RESUMO
OBJECTIVE: The aim of this study was to investigate the effect of different dietary inflammatory index diets on inflammatory markers, anthropometric measurements, and sleep quality in obese subjects. METHODS: This study was conducted in a public hospital in Turkey between November 2021 and May 2022. Participants with pro-inflammatory dietary habits were included in the study. Randomly divided into two groups of 33 participants, they were subjected to an anti-inflammatory diet or a control diet for 8 weeks. The study evaluated the anthropometric parameters, inflammatory biomarkers, and sleep quality indices of the diet groups. RESULTS: Significant reductions in body mass index were observed in both groups, more marked in the anti-inflammatory diet cohort. C-reactive protein levels, indicative of inflammation, also decreased substantially in both groups, with a more marked reduction in the anti-inflammatory diet cohort. Despite the improvement in sleep quality in both groups, the variation was not statistically significant. CONCLUSION: This study demonstrates the importance of anti-inflammatory diets in nutritional strategies for obesity by reducing body mass index and inflammation.
Assuntos
Índice de Massa Corporal , Proteína C-Reativa , Inflamação , Obesidade , Qualidade do Sono , Humanos , Obesidade/dietoterapia , Obesidade/complicações , Masculino , Inflamação/dietoterapia , Feminino , Adulto , Proteína C-Reativa/análise , Pessoa de Meia-Idade , Biomarcadores/sangue , Biomarcadores/análise , Dieta , Resultado do Tratamento , Sono/fisiologiaRESUMO
OBJECTIVES: The objective of this study was to evaluate the effectiveness of the combined use of empagliflozin (EMPA) and topiramate (TPM) versus a placebo in overweight/obese individuals without diabetes on a calorie-restricted diet. METHODS: In this study, 44 non-diabetic and overweight/obese subjects who were on a calorie restricted diet were randomly assigned into 2 groups: (1) Participants received a 10 mg EMPA tablet daily plus TPM tablet (at the 1st week 25 mg once a day and from the second week 25 mg twice a day); (2) Participants received an empagliflozin placebo (daily) plus a topiramate placebo (as mentioned for topiramate tablet in group 1), for 12 weeks. At baseline and weeks 4, 8, 12, weight, height, body mass index (BMI), waist circumference (WC), and body composition were evaluated. Before and after the intervention, blood pressure, C reactive protein, and glucose and lipid profile parameters were measured. RESULTS: The EMPA/TPM group, compared to placebo, had a greater percent change of weight at week 12 (- 8.92 ± 1.80 vs. - 4.93 ± 1.17). The intervention group had a greater percent change of fat mass and fat percent at week 12 (P < 0.05). However, there was no difference in the percent of change in fat-free percent between the two groups at week 12 (P = 0.577). Within-group analysis found a significant reduction in SBP, DBP, FBS, insulin, HOMA-IR, TC, LDL, HDL, TG, and CRP in both groups (P < 0.05). At week 12, no statistically significant difference was observed between the two groups in any of mentioned variables (P > 0.05). CONCLUSION: In non-diabetic overweight/obese individuals, the combination of EMPA/TPM and calorie restriction led to a notable decrease in body weight and was generally well-tolerated. Further research is required to evaluate the potential advantages of utilizing this combination for sustained weight management in the long run. LEVEL I: Randomized clinical trial.
Assuntos
Compostos Benzidrílicos , Restrição Calórica , Glucosídeos , Obesidade , Sobrepeso , Topiramato , Humanos , Compostos Benzidrílicos/uso terapêutico , Glucosídeos/uso terapêutico , Masculino , Feminino , Adulto , Obesidade/tratamento farmacológico , Obesidade/dietoterapia , Obesidade/complicações , Sobrepeso/tratamento farmacológico , Sobrepeso/dietoterapia , Topiramato/uso terapêutico , Pessoa de Meia-Idade , Índice de Massa Corporal , Glicemia/metabolismo , Glicemia/efeitos dos fármacos , Quimioterapia Combinada , Método Duplo-Cego , Fármacos Antiobesidade/uso terapêutico , Composição Corporal/efeitos dos fármacos , Circunferência da Cintura/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Resultado do Tratamento , Redução de Peso/efeitos dos fármacos , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêuticoRESUMO
BACKGROUND: Cardiovascular disease represents a significant risk factor for mortality in individuals with type 2 diabetes mellitus (T2DM). High-density lipoprotein (HDL) is believed to play a crucial role in maintaining cardiovascular health through its multifaceted atheroprotective effects and its capacity to enhance glycemic control. The impact of dietary interventions and intermittent fasting (IF) on HDL functionality remains uncertain. The objective of this study was to assess the effects of dietary interventions and IF as a strategy to safely improve glycemic control and reduce body weight on functional parameters of HDL in individuals with T2DM. METHODS: Before the 12-week intervention, all participants (n = 41) of the INTERFAST-2 study were standardized to a uniform basal insulin regimen and randomized to an IF or non-IF group. Additionally, all participants were advised to adhere to dietary recommendations that promoted healthy eating patterns. The IF group (n = 19) followed an alternate-day fasting routine, reducing their calorie intake by 75% on fasting days. The participants' glucose levels were continuously monitored. Other parameters were measured following the intervention: Lipoprotein composition and subclass distribution were measured by nuclear magnetic resonance spectroscopy. HDL cholesterol efflux capacity, paraoxonase 1 (PON1) activity, lecithin cholesterol acyltransferase (LCAT) activity, and cholesterol ester transfer protein (CETP) activity were assessed using cell-based assays and commercially available kits. Apolipoprotein M (apoM) levels were determined by ELISA. RESULTS: Following the 12-week intervention, the IF regimen significantly elevated serum apoM levels (p = 0.0144), whereas no increase was observed in the non-IF group (p = 0.9801). ApoM levels correlated with weight loss and fasting glucose levels in the IF group. Both groups exhibited a robust enhancement in HDL cholesterol efflux capacity (p < 0.0001, p = 0.0006) after 12 weeks. Notably, only the non-IF group exhibited significantly elevated activity of PON1 (p = 0.0455) and LCAT (p = 0.0117) following the 12-week intervention. In contrast, the changes observed in the IF group did not reach statistical significance. CONCLUSIONS: A balanced diet combined with meticulous insulin management improves multiple metrics of HDL function. While additional IF increases apoM levels, it does not further enhance other aspects of HDL functionality. TRIAL REGISTRATION: The study was registered at the German Clinical Trial Register (DRKS) on 3 September 2019 under the number DRKS00018070.
Assuntos
Biomarcadores , Glicemia , Diabetes Mellitus Tipo 2 , Jejum , Obesidade , Fosfatidilcolina-Esterol O-Aciltransferase , Humanos , Masculino , Pessoa de Meia-Idade , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/fisiopatologia , Feminino , Jejum/sangue , Fosfatidilcolina-Esterol O-Aciltransferase/sangue , Resultado do Tratamento , Obesidade/sangue , Obesidade/diagnóstico , Obesidade/dietoterapia , Obesidade/fisiopatologia , Obesidade/terapia , Glicemia/metabolismo , Fatores de Tempo , Biomarcadores/sangue , Restrição Calórica , Arildialquilfosfatase/sangue , HDL-Colesterol/sangue , Proteínas de Transferência de Ésteres de Colesterol/sangue , Redução de Peso , Idoso , Adulto , Dieta Saudável , Hipoglicemiantes/uso terapêutico , Insulina/sangue , Jejum IntermitenteRESUMO
Introduction: Obesity is a major public health challenge. In Spain the prevalence of excess of weight and obesity and is 56 % and 19 %, respectively, and it is linked to numerous preventable chronic diseases. Nutritional epidemiology focused on nutrients has evolved towards the study of dietary patterns that consider synergistic interactions between foods and nutrients. This study aims to investigate the relationship between obesity and its treatment by healthy dietary patterns. The Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH), based on plant products, whole grains and low levels of salt, sugars and red meat, have been shown to promote weight loss and reduce comorbidities associated with obesity. Although vegetarian and vegan diets are adequate options for disease management and prevention, they require planning to avoid nutritional deficiencies. In conclusion, healthy dietary patterns such as the Mediterranean diet, DASH and vegetarian options are effective in both the prevention and treatment of obesity, highlighting the importance of considering the synergy between foods and nutrients in the management of this health condition.
Introducción: La obesidad es un importante desafío de salud pública. En España, la prevalencia de exceso de peso y obesidad es del 56 % y del 19 %, respectivamente. Además, se vincula con numerosas enfermedades crónicas prevenibles. La epidemiología nutricional centrada en nutrientes ha evolucionado hacia el estudio de patrones dietéticos que consideran las interacciones sinérgicas entre alimentos y nutrientes. Este estudio tiene como objetivo investigar la relación entre la obesidad y su tratamiento mediante patrones dietéticos saludables. La dieta mediterránea y la dieta para detener la hipertensión (o dieta DASH), basadas en productos vegetales, cereales integrales y bajos niveles de sal, azúcares y carnes rojas, han demostrado favorecer la pérdida de peso y reducir comorbilidades asociadas a la obesidad. Aunque las dietas vegetarianas y veganas son opciones adecuadas en el manejo y en la prevención de la enfermedad, requieren planificación para evitar deficiencias nutricionales. En conclusión, patrones dietéticos saludables como la dieta mediterránea, la DASH y las opciones vegetarianas son efectivas tanto en la prevención como en el tratamiento de la obesidad. Destaca la importancia de considerar la sinergia entre alimentos y nutrientes en la gestión de esta condición de salud.
Assuntos
Comorbidade , Dieta Mediterrânea , Obesidade , Humanos , Obesidade/epidemiologia , Obesidade/dietoterapia , Espanha/epidemiologia , Abordagens Dietéticas para Conter a Hipertensão , Dieta , Dieta Vegetariana , Comportamento Alimentar , Padrões DietéticosRESUMO
Combining pharmacotherapy with lifestyle intervention is recommended for obese class II patients who fail lifestyle therapy and for obese class I patients. Diethylpropion, an obesity medication, has been approved for use in Indonesia, which is an Asia-Pacific country. This retrospective study aimed to assess the short-term effects of diethylpropion on weight and fat loss in obese patients in Indonesia. Secondary data were collected from 142 patients' medical records with a body mass indexâ ≥â 25â kg/m2 who underwent short-term diethylpropion treatment for 84 days between January 2022 and November 2023 at the Kimia Farma Nutrition Clinic in Bandung, Indonesia. Blood pressure, body weight, height, waist circumference, and body composition were assessed at each follow-up visit to determine the fat and muscle mass. Patients were prescribed diethylpropion 25â mg 3 times daily every 2 weeks together with dietary intervention. Kruskal-Wallis test was used to analyze the changes in body weight, skeletal muscle, fat mass, and waist circumference after the diethylpropion therapy. Mann-Whitney test was used for the relation between age, sex, and body mass index with weight loss on the last day of follow-up. Simple linear regression analysis was also performed to identify the correlation between weight loss and therapy duration. This study showed body weight reduction of up to 9.5â ±â 3â kg (10â ±â 0.0%) (Pâ =â .008) on 84 days of treatment. Significant fat loss 11.5â ±â 4.6â kg (20.5â ±â 0.0%) (Pâ =â .005) was also reported in our study without significant loss of muscle mass -2.4â ±â 4.6â kg (3.6â ±â 1.3%) (Pâ =â .58). Waist circumference was insignificantly reduced by 5.6â ±â 0.0â cm (4.9â ±â 2.8%) (Pâ =â .21) after 84 days of diethylpropion therapy. This study revealed no significant changes in patient systolic and diastolic pressures despite showing mild increases after 70 days. The combination of diethylpropion and an appropriate diet resulted in weight loss accompanied by significant fat loss and preserved muscle mass without an increase in blood pressure during the 12-week treatment period.
Assuntos
Obesidade , Redução de Peso , Humanos , Masculino , Feminino , Estudos Retrospectivos , Adulto , Obesidade/dietoterapia , Obesidade/terapia , Pessoa de Meia-Idade , Índice de Massa Corporal , Indonésia , Circunferência da Cintura , Músculo Esquelético/efeitos dos fármacos , Composição Corporal , Terapia Combinada , Fármacos Antiobesidade/uso terapêutico , Peso CorporalRESUMO
Weight loss improves metabolic dysfunction-associated steatohepatitis (MASH). We investigated whether there were associated changes in intestinal permeability, short-chain fatty acids (SCFAs), and gut microbiota, which are implicated in the pathophysiology of MASH. Sixteen adults with MASH, moderate fibrosis, and obesity received a low-energy total diet replacement program for 12 weeks and stepped food re-introduction over the following 12 weeks (ISRCTN12900952). Intestinal permeability, fecal SCFAs, and fecal microbiota were assessed at 0, 12, and 24 weeks. Data were analyzed using mixed-effects linear regression and sparse partial least-squares regression. Fourteen participants completed the trial, lost 15% (95% CI: 11.2-18.6%) of their weight, and 93% had clinically relevant reductions in liver disease severity markers. Serum zonulin concentrations were reduced at both 12 and 24 weeks (152.0 ng/ml, 95% CI: 88.0-217.4, p < 0.001). Each percentage point of weight loss was associated with a 13.2 ng/mL (95% CI: 3.8-22.5, p < 0.001) reduction in zonulin. For every 10 ng/mL reduction in zonulin, there was a 6.8% (95% CI: 3.5%-10.2, p < 0.001) reduction in liver fat. There were reductions in SCFA and alpha diversity evenness as well as increases in beta diversity of the gut microbiota at 12 weeks, but the changes did not persist at 24 weeks. In conclusion, substantial dietary energy restriction is associated with significant improvement in MASH markers alongside reduction in intestinal permeability. Changes in gut microbiota and SCFA were not maintained with sustained reductions in weight and liver fat, suggesting that microbiome modulation may not explain the relationship between weight loss and improvements in MASH.
Assuntos
Fezes , Microbioma Gastrointestinal , Haptoglobinas , Cirrose Hepática , Permeabilidade , Redução de Peso , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Cirrose Hepática/microbiologia , Cirrose Hepática/metabolismo , Adulto , Haptoglobinas/metabolismo , Fezes/microbiologia , Fezes/química , Precursores de Proteínas/metabolismo , Precursores de Proteínas/sangue , Ácidos Graxos Voláteis/metabolismo , Obesidade/microbiologia , Obesidade/metabolismo , Obesidade/dietoterapia , Fígado Gorduroso/metabolismo , Fígado Gorduroso/microbiologia , Dieta Redutora , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiologia , Toxina da Cólera/metabolismo , Toxina da Cólera/sangue , Idoso , Função da Barreira IntestinalRESUMO
This study analyzes the effects on body composition and variables related to metabolic syndrome of two coffees with different degree of roasting and phenolic content. Sixty participants with body mass index between 25 and 35 kg/m2 and a median age of 51.0 years (Interquartile range 46.3-56) were recruited. The study was a controlled, randomized, single-blind crossover trial consisting in drinking three cups/day of roasted coffee (RC) or lightly roasted coffee (LRC) during 12 weeks with 2-week wash-out stages before each coffee intervention. LRC contained ≈400 mg of hydroxycinnamic acids and ≈130 mg of caffeine per 200 mL/cup while RC contained ≈150 mg of hydroxycinnamic acids and ≈70 mg of caffeine per 200 mL/cup. Along the study, in each of the six visits, blood pressure, body composition by bioimpedance, anthropometric measurements, and blood biochemistry were analyzed. The mean differences and p values were calculated using a linear mixed model (JASP.v.0.18.0.3). A total of 38 participants completed the study. After the consumption of both coffees, fat mass and body fat percentage (LRC: -1.4%, p < 0.001; RC: -1.0%, p = 0.005) were reduced, whereas muscle mass and muscle mass percentage slightly increased (LRC: 0.8%, p < 0.001; RC: 0.7%, p = 0.002). The decrease in fat percentage was greater with LRC compared to RC (-0.8%; p = 0.029). There were no significant changes in metabolic syndrome variables or in body weight. In conclusion, LRC was slightly superior at inducing changes in body composition.
Assuntos
Composição Corporal , Café , Estudos Cross-Over , Obesidade , Sobrepeso , Fenóis , Humanos , Café/química , Pessoa de Meia-Idade , Masculino , Composição Corporal/efeitos dos fármacos , Feminino , Método Simples-Cego , Fenóis/análise , Obesidade/dietoterapia , Sobrepeso/dietoterapia , Cafeína/administração & dosagem , Índice de Massa Corporal , Adulto , Ácidos Cumáricos/análise , Síndrome Metabólica/dietoterapiaRESUMO
This study aimed to assess the effects of a diet intervention on visceral and hepatic fat in patients with obesity or type 2 diabetes (T2D). Participants with obesity or T2D were randomized to a diet intervention or their usual diet. The intervention comprised a "3G rice" regimen combined with a low-salt, high-fiber diet. The primary outcomes were changes in visceral adipose tissue (VAT) area and hepatic fat over 12 weeks assessed by magnetic resonance imaging. Eighty-six patients were randomized. Their mean age was 47.5 ± 11.0 years, and 82.3% were female. Eighty-one (94.2%) had obesity, and 16 (18.6%) had T2D. Baseline metrics were body weight 76.3 ± 16.1 kg, BMI 29.6 ± 4.6, VAT 12 629 ± 5819 mm2, and hepatic fat 7.9% ± 7.2%. At the 12-week follow-up, the diet group had greater VAT and hepatic fat reductions than controls (- 1468 ± 1468 vs. - 179 ± 1576 mm2, P = 0.001; and - 2.6% ± 3.4% vs. 0.4% ± 2.2%, P < 0.001). Adjusted differences remained significant for VAT (- 1093 mm2, P < 0.001) and hepatic fat (- 2.5%, P < 0.001). In conclusion, the 12-week diet intervention decreased VAT, hepatic fat, body weight, and BMI compared to a usual diet.
Assuntos
Diabetes Mellitus Tipo 2 , Gordura Intra-Abdominal , Fígado , Obesidade , Humanos , Diabetes Mellitus Tipo 2/dietoterapia , Feminino , Gordura Intra-Abdominal/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Obesidade/dietoterapia , Fígado/metabolismo , Adulto , Imageamento por Ressonância MagnéticaRESUMO
OBJECTIVES: Heart failure (HF) is a global health concern with rising incidence and poor prognosis. While the essential role of nutritional and dietary strategies in HF patients is acknowledged in the existing scientific guidelines and clinical practice, there are no comprehensive nutritional recommendations for optimal dietary management of HF. METHODS: In this review, we discuss results from recent studies on the obesity paradox and the effects of calorie restriction and weight loss, intermittent fasting, the Western diet, the Mediterranean diet, the ketogenic diet, and the DASH diet on HF progression. RESULTS: Many of these strategies remain under clinical and basic investigation for their safety and efficacy, and there is considerable heterogeneity in the observed response, presumably because of heterogeneity in the pathogenesis of different types of HF. In addition, while specific aspects of cardiac metabolism, such as changes in ketone body utilization, might underlie the effects of certain dietary strategies on the heart, there is a critical divide between supplement strategies (i.e., with ketones) and dietary strategies that impact ketogenesis. CONCLUSION: This review aims to highlight this gap by exploring emerging evidence supporting the importance of personalized dietary strategies in preventing progression and improving outcomes in the context of HF.
Assuntos
Dieta Cetogênica , Insuficiência Cardíaca , Humanos , Insuficiência Cardíaca/dietoterapia , Restrição Calórica/métodos , Dieta Mediterrânea , Redução de Peso , Abordagens Dietéticas para Conter a Hipertensão , Obesidade/dietoterapiaRESUMO
BACKGROUND/OBJECTIVE: Obesity and overweight have become growing health-related issues worldwide, which also applies to Poland. Excess fat mass is associated with an increased risk of metabolic and non-metabolic complications. The aim of our pre-post-designed study was to assess the effect of behavioral intervention on body weight, fat mass and anthropometric and metabolic parameters in obese and overweight individuals. METHODS: The study included one hundred people (85 women) with excess fat mass who voluntarily declared their willingness to participate in the weight-loss program consisted of 12 weeks of the DASH diet combined with regular, supervised physical activity. Anthropometric measurements and laboratory tests were performed in all study participants, and anthropometric and metabolic indices were calculated at baseline and after three months of treatment. RESULTS: Body weight decreased significantly by 5.63 ± 4.03 kg, BMI by 2.06 ± 1.44 kg/m2, waist circumference by 5.6 ± 3.7 cm, fat mass from 40.04 ± 6.90 to 36.56 ± 7.07% and uric acid level by 16.0 ± 41.6 µmol/L (p < 0.001 in all cases). We also found an improvement in lipid profile and anthropometric and metabolic indices, except for HDL cholesterol and plasma glucose levels. CONCLUSIONS: The effect of the DASH diet and supervised physical activity was beneficial regardless of age, sex and the presence of hypertension or dysglycemia at baseline. The implementation of a healthy lifestyle was associated with a significant improvement in anthropometric and metabolic parameters, which, if continued, may reduce the risk of unfavorable health-related outcomes in the future.
Assuntos
Abordagens Dietéticas para Conter a Hipertensão , Exercício Físico , Obesidade , Sobrepeso , Humanos , Feminino , Masculino , Obesidade/dietoterapia , Obesidade/terapia , Pessoa de Meia-Idade , Exercício Físico/fisiologia , Adulto , Sobrepeso/dietoterapia , Sobrepeso/terapia , Circunferência da Cintura , Antropometria , Redução de Peso/fisiologia , Índice de Massa Corporal , Polônia , Glicemia/metabolismoRESUMO
BACKGROUND: Current clinical guidelines for the management of type 2 diabetes mellitus (T2DM) in older adults recommend the use of antihyperglycemic medications, monitoring of blood glucose levels, regular exercise, and a healthy diet to improve glycemic control and reduce associated comorbidities. However, adherence to traditional exercise programs is poor (<35%). Common barriers to adherence include fear of hypoglycemia and the need for blood glucose level monitoring before exercise. Digital health strategies offer great promise for managing T2DM as they facilitate patient-practitioner communication, support self-management, and improve access to health care services for underserved populations. We have developed a novel web-based software program allowing practitioners to create tailored interventions and deliver them to patients via digital voice assistants (DVAs) in their own homes. OBJECTIVE: We aim to evaluate the feasibility of a 12-week, home-based, personalized lifestyle intervention delivered and monitored by DVAs for older adults with obesity and T2DM. METHODS: In total, 50 older adults with obesity aged 50-75 years with oral hypoglycemic agent-treated T2DM were randomized to the intervention (DVA, n=25) or a control group (n=25). Participants allocated to the DVA group were prescribed a home-based muscle strengthening exercise program (~20- to 30-min sessions) and healthy eating intervention, delivered via DVAs (Alexa Echo Show 8; Amazon) using newly developed software ("Buddy Link"; Great Australian Pty Ltd). Control group participants received generalized physical activity information via email. Outcomes were feasibility, DVA usability (System Usability Scale), and objectively assessed physical activity and sedentary time (wrist-worn accelerometers). RESULTS: In total, 45 (90%) out of 50 participants completed this study. Mean adherence to prescribed exercise was 85% (SD 43%) with no intervention-related adverse events. System usability was rated above average (70.4, SD 16.9 out of 100). Compared with controls, the DVA group significantly decreased sedentary time (mean difference -67, SD 23; 95% CI -113 to -21 min/d), which was represented by a medium to large effect size (d=-0.6). CONCLUSIONS: A home-based lifestyle intervention delivered and monitored by health professionals using DVAs was feasible for reducing sedentary behavior and increasing moderate-intensity activity in older adults with obesity and T2DM. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621000307808; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=381364&isReview=true.
Assuntos
Diabetes Mellitus Tipo 2 , Terapia por Exercício , Estudos de Viabilidade , Obesidade , Humanos , Diabetes Mellitus Tipo 2/terapia , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Obesidade/terapia , Obesidade/dietoterapia , Terapia por Exercício/métodos , Exercício Físico/fisiologiaRESUMO
BACKGROUND & AIMS: Obesity is associated with chronic low-grade inflammation, and adipose tissue inflammation is required for fatty tissue remodeling. Interestingly, immunosuppressed patients, as liver transplant recipients, often experience excessive weight gain. We investigated how liver recipients' inflammatory response affects body weight loss induced by dietary treatment. METHODS: Overweight liver recipients were paired with non-transplanted subjects to compare their peripheral immune profiles. RESULTS: Transplanted patients had similar profiles of peripheral blood mononuclear cells compared to controls but lower CD8lowCD56+CD16+NK cells and higher B lymphocytes. Patients showed lower serum concentrations of IFN-γ, TNF, IL-4, IL-2, and IL-10 and lower inflammatory responsiveness of peripheral blood mononuclear cells under inflammatory stimuli. Liver recipients paired with non-transplanted subjects followed a weight loss dietary plan for 6 months to verify body composition changes. After 3 and 6 months of nutritional follow-up, the control group lost more body weight than the liver recipient group. The control group decreased fat mass and waist circumference, which was not observed in transplanted patients. CONCLUSION: Therefore, liver recipients under immunosuppressant treatment responded less to different inflammatory stimuli. This impaired inflammatory milieu might be implicated in the lack of response to weight loss dietary intervention. Inflammation may be essential to trigger the weight loss induced by dietary prescription. CLINICAL TRIAL REGISTRY: ClinicalTrials.gov identification number: NCT03103984.
Assuntos
Dieta Redutora , Inflamação , Transplante de Fígado , Redução de Peso , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Composição Corporal , Citocinas/sangue , Dieta Redutora/métodos , Imunossupressores/administração & dosagem , Inflamação/sangue , Leucócitos Mononucleares/imunologia , Obesidade/dietoterapia , Obesidade/cirurgia , Obesidade/imunologia , Sobrepeso/dietoterapia , Sobrepeso/imunologia , Sobrepeso/complicaçõesRESUMO
Adherence to the Mediterranean diet (MedDiet) has long been associated with several health benefits, including a reduced risk of heart disease, diabetes, and obesity. The MedDiet is characterized by a high consumption of foods such as fruits, vegetables, whole grains, fish, and olive oil, along with a moderate intake of red meat and red wine with meals. Some studies report significant differences between men and women in susceptibility to obesity, with women at a higher prevalence of obesity than men. One unexplored aspect, however, concerns the sex difference in MedDiet adherence, which could be influenced by various factors, such as health perceptions, food preferences, and cultural influences. The aim of this study is to assess the effectiveness and impact of MedDiet adherence in men and women, with a focus on its influence on health and well-being, as well as its ability to promote sex equity in healthcare outcomes. Moreover, we aim to measure the overall health improvements in men and women participating in a MedDiet program, including changes in body composition and overall quality of life. This study highlights that the MedDiet is associated with more significant body weight loss in women, although their increase in MedDiet adherence was lower than in men. Trial registration: NCT01890070. Registered 24 June 2013.
Assuntos
Dieta Mediterrânea , Obesidade , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Composição Corporal , Obesidade/dietoterapia , Obesidade/prevenção & controle , Cooperação do Paciente/estatística & dados numéricos , Qualidade de Vida , Fatores Sexuais , Redução de PesoRESUMO
This single blind placebo-controlled study has as its main objectives to investigate the influence of dark sweet cherries (DSC) consumption on obesity-related dysbiosis, metabolic endotoxemia, and intestinal permeability. Participants (>18 years old, BMI: 30-40 kg m-2) consumed 200 mL of DSC juice with 3 g of DSC powder (n = 19) or a placebo drink (n = 21) twice per day for 30 days. The gut microbiota abundance was investigated using 16S ribosomal RNA sequencing on fecal DNA. Metabolic endotoxemia was evaluated by measuring lipopolysaccharide-binding protein (LBP) in fasting plasma samples. Intestinal permeability was assessed using the lactulose/mannitol (L/M) test and by measuring regeneration islet-derived protein 4 (REG4), and interleukin-22 (IL-22) mRNA levels in stool samples. Results showed that DSC supplementation decreased the abundance of Anaerostipes hadrus (p = 0.02) and Blautia (p = 0.04), whose changes were significant in BMI ≥ 35 participants (p = 0.004 and p = 0.006, respectively). Additionally, DSC prevented the increase of Alistipes shahii (p = 0.005) and Bilophila (p = 0.01) compared to placebo. Notably, DSC intervention favored the abundance of bacteria supporting a healthy gut ecosystem such as Roseburia intestinalis (p = 0.01), Turicibacter (p = 0.01), and Bacteroides vulgatus (p = 0.003) throughout the intervention, along with Clostridium leptum (p = 0.03) compared to placebo. The LBP, L/M ratio, REG-4 and IL-22 mRNA levels remained unchanged in placebo and cherry groups, implying that participants did not experience alterations in intestinal permeability. These findings highlight the potential gut-health benefits of DSC and encourage future research among individuals with BMI ≥ 35 and increased intestinal permeability.
Assuntos
Suplementos Nutricionais , Endotoxemia , Fezes , Microbioma Gastrointestinal , Obesidade , Permeabilidade , Prunus avium , Humanos , Microbioma Gastrointestinal/efeitos dos fármacos , Masculino , Fezes/microbiologia , Obesidade/microbiologia , Obesidade/metabolismo , Obesidade/dietoterapia , Adulto , Feminino , Pessoa de Meia-Idade , Método Simples-Cego , Interleucina 22 , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Mucosa Intestinal/metabolismo , Adulto Jovem , Função da Barreira IntestinalRESUMO
This non-randomized controlled trial aimed to compare the effect of the 5:2 diet on insulin levels as a primary outcome and markers of insulin secretion (connecting peptide (C-peptide) and insulin-like growth factor binding protein-1 (IGFBP-1)) and sensitivity (Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)), as well as body composition as secondary outcomes in overweight/obese individuals with and without type 2 diabetes (T2D). Ninety-seven participants (62% women), 35 with T2D and 62 BMI- and waist-matched controls without T2D, followed the 5:2 diet (two days per week of fasting) for six months with a 12-month follow-up. At six months, there was no loss to follow-up in the T2D group, whereas four controls discontinued this study. Overall, 82% attended the 12-month follow-up. After the intervention, insulin levels decreased in the control group and glucose decreased in the T2D group, while C-peptide, HOMA-IR, waist circumference, BMI, trunk, and total fat% decreased in both groups. Furthermore, low IGFBP-1, indicating hyperinsulinemia, improved in the T2D group. The changes in fasting glucose and waist measurement were significantly more improved in the T2D group than in the controls. Persistent positive effects were observed at the 12-month follow-up. The 5:2 diet for six months was feasible and efficient to reduce markers of insulin secretion and resistance and therefore holds promise as management of overweight/obesity in subjects with and without T2D.
Assuntos
Biomarcadores , Diabetes Mellitus Tipo 2 , Resistência à Insulina , Secreção de Insulina , Insulina , Humanos , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/dietoterapia , Feminino , Masculino , Pessoa de Meia-Idade , Insulina/metabolismo , Insulina/sangue , Peptídeo C/sangue , Peptídeo C/metabolismo , Proteína 1 de Ligação a Fator de Crescimento Semelhante à Insulina/metabolismo , Proteína 1 de Ligação a Fator de Crescimento Semelhante à Insulina/sangue , Adulto , Glicemia/metabolismo , Dieta , Índice de Massa Corporal , Obesidade/metabolismo , Obesidade/dietoterapia , Composição Corporal , Sobrepeso/metabolismo , Sobrepeso/dietoterapiaRESUMO
Obesity is a critical public health issue, necessitating effective weight loss interventions. While various dietary regimens have been explored, individual responses to interventions often vary. This study involved a 3-month dietary intervention aiming at assessing the role of macronutrient composition and the potential role of genetic predisposition in weight loss among Greek adults. This randomized clinical trial followed the CONSORT principles, recruiting 202 participants overall; 94 received a hypocaloric, high-protein diet and 108 received a high-carbohydrate, hypocaloric diet. Genetic predispositions were assessed through 10 target variants known for their BMI associations. Participants' weight and BMI values were recorded at baseline and post-intervention (n = 202 at baseline, n = 84 post-intervention) and an imputation method was applied to account for the observed missing values. Participants experienced a statistically significant weight loss across all dietary regimens (p < 0.001). Genetic analyses did not display statistically significant effects on weight loss. No significant differences in weight loss were observed between macronutrient groups, aligning with the POUNDS Lost and DIETFITS studies. This study underscores the importance of dietary interventions for weight loss and the potential contributions of genetic makeup. These findings contribute to obesity management within the Greek population and support the need for further research in personalized interventions.
Assuntos
Dieta Redutora , Nutrientes , Obesidade , Sobrepeso , Redução de Peso , Humanos , Masculino , Obesidade/dietoterapia , Feminino , Adulto , Pessoa de Meia-Idade , Grécia , Sobrepeso/dietoterapia , Dieta Redutora/métodos , Índice de Massa Corporal , Dieta Rica em Proteínas , Carboidratos da Dieta/administração & dosagem , Predisposição Genética para Doença , Proteínas Alimentares/administração & dosagemRESUMO
This study used a multimodal approach to address the issue of obesity among individuals with a Body Mass Index (BMI) between 30 and 40 residing in a rural region of north-east Spain. A pretest-posttest model was employed in a clinical trial design, comparing an intervention group with a control group. The intervention, which lasted for a period of nine months, was based on three main strategies: the prescription of physical activity, the promotion of healthy nutritional habits, and the management of emotional wellbeing through Positive Mental Health (PMH). A variety of assessment tools were employed, including the CLASS-AF scale and a stress test for physical activity levels; advanced anthropometry and blood analysis for metabolic and body composition variables; a Mediterranean diet adherence questionnaire for nutritional habits; and a PMH multifactorial questionnaire for the assessment of emotional management. The results revealed significant improvements in the level of physical activity and adherence to the Mediterranean diet in favor of the intervention group, where 89.4% (n = 17) of the participants went from being not very active/sedentary to being active. Also, adherence to the Mediterranean diet improved with a mean increase of 2.2 points on the scale [mean: 10.5 (CI 95%: 9.90, 11.09)]. In addition, significant reductions in body fat [mean: -2.50 kg (CI 95%: -3.56, -1.44)] and free fat mass [mean: -3.38% (IC 95%: -4.34, -2.41), along with decreased cholesterol levels (196 vs. 182 mg/dL), were observed, suggesting a decrease in cardiovascular and metabolic risk. In conclusion, this multimodal intervention was effective at improving the lifestyle of people with obesity and reducing their cardiovascular and metabolic risk. The combination of interventions focused on physical activity, diet, Positive Mental Health, and metabolic changes and were perceived as a comprehensive and complementary strategy in obesity care. These findings highlight the importance of approaching this condition from multiple perspectives to ensure optimal health outcomes.
Assuntos
Dieta Mediterrânea , Exercício Físico , Estilo de Vida Saudável , Saúde Mental , Obesidade , Humanos , Obesidade/terapia , Obesidade/psicologia , Obesidade/dietoterapia , Masculino , Feminino , Adulto , Espanha , Pessoa de Meia-Idade , Índice de Massa Corporal , Promoção da Saúde/métodos , Dieta SaudávelRESUMO
AIM: To assess the impact of intermittent fasting, with or without probiotic supplementation, versus a calorie-restricted diet on anthropometric measures, metabolic status and gonadal variables in women with polycystic ovary syndrome (PCOS). METHODS: This is a randomized, placebo-controlled, parallel-arm clinical trial. The effects of the 14:10 early time-restricted eating (eTRE) strategy alone or combined with probiotics, on obese women with PCOS, were investigated. Participants were divided into three groups: eTRE plus probiotics (n = 30), eTRE plus placebo (n = 30) and a control group following a standard three-meal-per-day diet with daily calorie restriction (DCR) (n = 30). Over 8 weeks, various anthropometric, metabolic, menstrual and gonadal variables were assessed. RESULTS: A total of 90 individuals were included in the study, with a mean body weight of 81.4 kg, and a mean age of 30 years. Mean (standard deviation) weight loss was not different between the groups at week 8 (TRE + probiotic: -2.2 [1.6] kg vs. TRE + placebo: -2.9 [2.7] kg vs. DCR: -2.5 [1.7] kg). Results revealed that, while all three regimes led to reductions in body weight, body mass index, vascular risk indicators, hirsutism and acne scores, there were no statistically significant differences between the eTRE groups and the control group in terms of weight loss, or improvements in metabolic, menstrual and gonadal variables (P > .05). Additionally, combining probiotics with eTRE did not benefit hormonal and cardiometabolic factors (P > .05). CONCLUSIONS: The eTRE alone or eTRE plus probiotics did not result in significantly greater weight loss or improvements in metabolic, menstrual and gonadal variables compared with the standard three-meal DCR diet.