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Effects of circuit training or a nutritional intervention on body mass index and other cardiometabolic outcomes in children and adolescents with overweight or obesity.
Seo, YG, Lim, H, Kim, Y, Ju, YS, Choi, YJ, Lee, HJ, Jang, HB, Park, SI, Park, KH
PloS one. 2021;(1):e0245875
Abstract
OBJECTIVE We aimed to assess the effectiveness of the first 6 months of a 24 month multidisciplinary intervention program including circuit training and a balanced diet in children and adolescents with obesity. METHODS A quasi-experimental intervention trial included 242 participants (age [mean±standard deviation]: 11.3±2.06 years, 97 girls) of at least 85th percentile of age- and sex-specific body mass index (BMI). Participants were grouped into three to receive usual care (usual care group), exercise intervention with circuit training (exercise group), or intensive nutritional and feedback intervention with a balanced diet (nutritional group). Primary outcome was BMI z-score, while secondary outcomes included body composition, cardiometabolic risk markers, nutrition, and physical fitness. RESULTS Among the participants, 80.6% had a BMI ≥ the 97th percentile for age and sex. The BMI z-score of the overall completers decreased by about 0.080 after 6 months of intervention (p < 0.001). After the intervention, both exercise and nutritional groups had significantly lower BMI z-scores than the baseline data by about 0.14 and 0.075, respectively (p < 0.05). Significant group by time interaction effects were observed between exercise versus usual care group in BMI z-score (β, -0.11; 95% confidence interval (CI), -0.20 to -0.023) and adiponectin (β, 1.31; 95% CI, 1.08 to 1.58); and between nutritional versus usual care group in waist circumference (β, -3.47; 95% CI, -6.06 to -0.89). No statistically significant differences were observed in any of the other secondary outcomes assessed. CONCLUSION Multidisciplinary intervention including circuit training and a balanced diet for children and adolescents with obesity reduced the BMI z-score and improved cardiometabolic risk markers such as adiponectin and waist circumference.
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A Properly Balanced Reduction Diet and/or Supplementation Solve the Problem with the Deficiency of These Vitamins Soluble in Water in Patients with PCOS.
Szczuko, M, Szydłowska, I, Nawrocka-Rutkowska, J
Nutrients. 2021;(3)
Abstract
Polycystic ovary syndrome (PCOS) is an increasingly common problem for women in the reproductive age throughout the entire world. A reduction diet with a low glycaemic index (GI) has proved to support the treatment of PCOS. The aim of the study was to analyse the influence of the diet on the level of vitamins soluble in water. The study included 55 women, 40 of which suffered from PCOS (identified by means of the Rotterdam Criteria) and 15 healthy women of the Caucasian race. The level of vitamins before and after the dietary intervention was measured. The diet was a reduction diet with a reduced glycaemic index (GI). Biochemical analyses were made on the basis of liquid chromatography-Infinity 1260 Binary liquid chromatography (LC) Agilent Technology. The level of vitamins in the serum was analysed together with the consumption before and after the dietary intervention. A higher level of vitamin C in the plasma was observed before and after the dietary intervention in the PCOS group in comparison to the control group despite the lower intake of this vitamin in the PCOS group. The remaining vitamins were at a comparable or lower level (B1, B3, B5, B6 and B12). After the dietary intervention, only B1 and B9 were at a clearly lower level (a trend of p = 0.093 and p = 0.085). A properly balanced reduction diet with reduced GI improves the supply of vitamins in women with PCOS. An additional recommendation should be the additional supplementation of B1, niacinamide and the combination of folates with inositol. The level of vitamin C in the plasma may not be a good marker of its supply in the PCOS group.
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Application of Machine Learning to Predict Dietary Lapses During Weight Loss.
Goldstein, SP, Zhang, F, Thomas, JG, Butryn, ML, Herbert, JD, Forman, EM
Journal of diabetes science and technology. 2018;(5):1045-1052
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Abstract
BACKGROUND Individuals who adhere to dietary guidelines provided during weight loss interventions tend to be more successful with weight control. Any deviation from dietary guidelines can be referred to as a "lapse." There is a growing body of research showing that lapses are predictable using a variety of physiological, environmental, and psychological indicators. With recent technological advancements, it may be possible to assess these triggers and predict dietary lapses in real time. The current study sought to use machine learning techniques to predict lapses and evaluate the utility of combining both group- and individual-level data to enhance lapse prediction. METHODS The current study trained and tested a machine learning algorithm capable of predicting dietary lapses from a behavioral weight loss program among adults with overweight/obesity (n = 12). Participants were asked to follow a weight control diet for 6 weeks and complete ecological momentary assessment (EMA; repeated brief surveys delivered via smartphone) regarding dietary lapses and relevant triggers. RESULTS WEKA decision trees were used to predict lapses with an accuracy of 0.72 for the group of participants. However, generalization of the group algorithm to each individual was poor, and as such, group- and individual-level data were combined to improve prediction. The findings suggest that 4 weeks of individual data collection is recommended to attain optimal model performance. CONCLUSIONS The predictive algorithm could be utilized to provide in-the-moment interventions to prevent dietary lapses and therefore enhance weight losses. Furthermore, methods in the current study could be translated to other types of health behavior lapses.
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HIV infection does not prevent the metabolic benefits of diet-induced weight loss in women with obesity.
Reeds, DN, Pietka, TA, Yarasheski, KE, Cade, WT, Patterson, BW, Okunade, A, Abumrad, NA, Klein, S
Obesity (Silver Spring, Md.). 2017;(4):682-688
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Abstract
OBJECTIVE To test the hypothesis that HIV infection impairs the beneficial effects of weight loss on insulin sensitivity, adipose tissue inflammation, and endoplasmic reticulum (ER) stress. METHODS A prospective clinical trial evaluated the effects of moderate diet-induced weight loss on body composition, metabolic function, and adipose tissue biology in women with obesity who were HIV-seronegative (HIV-) or HIV-positive (HIV+). Body composition, multiorgan insulin sensitivity (assessed by using a two-stage hyperinsulinemic-euglycemic clamp procedure with stable isotopically labeled tracer infusions), and adipose tissue expression of markers of inflammation, autophagy, and ER stress were evaluated in 8 HIV- and 20 HIV+ women with obesity before and after diet-induced weight loss of 6% to 8%. RESULTS Although weight loss was not different between groups (∼7.5%), the decrease in fat-free mass was greater in HIV+ than HIV- subjects (-4.4 ± 0.7% vs. -1.7 ± 1.0%, P < 0.05). Weight loss improved insulin sensitivity in adipose tissue (suppression of palmitate rate of appearance [Ra]), liver (suppression of glucose Ra), and muscle (glucose disposal) similarly in both groups. Weight loss did not affect adipose tissue expression of markers of inflammation or ER stress in either group. CONCLUSIONS Moderate diet-induced weight loss improves multiorgan insulin sensitivity in HIV+ women to the same extent as women who are HIV-. However, weight loss causes a greater decline in fat-free mass in HIV+ than HIV- women.
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A Potential Tool for Clinicians; Evaluating a Computer-Led Dietary Assessment Method in Overweight and Obese Women during Weight Loss.
Widaman, AM, Keim, NL, Burnett, DJ, Miller, B, Witbracht, MG, Widaman, KF, Laugero, KD
Nutrients. 2017;(3)
Abstract
Many Americans are attempting to lose weight with the help of healthcare professionals. Clinicians can improve weight loss results by using technology. Accurate dietary assessment is crucial to effective weight loss. The aim of this study was to validate a computer-led dietary assessment method in overweight/obese women. Known dietary intake was compared to Automated Self-Administered 24-h recall (ASA24) reported intake in women (n = 45), 19-50 years, with body mass index of 27-39.9 kg/m². Participants received nutrition education and reduced body weight by 4%-10%. Participants completed one unannounced dietary recall and their responses were compared to actual intake. Accuracy of the recall and characteristics of respondent error were measured using linear and logistic regression. Energy was underreported by 5% with no difference for most nutrients except carbohydrates, vitamin B12, vitamin C, selenium, calcium and vitamin D (p = 0.002, p < 0.0001, p = 0.022, p = 0.010, p = 0.008 and p = 0.001 respectively). Overall, ASA24 is a valid dietary assessment tool in overweight/obese women participating in a weight loss program. The automated features eliminate the need for clinicians to be trained, to administer, or to analyze dietary intake. Computer-led dietary assessment tools should be considered as part of clinician-supervised weight loss programs.
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Significant Improvement Selected Mediators of Inflammation in Phenotypes of Women with PCOS after Reduction and Low GI Diet.
Szczuko, M, Zapałowska-Chwyć, M, Maciejewska, D, Drozd, A, Starczewski, A, Stachowska, E
Mediators of inflammation. 2017;:5489523
Abstract
Many researchers suggest an increased risk of atherosclerosis in women with polycystic ovary syndrome. In the available literature, there are no studies on the mediators of inflammation in women with PCOS, especially after dietary intervention. Eicosanoids (HETE and HODE) were compared between the biochemical phenotypes of women with PCOS (normal and high androgens) and after the 3-month reduction diet. Eicosanoid profiles (9(S)-HODE, 13(S)-HODE, 5(S)-HETE, 12(S)-HETE, 15(S)-HETE, 5(S)-oxoETE, 16(R)-HETE, 16(S)-HETE and 5(S), 6(R)-lipoxin A4, 5(S), 6(R), 15(R)-lipoxin A4) were extracted from 0.5 ml of plasma using solid-phase extraction RP-18 SPE columns. The HPLC separations were performed on a 1260 liquid chromatograph. No significant differences were found in the concentration of analysed eicosanoids in phenotypes of women with PCOS. These women, however, have significantly lower concentration of inflammatory mediators than potentially healthy women from the control group. Dietary intervention leads to a significant (p < 0.01) increase in the synthesis of proinflammatory mediators, reaching similar levels as in the control group. The development of inflammatory reaction in both phenotypes of women with PCOS is similar. The pathways for synthesis of proinflammatory mediators in women with PCOS are dormant, but can be stimulated through a reduction diet. Three-month period of lifestyle change may be too short to stimulate the pathways inhibiting inflammatory process.
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The Effect of Casein Protein Prior to Sleep on Fat Metabolism in Obese Men.
Kinsey, AW, Cappadona, SR, Panton, LB, Allman, BR, Contreras, RJ, Hickner, RC, Ormsbee, MJ
Nutrients. 2016;(8)
Abstract
We have previously shown that ingesting protein at night before sleep is either beneficial or non-detrimental to metabolism, health, and body composition in obese women. However, the overnight protein-induced lipolytic actions and mechanism for improved metabolism and body composition have not been fully established. Therefore, in a crossover design, twelve obese men (age, 27.0 ± 2.2 years) were randomly assigned to ingest (within 30 min of sleep) casein protein (CAS, 120 kcal) or a non-nutritive placebo (PLA) before going to sleep. Markers of fat metabolism (lipolysis, substrate utilization, growth hormone), insulin, glucose, resting energy expenditure (REE), and appetite (questionnaire and ghrelin) were measured. During sleep and the next morning, interstitial glycerol from the subcutaneous abdominal adipose tissue (SCAAT) was measured using microdialysis. There were no differences in SCAAT glycerol (overnight: CAS, 177.4 ± 26.7; PLA, 183.8 ± 20.2 μmol/L; morning: CAS, 171.6 ± 19.1; PLA, 161.5 ± 18.6 μmol/L), substrate utilization, REE, or any blood markers between CAS and PLA. Desire to eat was greater for CAS compared to baseline (p = 0.03), but not different from PLA (baseline: 39 ± 6, CAS: 62 ± 8, PLA: 55 ± 5 mm). CAS consumption before sleep did not affect fat or glucose metabolism, REE, or suppress appetite in hyperinsulemic obese men. CAS may be consumed before sleep without impeding overnight or morning fat metabolism in young, obese men.
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Investigation into the acute effects of total and partial energy restriction on postprandial metabolism among overweight/obese participants.
Antoni, R, Johnston, KL, Collins, AL, Robertson, MD
The British journal of nutrition. 2016;(6):951-9
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The intermittent energy restriction (IER) approach to weight loss involves short periods of substantial (75-100 %) energy restriction (ER) interspersed with normal eating. This study aimed to characterise the early metabolic response to these varying degrees of ER, which occurs acutely and prior to weight loss. Ten (three female) healthy, overweight/obese participants (36 (SEM 5) years; 29·0 (sem 1·1) kg/m2) took part in this acute three-way cross-over study. Participants completed three 1-d dietary interventions in a randomised order with a 1-week washout period: isoenergetic intake, partial 75 % ER and total 100 % ER. Fasting and postprandial (6-h) metabolic responses to a liquid test meal were assessed the following morning via serial blood sampling and indirect calorimetry. Food intake was also recorded for two subsequent days of ad libitum intake. Relative to the isoenergetic control, postprandial glucose responses were increased following total ER (+142 %; P=0·015) and to a lesser extent after partial ER (+76 %; P=0·051). There was also a delay in the glucose time to peak after total ER only (P=0·024). Both total and partial ER interventions produced comparable reductions in postprandial TAG responses (-75 and -59 %, respectively; both P<0·05) and 3-d energy intake deficits of approximately 30 % (both P=0·015). Resting and meal-induced thermogenesis were not significantly affected by either ER intervention. In conclusion, our data demonstrate the ability of substantial ER to acutely alter postprandial glucose-lipid metabolism (with partial ER producing the more favourable overall response), as well as incomplete energy-intake compensation amongst overweight/obese participants. Further investigations are required to establish how metabolism adapts over time to the repeated perturbations experienced during IER, as well as the implications for long-term health.
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Weight gain since menopause and its associations with weight loss maintenance in obese postmenopausal women.
Sénéchal, M, Arguin, H, Bouchard, DR, Carpentier, AC, Ardilouze, JL, Dionne, IJ, Brochu, M
Clinical interventions in aging. 2011;:221-5
Abstract
OBJECTIVE To examine the association between weight gain since menopause and weight regain after a weight loss program. METHODS Participants were 19 obese women who participated in a 15-week weight loss program and a 12-month follow-up. Main outcomes were: body composition, resting metabolic rate, energy intake, energy expenditure, and weight regain at follow-up. RESULTS All body composition measures significantly decreased after intervention (all P ≤ 0.01) while all measures of fatness increased significantly after the 12-month follow-up (P ≤ 0.01). Body weight gain since menopause was associated with body weight regain (r = 0.65; P = 0.003) after follow-up even after adjustment for confounders. CONCLUSION Weight gain since menopause is associated with body weight regain following the weight loss program. Therefore, weight gain since menopause should be considered as a factor influencing weight loss maintenance in older women.
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High-protein, reduced-carbohydrate weight-loss diets promote metabolite profiles likely to be detrimental to colonic health.
Russell, WR, Gratz, SW, Duncan, SH, Holtrop, G, Ince, J, Scobbie, L, Duncan, G, Johnstone, AM, Lobley, GE, Wallace, RJ, et al
The American journal of clinical nutrition. 2011;(5):1062-72
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BACKGROUND Diets that are high in protein but reduced in carbohydrate contents provide a common approach for achieving weight loss in obese humans. However, the effect of such diets on microbiota-derived metabolites that influence colonic health has not been established. OBJECTIVE We designed this study to assess the effect of diets with reduced carbohydrate and increased protein contents on metabolites considered to influence long-term colonic health, in particular the risk of colorectal disease. DESIGN We provided 17 obese men with a defined weight-maintenance diet (85 g protein, 116 g fat, and 360 g carbohydrate/d) for 7 d followed by 4 wk each of a high-protein and moderate-carbohydrate (HPMC; 139 g protein, 82 g fat, and 181 g carbohydrate/d) diet and a high-protein and low-carbohydrate (HPLC; 137 g protein, 143 g fat, and 22 g carbohydrate/d) diet in a crossover design. Fecal samples were analyzed to determine concentrations of phenolic metabolites, short-chain fatty acids, and nitrogenous compounds of dietary and microbial origin. RESULTS Compared with the maintenance diet, the HPMC and HPLC diets resulted in increased proportions of branched-chain fatty acids and concentrations of phenylacetic acid and N-nitroso compounds. The HPLC diet also decreased the proportion of butyrate in fecal short-chain fatty acid concentrations, which was concomitant with a reduction in the Roseburia/Eubacterium rectale group of bacteria, and greatly reduced concentrations of fiber-derived, antioxidant phenolic acids such as ferulate and its derivatives. CONCLUSIONS After 4 wk, weight-loss diets that were high in protein but reduced in total carbohydrates and fiber resulted in a significant decrease in fecal cancer-protective metabolites and increased concentrations of hazardous metabolites. Long-term adherence to such diets may increase risk of colonic disease.