Tag: weight management

Categories : Diet and Nutrition GastrointestinalTags :

Ketogenic Diet Reduces Friendly Gut Bacteria and Raises Cholesterol Levels

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A study from the University of Bath reveals that ketogenic low-carbohydrate diets can increase cholesterol levels and reduce beneficial gut bacteria, specifically Bifidobacterium.

Published in Cell Reports Medicine, the research from the Centre for Nutrition, Exercise, and Metabolism involved 53 healthy adults for up to 12 weeks. Participants followed either a moderate sugar diet (control), a low-sugar diet (less than 5% of calories from sugar), or a ketogenic (keto) low-carbohydrate diet (less than 8% of calories from carbohydrates).

Key findings include:

•Increased Cholesterol: The keto diet raised cholesterol levels, particularly in small and medium sized LDL particles. The diet increased apolipoprotein B (apoB), which causes plaque buildup in arteries. In contrast, the low-sugar diet significantly reduced cholesterol in LDL particles.

•Reduced Favourable Gut Bacteria: The keto diet altered gut microbiome composition, notably decreasing Bifidobacteria, beneficial bacteria often found in probiotics. This bacteria has wide ranging benefits: producing b vitamins, inhibiting pathogens and harmful bacteria and lowering cholesterol. Sugar restriction did not significantly impact the gut microbiome composition.

•Glucose Tolerance: The keto diet reduced glucose tolerance, meaning the adults’ bodies became less efficient at handling carbohydrates.

•Both Diets Resulted In Fat Loss: Keto Diet resulted in an average of 2.9kg fat mass loss per person, whilst the sugar restricted diet followed with an average 2.1kg fat mass loss per person at 12 weeks.

•Metabolism: Researchers also noticed that the keto diet caused significant changes in lipid metabolism and muscle energy use, shifting the body’s fuel preference from glucose to fats.

•Physical Activity Levels: Both sugar restriction and keto diets achieved fat loss without changing physical activity levels. Previous studies from the Centre for Nutrition, Exercise and Metabolism have shown that skipping breakfast or intermittent fasting cause reductions in physical activity.

Lead researcher Dr. Aaron Hengist highlighted the concerning cholesterol findings:

“Despite reducing fat mass, the ketogenic diet increased the levels of unfavourable fats in the blood of our participants, which, if sustained over years, could have long-term health implications such as increased risk of heart disease and stroke.”

Dr. Russell Davies, who led the microbiome research, explained the impact on gut health:

“Dietary fibre is essential for the survival of beneficial gut bacteria like Bifidobacteria. The ketogenic diet reduced fibre intake to around 15 grams per day, half the NHS recommended intake. This reduction in Bifidobacteria might contribute to significant long-term health consequences such as an increased risk of digestive disorders like irritable bowel disease, increased risk of intestinal infection and a weakened immune function.”

Professor Javier Gonzalez, who oversaw the research, commented on the glucose findings:

“The ketogenic diet reduced fasting glucose levels but also reduced the body’s ability to handle carbs from a meal. By measuring proteins in muscle samples taken from participants’ legs, we think this is probably an adaptive response to eating less carbohydrates day-to-day and reflects insulin resistance to storing carbs in muscle. This insulin resistance is not necessarily a bad thing if people are following a ketogenic diet, but if these changes persist when people switch back to a higher carbohydrate diet it could increase the risk of developing type 2 diabetes in the long-term”

In light of this new research, the academics conclude that if you’re considering a diet, a low sugar one will be better for most people. More work is needed to understand how individuals may benefit from each type of diet. The government recommends that free sugars (those added to food or drink or found naturally in honey, syrups, fruit juices and smoothies) should be restricted to less than 5% of total energy intake. Professor Dylan Thompson, who also oversaw the work, said:

“The ketogenic diet is effective for fat loss, but it comes with varied metabolic and microbiome effects that may not suit everyone. In contrast, sugar restriction supports government guidelines for reducing free sugar intake, promoting fat loss without apparent negative health impacts.”

Source: University of Bath

Categories : Dermatology Diet and NutritionTags :

UV Exposure Increases Appetite but Suppresses Weight Gain

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In a novel study, a team of dermatologists evaluated the effect of ultraviolet (UV) exposure on appetite and weight regulation. They found that UV exposure raises norepinephrine levels, decreases leptin levels, and induces the browning of subcutaneous fat, thereby increasing energy expenditure. These results potentially pave the way for new approaches to prevent and treat obesity and metabolic disorders. Their findings appear in the Journal of Investigative Dermatology, published by Elsevier.

Co-first authors Qing-Ling Quan, MD, PhD, and Eun Ju Kim, PhD, Department of Dermatology, Seoul National University Hospital, explained, “Recent evidence has suggested that UV exposure limits body weight gain in mouse models of obesity. Subcutaneous fat is a critical organ in regulating energy homeostasis. Alongside previous studies on the effects of UV exposure on obesity and metabolic disorders, our team was inspired by our prior discovery that, although UV rays do not directly reach subcutaneous fat when exposed to the skin, they can regulate the metabolism of subcutaneous fat. This led us to hypothesise that skin exposure to UV rays could play a significant role in systemic energy homeostasis, prompting this research.”

Investigators discovered that when exposed to UV radiation consistently, mice fed a normal diet and those on a high-fat diet exhibited increased appetite due to a decrease in leptin, a key hormone in appetite regulation. But there was no weight increase – they found that UV radiation inhibits weight gain by enhancing secretion of the neurotransmitter norepinephrine, which not only decreases leptin but also increases energy expenditure through the “browning” of subcutaneous fat.

The increased energy intake, driven by heightened appetite, is converted to heat and burned before it can accumulate in subcutaneous fat, thus preventing weight gain.

This research provides new insights into the impact of UV exposure on appetite and weight regulation, opening possibilities for novel approaches in the prevention and treatment of obesity and metabolic disorders. Specifically, uncovering the mechanism by which UV radiation prevents weight gain could offer new approaches to dietary regulation and weight loss, providing innovative insights into health and obesity management that could positively impact human health.

Lead investigator Jin Ho Chung, MD, PhD, Department of Dermatology, Seoul National University Hospital, Seoul National University College of Medicine, explained, “This study elucidates the mechanism by which UV exposure can increase appetite while inhibiting weight gain. These findings contribute significantly to understanding the effects of UV radiation on energy metabolism and homeostasis and open new avenues for exploring prevention and treatment strategies for obesity and metabolic disorders. Notably, the fact that UV radiation lowers leptin levels and increases norepinephrine, thereby promoting the browning of subcutaneous fat and increasing energy expenditure, provides a groundbreaking clue for the development of obesity treatment strategies. This research demonstrates that UV exposure not only affects the skin but also plays a deep role in our body’s energy metabolism and homeostasis processes. However, further research is needed on the long-term effects and safety of UV exposure, and there should be significant interest in developing new therapeutic approaches that utilise the efficacy of UV radiation.”

However, as co-corresponding author Dong Hun Lee, MD, PhD, Institute of Human-Environment Interface Biology, Seoul National University, noted, “Because UV exposure can accelerate skin aging and promote skin cancer, it is advisable to minimise UV exposure and protect the skin with sunscreen. Thus, our research team plans to conduct follow-up studies to develop new strategies that could mimic the effects of UV radiation for obesity and metabolic regulation.”

Source: Elsevier

Categories : Metabolic DisordersTags :

Significant Gaps between Obesity Science and Patient Care

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As research continues to produce evidence about the underlying causes of obesity and optimal strategies to treat and manage obesity have evolved, there are disparities in application of the latest scientific advances in the clinical care for people with obesity. Widespread adoption of current findings, consistency of care and expertise in obesity care varies by health care professional and institution. These findings are detailed in a new American Heart Association scientific statement, “Implementation of Obesity Science Into Clinical Practice,” published in the journal Circulation.

“Obesity is undeniably a critical public health concern in the U.S. and around the world, affecting nearly all populations and straining our health care systems,” said Deepika Laddu, Ph.D., FAHA, chair of the statement writing committee and a senior research scientist at Arbor Research Collaborative for Health in Ann Arbor, Michigan. “As a major risk factor for heart disease, obesity has significantly hindered progress in reducing heart disease rates. Despite advancements in understanding the complexities of obesity and newer treatment options, major gaps remain between obesity research and real-world implementation in clinical practice.”

Studies show intensive lifestyle therapy is considerably more effective for weight loss than brief advice from a health care professional. However, general educational information is offered more frequently by health professionals rather than referrals to classes, programs or tangible resources for lifestyle changes. One study revealed that only 16% of health care professionals had working knowledge about evidence-based lifestyle treatments for obesity, including diet and nutrition, physical activity and intensive behavioral therapy referral. Other barriers to addressing weight loss are exacerbated by socioeconomic and racial or ethnic inequities. People of diverse races and ethnicities and people who are covered by Medicare or Medicaid are less likely to be referred to weight management programs or to have them covered by insurance.

For about 30 years, the prevalence of obesity in the US and around the world has been escalating. Recent estimates indicate more than 40% of US adults ages 20 and older are living with obesity, according to the US Centers for Disease Control and Prevention.

Research has led experts to unlock the multifactorial causes of obesity, including sociological and physiological determinants of health. Treatments for obesity have also evolved with more strategies for lifestyle modifications, medication therapy and bariatric surgery – but each treatment approach comes with challenges.

“While significant strides have been made in advancing the science to help us understand obesity, there remains a considerable gap between what we know and what happens in the doctor’s office,” said Laddu. “Health care professionals and health care systems need to find better ways to put what we know about obesity into action so more people can get the right support and treatment. Adopting new technologies and telemedicine, making referrals to community-based weight management programs to encourage behavioural change, providing social support and increasing reach and access to treatments are just some of the promising methods we could implement to unlock successful, evidence-based obesity care.”

Weight loss medications

Glucagon-like peptide-1 (GLP-1) agonists, such as high-dose semaglutide and tirzepatide, are the most recently FDA-approved medications for long-term weight management, and both are associated with an average weight loss of more than 10% at six months in clinical studies. However, despite half of adults in the U.S. meeting the BMI criteria for obesity and being eligible for these medications, a small proportion of this population is currently taking them.

Weight loss surgery

In the decades since bariatric (weight loss) surgery was first introduced as an option for people with severe obesity, there have been advances in the expertise and safety of the procedures, as well as an increased understanding of the health benefits that often result after bariatric surgery. A comprehensive review of studies focused on weight loss surgeries showed that patients who underwent bariatric surgery had lower risks of cardiovascular disease and decreased risks for multiple other obesity-associated conditions, including Type 2 diabetes and high blood pressure. One challenge facing health care professionals is ensuring that the populations with the greatest needs have access to bariatric surgery in terms of costs, resources and social support.

The statement describes strategies that both address these challenges and improve how obesity-based research is incorporated into clinical care. The statement also identifies the need to develop solutions across populations in order to manage obesity at the community level. Potential improved public health policies and future research to expand patient care models and optimize the delivery and sustainability of equitable obesity-related care are suggested.

Specific approaches are highlighted in the statement to help bridge the gap between the science about obesity and clinical care, such as:

  • To reach and successfully impact populations in need, health care professionals may consider how social determinants of health, including insurance type, household income, race and ethnicity, environment, health literacy, access to health-promoting resources and social supports all influence the likelihood of successful patient treatment.
  • Education for health care professionals explaining the complex origins and clinical consequences of obesity is discussed. Such training should emphasize information about diagnosis, prevention and treatment of obesity. Despite the high prevalence of obesity around the world, there is a lack of education programs centered on obesity for medical professionals.
  • Further evaluation of health policy changes that health care systems and insurance plans can implement and scale in order to make obesity treatment affordable for patients, especially those at high risk for adverse outcomes such as cardiovascular disease.
  • A framework for delivering obesity care into clinical practice settings is reviewed, as well as efforts by some professional societies for developing interventions that make obesity treatment more accessible.

“The statement emphasises the importance of a comprehensive approach across different levels of health care delivery and public policy, along with the adoption of feasible, evidence-based strategies in clinical settings,” said Laddu. “It also underscores the need for future research and policy changes to improve current patient care models and ensure equitable access to obesity-related care for people in underrepresented groups.”

The scientific statement also provides possible solutions for how to help people in their day-to-day lives, including interventions with digital technology and access through telemedicine. However, more research is needed in obesity science and treatment. Limited understanding of the cost-effectiveness of obesity prevention and the long-term health outcomes for established therapies has hindered the implementation of obesity science into clinical settings. Cross-collaborative obesity science research between stakeholders and health economists may serve as the bridge to developing and scaling cost-effective prevention programs.

Source: American Heart Association

Categories : Mental Health Metabolic DisordersTags :

Feeling Depressed Linked to Short-term Increase in Bodyweight

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Increases in symptoms of depression are associated with a subsequent increase in bodyweight when measured one month later, new research from the University of Cambridge has found.

The study, published in PLOS ONE, found that the increase was only seen among people with overweight or obesity, but found no link between generally having greater symptoms of depression and higher bodyweight.

Research has suggested a connection between weight and mental health – with each potentially influencing the other – but the relationship is complex and remains poorly understood, particularly in relation to how changes in an individual’s mental health influence their bodyweight over time.

To help answer this question, researchers at Cambridge’s Medical Research Council (MRC) Epidemiology Unit examined data from over 2,000 adults living in Cambridgeshire, UK, who had been recruited to the Fenland COVID-19 Study.

Participants completed digital questionnaires on mental wellbeing and bodyweight every month for up to nine months during the COVID-19 pandemic (August 2020 – April 2021) using a mobile app developed by Huma Therapeutics Limited.

Questions assessed an individual’s symptoms of depression, anxiety and perceived stress.

A higher score indicated greater severity, with the maximum possible scores being 24 for depression, 21 for anxiety and 40 for stress.

The team then used statistical modelling to explore whether having poorer mental wellbeing than usual was related to changes in bodyweight one month later.

The researchers found that for every increment increase in an individual’s usual score for depressive symptoms, their subsequent weight one month later increased by 45g.

This may seem small but would mean, for example, that in an individual whose depressive symptoms score rose from five to 10 (equal to an increase from ‘mild’ to ‘moderate’ depressive symptoms) it would relate to an average weight gain of 225g (0.225kg).

This effect was only observed in those individuals with overweight (defined as BMI 25-29.9kg/m2) or with obesity (BMI of over 30kg/m2). Individuals with overweight had on average an increase of 52g for each increment point increase from their usual depressive symptoms score and for those with obesity the comparable weight gain was 71g.

The effect was not seen in those individuals with a healthy weight.

First author Dr Julia Mueller from the MRC Epidemiology Unit said: “Overall, this suggests that individuals with overweight or obesity are more vulnerable to weight gain in response to feeling more depressed. Although the weight gain was relatively small, even small weight changes occurring over short periods of time can lead to larger weight changes in the long-term, particularly among those with overweight and obesity.

“People with a high BMI are already at greater risk from other health conditions, so this could potentially lead to a further deterioration in their health. Monitoring and addressing depressive symptoms in individuals with overweight or obesity could help prevent further weight gain and be beneficial to both their mental and physical health.”

The researchers found no evidence that perceived stress or anxiety were related to changes in weight.

Senior author Dr Kirsten Rennie from the MRC Epidemiology Unit said: “Apps on our phones make it possible for people to answer short questions at home more frequently and over extended periods of time, which provides much more information about their wellbeing. This technology could help us understand how changes in mental health influence behaviour among people with overweight or obesity and offer ways to develop timely interventions when needed.”

Although previous studies have suggested that poor mental health is both a cause and consequence of obesity, the research team found no evidence that weight predicted subsequent symptoms of depression.

The research was supported by the Medical Research Council.

The original text of this story is licensed under Creative Commons CC BY-SA 4.0.

Source: University of Cambridge.  Note: Content may be edited for style and length.

Journal Reference:

  1. Julia Mueller, Amy L. Ahern, Rebecca A. Jones, Stephen J. Sharp, Alan Davies, Arabella Zuckerman, Benjamin I. Perry, Golam M. Khandaker, Emanuella De Lucia Rolfe, Nick J. Wareham, Kirsten L. Rennie. The relationship of within-individual and between-individual variation in mental health with bodyweight: An exploratory longitudinal study. PLOS ONE, 2024; 19 (1): e0295117 DOI: 10.1371/journal.pone.0295117
Categories : Mental Health Surgeries & ProceduresTags :

No Mental Health Benefit from Bariatric Surgery for Young Patients

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Sleeve gastrectomy. Credit: Scientific Animations CC4.0

Young people who have had surgery for obesity do not improve their mental health despite significant and permanent weight loss. At the same time, bariatric surgery also increases the risk of early alcohol problems. This is according to the largest long-term study of young people who have undergone bariatric surgery, the results of which were published in Lancet Child and Adolescent Health.

The researchers studied mental health problems – before and after surgery – among all young people in Sweden who underwent bariatric surgery between 2007 and 2017. The study was conducted using register data, which enabled the scope of the study and facilitated comparisons with other groups in society. 

The study recruited 1554 adolescents (< 21 years) with severe obesity underwent bariatric surgery between 2007 and 2017, 1169 (75%) of whom were female. At time of surgery, the mean age was 19·0 years [SD 1·0], and the mean BMI was 43·7 kg/m2 (SD 5·5). They were matched with 15 540 adolescents from the general population.

It was found that young people who underwent surgery were more likely to have received treatment and medication for mental health problems already five years before the surgery.

“Although mental illness generally increases between the ages of 15 and 21, for this group the need for treatment increased faster than for young people in general”, says Kajsa Järvholm, Associate Professor of Psychology at Lund University.

Unfortunately, this pattern continued even after obesity surgery; the young people who had the surgery continued to have a greater need for mental health treatment than their peers. 

“Obesity surgery has very positive effects on weight, blood sugar and blood pressure control, but when it comes to mental health, it does not get better or worse after bariatric surgery”, says Martin Neovius, Professor of Clinical Epidemiology at Karolinska Institutet.

Additional findings from the new study include an increase in dependency diagnoses, particularly on alcohol, in the surgical group, both in comparison to pre-surgery and to young people in general.

The study is the largest long-term study in the world of young people who have had obesity surgery.

Source: Karolinska Institutet

Categories : Diet and NutritionTags :

People Struggle to Maintain Healthy Habits During the Festive Season

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The holiday season is a time for joy and celebration but many Americans admit the endless flurry of activities make it difficult to eat healthy, exercise and get adequate rest, according to a new survey from The Ohio State University Wexner Medical Center.

Two-thirds of those surveyed said they overindulge in food, nearly 45% said they take a break from exercise and more than half report feeling tired and have less time for themselves. Plus, a third admit they drink more alcohol during the holidays.

“Holiday travel, activities with friends and family, and trying to get a bunch of things done can cause people to lose track of their healthy habits,” said Barbara Bawer, MD, family medicine physician at Ohio State Wexner Medical Center and clinical assistant professor of family and community medicine at The Ohio State University College of Medicine.

“If one healthy habit drops off, it can affect other areas very quickly.”

To make it through the holiday season with healthy habits intact, Bawer suggests trying to stick to a normal routine as much as possible while giving yourself some grace.

“Once you’re out of a routine, which typically happens around the holidays, it’s really hard to get back on track partly because the motivation is no longer there,” said Bawer.

When the invitations start to pile up and decadent menus feels tempting, Bawer offers this advice, “Remember that it’s OK to say no.”

To keep healthy habits in check, try the following:

Diet: When it comes to sustaining healthy eating habits, it’s important to plan ahead. If you have an evening event, don’t starve yourself all day. Eat a high protein, low carb meal earlier in the day so you don’t overeat.

You can indulge with a favorite dish or dessert but it’s OK to say no to sampling every entrée or treat so you’re not eating excess calories at each event.

Exercise: Try to keep the same exercise schedule. If an obligation prevents you from going to a fitness centre or going for a run, be flexible. It’s OK to say no to the gym and consider doing an activity with family and friends that keeps you moving like going for a walk or playing a game of basketball.

Sleep: Go to sleep and wake up at your normal times, even when travelling. Limit the use of supplements like melatonin, as long-term use can disrupt healthy sleep-wake cycles. It’s OK to say no to some invitations if you feel like you’re going to overextend yourself.

Alcohol: People may drink more during the holidays but binge drinking is never a healthy choice. Binge drinking is when a man consumes five drinks or a woman consume four drinks in one setting. It’s OK to say no to excessive drinking. If you do drink, try to stick to the recommended two drinks for men or one drink for women. Avoid drinking on an empty stomach and drink plenty of water.

“Small, consistent changes and slowly adding to them can help you reach your health goals,” Bawer said.

Survey results and methodology This survey was conducted on behalf of The Ohio State University Wexner Medical Center by SSRS on its Opinion Panel Omnibus platform. The SSRS Opinion Panel Omnibus is a national, twice-per-month, probability-based survey. Data collection was conducted from Oct. 20-23 among a sample of 1 007 respondents. The survey was conducted via web (n = 977) and telephone (n = 30) and administered in English. The margin of error for total respondents is +/-3.6 percentage points at the 95% confidence level. All SSRS Opinion Panel Omnibus data are weighted to represent the target population of U.S. adults ages 18 or older.

Source: Ohio State University Wexner Medical Center

Categories : Diet and NutritionTags :

The Seasons Affect Appetite in Unexpected Ways

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Many people may feel that they are healthier in the summer: the sun is shining, they get plenty of vitamin D, and the days are long. However, recent research from the University of Copenhagen suggests that eating habits in winter may be better for metabolic health than eating habits in summer – at least in the case of mice. Researchers have examined the metabolism and weight of mice exposed to both ‘winter light’ and ‘summer light’.

“We found that even in non-seasonal animals, differences in light hours between summer and winter do cause differences in energy metabolism. In this case, body weight, fat mass and liver fat content,” says Lewin Small, who carried out the research while a postdoc at Novo Nordisk Foundation Center for Basic Metabolic Research at the University of Copenhagen. He adds:

“We found this mostly in mice exposed to winter light hours. These mice had less body weight gain and adiposity. They have more rhythmicity in the way they eat over a 24-hour period. And this then led to benefits in metabolic health.”

The study, published in Cell Metabolism, is the first of its kind to examine light hour’s influence on metabolism in mice, that are not considered seasonal animals as like humans they do not only breed in specific seasons. Animals breeding in specific seasons gain weight before the breeding season to save energy supplies.

Light hours impact metabolism

Lewin Small’s inspiration for initiating the study stemmed from the significant variation in daylight hours across various regions of the world.

“We study the influence of the time-of-day on aspects of metabolism such as exercise, obesity and diabetes. However, most studies that investigate this link do so assuming an equal length of day and night all year round,” says Lewin Small.

Therefore, they wanted to find out what the seasonal light differences meant for the metabolism. Most people in the world live with at least a two-hour difference in light between summer and winter.

“I come from Australia, and when I first moved to Denmark, I was not used to the huge difference in light between summer and winter and I was interested in how this might affect both circadian rhythms and metabolism,” says Lewin Small and adds:

“Therefore, we exposed laboratory mice to different light hours representing different seasons and measured markers of metabolic health and the circadian rhythms of these animals.”

Because the research was conducted using mice as the experimental subjects, it is not possible to assume that the same thing goes for humans.

“This is a proof of principle. Do differences in light hours affect energy metabolism? Yes, it does. Further studies in humans may find that altering our exposure to artificial light at night or natural light exposure over the year could be used to improve our metabolic health,” says Juleen Zierath, Professor at the Novo Nordisk Center for Basic Metabolism Research (CBMR) and senior author of the study.

Lewin Small adds that the findings are important to understand how eating patterns are affected by the light and seasons which might help us understand why some people gain more weight or if people gain more weight in a specific time of year.

“Differences in light between summer and winter could affect our hunger pathways and when we get hungry during the day,” he says.

Source: University of Copenhagen – The Faculty of Health and Medical Sciences

Categories : Ageing GenderTags :

Women Who Reach Their 90s Tend to Have Maintained Stable Weight

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Reaching the age of 90, 95 or 100, known as exceptional longevity, was more likely for women who maintained their body weight after age 60, according to a multi-institutional study led by University of California San Diego. Older women who sustained a stable weight were 1.2 to 2 times more likely to achieve longevity compared to those who lost 5% of their weight or more.

In this study published in the Journal of Gerontology: Medical Sciences, researchers investigated the link between weight changes later in life with exceptional longevity among 54 437 women who enrolled in the Women’s Health Initiative, a prospective study investigating causes of chronic diseases among postmenopausal women. Throughout the follow up period, 30 647 (56%) of the participants survived to the age of 90 or beyond.

Women who lost at least 5% weight were less likely to achieve longevity compared to those who achieved stable weight. For example, women who unintentionally lost weight were 51% less likely to survive to the age of 90. However, gaining 5% or more weight, compared to stable weight, was not associated with exceptional longevity.

“It is very common for older women in the United States to experience overweight or obesity with a body mass index range of 25 to 35. Our findings support stable weight as a goal for longevity in older women,” said first author Aladdin H. Shadyab, PhD, MPH, associate professor at UC San Diego.

“If aging women find themselves losing weight when they are not trying to lose weight, this could be a warning sign of ill health and a predictor of decreased longevity.”

The findings suggest that general recommendations for weight loss in older women may not help them live longer. Nevertheless, the authors caution that women should heed medical advice if moderate weight loss is recommended to improve their health or quality of life.

The data adds to research connecting weight change and mortality and is notably the first large study to examine weight change later in life and its relation to exceptional longevity.

Source: University of California – San Diego

Categories : Metabolic DisordersTags :

More Adolescents Are Underestimating Their Body Weight

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A study involving more than 745 000 adolescents from 41 countries across Europe and North America identified an increase in the amount of teenagers who underestimate their body weight. Tracking data from 2002 to 2018, the findings, published in Child and Adolescent Obesity, also show fewer adolescents overestimating their weight.

The team of international experts, who carried out the research, warn these shifting trends in body weight perception could reduce the effectiveness of public health interventions aimed at weight reduction in young people.

“During this impressionable age, body weight perception may influence a young person’s lifestyle choices, such as the amount and types of food they eat and their exercise habits,” says lead author Doctor Anouk Geraets, from the Department of Social Sciences, at the University of Luxembourg.

“So it’s concerning that we’re seeing a trend where fewer adolescents perceive themselves as being overweight — as this could undermine ongoing efforts to tackle increasing levels of obesity in this age group. Young people who underestimate their weight and therefore do not consider themselves to be overweight may not feel they need to lose excess weight and, as a result, they may make unhealthy lifestyle choices.”

A person’s perception of their body weight may not accurately reflect their actual weight. A discrepancy in body weight perception (BWP) may either be an underestimation (where actual weight is higher than perceived weight) or an overestimation (where actual weight is lower than perceived weight).

In the present study, the researchers examined survey data from 746,121 11-, 13- and 15-year-olds from 41 countries collected at four-yearly intervals between 2002 and 2018 in the International Health Behavior in School-Aged Children (HBSC), a WHO collaborative study.

The team modeled trends in BWP among adolescents across different countries over time, making adjustments for age, gender, and family socioeconomic status. They found:

  • Underestimation of weight status increased, and overestimation of weight status decreased over time among both sexes, with stronger trends for girls.
  • Correct weight perception increased over time among girls, while it decreased among boys.
  • Changes in correct weight perception, underestimation and overestimation of weight status differed across different countries — but these changes could not be explained by an increase in country-level overweight/obesity prevalence.

The authors speculated that the observed differences between girls and boys in BWP may support the idea there are sex differences in body ideals — and that these body ideals have changed over time. Notably, the increased underestimation and decreased overestimation of weight status over time for girls may be explained by the emergence of an athletic and strong body, as a new contemporary body ideal for both sexes.

“This study has clinical and public health implications. The increase in correct weight perception and the decrease in overestimation may have a positive effect on unnecessary and unhealthy weight loss behaviors among adolescents, while the increase in underestimation might indicate the need for interventions to strengthen correct weight perception,” says lead author Doctor Anouk Geraets.

“More research is now needed to understand the factors underlying these time trends and to develop effective public health interventions.”

While the large number of participating countries is a strength of the present study, but as these only included countries in Europe, the USA and Canada, the results can’t be generalised to other regions. In addition, although steps were taken to adjust the models for certain potential confounding factors, several other factors – such as body image, dieting, changing eating patterns, or migration – may also have played a role in the observed trends over time.

Source: Taylor & Francis Group

Categories : Metabolic DisordersTags :

Safety and Efficacy of Oral Semaglutide Shown in Clinical Trial Success

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Participants taking a daily 50mg dose of oral semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, lost more weight than those taking placebo, according to results announced by the manufacturer, Norvo Nordisk.

Novo Nordisk announced headline results from phase 3a trial in a statement. The OASIS 1 trial is a 68-week, efficacy and safety trial comparing once-daily oral semaglutide 50mg for weight management to placebo in 667 adults with obesity or overweight with one or more comorbidities. Participants also undertook lifestyle interventions.

When evaluating the effects of treatment if all people adhered to treatment from a mean baseline body weight of 105.4 kg, people treated with oral semaglutide 50mg achieved a statistically significant weight loss of 17.4% after 68 weeks compared to a 1.8% reduction with placebo. In addition, 89.2% of those who received oral semaglutide 50mg, reached a weight loss of 5% or more after 68 weeks, compared to 24.5% with placebo.

When applying the treatment policy estimand, people treated with oral semaglutide 50 mg achieved a superior weight loss of 15.1% compared to a reduction of 2.4% with placebo and 84.9% achieved a weight loss of 5% or more, compared to 25.8% with placebo.

“We are very pleased with the weight loss demonstrated by the once-daily oral formulation of semaglutide in obesity. The results show comparable weight loss as in the STEP 1 trial with injectable semaglutide 2.4mg in obesity branded as Wegovy®”, said Martin Holst Lange, executive vice president for Development at Novo Nordisk. ”The choice between a daily tablet or weekly injection for obesity has the potential to offer patients and healthcare providers the opportunity to choose what best suits individual treatment preferences”.

Oral semaglutide 50 mg also appeared be safe and was well tolerated, with the most common adverse events being mostly mild to moderate gastrointestinal ones consistent with the GLP-1 receptor agonist class. Gastrointestinal adverse events were most prominent during dose escalation.

Novo Nordisk expects to file for regulatory approval in the US and the EU in 2023. The global launch of oral semaglutide 50mg is contingent on portfolio prioritisations and manufacturing capacity.

Source: Novo Nordisk