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Recent trends in anti-obesity and anti-inflammatory studies in modern health care.
Na, EJ, Kim, DJ, Kim, JH, Kim, GR
Technology and health care : official journal of the European Society for Engineering and Medicine. 2019;(5):519-530
Abstract
BACKGROUND This study was planned to investigate the research trends related to naturally derived anti-inflammatory and anti-obesity components. The main purpose of this study was to find out and develop natural health cosmetic ingredients which has high effects on lipid degradation, moisturizing and elasticity enhancement. OBJECTIVE We all hope this research provided systematic and practical data that can suggest an opportunity to further develop new products. METHODS This is a descriptive research which classified the natural and traditional components that have important obesity management effects based on the experimental technique (in vitro and in vivo). we investigated the effects of 13 natural raw materials selected through preliminary investigation on lipid metabolism related enzyme activity. We first introduced Ainsliaea acerifolea, Onion, pear, Sanguisorba, Limonium tetragonum, Cornus walteri, Loquat, and Loquat-which have recently been shown to be effective in anti-obesity tests, and then described the research methods by showing the effects of onion extracts, Glasswort, Pine Cone (Korean white pine), Orostachys japonicus, African mangoes, Pepper, and Clathratum (sea weed), which actually had effects on anti-obesity in the in vivo experiment. RESULTS As a result of investigating the effect of 13 natural raw materials selected through a preliminary investigation on lipid metabolism related enzyme activity, the study found nature-derived ingredients which induce anti-inflammatory and enhance the anti-obesity enzyme activity, and ingredients showing myriads of biological activities such as anti-oxidant, body fat reduction, lowering of blood cholesterol, and weight control. CONCLUSION In this paper, we would like to delve into the possibility of using natural components with natural lipid-lowering effect, and systematically and practically study if they can actually be helpful to develop new cosmetic products.
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Neuroprotective and Anti-Obesity Effects of Tocotrienols.
Fukui, K
Journal of nutritional science and vitaminology. 2019;(Supplement):S185-S187
Abstract
Vitamin E is a natural lipophilic vitamin, and the most famous function of vitamin E is an antioxidant activity. Because we have α-tocopherol transfer protein, many vitamin E-related reports are about α-tocopherol. Recently, other vitamin E isoforms, tocotrienols are focusing. Because tocotrienols have unique biological functions such as induction of apoptosis, neuroprotective and anti-obesity effects. Tocotrienols contain in annatto, palm, whole wheat and rice bran. Rice is a typical food in the East Asian countries and Japan. Recently, intake of whole rice is a popular in young women of Japan. Previously, we demonstrated that treatment with tocotrienols on the neuronal cells shows a strong antioxidant effect compared to the tocopherols. In this review, I introduce about neuroprotective and anti-obesity effects of tocotrienols. I would like to show daily intake of whole rice is very good for our health in this review.
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Precision Medicine in Weight Loss and Healthy Living.
Severin, R, Sabbahi, A, Mahmoud, AM, Arena, R, Phillips, SA
Progress in cardiovascular diseases. 2019;(1):15-20
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Abstract
Obesity affects 600 million people globally and over one third of the American population. Along with associated comorbidities, including cardiovascular disease, stroke, diabetes, and cancer; the direct and indirect costs of managing obesity are 21% of the total medical costs. These factors shed light on why developing effective and pragmatic strategies to reduce body weight in obese individuals is a major public health concern. An estimated 60-70% of obese Americans attempt to lose weight each year, with only a small minority able to achieve and maintain long term weight loss. To address this issue a precision medicine approach for weight loss has been considered, which places an emphasis on sustainability and real-world application to individualized therapy. In this article we review weight loss interventions in the context of precision medicine and discuss the role of genetic and epigenetic factors, pharmacological interventions, lifestyle interventions, and bariatric surgery on weight loss.
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Current Options for the Pharmacotherapy of Obesity.
Gouni-Berthold, I, Berthold, HK
Current pharmaceutical design. 2019;(18):2019-2032
Abstract
650 millions of adults are obese worldwide - in the US alone, forty percent of the adults are obese. Although the obesity pandemic is constantly expanding at very high costs for health care systems, the currently available options of pharmacotherapy for obesity are rather limited. Despite intensive research efforts, the vast majority of the anti-obesity drugs developed up to now have a rather limited efficacy and/or safety profile. In the last fifty years, various drugs reached advanced states of clinical development but were either never marketed or were initially approved but withdrawn later due to safety issues. However, the understanding of the pathophysiology of obesity has been steadily improving and new, promising drugs targeting various selective obesityassociated and energy-homeostasis-related pathways are now available. When lifestyle changes alone fail to combat, then additional pharmacotherapy with an acceptable efficacy and safety profile could provide a useful therapeutic option.
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Incorporating Weight Loss Medications Into Hepatology Practice for Nonalcoholic Steatohepatitis.
Do, A, Kuszewski, EJ, Langberg, KA, Mehal, WZ
Hepatology (Baltimore, Md.). 2019;(4):1443-1456
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Abstract
There is an urgent need for practical approaches to patients with nonalcoholic steatohepatitis (NASH). Total body weight loss (TBWL) is an important approach, as its effects are amplified in the liver, with 10% TBWL resulting in a 50% loss of liver triglycerides and improvement in all aspects of NASH histology. Lifestyle changes are the first step in addressing TBWL, but uncommonly result in the range required to improve liver histology in NASH (7%-10%). Weight loss medications (WLMs) are an effective additional tool because they can provide TBWL in the 7%-10% range, have a well-characterized clinical profile, have clear guidelines, and meet approved criteria for their use (body mass index greater than 27 kg/m2 ) for most NASH patients. Use of WLMs requires shared decision making with the patient, which hepatologists, due to their understanding of the natural history of NASH, are uniquely positioned to provide. WLMs do present the challenge of incorporating new medications into the hepatology clinic, but this will be necessary with all medications to manage NASH. WLMs provide a practical intervention that can be incorporated into hepatology clinics and can be offered to most NASH patients. NASH-specific medicines in clinical trials offer partial histological responses, and TBWL will likely enhance this. Conclusion: WLMs provide the hepatologist with effective and welcome clinical intervention beyond the diagnosis and staging of NASH and provide patients with a sense of empowerment about the treatment of their liver disease.
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Mendelian obesity, molecular pathways and pharmacological therapies: a review.
Paolacci, S, Borrelli, A, Stuppia, L, Campanile, FC, Dallavilla, T, Krajčovič, J, Veselenyiova, D, Beccari, T, Unfer, V, Bertelli, M, et al
European review for medical and pharmacological sciences. 2019;(3):1357-1378
Abstract
OBJECTIVE In this qualitative review we analyze the major pathways and mechanisms involved in the onset of genetically-determined obesity (Mendelian obesity), identifying possible pharmacological treatments and trials. MATERIALS AND METHODS We searched PubMed with the keywords (obesity[Title/Abstract]) AND mutation[Title/Abstract], and OMIM with the keyword "obesity". In both cases, we selected non-syndromic Mendelian obesity. We then searched ClinicalTrials.gov with the following criteria: "recruitment status: active, not recruiting and completed"; "study type: interventional (clinical trial)"; "study results: with results"; type of intervention: "drug or dietary supplement". RESULTS From the PubMed and OMIM searches we obtained a total of 15 genes associated with monogenic Mendelian obesity. From ClinicalTrials.gov we retrieved 46 completed or active trials of pharmacological treatments. CONCLUSIONS We summarized the molecular bases of Mendelian obesity and searched for any clinical trials completed or underway for the treatment of severe forms of obesity. Most Mendelian obesities are linked to dysfunctions in the leptin/melanocortin signaling pathway, and most of the possible drugs target this pathway in order to improve energy expenditure and reduce food intake.
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[Pharmacological treatment of obesity for Primary Care physicians].
Rubio Herrera, MA, Fernández-García, JM, Corio Andújar, R, Santos Altozano, C, Urieta Carpi, JJ
Semergen. 2019;(8):559-565
Abstract
Obesity is a disease of high prevalence in Primary Care clinics. It is associated with major comorbidities (dyslipidaemia, diabetes, hypertension) that increase morbidity and mortality, health expenditure, and reduces the quality of life of patients. Changes in lifestyle are still the pillars of the treatment of excess weight. Pharmacological treatment should be considered when there are difficulties in achieving weight loss goals. In this article, a review is presented on the currently authorised drugs for the treatment of obesity and overweight with major comorbidities.
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Will medications that mimic gut hormones or target their receptors eventually replace bariatric surgery?
Kokkinos, A, Tsilingiris, D, le Roux, CW, Rubino, F, Mantzoros, CS
Metabolism: clinical and experimental. 2019;:153960
Abstract
Bariatric surgery is currently the most effective therapeutic modality through which sustained beneficial effects on weight loss and metabolic improvement are achieved. During recent years, indications for bariatric surgery have been expanded to include cases of poorly controlled type 2 (T2DM) diabetes mellitus in lesser extremes of body weight. A spectrum of the beneficial effects of surgery is attributed to robust changes of postprandial gut peptide responses that are observed post operatively. Consolidated knowledge regarding gut peptide physiology as well as emerging new evidence shedding light on the mode of action of previously overlooked gut hormones provide appealing potential obesity and T2DM therapeutic perspectives. The accumulation of evidence from the effect of exogenous administration of native gut peptides alone or in combinations to humans as well as the development of mimetic agents exerting agonistic effects on combinations of gut hormone receptors pave the way for future integrated gut peptide-based treatments, which may mimic the effects of bariatric surgery.
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Long-term pharmacotherapy of obesity in patients that have undergone bariatric surgery: pharmacological prevention and management of body weight regain.
Gutt, S, Schraier, S, González Bagnes, MF, Yu, M, González, CD, Di Girolamo, G
Expert opinion on pharmacotherapy. 2019;(8):939-947
Abstract
INTRODUCTION The obesity epidemic continues to grow. Bariatric surgery is part of the arsenal to treat the disease. Surgery results in an effective option for patients with severe obesity but also when obesity is associated with significant comorbidities. Weight regain is frequent after bariatric surgery. Consequently, the addition of anti-obesity drugs to prevent and manage weight regain are commonly recommended even when the quality of the evidence supporting this recommendation is relatively weak. cfsda65 AREAS COVERED The aim of this review is to summarize the available evidence concerning long-term pharmacotherapy of obesity in patients that have undergone bariatric surgery with a focus on pharmacological prevention and management of weight regain. The etiology and epidemiology of weight regain are summarized, as well as the available information about the benefits and risks of long-term pharmacotherapy in the prevention and management of recidivism. EXPERT OPINION The available information, mainly obtained from observational studies and small trials, is encouraging but calls for a prudent approach in the selection of appropriate agents for each individual patient and a careful follow-up to detect adverse reactions or drug interactions. Results from well-designed trials are upcoming. In the meantime, a cautious, individualized approach is advisable.
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Pharmacologic Randomized Clinical Trials in Prevention of Type 2 Diabetes.
Knowler, WC, Crandall, JP
Current diabetes reports. 2019;(12):154
Abstract
PURPOSE OF REVIEW There have been many randomized clinical trials testing lifestyle and drug interventions to prevent the development of type 2 diabetes in nondiabetic adults at high risk of the disease. We review the major trials using pharmacologic interventions with the primary outcome of preventing diabetes. The trials are grouped according to the main mechanism by which the drugs were thought to have the potential for preventing diabetes. RECENT FINDINGS Drugs in several different classes have been effective in reducing the incidence of diabetes, but evidence for other long-term benefits, such as avoidance of complications and reducing mortality rates, is very limited. Both drugs and lifestyle interventions are effective in preventing and delaying the onset of type 2 diabetes in high-risk adults. The choices of what drugs to use and when during the development of type 2 diabetes to introduce them are not clear.