with this rising prevalence, pharmacological and surgical interventions for obesity have emerged. How many people need these treatments is unknown. We quantified the prevalence of people in need of pharmacological and surgical treatment for obesity in Peru between 2014 and 2022. Methods Repeated cross-sectional analysis of national health surveys in Peru was conducted. Eligibility for pharmacological treatment for obesity was: body mass index (BMI) ≥30 kg/m ² or BMI ≥27 kg/m ² alongside type 2 diabetes or hypertension (self-reported). Eligibility for bariatric surgery were BMI ≥40 kg/m ² or BMI between 35 to 39.9 kg/m ² linked to weight-related health problems. We used Poisson regressions to identify associated factors with eligibility for obesity management. Results Across years, 260,131 people (mean age 44.0 and 54.5% were women) were studied, 66,629 (27.7%; 95% CI: 27.4% - 28.1%) were eligible for obesity medication, and 5,263 (2.5%; 95% CI: 2.4% - 2.6%) were eligible for bariatric surgery. Female sex, older age, higher socioeconomic level and study year were associated with higher probability of eligibility for both obesity medication and bariatric surgery. Conclusions Eligibility for obesity management has increased over time in Peru. There is a need to strengthen policies to tackle overweight and obesity in Peru, acknowledging that some individuals may benefit from pharmacological and surgical interventions.

Potential barriers to the use of anti‐obesity medications in persons with spinal cord injuries and disorders

Article

Full-text available

Aug 2024

Background Anti‐obesity medications (AOMs) may provide a viable option for obesity management. However, little is known about the use of AOMs in persons with SCI/D. Objective Describe health care providers' (HCPs) views about barriers to AOM use in persons living with SCI/D. Methods Descriptive qualitative design using in‐depth interviews Descriptive statistics were used to calculate demographic and employment characteristics. Interviews were audio‐recorded and transcribed verbatim. Transcripts were coded and analyzed using Braun and Clarke's (2006) six thematic analysis phases. Results HCPs (n = 12) were from 11 different nationwide facilities. Most HCPs were male (75%), a large majority were white (67%), and most were 26–49 years of age. Participants were dietitians (75%), physicians (17%), and psychologists (8%). HCPs ranged from 1.5 to 15 years of providing SCI/D care. HCPs described four main thematic barriers to AOM use in persons with SCI/D: (1) AOM side effects that are especially concerning in persons with SCI/D; (2) AOMs contribute to poor eating habits; (3) availability, accessibility, and administration; and (4) lack of evidence, clinical agreement, and knowledge about AOM use in the SCI/D population. Conclusions There are several potential barriers to AOM use in the SCI/D population. Barriers include AOM side effects which may cause or exacerbate conditions that are already concerns in persons with SCI/D, such as bowel and skin problems, and muscle loss. SCI/D HCPs reported a lack of evidence about AOM use in persons with SCI/D, but interest in obtaining more knowledge.

Оцінка рівня болю опорно-рухового апарату жінок молодого віку з метаболічним синдромомAssessment of the Musculoskeletal Pain Level of Young Women with Metabolic Syndrome

Article

Full-text available

Jun 2024

Yuliya Kalmykova

Topicality. Metabolic syndrome is an urgent issue and a serious health risk not only for adults but also for children, adolescents, and young people. An essential role in the metabolic syndrome emergence is played by the negative “achievements” of progress such as low physical activity, increased caloric intake, and chronic stress. All these factors cause a steady increase in arterial hypertension, obesity, dyslipidemia, and diabetes. There is significant evidence that obesity and chronic pain are closely related. Chronic pain is one of the main causes of weight gain of obese patients. The Research Aims to determine the intensity of musculoskeletal pain in young women with metabolic syndrome and the localization of their maximum pain, as well as to investigate the correlation between the intensity of pain depending on the location and indicators of body weight, body mass index, waist-to-hip ratio, waist circumference, and body length. Research Methods. To identify the subjective pain sensation according to the domain of the International Classification of Functioning, Disability and Health b.280 – pain sensation, a visual analog pain scale was used in patients; to establish a correlation between pain intensity and pain localization in young women with metabolic syndrome, body weight, body mass index, and waist-to-hip ratio, as well as the ratio of waist circumference to body length were additionally calculated based on bioelectrical impedance. Research Results. According to the results of the responses, we can note that among the surveyed young women with metabolic syndrome, only 3,09 % indicated that they had practically no pain with localization in the neck, back, lumbar region, or joints. In general, we can state that in many cases it has been found that the manifestation of pain in women with metabolic syndrome in the back averages 4.8±1,5 cm (▁x±S), which corresponds to the level of “moderate” pain. A comparison of the subjects’ pain scores during the worst period, which was performed using the nonparametric Kruskal-Wallis H test, showed that its intensity was statistically significant (H (3, N= 388) =87,69; p<0,05) depending on the localization. Conclusions. The obtained results prove that both overweight and abdominal obesity have negative effects on the manifestation of pain syndrome among women in the first period of adulthood but abdominal obesity has a stronger effect on its intensity. In particular, this type of obesity harms the lumbar spine of the subjects.

Personal, external, and psychological factors influencing adherence to nutrition and diet in patients undergoing metabolic/bariatric surgery: a systematic synthesis of mixed methods research

Article

Jun 2024
ACTA DIABETOL

To offer a holistic view of the personal, external, and psychological factors influencing adherence to nutrition and diet in patients undergoing metabolic/bariatric surgery. This systematic synthesis of mixed methods research involved a comprehensive search for articles in English databases, including PubMed, Cochrane Library, Web of Science, EBSCO, Scopus, and Embase, as well as Chinese databases. The search encompassed articles published from the inception of the database up to June 2023. Following the evaluation of literature quality and extraction of relevant information from the selected studies, data from both quantitative and qualitative studies were integrated. The extracted data were analyzed separately, and themes were identified and summarized to elucidate the factors influencing adherence to nutritional and dietary guidelines. The methodology adhered to the guidelines recommended by the Joanna Briggs Institute (JBI) for mixed methods systematic evaluations. Three themes and their corresponding descriptive elements were identified, including: (1) Personal factors: subjective factors (attitude, capability, awareness, behaviors), objective factors (age, sex, work status, economic level, physical activity, dietary habits, weight change); (2) External factors: medication (quantity of pills, complexity of intake times, side effects, unpleasant smell or taste), surgery factor, social influences (family members, dietitians, and peers); (3) Psychological factors: self-efficacy, attachment anxiety, and mental health problems. The synthesis provided a comprehensive overview of the factors influencing postoperative compliance of nutrition and diet among patients undergoing metabolic and bariatric surgery. It emphasizes the necessity for clinical staff to tailor interventions based on these diverse factors, as well as to attach importance to patients' mental health, giving multidimensional dietary guidance and health care.

Integration of Endogenous Opioid System Research in the Interprofessional Diagnosis and Treatment of Obesity and Eating Disorders

Article

Jun 2024

This third and final chapter in our trilogy introduces the clinical distinctions and phenotypical similarities between obesity and eating disorders. Research elaborating on the shared neurobiological substrates for obesity and eating disorders is discussed. We present an interprofessional model of treatment for both disordered eating and for obesity. Additionally, this chapter establishes the translational importance of research connecting endogenous opioid activity with both obesity and eating disorders, with an emphasis on clinical interventions. We conclude with a discussion of future directions for research.

Nutritional considerations with antiobesity medications

Article

Full-text available

Jun 2024
OBESITY

The improved efficacy and generally favorable safety profile of recently approved and emerging antiobesity medications (AOMs), which result in an average weight reduction of ≥15%, represent significant advancement in the treatment of obesity. This narrative review aims to provide practical evidence‐based recommendations for nutritional assessment, management, and monitoring of patients treated with AOMs. Prior to treatment, clinicians can identify preexisting nutritional risk factors and counsel their patients on recommended intakes of protein, dietary fiber, micronutrients, and fluids. During treatment with AOMs, ongoing monitoring can facilitate early recognition and management of gastrointestinal symptoms or inadequate nutrient or fluid intake. Attention should also be paid to other factors that can impact response to treatment and quality of life, such as physical activity and social and emotional health. In the context of treatment with AOMs, clinicians can play an active role in supporting their patients with obesity to improve their health and well‐being and promote optimal nutritional and medical outcomes.

Eligibility for obesity management in Peru: Analysis of National Health Surveys from 2014 to 2022

Article

Jun 2024

Background The prevalence of overweight and obesity has increased fastest in low- and middle-income countries in the last decades. Together with this rising prevalence, pharmacological and surgical interventions for obesity have emerged. How many people need these treatments is unknown. We quantified the prevalence of people in need of pharmacological and surgical treatment for obesity in Peru between 2014 and 2022. Methods Repeated cross-sectional analysis of national health surveys in Peru was conducted. Eligibility for pharmacological treatment for obesity was: body mass index (BMI) ≥30 kg/m ² or BMI ≥27 kg/m ² alongside type 2 diabetes or hypertension (self-reported). Eligibility for bariatric surgery were BMI ≥40 kg/m ² or BMI between 35 to 39.9 kg/m ² linked to weight-related health problems. We used Poisson regressions to identify associated factors with eligibility for obesity management. Results Across years, 260,131 people (mean age 44.0 and 54.5% were women) were studied, 66,629 (27.7%; 95% CI: 27.4% - 28.1%) were eligible for obesity medication, and 5,263 (2.5%; 95% CI: 2.4% - 2.6%) were eligible for bariatric surgery. Female sex, older age, higher socioeconomic level and study year were associated with higher probability of eligibility for both obesity medication and bariatric surgery. Conclusions Eligibility for obesity management has increased over time in Peru. There is a need to strengthen policies to tackle overweight and obesity in Peru, acknowledging that some individuals may benefit from pharmacological and surgical interventions.

Reconnaître l’obésité comme une maladie

Chapter

Jan 2024

Sandra Christensen

Ginkgolide B alleviates glucolipid metabolism disorders and adipose tissue inflammation by inhibiting thromboxane A2 synthesis

Article

Feb 2024

Comparison of the low-calorie DASH diet and a low-calorie diet on serum TMAO concentrations and gut microbiota composition of adults with overweight/obesity: a randomized control trial

Article

Dec 2023

This study compares two diets, Dietary Approaches to Stop Hypertension (DASH) and a Low-Calorie Diet on Trimethylamine N-oxide (TMAO) levels and gut microbiota. 120 obese adults were randomly allocated to these three groups: a low-calorie DASH diet, a Low-Calorie diet, or a control group for 12 weeks. Outcomes included plasma TMAO, lipopolysaccharides (LPS), and gut microbiota profiles. After the intervention, the low-calorie DASH diet group demonstrated a greater decrease in TMAO levels (-20 ± 8.1 vs. -10.63 ± 4.6 μM) and a significant decrease in LPS concentration (-19.76 ± 4.2 vs. -5.68 ± 2.3) compared to the low-calorie diet group. Furthermore, the low-calorie DASH diet showed a higher decrease in the Firmicutes and Bactericides (F/B) ratio, which influenced TMAO levels, compared to the Low-Calorie diet (p = 0.028). The current study found the low-calorie DASH diet improves TMAO and LPS in comparison to a Low-Calorie diet.

The Antiobesity Effects and Potential Mechanisms of Theaflavins

Article

Dec 2023
J MED FOOD

Theaflavins are the characteristic polyphenols in black tea which can be enzymatically synthesized. In this review, the effects and molecular mechanisms of theaflavins on obesity and its comorbidities, including dyslipidemia, insulin resistance, hepatic steatosis, and atherosclerosis, were summarized. Theaflavins ameliorate obesity potentially via reducing food intake, inhibiting pancreatic lipase to reduce lipid absorption, activating the adenosine monophosphate-activated protein kinase (AMPK), and regulating the gut microbiota. As to the comorbidities, theaflavins ameliorate hypercholesterolemia by inhibiting micelle formation to reduce cholesterol absorption. Theaflavins improve insulin sensitivity by increasing the signaling of protein kinase B, eliminating glucose toxicity, and inhibiting inflammation. Theaflavins ameliorate hepatic steatosis via activating AMPK. Theaflavins reduce atherosclerosis by upregulating nuclear factor erythropoietin-2-related factor 2 signaling and inhibiting plasminogen activator inhibitor 1. In randomized controlled trails, black tea extracts containing theaflavins reduced body weight in overweight people and improved glucose tolerance in healthy adults. The amelioration on the hyperlipidemia and the prevention of coronary artery disease by black tea extracts were supported by meta-analysis.

Guideline Recommendations for Obesity Management

Abstract

No full-text available

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