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Nutrition and frailty: Current knowledge.
Feart, C
Progress in neuro-psychopharmacology & biological psychiatry. 2019;:109703
Abstract
PURPOSE OF THE REVIEW Nutrition, as part of lifestyle and modifiable environmental factors, constitutes an interesting approach for the prevention of geriatric syndromes. The objective of this review was to examine the most recent evidence on the association between nutrition, from dietary patterns to specific nutrients, and frailty, before the onset of disability, among elderly individuals. RECENT FINDINGS Based on available epidemiological studies, three meta-analyses published in 2018 have outlined a protective effect of greater adherence to a Mediterranean-type diet (MeDi) on the risk for frailty, with up to a 60% reduction in risk. Several studies focusing on particular food groups, macronutrients and micronutrients have also been published and have highlighted that a protein intake of 1 g/kg in body weight per day should be fulfilled (except for patients suffering from kidney or hepatic dysfunction) and that vitamin deficiencies should be avoided. Available interventional studies of nutritional supplements and/or physical activity programs have mainly been limited to disabled participants to date. SUMMARY Research efforts should target both developing a better understanding of the mechanisms underlying frailty and improving detection tools and the effectiveness of intervention studies, alongside efforts to address the specific needs of older people. For instance, ensuring an adequate nutritional status, by fighting the age-related increased prevalence of undernutrition or sarcopenic obesity, should be privileged.
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Non-caloric sweeteners and body weight.
Cavagnari, BM
Medicina. 2019;(2):115-122
Abstract
Both total caloric intake and consumption of free sugars is higher than recommended. This situation contributes, among many other factors, to the increase of overweight and obesity in the population. To maintain the sweet taste of foods and beverages while reducing the caloric content and the amount of free sugars in said products, many people choose to replace sugary products in their diet for options containing noncaloric sweeteners. This change in their dietary choice is accompanied by an increasing number of consultations with health professionals about the effects that non-caloric sweeteners could have on their body weight. Results reported in different scientific publications seem contradictory in relation to this topic: some of them, showing a positive association between the consumption of non-caloric sweeteners and energy intake and body weight, while others reporting that the consumption of these additives -in replacement of sugar- may lead to a reduction in caloric intake and body weight. The main objective of this article is to review the available evidence on the consumption of non-caloric sweeteners in relation to body weight, thus providing another tool for health professionals to make nutritional recommendations based on the best available evidence.
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Potential Mechanisms of Sodium-Glucose Co-Transporter 2 Inhibitor-Related Cardiovascular Benefits.
Verma, S
The American journal of cardiology. 2019;:S36-S44
Abstract
The findings of recent clinical trials have shown that sodium-glucose co-transporter 2 (SGLT2) inhibitors produce effects beyond glucose lowering and have demonstrated beneficial cardiovascular effects that have been observed across a broad range of patients with type 2 diabetes mellitus. In particular, the cardiovascular benefit results largely from substantial and early effects of SGLT2 inhibition on cardiovascular death and hospitalization for heart failure. Recent cardiovascular outcomes trials (CVOTs) have also shown that relative risk reductions in cardiovascular outcomes were observed with SGLT2 inhibition both in patients with current and prior heart failure. Since the observed reductions of cardiovascular outcomes with SGLT2 inhibitor therapy were observed much earlier than would be expected by an anti-atherosclerotic effect, these results have led to speculation about the potential underlying pathways. Suggested mechanisms include natriuresis and osmotic diuresis; reductions in inflammation, oxidative stress, and arterial stiffness; reductions in blood pressure and body weight; and possible renoprotective effects. These effects could produce cardiovascular benefits through a range of cardiac effects, including reduction in left ventricular load, attenuation of cardiac fibrosis and inflammation, and improved myocardial energy production. Other possible mechanisms include inhibition of sodium-hydrogen exchange, increases in erythropoietin levels, and reduction in myocardial ischemia or reperfusion injury. It is likely that a range of mechanisms underlie the observed cardiovascular benefits of SGLT2 inhibitors; further elucidation of these mechanisms will be answered by ongoing research.
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Effect of physical exercise and training on gastrointestinal hormones in populations with different weight statuses.
Zouhal, H, Sellami, M, Saeidi, A, Slimani, M, Abbassi-Daloii, A, Khodamoradi, A, El Hage, R, Hackney, AC, Ben Abderrahman, A
Nutrition reviews. 2019;(7):455-477
Abstract
Several types of hormones exert control over appetite in humans. This narrative review explores the effects of exercise and training on the concentrations of gastrointestinal hormones in healthy and obese individuals. It focuses on the major hormones of appetite regulation: ghrelin, glucagon-like peptide 1, peptide YY, cholecystokinin, leptin, and oxyntomodulin. In normal-weight and overweight individuals, responses to most of these hormones depend on the intensity of exercise and training. However, findings in obese individuals are limited in number and, to some degree, contradictory. Although some gastrointestinal hormones have been studied extensively (eg, leptin), most have not been investigated systematically. Further research is required to confirm the effectiveness of exercise and training on gut hormones and to better understand the effect of gut hormones on appetite and hunger suppression in individuals with obesity. Investigations to elucidate the impact of various forms of exercise that have recently engaged the public interest, eg, high-intensity interval training or concurrent aerobic and resistance training, are warranted.
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5.
Food cravings and body weight: a conditioning response.
Myers, CA, Martin, CK, Apolzan, JW
Current opinion in endocrinology, diabetes, and obesity. 2018;(5):298-302
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Abstract
PURPOSE OF REVIEW To provide current information on interventions that alter food cravings. Specifically, dietary, physical activity, pharmacologic, and bariatric surgery interventions are examined. Lastly, the effects of social determinants and current controversies on food cravings are outlined. RECENT FINDINGS Dietary, pharmacologic, and bariatric surgery weight loss interventions decrease food cravings. Physical activity interventions also decrease cravings. There is potential to see differential responses in food cravings in different demographic and socioeconomic groups, but more research is needed. SUMMARY Food cravings influence body weight. Food craving reductions are because of reductions in the frequency of consuming craved foods, independent of energy content, but further research is warranted. Most findings continue to support the conditioning model of food cravings.
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Supplemental protein from dairy products increases body weight and vitamin D improves physical performance in older adults: a systematic review and meta-analysis.
Dewansingh, P, Melse-Boonstra, A, Krijnen, WP, van der Schans, CP, Jager-Wittenaar, H, van den Heuvel, EGHM
Nutrition research (New York, N.Y.). 2018;:1-22
Abstract
The purpose of these systematic review and meta-analysis was to assess the effectiveness of dairy components on nutritional status and physical fitness in older adults, as evidence for efficacy of the supplementation of these components is inconclusive. Scopus and MEDLINE were searched. Main inclusion criteria for articles were as follows: double-blind, randomized, placebo-controlled trials including participants aged ≥55 years who received dairy components or a placebo. Outcome measures were nutrient status (body weight and body mass index) and physical fitness (body composition, muscle strength, and physical performance). Thirty-six trials with 4947participants were included. Most trials investigated protein and vitamin D supplementation and showed no effect on the outcomes. Meta-analysis on the effect of protein on body weight showed a significant increase in mean difference of 1.13 kg (95% confidence interval, 0.59-1.67). This effect increased by selecting trials with study a duration of 6 months in which less nourished and physically fit participants were included. Trials where the participants were (pre-)frail, inactive older adults or when supplementing ≥20 g of protein per day tended to increase lean body mass. Only small significant effects of vitamin D supplementation on Timed Up and Go (mean difference -0.75 seconds; 95% confidence interval -1.44 to -0.07) were determined. This effect increased when vitamin D doses ranged between 400 and 1000 IU. Additional large randomized controlled trials of ≥6 months are needed regarding the effect of dairy components containing an adequate amount of vitamin D (400-1000 IU) and/or protein (≥20 g) on nutritional status and physical fitness in malnourished or frail older adults.
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Healthy lifestyle and prevention of atrial fibrillation: Weighty matters.
Aeschbacher, S, Conen, D
European journal of preventive cardiology. 2018;(13):1371-1373
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Energy expenditure in the etiology of human obesity: spendthrift and thrifty metabolic phenotypes and energy-sensing mechanisms.
Piaggi, P, Vinales, KL, Basolo, A, Santini, F, Krakoff, J
Journal of endocrinological investigation. 2018;(1):83-89
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Abstract
The pathogenesis of human obesity is the result of dysregulation of the reciprocal relationship between food intake and energy expenditure (EE), which influences daily energy balance and ultimately leads to weight gain. According to principles of energy homeostasis, a relatively lower EE in a setting of energy balance may lead to weight gain; however, results from different study groups are contradictory and indicate a complex interaction between EE and food intake which may differentially influence weight change in humans. Recently, studies evaluating the adaptive response of one component to perturbations of the other component of energy balance have revealed both the existence of differing metabolic phenotypes ("spendthrift" and "thrifty") resulting from overeating or underfeeding, as well as energy-sensing mechanisms linking EE to food intake, which might explain the propensity of an individual to weight gain. The purpose of this review is to debate the role that human EE plays on body weight regulation and to discuss the physiologic mechanisms linking EE and food intake. An increased understanding of the complex interplay between human metabolism and food consumption may provide insight into pathophysiologic mechanisms underlying weight gain, which may eventually lead to prevention and better treatment of human obesity.
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Sodium-glucose Cotransporter 2 Inhibitors: Impact on Body Weight and Blood Pressure Compared with other Antidiabetic Drugs.
Imprialos, KP, Stavropoulos, K, Stavropoulos, N, Patoulias, D, Petidis, K, Grassos, C, Dimitriadis, K, Tsioufis, C
Cardiovascular & hematological disorders drug targets. 2018;(2):104-113
Abstract
BACKGROUND Sodium-glucose co-transporters 2 inhibitors have emerged as a novel antidiabetic class of drugs offering significant ameliorating effects on a variety of cardiovascular risk factors, secondary to their mechanism of action, including blood pressure and body weight. OBJECTIVE The purpose of this article is to discuss available data on the impact of SGLT-2 inhibitors on blood pressure and body weight compared with other available anti-diabetic drugs and to present potential mechanisms mediating these effects. METHODS A comprehensive review of the literature was performed to identify studies examining the effects of SGLT-2 inhibitors on blood pressure and body weight. RESULTS SGLT-2 inhibition has been related with a mild decrease in blood pressure of approximately 3-5mmHg in systolic and 1-2mmHg in diastolic blood pressure. These data have been confirmed with 24h ambulatory measurements, as well. Furthermore, given the loss of calories in the urine, a mild decrease in body weight is anticipated, as well. Studies with this class of drugs noted a reduction in body weight of 2 to 3 kg, similar to the loss noted with the use of glucagon-like peptide 1 analogues, the only class of drugs that has offered significant reductions in body weight so far. Consclusion: The beneficial effects of the SGLT-2 inhibition on an abundance of cardiovascular risk factors, including blood pressure and body weight, have created great expectations for potential benefits from the cardiovascular events standpoint, a theory that was confirmed in the two available cardiovascular studies of this promising class of drugs.
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Reprint of: Healthy Weight and Obesity Prevention: JACC Health Promotion Series.
Lavie, CJ, Laddu, D, Arena, R, Ortega, FB, Alpert, MA, Kushner, RF
Journal of the American College of Cardiology. 2018;(23 Pt B):3027-3052
Abstract
Overweight and obesity have reached epidemic levels in the United States and worldwide, and this has contributed to substantial cardiovascular and other health risks. However, controversy exists concerning the causes of obesity and effective modalities for its prevention and treatment. There is also controversy related to the concept of metabolically healthy obesity phenotype, the "obesity paradox," and on the importance of fitness to protect individuals who are overweight or obese from cardiovascular diseases. In this state-of-the-art review, the authors focus on "healthy weight" with the emphasis on the pathophysiologic effects of weight gain on the cardiovascular system; mechanistic/triggering factors; and the role of preventive actions through personal, education/environment, and societal/authoritative factors, as well as factors to provide guidance for caregivers of health promotion. Additionally, the authors briefly review metabolically healthy obesity, the obesity paradox, and issues beyond lifestyle consideration for weight loss with medications and bariatric surgery.