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A clinical trial about effects of prebiotic and probiotic supplementation on weight loss, psychological profile and metabolic parameters in obese subjects.
Ben Othman, R, Ben Amor, N, Mahjoub, F, Berriche, O, El Ghali, C, Gamoudi, A, Jamoussi, H
Endocrinology, diabetes & metabolism. 2023;6(2):e402
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Gut microbiota is defined by all the beneficial microorganisms that live and grow in the intestine. It is set up from birth and evolves according to different factors. Today, the microbiota is considered a therapeutic revolution, where researchers use its enrichment to prevent or treat certain diseases including obesity. The aim of this study was to evaluate the effects of a probiotic supplement containing Bifidobacteruim, Lactobacillus strains and a prebiotic supplement by carob on the changes in body composition and metabolic biomarkers in subjects with obesity. This study was a prospective interventional study. Forty-five patients were recruited on their first visit to the obesity unit and were randomly assigned to three groups. All participants were enrolled in the weight loss program at the beginning of the study and followed a low-carbohydrate, reduced-energy intake eating plan. Results showed that a low-carbohydrate, restricted-energy diet effectively showed positive results in terms of weight loss, metabolic parameters and obesity-related psychiatric disorders in obese individuals. Authors concluded that prebiotics and probiotics supplementation with lifestyle measures can be taken into consideration for the management of obesity.
Abstract
INTRODUCTION The management of obesity is difficult with many failures of lifestyle measures, hence the need to broaden the range of treatments prescribed. The aim of our work was to study the influence of pre and probiotics on weight loss psychological profile and metabolic parameters in obese patients. METHODS It is a clinical trial involving 45 obese patients, recruited from the Obesity Unit of the National Institute of Nutrition between March and August 2022 divided into three groups: diet only (low-carbohydrate and reduced energy diet), prebiotics (30 g of carob/day) and probiotics (one tablet containing Bifidobacterium longum, Lactobacillus helveticus, Lactococcus lactis, Streptococcus thermophilus/day). The three groups were matched for age, sex and BMI. Patients were seen after 1 month from the intervention. Anthropometric measures, biological parameters, dietary survey and psychological scores were performed. RESULTS The average age of our population was 48.73 ± 7.7 years, with a female predominance. All three groups showed a significant decrease in weight, BMI and waist circumference with p < .05. Only the prebiotic and probiotic group showed a significant decrease in fat mass (p = .001) and a significant increase in muscle strength with p = .008 and .004, but the differences were not significant between the three groups. Our results showed also a significant decrease in insulinemia and HOMA-IR in the prebiotic group compared to the diet-alone group (p = .03; p = .012) and the probiotic group showed a significant decrease in fasting blood glucose compared to the diet alone group (p = .02). A significant improvement in sleep quality was noted in the prebiotic group (p = .02), with a significant decrease in depression, anxiety and stress in all three groups. CONCLUSIONS The prescription of prebiotics and probiotics with the lifestyle measures seems interesting for the management of obesity especially if it is sarcopenic, in addition to the improvement of metabolic parameters and obesity-related psychiatric disorders.
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Body Composition Changes Following a Very-Low-Calorie Pre-Operative Diet in Patients Undergoing Bariatric Surgery.
Sivakumar, J, Chong, L, Ward, S, Sutherland, TR, Read, M, Hii, MW
Obesity surgery. 2020;30(1):119-126
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Surgery for the treatment of morbid obesity has become a very common intervention due to the increased prevalence of disease and relative ineffective comparative therapies. The aim of this study was to evaluate overall changes in body composition in bariatric surgery patients undergoing a very-low-calorie-diet (VLCD). The study is a prospective analysis on patients who underwent a 2-week period of VLCD prior to bariatric surgery. A total of 60 patients were enrolled. This study demonstrated that although VLCD appears to induce considerable weight loss in a short period of time, the majority of this is attributable to lean body mass (62.2%) rather than fat mass (37.6%). Another notable finding is that greater losses in weight occur largely at the expense of lean body mass rather than fat mass. Authors conclude that a 2-week VLCD is an effective tool for pre-operative weight reduction. However, a large amount of the total weight loss is attributed to a loss of lean body mass.
Abstract
BACKGROUND Fatty liver in obese patients increases the technical difficulty of bariatric surgery. Pre-operative weight loss with a very-low-calorie diet (VLCD) is commonly used to facilitate surgery. Few studies have quantified the systemic effect of rapid pre-operative weight loss on body composition. The objective of this study is to evaluate body composition changes in bariatric surgery patients undergoing a VLCD. METHODS Body composition assessments were performed between August 2017 and January 2019 using dual-energy X-ray absorptiometry immediately before and after a 2-week VLCD at St Vincent's Hospital Melbourne. Data collected prospectively pre- and post-VLCD included total body weight, excess body weight, body mass index (BMI), lean body mass (LBM), fat mass (FM) and bone mineral content (BMC). The pre- and post-operative results were compared. RESULTS Forty-four patients completed both the 2-week VLCD and body composition assessments. Following a 2-week VLCD, patients lost a mean of 4.5 kg (range - 0.3 to 9.5) in a total body weight and 8.8% (range - 0.9 to 17.1) of excess body weight, with a mean reduction in body mass index of 1.6 kg/m2 (range - 0.2 to 3.1). Loss of LBM was 2.8 kg and was significantly greater than loss of FM, 1.7 kg (p < 0.05). BMC changes were insignificant. CONCLUSION A VLCD is an effective tool for pre-operative weight reduction. In this cohort, a large amount of the total weight loss was attributed to a loss of lean body mass. The impact of significant lean body mass loss and its relationship to short- and long-term health outcomes warrants further assessment.
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Development and content validity of an instrument for assessing the motivation for weight loss in adolescents with overweight and obesity.
Silva, DFO, Souza, ALS, Pimentel, JB, Souza, TO, Araújo, EPDS, Sena-Evangelista, KCM, Arrais, RF, Lima, SCVC
PloS one. 2020;15(11):e0242680
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Reduction and control of body weight is an important measure in order to reduce health risks in adolescence and adulthood. The aim of this study was to develop and validate the content of an instrument to assess the motivation for weight loss in adolescents with overweight and obesity. This is a methodological study. The development and content validation of the instrument was conducted in five stages. There were three rounds of evaluation; in the first round the responses of 12 experts were included, in the second round the responses of 10 experts were included and in the final round the responses of four experts were included. Findings show that the content validity evaluation of the items by the panel of experts allowed the selection of the most practical items for adolescents. Additionally, the revisions made in the wording of the items provided a better standardization in the presentation of the items and a clearer language adapted to the age range of the target audience. Authors conclude that further psychometric testing is needed to determine reliability and construct validity of the instrument.
Abstract
OBJECTIVE To develop and validate the content of an instrument for assessing the motivation for weight loss in adolescents with overweight and obesity. METHODS The development and validation of the instrument were conducted in five stages, for which two systematic reviews were conducted. The first one, for the identification of questionnaires assessing the motivation for weight loss, included six studies and contributed to the selection of the domains for the instrument. The second one, conducted to identify the motivations for weight loss in adolescents with overweight and/or obesity, included six studies and contributed to the selection of 17 motivations included in the initial version of the instrument. The motivations most commonly identified were: having better health, improving my appearance, improving my self-esteem and avoiding bullying. The content validity was confirmed by a committee of 12 experts from the areas of nutrition, endocrinology, psychology, and physical education. Based on these evaluations, the content validity index was calculated. Only the items with a content validity index >0.80 for practical relevance were held in the instrument. RESULTS Five of the 17 motivations included in the initial version of the instrument were excluded because they had content validity index <0.80 for practical relevance. Of the 12 items held in the instrument, five were revised by experts in order to standardize wording and make the language more appropriate for adolescents. Experts categorized the items into the health, personal satisfaction, appearance and social domains. CONCLUSIONS This is the first instrument assessing the motivation for weight loss in adolescents with overweight and obesity in Brazil. The content validity evaluation by the panel of experts provided more practical relevance, as well as contributed to a better presentation of the items. Further psychometric testing is needed to determine reliability and construct validity of the instrument.
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Calorie restriction regime enhances physical performance of trained athletes.
Pons, V, Riera, J, Capó, X, Martorell, M, Sureda, A, Tur, JA, Drobnic, F, Pons, A
Journal of the International Society of Sports Nutrition. 2018;15:12
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Athletes commonly aim to reduce body weight to improve their strength-to-mass ratio. In this study caloric restriction (CR) of 33% was achieved through alternate day fasting in trained athletes, which the authors hypothesised to be more easy to adhere to than daily reduced energy intake. The macronutrient composition remained the same as prior to calorie reduction. Study participants lost an average of 4.4% in body weight over 6 weeks, most of which came from fat, 15.1%. Despite also losing some lean mass (2.9%), exercise performance of the athletes improved, as did energy efficiency, possibly due to increased mitochondrial efficiency. Nutritional record analysis revealed that athletes ingested less than the RDA for several nutrients prior to the CR intervention, and intake was even lower with CR. The authors conclude that CR may be a good way for athletes to achieve weight loss as, unlike other body weight reduction techniques, the alternate day fasting CR improved physical performance. They suggest though that to ensure adequate micronutrient intake, supplementation may be required.
Abstract
BACKGROUND Caloric restriction induces mitochondrial biogenesis and improves physical fitness in rodents. We aimed to provide evidence of how caloric restriction affects the body composition and physical performance of trained athletes and to evaluate the possible impact of an every-other-day feeding diet on nutritional deficiencies of micronutrients and essential fatty acids. METHODS The study was performed with 12 healthy male athletes by carrying out a 33% caloric restriction with respect to their usual diet. Athletes performed a maximal exercise stress test both before and after the caloric restriction period. Blood samples were taken before and after the caloric restriction at basal conditions and 30 min post-exercise. Although energy intake was reduced by about 33%, the contribution of carbohydrates, proteins, and lipids to total energy intake during the caloric restriction was similar to the original diet. RESULTS The caloric restriction reduced the daily specific micronutrient intake to values lower than 90% of recommended dietary allowances. No effects were observed in blood parameters related to iron metabolism and tissue damage, glucose levels, lipid profiles, or erythrocyte fatty acid composition. In addition, oxidative damage markers decreased after the nutritional intervention. The caloric restriction intervention significantly reduced body weight and trunk, arm, and leg weights; it also caused a decrease in fat and lean body mass, the energy expenditure rate when performing a maximal exercise stress test, and the energy cost to run one meter at various exercise intensities. Furthermore, the intervention ameliorated the onset of the anaerobic phase of exercise. CONCLUSION A caloric restriction improves athletes' performance and energy efficiency, but reduces the daily intake of micronutrients; so, when caloric restriction programs are implemented micronutrient supplementation should be considered. TRIAL REGISTRATION The project was registered at ClinicalTrials.gov (NCT02533479).