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Weight Management Interventions for Adults With Overweight or Obesity: An Evidence Analysis Center Scoping Review.
Cheng, FW, Garay, JL, Handu, D
Journal of the Academy of Nutrition and Dietetics. 2021;(9):1855-1865
Abstract
The objectives of this evidence scoping review were to identify and characterize studies investigating weight management interventions provided by a registered dietitian nutritionist or international equivalent (RDN) among adults with overweight or obesity. A medical librarian conducted an electronic literature search in 6 databases-MEDLINE (Ovid), Embase (Ovid), PyscINFO (Ovid), Cochrane CENTRAL (Ovid), Cochrane Database of Systematic Reviews (Ovid), and CINAHL (Ebsco). Except for narrative review, gray literature, and case study or report, all types of peer-reviewed articles published between January 2008 and April 26, 2019 were eligible. Two content advisors, who are experts in adult weight management, guided the process and reviewed the search plan and findings. The literature search resulted in 30,551 records with 16 additional records identified through other sources. A total of 29,756 records were excluded during the first round of screening due to duplication or irrelevancy. Of the 811 full-text articles that were screened, 139 met the criteria and were included. Approximately 51% and 43% of the studies were conducted in the community setting and in the United States or Canada, respectively. Over 97% of the studies were clinical or quasi-experimental trials. A total of 6 different intervention delivery modes were reported, which resulted in 22 combinations of the modes of delivery. RDNs delivered the weight management intervention (especially the nutrition component) in all studies, but some (61%) also involved an interdisciplinary team to deliver other components of the intervention. The average length of the intervention was about 10 months with a follow-up that ranged from 0 to 9 years. The commonly reported outcomes were anthropometrics, endocrine, and cardiovascular measures; dietary intake; and physical activity. Based on the scoping review, there were systematic reviews and evidence-based practice guidelines on weight management interventions but none of them met the a priori inclusion or exclusion criteria. Therefore, it would be beneficial to conduct a systematic review and develop an evidence-based practice guideline on adult weight management interventions provided by an RDN to guide practitioners and to evaluate their effects on health and nutrition-related outcomes.
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Predictors of successful weight loss outcomes amongst individuals with obesity undergoing lifestyle interventions: A systematic review.
Chopra, S, Malhotra, A, Ranjan, P, Vikram, NK, Sarkar, S, Siddhu, A, Kumari, A, Kaloiya, GS, Kumar, A
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2021;(3):e13148
Abstract
Understanding the predictors of weight loss with lifestyle interventions can help to ascertain the probable outcomes of individuals with obesity who undergo such interventions. This systematic review assessed the evidence of predictors of successful weight loss among individuals who are overweight or with obesity undergoing lifestyle interventions. Four electronic databases (PubMed, Cochrane Reviews, PsychInfo and Wiley) were searched to find relevant literature published in the past 20 years. A total of 1351 titles were identified in the initial search, of which 23 studies were finally included. Predictors were synthesized in the domains of socio-demographic factors, anthropometric parameters, psychological and behavioural factors and intervention-based factors. The overall quality of evidence on predictors was then appraised using an adapted GRADE approach. Patient-specific factors such as being male, older in age, having existing cardiometabolic comorbidities and limited fat intake were significantly associated with weight loss success. Amongst intervention specific predictors, greater initial weight loss and higher adherence to lifestyle advice were associated with greater weight loss success. In this review, initial weight loss came out to be as the most important predictor of successful weight loss outcome.
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Cancer survivorship, excess body fatness and weight-loss intervention-where are we in 2020?
Anderson, AS, Martin, RM, Renehan, AG, Cade, J, Copson, ER, Cross, AJ, Grimmett, C, Keaver, L, King, A, Riboli, E, et al
British journal of cancer. 2021;(6):1057-1065
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Abstract
Earlier diagnosis and more effective treatments mean that the estimated number of cancer survivors in the United Kingdom is expected to reach 4 million by 2030. However, there is an increasing realisation that excess body fatness (EBF) is likely to influence the quality of cancer survivorship and disease-free survival. For decades, the discussion of weight management in patients with cancer has been dominated by concerns about unintentional weight loss, low body weight and interventions to increase weight, often re-enforced by the existence of the obesity paradox, which indicates that high body weight is associated with survival benefits for some types of cancer. However, observational evidence provides strong grounds for testing the hypothesis that interventions for promoting intentional loss of body fat and maintaining skeletal muscle in overweight and obese cancer survivors would bring important health benefits in terms of survival outcomes and long-term impact on treatment-related side effects. In this paper, we outline the need for studies to improve our understanding of the health benefits of weight-loss interventions, such as hypocaloric healthy-eating plans combined with physical activity. In particular, complex intervention trials that are pragmatically designed are urgently needed to develop effective, clinically practical, evidence-based strategies for reducing EBF and optimising body composition in people living with and beyond common cancers.
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Overweight/Obesity and Monoclonal Gammopathy of Undetermined Significance.
Georgakopoulou, R, Andrikopoulou, A, Sergentanis, TN, Fiste, O, Zagouri, F, Gavriatopoulou, M, Psaltopoulou, T, Kastritis, E, Terpos, E, Dimopoulos, MA
Clinical lymphoma, myeloma & leukemia. 2021;(6):361-367
Abstract
BACKGROUND Obesity and high body mass index (BMI) are associated with increased incidence of multiple myeloma (MM). MM usually evolves from a precursor asymptomatic disease, namely monoclonal gammopathy of undetermined significance (MGUS). MGUS progresses to MM at a 1% annual rate; however, risk factors predisposing to MGUS are not completely understood. We conducted a systematic review to assess the relationship between obesity and high BMI with MGUS prevalence and progression to MM. To our knowledge, this is the first systematic review evaluating the role of obesity in MGUS. PATIENTS AND METHODS We searched the Medline database and ClinicalTrials.gov for studies investigating BMI and obesity association with MGUS incidence and progression. The algorithm consisted of a predefined combination of the words "obesity," "obese," "body mass index," "overweight," "diet," "nutrition," "food," "dietary," "adiponectin," "monoclonal gammopathy," and "MGUS". RESULTS Overall, 12 articles were retrieved, including 11 eligible articles and 1 clinical trial. More than 57,068 patients were evaluated in this systematic review. Discrepancies between the identified studies were noted. Multiple studies support the notion that obesity or high BMI are positively linked to MGUS prevalence and transition to MM. In contrast, other studies revealed no such association. Visceral adipose tissue metabolic activity and decreased adiponectin concentrations were identified as biomarkers of MGUS progression to MM. CONCLUSION Obesity and increased BMI seem to be implicated both in MGUS development and progression to MM. Further studies should be designed to confirm this hypothesis.
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A Scoping Review of Policies Related to the Prevention and Control of Overweight and Obesity in Africa.
Adom, T, De Villiers, A, Puoane, T, Kengne, AP
Nutrients. 2021;(11)
Abstract
To address the issue of obesity, the World Health Organization (WHO) recommends a set of comprehensive programmes aimed at changing the obesogenic environments to provide opportunities for healthy food options and increased physical activity in the school, home, and at the population level. The objectives of this study were to examine the nature and range of policies related to overweight and obesity prevention in Africa, and to assess how they align with international guidelines. An existing methodological framework was adapted for this scoping review. A search of publicly available national documents on overweight/obesity, general health, and non-communicable diseases (NCDs) was undertaken from relevant websites, including WHO, ministries, and Google Scholar. Additional requests were sent to key contacts at relevant ministries about existing policy documents. The documents were reviewed, and the policies were categorised, using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. The framework categorises the environmental drivers of obesity into four domains (physical, economic, legislative, and socio-cultural) and two scales: macro (national, regional, sectors, food industries, media, etc.) and micro (household, institutional, and community). This review included documents from 41 African countries. The policy initiatives to prevent overweight/obesity target the school, family and community settings, and macro environments, and broadly align with global recommendations. The NCD documents were in the majority, with only two on obesity. The majority of the documents detailed strategies and key interventions on unhealthy diets and physical inactivity. The physical, legislative, and sociocultural domains were largely featured, with less emphasis on the economic domain. Additionally, nutrition- and diet-related policies were in the majority. Overlaps and interactions of policies were observed in the application of the ANGELO framework. This study has provided information on national policies and programmes in Africa and can be useful as a first point of call for policymakers. The overlapping and interaction in the initiatives demonstrate the importance of multi-sectoral partnerships in providing supportive environments for healthy behaviours.
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Effect of n-3 long-chain polyunsaturated fatty acid intake on the eicosanoid profile in individuals with obesity and overweight: a systematic review and meta-analysis of clinical trials.
Schweitzer, GRB, Rios, INMS, Gonçalves, VSS, Magalhães, KG, Pizato, N
Journal of nutritional science. 2021;:e53
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Abstract
Dietary n-3 polyunsaturated fatty acids (PUFAs) present beneficial effects on counteracting inflammation status, displaying a critical anti-inflammatory role and maintaining physiological homeostasis in obesity. The primary objective of this systematic review was to evaluate the effect of n-3 PUFAs intake on the eicosanoid profile of people with obesity and overweight. The search strategy on Embase, Scopus, PubMed, Web of Science, Cochrane Library, Google Scholar and ProQuest was undertaken until November 2019 and updated January 2021. The effect size of n-3 PUFAs on prostaglandins was estimated by Glass's, type 1 in a random-effect model for the meta-analysis. Seven clinical trials met the eligible criteria and a total of 610 subjects were included in this systematic review, and four of seven studies were included in meta-analysis. The intake of n-3 PUFAs promoted an overall reduction in serum pro-inflammatory eicosanoids. Additionally, n-3 PUFAs intake significantly decreased the arachidonic acid COX-derived PG eicosanoid group levels (Glass's Δ -0⋅35; CI -0⋅62, -0⋅07, I 2 31⋅48). Subgroup analyses showed a higher effect on periods up to 8 weeks (Glass's Δ -0⋅51; CI -0⋅76, -0⋅27) and doses higher than 0⋅5 g of n-3 PUFAs (Glass's Δ -0⋅46; CI -0⋅72, -0⋅27). Dietary n-3 PUFAs intake contributes to reduce pro-inflammatory eicosanoids of people with obesity and overweight. Subgroup's analysis showed that n-3 PUFAs can reduce the overall arachidonic acid COX-derived PG when adequate dose and period are matched.
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Weight loss probiotic supplementation effect in overweight and obesity subjects: A review.
Guazzelli Marques, C, de Piano Ganen, A, Zaccaro de Barros, A, Thomatieli Dos Santos, RV, Dos Santos Quaresma, MVL
Clinical nutrition (Edinburgh, Scotland). 2020;(3):694-704
Abstract
Obese individuals present adverse changes in the diversity and composition of the gut microbiota, leading to alterations in energy balance, lipid metabolism, endocrine disturbances, and low-grade chronic systemic inflammation increases. Probiotic supplementation appears to change gut microbiota by decrease gut permeability, inflammation, and metabolic disorders, creating a promising environment to weight loss. This revision resumes the main findings of probiotic supplementation and weight loss that contributed to building the current background linking changes in gut microbiota profile and with obesity.
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Africa's Changing Food Environments and Nutritional Effects on Adults and Children.
Demmler, KM, Qaim, M
World review of nutrition and dietetics. 2020;:31-41
Abstract
Many low- and middle-income countries (LMICs) are experiencing profound changes in food environments, including a rapid growth of supermarkets and other modern retailers. Changing food environments can influence people's diets, nutrition, and health. While in many LMICs, undernutrition and micronutrient deficiencies are still widespread, problems of overweight, obesity, and related non-communicable diseases are also massively on the rise. Supermarkets seem to contribute to overweight and obesity among adults, but effects on children and adolescents could possibly be different. Here, we review the available evidence about the implications of supermarkets for people's diets, nutrition, and health. Particular emphasis is placed on recent studies from urban Kenya that used panel data and differencing techniques to identify causal effects on different age cohorts. The results from Kenya show that shopping in supermarkets contributes to higher consumption of processed and highly processed foods and lower consumption of unprocessed foods. These dietary changes lead to significant increases in the body mass index and the probability of being overweight/obese and pre-diabetic among adults. For children, the same increases in overweight are not observed. Instead, supermarket shopping increases child height-for-age Z-scores. Despite higher food processing levels, supermarkets enhance food variety and dietary diversity in the relatively poor households. The results confirm that the growth of supermarkets affects adult and child nutrition differently; while the effects on adults are negative, the effects on children are positive, especially in the Kenyan context where child undernutrition is still widespread. Better understanding the effects of changing food environments on different age cohorts and in different contexts is important to design strategies that can help to make food choices in LMICs healthier. More research in different geographical settings will be useful.
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Core outcome set for behavioural weight management interventions for adults with overweight and obesity: Standardised reporting of lifestyle weight management interventions to aid evaluation (STAR-LITE).
Mackenzie, RM, Ells, LJ, Simpson, SA, Logue, J
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2020;(2):e12961
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Abstract
Behavioural weight management interventions in research studies and clinical practice differ in length, advice, frequency of meetings, staff, and cost. Few real-world programmes have published patient outcomes and those that have used different ways of reporting information, making it impossible to compare interventions and develop the evidence base. To address this issue, we have developed a core outcome set for behavioural weight management intervention programmes for adults with overweight and obesity. Outcomes were identified via systematic review of the literature. A representative expert group was formed comprising people with experience of adult weight management services. An online Delphi process was employed to reach consensus as to which outcomes should be measured and reported and which definitions/instruments should be utilised. The expert group identified eight core outcomes and 12 core processes for reporting by weight management services. Eleven outcomes and five processes were identified as optional. The most appropriate definitions/instruments for measuring each outcome/process were also agreed. Our core outcome set will ensure consistency of reporting. This will allow behavioural weight management interventions to be compared, revealing which interventions work best for which members of the population and helping inform development of adult behavioural weight management interventions.
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Review of the Experience of Weight-Based Stigmatization in Romantic Relationships.
Côté, M, Bégin, C
Current obesity reports. 2020;(3):280-287
Abstract
PURPOSE OF REVIEW This narrative review summarizes literature on the stigma and prejudices experienced by individuals based on their weight in the context of romantic relationships. RECENT FINDINGS Individuals presenting with overweight or obesity, particularly women, are disadvantaged in the formation of romantic relationships compared with their normal-weight counterparts. They are also more prone to experience weight-based stigmatization towards their couple (from others), as well as among their couple (from their romantic partner). Currently available studies showed that weight-based stigmatization by a romantic partner was found to be associated with personal and interpersonal correlates, such as body dissatisfaction, relationship and sexual dissatisfaction, and disordered eating behaviors. Scientific literature on weight-based stigmatization among romantic relationships is still scarce. Prospective researches are clearly needed to identify consequences of this specific type of stigmatization on individuals' personal and interpersonal well-being. The use of dyadic designs could help to deepen our understanding as it would take into account the interdependence of both partners.