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1.
Hepatotoxicity caused by Garcinia cambogia.
Mas Ordeig, A, Bordón García, N
Gastroenterologia y hepatologia. 2020;(3):134-135
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2.
New-generation anti-obesity drugs: naltrexone/bupropion and liraglutide. An update for endocrinologists and nutritionists.
Barrea, L, Pugliese, G, Muscogiuri, G, Laudisio, D, Colao, A, Savastano, S
Minerva endocrinologica. 2020;(2):127-137
Abstract
The prevalence of obesity increases worldwide and has a significant economic impact on health care systems. A comprehensive program of lifestyle modification, including diet, exercise, and behavior therapy is considered the first option for achieving the significant weight loss. However, the intrinsic difficulties associated with maintenance of lifestyle changes contribute to the unsatisfactory long-term outcomes reported and weight regain in the obesity management. In this context, pharmacological approaches are useful to maximize non-pharmacological interventions in the long-term management of obesity. As add-on to lifestyle modification, pharmacological interventions are useful to facilitate clinically weight loss. In the past, anti-obesity drugs were limited. To date, the landscape has changed and naltrexone/bupropion and liraglutide have been recently added as new-generation anti-obesity drugs on obesity treatment and could represent important tools to manage of obesity. Liraglutide is a glucagon-like peptide 1 (GLP-1) receptor agonist that shares 97% homology to native GLP-1 with effects on the limbic system. The treatment with liraglutide 3.0 mg, in combination with a hypocaloric diet and increased physical activity, provides a clinically meaningful weight loss. The combination of naltrexone 32 mg and bupropion 360 mg acts on the mesolimbic reward pathway and the hypothalamic hunger system, two areas of the central nervous system. The combination of naltrexone/bupropion, an adjunct to a hypocaloric diet and increased physical activity, is approved for chronic weight management in adults with obesity or overweight and ≥1 weight-related comorbidity. In the present review, we have focused on the current evidence on two new-generation anti-obesity drugs, naltrexone/bupropion and liraglutide 3.0 mg addressing the main studies that investigated these two new drugs for obesity treatment. Furthermore, evidence on semaglutide, currently in the pipeline for potential future therapeutic use for weight loss, are reported.
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3.
[Effectiveness of hydroxycinamates and beta-glucans as dietary tools against obesity and its associated dysfunctions, and their application as nutraceuticals].
García Cordero, J, Sarria Ruiz, B, González Rámila, S, Bravo Clemente, L, Mateos Briz, R
Nutricion hospitalaria. 2020;(5):1061-1071
Abstract
Over the last few years the prevalence of overweight and obesity has increased, affecting in certain parts of the world more than half of the adult population. Obesity has been related to disorders such as type-2 diabetes, non-alcoholic fatty liver disease, and cardiovascular diseases, among others, which has made of obesity the second cause of preventable death, only behind smoking. Bearing this in mind, it is necessary to find new strategies to overcome overweight/obesity and its associated pathologies. In this context, nutraceuticals and dietary supplements have become interesting tools thanks to their composition, rich in bioactive compounds beneficial to health. Among bioactive compounds, this study will focus on β-glucans, a type of soluble dietary fiber, and hydroxycinnamic acids, a group of phenols. Both types of compounds show complex and multifactorial effects, acting as hypolipemic, hypoglycemic, antioxidant, prebiotic and satiating agents. They act by modulating different metabolic pathways, affecting the absorption and metabolism of lipids and carbohydrates, reducing oxidative damage, promoting the proliferation of beneficial bacterial species, and reducing dietary intake. It may be concluded that both beta-glucans and hydroxycinnamates have potential as a nutritional tool for the management of obesity and its associated metabolic dysfunctions.
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4.
Targeting obesity with plant-derived pancreatic lipase inhibitors: A comprehensive review.
Rajan, L, Palaniswamy, D, Mohankumar, SK
Pharmacological research. 2020;:104681
Abstract
The prevalence of obesity is alarmingly increasing in the last few decades and leading to many serious public health concerns worldwide. The dysregulated lipid homeostasis due to various genetic, environmental and lifestyle factors is considered one of the critical putative pathways mediating obesity. Nonetheless, the scientific advancements unleashing the molecular dynamics of lipid metabolism have provided deeper insights on the emerging roles of lipid hydrolysing enzymes, including pancreatic lipase. It is hypothesized that inhibiting pancreatic lipase would prevent the breakdown of triglyceride and delays the absorption of fatty acids into the systemic circulation and adipocytes. Whilst, orlistat is the only conventional pancreatic lipase enzyme inhibitor available in clinics, identifying the safe clinical alternatives from plants to inhibit pancreatic lipase has been considered a significant advancement. Consequently, plants which have shown significant potential to combat obesity are now revisited for its abilities to inhibit pancreatic lipase. In this regard, our review surveyed the potential of medicinal plants and its phytoconstituents to inhibit pancreatic lipase and to elicit anti-obesity effects. Thus, the review collate and critically appraise the potential of medicinal plants and phyto-molecules inhibiting pancreatic lipase enzyme and consequently modulating triglyceride absorption in gut, and discuss its implications in the development of novel therapeutic strategies to combat obesity.
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5.
Hypertension in Obesity: Novel Insights.
Natsis, M, Antza, C, Doundoulakis, I, Stabouli, S, Kotsis, V
Current hypertension reviews. 2020;(1):30-36
Abstract
BACKGROUND The relationship between obesity and hypertension has been established in both adults and children. The combination of obesity, hypertension and other cardiovascular risk factors significantly increases the likelihood of adverse cardiovascular effects and raises concerns about aggressive treatment strategies. OBJECTIVE Despite the impressive elements which indicate an important role for excessive weight gain in increasing blood pressure, not all obese patients are hypertensive. A subgroup of obese people may not develop hypertension. Furthermore, masked hypertension occurs more common among obese patients, and body fat distribution has a major role in the development of hypertension. METHOD We conducted a research of the relevant literature regarding obesity-induced hypertension and possible treatment strategies. RESULTS Successful weight loss is correlated with blood pressure reduction and requires a multidisciplinary approach that includes personalized dietary interventions combined with regular exercise and cognitive behavioral therapy. CONCLUSION Pharmacological therapy may be considered as part of a comprehensive obesity management strategy. More research and new treatment therapies are required in this field.
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6.
Obesity: The New Global Epidemic Pharmacological Treatment, Opportunities and Limits for Personalized Therapy.
Milano, W, De Biasio, V, Di Munzio, W, Foggia, G, Capasso, A
Endocrine, metabolic & immune disorders drug targets. 2020;(8):1232-1243
Abstract
BACKGROUND The increase in global obesity rates over the past three decades has been remarkable, a true epidemic, both in developed and in developing countries. The projections, based on current trends, suggest an increase in the prevalence of obesity at 60% in adult men, 40% in adult women and 25% in children in 2050. Given the limitations of lifestyle and surgery interventions bariatric, drug therapy approaches for the treatment of obesity, therefore become important options. AIM: The purpose of this review is a review of the literature, based on research on MEDLINE until 2019, on the possible pharmacological options in the treatment of obesity. RESULTS Currently, the FDA has approved several molecules for the treatment of obesity, both in monotherapy and in combination. Pharmacological monotherapies focus mainly on a single protein target and include orlistat, lorcaserin and liraglutide while the combination molecules propose a multitarget approach and include phentermine/topiramate and naltrexone/bupropion. All the approved drugs showed, in the different studies, a weight reduction of at least 5%, compared to placebo, in 52 weeks of observation. Phentermine-topiramate and liraglutide have been associated with the highest probability of at least 5% weight loss. Liraglutide and naltrexone-bupropion had the lowest rates of therapy discontinuation due to adverse events. CONCLUSION The drugs, associated with the standard diet and/or exercise protocols, represent a good therapeutic opportunity to allow not only weight loss but also to reduce the risk of developing diseases caused by obesity, particularly cardiovascular diseases, and to maintain the set objectives over time. However, future research on the pharmacological treatment of obesity should encourage greater personalization of therapy, given the differences in safety, efficacy and response to therapy, in the different subpopulations of patients with obesity.
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7.
Comprehensive Review of Current and Upcoming Anti-Obesity Drugs.
Son, JW, Kim, S
Diabetes & metabolism journal. 2020;(6):802-818
Abstract
Obesity is among the leading causes of morbidity and mortality worldwide and its prevalence continues to increase globally. Because obesity is a chronic, complex, and heterogeneous disease influenced by genetic, developmental, biological, and environmental factors, it is necessary to approach obesity with an integrated and comprehensive treatment strategy. As it is difficult to achieve and sustain successful long-term weight loss in most patients with obesity through lifestyle modifications (e.g., diet, exercise, and behavioral therapy), pharmacological approaches to the treatment of obesity should be considered as an adjunct therapy. Currently, four drugs (orlistat, naltrexone extended-release [ER]/bupropion ER, phentermine/topiramate controlled-release, and liraglutide) can be used long-term (>12 weeks) to promote weight loss by suppressing appetite or decreasing fat absorption. Pharmacotherapy for obesity should be conducted according to a proper assessment of the clinical evidence and customized to individual patients considering the characteristics of each drug and comorbidities associated with obesity. In this review, we discuss the mechanisms of action, efficacy, and safety of these available long-term anti-obesity drugs and introduce other potential agents under investigation. Furthermore, we discuss the need for research on personalized obesity medicine.
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8.
Medical and surgical management of obesity and diabetes: what's new?
Ammori, BJ, Skarulis, MC, Soran, H, Syed, AA, Eledrisi, M, Malik, RA
Diabetic medicine : a journal of the British Diabetic Association. 2020;(2):203-210
Abstract
We conducted a narrative review of the medical and surgical management of people with obesity and diabetes. Results of this review showed that a 5-10% loss in body weight can be achieved with a change in lifestyle, diet and behaviour and with approved pharmacological therapies in people with obesity and diabetes. New targeted therapies are now available for patients with previously untreatable genetic causes of obesity. Compared to medical treatment, metabolic and bariatric surgery is associated with significantly higher rates of remission from type 2 diabetes and lower rates of incident macrovascular and microvascular complications and mortality. The National Institute for Health and Care Excellence and the American Diabetes Association endorse metabolic and bariatric surgery in obese adults with type 2 diabetes and there may also be a role for this in obese individuals with type 1 diabetes. The paediatric committee of the American Society for Metabolic and Bariatric Surgery have recommended metabolic and bariatric surgery in obese adolescents with type 2 diabetes. Earlier and more aggressive treatment with metabolic and bariatric surgery in obese or overweight people with diabetes can improve morbidity and mortality.
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9.
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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10.
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.