Changes in Regional Adiposity and Cardio-Metabolic Function Following a Weight Loss Program with Sibutramine in Obese Men with Obstructive Sleep Apnea

PubMed Central

Phillips, Craig L.; Yee, Brendon J.; Trenell, Mike I.; Magnussen, John S.; Wang, David; Banerjee, Dev; Berend, Norbert; Grunstein, Ronald R.

2009-01-01

Background: Although obstructive sleep apnea (OSA) is strongly linked with obesity, both conditions have been associated with increased cardiovascular risk including glucose intolerance, dyslipidemia, and hypertension independent of one another. Weight loss is known to improve both cardiovascular risk and OSA severity. The aim of this study was to evaluate cardiovascular and metabolic changes, including compartment-specific fat loss in obese OSA subjects undergoing a weight loss program. Design: Observational study. Participants: 93 men with moderate-severe OSA. Interventions: 6-month open-label weight loss trial combining sibutramine (a serotonin and noradrenaline reuptake inhibitor) with a 600-kcal deficit diet and exercise. Measurements and Results: At baseline and following 6 months of weight loss, OSA was assessed together with CT-quantified intra-abdominal and liver fat and markers of metabolic and cardiovascular function. At 6 months, weight loss and improvements in OSA were accompanied by improved insulin resistance (HOMA), increased HDL cholesterol, and reduced total cholesterol/HDL ratio. There were also reductions in measures of visceral and subcutaneous abdominal fat and liver fat. Reductions in liver fat and sleep time spent below 90% oxyhemoglobin saturation partly explained the improvement in HOMA (R2 = 0.18). In contrast, arterial stiffness (aortic augmentation index), heart rate, blood pressure, and total cholesterol did not change. Conclusions: Weight loss with sibutramine was associated with improvements in metabolic and body composition risk factors but not blood pressure or arterial stiffness. Improved insulin resistance was partly associated with reductions in liver fat and hypoxemia associated with sleep apnea. Citation: Phillips CL; Yee BJ; Trenell MI; Magnussen JS; Wang D; Banerjee D; Berend N; Grunstein RR. Changes in regional adiposity and cardio-metabolic function following a weight loss program with sibutramine in obese men with obstructive sleep apnea. J Clin Sleep Med 2009;5(5):416-421. PMID:19961024

Effects of Visceral Fat Accumulation Awareness on a Web-Based Weight-Loss Program: Japanese Study of Visceral Adiposity and Lifestyle Information-Utilization and Evaluation (J-VALUE).

PubMed

Sakane, Naoki; Dohi, Seitaro; Sakata, Koichi; Hagiwara, Shin-Ichi; Morimoto, Toshihisa; Uchida, Takanobu; Katashima, Mitsuhiro; Yanagisawa, Yoshiko; Yasumasu, Takeshi; Study Group, J-Value

2013-01-01

A reduction of visceral fat is important for improvement of metabolic risk. This study was designed to compare the effects of a web-based program alone or together with measurement and self-awareness of accumulated visceral fat in Japanese workers. A new noninvasive device to measure visceral fat accumulation was introduced, and efficacy on weight-loss and improvement of healthy behaviors were examined. This study was conducted according to Helsinki declaration and approved by the ethical committee of Japan Hospital Organization, National Kyoto Hospital. Two-hundred and sixteen overweight and obese males with BMI of more than 23 participated from 8 healthcare offices of 3 Japanese private companies. Subjects were randomly allocated into control group, Web-based weight-loss program (Web), or Web + Visceral fat measurement group (Web + VFA). Eighty-one percent of participants completed the study. Reductions of body weight, waist circumference, and BMI were the largest in Web + VFA group, and the differences between groups were significant by ANOVA. Improvements of healthy behaviors were the largest in Web + VFA group, and the differences of healthy eating improvement scores between Web + VFA and control groups were significant. Our findings suggest that measurement and awareness of visceral fat are effective in weight reduction in overweight and obese males in the workplace.

Three experiments to support the design of lightweight comfortable vehicle seats.

PubMed

Vink, P; Franz, M; Kamp, I; Zenk, R

2012-01-01

Seats need to be more lightweight for airplanes, cars, busses and even trains to contribute to a better environment and to reduce energy consumption. However, a reduction in comfort due to weight reduction is not preferable, which opens a new area of research: improving comfort with a minimum of material or with lightweight materials and systems. In this paper three experiments are performed to test the effects of light weight seats and parts of a seat on comfort. The first experiment shows that a new developed light weight massage system improves comfort and reduces muscle activity. The second experiment shows that the automatic seat adjustment without motors improves the comfort as well. The third experiment showed that a light weight seat following closely the human body contour is experienced on many aspects in the same way as current more heavy seats. More research and models will be needed in this ergonomic field which needs more attention.

Aeroelastic Tailoring of the NASA Common Research Model via Novel Material and Structural Configurations

NASA Technical Reports Server (NTRS)

Jutte, Christine V.; Stanford, Bret K.; Wieseman, Carol D.; Moore, James B.

2014-01-01

This work explores the use of tow steered composite laminates, functionally graded metals (FGM), thickness distributions, and curvilinear rib/spar/stringer topologies for aeroelastic tailoring. Parameterized models of the Common Research Model (CRM) wing box have been developed for passive aeroelastic tailoring trade studies. Metrics of interest include the wing weight, the onset of dynamic flutter, and the static aeroelastic stresses. Compared to a baseline structure, the lowest aggregate static wing stresses could be obtained with tow steered skins (47% improvement), and many of these designs could reduce weight as well (up to 14%). For these structures, the trade-off between flutter speed and weight is generally strong, although one case showed both a 100% flutter improvement and a 3.5% weight reduction. Material grading showed no benefit in the skins, but moderate flutter speed improvements (with no weight or stress increase) could be obtained by grading the spars (4.8%) or ribs (3.2%), where the best flutter results were obtained by grading both thickness and material. For the topology work, large weight reductions were obtained by removing an inner spar, and performance was maintained by shifting stringers forward and/or using curvilinear ribs: 5.6% weight reduction, a 13.9% improvement in flutter speed, but a 3.0% increase in stress levels. Flutter resistance was also maintained using straightrotated ribs although the design had a 4.2% lower flutter speed than the curved ribs of similar weight and stress levels were higher. These results will guide the development of a future design optimization scheme established to exploit and combine the individual attributes of these technologies.

Reductions in Cardiovascular Risk After Bariatric Surgery

PubMed Central

Benraoune, Fethi; Litwin, Sheldon E.

2012-01-01

Purpose of review Obesity is commonly associated with multiple conditions imparting adverse cardiovascular risk including, hypertension, dyslipidemia and insulin resistance or diabetes. In addition, sleep disordered breathing, inflammation, left ventricular hypertrophy, left atrial enlargement and subclinical left ventricular systolic and diastolic dysfunction may collectively contribute to increased cardiovascular morbidity and mortality. This review will describe improvements in cardiovascular risk factors after bariatric surgery. Recent findings All of the cardiovascular risk factors listed above are improved or even resolved after bariatric surgery. Cardiac structure and function also have shown consistent improvement after surgically-induced weight loss. The amount of improvement in cardiac risk factors is generally proportional to the amount of weight lost. The degree of weight loss varies with different bariatric procedures. Based on the improvement in risk profiles, it has been predicted that progression of atherosclerosis could be slowed and the 10 year risk of cardiac events would decline by ~ 50% in patients undergoing weight loss surgery. In keeping with these predictions, 2 studies have demonstrated reductions in 10-year total and cardiovascular mortality of approximately 50% in patients who had bariatric surgery. Summary These encouraging data support the continued, and perhaps expanded use of surgical procedures to induce weight loss in severely obese patients. PMID:21934498

A meta-analysis of overall effects of weight loss interventions delivered via mobile phones and effect size differences according to delivery mode, personal contact, and intervention intensity and duration.

PubMed

Schippers, M; Adam, P C G; Smolenski, D J; Wong, H T H; de Wit, J B F

2017-04-01

Weight loss interventions are delivered through various mediums including, increasingly, mobile phones. This systematic review and meta-analysis assesses whether interventions delivered via mobile phones reduce body weight and which intervention characteristics are associated with efficacy. The study included randomised controlled trials assessing the efficacy of weight loss interventions delivered via mobile phones. A meta-analysis to test intervention efficacy was performed, and subgroup analyses were conducted to determine whether interventions' delivery mode(s), inclusion of personal contact, duration and interaction frequency improve efficacy. Pooled body weight reduction (d = -0.23; 95% confidence interval = -0.38, -0.08) was significant. Interventions delivered via other modes in addition to the mobile phone were associated with weight reduction. Personal contact and more frequent interactions in interventions were also associated with greater weight reduction. In conclusion, the current body of evidence shows that interventions delivered via mobile phones produce a modest reduction in body weight when combined with other delivery modes. Delivering interventions with frequent and personal interactions may in particular benefit weight loss results. © 2017 World Obesity Federation.

Heart rate recovery improves after weight loss in overweight and obese women with polycystic ovary syndrome.

PubMed

Thomson, Rebecca L; Buckley, Jonathan D; Noakes, Manny; Clifton, Peter M; Norman, Robert J; Brinkworth, Grant D

2010-03-01

To determine the effects of weight loss on heart rate recovery (HRR) in overweight women with polycystic ovary syndrome (PCOS). A 10-week prospective clinical intervention. Clinical research unit. Fifty-seven overweight and obese women with PCOS (age: 29.8 +/- 0.8 years; body mass index [BMI] 36.2 +/- 0.7 kg/m(2)). A dietary plan of 5-6 MJ/day ( approximately 30% energy restricted). Heart rate recovery (defined as the reduction in heart rate after 1 minute from peak heart rate after a graded treadmill test to exhaustion), weight, waist circumference, blood pressure, glucose, insulin, homeostasis model assessment of insulin resistance, and sex steroids before and after the intervention. The mean percentage of weight loss was (-6.7 +/- 0.4%). There were significant reductions in waist circumference (-6.9 +/- 0.6 cm), blood pressure (-4.9/-2.5 +/- 1.2/1.2 mm Hg), fasting insulin (-3.4 +/- 0.7 mU/L), fasting glucose (-0.17 +/- 0.05 mmol/L), homeostasis model assessment of insulin resistance (-0.43 +/- 0.09), T (-0.38 +/- 0.07 nmol/L), free androgen index (-2.86 +/- 0.58), and an increase in sex hormone-binding globulin [SHBG] (5.86 +/- 1.12 nmol/L). The HRR improved from 30.9 +/- 1.1 to 38.0 +/- 1.1 beats/min and that was related to the reduction in body weight (r = -0.34) and waist circumference (r = -0.27). Weight loss in overweight and obese women with PCOS is associated with improvements in HRR, which suggests improved autonomic function. This highlights the importance of weight loss to reduce the cardiovascular disease risk in these women. Crown Copyright 2010. Published by Elsevier Inc. All rights reserved.

Improvement of metabolism among obese breast cancer survivors in differing weight loss regimens.

PubMed

Jen, K-L Catherine; Djuric, Zora; DiLaura, Nora M; Buison, Anne; Redd, Jennifer N; Maranci, Vera; Hryniuk, William M

2004-02-01

To compare the efficacy of different weight loss regimens on body weight loss and metabolic improvement in breast cancer survivors. Forty-eight obese breast cancer survivors were randomly divided into four groups and were followed for 1 year: 1) the Control group (subjects did not receive specific nutrition counseling); 2) the Weight Watchers group (subjects were given free coupons to attend weekly Weight Watchers meetings); 3) the Individualized group (a registered dietitian provided one-on-one nutritional counseling); and 4) the Comprehensive group (subjects received individualized dietary counseling and free coupons for the weekly Weight Watchers meetings). At baseline and 3-, 6-, and 12-month data collection visits, a fasting blood sample was obtained for assays. A three-day dietary record was kept during the week before these visits and dietary intake was analyzed. Subjects in the three intervention groups lost weight (Control: 1.1 +/- 1.7 kg; Weight Watchers: -2.7 +/- 2.1 kg; Individualized: -8.0 +/- 1.9 kg; Comprehensive: -9.5 +/- 2.7 kg) and percentage body fat, but only the Individualized and Comprehensive groups had significant losses. Subjects in the Comprehensive group showed the most improvement in cholesterol levels and had reductions in blood leptin levels. Because insulin resistance and high blood leptin levels are associated with breast cancer, losing weight to improve these parameters may reduce the risk of recurrence. Only subjects in the Comprehensive group showed significant reductions in body weight and fat, energy intake, and leptin levels. For breast cancer survivors, different weight loss strategies should be considered to assist them in losing weight.

Rapid Weight Loss vs. Slow Weight Loss: Which is More Effective on Body Composition and Metabolic Risk Factors?

PubMed

Ashtary-Larky, Damoon; Ghanavati, Matin; Lamuchi-Deli, Nasrin; Payami, Seyedeh Arefeh; Alavi-Rad, Sara; Boustaninejad, Mehdi; Afrisham, Reza; Abbasnezhad, Amir; Alipour, Meysam

2017-07-01

Achieving weight loss (WL) in a short time regardless of its consequences has always been the focus of many obese and overweight people. In this study, anthropometric and metabolic effects of two diets for rapid and slow WL and their consequences were examined. Forty-two obese and overweight individuals were randomly divided to 2 groups; rapid WL (weight loss of at least 5% in 5 weeks) and slow WL (weight loss of at least 5% in 15 weeks). To compare the effects of the rate of WL in 2 groups, the same amount of was achieved with different durations. Anthropometric indices, lipid, and glycemic profiles, and systolic and diastolic blood pressures were evaluated before and after the intervention. Both protocols of rapid WL and slow WL caused reduction in waist circumference, hip circumference, total body water, body fat mass, lean body mass, and resting metabolic rate (RMR). Further reduction in waist circumference, hip circumference, fat mass, and percentage of body fat was observed in slow WL and decreased total body water, lean body mass, fat free mass, and RMR was observed in rapid WL. Improvement in lipid and glycemic profiles was observed in both groups. Reduction of low-density lipoprotein and fasting blood sugar, improvement of insulin resistance, and sensitivity were more significant in rapid WL in comparison to slow WL. Weight Loss regardless of its severity could improve anthropometric indicators, although body composition is more favorable following a slow WL. Both diets improved lipid and glycemic profiles. In this context, rapid WL was more effective. (IRCT2016010424699N2).

Leptin Is Required for Glucose Homeostasis after Roux-en-Y Gastric Bypass in Mice.

PubMed

Mokadem, Mohamad; Zechner, Juliet F; Uchida, Aki; Aguirre, Vincent

2015-01-01

Leptin, the protein product of the ob gene, increases energy expenditure and reduces food intake, thereby promoting weight reduction. Leptin also regulates glucose homeostasis and hepatic insulin sensitivity via hypothalamic proopiomelanocortin neurons in mice. Roux-en-Y gastric bypass (RYGB) induces weight loss that is substantial and sustained despite reducing plasma leptin levels. In addition, patients who fail to undergo diabetes remission after RYGB are hypoletinemic compared to those who do and to lean controls. We have previously demonstrated that the beneficial effects of RYGB in mice require the melanocortin-4 receptor, a downstream effector of leptin action. Based on these observations, we hypothesized that leptin is required for sustained weight reduction and improved glucose homeostasis observed after RYGB. To investigate this hypothesis, we performed RYGB or sham operations on leptin-deficient ob/ob mice maintained on regular chow. To investigate whether leptin is involved in post-RYGB weight maintenance, we challenged post-surgical mice with high fat diet. RYGB reduced total body weight, fat and lean mass and caused reduction in calorie intake in ob/ob mice. However, it failed to improve glucose tolerance, glucose-stimulated plasma insulin, insulin tolerance, and fasting plasma insulin. High fat diet eliminated the reduction in calorie intake observed after RYGB in ob/ob mice and promoted weight regain, although not to the same extent as in sham-operated mice. We conclude that leptin is required for the effects of RYGB on glucose homeostasis but not body weight or composition in mice. Our data also suggest that leptin may play a role in post-RYGB weight maintenance.

Changes in subcutaneous fat cell volume and insulin sensitivity after weight loss.

PubMed

Andersson, Daniel P; Eriksson Hogling, Daniel; Thorell, Anders; Toft, Eva; Qvisth, Veronica; Näslund, Erik; Thörne, Anders; Wirén, Mikael; Löfgren, Patrik; Hoffstedt, Johan; Dahlman, Ingrid; Mejhert, Niklas; Rydén, Mikael; Arner, Erik; Arner, Peter

2014-07-01

Large subcutaneous fat cells associate with insulin resistance and high risk of developing type 2 diabetes. We investigated if changes in fat cell volume and fat mass correlate with improvements in the metabolic risk profile after bariatric surgery in obese patients. Fat cell volume and number were measured in abdominal subcutaneous adipose tissue in 62 obese women before and 2 years after Roux-en-Y gastric bypass (RYGB). Regional body fat mass by dual-energy X-ray absorptiometry; insulin sensitivity by hyperinsulinemic-euglycemic clamp; and plasma glucose, insulin, and lipid profile were assessed. RYGB decreased body weight by 33%, which was accompanied by decreased adipocyte volume but not number. Fat mass in the measured regions decreased and all metabolic parameters were improved after RYGB (P < 0.0001). Whereas reduced subcutaneous fat cell size correlated strongly with improved insulin sensitivity (P = 0.0057), regional changes in fat mass did not, except for a weak correlation between changes in visceral fat mass and insulin sensitivity and triglycerides. The curve-linear relationship between fat cell size and fat mass was altered after weight loss (P = 0.03). After bariatric surgery in obese women, a reduction in subcutaneous fat cell volume associates more strongly with improvement of insulin sensitivity than fat mass reduction per se. An altered relationship between adipocyte size and fat mass may be important for improving insulin sensitivity after weight loss. Fat cell size reduction could constitute a target to improve insulin sensitivity. © 2014 by the American Diabetes Association.

HNF1A variant, energy-reduced diets and insulin resistance improvement during weight loss: The POUNDS Lost trial and DIRECT.

PubMed

Huang, Tao; Wang, Tiange; Heianza, Yoriko; Sun, Dianjianyi; Ivey, Kerry; Durst, Ronen; Schwarzfuchs, Dan; Stampfer, Meir J; Bray, George A; Sacks, Frank M; Shai, Iris; Qi, Lu

2018-06-01

To determine whether weight-loss diets varying in macronutrients modulate the genetic effect of hepatocyte nuclear factor 1α (HNF1A) rs7957197 on weight loss and improvement of insulin resistance. We analysed the interaction between HNF1A rs7957197 and weight-loss diets with regard to weight loss and insulin resistance improvement among 722 overweight/obese adults from a 2-year randomized weight-loss trial, the POUNDS Lost trial. The findings were replicated in another independent 2-year weight-loss trial, the Dietary Intervention Randomized Controlled Trial (DIRECT), in 280 overweight/obese adults. In the POUNDS Lost trial, we found that a high-fat diet significantly modified the genetic effect of HNF1A on weight loss and reduction in waist circumference (P for interaction = .006 and .005, respectively). Borderline significant interactions for fasting insulin and insulin resistance (P for interaction = .07 and .06, respectively) were observed. We replicated the results in DIRECT. Pooled results showed similar significant interactions with weight loss, waist circumference reduction, and improvement in fasting insulin and insulin resistance (P values for interaction = .001, .005, .02 and .03, respectively). Greater decreases in weight, waist circumference, fasting insulin level and insulin resistance were observed in participants with the T allele compared to those without the T allele in the high-fat diet group (P = .04, .03 and .01, respectively). Our replicable findings provide strong evidence that individuals with the HNF1A rs7957197 T allele might obtain more benefits in weight loss and improvement of insulin resistance by choosing a hypocaloric and high-fat diet. © 2018 John Wiley & Sons Ltd.

Designing for Cost

NASA Technical Reports Server (NTRS)

Dean, Edwin B.; Unal, Resit

1991-01-01

Designing for cost is a state of mind. Of course, a lot of technical knowledge is required and the use of appropriate tools will improve the process. Unfortunately, the extensive use of weight based cost estimating relationships has generated a perception in the aerospace community that the primary way to reduce cost is to reduce weight. Wrong! Based upon an approximation of an industry accepted formula, the PRICE H (tm) production-production equation, Dean demonstrated theoretically that the optimal trajectory for cost reduction is predominantly in the direction of system complexity reduction, not system weight reduction. Thus the phrase "keep it simple" is a primary state of mind required for reducing cost throughout the design process.

Body composition and power performance improved after weight reduction in male athletes without hampering hormonal balance.

PubMed

Huovinen, Heikki T; Hulmi, Juha J; Isolehto, Juha; Kyröläinen, Heikki; Puurtinen, Risto; Karila, Tuomo; Mackala, Krzysztof; Mero, Antti A

2015-01-01

The aim of this study was to investigate the effects of a 4-week weight reduction period with high protein and reduced carbohydrate intake on body composition, explosive power, speed, serum hormones, and acid-base balance in male track and field jumpers and sprinters. Eight participants were assigned to a high weight reduction group (HWR; energy restriction 750 kcal·d) and 7 to a low weight reduction group (LWR; energy restriction 300 kcal·d). Energy and carbohydrate intake decreased significantly (p ≤ 0.05) only in HWR by 740 ± 330 kcal·d and 130 ± 29 g·d, respectively. Furthermore, total body mass and fat mass decreased (p ≤ 0.05) only in HWR by 2.2 ± 1.0 kg and 1.7 ± 1.6 kg, respectively. Fat-free mass (FFM), serum testosterone, cortisol, and sex hormone-binding globulin did not change significantly. Ca ion and pH decreased (p ≤ 0.05) only in HWR (3.1 ± 2.8% and 0.8 ± 0.8%, respectively), whereas (Equation is included in full-text article.)declined (p ≤ 0.05) in both groups by 19.3 ± 6.2% in HWR and by 13.1 ± 8.5% in LWR. The countermovement jump and 20-m sprint time improved consistently (p ≤ 0.05) only in HWR, by 2.6 ± 2.5 cm and 0.04 ± 0.04 seconds, respectively. Finally, athletes with a fat percentage of 10% or more at the baseline were able to preserve FFM. In conclusion, altered acid-base balance but improved weight-bearing power performance was observed without negative consequences on serum hormones and FFM after a 4-week weight reduction of 0.5 kg·wk achieved by reduced carbohydrate but maintained high protein intake.

Management of obesity in non- insulin- dependent diabetes mellitus.

PubMed

Cheah, J S

1998-12-01

Obesity is common in non-insulin-dependent diabetes mellitus (NIDDM) patients; in Singapore in a cohort of 314 diabetics, 44.3% were overweight. Management of obesity in diabetics differs from that in non-diabetics in that it is more urgent; weight maintenance is more difficult and hypoglycaemic medication may cause weight changes. However, like in the non-diabetic, management of obesity in the diabetic requires a pragmatic and realistic approach. A team approach is required: the help of a nurse educator, a dietitian, behaviour modification therapist, exercise therapist and others are required. A detailed history, careful physical examination and relevant investigations are required to assess the severity of the diabetic state and to exclude an occasional underlying cause of the obesity in the obese NIDDM patient. Weight loss is urgent in the obese NIDDM patient, especially for those with android obesity. There must be a reduction in energy intake. Weight loss leads to an improvement in glucose tolerance and in insulin sensitivity, as well as to a reduction in lipid levels and to a fall in blood pressure in the hypertensive. Exercise is of limited short-term value measured in terms of weight reduction, except in the younger obese NIDDM patient; but it does allow improvement in overall metabolic control and, long-term, is critical for preferred weight maintenance. The biguanide, Metformin, is the hypoglycaemic drug of choice as it leads to consistent weight reduction. The sulphonylureas may cause weight gain. Insulin should be avoided where possible as it causes further weight gain. Other hypoglycaemic agents include Glucobay (alpha-glucosidase inhibitor) and Troglitazone (insulin sensitizer) which do not alter the weight. Orlistat (lipase inhibitor) is promising as it causes reduction of weight, blood glucose and lipid levels. Anti-obesity drugs (noradrenergic and serotonergic agents) have modest effects on weight reduction in the obese NIDDM patient; a widely-used preparation, Dexfenfluramine (Adifax), has been withdrawn because of side-effects. Surgery such as gastric plication is the last resort in treating the morbidly obese NIDDM patient. Against this background, the institution of life-long food and exercise habits which favour health, body composition and fat distribution are paramount in the prevention and minimization of expression of NIDDM. The discovery of leptin in 1994 has led to intense research into energy homeostasis in obesity; hopefully this will lead to better treatment of obesity in diabetics and non-diabetics.

Adaptive Trajectory Prediction Algorithm for Climbing Flights

NASA Technical Reports Server (NTRS)

Schultz, Charles Alexander; Thipphavong, David P.; Erzberger, Heinz

2012-01-01

Aircraft climb trajectories are difficult to predict, and large errors in these predictions reduce the potential operational benefits of some advanced features for NextGen. The algorithm described in this paper improves climb trajectory prediction accuracy by adjusting trajectory predictions based on observed track data. It utilizes rate-of-climb and airspeed measurements derived from position data to dynamically adjust the aircraft weight modeled for trajectory predictions. In simulations with weight uncertainty, the algorithm is able to adapt to within 3 percent of the actual gross weight within two minutes of the initial adaptation. The root-mean-square of altitude errors for five-minute predictions was reduced by 73 percent. Conflict detection performance also improved, with a 15 percent reduction in missed alerts and a 10 percent reduction in false alerts. In a simulation with climb speed capture intent and weight uncertainty, the algorithm improved climb trajectory prediction accuracy by up to 30 percent and conflict detection performance, reducing missed and false alerts by up to 10 percent.

Patient-reported quality of life in a randomized placebo-controlled trial of naltrexone/bupropion for obesity.

PubMed

Kolotkin, R L; Chen, S; Klassen, P; Gilder, K; Greenway, F L

2015-10-01

Weight loss is associated with improved quality of life in some, but not all, weight loss trials. We evaluated changes at 56 weeks in quality of life, measured by the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire, in a pooled analysis of patient-level data from four randomized controlled Phase 3 studies of naltrexone/bupropion (NB32 or Contrave®). The total number of subjects was 3362 (NB32 = 2043; placebo = 1319; mean body mass index = 36.3 kg m(2); mean age = 46). Improvements in IWQOL-Lite Total Score were greater in subjects treated with NB32 (11.9 points [SE 0.3]) vs. placebo (8.2 points [SE 0.3]; P < 0.001), corresponding to weight reductions of 7.0% (SE 0.2) and 2.3% (SE 0.2), respectively. Greater improvements were also observed for NB32 vs. placebo on all five subscale scores of the IWQOL-Lite. Fifty per cent of NB32-treated subjects achieved clinically meaningful improvements in IWQOL-Lite Total Score vs. 32.3% of placebo-treated subjects (odds ratio, 95% confidence interval; 2.09, 1.79-2.44). Subjects losing the most weight (≥ 15% of baseline weight) experienced the greatest improvement in IWQOL-Lite Total Score (19.3 points [SE 0.7] for NB32 and 18.7 points [SE 1.3] for placebo; P = 0.624). Improved quality of life was associated with weight reduction and was achieved in more subjects treated with NB32 than placebo. © 2015 World Obesity.

Effects of diet-induced moderate weight reduction on intrahepatic and intramyocellular triglycerides and glucose metabolism in obese subjects.

PubMed

Sato, Fumihiko; Tamura, Yoshifumi; Watada, Hirotaka; Kumashiro, Naoki; Igarashi, Yasuhiro; Uchino, Hiroshi; Maehara, Tadayuki; Kyogoku, Shinsuke; Sunayama, Satoshi; Sato, Hiroyuki; Hirose, Takahisa; Tanaka, Yasushi; Kawamori, Ryuzo

2007-08-01

Although moderate weight reduction is recommended as primary therapy of metabolic syndrome, little information is known regarding metabolic changes associated with moderate weight reduction in nondiabetic obese subjects. The aim of this study was to determine the effects of a moderate weight reduction program on intracellular lipid and glucose metabolism in muscle and liver. Data for 13 nondiabetic obese subjects were evaluated. Subjects were put on a 3-month mildly hypocaloric diet therapy (approximately 35 kcal/kg of ideal body weight). Intrahepatic lipid (IHL) and intramyocellular lipid were measured by using (1)H magnetic resonance spectroscopy. Peripheral insulin sensitivity and splanchnic glucose uptake were evaluated by euglycemic-hyperinsulinemic clamp with oral glucose load. Diet therapy for 3 months resulted in 6% reduction in body weight (from 99.9 +/- 7.3 to 93.8 +/- 6.6 kg, P < 0.0001). This change was accompanied by reduction of plasma glucose and insulin excursions during 75-g oral glucose tolerance tests, decrease in diastolic blood pressure, glycated hemoglobin, serum low-density lipoprotein cholesterol, and triglyceride. These changes were also accompanied by a decrease in IHL (from 12.9 to 8.2%, P < 0.01) and increase in splanchnic glucose uptake (from 13.5 to 35.0%, P < 0.03). On the other hand, the diet program did not affect intramyocellular lipid or glucose infusion rate during euglycemic hyperinsulinemic clamp. Our results suggest that moderate weight reduction in obese subjects decreased IHL and augmented splanchnic glucose uptake. This mechanism is at least in part involved in improvement of glucose metabolism by moderate weight reduction in obese subjects.

Short-term meal replacements followed by dietary macronutrient restriction enhance weight loss in polycystic ovary syndrome.

PubMed

Moran, Lisa J; Noakes, Manny; Clifton, Peter M; Wittert, Gary A; Williams, Gemma; Norman, Robert J

2006-07-01

Polycystic ovary syndrome (PCOS), a common condition in women, improves with weight loss. Meal replacements in short-term weight loss and strategies for weight maintenance have not been investigated in PCOS. We compared in overweight women with PCOS the effects of meal replacements in short-term weight-loss and longer-term carbohydrate- or fat-restriction strategies on weight maintenance and improvements in reproductive and metabolic variables. Overweight women with PCOS (n = 43; x +/- SD age: 32.1 +/- 5.2 y; weight: 96.1 +/- 18.4 kg) followed an 8-wk weight-loss regimen (2 meal replacements/d, 4904.4 +/- 127 kJ; phase 1) and then a 6-mo weight-maintenance carbohydrate- (<120 g/d) or fat- (<50 g/d) restriction regimen (phase 2). Thirty-four women completed phase 1, and 23 women completed phase 2; the proportion of dropouts was similar in the 2 groups. During phase 1, significant (P < 0.05) reductions in weight (5.6 +/- 2.4 kg), waist circumference (6.1 +/- 2.5 cm), body fat (4.1 +/- 2.2 kg), insulin (2.8 +/- 1.1 mU/L), total testosterone (0.3 +/- 0.7 nmol/L), and free androgen index (3.1 +/- 4.6) occurred; these changes were sustained during phase 2. No significant differences between diet groups were seen for any variables. At 6 mo, both approaches resulted in a net weight loss of 4.7 +/- 4.6 kg. Improvements in menstrual cyclicity occurred for 16 (57.1%) of 28 subjects. Meal replacements are an effective strategy for the short-term management of PCOS. Advice on moderate fat or carbohydrate restriction was equally effective in maintaining weight reduction and improving reproductive and metabolic variables.

Improved Function With Enhanced Protein Intake per Meal: A Pilot Study of Weight Reduction in Frail, Obese Older Adults.

PubMed

Porter Starr, Kathryn N; Pieper, Carl F; Orenduff, Melissa C; McDonald, Shelley R; McClure, Luisa B; Zhou, Run; Payne, Martha E; Bales, Connie W

2016-10-01

Obesity is a significant cause of functional limitations in older adults; yet, concerns that weight reduction could diminish muscle along with fat mass have impeded progress toward an intervention. Meal-based enhancement of protein intake could protect function and/or lean mass but has not been studied during geriatric obesity reduction. In this 6-month randomized controlled trial, 67 obese (body mass index ≥30kg/m(2)) older (≥60 years) adults with a Short Physical Performance Battery score of 4-10 were randomly assigned to a traditional (Control) weight loss regimen or one with higher protein intake (>30g) at each meal (Protein). All participants were prescribed a hypo-caloric diet, and weighed and provided dietary guidance weekly. Physical function (Short Physical Performance Battery) and lean mass (BOD POD), along with secondary measures, were assessed at 0, 3, and 6 months. At the 6-month endpoint, there was significant (p < .001) weight loss in both the Control (-7.5±6.2kg) and Protein (-8.7±7.4kg) groups. Both groups also improved function but the increase in the Protein (+2.4±1.7 units; p < .001) was greater than in the Control (+0.9±1.7 units; p < .01) group (p = .02). Obese, functionally limited older adults undergoing a 6-month weight loss intervention with a meal-based enhancement of protein quantity and quality lost similar amounts of weight but had greater functional improvements relative to the Control group. If confirmed, this dietary approach could have important implications for improving the functional status of this vulnerable population (ClinicalTrials.gov identifier: NCT01715753). © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America.

Improved Function With Enhanced Protein Intake per Meal: A Pilot Study of Weight Reduction in Frail, Obese Older Adults

PubMed Central

Pieper, Carl F.; Orenduff, Melissa C.; McDonald, Shelley R.; McClure, Luisa B.; Zhou, Run; Payne, Martha E.; Bales, Connie W.

2016-01-01

Abstract Background: Obesity is a significant cause of functional limitations in older adults; yet, concerns that weight reduction could diminish muscle along with fat mass have impeded progress toward an intervention. Meal-based enhancement of protein intake could protect function and/or lean mass but has not been studied during geriatric obesity reduction. Methods: In this 6-month randomized controlled trial, 67 obese (body mass index ≥30kg/m2) older (≥60 years) adults with a Short Physical Performance Battery score of 4–10 were randomly assigned to a traditional (Control) weight loss regimen or one with higher protein intake (>30g) at each meal (Protein). All participants were prescribed a hypo-caloric diet, and weighed and provided dietary guidance weekly. Physical function (Short Physical Performance Battery) and lean mass (BOD POD), along with secondary measures, were assessed at 0, 3, and 6 months. Results: At the 6-month endpoint, there was significant (p < .001) weight loss in both the Control (−7.5±6.2kg) and Protein (−8.7±7.4kg) groups. Both groups also improved function but the increase in the Protein (+2.4±1.7 units; p < .001) was greater than in the Control (+0.9±1.7 units; p < .01) group (p = .02). Conclusion: Obese, functionally limited older adults undergoing a 6-month weight loss intervention with a meal-based enhancement of protein quantity and quality lost similar amounts of weight but had greater functional improvements relative to the Control group. If confirmed, this dietary approach could have important implications for improving the functional status of this vulnerable population (ClinicalTrials.gov identifier: NCT01715753). PMID:26786203

Rapid Weight Loss vs. Slow Weight Loss: Which is More Effective on Body Composition and Metabolic Risk Factors?

PubMed Central

Ashtary-Larky, Damoon; Ghanavati, Matin; Lamuchi-Deli, Nasrin; Payami, Seyedeh Arefeh; Alavi-Rad, Sara; Boustaninejad, Mehdi; Afrisham, Reza; Abbasnezhad, Amir; Alipour, Meysam

2017-01-01

Background Achieving weight loss (WL) in a short time regardless of its consequences has always been the focus of many obese and overweight people. In this study, anthropometric and metabolic effects of two diets for rapid and slow WL and their consequences were examined. Methods Forty-two obese and overweight individuals were randomly divided to 2 groups; rapid WL (weight loss of at least 5% in 5 weeks) and slow WL (weight loss of at least 5% in 15 weeks). To compare the effects of the rate of WL in 2 groups, the same amount of was achieved with different durations. Anthropometric indices, lipid, and glycemic profiles, and systolic and diastolic blood pressures were evaluated before and after the intervention. Results Both protocols of rapid WL and slow WL caused reduction in waist circumference, hip circumference, total body water, body fat mass, lean body mass, and resting metabolic rate (RMR). Further reduction in waist circumference, hip circumference, fat mass, and percentage of body fat was observed in slow WL and decreased total body water, lean body mass, fat free mass, and RMR was observed in rapid WL. Improvement in lipid and glycemic profiles was observed in both groups. Reduction of low-density lipoprotein and fasting blood sugar, improvement of insulin resistance, and sensitivity were more significant in rapid WL in comparison to slow WL. Conclusions Weight Loss regardless of its severity could improve anthropometric indicators, although body composition is more favorable following a slow WL. Both diets improved lipid and glycemic profiles. In this context, rapid WL was more effective. (IRCT2016010424699N2) PMID:29201070

The Impact of Weight Gain on Motivation, Compliance, and Metabolic Control in Patients with Type 2 Diabetes Mellitus

PubMed Central

Pi-Sunyer, F. Xavier

2010-01-01

Patients with type 2 diabetes, approximately 85% of whom are overweight or obese, often have an increased incidence of cardiovascular disease (CVD) risk factors such as hypertension and dyslipidemia. Both type 2 diabetes and obesity are independent risk factors for CVD. Unfortunately, many therapies aimed at maintaining and improving glucose control are associated with weight gain. Among the older antidiabetes agents, most, including the insulin secretagogues and sensitizers, can lead to weight gain, except for metformin, which is weight-neutral. Among the newer agents, the dipeptidyl peptidase-4 inhibitors generally are weight-neutral in addition to lowering glucose, while the glucagon-like peptide–1 receptor agonists lead to weight reduction. Patients with type 2 diabetes are at an increased risk for both diabetes-and CV-related outcomes, and weight reduction is an important component of diabetes management. Weight gain in patients with type 2 diabetes can contribute to patient frustration and may negatively impact their compliance to therapeutic regimens. The selection of antidiabetes agents that not only improve glucose control but reduce or have a neutral effect on weight with beneficial effects on lipids are ideal options for managing patients with type 2 diabetes. PMID:19820278

The Effect of Rotor Cruise Tip Speed, Engine Technology and Engine/Drive System RPM on the NASA Large Civil Tiltrotor (LCTR2) Size and Performance

NASA Technical Reports Server (NTRS)

Robuck, Mark; Wilkerson, Joseph; Maciolek, Robert; Vonderwell, Dan

2012-01-01

A multi-year study was conducted under NASA NNA06BC41C Task Order 10 and NASA NNA09DA56C task orders 2, 4, and 5 to identify the most promising propulsion system concepts that enable rotor cruise tip speeds down to 54% of the hover tip speed for a civil tiltrotor aircraft. Combinations of engine RPM reduction and 2-speed drive systems were evaluated. Three levels of engine and the drive system advanced technology were assessed; 2015, 2025 and 2035. Propulsion and drive system configurations that resulted in minimum vehicle gross weight were identified. Design variables included engine speed reduction, drive system speed reduction, technology, and rotor cruise propulsion efficiency. The NASA Large Civil Tiltrotor, LCTR, aircraft served as the base vehicle concept for this study and was resized for over thirty combinations of operating cruise RPM and technology level, quantifying LCTR2 Gross Weight, size, and mission fuel. Additional studies show design sensitivity to other mission ranges and design airspeeds, with corresponding relative estimated operational cost. The lightest vehicle gross weight solution consistently came from rotor cruise tip speeds between 422 fps and 500 fps. Nearly equivalent results were achieved with operating at reduced engine RPM with a single-speed drive system or with a two-speed drive system and 100% engine RPM. Projected performance for a 2025 engine technology provided improved fuel flow over a wide range of operating speeds relative to the 2015 technology, but increased engine weight nullified the improved fuel flow resulting in increased aircraft gross weights. The 2035 engine technology provided further fuel flow reduction and 25% lower engine weight, and the 2035 drive system technology provided a 12% reduction in drive system weight. In combination, the 2035 technologies reduced aircraft takeoff gross weight by 14% relative to the 2015 technologies.

Early detection of changes in lung mechanics with oscillometry following bariatric surgery in severe obesity.

PubMed

Peters, Ubong; Hernandez, Paul; Dechman, Gail; Ellsmere, James; Maksym, Geoffrey

2016-05-01

Obesity is associated with respiratory symptoms that are reported to improve with weight loss, but this is poorly reflected in spirometry, and few studies have measured respiratory mechanics with oscillometry. We investigated whether early changes in lung mechanics following weight loss are detectable with oscillometry. Furthermore, we investigated whether the changes in lung mechanics measured in the supine position following weight loss are associated with changes in sleep quality. Nineteen severely obese female subjects (mean body mass index, 47.2 ± 6.6 kg/m(2)) were evaluated using spirometry, oscillometry, plethysmography, and the Pittsburgh Sleep Quality Index before and 5 weeks after bariatric surgery. These tests were conducted in both the upright and the supine position, and pre- and postbronchodilation with 200 μg of salbutamol. Five weeks after surgery, weight loss of 11.5 ± 2.5 kg was not associated with changes in spirometry and plethysmography, with the exception of functional residual capacity. There were also no changes in upright respiratory system resistance (Rrs) or reactance following weight loss. Importantly, however, in the supine position, weight loss caused a substantial reduction in Rrs. In addition, sleep quality improved significantly and was highly correlated with the reduction in supine Rrs. Prior to weight loss, subjects did not respond to the bronchodilator when assessed in the upright position with either spirometry or oscillometry; however, with modest weight loss, bronchodilator responsiveness returned to the normal range. Improvements in lung mechanics occur very early after weight loss, mostly in the supine position, resulting in improved sleep quality. These improvements are detectable with oscillometry but not with spirometry.

Moderate energy restriction with high protein diet results in healthier outcome in women.

PubMed

Mero, Antti A; Huovinen, Heikki; Matintupa, Olle; Hulmi, Juha J; Puurtinen, Risto; Hohtari, Hannele; Karila, Tuomo Am

2010-01-25

The present study compares two different weight reduction regimens both with a moderately high protein intake on body composition, serum hormone concentration and strength performance in non-competitive female athletes. Fifteen normal weighted women involved in recreational resistance training and aerobic training were recruited for the study (age 28.5 +/- 6.3 yr, height 167.0 +/- 7.0 cm, body mass 66.3 +/- 4.2 kg, body mass index 23.8 +/- 1.8, mean +/- SD). They were randomized into two groups. The 1 KG group (n = 8; energy deficit 1100 kcal/day) was supervised to reduce body weight by 1 kg per week and the 0.5 KG group (n = 7; energy deficit 550 kcal/day) by 0.5 kg per week, respectively. In both groups protein intake was kept at least 1.4 g/kg body weight/day and the weight reduction lasted four weeks. At the beginning of the study the energy need was calculated using food and training diaries. The same measurements were done before and after the 4-week weight reduction period including total body composition (DXA), serum hormone concentrations, jumping ability and strength measurements During the 4-week weight reduction period there were no changes in lean body mass and bone mass, but total body mass, fat mass and fat percentage decreased significantly in both groups. The changes were greater in the 1 KG group than in the 0.5 KG group in total body mass (p < 0.001), fat mass (p < 0.001) and fat percentage (p < 0.01). Serum testosterone concentration decreased significantly from 1.8 +/- 1.0 to 1.4 +/- 0.9 nmol/l (p < 0.01) in 1 KG and the change was greater in 1 KG (30%, p < 0.001) than in 0.5 KG (3%). On the other hand, SHBG increased significantly in 1 KG from 63.4 +/- 17.7 to 82.4 +/- 33.0 nmol/l (p < 0.05) during the weight reducing regimen. After the 4-week period there were no changes in strength performance in 0.5 KG group, however in 1 KG maximal strength in bench press decreased (p < 0.05) while endurance strength in squat and counter movement jump improved (p < 0.05) It is concluded that a weight reduction by 0.5 kg per week with ~1.4 g protein/kg body weight/day can be recommended to normal weighted, physically active women instead of a larger (e.g. 1 kg per week) weight reduction because the latter may lead to a catabolic state. Vertical jumping performance is improved when fat mass and body weight decrease. Thus a moderate weight reduction prior to a major event could be considered beneficial for normal built athletes in jumping events.

Nutrition in Diabetes.

PubMed

Hamdy, Osama; Barakatun-Nisak, Mohd-Yusof

2016-12-01

Medical nutrition therapy (MNT) is a key component of diabetes management. The importance of balancing macronutrients, reducing carbohydrate load, lowering glycemic index, and implementing an overall healthy dietary pattern are emerging as better approaches for MNT in diabetes. Recent research points to improved glycemic control, reduction in body weight, and improvement in many cardiovascular risk factors when these approaches are provided by registered dietitians or health care providers. This review article discusses the current evidence about the role of sensible nutrition in diabetes management. Specific eating plans for weight reduction and for patients with type 1 diabetes are also discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

[Increase of physical activity by improvement of the nutritional status].

PubMed

Torún, B

1989-09-01

Physical activity is affected by nutritional modifications and, in turn, influences growth, cognition, social behavior, work performance and other functions. Studies in preschool children showed that: 1. A decrease in energy intake during four to seven days reduced the time allocated to energy-demanding activities and increased sedentary activities. 2. Children with mild weight deficit were more sedentary than well-nourished counterparts. 3. Children became more active when nutritional status improved. 4. A 10% reduction in energy intake reduced total energy expenditure by 15% without affecting weight gain nor basal metabolism. Studies of men working in non-mechanized agriculture showed that: 1. Dietary improvements led to faster salaried work, reduction of napping time and greater physical activity after work. 2. An increase in energy intake increased total daily energy expenditure, tending to maintain energy balance and relatively stable body weight within the cyclic variations of the agricultural year. 3. Food supplementation did not necessarily improve productivity. Other labor incentives without dietary improvements increased energy expenditure during working hours, which resulted in weight loss. In conclusion, good health and nutrition provide the biological basis for adequate physical activity that may improve cognitive development, social interactions, economic productivity and the quality of life of an individual or a population, but other incentives are required for the optimal expression of that biologic potential.

Neurocognitive Treatments for Eating Disorders and Obesity.

PubMed

Eichen, Dawn M; Matheson, Brittany E; Appleton-Knapp, Sara L; Boutelle, Kerri N

2017-09-01

Recent research has highlighted executive function and neurocognitive deficits among individuals with eating and weight disorders, identifying a potential target for treatment. Treatments targeting executive function for eating and weight disorders are emerging. This review aims to summarize the recent literature evaluating neurocognitive/executive function-oriented treatments for eating and weight disorders and highlights additional work needed in this area. Cognitive remediation therapy (CRT) for anorexia nervosa has been the most extensively studied neurocognitive treatment for eating disorders. Results demonstrate that CRT improves executive function and may aid in the reduction of eating disorder symptomatology. Computer training programs targeting modifying attention and increasing inhibition are targeting reduction of binge eating and weight loss with modest success. Neurocognitive treatments are emerging and show initial promise for eating and weight disorders. Further research is necessary to determine whether these treatments can be used as stand-alone treatments or whether they need to be used as an adjunct to or in conjunction with other evidence-based treatments to improve outcomes.

Serum markers of bone turnover are increased by modest weight loss with or without weight-bearing exercise in overweight premenopausal women.

PubMed

Rector, R Scott; Loethen, Joanne; Ruebel, Meghan; Thomas, Tom R; Hinton, Pamela S

2009-10-01

Weight loss improves metabolic fitness and reduces morbidity and mortality; however, weight reduction also reduces bone mineral density (BMD) and increases bone turnover. Weight-bearing aerobic exercise may preserve bone mass and maintain normal bone turnover during weight reduction. We investigated the impact of weight-bearing and nonweight-bearing exercise on serum markers of bone formation and breakdown during short-term, modest weight loss in overweight premenopausal women. Subjects (n = 36) were assigned to 1 of 3 weight-loss interventions designed to produce a 5% reduction in body weight over 6 weeks: (i) energy restriction only (n = 11; DIET); (ii) energy restriction plus nonweight-bearing exercise (n = 12, CYCLE); or (iii) energy restriction plus weight-bearing exercise (n = 13, RUN). Bone turnover markers were measured in serum collected at baseline and after weight loss. All groups achieved a ~5% reduction in body weight (DIET = 5.2%; CYCLE = 5.0%; RUN = 4.7%). Osteocalcin (OC) and C-terminal telopeptide of type I collagen (CTX) increased with weight loss in all 3 groups (p < 0.05), whereas bone alkaline phosphatase was unaltered by the weight-loss interventions. At baseline, OC and CTX were positively correlated (r = 0.36, p = 0.03), but the strength of this association was diminished (r = 0.30, p = 0.06) after weight loss. Modest weight loss, regardless of method, resulted in a significant increase in both OC and CTX. Low-impact, weight-bearing exercise had no effect on serum markers of bone formation or resorption in premenopausal women during weight loss. Future studies that examine the effects of high-impact, weight-bearing activity on bone turnover and BMD during weight loss are warranted.

Reducing alcohol consumption to minimize weight gain and facilitate smoking cessation among military beneficiaries.

PubMed

Sobell, Mark B; Peterson, Alan L; Sobell, Linda Carter; Brundige, Antoinette; Hunter, Christopher M; Hunter, Christine M; Goodie, Jeffrey L; Agrawal, Sangeeta; Hrysko-Mullen, Ann S; Isler, William C

2017-12-01

Smoking cessation-related weight gain can have significant negative health and career consequences for military personnel. Alcohol reduction combined with smoking cessation may decrease weight gain and relapse. A randomized clinical trial of military beneficiaries compared a standard smoking cessation (i.e., brief informational) intervention (N=159), with a brief motivational smoking cessation intervention that emphasized reduced drinking to lessen caloric intake and minimize weight gain (N=158). Participants who received the motivational intervention were significantly more likely to quit smoking at the 3-month follow-up (p=0.02), but the differences were not maintained at 6 (p=0.18) or 12months (p=0.16). Neither weight change nor alcohol reduction distinguished the 2 groups. Smoking cessation rates at 12months (motivational group=32.91%, informational group=25.79%) were comparable to previous studies, but successful cessation was not mediated by reduced drinking. Alcohol reduction combined with smoking cessation did not result in decreased weight gain or improved outcomes. Copyright © 2017. Published by Elsevier Ltd.

The effects of intermittent compared to continuous energy restriction on glycaemic control in type 2 diabetes; a pragmatic pilot trial.

PubMed

Carter, S; Clifton, P M; Keogh, J B

2016-12-01

Weight loss improves glycaemic control in type 2 diabetes mellitus (T2DM). However, as achieving and maintaining weight loss is difficult, alternative strategies are needed. Our primary aim was to investigate the effects of intermittent energy restriction (IER) compared to continuous energy restriction (CER) on glycated haemoglobin A1c (HbA1c). Secondary aims were to assess effects on weight loss, body composition, medication changes and subjective measures of appetite. Using a 2-day IER method, we expected equal improvements to HbA1c and weight in both groups. Sixty-three overweight or obese participants (BMI 35.2±5kg/m 2 ) with T2DM (HbA1c 7.4±1.3%) (57mmol/mol) were randomised to a 2-day severe energy restriction (1670-2500kJ/day) with 5days of habitual eating, compared to a moderate CER diet (5000-6500kJ/day) for 12weeks. At 12weeks HbA1c (-0.7±0.9% P<0.001) and percent body weight reduction (-5.9±4% P<0.001) was similar in both groups with no group by time interaction. Similar reductions were also seen for medication dosages, all measures of body composition and subjective reports of appetite. In this pilot trial, 2days of IER compared with CER resulted in similar improvements in glycaemic control and weight reduction offering a suitable alternative treatment strategy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Metabolic, endocrine, and immunologic biomarkers change in response to weight loss in obese Hispanic children

USDA-ARS?s Scientific Manuscript database

Pediatric obesity and its associated comorbid conditions continue to grow in epidemic proportions. While it is known that moderate 10% weight loss in adults is correlated with improvements in metabolic risk factors, the relationship between weight loss and risk reduction in children is not well defi...

Combination of the sodium-glucose cotransporter-2 inhibitor empagliflozin with orlistat or sibutramine further improves the body-weight reduction and glucose homeostasis of obese rats fed a cafeteria diet.

PubMed

Vickers, Steven P; Cheetham, Sharon C; Headland, Katie R; Dickinson, Keith; Grempler, Rolf; Mayoux, Eric; Mark, Michael; Klein, Thomas

2014-01-01

The present study assessed the potential of the sodium glucose-linked transporter (SGLT)-2 inhibitor empagliflozin to decrease body weight when administered alone or in combination with the clinically effective weight-loss agents orlistat and sibutramine in obese rats fed a cafeteria diet. Female Wistar rats were exposed to a cafeteria diet to induce obesity. Empagliflozin was dosed once daily (10, 30, and 60 mg/kg) for 28 days. Combination studies were subsequently performed using a submaximal empagliflozin dose (10 mg/kg) with either sibutramine or orlistat. Body weight, food, and water intake were recorded daily. The effect of drug treatment on glucose tolerance, relevant plasma parameters, and carcass composition was determined. Empagliflozin dose-dependently reduced body weight, plasma leptin, and body fat though increased urinary glucose excretion. The combination of empagliflozin and orlistat significantly reduced body weight compared to animals treated with either drug alone, and significantly improved glucose tolerance, plasma insulin, and leptin compared to vehicle-treated controls. The effect of sibutramine to improve glycemic control in an oral glucose-tolerance test was also significantly increased, with empagliflozin and combination treatment leading to a reduction in carcass fat greater than that observed with either drug alone. These data demonstrate that empagliflozin reduces body weight in cafeteria-fed obese rats. In combination studies, empagliflozin further improved the body-weight or body-fat loss of animals in comparison to orlistat or sibutramine alone. Such studies may indicate improved strategies for the treatment of obese patients with prediabetes or type 2 diabetes.

Tofogliflozin, a sodium/glucose cotransporter 2 inhibitor, attenuates body weight gain and fat accumulation in diabetic and obese animal models

PubMed Central

Suzuki, M; Takeda, M; Kito, A; Fukazawa, M; Yata, T; Yamamoto, M; Nagata, T; Fukuzawa, T; Yamane, M; Honda, K; Suzuki, Y; Kawabe, Y

2014-01-01

Objective: Tofogliflozin, a highly selective inhibitor of sodium/glucose cotransporter 2 (SGLT2), induces urinary glucose excretion (UGE), improves hyperglycemia and reduces body weight in patients with Type 2 diabetes (T2D). The mechanisms of tofogliflozin on body weight reduction were investigated in detail with obese and diabetic animal models. Methods: Diet-induced obese (DIO) rats and KKAy mice (a mouse model of diabetes with obesity) were fed diets containing tofogliflozin. Body weight, body composition, biochemical parameters and metabolic parameters were evaluated. Results: In DIO rats tofogliflozin was administered for 9 weeks, UGE was induced and body weight gain was attenuated. Body fat mass decreased without significant change in bone mass or lean body mass. Food consumption (FC) increased without change in energy expenditure, and deduced total calorie balance (deduced total calorie balance=FC−UGE−energy expenditure) decreased. Respiratory quotient (RQ) and plasma triglyceride (TG) level decreased, and plasma total ketone body (TKB) level increased. Moreover, plasma leptin level, adipocyte cell size and proportion of CD68-positive cells in mesenteric adipose tissue decreased. In KKAy mice, tofogliflozin was administered for 3 or 5 weeks, plasma glucose level and body weight gain decreased together with a reduction in liver weight and TG content without a reduction in body water content. Combination therapy with tofogliflozin and pioglitazone suppressed pioglitazone-induced body weight gain and reduced glycated hemoglobin level more effectively than monotherapy with either pioglitazone or tofogliflozin alone. Conclusion: Body weight reduction with tofogliflozin is mainly due to calorie loss with increased UGE. In addition, tofogliflozin also induces a metabolic shift from carbohydrate oxidation to fatty acid oxidation, which may lead to prevention of fat accumulation and inflammation in adipose tissue and liver. Tofogliflozin may have the potential to prevent obesity, hepatic steatosis and improve insulin resistance as well as hyperglycemia. PMID:25000147

Weight management practices and their relationship to knowledge, perception and health status of Saudi females attending diet clinics in Riyadh city.

PubMed

Albassam, Reem Suliman; Abdel Gawwad, Ensaf S; Khanam, Latifa

2007-01-01

The objective of the study was to identify weight management (WM) practices among women attending diet clinics in Riyadh city, assess their impact on knowledge, perceptions, nutritional and health status and define some predictors for weight reduction among these women. The pretest-posttest research design was used. All female clients attending 8 diet clinics for the first visit within 8 months period and fulfilling the study inclusion criteria (212 out of 263) were included. The results show that out of 170 females who had previously tried to lose weight, only 32.4% reported success in reducing weight, meanwhile 61.7% reported weight regain. The mean total score of dietary practices, physical activity score, self efficacy and satisfaction of self-body image were improved significantly at posttest. Analysis of 24 h. dietary recall revealed that total energy and nutrients intake were significantly reduced at posttest. Dieting related problems increased significantly at posttest. Nutritional knowledge was at moderately fair level at both pretest and posttest; however it showed a significant improvement in the posttest. Perceived severity, perceived barriers and negative modeling effect were significantly decreased at the posttest. Over expectation for weight reduction was clearly evident as posttest body mass index (BMI) revealed a wide discrepancy between the expected and final weights. However, as compared to initial and final BMI, there was an increase in women who attained normal weight and a decrease in the percentage of obese and morbid obese women. All anthropometric indices, blood pressure, biochemical investigation showed significant improvement at posttest. Among the five WM modalities studied, moderate hypo-calorie plan diet modality was the longest (chi = 5.6 month) with the least weight loss (7.8%) and the minimum side effects. Both groups under very low calorie diet and protein diet had the highest weight reduction (13.2% &12.3%), at the same time both diets exhibited the highest number of side effects. The study recommends use of the primary approach for achieving weight loss through therapeutic life style change with banning those modalities accompanied with serious health complications.

Materials, Manufacturing and Test Development of a Composite Fan Blade Leading Edge Subcomponent for Improved Impact Resistance

NASA Technical Reports Server (NTRS)

Handschuh, Katherine M.; Miller, Sandi G.; Sinnott, Matthew J.; Kohlman, Lee W.; Roberts, Gary D.; Pereira, J. Michael; Ruggeri, Charles R.

2014-01-01

Application of polymer matrix composite materials for jet engine fan blades is becoming attractive as an alternative to metallic blades; particularly for large engines where significant weight savings are recognized on moving to a composite structure. However, the weight benefit of the composite of is offset by a reduction of aerodynamic efficiency resulting from a necessary increase in blade thickness; relative to the titanium blades. Blade dimensions are largely driven by resistance to damage on bird strike. Further development of the composite material is necessary to allow composite blade designs to approximate the dimensions of a metallic fan blade. The reduction in thickness over the state of the art composite blades is expected to translate into structural weight reduction, improved aerodynamic efficiency, and therefore reduced fuel consumption. This paper presents test article design, subcomponent blade leading edge fabrication, test method development, and initial results from ballistic impact of a gelatin projectile on the leading edge of composite fan blades. The simplified test article geometry was developed to realistically simulate a blade leading edge while decreasing fabrication complexity. Impact data is presented on baseline composite blades and toughened blades; where a considerable improvement to impact resistance was recorded.

Materials, Manufacturing, and Test Development of a Composite Fan Blade Leading Edge Subcomponent for Improved Impact Resistance

NASA Technical Reports Server (NTRS)

Miller, Sandi G.; Handschuh, Katherine; Sinnott, Matthew J.; Kohlman, Lee W.; Roberts, Gary D.; Martin, Richard E.; Ruggeri, Charles R.; Pereira, J. Michael

2015-01-01

Application of polymer matrix composite materials for jet engine fan blades is becoming attractive as an alternative to metallic blades; particularly for large engines where significant weight savings are recognized on moving to a composite structure. However, the weight benefit of the composite is offset by a reduction of aerodynamic efficiency resulting from a necessary increase in blade thickness; relative to the titanium blades. Blade dimensions are largely driven by resistance to damage on bird strike. Further development of the composite material is necessary to allow composite blade designs to approximate the dimensions of a metallic fan blade. The reduction in thickness over the state of the art composite blades is expected to translate into structural weight reduction, improved aerodynamic efficiency, and therefore reduced fuel consumption. This paper presents test article design, subcomponent blade leading edge fabrication, test method development, and initial results from ballistic impact of a gelatin projectile on the leading edge of composite fan blades. The simplified test article geometry was developed to realistically simulate a blade leading edge while decreasing fabrication complexity. Impact data is presented on baseline composite blades and toughened blades; where a considerable improvement to impact resistance was recorded.

Effect of changes on body weight and lifestyle in nonalcoholic fatty liver disease.

PubMed

Suzuki, Ayako; Lindor, Keith; St Saver, Jenny; Lymp, James; Mendes, Flavia; Muto, Ayako; Okada, Toshihide; Angulo, Paul

2005-12-01

The effects of lifestyle modifications in nonalcoholic fatty liver disease (NAFLD) are incompletely defined. We aimed at determining the association of changes in body weight and lifestyle with changes in serum ALT levels. We analyzed annual health checkup data from 1546 employees. Of 469 subjects with elevated ALT, we selected 348 male subjects by excluding those who had other causes of liver disease. They were followed for one year to assess the association of change in lifestyle with change in serum ALT. The 136 subjects who had ALT normalization were followed for two years to assess the association between lifestyle management and persistently normal ALT. In adjusted analysis, weight loss and regular exercise were significantly associated with improvement in serum ALT and increased the odds of ALT normalization, while starting smoking was significantly associated with deterioration in serum ALT. Subjects achieving > or = 5% weight reduction showed improvement in serum ALT. Reduction in alcohol consumption was not associated with changes in serum ALT. Maintaining reduced weight (<5% gain) was significantly associated with persistently normal ALT. Reducing weight by at least 5% with subsequent weight control and exercising regularly may be beneficial in treating NAFLD.

Genetic Predisposition to Polycystic Ovary Syndrome, Postpartum Weight Reduction, and Glycemic Changes: A Longitudinal Study in Women With Prior Gestational Diabetes.

PubMed

Wang, Tiange; Leng, Junhong; Li, Nan; Martins de Carvalho, Aline; Huang, Tao; Zheng, Yan; Li, Weiqin; Liu, Huikun; Wang, Leishen; Hu, Gang; Qi, Lu

2015-12-01

Polycystic ovary syndrome (PCOS) is a common condition in reproductive-aged women and a major female-specific risk factor of obesity, impaired glucose tolerance, and diabetes. We examined whether the genetic variation predisposing to PCOS affected glycemic changes in women with prior gestational diabetes mellitus (GDM) and whether such an effect was modified by changes in body adiposity, especially during and after pregnancy. This is a longitudinal study in Tianjin, China. We genotyped 7 genome-wide association study-identified PCOS single nucleotide polymorphisms and assessed gestational weight gain and changes in glycemic traits and weight at 1 to 5 years postpartum in 1133 women with prior GDM. The main outcome measure was postpartum glycemic changes. The PCOS genetic risk score significantly interacted with postpartum weight reduction on changes in fasting glucose and 2-h glucose (P for interaction = .032 and .007; respectively) after multivariable adjustment. In women with postpartum weight reduction of ≥ 5 kg/y, the genetic risk score was associated with decreased fasting and 2-h glucose, whereas an opposite genetic effect was found in women who lost less weight. The association between postpartum weight reduction and glycemic improvement was more significant among women with a higher genetic risk score. In a large cohort of Chinese women with a history of GDM, our data for the first time indicate that the genetic predisposition to PCOS may interact with postpartum weight reduction on long-term glycemic changes, emphasizing the importance of postpartum weight management in prevention of diabetes in this subgroup of women.

Comparing Binaural Pre-processing Strategies I: Instrumental Evaluation.

PubMed

Baumgärtel, Regina M; Krawczyk-Becker, Martin; Marquardt, Daniel; Völker, Christoph; Hu, Hongmei; Herzke, Tobias; Coleman, Graham; Adiloğlu, Kamil; Ernst, Stephan M A; Gerkmann, Timo; Doclo, Simon; Kollmeier, Birger; Hohmann, Volker; Dietz, Mathias

2015-12-30

In a collaborative research project, several monaural and binaural noise reduction algorithms have been comprehensively evaluated. In this article, eight selected noise reduction algorithms were assessed using instrumental measures, with a focus on the instrumental evaluation of speech intelligibility. Four distinct, reverberant scenarios were created to reflect everyday listening situations: a stationary speech-shaped noise, a multitalker babble noise, a single interfering talker, and a realistic cafeteria noise. Three instrumental measures were employed to assess predicted speech intelligibility and predicted sound quality: the intelligibility-weighted signal-to-noise ratio, the short-time objective intelligibility measure, and the perceptual evaluation of speech quality. The results show substantial improvements in predicted speech intelligibility as well as sound quality for the proposed algorithms. The evaluated coherence-based noise reduction algorithm was able to provide improvements in predicted audio signal quality. For the tested single-channel noise reduction algorithm, improvements in intelligibility-weighted signal-to-noise ratio were observed in all but the nonstationary cafeteria ambient noise scenario. Binaural minimum variance distortionless response beamforming algorithms performed particularly well in all noise scenarios. © The Author(s) 2015.

Comparing Binaural Pre-processing Strategies I

PubMed Central

Krawczyk-Becker, Martin; Marquardt, Daniel; Völker, Christoph; Hu, Hongmei; Herzke, Tobias; Coleman, Graham; Adiloğlu, Kamil; Ernst, Stephan M. A.; Gerkmann, Timo; Doclo, Simon; Kollmeier, Birger; Hohmann, Volker; Dietz, Mathias

2015-01-01

In a collaborative research project, several monaural and binaural noise reduction algorithms have been comprehensively evaluated. In this article, eight selected noise reduction algorithms were assessed using instrumental measures, with a focus on the instrumental evaluation of speech intelligibility. Four distinct, reverberant scenarios were created to reflect everyday listening situations: a stationary speech-shaped noise, a multitalker babble noise, a single interfering talker, and a realistic cafeteria noise. Three instrumental measures were employed to assess predicted speech intelligibility and predicted sound quality: the intelligibility-weighted signal-to-noise ratio, the short-time objective intelligibility measure, and the perceptual evaluation of speech quality. The results show substantial improvements in predicted speech intelligibility as well as sound quality for the proposed algorithms. The evaluated coherence-based noise reduction algorithm was able to provide improvements in predicted audio signal quality. For the tested single-channel noise reduction algorithm, improvements in intelligibility-weighted signal-to-noise ratio were observed in all but the nonstationary cafeteria ambient noise scenario. Binaural minimum variance distortionless response beamforming algorithms performed particularly well in all noise scenarios. PMID:26721920

Cost consideration for aircraft configuration changes, 1

NASA Technical Reports Server (NTRS)

Tumlinson, R. R.

1975-01-01

The costs of improvements in aircraft drag reduction design changes are outlined in the context of production decisions. A drag reduction design with increased airframe weight requires cost increases for direct labor, overhead and direct expenses, plus general and administrative expenses.

Improvement in insulin sensitivity by weight loss does not affect hyperinsulinemia-mediated reduction in total and high molecular weight adiponectin: a MONET study.

PubMed

Drapeau, Sophie; Doucet, Eric; Rabasa-Lhoret, Remi; Brochu, Martin; Prud'homme, Denis; Imbeault, Pascal

2011-04-01

Acute hyperinsulinemia reduces total and high molecular weight (HMW) adiponectin levels in humans. Whether an increase in insulin sensitivity (IS) is accompanied by a greater suppressive effect of hyperinsulinemia on adiponectin levels is unknown, however. To clarify the inhibitory role of insulin on adiponectin, total and HMW adiponectin levels were measured during acute hyperinsulinemia before and after an improvement in insulin sensitivity in response to weight loss. Forty-six overweight and obese postmenopausal women were randomized to either 6-month caloric restriction (CR) alone (n = 22), or CR with resistance training (CR+RT, n = 24). IS (hyperinsulinemic-euglycemic clamp) was assessed before and after weight loss. Total and HMW adiponectin levels were measured by ELISA at baseline, 90, 160, and 180 min of each clamp. Relative mean body weight loss was -8.0% ± 4.4% for both groups (CR: -7.7% ± 3.8%; CR+RT: -8.2% ± 5.0%). IS increased significantly, by 18.4% ± 25.3% (CR: 19.3% ± 29.7%; CR+RT: 17.7% ± 21.0%). Before each intervention, total and HMW adiponectin levels in both groups significantly decreased in response to hyperinsulinemia (total: -8.4% ± 19.4%; HMW: -3.2% ± 13.2%). Despite the improvement in IS seen after each intervention, a similar pattern of reduction to that before weight loss was observed in total and HMW adiponectin levels during hyperinsulinemia. These results establish that total and HMW adiponectin levels decline during a hyperinsulinemic-euglycemic clamp. Also, the insulin-sensitizing effect of weight loss via caloric restriction alone or with resistance training does not amplify the reduction in adiponectin levels observed during hyperinsulinemia in healthy postmenopausal women.

ANP system activity predicts variability of fat mass reduction and insulin sensitivity during weight loss.

PubMed

Brachs, Maria; Wiegand, Susanna; Leupelt, Verena; Ernert, Andrea; Kintscher, Ulrich; Jumpertz von Schwarzenberg, Reiner; Decker, Anne-Marie; Bobbert, Thomas; Hübner, Norbert; Chen, Wei; Krude, Heiko; Spranger, Joachim; Mai, Knut

2016-06-01

In weight loss trials, a considerable inter-individual variability in reduction of fat mass and changes of insulin resistance is observed, even under standardized study conditions. The underlying mechanisms are not well understood. Given the metabolic properties of the atrial natriuretic peptide (ANP) system, we hypothesized that ANP signaling might be involved in this phenomenon by changes of ANP secretion or receptor balance. Therefore, we investigated the impact of systemic, adipose and myocellular ANP system on metabolic and anthropometric improvements during weight loss. We comprehensively investigated 143 subjects (31 male, 112 female) before and after a 3 month-standardized weight loss program. The time course of BMI, fat mass, insulin sensitivity, circulating mid-regional proANP (MR-proANP) levels as well as adipose and myocellular natriuretic receptor A (NPR-A) and C (NPR-C) mRNA expression were investigated. BMI decreased by -12.6±3.7%. This was accompanied by a remarkable decrease of adipose NPR-C expression (1005.0±488.4 vs. 556.7±465.6; p<0.001) as well as a tendency towards increased adipose NPR-A expression (4644.7±946.8 vs. 4877.6±869.8; p=0.051). Weight loss induced changes in NPR-C (ΔNPR-C) was linked to relative reduction of total fat mass (ΔFM) (r=0.281; p<0.05), reduction of BMI (r=0.277; p<0.01), and increase of free fatty acids (ΔFFA) (r=-0.258; p<0.05). Basal NPR-C expression and weight loss induced ΔNPR-C independently explained 22.7% of ΔFM. In addition, ΔMR-proANP was independently associated with improvement of insulin sensitivity (standardized ß=0.246, p<0.01). ANP receptor expression predicted the degree of weight loss induced fat mass reduction. Our comprehensive human data support that peripheral ANP signalling is involved in control of adipose tissue plasticity and function during weight loss. (Funded by the Deutsche Forschungsgemeinschaft (KFO281/2), the Berlin Institute of Health (BIH) and the German Centre for Cardiovascular Research (DZHK/BMBF); ClinicalTrials.gov number: NCT00850629). Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of adjunctive treatment with aripiprazole on body weight and clinical efficacy in schizophrenia patients treated with clozapine: a randomized, double-blind, placebo-controlled trial.

PubMed

Fleischhacker, W Wolfgang; Heikkinen, Martti E; Olié, Jean-Pierre; Landsberg, Wally; Dewaele, Patricia; McQuade, Robert D; Loze, Jean-Yves; Hennicken, Delphine; Kerselaers, Wendy

2010-09-01

Clozapine is associated with significant weight gain and metabolic disturbances. This multicentre, randomized study comprised a double-blind, placebo-controlled treatment phase of 16 wk, and an open-label extension phase of 12 wk. Outpatients who met DSM-IV-TR criteria for schizophrenia, who were not optimally controlled while on stable dosage of clozapine for > or =3 months and had experienced weight gain of > or =2.5 kg while taking clozapine, were randomized (n=207) to aripiprazole at 5-15 mg/d or placebo, in addition to a stable dose of clozapine. The primary endpoint was mean change from baseline in body weight at week 16 (last observation carried forward). Secondary endpoints included clinical efficacy, body mass index (BMI) and waist circumference. A statistically significant difference in weight loss was reported for aripiprazole vs. placebo (-2.53 kg vs. -0.38 kg, respectively, difference=-2.15 kg, p<0.001). Aripiprazole-treated patients also showed BMI (median reduction 0.8 kg/m(2)) and waist circumference reduction (median reduction 2.0 cm) vs. placebo (no change in either parameter, p<0.001 and p=0.001, respectively). Aripiprazole-treated patients had significantly greater reductions in total and low-density lipoprotein (LDL) cholesterol. There were no significant differences in Positive and Negative Syndrome Scale total score changes between groups but Clinical Global Impression Improvement and Investigator's Assessment Questionnaire scores favoured aripiprazole over placebo. Safety and tolerability were generally comparable between groups. Combining aripiprazole and clozapine resulted in significant weight, BMI and fasting cholesterol benefits to patients suboptimally treated with clozapine. Improvements may reduce metabolic risk factors associated with clozapine treatment.

The level of associated depression and anxiety traits improves during weight regain in eating disorder patients.

PubMed

Sala, L; Mirabel-Sarron, C; Gorwood, P; Pham-Scottez, A; Blanchet, A; Rouillon, F

2011-12-01

We assessed whether re-nutrition and weight gain have an influence on comorbid depression and anxiety in patients hospitalised for chronic eating disorders (ED). Seventy-five inpatients agreed to participate by completing the Eating Attitudes Test (EAT-40), the Beck Depression Inventory (BDI-13), and the State-Trait Anxiety Inventory (STAI-Y) before, during and after three months of treatment. Patients suffering from either anorexia nervosa or bulimia nervosa successfully regained weight during treatment. This weight gain was accompanied by statistically significant reductions in ED symptoms. Anxiety and, to a lesser extent, depressive symptoms diminished, but remained at pathological levels, with between diagnostic subtype differences. Improvement of depressive (r=0.77) and anxiety (r=0.64) levels were significantly (p<0.001) and positively correlated with the reduction of eating attitudes (EAT). These results are discussed in the context of re-orienting the therapeutic strategies aimed at reducing emotional suffering in patients with ED.

Effect of Dose of Behavioral Treatment for Obesity on Binge Eating Severity

PubMed Central

Ariel, Aviva H.; Perri, Michael G.

2016-01-01

Objectives We evaluated the effects of three doses of a behavioral intervention for obesity (High dose = 24 sessions, Moderate = 16 sessions, Low = 8 sessions) compared with a nutrition education control group (Control) on binge eating. We also examined whether participants with clinically significant improvements in binge eating had better treatment adherence and weight-loss outcomes than those who did not experience clinically significant improvements in binge eating. Finally, we examined the relation of pretreatment binge eating severity to changes at six months. Methods Participants included 572 adults (female = 78.7%; baseline mean ±SD: age = 52.7 ±11.2 years, BMI = 36.4 ±3.9 kg/m2) who provided binge eating data at baseline. We evaluated binge eating severity (assessed via the Binge Eating Scale) and weight status at baseline and six months, as well as treatment adherence over six months. Results At six months, participants in the Moderate and High treatment conditions reported greater reductions in binge eating severity than participants in the Low and Control conditions, ps < .02. Participants who demonstrated improvements in binge eating severity reported greater dietary self-monitoring adherence and attained larger weight losses than those who did not experience clinically significant reductions, ps < .001. Pretreatment binge eating severity predicted less improvement in binge eating severity over six months and fewer days with dietary self-monitoring records completed, ps ≤ .002. Conclusion A moderate or high dose of behavioral weight-loss treatment may be required to produce clinically significant reductions in binge eating severity in adults with obesity. PMID:27086049

Brain-derived neurotrophic factor, but not body weight, correlated with a reduction in depression scale scores in men with metabolic syndrome: a prospective weight-reduction study.

PubMed

Lee, I-Te; Fu, Chia-Po; Lee, Wen-Jane; Liang, Kae-Woei; Lin, Shih-Yi; Wan, Chu-Jen; Sheu, Wayne Huey-Herng

2014-02-13

Obesity, a critical component of metabolic syndrome (MetS), is associated with depression. Deficiency of brain-derived neurotrophic factor (BDNF) is involved in the mechanism of depression. We hypothesized that weight reduction would improve depressive symptoms via increasing BDNF levels in obese men. Male adults with obesity were enrolled in a weight-reduction program for twelve weeks. All subjects underwent daily caloric restriction and an exercise program which was regularly assessed in group classes. Fasting blood samples and Zung Self-Rating Depression Scale (Zung SDS) scores were collected for assessments before and after the study. A total of 36 subjects completed this program. The average reduction in body weight was 8.4 ± 5.1 kg (8.8 ± 5.1%, P < 0.001). Fasting serum BDNF significantly increased after the study (from 40.4 ± 7.8 to 46.9 ± 8.9 ng/ml, P < 0.001). However, the depression symptoms, as assessed by the Zung Self-Rating Depression Scale (Zung SDS), did not reduce significantly (P = 0.486). Divided into subgroups based on changes in BDNF, Zung SDS scores were significantly reduced in subjects with greater BDNF increase than in those with minor BDNF change (-3.9 ± 6.2 vs. 2.3 ± 6.7, P = 0.009). The increased percentage of BDNF was inversely correlated with the change in Zung SDS (r = -0.380, P = 0.022). Multivariate regression analysis showed that reduction in BDNF was independently associated with change in Zung SDS (95% confidence interval -0.315 to -0.052, P = 0.008). Zung SDS only significantly improved in men with increased fasting BDNF levels after a lifestyle intervention. (NCT01065753, ClinicalTrials.gov).

Comprehensive Group Therapy of Obesity and Its Impact on Selected Anthropometric and Postural Parameters.

PubMed

Horák, Stanislav; Sovová, Eliška; Pastucha, Dalibor; Konečný, Petr; Radová, Lenka; Calabová, Naděžda; Janoutová, Jana; Janout, Vladimír

2017-12-01

Obesity is a multifactorial disease. This non-infectious epidemic has reached pandemic proportions in the 21 century. Posture is a dynamic process referring to an active maintenance of body movement segments against the action of external forces. The aim of the study was to investigate the effect of comprehensive group therapy for obese persons on selected anthropometric and postural parameters. The study comprised 53 females with a mean age of 44.5 years (range 29–65 years, standard deviation 9.42 years, median 44 years), who completed a controlled weight loss programme. At the beginning and at the end of the programme, anthropometric parameters (Body Mass Index (BMI), weight and waist circumference) were measured and the posturography tests Limits of Stability (LOS) and Motor Control Test (MCT) were performed using the NeuroCom's SMART EquiTest system. The data were statistically analyzed using R software at a level of significance of 0.05. There were positive changes after the controlled weight loss programme in anthropometric parameters (BMI reduction, with p<0.001; waist circumference reduction, with p<0.001; and weight loss, with p<0.001), postural stability with statistically significant (p<0.05) improvements in both postural activity (LOS test parameters) and reactions (MCT parameters). The study showed a statistically significant effect of comprehensive group therapy for obesity in terms of reductions in waist circumference, body weight and BMI, and thus the overall reduction of both cardiovascular and metabolic risks, as well as improved postural skills (activity and reactions). Copyright© by the National Institute of Public Health, Prague 2017

Exenatide's effect in reducing weight and glycosylated hemoglobin level in an Arab population with type 2 diabetes.

PubMed

Bashier, Alaaeldin M; Abdelgadir, Elamin I; Khalifa, Azza A; Rashid, Fouzia; Abuelkeir, Sona M; Bachet, Fawzi E

2014-11-01

To determine whether exenatide is effective in reducing weight and glycosylated hemoglobin level (HbA1c), and to investigate its efficacy in improving lipid profile, blood pressure, and creatinine levels in the Arab population. This study was conducted at the Endocrine Unit, Dubai Hospital, Dubai, United Arab Emirates. We retrospectively collected data from patients with type 2 diabetes started on exenatide between November 2011 and February 2012. Data included demographics, clinical, laboratory results, and medications used. A general linear model adjusted by baseline characteristics (weight, HbA1C, age, use of statins, and duration of diabetes) was used to assess changes between baseline and end of trial in HbA1C, weight, low density lipoprotein cholesterol, total cholesterol, triglycerides, creatinine, and blood pressure. After 6 months of treatment with exenatide, the HbA1c decreased by 0.47% (95% confidence level [CI]: -0.01 - 0.95) (p=0.055). Weight reduction was highly significant; 5.6 kg (95% CI: 3.34 - 7.85) (p<0.001). Those reductions remained significant after adjustment for confounding factors. This study showed that weight reduction was highly significant with exenatide. The borderline significance in HbA1c reduction can be attributed to the small sample size. 

Application of response surface methodology for optimization of parameters for microwave heating of rare earth carbonates

NASA Astrophysics Data System (ADS)

Yin, Shaohua; Lin, Guo; Li, Shiwei; Peng, Jinhui; Zhang, Libo

2016-09-01

Microwave heating has been applied in the field of drying rare earth carbonates to improve drying efficiency and reduce energy consumption. The effects of power density, material thickness and drying time on the weight reduction (WR) are studied using response surface methodology (RSM). The results show that RSM is feasible to describe the relationship between the independent variables and weight reduction. Based on the analysis of variance (ANOVA), the model is in accordance with the experimental data. The optimum experiment conditions are power density 6 w/g, material thickness 15 mm and drying time 15 min, resulting in an experimental weight reduction of 73%. Comparative experiments show that microwave drying has the advantages of rapid dehydration and energy conservation. Particle analysis shows that the size distribution of rare earth carbonates after microwave drying is more even than those in an oven. Based on these findings, microwave heating technology has an important meaning to energy-saving and improvement of production efficiency for rare earth smelting enterprises and is a green heating process.

Diet, inflammation and prediabetes-impact of quality of diet.

PubMed

Uusitupa, Matti; Schwab, Ursula

2013-10-01

Low grade inflammation has been linked to risk of type 2 diabetes and atherosclerotic vascular diseases. Obesity and, in particular, abdominal obesity increase the risk of diabetes and atherosclerotic vascular diseases. One of the mechanisms could be low grade inflammation and vascular endothelial dysfunction. Permanent weight reduction is the first line of treatment both for obese individuals at increased risk of diabetes and for newly onset type 2 diabetes. Weight reduction lowers the level of several inflammatory factors in the body while increasing the level of adiponectin. Besides weight reduction the quality of diet and physical activity also modifies low grade inflammation. Based on the literature survey and our own studies in humans, it is possible to have dietary patterns that reduce inflammatory stress in the body and improves vascular endothelial dysfunction. There is strong evidence to suggest that IL-1 Ra is a very sensitive marker of low grade inflammation in obesity and related phenotypes; however, its level is markedly lowered by weight reduction and by choosing foods that have been shown to reduce inflammatory stress in the body. Copyright © 2013. Published by Elsevier Inc.

A legume-based hypocaloric diet reduces proinflammatory status and improves metabolic features in overweight/obese subjects.

PubMed

Hermsdorff, Helen Hermana M; Zulet, M Ángeles; Abete, Itziar; Martínez, J Alfredo

2011-02-01

The nutritional composition of the dietary intake could produce specific effects on metabolic variables and inflammatory marker concentrations. This study assessed the effects of two hypocaloric diets (legume-restricted- vs. legume-based diet) on metabolic and inflammatory changes, accompanying weight loss. Thirty obese subjects (17 M/13F; BMI: 32.5 ± 4.5 kg/m(2); 36 ± 8 years) were randomly assigned to one of the following hypocaloric treatments (8 weeks): Calorie-restricted legume-free diet (Control: C-diet) or calorie-restricted legume-based diet (L-diet), prescribing 4 weekly different cooked-servings (160-235 g) of lentils, chickpeas, peas or beans. Body composition, blood pressure (BP), blood biochemical and inflammatory marker concentrations as well as dietary intake were measured at baseline and after the nutritional intervention. The L-diet achieved a greater body weight loss, when compared to the C-diet (-7.8 ± 2.9% vs. -5.3 ± 2.7%; p = 0.024). Total and LDL cholesterol levels and systolic BP were improved only when consuming the L-diet (p < 0.05). L-diet also resulted in a significant higher reduction in C-reactive protein (CRP) and complement C3 (C3) concentrations (p < 0.05), compared to baseline and C-diet values. Interestingly, the reduction in the concentrations of CRP and C3 remained significantly higher to L-diet group, after adjusting by weight loss (p < 0.05). In addition, the reduction (%) in CRP concentrations was positively associated with decreases (%) in systolic BP and total cholesterol concentration specifically in the L-diet group, independent from weight loss (p < 0.05). The consumption of legumes (4 servings/week) within a hypocaloric diet resulted in a specific reduction in proinflammatory markers, such as CRP and C3 and a clinically significant improvement of some metabolic features (lipid profile and BP) in overweight/ obese subjects, which were in some cases independent from weight loss.

The use of anti-mullerian hormone in predicting menstrual response after weight loss in overweight women with polycystic ovary syndrome.

PubMed

Moran, Lisa J; Noakes, Manny; Clifton, Peter M; Norman, Robert J

2007-10-01

Polycystic ovary syndrome (PCOS) is associated with reproductive and metabolic abnormalities, specifically menstrual dysfunction and anovulation in conjunction with elevated pre-antral follicle number and arrested follicular maturation. Although anti-müllerian hormone (AMH), an inhibitor of follicle recruitment and maturation, is increased in women with PCOS, the usefulness of circulating AMH levels as a clinical predictor of menstrual response to weight loss in PCOS is not known. Overweight women with PCOS (n = 26, age 32.9 +/- 5.8 yr, weight 98.9 +/- 20.8 kg, body mass index 36.1 +/- 7.0 kg/m(2), mean +/- sd) followed an 8-wk weight loss and 6-month weight maintenance program. Net reductions in weight (4.6 +/- 4.8 kg), waist circumference (6.0 +/- 5.3 cm), testosterone (0.3 +/- 0.6 nmol/liter), fasting insulin (3.7 +/- 7.6 mU/liter), and the homeostasis model assessment of insulin sensitivity (0.7 +/- 1.3) occurred for all subjects over the entire study duration. Of 26 subjects, 15 (57.7%) responded to the intervention with improvements in menstrual cyclicity (responders). Compared to nonresponders, responders had lower AMH levels at baseline (23.6 +/- 12.0 vs. 37.9 +/- 17.8 pmol/liter; P = 0.021). Only responders had reductions in fasting insulin (6.1 +/- 5.9 mU/liter; P = 0.001) and homeostasis model assessment (1.3 +/- 5.9; P = 0.002) with acute weight loss (wk 0-8). Baseline AMH was most strongly predicted by baseline ghrelin, free testosterone, and insulin (r(2) = 0.528; P = 0.002). Overweight women with PCOS who respond to weight loss with menstrual improvements have significantly reduced preweight loss AMH and demonstrate improvements in surrogate measures of insulin resistance with weight loss. Pretreatment AMH is a potential clinical predictor of menstrual improvements with weight loss in PCOS.

Reducing Weight for Transportation Applications: Technology Challenges and Opportunities

NASA Astrophysics Data System (ADS)

Taub, Alan I.

Today's land, sea and air transportation industries — as a business necessity — are focused on technology solutions that will make vehicles more sustainable in terms of energy, the environment, safety and affordability. Reducing vehicle weight is a key enabler for meeting these challenges as well as increasing payload and improving performance. The potential weight reductions from substituting lightweight metals (advanced high-strength steels, aluminum, magnesium and titanium alloys) are well established. For magnesium castings, weight savings of 60% have been reported [1]. The value of weight reduction depends on the transportation sector and ranges from about 5/kg saved for automobiles to over 500/kg saved for aircraft [2]. The challenge is to optimize the material properties and develop robust, high volume, manufacturing technologies and the associated supply chain to fabricate components and subsystems at the appropriate cost for each application.

Surgically-Induced Weight Loss Significantly Improves Nonalcoholic Fatty Liver Disease and the Metabolic Syndrome

PubMed Central

Mattar, Samer G.; Velcu, Laura M.; Rabinovitz, Mordechai; Demetris, A J.; Krasinskas, A M.; Barinas-Mitchell, Emma; Eid, George M.; Ramanathan, Ramesh; Taylor, Debra S.; Schauer, Philip R.

2005-01-01

Objective: To evaluate the effects of surgical weight loss on fatty liver disease in severely obese patients. Summary Background Data: Nonalcoholic fatty liver disease (NAFLD), a spectrum that extends to liver fibrosis and cirrhosis, is rising at an alarming rate. This increase is occurring in conjunction with the rise of severe obesity and is probably mediated in part by metabolic syndrome (MS). Surgical weight loss operations, probably by reversing MS, have been shown to result in improvement in liver histology. Methods: Patients who underwent laparoscopic surgical weight loss operations from March 1999 through August 2004, and who agreed to have an intraoperative liver biopsy followed by at least one postoperative liver biopsy, were included. Results: There were 70 patients who were eligible. All patients underwent laparoscopic operations, the majority being laparoscopic Roux-en-Y gastric bypass. The mean excess body weight loss at time of second biopsy was 59% ± 22% and the time interval between biopsies was 15 ± 9 months. There was a reduction in prevalence of metabolic syndrome, from 70% to 14% (P < 0.001), and a marked improvement in liver steatosis (from 88% to 8%), inflammation (from 23% to 2%), and fibrosis (from 31% to 13%; all P < 0.001). Inflammation and fibrosis resolved in 37% and 20% of patients, respectively, corresponding to improvement of 82% (P < 0.001) in grade and 39% (P < 0.001) in stage of liver disease. Conclusion: Surgical weight loss results in significant improvement of liver morphology in severely obese patients. These beneficial changes may be associated with a significant reduction in the prevalence of the metabolic syndrome. PMID:16192822

Comparison of glucostatic parameters after hypocaloric diet or bariatric surgery and equivalent weight loss.

PubMed

Plum, Leona; Ahmed, Leaque; Febres, Gerardo; Bessler, Marc; Inabnet, William; Kunreuther, Elizabeth; McMahon, Donald J; Korner, Judith

2011-11-01

Weight-loss independent mechanisms may play an important role in the improvement of glucose homeostasis after Roux-en-Y gastric bypass (RYGB). The objective of this analysis was to determine whether RYGB causes greater improvement in glucostatic parameters as compared with laparoscopic adjustable gastric banding (LAGB) or low calorie diet (LCD) after equivalent weight loss and independent of enteral nutrient passage. Study 1 recruited participants without type 2 diabetes mellitus (T2DM) who underwent LAGB (n = 8) or RYGB (n = 9). Study 2 recruited subjects with T2DM who underwent LCD (n = 7) or RYGB (n = 7). Insulin-supplemented frequently-sampled intravenous glucose tolerance test (fsIVGTT) was performed before and after equivalent weight reduction. MINMOD analysis of insulin sensitivity (Si), acute insulin response to glucose (AIRg) and C-peptide (ACPRg) response to glucose, and insulin secretion normalized to the degree of insulin resistance (disposition index (DI)) were analyzed. Weight loss was comparable in all groups (7.8 ± 0.4%). In Study 1, significant improvement of Si, ACPRg, and DI were observed only after LAGB. In Study 2, Si, ACPRg, and plasma adiponectin increased significantly in the RYGB-DM group but not in LCD. DI improved in both T2DM groups, but the absolute increase was greater after RYGB (258.2 ± 86.6 vs. 55.9 ± 19.9; P < 0.05). Antidiabetic medications were discontinued after RYGB contrasting with 55% reduction in the number of medications after LCD. No intervention affected fasting glucagon-like peptide (GLP)-1, peptide YY (PYY) or ghrelin levels. In conclusion, RYGB produced greater improvement in Si and DI compared with diet at equivalent weight loss in T2DM subjects. Such a beneficial effect was not observed in nondiabetic subjects at this early time-point.

Impact of Advanced Propeller Technology on Aircraft/Mission Characteristics of Several General Aviation Aircraft

NASA Technical Reports Server (NTRS)

Keiter, I. D.

1982-01-01

Studies of several General Aviation aircraft indicated that the application of advanced technologies to General Aviation propellers can reduce fuel consumption in future aircraft by a significant amount. Propeller blade weight reductions achieved through the use of composites, propeller efficiency and noise improvements achieved through the use of advanced concepts and improved propeller analytical design methods result in aircraft with lower operating cost, acquisition cost and gross weight.

Health-related quality of life in randomized controlled trials of lorcaserin for obesity management: what mediates improvement?

PubMed

Kolotkin, R L; Crosby, R D; Wang, Z

2017-12-01

Lorcaserin, plus diet and exercise, has demonstrated significant weight loss and improved cardiometabolic parameters vs. placebo in patients with overweight/obesity in three randomized, placebo-controlled trials. We examined whether lorcaserin is also associated with greater improvements in health-related quality of life (HRQOL) and whether these improvements are wholly attributable to weight loss. Pooled data from Behavioral Modification and Lorcaserin for Overweight and Obesity Management (BLOOM), Behavioral Modification and Lorcaserin Second Study for Obesity Management (BLOSSOM) and BLOOM-Diabetes Mellitus (BLOOM-DM) trials were analysed (n = 5624). HRQOL was assessed at baseline and 52 weeks using the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire. Multiple mediation analyses were conducted to evaluate the mechanisms underlying improved HRQOL. Greater HRQOL improvements were observed at 52 weeks in lorcaserin vs. placebo (P < 0.0001). A greater percentage of lorcaserin patients (54.1%) experienced meaningful improvements in IWQOL-Lite total score than placebo patients (48.2%) (P < 0.001). Body mass index (BMI) reduction was the primary driver of improved HRQOL (P < 0.0001), with depressive symptoms and total cholesterol also playing a role (P < 0.05). Improved HRQOL varied by gender, age, race and presence of diabetes and other comorbidities. Lorcaserin treatment significantly improves HRQOL compared with placebo. Although BMI reduction accounts for the majority of these improvements, improvement in depressive symptoms and total cholesterol are contributing factors. © 2017 World Obesity Federation.

Effects of meal preparation training on body weight, glycemia, and blood pressure: results of a phase 2 trial in type 2 diabetes.

PubMed

Dasgupta, Kaberi; Hajna, Samantha; Joseph, Lawrence; Da Costa, Deborah; Christopoulos, Stavroula; Gougeon, Rejeanne

2012-10-17

Modest reductions in weight and small increases in step- related activity (e.g., walking) can improve glycemic and blood pressure control in type 2 diabetes mellitus (DM2). We examined changes in these parameters following training in time- efficient preparation of balanced, low- energy meals combined with pedometer- based step count monitoring. Seventy- two adults with DM2 were enrolled in a 24- week program (i.e., 15 three- hour group sessions). They prepared meals under a chef's supervision, and discussed eating behaviours/nutrition with a registered dietitian. They maintained a record of pedometer- assessed step counts. We evaluated changes from baseline to 24 weeks in terms of weight, step counts, hemoglobin A1c (HbA1c, glycemic control), blood pressure, and eating control ability (Weight Efficacy Lifestyle WEL Questionnaire). 53 participants (73.6%) completed assessments. There were improvements in eating control (11.2 point WEL score change, 95% CI 4.7 to 17.8), step counts (mean change 869 steps/day, 95% CI 198 to 1,540), weight (mean change -2.2%; 95% CI -3.6 to -0.8), and HbA1c (mean change -0.3% HbA1c, 95% CI -0.6 to -0.1), as well as suggestion of systolic blood pressure reduction (mean change -3.5 mm Hg, 95% CI -7.8 to 0.9). Findings were not attributable to medication changes. In linear regression models (adjusted for age, sex, ethnicity, insulin use, season), a -2.5% weight change was associated with a -0.3% HbA1c change (95% CI -0.4 to -0.2) and a -3.5% systolic blood pressure change (95% CI -5.5 to -1.4). In this 'proof of concept' study, persistence with the program led to improvements in eating and physical activity habits, glycemia reductions, and suggestion of blood pressure lowering effects. The strategy thus merits further study and development to expand the range of options for vascular risk reduction in DM2.

Dietary interventions for weight loss and cardiovascular risk reduction in people of African ancestry (blacks): a systematic review.

PubMed

Osei-Assibey, G; Boachie, C

2012-01-01

To systematically review weight and cardiovascular risk reduction in blacks by diet and lifestyle changes. Randomised and non-randomised controlled trials of diet with/without lifestyle changes with duration of intervention ≥3 months, and published between January 1990 and December 2009, were searched in electronic databases including MEDLINE, EMBASE, CINAHL and CCTR (Cochrane Controlled Trials Register). Studies were included if they reported weight/BMI changes with changes in at least one of the following: systolic and diastolic blood pressure, fasting plasma lipids and glucose, and glycated haemoglobin. Clinical, community and church-based interventions. Study participants were of African ancestry (blacks). Eighteen studies met the inclusion criteria. Average mean difference in weight loss was -2·66 kg, with improvements in all outcomes except total cholesterol. No significant difference was observed in outcome measures between all studies and studies that recruited only healthy participants or patients with type 2 diabetes. Diet and lifestyle changes result in weight loss with improvements in cardiovascular risk factors in blacks. However, more culturally tailored programmes have been suggested to motivate and encourage blacks to participate in intervention trials.

Management of obesity in NIDDM (non-insulin-dependent diabetes mellitus).

PubMed

Cheah, J S

1998-08-01

Obesity is common in NIDDM; in a cohort of 314 diabetics in Singapore, 44.3% are overweight. Management of obesity in diabetics differs from that in non-diabetics in that it is more urgent; weight maintenance is more difficult and hypoglycaemic medication may cause weight changes. Like in the non-diabetic, management of obesity in diabetic requires a pragmatic and realistic approach. A team approach is required: the help of the nurse educator, the dietitian, behaviour modification therapist, exercise therapist etc are required. A detailed history, careful physical examination and relevant investigations are required to assess the severity of the diabetic state and to exclude an occasional underlying cause of the obesity in the obese NIDDM. Weight loss is urgent in the obese NIDDM, especially those with android obesity. There must be a reduction in caloric intake. Weight loss leads to improvement in the glucose tolerance, insulin sensitivity, reduction in lipid levels and fall in blood pressure in the hypertensive. Exercise is of limited value except in the younger obese NIDDM. Metformin is the hypoglycaemic drug of choice as it leads to consistent weight reduction. The sulphonylureas may cause weight gain. Insulin should be avoided where possible as it causes further weight gain. Other hypoglycaemic agents include Glucobay (alpha-glucosidase inhibitor) and Troglitazone (insulin sensitizer) which do not alter the weight. Orlistat (lipase inhibitor) is promising as it causes reduction of weight, blood-glucose and lipid levels. Anti-obesity drugs (noradrenergic and serotonergic agents) have modest effects on weight reduction in the obese NIDDM; a widely use preparation, Dexfenfluramine (Adifax) has been withdrawn because of side effects. Surgery such as gastric plication is the last resort in treating the morbidly obese NIDDM. The discovery of leptin in 1994 has led to intense research into energy homeostasis in obesity; hopefully this will lead to better treatment of obesity in diabetics and non-diabetics.

Process for Making Carbon-Carbon Turbocharger Housing Unit for Intermittent Combustion Engines

NASA Technical Reports Server (NTRS)

Northam, G. Burton (Inventor); Ransone, Philip O. (Inventor); Rivers, H. Kevin (Inventor)

1999-01-01

An improved. lightweight, turbine housing unit for an intermittent combustion reciprocating internal combustion engine turbocharger is prepared from a lay-up or molding of carbon-carbon composite materials in a single-piece or two-piece process. When compared to conventional steel or cast iron, the use of carbon-carbon composite materials in a turbine housing unit reduces the overall weight of the engine and reduces the heat energy loss used in the turbo-charging process. This reduction in heat energy loss and weight reduction provides for more efficient engine operation.

Carbon-Carbon Turbocharger Housing Unit for Intermittent Combustion Engines

NASA Technical Reports Server (NTRS)

Northam, G. Burton (Inventor); Ransone, Philip O. (Inventor); Rivers, H. Kevin (Inventor)

1998-01-01

An improved, lightweight, turbine housing unit for an intermittent combustion reciprocating internal combustion engine turbocharger is prepared from a lay-up or molding of carbon-carbon composite materials in a single-piece or two-piece process. When compared to conventional steel or cast iron, the use of carbon-carbon composite materials in a turbine housing unit reduces the overall weight of the engine and reduces the heat energy loss used in the turbocharging process. This reduction in heat energy loss and weight reduction provides for more efficient engine operation.

Numerical and Experimental Evaluation on the Residual Stresses of Welded Joints

NASA Astrophysics Data System (ADS)

Huh, Sun Chul; Park, Wonjo; Yang, Haesug; Jung, Haeyoung; Kim, Chuyoung

Wings for the defense industry such as fighters, missiles, and rockets should show no deformation or damage on the structure. The structures of existing wings had holes for weight reduction. The plates and frames were fixed with rivets or screws, which limited the weight reduction possible. In this study, an improvement was made in jointing methods through EB welding and laser welding. Welding strength was measured through tension testing. In addition, finite element analysis was performed for the welding process so as to deduce the optimum welding condition.

Energy weighting improves dose efficiency in clinical practice: implementation on a spectral photon-counting mammography system

PubMed Central

Berglund, Johan; Johansson, Henrik; Lundqvist, Mats; Cederström, Björn; Fredenberg, Erik

2014-01-01

Abstract. In x-ray imaging, contrast information content varies with photon energy. It is, therefore, possible to improve image quality by weighting photons according to energy. We have implemented and evaluated so-called energy weighting on a commercially available spectral photon-counting mammography system. The technique was evaluated using computer simulations, phantom experiments, and analysis of screening mammograms. The CNR benefit of energy weighting for a number of relevant target-background combinations measured by the three methods fell in the range of 2.2 to 5.2% when using optimal weight factors. This translates to a potential dose reduction at constant CNR in the range of 4.5 to 11%. We expect the choice of weight factor in practical implementations to be straightforward because (1) the CNR improvement was not very sensitive to weight, (2) the optimal weight was similar for all investigated target-background combinations, (3) aluminum/PMMA phantoms were found to represent clinically relevant tasks well, and (4) the optimal weight could be calculated directly from pixel values in phantom images. Reasonable agreement was found between the simulations and phantom measurements. Manual measurements on microcalcifications and automatic image analysis confirmed that the CNR improvement was detectable in energy-weighted screening mammograms. PMID:26158045

Effectiveness of a Low-Calorie Weight Loss Program in Moderately and Severely Obese Patients

PubMed Central

Winkler, Julia K.; Schultz, Jobst-Hendrik; Woehning, Annika; Piel, David; Gartner, Lena; Hildebrand, Mirjam; Roeder, Eva; Nawroth, Peter P.; Wolfrum, Christian; Rudofsky, Gottfried

2013-01-01

Aims To compare effectiveness of a 1-year weight loss program in moderately and severely obese patients. Methods The study sample included 311 obese patients participating in a weight loss program, which comprised a 12-week weight reduction phase (low-calorie formula diet) and a 40-week weight maintenance phase. Body weight and glucose and lipid values were determined at the beginning of the program as well as after the weight reduction and the weight maintenance phase. Participants were analyzed according to their BMI class at baseline (30-34.9 kg/m2; 35-39.9 kg/m2; 40-44.9 kg/m2; 45-49.9 kg/m2; ≥50 kg/m2). Furthermore, moderately obese patients (BMI ℋ 40 kg/m2) were compared to severely obese participants (BMI ≥ 40 kg/m2). Results Out of 311 participants, 217 individuals completed the program. Their mean baseline BMI was 41.8 ± 0.5 kg/m2. Average weight loss was 17.9 ± 0.6%, resulting in a BMI of 34.3 ± 0.4 kg/m2 after 1 year (p ℋ 0.001). Overall weight loss was not significantly different in moderately and severely obese participants. Yet, severely obese participants achieved greater weight loss during the weight maintenance phase than moderately obese participants (−3.1 ± 0.7% vs. −1.2 ± 0.6%; p = 0.04). Improvements in lipid profiles and glucose metabolism were found throughout all BMI classes. Conclusion 1-year weight loss intervention improves body weight as well as lipid and glucose metabolism not only in moderately, but also in severely obese individuals. PMID:24135973

Green Tea Improves Metabolic Biomarkers, not Weight or Body Composition: A Pilot Study in Overweight Breast Cancer Survivors

PubMed Central

Stendell-Hollis, Nicole R; Thomson, Cynthia A; Thompson, Patricia A; Bea, Jennifer W; Cussler, Ellen C; Hakim, Iman A

2010-01-01

Background Overweight status after breast cancer treatment may increase a woman’s risk for recurrent disease and/or early onset cardiovascular disease. Green tea has been proposed to promote weight loss and favourably modify glucose, insulin and blood lipids. This pilot study tested the effect of daily decaffeinated green tea consumption for 6 months on weight and body composition, select metabolic parameters, and lipid profiles in overweight breast cancer survivors. Methods The effect of daily decaffeinated green tea intake on weight, body composition and changes in resting metabolic rate, energy intake, glucose, insulin, HOMA-IR, and lipids was evaluated in overweight breast cancer survivors. Participants had a mean weight of 80.2 kg; BMI 30.1 kg/m2; and body fat 46.4%. Participants (N=54) were randomised to 960 mL decaffeinated green or placebo tea daily for 6 months. Results Average tea intake among study completers (N=39) was 5952 ± 1176 mL/week and was associated with a significant reduction in energy intake (P =0.02). Change in body weight of −1.2 kg (green tea) versus + 0.2 kg (placebo) suggests a weight change effect, but was not statistically significant. Decaffeinated green tea intake was associated with elevated HDL levels (P=0.003) and non-significant improvements in the HOMA-IR (−1.1±5.9: green tea; +3.2±7.2: herbal) and the HDL/LDL ratio. Conclusions Intake of decaffeinated green tea for 6 months was associated with a slight reduction in body weight and improved HDL and glucose homeostasis in overweight breast cancer survivors. PMID:20807303

Spatiotemporal Interpolation for Environmental Modelling

PubMed Central

Susanto, Ferry; de Souza, Paulo; He, Jing

2016-01-01

A variation of the reduction-based approach to spatiotemporal interpolation (STI), in which time is treated independently from the spatial dimensions, is proposed in this paper. We reviewed and compared three widely-used spatial interpolation techniques: ordinary kriging, inverse distance weighting and the triangular irregular network. We also proposed a new distribution-based distance weighting (DDW) spatial interpolation method. In this study, we utilised one year of Tasmania’s South Esk Hydrology model developed by CSIRO. Root mean squared error statistical methods were performed for performance evaluations. Our results show that the proposed reduction approach is superior to the extension approach to STI. However, the proposed DDW provides little benefit compared to the conventional inverse distance weighting (IDW) method. We suggest that the improved IDW technique, with the reduction approach used for the temporal dimension, is the optimal combination for large-scale spatiotemporal interpolation within environmental modelling applications. PMID:27509497

Fuel Consumption Reduction and Weight Estimate of an Intercooled-Recuperated Turboprop Engine

NASA Astrophysics Data System (ADS)

Andriani, Roberto; Ghezzi, Umberto; Ingenito, Antonella; Gamma, Fausto

2012-09-01

The introduction of intercooling and regeneration in a gas turbine engine can lead to performance improvement and fuel consumption reduction. Moreover, as first consequence of the saved fuel, also the pollutant emission can be greatly reduced. Turboprop seems to be the most suitable gas turbine engine to be equipped with intercooler and heat recuperator thanks to the relatively small mass flow rate and the small propulsion power fraction due to the exhaust nozzle. However, the extra weight and drag due to the heat exchangers must be carefully considered. An intercooled-recuperated turboprop engine is studied by means of a thermodynamic numeric code that, computing the thermal cycle, simulates the engine behavior at different operating conditions. The main aero engine performances, as specific power and specific fuel consumption, are then evaluated from the cycle analysis. The saved fuel, the pollution reduction, and the engine weight are then estimated for an example case.

NASA Heavy Lift Rotorcraft Systems Investigation

NASA Technical Reports Server (NTRS)

Johnson, Wayne; Yamauchi, Gloria K.; Watts, Michael E.

2005-01-01

The NASA Heavy Lift Rotorcraft Systems Investigation examined in depth several rotorcraft configurations for large civil transport, designed to meet the technology goals of the NASA Vehicle Systems Program. The investigation identified the Large Civil Tiltrotor as the configuration with the best potential to meet the technology goals. The design presented was economically competitive, with the potential for substantial impact on the air transportation system. The keys to achieving a competitive aircraft were low drag airframe and low disk loading rotors; structural weight reduction, for both airframe and rotors; drive system weight reduction; improved engine efficiency; low maintenance design; and manufacturing cost comparable to fixed-wing aircraft. Risk reduction plans were developed to provide the strategic direction to support a heavy-lift rotorcraft development. The following high risk areas were identified for heavy lift rotorcraft: high torque, light weight drive system; high performance, structurally efficient rotor/wing system; low noise aircraft; and super-integrated vehicle management system.

Designs and Technology Requirements for Civil Heavy Lift Rotorcraft

NASA Technical Reports Server (NTRS)

Johnson, Wayne; Yamauchi, Gloria K.; Watts, Michael E.

2006-01-01

The NASA Heavy Lift Rotorcraft Systems Investigation examined in depth several rotorcraft configurations for large civil transport, designed to meet the technology goals of the NASA Vehicle Systems Program. The investigation identified the Large Civil Tiltrotor as the configuration with the best potential to meet the technology goals. The design presented was economically competitive, with the potential for substantial impact on the air transportation system. The keys to achieving a competitive aircraft were low drag airframe and low disk loading rotors; structural weight reduction, for both airframe and rotors; drive system weight reduction; improved engine efficiency; low maintenance design; and manufacturing cost comparable to fixed-wing aircraft. Risk reduction plans were developed to provide the strategic direction to support a heavy-lift rotorcraft development. The following high risk areas were identified for heavy lift rotorcraft: high torque, light weight drive system; high performance, structurally efficient rotor/wing system; low noise aircraft; and super-integrated vehicle management system.

Effects of a tailored lifestyle self-management intervention (TALENT) study on weight reduction: a randomized controlled trial.

PubMed

Melchart, Dieter; Löw, Peter; Wühr, Erich; Kehl, Victoria; Weidenhammer, Wolfgang

2017-01-01

Overweight and obesity are globally increasing risk factors for diseases in the context of metabolic syndrome. A randomized controlled trial was conducted to investigate whether there are any existing differences between two lifestyle intervention strategies with respect to weight reduction after 1 year. A total of 166 subjects with a body mass index of 28-35 kg/m 2 were enrolled in this trial at seven study centers; 109 were randomly allocated to the intervention group (comprehensive lifestyle modification program: web-based Individual Health Management [IHM]) with 3-month reduction phase plus 9-month maintenance phase, and 57 were allocated to the control group (written information with advice for healthy food habits: usual care [UC]). Body weight, waist circumference, blood pressure, laboratory findings, and bioimpedance analysis used to determine body composition were measured at baseline and after 3, 6, 9, and 12 months. The primary outcome parameter was body weight at month 12 compared to baseline. With respect to baseline status there were no statistically significant differences between the groups. Based on the intent-to-treat population, body weight showed a mean decrease of 8.7 kg (SD 6.1) in the intervention group (IHM) and 4.2 kg (SD 5) in the control group (UC) at month 12. This statistically significant difference ( P <0.001) was confirmed by various sensitivity analyses. Body mass index, waist circumference, high-density lipid cholesterol, body fat, and the ratio of fat and body cell mass improved to a significantly higher degree in the IHM group. IHM proved to be superior to UC in weight reduction after 1 year. With a mean loss of about 10% of the baseline weight, a clinically high relevant risk reduction for cardio-metabolic diseases is achievable.

Overweight and obese anovulatory patients with polycystic ovaries: parallel improvements in anthropometric indices, ovarian physiology and fertility rate induced by diet.

PubMed

Crosignani, Pier Giorgio; Colombo, Michela; Vegetti, Walter; Somigliana, Edgardo; Gessati, Alessio; Ragni, Guido

2003-09-01

This prospective study evaluated the effect of weight reduction on anthropometric indices and ovarian morphology in anovulatory overweight patients with polycystic ovary syndrome (PCOS). Thirty-three anovulatory overweight patients with PCOS were enrolled in the study. All had patent Fallopian tubes and chronic anovulation: 27 of them were oligo-amenorrhoeic. The partners were normospermic. Patients were prescribed a 1200 kcal/day diet, and physical exercise was recommended. Anthropometric indices and ovarian imaging parameters were assessed at baseline and after weight loss of 5 and 10%. Twenty-five patients (76%) lost at least 5% of their body weight. Eleven of these patients (33%) reached a 10% decrease in weight. Waist circumference at the umbilical level, hip circumference, four skin folds, body mass index and fatty mass ratio were significantly reduced after 5 and 10% weight loss. Ovarian morphology changed during the diet: we observed a significant reduction in ovarian volume and in the number of microfollicles per ovary. Among the 27 patients with oligo-amenorrhoea, 18 had a resumption of regular cycles and 15 experienced spontaneous ovulation; 10 spontaneous pregnancies occurred in patients who lost at least 5% of their weight. Weight loss through a controlled low-calorie diet improves anthropometric indices in obese PCOS patients, reduces ovarian volume and microfollicle number and can restore ovulatory cycles, allowing spontaneous pregnancy.

Effects of Laparoscopic Sleeve Gastrectomy on Central Obesity and Metabolic Syndrome in Indian Adults- A Prospective Study

PubMed Central

Thillai, Manoj; Nain, Prabhdeep Singh; Ahuja, Ashish; Vayoth, Sudheer Othiyil; Khurana, Preetika

2017-01-01

Introduction Increasing incidence of obesity in Indian population has led to an exponential rise in the number of bariatric operations performed annually. Laparoscopic Sleeve Gastrectomy (LSG) has been proposed to cause rapid remission of Type 2 Diabetes Melitus (T2DM) and metabolic syndrome in a weight loss independent manner. Aim To evaluate the effects of LSG on metabolic syndrome and central obesity in morbidly and severely obese Indian adults. Material and Methods: Study was conducted on 91 morbidly obese [Body Mass Index (BMI)>40 kg/m2] and severely obese (BMI>35 kg/m2) individuals who were suffering from diabetes, hypertension or dyslipidemia. The patients were followed up for six months and the trends of glycaemic control, mean blood pressure, lipid profile, weight loss parameters and changes in parameters of central obesity were studied. Results Weight loss was significant at three months postsurgery and was sustained through six months. There was significant improvement in glycaemic control leading to reduction in need for oral hypoglycaemic agents or insulin in majority of them and even discontinuation of these medications in few patients. Hypertension and dyslipidemia also showed an improving trend through six months postsurgery. There was a significant impact on reduction of central obesity in these patients as marked by significant reduction in waist to hip ratio. Conclusion LSG produces sustainable weight loss with significant improvement in glycaemic status and control of metabolic syndrome in severe to morbidly obese patients. LSG is also efficacious in reducing central obesity in Indian population which is a major depressive ailment amongst obese individuals. PMID:28273998

Effects of Laparoscopic Sleeve Gastrectomy on Central Obesity and Metabolic Syndrome in Indian Adults- A Prospective Study.

PubMed

Sethi, Pulkit; Thillai, Manoj; Nain, Prabhdeep Singh; Ahuja, Ashish; Vayoth, Sudheer Othiyil; Khurana, Preetika

2017-01-01

Increasing incidence of obesity in Indian population has led to an exponential rise in the number of bariatric operations performed annually. Laparoscopic Sleeve Gastrectomy (LSG) has been proposed to cause rapid remission of Type 2 Diabetes Melitus (T2DM) and metabolic syndrome in a weight loss independent manner. To evaluate the effects of LSG on metabolic syndrome and central obesity in morbidly and severely obese Indian adults. Material and Methods: Study was conducted on 91 morbidly obese [Body Mass Index (BMI)>40 kg/m 2 ] and severely obese (BMI>35 kg/m 2 ) individuals who were suffering from diabetes, hypertension or dyslipidemia. The patients were followed up for six months and the trends of glycaemic control, mean blood pressure, lipid profile, weight loss parameters and changes in parameters of central obesity were studied. Weight loss was significant at three months postsurgery and was sustained through six months. There was significant improvement in glycaemic control leading to reduction in need for oral hypoglycaemic agents or insulin in majority of them and even discontinuation of these medications in few patients. Hypertension and dyslipidemia also showed an improving trend through six months postsurgery. There was a significant impact on reduction of central obesity in these patients as marked by significant reduction in waist to hip ratio. LSG produces sustainable weight loss with significant improvement in glycaemic status and control of metabolic syndrome in severe to morbidly obese patients. LSG is also efficacious in reducing central obesity in Indian population which is a major depressive ailment amongst obese individuals.

Effect of two different hypocaloric diets in transaminases and insulin resistance in nonalcoholic fatty liver disease and obese patients.

PubMed

de Luis, D A; Aller, R; Izaola, O; Gonzalez Sagrado, M; Conde, R

2010-01-01

The aim of our study was to examine the changes in hypertransaminasemia after weight reduction in obese patients with and without NAFLD and the relation with insulin resistance. A population of 162 obese patients was randomly allocated to two groups: a) diet I (low fat) and b) diet II (low carbohydrate), dieting along 3 months. Patients were classified as group I (n=112) when serum ALT activity was normal or group II (NAFLD, n=30) when serum ALT activity was (>or=43 UI/L). In control group with diet I, BMI, weight, fat mass, waist to hip ratio, waist circumference, systolic pressure, total cholesterol, LDL cholesterol, HOMA and insulin levels decreased. In NAFLD group with diet I improved the same parameters and glucose, triglycerides, ALT, AST, gamaglutamine transferase levels, too. In control group with diet II, BMI, weight, fat mass, waist to hip ratio, waist circumference, systolic pressure, total cholesterol, LDL cholesterol, HOMA and insulin levels decreased. In NAFLD group with diet II improved the same parameters and glucose, triglycerides, ALT and gamaglutamine transferase levels, without statistical changes in AST. We showed that weight reduction secondary to two hypocaloric diets was associated with improvement in hipertransaminasemia and insulin resistance in NAFLD patients.

The effect of intermittent energy and carbohydrate restriction v. daily energy restriction on weight loss and metabolic disease risk markers in overweight women.

PubMed

Harvie, Michelle; Wright, Claire; Pegington, Mary; McMullan, Debbie; Mitchell, Ellen; Martin, Bronwen; Cutler, Roy G; Evans, Gareth; Whiteside, Sigrid; Maudsley, Stuart; Camandola, Simonetta; Wang, Rui; Carlson, Olga D; Egan, Josephine M; Mattson, Mark P; Howell, Anthony

2013-10-01

Intermittent energy restriction may result in greater improvements in insulin sensitivity and weight control than daily energy restriction (DER). We tested two intermittent energy and carbohydrate restriction (IECR) regimens, including one which allowed ad libitum protein and fat (IECR+PF). Overweight women (n 115) aged 20 and 69 years with a family history of breast cancer were randomised to an overall 25 % energy restriction, either as an IECR (2500-2717 kJ/d, < 40 g carbohydrate/d for 2 d/week) or a 25 % DER (approximately 6000 kJ/d for 7 d/week) or an IECR+PF for a 3-month weight-loss period and 1 month of weight maintenance (IECR or IECR+PF for 1 d/week). Insulin resistance reduced with the IECR diets (mean - 0·34 (95% CI - 0·66, - 0·02) units) and the IECR+PF diet (mean - 0·38 (95% CI - 0·75, - 0·01) units). Reductions with the IECR diets were significantly greater compared with the DER diet (mean 0·2 (95% CI - 0·19, 0·66) μU/unit, P= 0·02). Both IECR groups had greater reductions in body fat compared with the DER group (IECR: mean - 3·7 (95% CI - 2·5, - 4·9) kg, P= 0·007; IECR+PF: mean - 3·7 (95% CI - 2·8, - 4·7) kg, P= 0·019; DER: mean - 2·0 (95% CI - 1·0, 3·0) kg). During the weight maintenance phase, 1 d of IECR or IECR+PF per week maintained the reductions in insulin resistance and weight. In the short term, IECR is superior to DER with respect to improved insulin sensitivity and body fat reduction. Longer-term studies into the safety and effectiveness of IECR diets are warranted.

Noise reduction and image enhancement using a hardware implementation of artificial neural networks

NASA Astrophysics Data System (ADS)

David, Robert; Williams, Erin; de Tremiolles, Ghislain; Tannhof, Pascal

1999-03-01

In this paper, we present a neural based solution developed for noise reduction and image enhancement using the ZISC, an IBM hardware processor which implements the Restricted Coulomb Energy algorithm and the K-Nearest Neighbor algorithm. Artificial neural networks present the advantages of processing time reduction in comparison with classical models, adaptability, and the weighted property of pattern learning. The goal of the developed application is image enhancement in order to restore old movies (noise reduction, focus correction, etc.), to improve digital television images, or to treat images which require adaptive processing (medical images, spatial images, special effects, etc.). Image results show a quantitative improvement over the noisy image as well as the efficiency of this system. Further enhancements are being examined to improve the output of the system.

Heat Pipes Cool Power Magnetics

NASA Technical Reports Server (NTRS)

Hansen, I.; Chester, M.; Luedke, E.

1983-01-01

Configurations originally developed for space use are effective in any orientation. Heat pipes integrated into high-power, high-frequency, highvoltage spaceflight magnetics reduce weight and improve reliability by lowering internal tempertures. Two heat pipes integrated in design of power transformer cool unit in any orientation. Electrostatic shield conducts heat from windings to heat pipe evaporator. Technology allows dramatic reductions in size and weight, while significantly improving reliability. In addition, all attitude design of heat pipes allows operation of heat pipes independent of local gravity forces.

The effect of young children's faeces disposal practices on child growth: evidence from 34 countries.

PubMed

Bauza, Valerie; Guest, Jeremy S

2017-10-01

To characterize the relationship between child faeces disposal and child growth in low- and middle-income countries. We analysed caregiver responses and anthropometric data from Demographic and Health Surveys (2005-2014) for 202 614 children under five and 82 949 children under two to examine the association between child faeces disposal and child growth. Child faeces disposal in an improved toilet was associated with reduced stunting for children under five [adjusted prevalence ratio (aPR) = 0.90, 95% confidence interval (CI) 0.89-0.92] and a 0.12 increase in height-for-age z-score (HAZ; 95% CI: 0.10-0.15) among all households. Among households with improved sanitation access, practicing improved child faeces disposal was still associated with a decrease in stunting (aPR = 0.94, 95% CI: 0.91-0.96) and a 0.09 increase in HAZ (95% CI: 0.06-0.13). Improved child faeces disposal was also associated with reductions in underweight and wasting, and an increase in weight-for-age z-score (WAZ), but not an increase in weight-for-height z-score (WHZ). Community coverage level of improved child faeces disposal was also associated with stunting, with 75-100% coverage associated with the greatest reduction in stunting. Child faeces disposal in an unimproved toilet was associated with reductions in underweight and wasting, but not stunting. Improved child faeces disposal practices could achieve greater reductions in child undernutrition than improving toilet access alone. Additionally, the common classification of child faeces disposal as 'safe' regardless of the type of toilet used for disposal may underestimate the benefits of disposal in an improved toilet and overestimate the benefits of disposal in an unimproved toilet. © 2017 John Wiley & Sons Ltd.

The Effect of the Agricultural Carbon Sequestration and Agrochemical Reduction on the Regional Water Environment Quality

NASA Astrophysics Data System (ADS)

Leyi, Wang; Baoli, Zhang; Xin, Li; Juan, Du

2018-05-01

This paper analysed the impact of the agricultural carbon reduction and emission reduction measures implementation on the environmental quality of surface water and groundwater in winter and summer in Henan and Anhui Province project areas by using entropy weight fuzzy matter element analysis method. The result showed that the reduction in the application of chemical fertilizers and pesticides had a certain impact on the improvement of the water environment by using agricultural carbon sequestration technologies.

A weight-neutral versus weight-loss approach for health promotion in women with high BMI: A randomized-controlled trial.

PubMed

Mensinger, Janell L; Calogero, Rachel M; Stranges, Saverio; Tylka, Tracy L

2016-10-01

Weight loss is the primary recommendation for health improvement in individuals with high body mass index (BMI) despite limited evidence of long-term success. Alternatives to weight-loss approaches (such as Health At Every Size - a weight-neutral approach) have been met with their own concerns and require further empirical testing. This study compared the effectiveness of a weight-neutral versus a weight-loss program for health promotion. Eighty women, aged 30-45 years, with high body mass index (BMI ≥ 30 kg/m(2)) were randomized to 6 months of facilitator-guided weekly group meetings using structured manuals that emphasized either a weight-loss or weight-neutral approach to health. Health measurements occurred at baseline, post-intervention, and 24-months post-randomization. Measurements included blood pressure, lipid panels, blood glucose, BMI, weight, waist circumference, hip circumference, distress, self-esteem, quality of life, dietary risk, fruit and vegetable intake, intuitive eating, and physical activity. Intention-to-treat analyses were performed using linear mixed-effects models to examine group-by-time interaction effects and between and within-group differences. Group-by-time interactions were found for LDL cholesterol, intuitive eating, BMI, weight, and dietary risk. At post-intervention, the weight-neutral program had larger reductions in LDL cholesterol and greater improvements in intuitive eating; the weight-loss program had larger reductions in BMI, weight, and larger (albeit temporary) decreases in dietary risk. Significant positive changes were observed overall between baseline and 24-month follow-up for waist-to-hip ratio, total cholesterol, physical activity, fruit and vegetable intake, self-esteem, and quality of life. These findings highlight that numerous health benefits, even in the absence of weight loss, are achievable and sustainable in the long term using a weight-neutral approach. The trial positions weight-neutral programs as a viable health promotion alternative to weight-loss programs for women of high weight. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reduction in food away from home is associated with improved child relative weight and body composition outcomes and this relation is mediated by changes in diet quality.

PubMed

Altman, Myra; Cahill Holland, Jodi; Lundeen, Delaney; Kolko, Rachel P; Stein, Richard I; Saelens, Brian E; Welch, R Robinson; Perri, Michael G; Schechtman, Kenneth B; Epstein, Leonard H; Wilfley, Denise E

2015-09-01

Reducing consumption of food away from home is often targeted during pediatric obesity treatment, given the associations with weight status and gain. However, the effects of this dietary change on weight loss are unknown. Our aim was to evaluate associations between changes in dietary factors and child anthropometric outcomes after treatment. It is hypothesized that reduced consumption of food away from home will be associated with improved dietary intake and greater reductions in anthropometric outcomes (standardized body mass index [BMI] and percent body fat), and the relationship between food away from home and anthropometric outcomes will be mediated by improved child dietary intake. We conducted a longitudinal evaluation of associations between dietary changes and child anthropometric outcomes. Child diet (three 24-hour recalls) and anthropometric data were collected at baseline and 16 weeks. Participants were 170 overweight and obese children ages 7 to 11 years who completed a 16-week family-based behavioral weight-loss treatment as part of a larger multi-site randomized controlled trial conducted in two cohorts between 2010 and 2011 (clinical research trial). Dietary treatment targets during family-based behavioral weight-loss treatment included improving diet quality and reducing food away from home. The main outcome measures in this study were child relative weight (standardized BMI) and body composition (percent body fat). We performed t tests and bootstrapped single-mediation analyses adjusting for relevant covariates. As hypothesized, decreased food away from home was associated with improved diet quality and greater reductions in standardized BMI (P<0.05) and percent body fat (P<0.01). Associations between food away from home and anthropometric outcomes were mediated by changes in diet quality. Specifically, change in total energy intake and added sugars mediated the association between change in food away from home and standardized BMI, and change in overall diet quality, fiber, added sugars, and added fats mediated the association between change in food away from home and percent body fat. Including physical activity as a covariate did not significantly impact these findings. These results suggest that reducing food away from home can be an important behavioral target for affecting positive changes in both diet quality and anthropometric outcomes during treatment. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Purse-string transoral outlet reduction (TORe) is effective at inducing weight loss and improvement in metabolic comorbidities after Roux-en-Y gastric bypass.

PubMed

Jirapinyo, Pichamol; Kröner, Paul T; Thompson, Christopher C

2018-04-01

BACKGROUND AND STUDY AIMS : Transoral outlet reduction (TORe), performed using a traditional interrupted or a recently described purse-string suture pattern, is effective at inducing short- and mid-term weight loss in patients with weight regain after Roux-en-Y gastric bypass (RYGB). We aimed to determine the technical feasibility and safety of purse-string TORe and to assess its impact on weight and metabolic profiles.  RYGB patients undergoing purse-string TORe were included. The gastrojejunal anastomosis (GJA) was ablated using argon plasma coagulation or dissected using endoscopic submucosal dissection. A suture was used to place stitches around the GJA in a continuous ring fashion. The suture was cinched over a balloon (8 - 12 mm). The primary outcome was technical feasibility. Secondary outcomes were the percentage of total body weight lost (%TWL), adverse events, impact on comorbidities, and predictors of weight loss.  252 RYGB patients underwent 260 purse-string TORes. They had regained 52.6 ± 46.4 % of lost weight and weighed 107.6 ± 24.6 kg. The technical success rate was 100 %. At 6 and 12 months, %TWL was 9.6 ± 6.3 and 8.4 ± 8.2. Two serious adverse events (0.8 %) occurred: gastrointestinal bleeding and GJA stenosis. At 12 months, blood pressure, hemoglobin A 1c , and ALT had improved. Prior weight regain was associated with %TWL at 12 months ( β  = 0.07, P  = 0.007) after controlling for BMI, pouch size, and number of purse-string rings.  Purse-string TORe to treat weight regain after RYGB is technically feasible and safe. Additionally, it is associated with improvement in weight and comorbidity profiles up to 12 months post-procedure. © Georg Thieme Verlag KG Stuttgart · New York.

Cardiovascular benefits of dietary fiber.

PubMed

Satija, Ambika; Hu, Frank B

2012-12-01

The relationship between dietary fiber and risk of cardiovascular disease (CVD) has been extensively studied. There is considerable epidemiological evidence indicating an inverse association between dietary fiber intake and CVD risk. The association has been found to be stronger for cereal fiber than for fruit or vegetable fiber, and several studies have also found increased whole grain consumption to be associated with CVD risk reduction. In light of this evidence, recent US dietary guidelines have endorsed increased consumption of fiber rich whole grains. Regular consumption of dietary fiber, particularly fiber from cereal sources, may improve CVD health through multiple mechanisms including lipid reduction, body weight regulation, improved glucose metabolism, blood pressure control, and reduction of chronic inflammation. Future research should focus on various food sources of fiber, including different types of whole grains, legumes, fruits, vegetables, and nuts, as well as resistant starch in relation to CVD risk and weight control; explore the biological mechanisms underlying the cardioprotective effect of fiber-rich diets; and study different ethnic groups and populations with varying sources of dietary fiber.

Lessons from the war on dietary fat.

PubMed

Walker, Thomas B; Parker, Mary Jo

2014-01-01

Conventional dietary guidelines put forth by health care institutions and providers for the past 40 years have stressed the importance of reducing the amount of dietary fat consumed. Such a diet is purported to mitigate metabolic risk factors and optimize the ability to achieve or maintain a healthy body weight. However, over the past 35 years obesity rates in the United States have risen dramatically though the level of dietary fat consumed by U.S. adults has fallen. This review examines the potential reasons for this paradox. Various meta-analyses, controlled trials, and cohort studies have demonstrated that reducing dietary fat intake provides for very little weight loss unless accompanied by equal or greater reductions in total energy intake. Due to both psychological (e.g., the tendency for people to eat more of what they consider low fat) and physiological (e.g., the low satiety that accompanies carbohydrate intake) factors, reducing total caloric intake while simultaneously reducing fat intake is a difficult challenge. Further, reductions in total carbohydrate intake, increases in protein intake, and adoption of a Mediterranean diet seem to be more effective in inducing weight loss than reductions in fat intake. Traditional claims that simply reducing dietary fat will improve metabolic risk factors are also not borne out by research. There is some evidence that replacing dietary saturated fat with unsaturated fat may improve metabolic risk factors, but that research is not conclusive. • Over the past 40 years, Americans have decreased the percentage of calories they get from dietary fat while rates of overweight and obesity have risen dramatically. • It appears that a decrease in total dietary fat in ad libitum diets may induce a very small decrease in body weight. • Evidence suggests that reductions in total dietary fat intake often occur in conjunction with an increase in total caloric intake. • It seems reasonable to conclude that guiding the public to simply reduce dietary fat intake is an ineffective method to mitigate the rise in obesity and improve public health.

Development in Geared Turbofan Aeroengine

NASA Astrophysics Data System (ADS)

Mohd Tobi, A. L.; Ismail, A. E.

2016-05-01

This paper looks into the implementation of epicyclic gear system to the aeroengine in order to increase the efficiency of the engine. The improvement made is in the direction of improving fuel consumption, reduction in pollutant gasses and perceived noise. Introduction of epicyclic gear system is capable to achieve bypass ratio of up to 15:1 with the benefits of weight and noise reduction. Radical new aircraft designs and engine installation are being studied to overcome some of the challenges associated with the future geared turbofan and open-rotor engine.

[Effect of psychotherapeutic interventions on weight reduction and personality development of a 13-year-old boy with Prader-Willi syndrome].

PubMed

Wurst, E; Möslinger, D; Widhalm, K

1992-01-01

A 12.10-year old boy (actual weight 88.8 kg, actual height 131.2 cm; 228% overweight) with Prader-Willi-syndrome achieved, after repeated ineffective therapy attempts over a period of 10 years, a weight reduction of 11.8 kg (185% overweight) during a 9-week in-patient treatment. In the following out-patient phase of therapy a further weight reduction of 20 kg (109% overweight) was achieved over a period of 16 months. Apart from the usual modes of action of therapy (reduced energy intake, physical exercise, behaviour modification), family therapeutic and special education interventions were used. These achieved an improvement of the patient's self-esteem, an increase in his competence to act and in his autonomy concerning his diet management, as well as a positive experience of his own abilities and social acceptance by other children and the stabilisation of the dysfunctional family system. It may be assumed that this therapeutic success is dependent on consequent compliance with the system model.

Reduced sCD36 following weight loss corresponds to improved insulin sensitivity, dyslipidemia and liver fat in obese children.

PubMed

Knøsgaard, L; Kazankov, K; Birkebæk, N H; Holland-Fischer, P; Lange, A; Solvig, J; Hørlyck, A; Kristensen, K; Rittig, S; Vilstrup, H; Grønbæk, H; Handberg, A

2016-09-01

Childhood obesity is a major health problem with serious long-term metabolic consequences. CD36 is important for the development of obesity-related complications among adults. We aimed to investigate circulating sCD36 during weight loss in childhood obesity and its associations with insulin resistance, dyslipidemia, hepatic fat accumulation and low-grade inflammation. The impact of a 10-week weight loss camp for obese children (N=113) on plasma sCD36 and further after a 12-month follow-up (N=68) was investigated. Clinical and biochemical data were collected, and sCD36 was measured by an in-house assay. Liver fat was estimated by ultrasonography and insulin resistance by the homeostasis model assessment (HOMA-IR). Along with marked weight loss, sCD36 was reduced by 21% (P=0.0013) following lifestyle intervention, and individual sCD36 reductions were significantly associated with the corresponding decreases in HOMA-IR, triglycerides and total cholesterol. The largest sCD36 decrease occurred among children who reduced HOMA-IR and liver fat. After 12 months of follow-up, sCD36 was increased (P=0.014) and the metabolic improvements were largely lost. Weight-loss-induced sCD36 reduction, coincident with improved insulin resistance, circulating lipids and hepatic fat accumulation, proposes that sCD36 may be an early marker of long-term health risk associated with obesity-related complications.

Multidisciplinary intervention with sibutramine: assessing successful weight loss predictors in military adolescent dependents.

PubMed

Cabrera, Jorge L; Wilks, Edward G; Symons, Jenna E; Blankson, Kwabena L; Cole, Renee E

2012-03-01

Assess body mass index (BMI) reduction through a multidisciplinary intervention with sibutramine in adolescents of military parents and examine characteristics and behavioral traits as predictors of successful weight loss. A prospective study where participants received sibutramine daily for 6 months. Adolescents ages 12 to 18 with BMI-for-age and sex greater than 95 percentile and good health were enrolled. Outcome variables are BMI, biochemical indices, and clinical measurements. Predictor variables are participant demographics, family history, lifestyle changes, and behavioral traits assessed with behavioral assessment for children. One hundred participants were recruited with 81% completion. In those participants who completed the 6-month intervention, a mean participant BMI reduction of 3.1 kg/m2 (-9.3%) (p < 0.001; 95% CI: -10.5% to -7.9%) was obtained with 79% successfully meeting the weight loss goal. Sibutramine dose was increased from 10 to 15 mg at 3 months for participant with <2.5% BMI reduction from baseline. Sibutramine dose at 3 months (p < 0.001) and participants perception of relationship with parents (p = 0.05) were statistically significant predictors of successful weight loss (> or =10% reduction in BMI). Sibutramine was effective at promoting minimum beneficial BMI reduction of 5% in adolescents with service-connected parents; however, increasing dosage at 3 months did not improve the likelihood of being successful.

Increased vegetable and fruit consumption during weight loss effort correlates with increased weight and fat loss.

PubMed

Whigham, L D; Valentine, A R; Johnson, L K; Zhang, Z; Atkinson, R L; Tanumihardjo, S A

2012-10-01

Individuals who focused on calorie counting lost more weight than those who focused on increasing vegetable and fruit (V&F) intake in a weight loss program. We now present serum carotenoid data (biomarkers of V&F intake) from both groups and test whether these biomarkers correlate with changes in weight and body fat. Sixty obese volunteers were randomized to one of the following weight loss programs: 500 kcal per day reduction (Reduction) or a focus on consuming eight vegetables per day and 2-3 fruits per day (HiVeg). Volunteers in the Reduction group were 36.8±10.3 years with a body mass index of 33.5; 83% were white, 17% chose not to report race; 70% were not Hispanic or Latino, 13% were Hispanic or Latino and 17% chose not to report ethnicity. Volunteers in the HiVeg group were 30.4±6.6 years with a body mass index of 33.2: 74% white, 11% Asian, 5% black or African American, 5% multiracial and 5% chose not to report race; 89% were not Hispanic or Latino, 5% were Hispanic or Latino and 5% chose not to report ethnicity. Subjects were taught basic nutrition principles, received breakfast and lunch 5 days per week for 3 months, meals 2 days per week during month 4, then regular phone calls to month 12. Total serum carotenoid concentrations increased from baseline to 3 months and remained elevated at 12 months, but there was no difference between groups. Changes in weight, fat and % fat correlated negatively with serum carotenoid concentrations. Increased serum carotenoids (a biomarker for V&F intake) correlated with improved weight and fat loss indicating that increased V&F consumption is an appropriate strategy for weight loss. However, in light of the fact that the Reduction group lost more weight, the consumption of increased V&F for the purpose of weight loss should happen within the context of reducing total caloric intake.

Fabrication and Optimization of Properties of Polymer Laminated Nanoreinforced Automobile Glasses: Experiments and Modeling

DOE Office of Scientific and Technical Information (OSTI.GOV)

Khaleel, Mohammad A.; Sun, Xin; Simmons, Kevin L.

2008-05-01

This paper describes the fabrication process for the thin cast-in-place laminate glazing systems to be used in cars of the future to achieve the weight reduction goals of FreedomCAR. The primary objective of the project is to reduce vehicle weight, improve fuel economy, and reduce vehicle emissions through the use of structurally reliable, high acoustic performance and lightweight glazing systems with low manufacturing costs. Energy savings come from reducing weight by using thinner glazing: prior studies at Pacific Northwest National Laboratory (PNNL) have demonstrated a potential of 30% weight reductions compared with standard glazing system. Energy savings will also comemore » from reducing interior heat loads; that, in turn, will reduce the demand for air conditioning. The evaluation of alternative glazing concepts seek to improve acoustical performance such that reduced interior noise levels can be achieved while maintaining glazing at minimal thickness and weight levels. The most important factor in utilizing laminated glazing systems as vehicle side glass is its advantage in cost savings for material and manufacturing processes. To this end, a new, innovative manufacturing process is developed such that laminated glazing systems can be made with low cost in terms of raw materials and process-related equipment/facility investment.« less

Effect of Roux-en-Y gastric bypass and diet-induced weight loss on diabetic kidney disease in the Zucker diabetic fatty rat.

PubMed

Neff, Karl J; Elliott, Jessie A; Corteville, Caroline; Abegg, Kathrin; Boza, Camilo; Lutz, Thomas A; Docherty, Neil G; le Roux, Carel W

2017-01-01

Reductions in urinary protein excretion after Roux-en-Y gastric bypass (RYGB) surgery in patients with diabetic kidney disease have been reported in multiple studies. To determine the weight loss dependence of the effect of RYGB on urinary protein excretion by comparing renal outcomes in Zucker diabetic fatty rats undergoing either gastric bypass surgery or a sham operation with or without weight matching. University laboratories. Zucker diabetic fatty rats underwent surgery at 18 weeks of age. A subgroup of sham operated rats were weight matched to RYGB operated rats by restricting food intake. Urinary protein excretion was assessed at baseline and at postoperative weeks 4 and 12. Renal histology and macrophage-associated inflammation were assessed at postoperative week 12. Progressive urinary protein excretion was attenuated by both RYGB and diet-induced weight loss, albeit to a lesser extent by the latter. Both weight loss interventions produced equivalent reductions in glomerulomegaly, glomerulosclerosis, and evidence of renal macrophage infiltration. Weight loss per se improves renal structure and attenuates renal inflammatory responses in an experimental animal model of diabetic kidney disease. Better glycemic control post-RYGB may in part explain the greater reductions in urinary protein excretion after gastric bypass surgery. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Weight-loss diets and 2-y changes in circulating amino acids in 2 randomized intervention trials.

PubMed

Zheng, Yan; Ceglarek, Uta; Huang, Tao; Li, Lerong; Rood, Jennifer; Ryan, Donna H; Bray, George A; Sacks, Frank M; Schwarzfuchs, Dan; Thiery, Joachim; Shai, Iris; Qi, Lu

2016-02-01

Circulating amino acids, such as branched-chain amino acids (BCAAs) and aromatic amino acids (AAAs), have been associated with diabetes risk; however, little is known about how a long-term dietary intervention for weight loss affects circulating amino acids. We examined the effects of weight-loss diets on long-term changes in plasma amino acids and the associations of these changes with weight loss and the improvement of insulin resistance. We repeatedly measured plasma amino acid profiles over 2 y in overweight or obese participants from 2 randomized, dietary intervention, weight-loss trials [774 subjects from the POUNDS LOST (Preventing Overweight Using Novel Dietary Strategies Trial) and 318 subjects from the DIRECT (Dietary Intervention Randomized Controlled Trial)]. Intervention diets consistently lowered most of the amino acid concentrations, including BCAAs and AAAs, in both trials. In the POUNDS LOST, average-protein diets (15% of daily energy) showed stronger effects than did high-protein diets (25% of daily energy) on reducing concentrations of the diabetes-associated BCAA valine at 6 mo independent of the weight change. In both trials, weight loss was directly related to the concurrent reduction of the BCAAs leucine and isoleucine, the AAAs tyrosine and phenylalanine, and 4 other amino acids. For example, per kilogram of weight loss, there was a 0.04-SD decrease in log tyrosine (∼0.6 μmol/L) in both trials. In addition, we showed that reductions in alanine and the AAA tyrosine were significantly related to improved insulin resistance (measured with the use of the homeostasis model assessment of insulin resistance), independent of weight loss, in both trials (both P < 0.05). For example, per 1-SD decrease in log tyrosine (∼17 μmol/L), there was a 0.04-SD (∼3%) improvement in insulin resistance in the POUNDS LOST and a 0.13-SD (∼8%) improvement in insulin resistance in the DIRECT. Our findings underscore the potential importance of dietary interventions in improving amino acid profiles (i.e., reducing diabetes risk-enhancing amino acid concentrations) along with and beyond weight loss. The POUNDS LOST and the DIRECT were registered at clinicaltrials.gov as NCT00072995 and NCT00160108, respectively. © 2016 American Society for Nutrition.

First Parity Evaluation of Body Condition, Weight, and Blood Beta-Hydroxybutyrate During Lactation of Range Cows Developed in the Same Ecophysiological System but Receiving Different Harvested Feed Inputs

USDA-ARS?s Scientific Manuscript database

Reduction of harvested feed inputs during heifer development could optimize range livestock production and improve economic feasibility for producers. The objective of this study was to measure body condition and weight as well as blood beta-hydroxybutyrate (BHB) concentrations for primiparous beef ...

First parity evaluation of body condition, weight, and blood beta-hydroxybutyrate during lactation of range cows developed in the same ecophysiological system but receiving different harvested feed inputs

USDA-ARS?s Scientific Manuscript database

Reduction of harvested feed inputs during heifer development could optimize range livestock production and improve economic feasibility for producers. The objective of this study was to measure body condition and weight as well as blood beta-hydroxybutyrate (BHB) concentrations for primiparous beef ...

Regional body composition changes exhibit opposing effects on coronary heart disease risk factors.

PubMed

Okura, Tomohiro; Nakata, Yoshio; Yamabuki, Keisuke; Tanaka, Kiyoji

2004-05-01

We investigated how regional body composition measured by dual-energy X-ray absorptiometry (DXA) is associated with risk factors for coronary heart disease (CHD) during weight reduction in obese women. Data were gathered from 128 overweight and obese women, aged 34 to 66 years, during a 14-week intervention study with diet and exercise. Regional (arms, legs, and trunk) fat tissue (FT) and lean soft tissue (LST) were measured by DXA. The FT change in legs correlated negatively with changes in diastolic blood pressure, low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), and the number of CHD risk factors per subject (r=-0.17, P<0.05 to -0.26, P<0.01) in response to weight reduction, whereas truncal FT change had positive correlations with changes in triglycerides, LDL-C, FPG, and the number of CHD risk factors per subject (r=0.17, P<0.05 to 0.25, P<0.01). LST change in legs correlated negatively with changes in systolic blood pressure, FPG, and the number of risk factors (r=-0.20 to -0.21, P<0.05). Regional body composition information is important for evaluating improvement of CHD risk factors during weight-reduction treatment for obesity; differential FTs had opposing effects on CHD risk factors during weight reduction in obese women.

Behavior Modification in Coaching.

ERIC Educational Resources Information Center

Lynch, Annette Rutt; Stillman, Stephen M.

1979-01-01

An example of behavior modification used in athletic coaching is presented. The case study involves a member of a women's basketball team and details the use of behavior modification for both weight reduction and skill improvement. (JMF)

Combined effects of high pressure and sodium hydrogen carbonate treatment on beef: improvement of texture and color

NASA Astrophysics Data System (ADS)

Ohnuma, Shun; Kim, Yun-Jung; Suzuki, Atsushi; Nishiumi, Tadayuki

2013-06-01

We investigated the effect of combined high pressure and sodium hydrogen carbonate (NaHCO3) treatment on the physical properties and color of silverside Australian beef. Meat samples were pressurized at 100-500 MPa and the water content, weight reduction, rupture stress, and meat color were determined. The water content of meat treated with NaHCO3 and high pressure (300 MPa) reached a maximum of 70.1%. Weight reduction tended to decrease with high pressure treatment at 300 MPa. Meats treated with NaHCO3 and high pressure at 400 MPa showed a>50% decrease in hardness. Whitening of the meat was reduced by the combined high pressure and NaHCO3 treatment. Therefore, the combined high pressure and NaHCO3 treatment is effective for improvement of beef quality.

"Structure-size me:" weight and health changes in a four week residential program.

PubMed

Shapiro, Jennifer R; Stout, Anna L; Musante, Gerard J

2006-08-01

The prevalence of obesity has been drastically increasing over the past 20 years. Other obesity related conditions, including type 2 diabetes mellitus, have also increased in a corresponding manner and, in 2005, the American Diabetes Association (ADA) reduced the cut-off for defining impaired blood glucose. Evidence suggests that just a modest amount of weight loss can improve obesity related co-morbidities. The present study first, investigated changes in health measures after participation in a four week residential weight loss program. Second, individuals were classified according to the 2005 criteria for the diagnosis of type 2 diabetes to determine if glucose regulation changed after weight loss. A total of 93 individuals were categorized as normal glucose (n=56), impaired fasting glucose (n=23) or diabetic range (n=14) after initial blood laboratory screening. After four weeks and a 6.5% weight reduction, participants showed significant improvements in health risks. Further, most participants with elevated fasting glucose shifted into a healthier range. Findings are discussed in terms of health improvements that occur after weight loss within a four week lifestyle intervention.

Landsat D Thematic Mapper image dimensionality reduction and geometric correction accuracy

NASA Technical Reports Server (NTRS)

Ford, G. E.

1986-01-01

To characterize and quantify the performance of the Landsat thematic mapper (TM), techniques for dimensionality reduction by linear transformation have been studied and evaluated and the accuracy of the correction of geometric errors in TM images analyzed. Theoretical evaluations and comparisons for existing methods for the design of linear transformation for dimensionality reduction are presented. These methods include the discrete Karhunen Loeve (KL) expansion, Multiple Discriminant Analysis (MDA), Thematic Mapper (TM)-Tasseled Cap Linear Transformation and Singular Value Decomposition (SVD). A unified approach to these design problems is presented in which each method involves optimizing an objective function with respect to the linear transformation matrix. From these studies, four modified methods are proposed. They are referred to as the Space Variant Linear Transformation, the KL Transform-MDA hybrid method, and the First and Second Version of the Weighted MDA method. The modifications involve the assignment of weights to classes to achieve improvements in the class conditional probability of error for classes with high weights. Experimental evaluations of the existing and proposed methods have been performed using the six reflective bands of the TM data. It is shown that in terms of probability of classification error and the percentage of the cumulative eigenvalues, the six reflective bands of the TM data require only a three dimensional feature space. It is shown experimentally as well that for the proposed methods, the classes with high weights have improvements in class conditional probability of error estimates as expected.

Soluble receptor for advanced glycation end products as a potential biomarker to predict weight loss and improvement of insulin sensitivity by a very low calorie diet of obese human subjects.

PubMed

Hagen, Imke; Schulte, Dominik M; Müller, Nike; Martinsen, Jessica; Türk, Kathrin; Hedderich, Jürgen; Schreiber, Stefan; Laudes, Matthias

2015-06-01

Obesity is associated with low-grade systemic inflammation which is thought to trigger the development of comorbidities such as type 2 diabetes. The soluble receptor for advanced glycation end products (sRAGE) belongs to the innate immune system and has been linked to obesity, recently. The aim of the present study was to examine whether serum sRAGE concentrations are related to the grade of weight loss and improvement of insulin resistance due to a very low calorie diet (VLCD). 22 severe obese subjects (Median Body Mass Index (BMI): 44.5kg/m(2)) were included in a dietary intervention study of 6month, consisting of a very low calorie formula diet phase (VLCD: 800kcal/d) for 12 weeks and a following 12 week weight maintenance phase. Fasting glucose, fasting insulin, adiponectin, leptin and sRAGE were determined from sera. Insulin sensitivity was estimated by Homeostasis Model Assessment (HOMA) index and leptin-to-adiponectin-ratio (LAR). Mean body weight reduction by VLCD accounted to 21.7kg with a significant improvement of insulin resistance. At baseline, sRAGE serum levels were significantly inversely related to BMI (rS=-0.642, p=0.001) and HOMA (rS=-0.419, p=0.041). Of interest, sRAGE serum levels at baseline were significantly lower in study subjects with greater reduction of BMI (p=0.017). In addition, a significantly greater HOMA reduction was observed in subjects with lower sRAGE serum levels at baseline (p=0.006). Finally, correlation analysis revealed, that changes of sRAGE serum levels were significantly correlated to changes of BMI (rS=-0.650, p=0.022) during intervention. Anti-inflammatory sRAGE might be a potential future biomarker to predict weight loss and improvement of insulin resistance by a VLCD whereby lower baseline sRAGE serum levels indicate a better outcome of the dietary intervention. Copyright © 2015 Elsevier Ltd. All rights reserved.

Polymeric Materials for Aerospace Power and Propulsion: Overview of Polymer Research at NASA Glenn

NASA Technical Reports Server (NTRS)

Meador, Michael A.

2007-01-01

Weight, durability and performance are all major concerns for any NASA mission. Use of lightweight materials, such as fiber reinforced polymer matrix composites can lead to significant reductions in vehicle weight and improvements in vehicle performance. Research in the Polymeric Materials Branch at NASA Glenn is focused on improving the durability, properties, processability and performance of polymeric materials by utilizing both conventional polymer science and engineering as well as nanotechnology and bioinspired approaches. This presentation will provide an overview of these efforts and highlight recent progress.

Central pedicled breast reduction technique in male patients after massive weight loss.

PubMed

Stoff, Alexander; Velasco-Laguardia, Fernando J; Richter, Dirk F

2012-03-01

Male patients after massive weight loss often suffer from redundant skin and soft tissue in the anterior and lateral chest region, causing various deformities of pseudogynecomastia. Techniques with free or pedicled nipple-areola complex (NAC) transposition are widely accepted. The authors present their approach to male breast reduction with preservation of the NAC on a central dermoglandular pedicle and a wide elliptical tissue excision of breast and lateral thorax tissue in combination with liposuction. Male breast reduction was performed on patients after moderate to massive weight loss due to diet or bariatric procedures. Former procedures included free nipple-areola grafts or inferior pedicled techniques for NAC preservation. As a modification, we performed a central pedicled breast reduction on nine male patients with excessive liposuction of the pedicle and a horizontal elliptical skin removal, allowing for sufficient tissue removal at the lateral thorax. From October 2010 until June 2011, nine male patients had central pedicled breast reconstructions after massive weight loss. Mean age was 29.1 years, mean preoperative body mass index was 29.2, and mean preoperative weight loss was 63.9 kg. The chest wall improvement was rated "very good" by eight patients. No major complications occurred in all nine patients. Male chest deformities after massive weight loss can be dealt by several approaches. The optimal scar positioning and the preservation of NAC may be the most challenging aspects of these procedures. Therefore, the preservation of the NAC on a central dermoglandular pedicle with a horizontal submammary scar course may optimize the esthetic outcome.

Visceral obesity, impaired glucose tolerance, metabolic syndrome, and growth hormone therapy.

PubMed

Attallah, Hamdee; Friedlander, Anne L; Hoffman, Andrew R

2006-07-01

Overweight adults with impaired glucose tolerance have a 5-10% risk of developing diabetes per year, and insulin resistance is an important cause of progression to diabetes in these individuals. Weight loss has been shown to improve insulin sensitivity and prevent or delay progression to diabetes. According to recent studies, the improvement in insulin sensitivity that occurs with weight loss is closely linked to the reduction of visceral adipose tissue (VAT), the collection of intra-abdominal adipose depots that includes omental and intrahepatic fat. After controlling for BMI, whole body fat, and subcutaneous fat, only VAT is an independent predictor of endogenous insulin sensitivity and glucose tolerance before or after weight loss. This, in turn, suggests that reducing VAT is crucial to improving insulin sensitivity and preventing diabetes in high-risk individuals. Recombinant human growth hormone (GH) is a lipolytic drug that reduces total body, abdominal, and visceral fat in growth hormone-deficient (GHD) adults. Several studies have reported substantial reductions in VAT following GH treatment in this population. Like GHD adults, abdominally obese individuals have increased VAT, insulin resistance, and growth hormone levels that are below normal during continuous 24-h monitoring. These similarities have prompted a number of recent investigations in abdominally obese adults that reported significant reductions in truncal and visceral fat and an improvement in insulin sensitivity following prolonged GH administration. However, other studies have shown that insulin resistance and glucose concentrations transiently worsen during the first few weeks of GH treatment and that these deleterious effects can persist even after VAT reduction has occurred. Prior studies involving GH treatment were generally limited to adults who were normoglycemic at baseline. Less is known about the effects of GH in adults with impaired glucose tolerance or diabetes. The effects of GH used in conjunction with insulin sensitizers on glycemic control and VAT in patients with impaired glucose tolerance will be reviewed.

Replacing caloric beverages with water or diet beverages for weight loss in adults: main results of the Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial1234

PubMed Central

Turner-McGrievy, Gabrielle; Lyons, Elizabeth; Stevens, June; Erickson, Karen; Polzien, Kristen; Diamond, Molly; Wang, Xiaoshan; Popkin, Barry

2012-01-01

Background: Replacement of caloric beverages with noncaloric beverages may be a simple strategy for promoting modest weight reduction; however, the effectiveness of this strategy is not known. Objective: We compared the replacement of caloric beverages with water or diet beverages (DBs) as a method of weight loss over 6 mo in adults and attention controls (ACs). Design: Overweight and obese adults [n = 318; BMI (in kg/m2): 36.3 ± 5.9; 84% female; age (mean ± SD): 42 ± 10.7 y; 54% black] substituted noncaloric beverages (water or DBs) for caloric beverages (≥200 kcal/d) or made dietary changes of their choosing (AC) for 6 mo. Results: In an intent-to-treat analysis, a significant reduction in weight and waist circumference and an improvement in systolic blood pressure were observed from 0 to 6 mo. Mean (±SEM) weight losses at 6 mo were −2.5 ± 0.45% in the DB group, −2.03 ± 0.40% in the Water group, and −1.76 ± 0.35% in the AC group; there were no significant differences between groups. The chance of achieving a 5% weight loss at 6 mo was greater in the DB group than in the AC group (OR: 2.29; 95% CI: 1.05, 5.01; P = 0.04). A significant reduction in fasting glucose at 6 mo (P = 0.019) and improved hydration at 3 (P = 0.0017) and 6 (P = 0.049) mo was observed in the Water group relative to the AC group. In a combined analysis, participants assigned to beverage replacement were 2 times as likely to have achieved a 5% weight loss (OR: 2.07; 95% CI: 1.02, 4.22; P = 0.04) than were the AC participants. Conclusions: Replacement of caloric beverages with noncaloric beverages as a weight-loss strategy resulted in average weight losses of 2% to 2.5%. This strategy could have public health significance and is a simple, straightforward message. This trial was registered at clinicaltrials.gov as NCT01017783. PMID:22301929

Advanced Rotorcraft Transmission (ART) program

NASA Technical Reports Server (NTRS)

Heath, Gregory F.; Bossler, Robert B., Jr.

1993-01-01

Work performed by the McDonnell Douglas Helicopter Company and Lucas Western, Inc. within the U.S. Army/NASA Advanced Rotorcraft Transmission (ART) Program is summarized. The design of a 5000 horsepower transmission for a next generation advanced attack helicopter is described. Government goals for the program were to define technology and detail design the ART to meet, as a minimum, a weight reduction of 25 percent, an internal noise reduction of 10 dB plus a mean-time-between-removal (MTBR) of 5000 hours compared to a state-of-the-art baseline transmission. The split-torque transmission developed using face gears achieved a 40 percent weight reduction, a 9.6 dB noise reduction and a 5270 hour MTBR in meeting or exceeding the above goals. Aircraft mission performance and cost improvements resulting from installation of the ART would include a 17 to 22 percent improvement in loss-exchange ratio during combat, a 22 percent improvement in mean-time-between-failure, a transmission acquisition cost savings of 23 percent of $165K, per unit, and an average transmission direct operating cost savings of 33 percent, or $24K per flight hour. Face gear tests performed successfully at NASA Lewis are summarized. Also, program results of advanced material tooth scoring tests, single tooth bending tests, Charpy impact energy tests, compact tension fracture toughness tests and tensile strength tests are summarized.

Hybrid feedforward-feedback active noise reduction for hearing protection and communication.

PubMed

Ray, Laura R; Solbeck, Jason A; Streeter, Alexander D; Collier, Robert D

2006-10-01

A hybrid active noise reduction (ANR) architecture is presented and validated for a circumaural earcup and a communication earplug. The hybrid system combines source-independent feedback ANR with a Lyapunov-tuned leaky LMS filter (LyLMS) improving gain stability margins over feedforward ANR alone. In flat plate testing, the earcup demonstrates an overall C-weighted total noise reduction of 40 dB and 30-32 dB, respectively, for 50-800 Hz sum-of-tones noise and for aircraft or helicopter cockpit noise, improving low frequency (<100 Hz) performance by up to 15 dB over either control component acting individually. For the earplug, a filtered-X implementation of the LyLMS accommodates its nonconstant cancellation path gain. A fast time-domain identification method provides a high-fidelity, computationally efficient, infinite impulse response cancellation path model, which is used for both the filtered-X implementation and communication feedthrough. Insertion loss measurements made with a manikin show overall C-weighted total noise reduction provided by the ANR earplug of 46-48 dB for sum-of-tones 80-2000 Hz and 40-41 dB from 63 to 3000 Hz for UH-60 helicopter noise, with negligible degradation in attenuation during speech communication. For both hearing protectors, a stability metric improves by a factor of 2 to several orders of magnitude through hybrid ANR.

Feasibility of magnetic bearings for advanced gas turbine engines

NASA Technical Reports Server (NTRS)

Hibner, David; Rosado, Lewis

1992-01-01

The application of active magnetic bearings to advanced gas turbine engines will provide a product with major improvements compared to current oil lubricated bearing designs. A rethinking of the engine rotating and static structure design is necessary and will provide the designer with significantly more freedom to meet the demanding goals of improved performance, increased durability, higher reliability, and increased thrust to weight ratio via engine weight reduction. The product specific technology necessary for this high speed, high temperature, dynamically complex application has been defined. The resulting benefits from this approach to aircraft engine rotor support and the complementary engine changes and improvements have been assessed.

The impact of exercise training compared to caloric restriction on hepatic and peripheral insulin resistance in obesity.

PubMed

Coker, Robert H; Williams, Rick H; Yeo, Sophie E; Kortebein, Patrick M; Bodenner, Don L; Kern, Philip A; Evans, William J

2009-11-01

It has been difficult to distinguish the independent effects of caloric restriction versus exercise training on insulin resistance. Utilizing metabolic feeding and supervised exercise training, we examined the influence of caloric restriction vs. exercise training with and without weight loss on hepatic and peripheral insulin resistance. Thirty-four obese, older subjects were randomized to: caloric restriction with weight loss (CR), exercise training with weight loss (EWL), exercise training without weight loss (EX), or controls. Based on an equivalent caloric deficit in EWL and CR, we induced matched weight loss. Subjects in the EX group received caloric compensation. Combined with [6,6(2)H(2)]glucose, an octreotide, glucagon, multistage insulin infusion was performed to determine suppression of glucose production (SGP) and insulin-stimulated glucose disposal (ISGD). Computed tomography scans were performed to assess changes in fat distribution. Body weight decreased similarly in EWL and CR, and did not change in EX and controls. The reduction in visceral fat was significantly greater in EWL (-71 +/- 15 cm(2)) compared to CR and EX. The increase in SGP was also almost 3-fold greater (27 +/- 2%) in EWL. EWL and CR promoted similar improvements in ISGD [+2.5 +/- 0.4 and 2.4 +/- 0.9 mg x kg fat-free mass (FFM)(-1) x min(-1)], respectively. EWL promoted the most significant reduction in visceral fat and the greatest improvement in SGP. Equivalent increases in ISGD were noted in EWL and CR, whereas EX provided a modest improvement. Based on our results, EWL promoted the optimal intervention-based changes in body fat distribution and systemic insulin resistance.

Unreported sauna use in anorexia nervosa: evidence from the world-wide-web.

PubMed

Vähäsoini, A; Vazquez, R; Birmingham, C L; Gutierrez, E

2004-03-01

Weight loss methods employed in anorexia nervosa (AN) are vomiting, laxatives, diuretics, enemas, suppositories, ipecac, weight loss medications and inadequate insulin in diabetics. Some methods result in weight loss from fluid depletion and not a reduction in body fat. Sauna use causes rapid fluid loss, but has not been reported in the medical literature as a weight loss strategy used in AN. We found reports of sauna use in AN on the world-wide-web are rare. We hypothesize that the warming caused by the use of sauna, may result in physical improvement in AN and thereby reduce its acceptability as a weight loss strategy.

Internal Structural Design of the Common Research Model Wing Box for Aeroelastic Tailoring

NASA Technical Reports Server (NTRS)

Jutte, Christine V.; Stanford, Bret K.; Wieseman, Carol D.

2015-01-01

This work explores the use of alternative internal structural designs within a full-scale wing box structure for aeroelastic tailoring, with a focus on curvilinear spars, ribs, and stringers. The baseline wing model is a fully-populated, cantilevered wing box structure of the Common Research Model (CRM). Metrics of interest include the wing weight, the onset of dynamic flutter, and the static aeroelastic stresses. Twelve parametric studies alter the number of internal structural members along with their location, orientation, and curvature. Additional evaluation metrics are considered to identify design trends that lead to lighter-weight, aeroelastically stable wing designs. The best designs of the individual studies are compared and discussed, with a focus on weight reduction and flutter resistance. The largest weight reductions were obtained by removing the inner spar, and performance was maintained by shifting stringers forward and/or using curvilinear ribs: 5.6% weight reduction, a 13.9% improvement in flutter speed, but a 3.0% increase in stress levels. Flutter resistance was also maintained using straight-rotated ribs although the design had a 4.2% lower flutter speed than the curved ribs of similar weight and stress levels were higher. For some configurations, the differences between curved and straight ribs were smaller, which provides motivation for future optimization-based studies to fully exploit the trade-offs.

How effective are weight-loss interventions for improving fertility in women and men who are overweight or obese? A systematic review and meta-analysis of the evidence.

PubMed

Best, Damian; Avenell, Alison; Bhattacharya, Siladitya

2017-11-01

The prevalence of obesity is increasing worldwide, with a corresponding increase in overweight and obese patients referred with infertility. This systematic review aimed to determine whether non-surgical weight reduction strategies result in an improvement in reproductive parameters affected by obesity, e.g. delayed time to pregnancy, oligozoospermia and azoospermia. No prior reviews have examined this within the general fertility population, or in both sexes. Our objective was to answer the question: 'In overweight and obese women, men and couples seeking fertility treatment, what non-surgical weight-loss interventions have been used, and how effective are they at weight loss and improving reproductive outcomes?' An electronic search of MEDLINE, EMBASE and the Cochrane Library was performed for studies between January 1966 and March 2016. Text word and MESH search terms used related to infertility, weight and barriers to weight loss. Inclusion criteria were an intervention to change lifestyle evaluated in any study design in participants of either gender with an unfulfilled desire to conceive. Studies were excluded if they included participants not attempting pregnancy, with illnesses that might cause weight fluctuations, or studies evaluating bariatric surgery. Two reviewers performed data extraction and quality assessment using the Cochrane Risk of Bias Tool for randomized trials, and a ratified checklist (ReBIP) for non-randomized studies. A total of 40 studies were included, of which 14 were randomised control trials. Primary outcomes were pregnancy, live birth rate and weight change. In women, reduced calorie diets and exercise interventions were more likely than control interventions to result in pregnancy [risk ratio 1.59, 95% CI (1.01, 2.50)], and interventions resulted in weight loss and ovulation improvement, where reported. Miscarriage rates were not reduced by any intervention. Overweight and obese persons seeking fertility should be educated on the detrimental effects of fatness and the benefits of weight reduction, including improvement in pregnancy rates. A combination of a reduced calorie diet, by reducing fat and refined carbohydrate intake, and increased aerobic exercise should form the basis of programmes designed for such individuals. A lack of randomized studies in men and couples, and studies evaluating barriers to undertaking weight loss in infertile populations is evident, and future research should examine these issues further. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Preferential reductions in intermuscular and visceral adipose tissue with exercise-induced weight loss compared with calorie restriction

PubMed Central

Murphy, Joan C.; McDaniel, Jennifer L.; Mora, Katherine; Villareal, Dennis T.; Fontana, Luigi

2012-01-01

Intermuscular adipose tissue (IMAT) and visceral adipose tissue (VAT) are associated with insulin resistance. We sought to determine whether exercise-induced weight loss (EX) results in greater reductions in IMAT and VAT compared with similar weight loss induced by calorie restriction (CR) and whether these changes are associated with improvements in glucoregulation. Sedentary men and women (50–60 yr; body mass index of 23.5–29.9 kg/m2) were randomized to 1 yr of CR (n = 17), EX (n = 16), or a control group (CON; n = 6). Bilateral thigh IMAT and VAT volumes were quantified using multi-slice magnetic resonance imaging. Insulin sensitivity index (ISI) was determined from oral glucose tolerance test glucose and insulin levels. Weight loss was comparable (P = 0.25) in the CR (−10.8 ± 1.4%) and EX groups (−8.3 ± 1.5%) and greater than in the control group (−2.0 ± 2.4%; P < 0.05). IMAT and VAT reductions were larger in the CR and EX groups than in the CON group (P ≤ 0.05). After controlling for differences in total fat mass change between the CR and EX groups, IMAT and VAT reductions were nearly twofold greater (P ≤ 0.05) in the EX group than in the CR group (IMAT: −45 ±5 vs. −25 ± 5 ml; VAT: −490 ± 64 vs. −267 ± 61 ml). In the EX group, the reductions in IMAT were correlated with increases in ISI (r = −0.71; P = 0.003), whereas in the CR group, VAT reductions were correlated with increases in ISI (r = −0.64; P = 0.006). In conclusion, calorie restriction and exercise-induced weight loss both decrease IMAT and VAT volumes. However, exercise appears to result in preferential reductions in these fat depots. PMID:22016371

Acoustic noise reduction in T 1- and proton-density-weighted turbo spin-echo imaging.

PubMed

Ott, Martin; Blaimer, Martin; Breuer, Felix; Grodzki, David; Heismann, Björn; Jakob, Peter

2016-02-01

To reduce acoustic noise levels in T 1-weighted and proton-density-weighted turbo spin-echo (TSE) sequences, which typically reach acoustic noise levels up to 100 dB(A) in clinical practice. Five acoustic noise reduction strategies were combined: (1) gradient ramps and shapes were changed from trapezoidal to triangular, (2) variable-encoding-time imaging was implemented to relax the phase-encoding gradient timing, (3) RF pulses were adapted to avoid the need for reversing the polarity of the slice-rewinding gradient, (4) readout bandwidth was increased to provide more time for gradient activity on other axes, (5) the number of slices per TR was reduced to limit the total gradient activity per unit time. We evaluated the influence of each measure on the acoustic noise level, and conducted in vivo measurements on a healthy volunteer. Sound recordings were taken for comparison. An overall acoustic noise reduction of up to 16.8 dB(A) was obtained by the proposed strategies (1-4) and the acquisition of half the number of slices per TR only. Image quality in terms of SNR and CNR was found to be preserved. The proposed measures in this study allowed a threefold reduction in the acoustic perception of T 1-weighted and proton-density-weighted TSE sequences compared to a standard TSE-acquisition. This could be achieved without visible degradation of image quality, showing the potential to improve patient comfort and scan acceptability.

The effect of intermittent energy and carbohydrate restriction v. daily energy restriction on weight loss and metabolic disease risk markers in overweight women

PubMed Central

Harvie, Michelle; Wright, Claire; Pegington, Mary; McMullan, Debbie; Mitchell, Ellen; Martin, Bronwen; Cutler, Roy G.; Evans, Gareth; Whiteside, Sigrid; Maudsley, Stuart; Camandola, Simonetta; Wang, Rui; Carlson, Olga D.; Egan, Josephine M.; Mattson, Mark P.; Howell, Anthony

2018-01-01

Intermittent energy restriction may result in greater improvements in insulin sensitivity and weight control than daily energy restriction (DER). We tested two intermittent energy and carbohydrate restriction (IECR) regimens, including one which allowed ad libitum protein and fat (IECR + PF). Overweight women (n 115) aged 20 and 69 years with a family history of breast cancer were randomised to an overall 25% energy restriction, either as an IECR (2500–2717 kJ/d, <40 g carbohydrate/d for 2 d/week) or a 25% DER (approximately 6000 kJ/d for 7 d/week) or an IECR + PF for a 3-month weight-loss period and 1 month of weight maintenance (IECR or IECR + PF for 1 d/week). Insulin resistance reduced with the IECR diets (mean −0·34 (95% CI −0·66, −0·02) units) and the IECR + PF diet (mean −0·38 (95% CI −0·75, −0·01) units). Reductions with the IECR diets were significantly greater compared with the DER diet (mean 0·2 (95% CI −0·19, 0·66) µU/unit, P=0·02). Both IECR groups had greater reductions in body fat compared with the DER group (IECR: mean −3·7 (95% CI −2·5, −4·9) kg, P=0·007; IECR + PF: mean −3·7 (95% CI −2·8, −4·7) kg, P=0·019; DER: mean −2·0 (95% CI −1·0, 3·0) kg). During the weight maintenance phase, 1 d of IECR or IECR + PF per week maintained the reductions in insulin resistance and weight. In the short term, IECR is superior to DER with respect to improved insulin sensitivity and body fat reduction. Longer-term studies into the safety and effectiveness of IECR diets are warranted. PMID:23591120

Magnetic suspension and balance system advanced study

NASA Technical Reports Server (NTRS)

Boom, R. W.; Eyssa, Y. M.; Mcintosh, G. E.; Abdelsalam, M. K.

1985-01-01

An improved compact design for a superconducting magnetic suspension and balance system for an 8 ft. x 8 ft. transonic wind tunnel is developed. The original design of an MSBS in NASA Cr-3802 utilized 14 external superconductive coils and a superconductive solenoid in the airplane test model suspended in a wind tunnel. The improvements are in the following areas: test model solenoid options, dynamic force limits on the model, magnet cooling options, structure and cryogenic designs, power supply specifications, and cost and performance evaluations. The improvements are: MSBS cost reduction of 28%, weight; reduction of 43%, magnet system ampere-meter reduction of 38%, helium liquifier capacity reduction by 33%, magnet system stored energy reduction by 55%, AC loss to liquid helium reduced by 76%, system power supply reduced by 68%, test coil pole strength increased by 19%, wing magnetization increased by 40%, and control frequency limit increased by 200% from 10 Hz to 30 Hz. The improvements are due to: magnetic holmium coil forms in the test model, better rare earth permanent magnets in the wings, fiberglass-epoxy structure replacing stainless steel, better coil configuration, and new saddle roll coil design.

Automotive Stirling engine development program - Overview and status report

NASA Technical Reports Server (NTRS)

Nightingale, N. P.

1983-01-01

The current status of the automotive-Stirling-engine development program being undertaken by DOE and NASA Lewis is reviewed. The program goals and the reference-engine design are explained, and the modifications introduced to improve performance and lower manufacturing costs are discussed and illustrated, including part-power optimization; increased operating temperature (from 720 to 820 C); 45.4-kg weight reduction; elimination of Co and reduction of Cr used; and improved seals, ceramic components, and high-temperature alloys. The test program, some difficulties encountered, and results after 2042 h are summarized.

JTT-553, a novel Acyl CoA:diacylglycerol acyltransferase (DGAT) 1 inhibitor, improves glucose metabolism in diet-induced obesity and genetic T2DM mice.

PubMed

Tomimoto, Daisuke; Okuma, Chihiro; Ishii, Yukihito; Kobayashi, Akio; Ohta, Takeshi; Kakutani, Makoto; Imanaka, Tsuneo; Ogawa, Nobuya

2015-09-01

Type 2 diabetes mellitus (T2DM) arises primarily due to lifestyle factors and genetics. A number of lifestyle factors are known to be important in the development of T2DM, including obesity. JTT-553, a novel Acyl CoA:diacylglycerol acyltransferase 1 inhibitor, reduced body weight depending on dietary fat in diet-induced obesity (DIO) rats in our previous study. Here, the effect of JTT-553 on glucose metabolism was evaluated using body weight reduction in T2DM mice. JTT-553 was repeatedly administered to DIO and KK-A(y) mice. JTT-553 reduced body weight gain and fat weight in both mouse models. In DIO mice, JTT-553 decreased insulin, non-esterified fatty acid (NEFA), total cholesterol (TC), and liver triglyceride (TG) plasma concentrations in non-fasting conditions. JTT-553 also improved insulin-dependent glucose uptake in adipose tissues and glucose intolerance in DIO mice. In KK-A(y) mice, JTT-553 decreased glucose, NEFA, TC and liver TG plasma concentrations in non-fasting conditions. JTT-553 also decreased glucose, insulin, and TC plasma concentrations in fasting conditions. In addition, JTT-553 decreased TNF-α mRNA levels and increased GLUT4 mRNA levels in adipose tissues in KK-A(y) mice. These results suggest that JTT-553 improves insulin resistance in adipose tissues and systemic glucose metabolism through reductions in body weight. Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Changes in hormones and biomarkers in polycystic ovarian syndrome treated with gastric bypass.

PubMed

Eid, George M; McCloskey, Carol; Titchner, Rebecca; Korytkowski, Mary; Gross, Debra; Grabowski, Cynthia; Wilson, Mark

2014-01-01

Small retrospective studies have demonstrated reduction in weight and co-morbid hirsutism and diabetes in women with polycystic ovary syndrome (PCOS) treated with Roux-en-Y gastric bypass. The objective of this study was to prospectively determine clinical improvements in obese women with PCOS treated with gastric bypass and identify postoperative biomarker changes. Data were collected on obese women with PCOS undergoing Roux-en-Y gastric bypass over 1 year. Testosterone, follicle stimulating hormone, lutenizing hormone, insulin, fasting glucose, and lipid levels were obtained preoperatively at baseline, and 6 and 12 months after surgery. Testosterone was used as the primary hormonal biomarker. A physical examination for body mass index (BMI) and hirsutism, and information on menstrual pattern were collected at baseline and 3, 6, and 12 months after surgery. Data were available for 14 women. Mean BMI decreased from 44.8±5.9 kg/m(2) at baseline to 29.2±5.9 kg/m(2) at 12 months postoperatively. Significant improvements were seen in testosterone, fasting glucose, insulin, cholesterol, and triglyceride at 12 months (P<.05). At baseline, irregular menses were reported in 10 patients; all patients were experiencing regular menses 6 and 12 months after surgery. Hirsutism was present in 11 patients at baseline and only 7 patients at 12 months. Improvements in biomarkers, menstrual cycling, and hirsutism was not correlated with degree of weight change. Gastric bypass achieved significant reductions in BMI, testosterone, and markers of glucose and lipid metabolism. These data confirm reports of previous retrospective studies showing weight reduction and health improvement in women with PCOS treated with gastric bypass. Published by Elsevier Inc.

AZP-531, an unacylated ghrelin analog, improves food-related behavior in patients with Prader-Willi syndrome: A randomized placebo-controlled trial.

PubMed

Allas, Soraya; Caixàs, Assumpta; Poitou, Christine; Coupaye, Muriel; Thuilleaux, Denise; Lorenzini, Françoise; Diene, Gwenaëlle; Crinò, Antonino; Illouz, Frédéric; Grugni, Graziano; Potvin, Diane; Bocchini, Sarah; Delale, Thomas; Abribat, Thierry; Tauber, Maithé

2018-01-01

Prader-Willi syndrome (PWS) is characterized by early-onset hyperphagia and increased circulating levels of the orexigenic Acylated Ghrelin (AG) hormone with a relative deficit of Unacylated Ghrelin (UAG). AZP-531, a first-in-class UAG analog, was shown to inhibit the orexigenic effect of AG in animals, to improve glycemic control and decrease body weight in humans. We aimed to investigate the safety and efficacy of AZP-531 in patients with PWS for whom no approved treatment for hyperphagia is currently available. Multi-center, randomized, double-blind, placebo-controlled trial. Forty-seven patients with genetically confirmed PWS and evidence of hyperphagia received daily subcutaneous injections of AZP-531 (3 and 4 mg for 50-70 kg and >70 kg body weight, respectively) or matching placebo for 14 days. Assessments included adverse events, vital signs, safety laboratory tests, the Hyperphagia Questionnaire (HQ), patient-reported appetite, body composition and glycemic measures. AZP-531 was well tolerated. There was a significant improvement with AZP-531 versus placebo in the mean total score, the 9-item score and the severity domain score of the HQ (p < .05). The highest reduction in the total and 9-item scores was observed in AZP-531 subjects with the highest hyperphagia score at baseline. Findings were supported by a reduction in appetite scores observed with AZP-531 only. Body weight did not change in both groups while a significant reduction in waist circumference and fat mass was observed only with AZP-531. AZP-531 significantly decreased post-prandial glucose levels in a baseline glucose dependent fashion. AZP-531 may constitute a new treatment strategy to improve hyperphagia and metabolic issues in patients with PWS. These findings support further investigation in longer-term clinical trials.

CLINICAL AND NUTRITIONAL ASPECTS IN OBESE WOMEN DURING THE FIRST YEAR AFTER ROUX-EN-Y GASTRIC BYPASS

PubMed Central

dos SANTOS, Tiago Dália; BURGOS, Maria Goretti Pessoa de Araújo; de LEMOS, Maria da Conceição Chaves; CABRAL, Poliana Coelho

2015-01-01

Background: Clinic care for morbid obesity is not very effective. Bariatric surgery is being considered the best way of intervention for this kind of obesity. Aim : Evaluate the clinical and nutritional evolution during the first year of obese women submitted to Roux-en-Y gastric bypass. Method : Retrospective series non-concurrent with 61 women. The variables were weight, BMI, weight loss percentage, loss of excessive weight percentage, waist circumference, hip circumference, lipid profile, daily use of supplements, practice of physical exercise, occurrence of sickness, nausea, constipation, diarrhea, asthenia, alopecia, dry skin, cramps and brittle nails. Results : They presented significant weight and IMC reduction as well as improvement in their lipid profile, in all consultations. After one year they presented 36,6% loss of the initial weight and 75% loss of excessive weight. The waist circumference also presented a considerable reduction on all the moments, decreasing from 122,1±13,4 cm to 94,1±10,6 cm. Regarding the intercurrences, the most frequent were alopecia, asthenia, dry skin and cramps. Conclusion : The Roux-en-Y gastric bypass was effective in promoting and maintenance weight loss during the period of the first postoperative year. PMID:26537276

Integrated application of active controls (IAAC) technology to an advanced subsonic transport project. Initial ACT configuration design study

NASA Technical Reports Server (NTRS)

1980-01-01

The initial ACT configuration design task of the integrated application of active controls (IAAC) technology project within the Energy Efficient Transport Program is summarized. A constrained application of active controls technology (ACT) resulted in significant improvements over a conventional baseline configuration previously established. The configuration uses the same levels of technology, takeoff gross weight, payload, and design requirements/objectives as the baseline, except for flying qualities, flutter, and ACT. The baseline wing is moved forward 1.68 m. The configuration incorporates pitch-augmented stability (which enabled an approximately 10% aft shift in cruise center of gravity and a 45% reduction in horizontal tail size), lateral/directional-augmented stability, an angle of attack limiter, wing load alleviation, and flutter mode control. This resulted in a 930 kg reduction in airplane operating empty weight and a 3.6% improvement in cruise efficiency, yielding a 13% range increase. Adjusted to the 3590 km baseline mission range, this amounts to 6% block fuel reduction and a 15.7% higher incremental return on investment, using 1978 dollars and fuel cost.

A novel prescription pedometer-assisted walking intervention and weight management for Chinese occupational population.

PubMed

Yu, Yingxiang; Lv, Yiran; Yao, Bin; Duan, Liguang; Zhang, Xiaoyuan; Xie, Lan; Chang, Cuiqing

2018-01-01

Information technology has been previously used for the research and practice of health promotion. Appropriate and effective health promotion methods used by professional groups remain to be investigated. This study aimed to assess the feasibility and effectiveness of a weight management program among the Chinese occupational population using and a novel information technology exercise prescription. A 3-month open, self-monitored intervention trial, involving individualized pedometer-assisted exercise prescription and a one-time targeted dietary guidance prior to exercise was conducted on the Chinese occupational population aged 18-65 years in China from 2015 to 2016. Data were collected from March 2015 to May 2016 and analyzed from June 2016 to August 2016. Participants were also asked to synchronize exercise data of the pedometer to the Internet-based Health System Center daily (at least weekly), by connecting to the personal computer (PC) using a USB cable or via Bluetooth. Eligible participants included 802 Chinese occupational persons, and 718 of them followed exercise interventions with 89.5% (718/802) adherence to the exercise programs. Of them, 688 participants completed the program with 85.8% (688/802) adherence to the exercise program and their data were analyzed. Weight decreased by 2.2% among all overweight/obese participants, with 1.8% reduction in waist circumference and 3.3% reduction in body fat percentage (p< 0.001). Weight and body fat percentage in normal-weight individuals decreased by 0.7% and 2.5%, respectively (p < 0.01). A weight gain of 1.0% was observed in all underweight participants (p< 0.05), and 68.2% (208/305) of overweight/obese participants experienced weight loss, with an average reduction of 3.5%, with 20.2% (42/208) of them achieving weight loss ≥5%. Blood pressure and fasting serum glucose decreased significantly in both the overweight/obese and the normal-weight individuals (p < 0.05). The incidence of hypertension was significantly lower and lifestyle behavior significantly improved (p < 0.05). The prescription pedometer-assisted walking intervention can effectively improve exercise adherence and manage weight. This approach was also effective in controlling the risk factors of weight-related chronic diseases. Chinese Clinical Trial Registry (ChiCTR) ChiCTR-OOh-16010229.

Extent of weight reduction necessary for minimization of diabetes risk in Japanese men with visceral fat accumulation and glycated hemoglobin of 5.6-6.4.

PubMed

Iwahashi, Hiromi; Noguchi, Midori; Okauchi, Yukiyoshi; Morita, Sachiko; Imagawa, Akihisa; Shimomura, Iichiro

2015-09-01

Weight reduction improves glycemic control in obese men with glycated hemoglobin (HbA1c) of 5.6-6.4%, suggesting that it can prevent the development of diabetes in these patients. The aim of the present study was to quantify the amount of weight reduction necessary for minimization of diabetes risk in Japanese men with visceral fat accumulation. The study participants were 482 men with an estimated visceral fat area of ≥100 cm(2), HbA1c of 5.6-6.4%, fasting plasma glucose (FPG) of <126 mg/dL or casual plasma glucose <200 mg/dL. They were divided into two groups based on weight change at the end of the 3-year follow-up period (weight gain and weight loss groups). The weight loss group was classified into quartile subgroups (lowest group, 0 to <1.2%: second lowest group, ≥1.2 to <2.5%: second highest group, ≥2.5 to <4.3%: highest group, ≥4.3% weight loss). The development of diabetes at the end-point represented a rise in HbA1c to ≥6.5% or FPG ≥126 mg/dL, or casual plasma glucose ≥200 mg/dL. The cumulative incidence of diabetes at the end of the 3-year follow-up period was 16.2% in the weight gain group and 10.1% in the weight loss group (P not significant). The incidence of diabetes was significantly lower in the highest weight loss group (3.1%), but not in the second highest, the second lowest and the lowest weight loss groups (9.7, 10.1 and 18.3%), compared with the weight gain group. Minimization of the risk of diabetes in Japanese men with visceral fat accumulation requires a minimum of 4-5% weight loss in those with HbA1c of 5.6-6.4%.

Sikorsky Aircraft Advanced Rotorcraft Transmission (ART) program

NASA Technical Reports Server (NTRS)

Kish, Jules G.

1993-01-01

The objectives of the Advanced Rotorcraft Transmission program were to achieve a 25 percent weight reduction, a 10 dB noise reduction, and a 5,000 hour mean time between removals (MTBR). A three engine Army Cargo Aircraft (ACA) of 85,000 pounds gross weight was used as the baseline. Preliminary designs were conducted of split path and split torque transmissions to evaluate weight, reliability, and noise. A split path gearbox was determined to be 23 percent lighter, greater than 10 dB quieter, and almost four times more reliable than the baseline two stage planetary design. Detail design studies were conducted of the chosen split path configuration, and drawings were produced of a 1/2 size gearbox consisting of a single engine path of the split path section. Fabrication and testing was then conducted on the 1/2 size gearbox. The 1/2 size gearbox testing proved that the concept of the split path gearbox with high reduction ratio double helical output gear was sound. The improvements were attributed to extensive use of composites, spring clutches, advanced high hot hardness gear steels, the split path configuration itself, high reduction ratio, double helical gearing on the output stage, elastomeric load sharing devices, and elimination of accessory drives.

Effectiveness of interventions targeting physical activity, nutrition and healthy weight for university and college students: a systematic review and meta-analysis.

PubMed

Plotnikoff, Ronald C; Costigan, Sarah A; Williams, Rebecca L; Hutchesson, Melinda J; Kennedy, Sarah G; Robards, Sara L; Allen, Jennifer; Collins, Clare E; Callister, Robin; Germov, John

2015-04-01

To examine the effectiveness of interventions aimed at improving physical activity, diet, and/or weight-related behaviors amongst university/college students. Five online databases were searched (January 1970 to April 2014). Experimental study designs were eligible for inclusion. Data extraction was performed by one reviewer using a standardized form developed by the researchers and checked by a second reviewer. Data were described in a narrative synthesis and meta-analyses were conducted when appropriate. Study quality was also established. Forty-one studies were included; of these, 34 reported significant improvements in one of the key outcomes. Of the studies examining physical activity 18/29 yielded significant results, with meta-analysis demonstrating significant increases in moderate physical activity in intervention groups compared to control. Of the studies examining nutrition, 12/24 reported significantly improved outcomes; only 4/12 assessing weight loss outcomes found significant weight reduction. This appears to be the first systematic review of physical activity, diet and weight loss interventions targeting university and college students. Tertiary institutions are appropriate settings for implementing and evaluating lifestyle interventions, however more research is needed to improve such strategies.

Diet-Induced Weight Loss Alters Functional Brain Responses during an Episodic Memory Task.

PubMed

Boraxbekk, Carl-Johan; Stomby, Andreas; Ryberg, Mats; Lindahl, Bernt; Larsson, Christel; Nyberg, Lars; Olsson, Tommy

2015-01-01

It has been suggested that overweight is negatively associated with cognitive functions. The aim of this study was to investigate whether a reduction in body weight by dietary interventions could improve episodic memory performance and alter associated functional brain responses in overweight and obese women. 20 overweight postmenopausal women were randomized to either a modified paleolithic diet or a standard diet adhering to the Nordic Nutrition Recommendations for 6 months. We used functional magnetic resonance imaging to examine brain function during an episodic memory task as well as anthropometric and biochemical data before and after the interventions. Episodic memory performance improved significantly (p = 0.010) after the dietary interventions. Concomitantly, brain activity increased in the anterior part of the right hippocampus during memory encoding, without differences between diets. This was associated with decreased levels of plasma free fatty acids (FFA). Brain activity increased in pre-frontal cortex and superior/middle temporal gyri. The magnitude of increase correlated with waist circumference reduction. During episodic retrieval, brain activity decreased in inferior and middle frontal gyri, and increased in middle/superior temporal gyri. Diet-induced weight loss, associated with decreased levels of plasma FFA, improves episodic memory linked to increased hippocampal activity. © 2015 S. Karger GmbH, Freiburg.

Diet-Induced Weight Loss Alters Functional Brain Responses during an Episodic Memory Task

PubMed Central

Boraxbekk, Carl-Johan; Stomby, Andreas; Ryberg, Mats; Lindahl, Bernt; Larsson, Christel; Nyberg, Lars; Olsson, Tommy

2015-01-01

Objective It has been suggested that overweight is negatively associated with cognitive functions. The aim of this study was to investigate whether a reduction in body weight by dietary interventions could improve episodic memory performance and alter associated functional brain responses in overweight and obese women. Methods 20 overweight postmenopausal women were randomized to either a modified paleolithic diet or a standard diet adhering to the Nordic Nutrition Recommendations for 6 months. We used functional magnetic resonance imaging to examine brain function during an episodic memory task as well as anthropometric and biochemical data before and after the interventions. Results Episodic memory performance improved significantly (p = 0.010) after the dietary interventions. Concomitantly, brain activity increased in the anterior part of the right hippocampus during memory encoding, without differences between diets. This was associated with decreased levels of plasma free fatty acids (FFA). Brain activity increased in pre-frontal cortex and superior/middle temporal gyri. The magnitude of increase correlated with waist circumference reduction. During episodic retrieval, brain activity decreased in inferior and middle frontal gyri, and increased in middle/superior temporal gyri. Conclusions Diet-induced weight loss, associated with decreased levels of plasma FFA, improves episodic memory linked to increased hippocampal activity. PMID:26139105

Changes in HbA1c and Weight Following Transition to Continuous Subcutaneous Insulin Infusion Therapy in Adults With Type 1 Diabetes.

PubMed

Mehta, Sanjeev N; Andersen, Henrik Ullits; Abrahamson, Martin J; Wolpert, Howard A; Hommel, Eva E; McMullen, William; Ridderstråle, Martin

2017-01-01

Historically, intensive insulin therapy for type 1 diabetes (T1D) has improved glycemic control at the risk of adverse weight gain. The impact of continuous subcutaneous insulin infusion therapy (CSII) on weight in the current era remains unknown. We assessed changes in hemoglobin A1c (HbA1c) and weight in adults with T1D transitioning to CSII at 2 diabetes centers in Denmark and the United States. Patients with T1D, aged ≥18 years, managed with multiple daily injections (MDI) who transitioned to CSII between 2002 and 2013 were identified using electronic health record data from the Steno Diabetes Center (n = 600) and Joslin Diabetes Center (n = 658). Changes in HbA1c and weight after 1 year was assessed overall and by baseline HbA1c cut points. Multivariate regression assessed correlates of HbA1c reduction. In adults with T1D transitioning to CSII, clinically significant HbA1c reductions were found in patients with baseline HbA1c 8.0-8.9% (Steno, -0.7%; Joslin, -0.4%) and baseline HbA1c ≥9.0% (Steno, -1.1%; Joslin, -0.9%) ( P < .005 for all). Overall, there was no significant change in weight after 1 year at either center. Modest (<2%) weight gain was noted in patients with baseline HbA1c ≥9% at Steno (1.1 ± 0.3 kg, P < .0001) and Joslin (1.7 ± 1.1, P < .005). In multivariate models, HbA1c reduction was associated with higher HbA1c, older age, female sex at Steno ( R 2 = .28, P < .005), but only higher baseline HbA1c at Joslin ( R 2 = .19, P < .005). Adults with T1D with suboptimal glycemic control significantly improved HbA1c without a negative impact on weight 1 year after transitioning from MDI to CSII.

Initial Response to Program, Program Participation, and Weight Reduction Among 375 MOVE! Participants, Augusta, Georgia, 2008-2010.

PubMed

Garvin, Jane T; Hardy, Dale; Xu, Hongyan

2016-04-21

Obesity management guidelines specify initial goals for participation and weight reduction for the first 6 months of a weight-reduction intervention, but guidelines do not specify when to assess early response and make adjustments. We aimed to determine whether very early or early weight reduction in the weight-reduction program MOVE! predicted later participation or achievement of weight-reduction goals. Using clinical data from 375 MOVE! participants enrolled from July 2008 through May 2010, we examined program participation and weight reduction. Very early response was defined as achieving a weight reduction of 0.5% or more at week 2, and early response was defined as achieving weight reduction of 1.0% or more at week 4. Success, or achievement of weight-reduction goal, at 6 months, 1 year, and 2 years was defined as a weight reduction of 5% or more. Participation was assessed according to the number of sessions attended within the first 6 months of program enrollment; attendance of 14 or more sessions was classified as high-intensity participation. Very early responders were more than 5 times as likely (odds ratio [OR] = 5.46; 95% confidence interval [CI], 1.69-17.71; P = .005) and early responders were more than 10 times as likely (OR = 10.76; 95% CI, 2.64-43.80; P = .001) to achieve the 6-month weight-reduction goal as participants who were not very early responders or early responders, respectively. Early responders were almost 7 times as likely to achieve the 1-year weight-reduction goal (OR = 6.96; 95% CI, 1.85-26.13; P = .004). Neither very early nor early response predicted participation, high-intensity participation, or success at 2 years. This research supports the predictive value of very early response and early response to MOVE! on weight-reduction success at 6 months; early response also predicted 1-year success, suggesting that the 2-week point may be an ideal time to assess initial response and make intervention adjustments.

Initial Response to Program, Program Participation, and Weight Reduction Among 375 MOVE! Participants, Augusta, Georgia, 2008–2010

PubMed Central

Hardy, Dale; Xu, Hongyan

2016-01-01

Introduction Obesity management guidelines specify initial goals for participation and weight reduction for the first 6 months of a weight-reduction intervention, but guidelines do not specify when to assess early response and make adjustments. We aimed to determine whether very early or early weight reduction in the weight-reduction program MOVE! predicted later participation or achievement of weight-reduction goals. Methods Using clinical data from 375 MOVE! participants enrolled from July 2008 through May 2010, we examined program participation and weight reduction. Very early response was defined as achieving a weight reduction of 0.5% or more at week 2, and early response was defined as achieving weight reduction of 1.0% or more at week 4. Success, or achievement of weight-reduction goal, at 6 months, 1 year, and 2 years was defined as a weight reduction of 5% or more. Participation was assessed according to the number of sessions attended within the first 6 months of program enrollment; attendance of 14 or more sessions was classified as high-intensity participation. Results Very early responders were more than 5 times as likely (odds ratio [OR] = 5.46; 95% confidence interval [CI], 1.69–17.71; P = .005) and early responders were more than 10 times as likely (OR = 10.76; 95% CI, 2.64–43.80; P = .001) to achieve the 6-month weight-reduction goal as participants who were not very early responders or early responders, respectively. Early responders were almost 7 times as likely to achieve the 1-year weight-reduction goal (OR = 6.96; 95% CI, 1.85–26.13; P = .004). Neither very early nor early response predicted participation, high-intensity participation, or success at 2 years. Conclusion This research supports the predictive value of very early response and early response to MOVE! on weight-reduction success at 6 months; early response also predicted 1-year success, suggesting that the 2-week point may be an ideal time to assess initial response and make intervention adjustments. PMID:27103265

GLP-1 receptor agonists in the treatment of polycystic ovary syndrome.

PubMed

Lamos, Elizabeth Mary; Malek, Rana; Davis, Stephen N

2017-04-01

Polycystic ovarian syndrome (PCOS) affects many women of child-bearing age and is characterized by hyperandrogenism, ovulatory and metabolic dysfunction. A primary treatment goal is weight reduction. The weight loss effects of glucagon-like peptide-1 receptor agonists (GLP-1RA), previously demonstrated in diabetic and obese non-diabetic patients, offer a unique opportunity to expand the medical options available to PCOS patients. Areas covered: Available clinical trials of glucagon-like peptide-1 receptor agonist therapy in PCOS were reviewed. Literature was searched from PubMed using appropriate search terms up to November 2016. Expert commentary: The available studies of GLP-1 RA therapy in the treatment of excess body weight in women with PCOS demonstrate that exenatide and liraglutide are effective in weight reduction either as monotherapy or in combination with metformin. A few studies showed that androgens may be modestly decreased and menstrual frequency may be increased. Eating behavior may be improved with liraglutide therapy. Glucose parameters are generally improved. GLP-1RAs were well-tolerated, with nausea being the most significant adverse side effect. Barriers to utilization may be the short duration studies, lack of familiarity of the medication, the route of administration (injection) and the variable outcomes on ovulation and hyperandrogenism.

Continuing weight-loss effect after topiramate discontinuation in obese persons with schizophrenia: a pilot open-label study.

PubMed

Liang, C-S; Yang, F-W; Huang, S-Y; Ho, P-S

2014-07-01

Few studies have investigated the likelihood of weight maintenance in obese persons with schizophrenia after their initial successful weight loss. This pilot open-label study examined the efficacy of topiramate in weight loss and the trajectory of weight changes after topiramate discontinuation. This study enrolled 10 obese persons with schizophrenia. A 4-month treatment phase was started, followed by a 12-month discontinuation phase. Body weight was measured as the primary outcome every month. Secondary outcomes included leptin levels, fasting glucose, lipid profiles, and insulin resistance index. After the 4-month addition of topiramate, participants lost 1.79 kg of their body weight (95% CI=-3.03 to -0.56, p=0.005). The maximum weight reduction was 4.32 kg, occurring when topiramate had been discontinued for 12 months (95% CI=-6.41 to -2.24, p<0.001). The continuing weight-loss effect after topiramate discontinuation might have resulted from topiramate's potential to improve leptin functioning. These findings demonstrate that topiramate's weight-loss effect could not only persist during its administration, but also continue to improve after its discontinuation. © Georg Thieme Verlag KG Stuttgart · New York.

Dietary intervention in the treatment of patients with cough and symptoms suggestive of airways reflux as determined by Hull airways Reflux Questionnaire

PubMed Central

2013-01-01

Background Chronic cough is a common and distressing symptom. Gastro-oesophageal reflux is a common cause of chronic cough however the symptom complex in cough is not confined to classic peptic symptoms. Dyspeptic symptoms have previously been shown to respond to dietary modifications and weight loss. We hypothesised that weight reduction maybe a useful non-pharmacological strategy in reducing reflux cough in the obese. Methods Subjects with cough were recruited from Hull Cough Clinic. They were randomised to one of two open parallel groups; one receiving the traditional dietary modifications and the other weight reduction advice in the form of an Energy Prescription (EP). Cough symptoms, using the Leicester cough questionnaire (LCQ) and dietary intake were measured at the start and end of the study. Results Thirty-three patients were recruited and 20 patients completed the study. Mean weight loss was 3.1 kg (p < 0.001) and reported an improvement in the LCQ (mean improvement 3.1); which is greater than the clinically significant score of 1.3. . Moreover, secondary outcomes showed a significant association between baseline high calorie (r = -0.24; p < 0.001) and fat intake (r = -0.36; p = 0.001), and LCQ scores. Conclusion A high calorie and fat intake is strongly correlated with cough score. Irrespective of diet, weight loss is associated with a reduction in cough symptoms. Asking patients to lose weight by reducing fat and calorie intake may be a simple strategy to ameliorate this intractable condition. Trial Registration The study was approved by the local research ethics committee (South Humber Local Research Ethics Committee; REC04/Q1105/62). The study was registered with the Research and Development Department, Clinical Governance Directorate, Hull and East Yorkshire Hospitals NHS Trust (reference number R0086). PMID:24380385

Hormone-injected gravid channel catfish held in individual mesh bag reduces handling stress and improves reproductive performance in hatcheries

USDA-ARS?s Scientific Manuscript database

This study compared holding hormone-injected female channel catfish in soft-mesh bags to communally held hormone-injected female catfish in a tank as a stress reduction strategy to improve reproductive performance. Fish held in tanks were crowded, handled multiple times to record weight prior to ho...

A novel dual amylin and calcitonin receptor agonist, KBP-089, induces weight loss through a reduction in fat, but not lean mass, while improving food preference.

PubMed

Gydesen, Sofie; Hjuler, Sara Toftegaard; Freving, Zenia; Andreassen, Kim Vietz; Sonne, Nina; Hellgren, Lars I; Karsdal, Morten Asser; Henriksen, Kim

2017-04-01

Obesity and associated co-morbidities, such as type 2 diabetes and non-alcoholic fatty liver disease, are major health challenges. Hence, there is an important need to develop weight loss therapies with the ability to reduce the co-morbidities. The effect of the dual amylin and calcitonin receptor agonist (DACRA), KBP-089, on body weight, glucose homeostasis and fatty acid accumulation in liver and muscle tissue and on food preference was investigated. Furthermore, we elucidated weight-independent effects of KBP-089 using a weight-matched group. Rats fed a high-fat diet were treated, s.c., with KBP-089 0.625, 1.25, 2.5 μg·kg -1 or vehicle. KB-089 induced in a dose-dependent and sustained weight loss (~17% by 2.5 μg·kg -1 ). Moreover, KBP-089 reduced fat depot size and reduced lipid accumulation in muscle and liver. In Zucker Diabetic Fatty rats, KBP-089 improved glucose homeostasis through improved insulin action. To obtain a weight-matched group, significantly less food was offered (9% less than in the KBP-089 group). Weight matching led to improved glucose homeostasis by reducing plasma insulin; however, these effect were inferior compared to those of KBP-089. In the food preference test, rats fed a normal diet obtained 74% of their calories from chocolate. KBP-089 reduced total caloric intake and induced a relative increase in chow consumption while drastically reducing chocolate consumption compared with vehicle. The novel DACRA, KBP-089, induces a sustained weight loss, leading to improved metabolic parameters including food preference, and these are beyond those observed simply by diet-induced weight loss. © 2017 The British Pharmacological Society.

An acoustic sensitivity study of general aviation propellers

NASA Technical Reports Server (NTRS)

Korkan, K. D.; Gregorek, G. M.; Keiter, I.

1980-01-01

This paper describes the results of a study in which a systematic approach has been taken in studying the effect of selected propeller parameters on the character and magnitude of propeller noise. Four general aviation aircraft were chosen, i.e., a Cessna 172, Cessna 210, Cessna 441, and a 19 passenger commuter concept, to provide a range in flight velocity, engine horsepower, and gross weight. The propeller parameters selected for examination consisted of number of blades, rpm reduction, thickness/chord reduction, activity factor reduction, proplets, airfoil improvement, sweep, position of maximum blade loading, and diameter reduction.

Combination phentermine and topiramate extended release in the management of obesity.

PubMed

Alfaris, Nasreen; Minnick, Alyssa M; Hopkins, Christina M; Berkowitz, Robert I; Wadden, Thomas A

2015-06-01

Losing ≥ 5% of initial weight improves quality of life and risk factors for cardiovascular disease (CVD) in obese individuals. Lifestyle modification, the cornerstone of weight reduction, may be complemented by pharmacotherapy. In 2012, the FDA approved the combination of phentermine and topiramate extended release (ER) for chronic weight management, as an adjunct to lifestyle modification. This review examines the safety and efficacy of phentermine-topiramate ER, as determined by randomized controlled trials (RCTs). A preliminary study confirmed the benefit of combining the two medications for improving weight loss and reducing adverse effects, as compared to using equivalent-dose monotherapy alone. Across RCTs, groups prescribed phentermine 15 mg/topiramate ER 92 mg lost an average of 10% of initial weight, ∼ 8% more than placebo and 2% more than phentermine 7.5 mg/topiramate 46 mg. Weight loss reduced the risk of developing type 2 diabetes and improved CVD risk factors. Phentermine-topiramate ER, however, was associated with increased heart rate, the clinical significance of which is being investigated in an FDA-required CVD outcomes study. The medication also must be used with caution in women of child-bearing age because of an increased risk to infants of oral cleft.

Effects of orlistat on serum androgen levels among iranian obese women with polycystic ovarian syndrome.

PubMed

Salehpour, Saghar; Hosseini, Sedighe; Nazari, Leila; Saharkhiz, Nasrin; Zademodarres, Shahrzad

2018-05-14

Polycystic ovary syndrome is one of the most common endocrinopathies in young women, and it affects 6% to 8% of women in reproductive age. Hyperandrogenism is the hallmark of polycystic ovary syndrome. The aim of the present study was to evaluate the effects of orlistat on weight loss and serum androgen levels among Iranian women with polycystic ovary syndrome. The present study was carried out in the clinic of Infertility and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Thirty-two patients with polycystic ovary syndrome were randomly enrolled. We measured serum androgens (Testosterone, 17α-hydroxyprogesterone, dehydroepiandrosterone and sex hormone-binding globulin) before and after 12 weeks of treatment with orlistat. We used the Rotterdam Criteria for all patients and transvaginal sonography was performed. The mean age of patients was 27.75±6.22 and the mean body mass index was 32.69±0.94 kg/m2. Comparing with baseline, treatment with orlistat resulted in a significant reduction in weight, BMI, and waist circumference (p=0.001). We also found a remarkable reduction in total testosterone levels (p>0.001). Treatment improved the sex hormone-binding globulin plasma levels, but the improvement was not statistically significant. There was no reduction in other androgen levels. This study showed a significant reduction of weight and total testosterone level - the most important androgen in polycystic ovary syndrome - after 12 weeks of treatment with orlistat. Therefore, it seems that a short course of orlistat can be useful in the management of patients with polycystic ovary syndrome.

Hybrid Wing-Body Pressurized Fuselage and Bulkhead, Design and Optimization

NASA Technical Reports Server (NTRS)

Mukhopadhyay, Vivek

2013-01-01

The structural weight reduction of a pressurized Hybrid Wing-Body (HWB) fuselage is a serious challenge. Hence, research and development are presently being continued at NASA under the Environmentally Responsible Aviation (ERA) and Subsonic Fixed Wing (SFW) projects in collaboration with the Boeing Company, Huntington Beach and Air Force Research Laboratory (AFRL). In this paper, a structural analysis of the HWB fuselage and bulkhead panels is presented, with the objectives of design improvement and structural weight reduction. First, orthotropic plate theories for sizing, and equivalent plate analysis with appropriate simplification are considered. Then parametric finite-element analysis of a fuselage section and bulkhead are conducted using advanced stitched composite structural concepts, which are presently being developed at Boeing for pressurized HWB flight vehicles. With this advanced stiffened-shell design, structural weights are computed and compared to the thick sandwich, vaulted-ribbed-shell, and multi-bubble stiffened-shell structural concepts that had been studied previously. The analytical and numerical results are discussed to assess the overall weight/strength advantages.

Nutrition-focused wellness coaching promotes a reduction in body weight in overweight US veterans.

PubMed

Shahnazari, Mohammad; Ceresa, Carol; Foley, Sharon; Fong, Angela; Zidaru, Elena; Moody, Sandra

2013-07-01

Diet plays a critical role in the pathogenesis of major chronic diseases common in populations of US veterans. The role of nutrition-focused wellness coaching in improving dietary behavior and/or reducing weight in overweight and obese US veterans is not known. At the San Francisco Veterans Affairs Medical Center, US veterans aged 25 to 80 years were randomized to receive nutrition coaching on eating behaviors at baseline only (control group, n=22) or an additional eight times over the course of 6 months (intervention group, n=28) in 2010-2011. Multiple coaching contacts decreased intake of energy, fat, and carbohydrate by 31% (P≤0.001) as evaluated by the 2005 Block food frequency questionnaire, which is composed of 111 food items. A weight loss of 5% from baseline (92.8 to 88.2 kg; P<0.01) was observed in the intervention group with mean body mass index decreasing from 30.4 to 28.9 (P<0.05). The control group showed a decrease in fat intake by 20% (P=0.01), but no statistically significant changes in intake of other nutrients or body weight (88.7 to 87.4 kg). Those in the intervention group reported diets at follow-up that were lower in cholesterol, saturated fat, sodium, sugar (P≤0.01), calcium (P< 0.05), and vitamin D (P<0.01), although when adjusted for energy (ie, nutrient density) calcium intake increased and vitamin D remained unchanged. Veterans' readiness to change eating behavior for weight loss improved with nutrition coaching. This study demonstrates that intermittent nutrition coaching can be an effective strategy to promote reductions in energy intake, body weight, and body mass index in overweight US veterans. Further research is needed to determine whether nutrition coaching improves other clinical outcomes and sustains weight loss. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Health-related quality of life and psychological functioning 9 years after restrictive surgical treatment for obesity.

PubMed

Herpertz, Stephan; Müller, Astrid; Burgmer, Ramona; Crosby, Ross D; de Zwaan, Martina; Legenbauer, Tanja

2015-01-01

Bariatric surgery leads to initial weight loss that is associated with improvement in mental health; however, long-term effects are uncertain. To investigate the impact of restrictive surgical treatment for obesity on weight loss, psychological functioning, and quality of life 9 years after surgery. University hospitals and obesity centers, Germany. 152 patients undergoing restrictive surgical treatment (SURG), 249 individuals participating in a conventional weight loss treatment (CONV), and 128 obese control participants without weight loss treatment (OC) were studied using a prospective longitudinal cohort design. After 9 years, 55% of SURG patients, 51% of CONV patients, and 65% of OC participants were reassessed. Body mass index, anxiety, depression, self-esteem, and health-related quality of life (HRQOL) were explored. The SURG group had significantly greater weight loss and improvements in physical HRQOL at all postbaseline assessments. Although SURG patients experienced initial improvements in depression, anxiety, self-esteem, and mental aspects of HRQOL, these improvements deteriorated at the 9-year assessment and were comparable to or worse than presurgical levels. Bariatric surgery is an effective treatment for obesity and is linked to maintained improvement of physical aspects of HRQOL. Weight reduction after surgery is also associated with significant initial improvement in mental health that may erode over time. Therefore, psychosocial screening should be included at follow-ups, with referral to mental health professionals as appropriate. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

A trial of reduced carbohydrate diet to improve metabolic outcomes and decrease adiposity in obese peripubertal African American girls: does macronutrient profile matter?

PubMed Central

Casazza, Krista; Cardel, Michelle; Dulin-Keita, Akilah; Hanks, Lynae J.; Gower, Barbara A.; Newton, Anna L.; Wallace, Stephenie

2011-01-01

Objectives Obesity prevalence among African American (AA) girls is higher than that of other groups. As typical calorie-restriction obesity treatment strategies have had limited success, alterations in macronutrient composition might effectively improve metabolic outcomes in this population and impact future body composition trajectories. The objective was to evaluate the efficacy of a moderately restricted carbohydrate (CHO) versus a standard CHO diet on weight/fat loss and metabolic parameters in overweight/obese AA girls aged 9–14 years. Methods A total of 26 AA girls (ranging from 92nd BMI percentile and above) were assigned to either a reduced- (SPEC: 42% calories from CHO, n=12) or a standard- (STAN: 55% of calories from CHO, n=14) CHO diet (protein held constant) for 16-weeks. All meals were provided and clinically tailored to meet the estimated energy requirements (REE × 1.2 in eucaloric phase and REE × 1.2 – 1000kcal in energy deficit phase). The first five-weeks encompassed a eucaloric phase evaluating metabolic changes in the absence of weight change. The subsequent 11-weeks were hypocaloric (1000kcal/d deficit) in effort to promote weight/fat loss. Meal tests were performed during the eucaloric phase for metabolic analyses. Dual-energy x-ray absorptiometry (DXA) was used to evaluate body composition. Results Both groups had reductions in weight/adiposity but the difference did not reach significance. The solid meal test indicated improved glucose/insulin homeostasis on the SPEC diet up to three hours post-ingestion. In addition, significantly lower triglycerides (p<0.001) were observed on the SPEC diet. Conclusions Dietary CHO reduction favorably influences metabolic parameters but did not result in greater weight/fat loss relative to a standard diet in obese AA girls. Future research is needed to determine long-term effectiveness of a reduced CHO diet on glucose and insulin homeostasis and how it may apply to weight maintenance/fat loss during development alone and/or in combination with additional weight loss/metabolic improvement strategies. PMID:22067112

The contribution of changes in diet, exercise, and stress management to changes in coronary risk in women and men in the multisite cardiac lifestyle intervention program.

PubMed

Daubenmier, Jennifer J; Weidner, Gerdi; Sumner, Michael D; Mendell, Nancy; Merritt-Worden, Terri; Studley, Joli; Ornish, Dean

2007-02-01

The relative contribution of health behaviors to coronary risk factors in multicomponent secondary coronary heart disease (CHD) prevention programs is largely unknown. Our purpose is to evaluate the additive and interactive effects of 3-month changes in health behaviors (dietary fat intake, exercise, and stress management) on 3-month changes in coronary risk and psychosocial factors among 869 nonsmoking CHD patients (34% female) enrolled in the health insurance-based Multisite Cardiac Lifestyle Intervention Program. Analyses of variance for repeated measures were used to analyze health behaviors, coronary risk factors, and psychosocial factors at baseline and 3 months. Multiple regression analyses evaluated changes in dietary fat intake and hours per week of exercise and stress management as predictors of changes in coronary risk and psychosocial factors. Significant overall improvement in coronary risk was observed. Reductions in dietary fat intake predicted reductions in weight, total cholesterol, low-density lipoprotein cholesterol, and interacted with increased exercise to predict reductions in perceived stress. Increases in exercise predicted improvements in total cholesterol and exercise capacity (for women). Increased stress management was related to reductions in weight, total cholesterol/high-density lipoprotein cholesterol (for men), triglycerides, hemoglobin A1c (in patients with diabetes), and hostility. Improvements in dietary fat intake, exercise, and stress management were individually, additively and interactively related to coronary risk and psychosocial factors, suggesting that multicomponent programs focusing on diet, exercise, and stress management may benefit patients with CHD.

Management of obesity after spinal cord injury: a systematic review.

PubMed

Shojaei, Mir Hatef; Alavinia, Seyed Mohammad; Craven, B Catharine

2017-11-01

Individuals with chronic spinal cord injury (SCI) are susceptible to central and visceral obesity and it's metabolic consequences; consensus based guidelines for obesity management after SCI have not yet been stablished. To identify and compare effective means of obesity management among SCI individuals. This systematic review included English and non-English articles, published prior to April 2017 found in the PubMed/Medline, Embase, CINAHL Psychinfo and Cochrane databases. Studies evaluating any obesity management strategy, alone or in combination, including: diet therapy, voluntary and involuntary exercise such as neuro-muscular electric stimulation (NMES), pharmacotherapy, and surgery, among individuals with chronic SCI were included. Outcomes of interest were reductions in waist circumference, body weight (BW), body mass index (BMI) and total fat mass (TFM) and increases in total lean body mass (TLBM) from baseline. From 3,553 retrieved titles and abstracts, 34 articles underwent full text review and 23 articles were selected for data abstraction. Articles describing weight loss due to inflammation, cancer or B12 deficiency were excluded. The Downs and Black reported poor to moderate quality of the studies. Bariatric surgery produced the greatest permanent weight reduction and BMI correction followed by combinations of physical exercise and diet therapy. Generally, NMES and pharmacotherapy improved TLBM and reduced TFM but not weight. The greatest weight reduction and BMI correction was produced by bariatric surgery, followed by a combination of physical exercise and diet therapy. NMES and pharmacologic treatment did not reduce weight or TFM but increased in TLBM.

The influence of weight loss on anaerobic threshold in obese women.

PubMed

Zak-Golab, Agnieszka; Zahorska-Markiewicz, Barbara; Langfort, Józef; Kocelak, Piotr; Holecki, Michal; Mizia-Stec, Katarzyna; Olszanecka-Glinianowicz, Magdalena; Chudek, Jerzy

2010-01-01

Obesity is associated with decreased physical activity. The aim of the study was to assess the anaerobic threshold in obese and normal weight women and to analyse the effect of weight-reduction therapy on the determined thresholds. 42 obese women without concomitant disease (age 30.5 ± 6.9y; BMI 33.6 ± 3.7 kg·m(-2)) and 19 healthy normal weight women (age 27.6 ± 7.0y; BMI 21.2 ± 1.9 kg·m(-2)) performed cycle ergometer incremental ramp exercise test up to exhaustion. The test was repeated in 19 obese women after 12.3 ± 4.2% weight loss. The lactate threshold (LT) and the ventilatory threshold (VT) were determined. Obese women had higher lactate (expressed as oxygen consumption) and ventilator threshold than normal weight women. The lactate threshold was higher than ventilatory one both in obese and normal weight women (1.11 ± 0.21 vs 0.88 ± 0.18 L·min(-1), p < 0.001; 0.94 ± 0.15 vs 0.79 ± 0.23 L·min(- 1), p < 0.01, respectively). After weight reduction therapy neither the lactate nor the ventilatory threshold changed significantly. The results concluded that; 1. The higher lactate threshold noted in obese women may be related to the increased fat acid usage in metabolism. 2. Both in obese and normal weight women lactate threshold appears at higher oxygen consumption than ventilatory threshold. 3. The obtained weight reduction, without weight normalisation was insufficient to cause significant changes of lactate and ventilatory thresholds in obese women. Key pointsResults showed that adolescent young female gymnasts have an altered serum inflammatory markers and endothelial activation, compared to their less physically active peers.Physical activities improved immune system.Differences in these biochemical data kept significant after adjustment for body weight and height.

Determinants of weight outcomes in type 2 diabetes prevention intervention in primary health care setting (the DE-PLAN project).

PubMed

Gilis-Januszewska, Aleksandra; Piwońska-Solska, Beata; Lindström, Jaana; Wójtowicz, Ewa; Tuomilehto, Jaakko; Schwarz, Peter E H; Kissimova-Skarbek, Katarzyna; Szybiński, Zbigniew; Windak, Adam; Hubalewska-Dydejczyk, Alicja

2018-01-02

Real life implementation studies performed in different settings have proved that lifestyle interventions in the prevention of type 2 diabetes (DM2) can be effective, although the weight reduction results are typically modest compared to randomized control trials. Our objective was to identify the factors that predict successful weight loss in a less intensive, lower budget, real life setting lifestyle diabetes prevention intervention. Study participants (n = 175) with increased DM2 risk (Finnish Diabetes Risk Score (FINDRISC) > 14) but no diabetes at baseline received ten group lifestyle counselling sessions, physical activity and motivation sessions during a ten-month intervention. Stepwise regression analysis was used to determine demographic, clinical, and lifestyle predictors of successful weight reduction defined as a reduction of ≥5% of the initial body weight. At 12 months following the initiation of the intervention, 23.4% of study participants lost ≥5% weight (mean loss of 7.9 kg, SD = 5.8). Increased physical activity (44% vs 25%, p = 0.03), decreased total fat consumption (88% vs 65%, p = 0.006) and adherence to four-five lifestyle goals (71% vs 46%, p = 0.007) were more often reported among those who managed to lose ≥5% weight versus those who did not. In a multivariate analysis, meeting the ≥5% weight loss goal was most effective in individuals with a higher baseline BMI (OR 1.1, 95%CI 1.0-1.2), baseline and medium versus higher education (OR 5.4, 95% CI 1.2-24.7) and a history of increased glucose (OR 2.6, 95%CI 1.1-1.3). A reduction of total fat in the diet was an independent lifestyle predictor, increasing the probability of successful weight loss by 3.8 times (OR 3.8, 95% CI 1.2-11.4). Baseline higher BMI, lower education and a history of increased glucose predicted the successful weight loss among individuals with a high risk for the DM2 following lifestyle intervention in a real life primary health care setting. People who manage to lose weight more often adhere to lifestyle changes, while the reduction of total fat in diet independently predicts successful weight loss. Further studies exploring the predictors of success in implementation studies in DM2 prevention should help health care providers redesign interventions to improve their effectiveness and outcomes. ISRCTN, ID ISRCTN96692060 , registered 03.08.2016 retrospectively.

Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet.

PubMed

Frassetto, L A; Schloetter, M; Mietus-Synder, M; Morris, R C; Sebastian, A

2009-08-01

The contemporary American diet figures centrally in the pathogenesis of numerous chronic diseases-'diseases of civilization'. We investigated in humans whether a diet similar to that consumed by our preagricultural hunter-gatherer ancestors (that is, a paleolithic type diet) confers health benefits. We performed an outpatient, metabolically controlled study, in nine nonobese sedentary healthy volunteers, ensuring no weight loss by daily weight. We compared the findings when the participants consumed their usual diet with those when they consumed a paleolithic type diet. The participants consumed their usual diet for 3 days, three ramp-up diets of increasing potassium and fiber for 7 days, then a paleolithic type diet comprising lean meat, fruits, vegetables and nuts, and excluding nonpaleolithic type foods, such as cereal grains, dairy or legumes, for 10 days. Outcomes included arterial blood pressure (BP); 24-h urine sodium and potassium excretion; plasma glucose and insulin areas under the curve (AUC) during a 2 h oral glucose tolerance test (OGTT); insulin sensitivity; plasma lipid concentrations; and brachial artery reactivity in response to ischemia. Compared with the baseline (usual) diet, we observed (a) significant reductions in BP associated with improved arterial distensibility (-3.1+/-2.9, P=0.01 and +0.19+/-0.23, P=0.05);(b) significant reduction in plasma insulin vs time AUC, during the OGTT (P=0.006); and (c) large significant reductions in total cholesterol, low-density lipoproteins (LDL) and triglycerides (-0.8+/-0.6 (P=0.007), -0.7+/-0.5 (P=0.003) and -0.3+/-0.3 (P=0.01) mmol/l respectively). In all these measured variables, either eight or all nine participants had identical directional responses when switched to paleolithic type diet, that is, near consistently improved status of circulatory, carbohydrate and lipid metabolism/physiology. Even short-term consumption of a paleolithic type diet improves BP and glucose tolerance, decreases insulin secretion, increases insulin sensitivity and improves lipid profiles without weight loss in healthy sedentary humans.

Weight loss in overweight patients maintained on atypical antipsychotic agents.

PubMed

Centorrino, F; Wurtman, J J; Duca, K A; Fellman, V H; Fogarty, K V; Berry, J M; Guay, D M; Romeling, M; Kidwell, J; Cincotta, S L; Baldessarini, R J

2006-06-01

Weight gain and associated medical morbidity offset the reduction of extrapyramidal side effects associated with atypical antipsychotics. Efforts to control weight in antipsychotic-treated patients have yielded limited success. We studied the impact of an intensive 24-week program of diet, exercise, and counseling in 17 chronically psychotic patients (10 women, seven men) who entered at high average body weight (105.0+/-18.4 kg) and body mass index (BMI) (36.6+/-4.6 kg/m(2)). A total of 12 subjects who completed the initial 24 weeks elected to participate in an additional 24-week, less intensive extension phase. By 24 weeks, weight-loss/patient averaged 6.0 kg (5.7%) and BMI decreased to 34.5 (by 5.7%). Blood pressure decreased from 130/83 to 116/74 (11% improvement), pulse fell slightly, and serum cholesterol and triglyceride concentrations changed nonsignificantly. With less intensive management for another 24 weeks, subjects regained minimal weight (0.43 kg). These findings add to the emerging view that weight gain is a major health problem associated with modern antipsychotic drugs and that labor-intensive weight-control efforts in patients requiring antipsychotic treatment yield clinically promising benefits. Improved treatments without weight-gain risk are needed.

Influence of Protein Intake, Race, and Age on Responses to a Weight-Reduction Intervention in Obese Women.

PubMed

Bales, Connie W; Porter Starr, Kathryn N; Orenduff, Melissa C; McDonald, Shelley R; Molnar, Karen; Jarman, Aubrey K; Onyenwoke, Ann; Mulder, Hillary; Payne, Martha E; Pieper, Carl F

2017-05-01

Women have higher rates of obesity than men and develop more pronounced functional deficits as a result. Yet, little is known about how obesity reduction affects their functional status, including whether their responses differ when protein intake is enhanced. The aim of this study was to confirm the feasibility of delivery of a higher-protein (balanced at each meal) calorie-restricted diet in obese women and determine its efficacy for influencing function and retention of lean mass. Obese community-dwelling women [ n = 80; body mass index (in kg/m 2 ), in means ± SDs: 37.8 ± 5.9; aged 45-78 y; 58.8% white] were enrolled in a weight-loss (-500 kcal/d) study and randomly assigned to either a Control-Weight-Loss (C-WL; 0.8 g protein/kg body weight) group or a High-Protein-Weight-Loss (HP-WL; 1.2 g protein/kg body weight; 30 g protein 3 times/d) group in a 1:2 allocation. Primary outcomes were function by 6-min walk test (6MWT) and lean mass by using the BodPod (Life Measurement, Inc.) at 0, 4, and 6 mo. Both groups reduced calorie intakes and body weights ( P < 0.001), and the feasibility of the HP-WL intervention was confirmed. The 6MWT results improved ( P < 0.01) at 4 mo in the HP-WL group and at 6 mo in both groups ( P < 0.001). Both groups improved function by several other measures while slightly decreasing ( P < 0.01) lean mass (-1.0 kg, C-WL; -0.6 kg, HP-WL). Weight loss was greater in white than in black women at both 4 mo (6.0 ± 3.6 compared with 3.7 ± 3.4 kg; P < 0.02) and 6 mo (7.2 ± 4.8 compared with 4.0 ± 4.7 kg; P < 0.04) and tended to be positively related to age ( P < 0.06). A clinically important functional benefit of obesity reduction was confirmed in both study groups, with no significant group effect. Our findings of racial differences in response to the intervention and a potential influence of participant age lend support for further studies sufficiently powered to explore the interaction of race and age with functional responses to obesity reduction in women. This trial was registered at clinicaltrials.gov as NCT02033655.

Effect of acetazolamide on visual function in patients with idiopathic intracranial hypertension and mild visual loss: the idiopathic intracranial hypertension treatment trial.

PubMed

Wall, Michael; McDermott, Michael P; Kieburtz, Karl D; Corbett, James J; Feldon, Steven E; Friedman, Deborah I; Katz, David M; Keltner, John L; Schron, Eleanor B; Kupersmith, Mark J

Acetazolamide is commonly used to treat idiopathic intracranial hypertension (IIH), but there is insufficient information to establish an evidence base for its use. To determine whether acetazolamide is beneficial in improving vision when added to a low-sodium weight reduction diet in patients with IIH and mild visual loss. Multicenter, randomized, double-masked, placebo-controlled study of acetazolamide in 165 participants with IIH and mild visual loss who received a low-sodium weight-reduction diet. Participants were enrolled at 38 academic and private practice sites in North America from March 2010 to November 2012 and followed up for 6 months (last visit in June 2013). All participants met the modified Dandy criteria for IIH and had a perimetric mean deviation (PMD) between -2 dB and -7 dB. The mean age was 29 years and all but 4 participants were women. Low-sodium weight-reduction diet plus the maximally tolerated dosage of acetazolamide (up to 4 g/d) or matching placebo for 6 months. The planned primary outcome variable was the change in PMD from baseline to month 6 in the most affected eye, as measured by Humphrey Field Analyzer. Perimetric mean deviation is a measure of global visual field loss (mean deviation from age-corrected normal values), with a range of 2 to -32 dB; larger negative values indicate greater vision loss. Secondary outcome variables included changes in papilledema grade, quality of life (Visual Function Questionnaire 25 [VFQ-25] and 36-Item Short Form Health Survey), headache disability, and weight at month 6. The mean improvement in PMD was greater with acetazolamide (1.43 dB, from -3.53 dB at baseline to -2.10 dB at month 6; n = 86) than with placebo (0.71 dB, from -3.53 dB to -2.82 dB; n = 79); the difference was 0.71 dB (95% CI, 0 to 1.43 dB; P = .050). Mean improvements in papilledema grade (acetazolamide: -1.31, from 2.76 to 1.45; placebo: -0.61, from 2.76 to 2.15; treatment effect, -0.70; 95% CI, -0.99 to -0.41; P < .001) and vision-related quality of life as measured by the National Eye Institute VFQ-25 (acetazolamide: 8.33, from 82.97 to 91.30; placebo: 1.98, from 82.97 to 84.95; treatment effect, 6.35; 95% CI, 2.22 to 10.47; P = .003) and its 10-item neuro-ophthalmic supplement (acetazolamide: 9.82, from 75.45 to 85.27; placebo: 1.59, from 75.45 to 77.04; treatment effect, 8.23; 95% CI, 3.89 to 12.56; P < .001) were also observed with acetazolamide. Participants assigned to acetazolamide also experienced a reduction in weight (acetazolamide: -7.50 kg, from 107.72 kg to 100.22 kg; placebo: -3.45 kg, from 107.72 kg to 104.27 kg; treatment effect, -4.05 kg, 95% CI, -6.27 to -1.83 kg; P < .001). In patients with IIH and mild visual loss, the use of acetazolamide with a low-sodium weight-reduction diet compared with diet alone resulted in modest improvement in visual field function. The clinical importance of this improvement remains to be determined. clinicaltrials.gov Identifier: NCT01003639.

Biologically produced acid precipitable polymeric lignin

DOEpatents

Crawford, Don L.; Pometto, III, Anthony L.

1984-01-01

A water soluble, acid precipitable polymeric degraded lignin (APPL), having a molecular weight of at least 12,000 daltons, and comprising, by percentage of total weight, at least three times the number of phenolic hydroxyl groups and carboxylic acid groups present in native lignin. The APPL may be modified by chemical oxidation and reduction to increase its phenolic hydroxyl content and reduce the number of its antioxidant inhibitory side chains, thereby improving antioxidant properties.

Biological Mechanisms that Promote Weight Regain Following Weight Loss in Obese Humans

PubMed Central

Ochner, Christopher N.; Barrios, Dulce M.; Lee, Clement D.; Pi-Sunyer, F. Xavier

2013-01-01

Weight loss dieting remains the treatment of choice for the vast majority of obese individuals, despite the limited long-term success of behavioral weight loss interventions. The reasons for the near universal unsustainability of behavioral weight loss in [formerly] obese individuals have not been fully elucidated, relegating researchers to making educated guesses about how to improve obesity treatment, as opposed to developing interventions targeting the causes of weight regain. This article discusses research on several factors that may contribute to weight regain following weight loss achieved through behavioral interventions, including adipose cellularity, endocrine function, energy metabolism, neural responsivity, and addiction-like neural mechanisms. All of these mechanisms are engaged prior to weight loss, suggesting that so called “anti-starvation” mechanisms are activated via reductions in energy intake, rather than depletion of energy stores. Evidence suggests that these mechanisms are not necessarily part of a homeostatic feedback system designed to regulate body weight or even anti-starvation mechanisms per se. Though they may have evolved to prevent starvation, they appear to be more accurately described as anti-weight loss mechanisms, engaged with caloric restriction irrespective of the adequacy of energy stores. It is hypothesized that these factors may combine to create a biological disposition that fosters the maintenance of an elevated body weight and work to restore the highest sustained body weight, thus precluding the long-term success of behavioral weight loss. It may be necessary to develop interventions that attenuate these biological mechanisms in order to achieve long-term weight reduction in obese individuals. PMID:23911805

Effects of lowering dietary fiber before marketing on finishing pig growth performance, carcass characteristics, carcass fat quality, and intestinal weights.

PubMed

Asmus, M D; Derouchey, J M; Tokach, M D; Dritz, S S; Houser, T A; Nelssen, J L; Goodband, R D

2014-01-01

A total of 264 pigs (initially 41.0 kg BW) were used in a 90-d study to determine the effects of lowering dietary fiber before market on pigs fed high dietary fiber [provided by wheat middlings (midds) and distillers dried grains with solubles (DDGS)] on growth performance, carcass characteristics, carcass fat quality, and intestinal weights of growing-finishing pigs. Pens of pigs were randomly allotted by initial BW and sex to 1 of 6 treatments with 6 replications per treatment and 7 or 8 pigs per pen. A positive control (corn-soybean meal-based) diet containing no DDGS or midds (9.3% NDF) and a negative control diet with 30% DDGS and 19% midds (19% NDF) were fed throughout the entire trial (d 0 to 90). The other 4 treatments were arranged in a 2 × 2 factorial with the main effects of length of fiber reduction (23 or 47 d before marketing) and fiber level fed during the reduction period (low or medium). Pigs on these treatments were fed the negative control before the reduction treatment. The medium-fiber diet contained 15% DDGS and 9.5% midds (14.2% NDF) with the low-fiber diet was the positive control diet. Increasing the feeding duration of the low-fiber diets lowered overall ADFI (linear, P = 0.03) and improved G:F (linear, P < 0.01). Lowering the fiber level for the last 23 d did not influence growth performance; however, lowering the fiber level improved carcass yield (P = 0.002), with a greater response (P < 0.001) when the low-fiber diet was fed for 23 d. Jowl fat iodine value (IV) decreased when the longer lower fiber diets were fed (linear, P < 0.01) and was lower (P < 0.001) for pigs fed the low-fiber diet during the fiber reduction period than pigs fed the medium-fiber diet during the same time period; however, increasing the time lower fiber diets were fed from 23 to 47 d further reduced (P < 0.01) jowl IV. Increasing the duration that the control diet was fed by increasing the reduction time from 23 to 47 d increased (P < 0.01) backfat depth. Reducing the fiber level decreased full large intestine weight (linear, P = 0.005) with a greater response (P = 0.04) when the low-fiber diet was fed during the reduction period instead of the medium-fiber diet. In summary, lowering the fiber level before marketing can improve G:F, carcass yield, carcass IV, and reduce large intestine weight; however, the optimal duration of the fiber reduction period depends on the targeted response criteria.

Health Promotion for Young Adults With Serious Mental Illness.

PubMed

Naslund, John A; Aschbrenner, Kelly A; Scherer, Emily A; Pratt, Sarah I; Bartels, Stephen J

2017-02-01

Young adulthood represents a critical time to address elevated obesity rates and the risk of early mortality, particularly among people with serious mental illness. Few studies have assessed the benefits of lifestyle interventions targeting weight loss among these young adults. This study examined the impact of the 12-month In SHAPE lifestyle intervention on weight loss and fitness among overweight and obese young adults with serious mental illness (ages 21-30) compared with participants over age 30. Data were combined from three trials of the 12-month In SHAPE program delivered through community mental health centers. In SHAPE includes weekly fitness trainer meetings, a gym membership, and nutrition education. Primary outcomes were weight loss and change in fitness at 12 months. Participants (N=194) had a schizophrenia spectrum disorder (53%) or a mood disorder (47%). The overall sample achieved significant weight loss and improved fitness; differences between young adults (N=29) and participants over age 30 (N=165) were not significant. An important finding was that 42% of young adults achieved clinically significant reductions in cardiovascular risk, defined as ≥5% weight loss or improved fitness (>50-m increase on the 6-Minute Walk Test), compared with 54% of adults over age 30 (a nonsignificant difference between age groups). Among persons enrolled in a lifestyle intervention, overweight and obese young adults experienced benefits comparable with those of adults over age 30. Young adults with serious mental illness face high risk of gaining weight, but a meaningful proportion of these individuals can achieve clinically significant cardiovascular risk reduction, thus highlighting the need to promote lifestyle intervention participation in this group.

Deleterious effects of increased body weight associated with intensive insulin therapy for type 1 diabetes: increased blood pressure and worsened lipid profile partially negate improvements in life expectancy.

PubMed

Palmer, Andrew J; Roze, Stéphane; Valentine, William J; Minshall, Michael E; Lammert, Morten; Nicklasson, Lars; Spinas, Giatgen A

2004-08-01

Weight gain is an unwanted side effect of improved glycaemic control in type 1 diabetes, associated with increased blood pressure (BP) and worsening lipid profiles. While improved glycaemic control per se should improve long-term patient outcomes, increases in BP and worsening lipid profiles may counteract these benefits. The aim of this modelling study was to assess whether the increased body weight and associated worsening of lipid profile and blood pressure would negate the improvements in glycaemic control seen with intensive therapy in patients with type 1 diabetes. A validated diabetes model projected life expectancy (LE), quality-adjusted LE (QALE) and total lifetime costs of complications in type 1 diabetes cohorts with the characteristics of patients from the Diabetes Control and Complications Trial (DCCT). The following four cohorts (A-D) were created based on increased body weight under either conventional or intensive therapy: A) conventional glycaemic control in the subgroup with lowest weight-gain quartile after 6.5 years (HbA1c increased by 11% from baseline); B) conventional control in the highest weight-gain quartile (no change in HbA1c from baseline); C) intensive control in the lowest quartile of weight gain (with 16.1% decrease in HbA1c, but no increase in weight or associated BP, and improved lipid profile); D) intensive control in the highest quartile of weight gain (with 21% decrease in HbA1c, increased systolic BP of 6 mmHg, and worsened lipid profile). Data were derived from DCCT and other published sources. Intensive control, even with weight gain, led to major improvements in LE and QALE, and reduction in costs of complications versus conventional therapy. Intensive therapy with no weight increase led to a higher LE (increased by 0.57 years) and higher QALE (increased by 0.28 years) and lower costs of complications (reduced by 523 dollars/patient), compared to intensive therapy with the highest quartile of weight gain. Concerns about weight gain should not deter intensive insulin therapy. However, the value of improving glycaemic control without increasing body weight (and associated increased BP and worsening of lipid profile) has been confirmed.

Psychosocial outcomes in a weight loss camp for overweight youth

PubMed Central

QUINLAN, NICOLE P.; KOLOTKIN, RONETTE L.; FUEMMELER, BERNARD F.; COSTANZO, PHILIP R.

2015-01-01

Objective There is good evidence that youth attending weight loss camps in the UK and US are successful at achieving weight loss. Limited research suggests improvement in body image and self-esteem as well. This study evaluated changes in eight psychosocial variables following participation in a weight loss camp and examined the role of gender, age, length of stay, and body mass index (BMI) in these changes. Methods This was an observational and self-report study of 130 participants (mean age=12.8; mean BMI=33.5; 70% female; 77% Caucasian). The program consisted of an 1 800 kcal/day diet, daily supervised physical activities, cooking/nutrition classes, and weekly psycho-educational/support groups led by psychology staff. Participants completed measures of anti-fat attitudes, values (e.g., value placed on appearance, athletic ability, popularity), body- and self-esteem, weight- and health-related quality of life, self-efficacy, and depressive symptoms. Results Participants experienced significant BMI reduction (average decrease of 7.5 kg [standard deviation, SD=4.2] and 2.9 BMI points [SD=1.4]). Participants also exhibited significant improvements in body esteem, self-esteem, self-efficacy, generic and weight-related quality of life, anti-fat attitudes, and the importance placed on appearance. Changes in self-efficacy, physical functioning and social functioning remained significant even after adjusting for initial zBMI, BMI change, and length of stay. Gender differences were found on changes in self-efficacy, depressive symptoms, and social functioning. Conclusion Participation in weight loss programs in a group setting, such as a camp, may have added benefit beyond BMI reduction. Greater attention to changes in psychosocial variables may be warranted when designing such programs for youth. PMID:19107660

Adherence to low-carbohydrate and low-fat diets in relation to weight loss and cardiovascular risk factors.

PubMed

Hu, Tian; Yao, Lu; Reynolds, Kristi; Niu, Tianhua; Li, Shengxu; Whelton, Paul K; He, Jiang; Steffen, Lyn M; Bazzano, Lydia A

2016-03-01

A low-carbohydrate diet can reduce body weight and some cardiovascular disease (CVD) risk factors more than a low-fat diet, but differential adherence may play a role in these effects. Data were used from 148 adults who participated in a 12-month clinical trial examining the effect of a low-carbohydrate diet (<40 g/day) and a low-fat diet (<30% fat, <7% saturated fat) on weight and CVD risk factors. We compared attendance at counseling sessions, deviation from nutrient goals, urinary ketone presence, and composite scores representing the overall adherence based on the distribution of these individual indicators between two interventions. Composite scores were similar between the two groups. A one-interquartile-range increase in composite score representing better adherence to a low-carbohydrate diet was associated with 2.2 kg or 2.3 % greater weight loss, 1.1 greater reduction in percent fat mass, and 1.3 greater increase in proportion of lean mass. Indicators of adherence to a low-fat diet was not associated with changes in weight, fat mass or lean mass. Despite comparable adherence between groups, a low-carbohydrate diet was associated with greater reductions in body weight and improvement in body composition, while a low-fat diet was not associated with weight loss.

Positive and negative dimensions of weight control motivation.

PubMed

Stotland, S; Larocque, M; Sadikaj, G

2012-01-01

This study examined weight control motivation among patients (N=5460 females and 547 males) who sought weight loss treatment with family physicians. An eight-item measure assessed the frequency of thoughts and feelings related to weight control "outcome" (e.g. expected physical and psychological benefits) and "process" (e.g. resentment and doubt). Factor analysis supported the existence of two factors, labeled Positive and Negative motivation. Positive motivation was high (average frequency of thoughts about benefits was 'every day') and stable throughout treatment, while Negative motivation declined rapidly and then stabilized. The determinants of changes in the Positive and Negative dimensions during treatment were examined within 3 time frames: first month, months 2-6, and 6-12. Maintenance of high scores on Positive motivation was associated with higher BMI and more disturbed eating habits. Early reductions in Negative motivation were greater for those starting treatment with higher weight and more disturbed eating habits, but less depression and stress, while later reductions in Negative motivation were predicted by improvements in eating habits, weight, stress and perfectionism. Clinicians treating obesity should be sensitive to fluctuations in both motivational dimensions, as they are likely to play a central role in determining long-term behavior and weight change. Copyright © 2011 Elsevier Ltd. All rights reserved.

Improved cognitive functioning in obese adolescents after a 30-week inpatient weight loss program.

PubMed

Vantieghem, Stijn; Bautmans, Ivan; Guchtenaere, Ann De; Tanghe, Ann; Provyn, Steven

2018-06-15

Studies linked obesity with a large number of medical conditions including decreased cognitive functioning. The relation between BMI and cognition was proven in adults, but in adolescents the results are conflicting. Further, limited data are available on the impact of weight loss on cognition. This study analyzed the impact of a 30-week lasting weight loss program on cognition and determined the impact of changes in body composition and self-perceived fatigue on changes in cognition. Sixty-two obese adolescents were evaluated at baseline and after 30 weeks. Stroop test (ST; selective attention), Continuous Performance Test (CPT; sustained attention) and Ray Auditory verbal learning test (RAVLT; short-term memory) were assessed. Additionally, body composition parameters and fatigue (MFI-20) were evaluated. Improved reaction times were found for ST and CPT after the intervention, but were independent for reductions in BMI, fat mass, fat%, and fatigue. Short memory also improved with decreased fatigue as an influencing parameter. Accuracy of ST and CPT showed no significant changes. A 30-week lasting inpatient weight loss program improved selective attention, sustained attention, and short-term memory. Changes in body composition did not explain the improvements in cognitive functioning. Decreased fatigue resulted in improved aspects of cognition.

Pilot study of a sensory room in an acute inpatient psychiatric unit.

PubMed

Novak, Theresa; Scanlan, Justin; McCaul, Damien; MacDonald, Nathan; Clarke, Timothy

2012-10-01

The use of sensory rooms (also known as comfort rooms) to reduce seclusion rates has generated a great deal of interest. This study examined the outcomes associated with the introduction of a sensory room in an acute inpatient psychiatric unit. Consumers rated distress and staff rated a variety of disturbed behaviours before and after each use of the room. Items used during each episode were recorded. Use of the room was associated with significant reductions in distress and improvements in a range of disturbed behaviours. Those individuals who used the weighted blanket reported significantly greater reductions in distress and clinician-rated anxiety than those who did not. No changes were noted in rates of seclusion or aggression. The sensory room was an effective intervention to ameliorate distress and disturbed behaviour, although this did not translate into reductions in overall rates of seclusion or aggression. Weighted blankets appear to be particularly useful.

Intervention based on Transtheoretical Model promotes anthropometric and nutritional improvements - a randomized controlled trial.

PubMed

Menezes, Mariana Carvalho de; Mingoti, Sueli Aparecida; Cardoso, Clareci Silva; Mendonça, Raquel de Deus; Lopes, Aline Cristine Souza

2015-04-01

To analyze the effects of an intervention based on the Transtheoretical Model on anthropometric and dietetic profile among women in the Primary Health Care in Brazil. Randomized controlled trial. The control group participated in physical activity and open group-education regarding nutrition of usual care. The intervention group participated in 10 workshops based on the Transtheoretical Model. Seventy-one women completed the study, with a mean age of 57.9±11.7years. Participants in the intervention group showed an improved body perception, reduced weight and body mass index post-intervention, and lower consumption of calories and foods high in fat. Significant weight reduction in the intervention group was associated with higher per capita income, reduced consumption of protein, reduced consumption of lipids, and the removal of visible fat from red meat and skin from chicken. An intervention based on the Transtheoretical Model promoted reduction in consumption of foods high in calories and fat, with positive effects on weight and body perception. These results provide evidence of the applicability and benefit of the Transtheoretical Model within primary care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effects of Weight Reduction on Obesity STUDIES OF LIPID AND CARBOHYDRATE METABOLISM IN NORMAL AND HYPERLIPOPROTEINEMIC SUBJECTS

PubMed Central

Olefsky, Jerrold; Reaven, Gerald M.; Farquhar, John W.

1974-01-01

Considerable controversy exists over the purported role of obesity in causing hyperglycemia, hyperlipemia, hyperinsulinemia, and insulin resistance; and the potential beneficial effects of weight reduction remain incompletely defined. Hypertriglyceridemia is one of the metabolic abnormalities proposed to accompany obesity, and in order to help explain the mechanisms leading to this abnormality we have proposed the following sequential hypothesis: insulin resistance → hyperinsulinemia → accelerated hepatic triglyceride(TG) production → elevated plasma TG concentrations. To test this hypothesis and to gain insight into both the possible role of obesity in causing the above metabolic abnormalities and the potential benefit of weight reduction we studied the effects of weight loss on various aspects of carbohydrate and lipid metabolism in a group of 36 normal and hyperlipoproteinemic subjects. Only weak to absent correlations (r = 0.03 — 0.46) were noted between obesity and the metabolic variables measured. This points out that in our study group obesity cannot be the sole, or even the major, cause of these abnormalities in the first place. Further, we have observed marked decreases after weight reduction in fasting plasma TG (mean value: pre-weight reduction, 319 mg/100 ml; post-weight reduction, 180 mg/100 ml) and cholesterol (mean values: pre-weight reduction, 282 mg/100 ml; post-weight reduction, 223 mg/100 ml) levels, with a direct relationship between the magnitude of the fall in plasma lipid values and the height of the initial plasma TG level. We have also noted significant decreases after weight reduction in the insulin and glucose responses during the oral glucose tolerance test (37% decrease and 12% decrease, respectively). Insulin and glucose responses to liquid food before and after weight reduction were also measured and the overall post-weight reduction decrease in insulin response was 48% while the glucose response was relatively unchanged. In a subgroup of patients we studied both the degree of cellular insulin resistance and the rate of hepatic very low density (VLDL) TG production before and after weight reduction. These subjects demonstrated significant decreases after weight reduction in both degree of insulin resistance (33% decrease) and VLDL-TG production rates (40% decrease). Thus, weight reduction has lowered each of the antecedent variables (insulin resistance, hyperinsulinemia, and VLDL-TG production) that according to the above hypothesis lead to hypertriglyceridemia, and we believe the overall scheme is greatly strengthened. Furthermore, the consistent decreases in plasma TG and cholesterol levels seen in all subjects lead us to conclude that weight reduction is an important therapeutic modality for patients with endogenous hypertriglyceridemia. Images PMID:4357617

Predictors of endothelial function in employees with sedentary occupations in a worksite exercise program.

PubMed

Lippincott, Margaret F; Desai, Aditi; Zalos, Gloria; Carlow, Andrea; De Jesus, Janet; Blum, Arnon; Smith, Kevin; Rodrigo, Maria; Patibandla, Sushmitha; Chaudhry, Hira; Glaser, Alexander P; Schenke, William H; Csako, Gyorgy; Waclawiw, Myron A; Cannon, Richard O

2008-10-01

A sedentary workforce may be at increased risk for future cardiovascular disease. Exercise at the work site has been advocated, but effects on endothelium as a biomarker of risk and relation to weight loss, lipid changes, or circulating endothelial progenitor cells (EPCs) have not been reported. Seventy-two office and laboratory employees (58 women; average age 45 years, range 22 to 62; 26 with body mass index values >30 kg/m(2)) completed 3 months of participation in the National Heart, Lung, and Blood Institute's Keep the Beat program, with the determination of vital signs, laboratory data, and peak oxygen consumption (VO(2)) during treadmill exercise. Brachial artery endothelium was tested by flow-mediated dilation (FMD), which at baseline was inversely associated with Framingham risk score (r = -0.3689, p <0.0001). EPCs were quantified by colony assay. With exercise averaging 98 +/- 47 minutes each workweek, there was improvement in FMD (from 7.8 +/- 3.4% to 8.5 +/- 3.0%, p = 0.0096) and peak VO(2) (+1.2 +/- 3.1 ml O(2)/kg/min, p = 0.0028), with reductions in diastolic blood pressure (-2 +/- 8 mm Hg, p = 0.0478), total cholesterol (-8 +/- 25 mg/dl, p = 0.0131), and low-density lipoprotein cholesterol (-7 +/- 19 mg/dl, p = 0.0044) but with a marginal reduction in weight (-0.5 +/- 2.1 kg, p = 0.0565). By multiple regression modeling, lower baseline FMD, greater age, reductions in total and low-density lipoprotein cholesterol and diastolic blood pressure, and increases in EPC colonies and peak VO(2) were jointly statistically significant predictors of change in FMD and accounted for 47% of the variability in FMD improvement with program participation. Results were similar when modeling was performed for women only. In contrast, neither adiposity at baseline nor change in weight was a predictor of improved endothelial function. In conclusion, daily exercise achievable at their work sites by employees with sedentary occupations improves endothelial function, even with the absence of weight loss, which may decrease cardiovascular risk, if sustained.

7 CFR 1709.123 - Evaluation criteria and weights.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 1709.123 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE... project once the grant period has ended. Reviewers must make a finding of operational sustainability for... reduction in energy cost or improvement in service. (5) Coordination with rural development initiatives...

7 CFR 1709.123 - Evaluation criteria and weights.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 1709.123 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE... project once the grant period has ended. Reviewers must make a finding of operational sustainability for... reduction in energy cost or improvement in service. (5) Coordination with rural development initiatives...

7 CFR 1709.123 - Evaluation criteria and weights.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 1709.123 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE... project once the grant period has ended. Reviewers must make a finding of operational sustainability for... reduction in energy cost or improvement in service. (5) Coordination with rural development initiatives...

7 CFR 1709.123 - Evaluation criteria and weights.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 1709.123 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE... project once the grant period has ended. Reviewers must make a finding of operational sustainability for... reduction in energy cost or improvement in service. (5) Coordination with rural development initiatives...

EXENATIDE IMPROVES HYPERTENSION IN A RAT MODEL OF THE METABOLIC SYNDROME

USDA-ARS?s Scientific Manuscript database

Exenatide is a peptide incretin mimetic that has glucoregulatory actions associated with weight reduction. Previous reports demonstrated acute increases in blood pressure after systemic or intracerebroventricular administration of exenatide or glucagon-like peptide-1 (GLP-1) in rats. However, there ...

Reduction of body fat and improved lipid profile associated with daily consumption of a Puer tea extract in a hyperlipidemic population: a randomized placebo-controlled trial

PubMed Central

Jensen, Gitte S; Beaman, Joni L; He, Yi; Guo, Zhixin; Sun, Henry

2016-01-01

Objective The goal for this study was to evaluate the effects of daily consumption of Puer tea extract (PTE) on body weight, body-fat composition, and lipid profile in a non-Asian population in the absence of dietary restrictions. Materials and methods A randomized, double-blind, placebo-controlled study design was used. A total of 59 overweight or mildly obese subjects were enrolled upon screening to confirm fasting cholesterol level at or above 220 mg/dL (5.7 mmol/dL). After giving informed consent, subjects were randomized to consume PTE (3 g/day) or placebo for 20 weeks. At baseline and at 4-week intervals, blood lipids, C-reactive protein, and fasting blood glucose were evaluated. A dual-energy X-ray absorptiometry scan was performed at baseline and at study exit to evaluate changes to body composition. Appetite and physical and mental energy were scored at each visit using visual analog scales (0–100). Results Consumption of PTE was associated with statistically significant weight loss when compared to placebo (P<0.05). Fat loss was seen for arms, legs, and the gynoid region (hip/belly), as well as for total fat mass. The fat reduction reached significance on within-group analysis, but did not reach between-group significance. Consumption of PTE was associated with improvements to lipid profile, including a mild reduction in cholesterol and the cholesterol:high-density lipoprotein ratio after only 4 weeks, as well as a reduction in triglycerides and very small-density lipoproteins, where average blood levels reached normal range at 8 weeks and remained within normal range for the duration of the study (P<0.08). No significant changes between the PTE group and the placebo group were seen for fasting glucose or C-reactive protein. A transient reduction in appetite was seen in the PTE group when compared to placebo (P<0.1). Conclusion The results from this clinical study showed that the daily consumption of PTE was associated with significant weight loss, reduced body mass index, and an improved lipid profile. PMID:27069360

Predictors and moderators of treatment outcome in a randomized clinical trial for adults with symptoms of bulimia nervosa.

PubMed

Accurso, Erin C; Wonderlich, Stephen A; Crosby, Ross D; Smith, Tracey L; Klein, Marjorie H; Mitchell, James E; Crow, Scott J; Berg, Kelly C; Peterson, Carol B

2016-02-01

This study examined predictors and moderators of outcome in 2 treatments for bulimia nervosa (BN). Eighty adults with BN symptoms at 1 of 2 sites were randomized to 21 sessions of integrative cognitive-affective therapy for BN (ICAT-BN) or enhanced cognitive behavior therapy (CBT-E). Generalized linear models examined predictors and moderators of improvements in bulimic behavior and eating disorder psychopathology at end of treatment (EOT) and 4-month follow-up (FU). At EOT, individuals with higher dietary restraint had greater reductions in bulimic behavior. At FU, individuals with higher weight and shape concern had greater reductions in bulimic behavior, whereas those with greater baseline depression had less improvement in eating disorder psychopathology. Individuals higher in stimulus seeking had greater reductions in bulimic behavior and eating disorder psychopathology at follow up in ICAT-BN than in CBT-E, whereas individuals lower in stimulus seeking had greater reductions in bulimic behavior in CBT-E than in ICAT-BN. Finally, individuals with higher affective lability had greater reductions in eating disorder psychopathology in ICAT-BN than in CBT-E, whereas improvements were comparable across treatments for individuals with lower affective lability. This study identified 3 nonspecific predictors of outcome (i.e., dietary restraint, weight and shape concern, and depression) and 2 moderators (i.e., affective lability and stimulus seeking). All moderator effects emerged at FU rather than at EOT, suggesting that the moderating effects of treatment were not immediately apparent. These results suggest that individuals with higher affective lability and stimulus seeking may benefit more from treatment with a greater focus on affective states and self-regulation. (c) 2016 APA, all rights reserved).

Long-term administration of pyridostigmine attenuates pressure overload-induced cardiac hypertrophy by inhibiting calcineurin signalling.

PubMed

Lu, Yi; Zhao, Ming; Liu, Jin-Jun; He, Xi; Yu, Xiao-Jiang; Liu, Long-Zhu; Sun, Lei; Chen, Li-Na; Zang, Wei-Jin

2017-09-01

Cardiac hypertrophy is associated with autonomic imbalance, characterized by enhanced sympathetic activity and withdrawal of parasympathetic control. Increased parasympathetic function improves ventricular performance. However, whether pyridostigmine, a reversible acetylcholinesterase inhibitor, can offset cardiac hypertrophy induced by pressure overload remains unclear. Hence, this study aimed to determine whether pyridostigmine can ameliorate pressure overload-induced cardiac hypertrophy and identify the underlying mechanisms. Rats were subjected to either sham or constriction of abdominal aorta surgery and treated with or without pyridostigmine for 8 weeks. Vagal activity and cardiac function were determined using PowerLab. Cardiac hypertrophy was evaluated using various histological stains. Protein markers for cardiac hypertrophy were quantitated by Western blot and immunoprecipitation. Pressure overload resulted in a marked reduction in vagal discharge and a profound increase in cardiac hypertrophy index and cardiac dysfunction. Pyridostigmine increased the acetylcholine levels by inhibiting acetylcholinesterase in rats with pressure overload. Pyridostigmine significantly attenuated cardiac hypertrophy based on reduction in left ventricular weight/body weight, suppression of the levels of atrial natriuretic peptide, brain natriuretic peptide and β-myosin heavy chain, and a reduction in cardiac fibrosis. These effects were accompanied by marked improvement of cardiac function. Additionally, pyridostigmine inhibited the CaN/NFAT3/GATA4 pathway and suppressed Orai1/STIM1 complex formation. In conclusion, pressure overload resulted in cardiac hypertrophy, cardiac dysfunction and a significant reduction in vagal discharge. Pyridostigmine attenuated cardiac hypertrophy and improved cardiac function, which was related to improved cholinergic transmission efficiency (decreased acetylcholinesterase and increased acetylcholine), inhibition of the CaN/NFAT3/GATA4 pathway and suppression of the interaction of Orai1/STIM1. © 2017 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

SU-C-207-05: A Comparative Study of Noise-Reduction Algorithms for Low-Dose Cone-Beam Computed Tomography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mukherjee, S; Yao, W

2015-06-15

Purpose: To study different noise-reduction algorithms and to improve the image quality of low dose cone beam CT for patient positioning in radiation therapy. Methods: In low-dose cone-beam CT, the reconstructed image is contaminated with excessive quantum noise. In this study, three well-developed noise reduction algorithms namely, a) penalized weighted least square (PWLS) method, b) split-Bregman total variation (TV) method, and c) compressed sensing (CS) method were studied and applied to the images of a computer–simulated “Shepp-Logan” phantom and a physical CATPHAN phantom. Up to 20% additive Gaussian noise was added to the Shepp-Logan phantom. The CATPHAN phantom was scannedmore » by a Varian OBI system with 100 kVp, 4 ms and 20 mA. For comparing the performance of these algorithms, peak signal-to-noise ratio (PSNR) of the denoised images was computed. Results: The algorithms were shown to have the potential in reducing the noise level for low-dose CBCT images. For Shepp-Logan phantom, an improvement of PSNR of 2 dB, 3.1 dB and 4 dB was observed using PWLS, TV and CS respectively, while for CATPHAN, the improvement was 1.2 dB, 1.8 dB and 2.1 dB, respectively. Conclusion: Penalized weighted least square, total variation and compressed sensing methods were studied and compared for reducing the noise on a simulated phantom and a physical phantom scanned by low-dose CBCT. The techniques have shown promising results for noise reduction in terms of PSNR improvement. However, reducing the noise without compromising the smoothness and resolution of the image needs more extensive research.« less

Integrated Application of Active Controls (IAAC) technology to an advanced subsonic transport project: Wing planform study and final configuration selection

NASA Technical Reports Server (NTRS)

1981-01-01

The Wing Planform Study and Final Configuration Selection Task of the Integrated Application of Active Controls (IAAC) Technology Project within the Energy Efficient Transport Program is documented. Application of Active Controls Technology (ACT) in combination with increased wing span resulted in significant improvements over the Conventional Baseline Configuration (Baseline) and the Initial ACT Configuration previously established. The configurations use the same levels of technology, takeoff gross weight, and payload as the Baseline. The Final ACT Configuration (Model 768-107) incorporates pitch-augmented stability (which enabled an approximately 10% aft shift in cruise center of gravity and a 44% reduction in horizontal tail size), lateral/directional-augmented stability, an angle-of-attack limiter, and wing-load alleviation. Flutter-mode control was not beneficial for this configuration. This resulted in an 890 kg (1960 lb) reduction in airplane takeoff gross weight and a 9.8% improvement in cruise lift/drag. At the Baseline mission range (3589 km 1938 nmi), this amounts to 10% block-fuel reduction. Results of this task strongly indicate that the IAAC Project should proceed with the Final ACT evaluation, and begin the required control system development and test.

Should we treat obesity in COPD? The effects of diet and resistance exercise training.

PubMed

McDonald, Vanessa M; Gibson, Peter G; Scott, Hayley A; Baines, Penelope J; Hensley, Michael J; Pretto, Jeffrey J; Wood, Lisa G

2016-07-01

Obesity is an established risk factor for poor health outcomes, but paradoxically in chronic obstructive pulmonary disease (COPD), it is associated with improved survival and lung function. A major evidence gap exisits to inform treatment recommendations for patients with COPD who are obese. We aimed to determine the effect of weight reduction involving a low-energy diet utilizing a partial meal replacement plan, coupled with resistance exercise training in obese COPD patients. In a proof of concept before-after clinical trial, obese (body mass index ≥30 kg/m(2) ) COPD patients received a 12 week weight reduction programme involving meal replacements, dietary counselling by a dietitian and resistance exercise training prescribed and supervised by a physiotherapist. Patients were reviewed face to face by the dietitian and physiotherapist every 2 weeks for counselling. Twenty-eight participants completed the intervention. Mean (standard deviation) body mass index was 36.3 kg/m(2) (4.6) at baseline and reduced by 2.4 kg/m(2) ((1.1) P < 0.0001) after the intervention. Importantly, skeletal muscle mass was maintained. Clinical outcomes improved with weight loss including exercise capacity, health status, dyspnea, strength and functional outcomes. There was also a significant reduction in the body mass index, obstruction, dyspnea and exercise score (BODE). Systemic inflammation measured by C-reactive protein however did not change. In obese COPD patients, dietary energy restriction coupled with resistance exercise training results in clinically significant improvements in body mass index, exercise tolerance and health status, whilst preserving skeletal muscle mass. This novel study provides a framework for development of guidelines for the management of obese COPD patients and in guiding future research. © 2016 Asian Pacific Society of Respirology.

Extracellular matrix remodeling and matrix metalloproteinase inhibition in visceral adipose during weight cycling in mice.

PubMed

Caria, Cíntia Rabelo E Paiva; Gotardo, Érica Martins Ferreira; Santos, Paola Souza; Acedo, Simone Coghetto; de Morais, Thainá Rodrigues; Ribeiro, Marcelo Lima; Gambero, Alessandra

2017-10-15

Extracellular matrix (ECM) remodeling is necessary for a health adipose tissue (AT) expansion and also has a role during weight loss. We investigate the ECM alteration during weight cycling (WC) in mice and the role of matrix metalloproteinases (MMPs) was assessed using GM6001, an MMP inhibitor, during weight loss (WL). Obesity was induced in mice by a high-fat diet. Obese mice were subject to caloric restriction for WL followed by reintroduction to high-fat diet for weight regain (WR), resulting in a WC protocol. In addition, mice were treated with GM6001 during WL period and the effects were observed after WR. Activity and expression of MMPs was intense during WL. MMP inhibition during WL results in inflammation and collagen content reduction. MMP inhibition during WL period interferes with the period of subsequent expansion of AT resulting in improvements in local inflammation and systemic metabolic alterations induced by obesity. Our results suggest that MMPs inhibition could be an interesting target to improve adipose tissue inflammation during WL and to support weight cyclers. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of intermittent fasting on body composition and clinical health markers in humans.

PubMed

Tinsley, Grant M; La Bounty, Paul M

2015-10-01

Intermittent fasting is a broad term that encompasses a variety of programs that manipulate the timing of eating occasions by utilizing short-term fasts in order to improve body composition and overall health. This review examines studies conducted on intermittent fasting programs to determine if they are effective at improving body composition and clinical health markers associated with disease. Intermittent fasting protocols can be grouped into alternate-day fasting, whole-day fasting, and time-restricted feeding. Alternate-day fasting trials of 3 to 12 weeks in duration appear to be effective at reducing body weight (≈3%-7%), body fat (≈3-5.5 kg), total cholesterol (≈10%-21%), and triglycerides (≈14%-42%) in normal-weight, overweight, and obese humans. Whole-day fasting trials lasting 12 to 24 weeks also reduce body weight (≈3%-9%) and body fat, and favorably improve blood lipids (≈5%-20% reduction in total cholesterol and ≈17%-50% reduction in triglycerides). Research on time-restricted feeding is limited, and clear conclusions cannot be made at present. Future studies should examine long-term effects of intermittent fasting and the potential synergistic effects of combining intermittent fasting with exercise. © The Author(s) 2015. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Kaiser Permanente Georgia's Experience with Operation Zero: A Group Medical Appointment to Address Pediatric Overweight

PubMed Central

Hinchman, Josephine; Beno, Luke; Mims, Adrienne

2006-01-01

Context: The rate of overweight (OW) in children in the United States has more than tripled since 1980. The health consequences of pediatric OW include type 2 diabetes and significant illness later in life. Treating pediatric OW is a necessity; however, health care clinicians have minimal access to successful and comprehensive treatment modalities for addressing it. Objective: Kaiser Permanente of Georgia (KPGA) offers a group medical appointment clinic, Operation Zero (O.Z.), as a referral program for preadolescent and adolescent patients who are in the 85th or higher percentile for body mass index (BMI) for their age. The eight-session clinic uses a family-oriented approach and provides a supportive group environment with interactive learning, games, physical activity, and creative problem solving. The goal of the program is to improve lifestyle behaviors for nutrition and physical activity. Clinically, meeting these goals can manifest as reductions in body fat (BF), waist size, and BMI-for-age percentile. Two implementation models help improve dissemination of the program within KPGA. Design: Baseline and eight-week postclinical outcomes for O.Z. participants were analyzed to determine program effectiveness. A retrospective analysis with a control group looked at long-term clinical outcomes to determine weight maintenance. Main outcome measures were weight, BMI-for-age percentile, waist size, and percentage of body fat (%BF). Results: At eight weeks after program completion compared with baseline, there were significant reductions in %BF and waist size for the total sample and specifically for adolescents, preteens, and participants who attended six or more sessions. Among O.Z. participants, there were insignificant increases in weight at six months after program participation and BMI-for-age percentile at one year after participation. At six months, the mean change in weight and BMI in the O.Z. group was statistically less than the mean change in the control group. Conclusions: A structured, family-oriented weight management program is effective in changing measures consistent with improved weight management. PMID:21519478

Effects of Low-Fat Diets Differing in Protein and Carbohydrate Content on Cardiometabolic Risk Factors during Weight Loss and Weight Maintenance in Obese Adults with Type 2 Diabetes.

PubMed

Watson, Nerylee; Dyer, Kathryn; Buckley, Jonathan; Brinkworth, Grant; Coates, Alison; Parfitt, Gaynor; Howe, Peter; Noakes, Manny; Murphy, Karen

2016-05-12

Despite evidence for the benefits of higher-protein (HP) diets in weight loss, their role in type 2 diabetes mellitus (T2DM) management and weight maintenance is not clear. This randomised study compared the effects of a HP diet (38% carbohydrate, 30% protein, 29% fat) to a isocaloric higher-carbohydrate diet (HC: 53%:21%:23%) on cardiometabolic risk factors for 12 weeks in energy restriction (~30% reduction) followed by 12 weeks of energy balance whilst performing regular exercise. Outcomes were measured at baseline and the end of each phase. Sixty-one overweight/obese adults (BMI (body mass index) 34.3 ± 5.1 kg/m², aged 55 ± 8 years) with T2DM who commenced the study were included in the intention-to-treat analysis including the 17 participants (HP n = 9, HC n = 8) who withdrew. Following weight loss (M ± SEM: -7.8 ± 0.6 kg), there were significant reductions in HbA1c (-1.4% ± 0.1%, p < 0.001) and several cardiometabolic health risk factors. Improvements were sustained for 12 weeks when weight was stabilised and weight loss maintained. Both the HP and HC dietary patterns with concurrent exercise may be effective strategies for weight loss and weight maintenance in T2DM although further studies are needed to determine the longer term effects of weight maintenance.

Effects of Low-Fat Diets Differing in Protein and Carbohydrate Content on Cardiometabolic Risk Factors during Weight Loss and Weight Maintenance in Obese Adults with Type 2 Diabetes

PubMed Central

Watson, Nerylee; Dyer, Kathryn; Buckley, Jonathan; Brinkworth, Grant; Coates, Alison; Parfitt, Gaynor; Howe, Peter; Noakes, Manny; Murphy, Karen

2016-01-01

Despite evidence for the benefits of higher-protein (HP) diets in weight loss, their role in type 2 diabetes mellitus (T2DM) management and weight maintenance is not clear. This randomised study compared the effects of a HP diet (38% carbohydrate, 30% protein, 29% fat) to a isocaloric higher-carbohydrate diet (HC: 53%:21%:23%) on cardiometabolic risk factors for 12 weeks in energy restriction (~30% reduction) followed by 12 weeks of energy balance whilst performing regular exercise. Outcomes were measured at baseline and the end of each phase. Sixty-one overweight/obese adults (BMI (body mass index) 34.3 ± 5.1 kg/m2, aged 55 ± 8 years) with T2DM who commenced the study were included in the intention-to-treat analysis including the 17 participants (HP n = 9, HC n = 8) who withdrew. Following weight loss (M ± SEM: −7.8 ± 0.6 kg), there were significant reductions in HbA1c (−1.4% ± 0.1%, p < 0.001) and several cardiometabolic health risk factors. Improvements were sustained for 12 weeks when weight was stabilised and weight loss maintained. Both the HP and HC dietary patterns with concurrent exercise may be effective strategies for weight loss and weight maintenance in T2DM although further studies are needed to determine the longer term effects of weight maintenance. PMID:27187457

Relations of mood with body mass index changes in severely obese women enrolled in a supported physical activity treatment.

PubMed

Annesi, James J

2008-01-01

It has been suggested that physical activity may affect weight reduction outcomes through associated improvements in mood. Relations of physical activity, mood, and weight change are not well understood in persons classified as severely obese (BMI > or = 40 kg/m(2)), however. This research tested these relationships in women with severe obesity. 57 women with a mean BMI of 43.8 kg/m(2) were enrolled in a cognitive-behavioral exercise support treatment with group-based nutrition information. Measurement of depression, tension, overall mood, and BMI was taken at baseline and month 6, and exercise session attendance was recorded. The treatment was associated with significant improvements in depression, tension and total mood disturbance scores as well as in BMI over 6 months. Changes in mood scores that were more positive were correlated with a greater reduction in BMI. Mean attendance in the prescribed 3 session/week exercise regimen was 46.0%, and attendance was significantly correlated with changes in tension and total mood disturbance scores, and approached significance with changes in depression scores. Findings suggested significant relations of mood and weight change as well as of physical activity and mood in severely obese women associated with a treatment of moderate physical activity. With extensions of this research, weight loss theory and treatment may benefit. Copyright 2008 S. Karger AG, Basel.

No compelling evidence that sibutramine prolongs life in rodents despite providing a dose-dependent reduction in body weight

PubMed Central

Smith, Daniel L.; Robertson, Henry; Desmond, Renee; Nagy, Tim R.; Allison, David B.

2010-01-01

Objective The health and longevity effects of body weight reduction resulting from exercise and caloric restriction in rodents are well known, but less is known about whether similar effects occur with weight reduction from the use of a pharmaceutical agent such as sibutramine, a serotonin-norepinephrine reuptake inhibitor. Results & Conclusion Using data from a two-year toxicology study of sibutramine in CD rats and CD-1 mice, despite a dose-dependent reduction in food intake and body weight in rats compared to controls, and a body weight reduction in mice at the highest dose, there was no compelling evidence for reductions in mortality rate. PMID:21079617

Bariatric surgery outcomes in black patients with super morbid obesity: a 1-year postoperative review.

PubMed

Onyewu, Samuel C; Ogundimu, Ololade O; Ortega, Gezzer; Bauer, Edward S; Emenari, Chijindu C; Molyneaux, Neh D; Layne, Sylvonne A; Changoor, Navin R; Tapscott, Denia; Tran, Daniel D; Fullum, Terrence M

2017-01-01

Super morbid obesity (body mass index [BMI] > 50 kg/m 2 ) is associated with significant comorbidities and is disparagingly prevalent among the black population. There is paucity of data regarding bariatric surgery outcomes among super morbid obese (SMO) blacks. Our aim is to evaluate the reduction in weight and resolution of comorbidities after bariatric surgery among SMO black patients at an urban academic institution. A retrospective review of SMO black patients who underwent bariatric surgery from August 2008 to June 2013 at Howard University Hospital. Outcomes of interest include weight loss, improvement or resolution of hypertension, type 2 diabetes, and hyperlipidemia at 12 months. Eighty-seven patients met our inclusion criteria. Mean preoperative weight and BMI were 347.2 lbs and 56.8 kg/m 2 , respectively. At 12 months, mean weight and BMI were 245.3 lbs and 40.1 kg/m 2 , respectively. There was also significant improvement or resolution of hypertension, type 2 diabetes, and hyperlipidemia. Bariatric surgery may result in significant weight loss and improvement or resolution of comorbidities in SMO black patients. Copyright © 2016. Published by Elsevier Inc.

Data-aided adaptive weighted channel equalizer for coherent optical OFDM.

PubMed

Mousa-Pasandi, Mohammad E; Plant, David V

2010-02-15

We report an adaptive weighted channel equalizer (AWCE) for orthogonal frequency division multiplexing (OFDM) and study its performance for long-haul coherent optical OFDM (CO-OFDM) transmission systems. This equalizer updates the equalization parameters on a symbol-by-symbol basis thus can track slight drifts of the optical channel. This is suitable to combat polarization mode dispersion (PMD) degradation while increasing the periodicity of pilot symbols which can be translated into a significant overhead reduction. Furthermore, AWCE can increase the precision of RF-pilot enabled phase noise estimation in the presence of noise, using data-aided phase noise estimation. Simulation results corroborate the capability of AWCE in both overhead reduction and improving the quality of the phase noise compensation (PNC).

Effect of Lifestyle Modification Using a Smartphone Application on Obesity With Obstructive Sleep Apnea: A Short-term, Randomized Controlled Study.

PubMed

Cho, Sung-Woo; Wee, Jee Hye; Yoo, Sooyoung; Heo, Eunyoung; Ryu, Borim; Kim, Yoojung; Lee, Joong Seek; Kim, Jeong-Whun

2018-01-30

To investigate the short-term effects of a lifestyle modification intervention based on a mobile application (app) linked to a hospital electronic medical record (EMR) system on weight reduction and obstructive sleep apnea (OSA). We prospectively enrolled adults (aged >20 years) with witnessed snoring or sleep apnea from a sleep clinic. The patients were randomized into the app user (n=24) and control (n=23) groups. The mobile app was designed to collect daily lifestyle data by wearing a wrist activity tracker and reporting dietary intake. A summary of the lifestyle data was displayed on the hospital EMR and was reviewed. In the control group, the lifestyle modification was performed as per usual practice. All participants underwent peripheral arterial tonometry (WatchPAT) and body mass index (BMI) measurements at baseline and after 4 weeks of follow-up. Age and BMI did not differ significantly between the two groups. While we observed a significant decrease in the BMI of both groups, the decrease was greater in the app user group (P <0.001). Apnea-hypopnea index, respiratory distress index, and oxygenation distress index did not change significantly in both groups. However, the proportion of sleep spent snoring at >45 dB was significantly improved in the app user group alone (P =0.014). In either group, among the participants with successful weight reduction, the apnea-hypopnea index was significantly reduced after 4 weeks (P =0.015). Multiple regression analyses showed that a reduction in the apnea-hypopnea index was significantly associated with BMI. Although a short-term lifestyle modification approach using a mobile app was more effective in achieving weight reduction, improvement in OSA was not so significant. Long-term efficacy of this mobile app should be evaluated in the future studies.

Effect of altered 'weight' upon animal tolerance to restraint.

NASA Technical Reports Server (NTRS)

Burton, R. R.; Smith, A. H.; Beljan, J. R.

1971-01-01

The effect of altered weight upon animal tolerance to restraint was determined by simulating various accelerative forces with directed lead weights using restrained and nonrestrained domestic fowl (chickens). Weighting (increased weight) and conterweighting (reduced weight) produced a stressed condition - reduced relative lymphocyte counts, loss of body mass, and/or the development of a disorientation syndrome - in both restrained and nonrestrained (caged only) birds. The animal's tolerance to altered weight appeared to be a function of its body weight. Unrestrained birds were stressed by counterweighting (mean plus or minus standard error) 58.3 plus or minus 41% of their body weight, whereas restrained birds tolerated only 32.2 plus or minus 2.6% reduction in body weight. A training regimen for restrained birds was not effective in improving their tolerance to a reduced weight environment. It was concluded that domestic fowl living in a weightless (space) environment should be restrained minimally and supported by ventrally directed tension equivalent to approximately 50% of their body mass (their weight in a 1 G environment).

Numerical investigation of tube hyroforming of TWT using Corner Fill Test

NASA Astrophysics Data System (ADS)

Zribi, Temim; Khalfallah, Ali

2018-05-01

Tube hydroforming presents a very good alternative to conventional forming processes for obtaining good quality mechanical parts used in several industrial fields, such as the automotive and aerospace sectors. Research in the field of tube hydroforming is aimed at improving the formability, stiffness and weight reduction of manufactured parts using this process. In recent years, a new method of hydroforming appears; it consists of deforming parts made from welded tubes and having different thicknesses. This technique which contributes to the weight reduction of the hydroformed tubes is a good alternative to the conventional tube hydroforming. This technique makes it possible to build rigid and light structures with a reduced cost. However, it is possible to improve the weight reduction by using dissimilar tailor welded tubes (TWT). This paper is a first attempt to analyze by numerical simulation the behavior of TWT hydroformed in square cross section dies, commonly called (Corner Fill Test). Considered tubes are composed of two materials assembled by butt welding. The present analysis will focus on the effect of loading paths on the formability of the structure by determining the change in thickness in several sections of the part. A comparison between the results obtained by hydroforming the butt joint of tubes made of dissimilar materials and those obtained using single-material tube is achieved. Numerical calculations show that the bi-material welded tube has better thinning resistance and a more even thickness distribution in the circumferential directions when compared to the single-material tube.

Extent of weight reduction necessary for minimization of diabetes risk in Japanese men with visceral fat accumulation and glycated hemoglobin of 5.6–6.4%

PubMed Central

Iwahashi, Hiromi; Noguchi, Midori; Okauchi, Yukiyoshi; Morita, Sachiko; Imagawa, Akihisa; Shimomura, Iichiro

2015-01-01

Aims/Introduction Weight reduction improves glycemic control in obese men with glycated hemoglobin (HbA1c) of 5.6–6.4%, suggesting that it can prevent the development of diabetes in these patients. The aim of the present study was to quantify the amount of weight reduction necessary for minimization of diabetes risk in Japanese men with visceral fat accumulation. Materials and Methods The study participants were 482 men with an estimated visceral fat area of ≥100 cm2, HbA1c of 5.6–6.4%, fasting plasma glucose (FPG) of <126 mg/dL or casual plasma glucose <200 mg/dL. They were divided into two groups based on weight change at the end of the 3-year follow-up period (weight gain and weight loss groups). The weight loss group was classified into quartile subgroups (lowest group, 0 to <1.2%: second lowest group, ≥1.2 to <2.5%: second highest group, ≥2.5 to <4.3%: highest group, ≥4.3% weight loss). The development of diabetes at the end-point represented a rise in HbA1c to ≥6.5% or FPG ≥126 mg/dL, or casual plasma glucose ≥200 mg/dL. Results The cumulative incidence of diabetes at the end of the 3-year follow-up period was 16.2% in the weight gain group and 10.1% in the weight loss group (P not significant). The incidence of diabetes was significantly lower in the highest weight loss group (3.1%), but not in the second highest, the second lowest and the lowest weight loss groups (9.7, 10.1 and 18.3%), compared with the weight gain group. Conclusions Minimization of the risk of diabetes in Japanese men with visceral fat accumulation requires a minimum of 4–5% weight loss in those with HbA1c of 5.6–6.4%. PMID:26417413

Effects of weight loss diet therapy on anthropometric measurements and biochemical variables in schizophrenic patients.

PubMed

Urhan, Murat; Ergün, Can; Aksoy, Meral; Ayer, Ahmet

2015-07-01

Prevalence of obesity in schizophrenic patients is two to three times higher than in the general population and unhealthy dietary patterns, a sedentary lifestyle and antipsychotic medication use may contribute to the higher levels of obesity among schizophrenic patients. We evaluated the effects of diet therapy on weight loss, anthropometric and biochemical variables in overweight or obese (body mass index, BMI ≥ 27 kg/m(2)) female schizophrenic patients who use antipsychotic medications and in healthy volunteers. Primary demographic variables were collected via questionnaire; blood samples and anthropometric measurements were obtained. Personalized diet recipes were prepared and nutritional education was shared. We logged the physical activity of the patients and maintained food consumption records at 3-day intervals. Participants were weighed every week; anthropometric measurements and blood samples were collected at the end of the first and second months. At the end of the study, reductions in body weight and other anthropometric measurements were statistically significant (P < 0.05). Reductions in body weight and BMI values for patient group were - 4.05 ± 1.73 kg and - 1.62 ± 0.73 kg/m(2) and for the control group were - 6.79 ± 1.80 kg and - 2.55 ± 0.64 kg/m(2), respectively. When compared with the patient group, reductions in the anthropometric variables of the control group were statistically significant (P < 0.05). Fasting glucose, blood lipids, albumin and leptin levels were decreased; insulin and homeostatic model assessment-measured insulin resistance (HOMA-IR) levels were increased insignificantly. Increases in the blood ghrelin levels for both groups were statistically significant (P < 0.05). Improvements to the diets of schizophrenic patient led to improvements in anthropometric measurements and biochemical variables and reduced the health risks caused by antipsychotic medications. Furthermore, we hypothesize that antipsychotic medications do not have any direct effect on leptin and ghrelin metabolism, and that changes in hormone metabolism may be attributable to changes in body weight.

Aerobic Exercise and Weight Loss Reduce Vascular Markers of Inflammation and Improve Insulin Sensitivity in Obese Women

PubMed Central

Ryan, Alice S.; Ge, Shealinna; Blumenthal, Jacob B.; Serra, Monica C.; Prior, Steven J.; Goldberg, Andrew P.

2014-01-01

Background/Objectives To examine the relationships of plasma and tissue markers of systemic and vascular inflammation to obesity and insulin resistance and determine the effects of aerobic exercise training+weight loss (AEX+WL) and weight loss (WL) on these biomarkers. Design Prospective controlled study. Participants Seventy-seven overweight and obese sedentary postmenopausal women. Interventions Six months, 3d/wk AEX+WL (n=37) or WL (n=40). Measurements Total body dual-energy x-ray absorptiometry, abdominal computed tomography scans, hyperinsulinemic-euglycemic clamps, adipose tissue biopsies (n=28), and blood for Homeostasis model assessment-insulin resistance, and soluble forms of intracellular adhesion molecule (sICAM-1) and vascular CAM-1 (sVCAM-1), C-reactive protein (CRP), and serum amyloid A (SAA). Results Body weight, %fat, visceral fat, triglyceride levels and systolic blood pressure decreased comparably after WL and AEX+WL (P<0.05). VO2max increased 16% after AEX+WL (P<0.001). Insulin resistance decreased in both groups (P<0.01). Glucose utilization increased 10% (P< 0.05) after AEX+WL and 8% with WL (P=0.07). AEX+WL and WL decreased CRP by 29% and 21%, (P<0.05). SAA levels decreased two-fold more after AEX+WL (−19%, P<0.05) than with WL (−9%, P=0.08). Plasma sICAM-1 and sVCAM-1 levels did not change; however, women with the greatest reduction in plasma sICAM-1 levels had the greatest reductions in fasting glucose, insulin and insulin resistance (P<0.05). Gluteal ICAM mRNA levels decreased 27% after AEX+WL (P<0.05) and did not change after WL. Conclusion Obesity and insulin resistance worsen markers of systemic and vascular inflammation. A reduction in plasma sICAM-1 is important to improve insulin sensitivity. CRP and SAA and tissue ICAM decrease with exercise and weight loss, suggesting that exercise training is a necessary component of lifestyle modification in obese postmenopausal women. PMID:24635342

Critical factors affecting life cycle assessments of material choice for vehicle mass reduction

EPA Science Inventory

This review examines the use of life-cycle assessments (LCAs) to compare different lightweight materials being developed to improve light-duty vehicle fuel economy. Vehicle manufacturers are designing passenger cars and light-duty trucks using lighter weight materials and design ...

Hypoglycemic potency of novel trivalent chromium in hyperglycemic insulin-deficient rats.

PubMed

Machaliński, Bogusław; Walczak, Mieczysław; Syrenicz, Anhelli; Machalińska, Anna; Grymuła, Katarzyna; Stecewicz, Iwona; Wiszniewska, Barbara; Dabkowska, Elzbieta

2006-01-01

Two sources of chromium III, "chromium 454" and "chromium picolinate," were tested in insulin-deficient Streptozocin-treated diabetic rats. This model was selected in order to evaluate the possibility of any hypoglycemic potency of chromium in a relative absence of blood insulin concentration. Three weeks of the treatment with CRC454 and CrP resulted in a 38% and 11% reduction of blood glucose levels, respectively. Body weight gains were equally improved by both treatments. Blood levels of CK, ALT and AST were significantly reduced by CRC454 and CrP. These results might suggest that any hypoglycemic effect of trivalent chromium under insulin-deficient conditions could be largely dependent upon the type of chromium agent and associated characteristics such as solubility and bioavalibility. In contrast, improvement of body weight gains and blood levels of CK, AST and ALT seems to be less dependent on the type of chromium compound under these experimental conditions. In conclusion, CRC454 showed significant reduction of hyperglycemia under insulin-deficient conditions.

Algorithms for the prediction of retinopathy of prematurity based on postnatal weight gain.

PubMed

Binenbaum, Gil

2013-06-01

Current ROP screening guidelines represent a simple risk model with two dichotomized factors, birth weight and gestational age at birth. Pioneering work has shown that tracking postnatal weight gain, a surrogate for low insulin-like growth factor 1, may capture the influence of many other ROP risk factors and improve risk prediction. Models including weight gain, such as WINROP, ROPScore, and CHOP ROP, have demonstrated accurate ROP risk assessment and a potentially large reduction in ROP examinations, compared to current guidelines. However, there is a need for larger studies, and generalizability is limited in countries with developing neonatal care systems. Copyright © 2013 Elsevier Inc. All rights reserved.

Weight Gain after Lung Reduction Surgery Is Related to Improved Lung Function and Ventilatory Efficiency

PubMed Central

Kretschman, Dana M.; Sternberg, Alice L.; DeCamp, Malcolm M.; Criner, Gerard J.

2012-01-01

Rationale: Lung volume reduction surgery (LVRS) is associated with weight gain in some patients, but the group that gains weight after LVRS and the mechanisms underlying this phenomenon have not been well characterized. Objectives: To describe the weight change profiles of LVRS patients enrolled in the National Emphysema Treatment Trial (NETT) and to correlate alterations in lung physiological parameters with changes in weight. Methods: We divided 1,077 non–high-risk patients in the NETT into groups according to baseline body mass index (BMI): underweight (<21 kg/m2), normal weight (21–25 kg/m2), overweight (25–30 kg/m2), and obese (>30 kg/m2). We compared BMI groups and LVRS and medical groups within each BMI stratum with respect to baseline characteristics and percent change in BMI (%ΔBMI) from baseline. We examined patients with (ΔBMI ≥ 5%) and without (ΔBMI < 5%) significant weight gain at 6 months and assessed changes in lung function and ventilatory efficiency (V̇e/V̇co2). Measurements and Main Results: The percent change in BMI was greater in the LVRS arm than in the medical arm in the underweight and normal weight groups at all follow-up time points, and at 12 and 24 months in the overweight group. In the LVRS group, patients with ΔBMI ≥ 5% at 6 months had greater improvements in FEV1 (11.53 ± 9.31 vs. 6.58 ± 8.68%; P < 0.0001), FVC (17.51 ± 15.20 vs. 7.55 ± 14.88%; P < 0.0001), residual volume (–66.20 ± 40.26 vs. –47.06 ± 39.87%; P < 0.0001), 6-minute walk distance (38.70 ± 69.57 vs. 7.57 ± 73.37 m; P < 0.0001), maximal expiratory pressures (12.73 ± 49.08 vs. 3.54 ± 32.22; P = 0.0205), and V̇e/V̇co2 (–1.58 ± 6.20 vs. 0.22 ± 8.20; P = 0.0306) at 6 months than patients with ΔBMI < 5% at 6 months. Conclusions: LVRS leads to weight gain in nonobese patients, which is associated with improvement in lung function, exercise capacity, respiratory muscle strength, and ventilatory efficiency. These physiological changes may be partially responsible for weight gain in patients who undergo LVRS. PMID:22878279

Weight gain after lung reduction surgery is related to improved lung function and ventilatory efficiency.

PubMed

Kim, Victor; Kretschman, Dana M; Sternberg, Alice L; DeCamp, Malcolm M; Criner, Gerard J

2012-12-01

Lung volume reduction surgery (LVRS) is associated with weight gain in some patients, but the group that gains weight after LVRS and the mechanisms underlying this phenomenon have not been well characterized. To describe the weight change profiles of LVRS patients enrolled in the National Emphysema Treatment Trial (NETT) and to correlate alterations in lung physiological parameters with changes in weight. We divided 1,077 non-high-risk patients in the NETT into groups according to baseline body mass index (BMI): underweight (<21 kg/m(2)), normal weight (21-25 kg/m(2)), overweight (25-30 kg/m(2)), and obese (>30 kg/m(2)). We compared BMI groups and LVRS and medical groups within each BMI stratum with respect to baseline characteristics and percent change in BMI (%ΔBMI) from baseline. We examined patients with (ΔBMI ≥ 5%) and without (ΔBMI < 5%) significant weight gain at 6 months and assessed changes in lung function and ventilatory efficiency (Ve/Vco(2)). The percent change in BMI was greater in the LVRS arm than in the medical arm in the underweight and normal weight groups at all follow-up time points, and at 12 and 24 months in the overweight group. In the LVRS group, patients with ΔBMI ≥ 5% at 6 months had greater improvements in FEV(1) (11.53 ± 9.31 vs. 6.58 ± 8.68%; P < 0.0001), FVC (17.51 ± 15.20 vs. 7.55 ± 14.88%; P < 0.0001), residual volume (-66.20 ± 40.26 vs. -47.06 ± 39.87%; P < 0.0001), 6-minute walk distance (38.70 ± 69.57 vs. 7.57 ± 73.37 m; P < 0.0001), maximal expiratory pressures (12.73 ± 49.08 vs. 3.54 ± 32.22; P = 0.0205), and Ve/Vco(2) (-1.58 ± 6.20 vs. 0.22 ± 8.20; P = 0.0306) at 6 months than patients with ΔBMI < 5% at 6 months. LVRS leads to weight gain in nonobese patients, which is associated with improvement in lung function, exercise capacity, respiratory muscle strength, and ventilatory efficiency. These physiological changes may be partially responsible for weight gain in patients who undergo LVRS.

Teledietetics Improves Weight Reduction by Modifying Eating Behavior: A Randomized Controlled Trial

PubMed Central

Law, Queenie Pui Sze; Fong, Shirley Siu Ming; Chung, Joanne Wai Yee

2014-01-01

Abstract Background: Weight reduction without behavioral modification is not sustainable. However, with a technology application such as teledietetics, the recording process could be a cognitive cue for individuals to change their eating behavior. This study tested obese participants to determine whether teledietetics shows better results in weight reduction. Study Design and Methods: We conducted a double-blinded randomized controlled trial. The participants in the food diary (FD) and electronic diary (ED) groups recorded their dietary intakes in logbooks and on an electronic diary system, respectively. The participants in the control group (CG) did nothing. Subjects were adults 20–60 years of age with a body mass index (BMI) of ≥25 kg/m2. The ED and FD groups were the intervention groups and were compared with the CG group. The participants' body weights, BMIs, fat percentages, waist-to-hip ratios (WHRs), and mean arterial pressures (MAPs) were measured before the study, at Week 6, and at Week 12. Demographic data were collected using self-administered questionnaires. A chi-squared test and descriptive statistics were used to describe the demographic and biomeasurement data. Repeated-measures analysis of variance was used to evaluate the effectiveness of the three groups over time. Results: Significant decreases in body weight (F1.705,86.950=20.508, p<0.001) and BMI (F1.657, 84.486=21.256, p<0.001) and insignificant decreases in fat percentage (F2,94=0.547, p=0.581), WHR (F1.785,91.052=2.888, p=0.067), and MAP (F2,94=7.542, p=0.0001) were observed among the three measurement times. Conclusions: Electronic dietary records were better than food diaries in terms of fat percentage reduction in our trials, indicating that teledietetics increases healthy-eating awareness. PMID:24205807

The need of a weight management control program in judo: a proposal based on the successful case of wrestling.

PubMed

Artioli, Guilherme G; Franchini, Emerson; Nicastro, Humberto; Sterkowicz, Stanislaw; Solis, Marina Y; Lancha, Antonio H

2010-05-04

Judo competitions are divided into weight classes. However, most athletes reduce their body weight in a few days before competition in order to obtain a competitive advantage over lighter opponents. To achieve fast weight reduction, athletes use a number of aggressive nutritional strategies so many of them place themselves at a high health-injury risk. In collegiate wrestling, a similar problem has been observed and three wrestlers died in 1997 due to rapid weight loss regimes. After these deaths, the National Collegiate Athletic Association had implemented a successful weight management program which was proven to improve weight management behavior. No similar program has ever been discussed by judo federations even though judo competitors present a comparable inappropriate pattern of weight control. In view of this, the basis for a weight control program is provided in this manuscript, as follows: competition should begin within 1 hour after weigh-in, at the latest; each athlete is allowed to be weighed-in only once; rapid weight loss as well as artificial rehydration (i.e., saline infusion) methods are prohibited during the entire competition day; athletes should pass the hydration test to get their weigh-in validated; an individual minimum competitive weight (male athletes competing at no less than 7% and females at no less than 12% of body fat) should be determined at the beginning of each season; athletes are not allowed to compete in any weight class that requires weight reductions greater than 1.5% of body weight per week. In parallel, educational programs should aim at increasing the athletes', coaches' and parents' awareness about the risks of aggressive nutritional strategies as well as healthier ways to properly manage body weight.

Identifying and analyzing methods for reducing the energy consumption of helicopters

NASA Technical Reports Server (NTRS)

Davis, S. J.; Rosenstein, H. J.

1976-01-01

Reductions in helicopter energy consumption can be accomplished through the use of advanced technology in the areas of powerplant design, improved rotor efficiency, reduced parasite drag, and reduced structural empty weight. Baseline helicopters incorporating technology were designed for a short range (200 n mi) and a very short haul (100 n mi) mission scenario. Parametric analyses were then conducted to determine the impact of technology improvement. Many of the parameters varied are interrelated. A summary of such interactions is presented, and some additional sensitivity values were added so that energy reduction and DOC as affected by the major technological factors or operational modes are clearly defined.

Testosterone and weight loss: the evidence

PubMed Central

Traish, Abdulmaged M.

2014-01-01

Purpose of review The purpose of this article is to examine the contemporary data linking testosterone therapy in overweight and obese men with testosterone deficiency to increased lean body mass, decreased fat mass, improvement in overall body composition and sustained weight loss. This is of paramount importance because testosterone therapy in obese men with testosterone deficiency represents a novel and a timely therapeutic strategy for managing obesity in men with testosterone deficiency. Recent findings Long-term testosterone therapy in men with testosterone deficiency produces significant and sustained weight loss, marked reduction in waist circumference and BMI and improvement in body composition. Further, testosterone therapy ameliorates components of the metabolic syndrome. The aforementioned improvements are attributed to improved mitochondrial function, increased energy utilization, increased motivation and vigor resulting in improved cardio-metabolic function and enhanced physical activity. Summary The implication of testosterone therapy in management of obesity in men with testosterone deficiency is of paramount clinical significance, as it produces sustained weight loss without recidivism. On the contrary, alternative therapeutic approaches other than bariatric surgery failed to produce significant and sustained outcome and exhibit a high rate of recidivism. These findings represent strong foundations for testosterone therapy in obese men with testosterone deficiency and should spur clinical research for better understanding of usefulness of testosterone therapy in treatment of underlying pathophysiological conditions of obesity. PMID:25105998

AZP-531, an unacylated ghrelin analog, improves food-related behavior in patients with Prader-Willi syndrome: A randomized placebo-controlled trial

PubMed Central

Caixàs, Assumpta; Poitou, Christine; Coupaye, Muriel; Thuilleaux, Denise; Lorenzini, Françoise; Diene, Gwenaëlle; Crinò, Antonino; Illouz, Frédéric; Grugni, Graziano; Potvin, Diane; Bocchini, Sarah; Delale, Thomas; Abribat, Thierry; Tauber, Maithé

2018-01-01

Context and objective Prader-Willi syndrome (PWS) is characterized by early-onset hyperphagia and increased circulating levels of the orexigenic Acylated Ghrelin (AG) hormone with a relative deficit of Unacylated Ghrelin (UAG). AZP-531, a first-in-class UAG analog, was shown to inhibit the orexigenic effect of AG in animals, to improve glycemic control and decrease body weight in humans. We aimed to investigate the safety and efficacy of AZP-531 in patients with PWS for whom no approved treatment for hyperphagia is currently available. Methods and design Multi-center, randomized, double-blind, placebo-controlled trial. Forty-seven patients with genetically confirmed PWS and evidence of hyperphagia received daily subcutaneous injections of AZP-531 (3 and 4 mg for 50–70 kg and >70 kg body weight, respectively) or matching placebo for 14 days. Assessments included adverse events, vital signs, safety laboratory tests, the Hyperphagia Questionnaire (HQ), patient-reported appetite, body composition and glycemic measures. Results AZP-531 was well tolerated. There was a significant improvement with AZP-531 versus placebo in the mean total score, the 9-item score and the severity domain score of the HQ (p < .05). The highest reduction in the total and 9-item scores was observed in AZP-531 subjects with the highest hyperphagia score at baseline. Findings were supported by a reduction in appetite scores observed with AZP-531 only. Body weight did not change in both groups while a significant reduction in waist circumference and fat mass was observed only with AZP-531. AZP-531 significantly decreased post-prandial glucose levels in a baseline glucose dependent fashion. Conclusions AZP-531 may constitute a new treatment strategy to improve hyperphagia and metabolic issues in patients with PWS. These findings support further investigation in longer-term clinical trials. PMID:29320575

The role of motivation in family-based guided self-help treatment for pediatric obesity.

PubMed

Accurso, Erin C; Norman, Gregory J; Crow, Scott J; Rock, Cheryl L; Boutelle, Kerri N

2014-10-01

Identifying factors associated with effective treatment for childhood obesity is important to improving weight loss outcomes. The current study investigated whether child or parent motivation throughout the course of treatment predicted reductions in BMI. Fifty 8- to 12-year-old children with overweight and obesity (BMI percentiles 85-98%) and their parents participated in a guided self-help weight loss program, which included 12 brief sessions across 5 months. Parents and interventionists reported on child and parent motivation level at each session. Multilevel slopes-as-outcome models were used to examine growth trajectories for both child and parent BMI across sessions. Greater interventionist-rated child motivation predicted greater reductions in child BMI; parent motivation did not. However, interventionist-rated parent motivation predicted greater reductions in parent BMI, and its impact on BMI became more pronounced over the course of treatment, such that sustained motivation was more important than initial motivation. Children who were older, Latino, or who had lower initial BMIs had slower reductions in BMI. This study suggests that motivation may be an important predictor of reduced BMI in child obesity treatment, with sustained motivation being more important than initial motivation. In particular, interventionist-rated, but not parent-rated, motivation is a robust predictor of child and parent BMI outcomes. Future research may evaluate whether motivational interventions can enhance outcome, with particular attention to improving outcomes for Latino children.

Effects of Naltrexone on Smoking Cessation Outcomes and Weight Gain in Nicotine-Dependent Men and Women

PubMed Central

King, Andrea C.; Cao, Dingcai; O'Malley, Stephanie S.; Kranzler, Henry R.; Cai, Xiaochen; deWit, Harriet; Matthews, Alicia K.; Stachoviak, Ryan J.

2015-01-01

This study examined whether the opioid receptor antagonist naltrexone is efficacious in smoking cessation and whether sex moderates the response. We assessed smoking quit rates and weight gain in a double-blind randomized trial comparing oral naltrexone (n = 162) with placebo (n = 154) in nicotine-dependent participants who wanted to quit smoking. The medication was gradually titrated up to 50 mg during the week before the quit date and then maintained at this dose for 12 weeks. For the first 4 weeks after the quit date, all participants received a nicotine patch to mitigate tobacco withdrawal and attended weekly individual cognitive-behavioral smoking cessation counseling sessions. After this time, participants continued with naltrexone or placebo through 12 weeks. Follow-up assessments were conducted at 26 and 52 weeks. During treatment, naltrexone (vs placebo) increased quit rates, attenuated smoking urge, and reduced weight gain. At follow-up, after medication discontinuation, the effect of naltrexone on improving quit rates was no longer evident. Men and women experienced different benefits from naltrexone; men showed greater reductions in smoking, whereas women showed greater reductions in weight gain. In sum, naltrexone showed acute efficacy in treating nicotine dependence, but after the medication was discontinued, the effect on quit rate was not maintained. Further study of naltrexone in smoking cessation treatment and reduction of cessation-related weight gain, as well as preclinical investigation of mechanisms underlying sex differences, is warranted. PMID:22926596

High Intensity Training Improves Health and Physical Function in Middle Aged Adults

PubMed Central

Adamson, Simon; Lorimer, Ross; Cobley, James N.; Lloyd, Ray; Babraj, John

2014-01-01

High intensity training (HIT) is effective at improving health; however, it is unknown whether HIT also improves physical function. This study aimed to determine whether HIT improves metabolic health and physical function in untrained middle aged individuals. Fourteen (three male and eleven female) untrained individuals were recruited (control group n = 6: age 42 ± 8 y, weight 64 ± 10 kg, BMI 24 ± 2 kg·m−2 or HIT group n = 8: age 43 ± 8 y, weight 80 ± 8 kg, BMI 29 ± 5 kg·m−2). Training was performed twice weekly, consisting of 10 × 6-second sprints with a one minute recovery between each sprint. Metabolic health (oral glucose tolerance test), aerobic capacity (incremental time to exhaustion on a cycle ergometer) and physical function (get up and go test, sit to stand test and loaded 50 m walk) were determined before and after training. Following eight weeks of HIT there was a significant improvement in aerobic capacity (8% increase in VO2 peak; p < 0.001), physical function (11%–27% respectively; p < 0.05) and a reduction in blood glucose area under the curve (6% reduction; p < 0.05). This study demonstrates for the first time the potential of HIT as a training intervention to improve skeletal muscle function and glucose clearance as we age. PMID:24833513

Health Promotion for Young Adults With Serious Mental Illness

PubMed Central

Naslund, John A.; Aschbrenner, Kelly A.; Scherer, Emily A.; Pratt, Sarah I.; Bartels, Stephen J.

2017-01-01

Objective Young adulthood represents a critical time to address elevated obesity rates and the risk of early mortality, particularly among people with serious mental illness. Few studies have assessed the benefits of lifestyle interventions targeting weight loss among these young adults. This study examined the impact of the 12-month In SHAPE lifestyle intervention on weight loss and fitness among overweight and obese young adults with serious mental illness (ages 21–30) compared with participants over age 30. Methods Data were combined from three trials of the 12-month In SHAPE program delivered through community mental health centers. In SHAPE includes weekly fitness trainer meetings, a gym membership, and nutrition education. Primary outcomes were weight loss and change in fitness at 12 months. Results Participants (N=194) had a schizophrenia spectrum disorder (53%) or a mood disorder (47%). The overall sample achieved significant weight loss and improved fitness; differences between young adults (N=29) and participants over age 30 (N=165) were not significant. An important finding was that 42% of young adults achieved clinically significant reductions in cardiovascular risk, defined as ≥5% weight loss or improved fitness (>50-m increase on the 6-Minute Walk Test), compared with 54% of adults over age 30 (a non-significant difference between age groups). Conclusions Among persons enrolled in a lifestyle intervention, overweight and obese young adults experienced benefits comparable with those of adults over age 30. Young adults with serious mental illness face high risk of gaining weight, but a meaningful proportion of these individuals can achieve clinically significant cardiovascular risk reduction, thus highlighting the need to promote lifestyle intervention participation in this group. PMID:27799016

Preoperative nutritional interventions in morbid obesity: impact on body weight, energy intake, and eating quality.

PubMed

Melendez-Araújo, Mariana Silva; de Matos Arruda, Sérgio Lincoln; de Oliveira Kelly, Emily; de Carvalho, Kênia Mara Baiocchi

2012-12-01

Although the benefits of preoperative weight loss and adequacy of dietary patterns in bariatric surgery is well-recognized, the nutritional strategies in the preoperative period have been scarcely investigated. We aimed to evaluate the impact of intensive and standard nutritional interventions on body weight, energy intake, and eating quality. This is a retrospective study in which 32 patients undergoing intensive nutritional intervention, with low-calorie diet (10 kcal/kg) and biweekly visits, were pair-matched by age, sex, and body mass index with 32 patients under a standard nutritional intervention, based on a general dietary counseling. Twenty-four-hour food recall was used to assess energy intake and to derive healthy eating index (HEI). The follow-up preoperative period varied from 8 to 16 weeks. Weight loss was observed in 72% of the patients from the intensive intervention group and 75% of the patients from the standard intervention group. According to the mixed model analysis, time effect on weight loss in both groups was significant (P = 0.0002); however, no difference was found between the intervention groups (P = 0.71). The time effect was significant in both groups for energy intake reduction as well (P < 0.0001), but no difference was found between the intervention groups (P = 0.25). Improvement of eating quality was expressed by the nutrient score of the HEI that increased significantly overtime (P = 0.02), also without distinction between the groups (P = 0.61). Both intensive and standard nutritional interventions promoted weight loss, energy intake reduction, and improvement of eating quality in morbidly obese patients during preoperative period.

Canagliflozin provides greater attainment of both HbA1c and body weight reduction versus sitagliptin in patients with type 2 diabetes.

PubMed

Schernthaner, Guntram; Lavalle-González, Fernando J; Davidson, Jaime A; Jodon, Holly; Vijapurkar, Ujjwala; Qiu, Rong; Canovatchel, William

2016-11-01

To evaluate the proportion of patients with type 2 diabetes mellitus (T2DM) achieving reductions in both glycated hemoglobin (HbA1c) and body weight with canagliflozin, a sodium glucose co-transporter 2 inhibitor, versus sitagliptin over 52 weeks. Data were pooled from two, randomized, Phase 3 studies of canagliflozin 100 and 300 mg versus sitagliptin 100 mg as add-on to metformin, and canagliflozin 300 mg versus sitagliptin 100 mg as add-on to metformin plus sulfonylurea (N = 1856). The composite end points of change from baseline in both HbA1c <0% and body weight <0 kg, and attainment of HbA1c <7.0% and body weight reduction ≥5% at Week 52 were evaluated. Safety was assessed based on adverse event reports. Canagliflozin provided reductions in HbA1c and body weight over 52 weeks versus sitagliptin. A greater proportion of patients had both HbA1c and body weight reductions with canagliflozin 100 and 300 mg versus sitagliptin 100 mg (67.7%, 72.6%, and 44.1%, respectively). Among patients with HbA1c and body weight reductions, more patients achieved the composite end point of HbA1c <7.0% and body weight reduction ≥5% with canagliflozin 100 and 300 mg versus sitagliptin 100 mg (18.9%, 18.3%, and 5.7%, respectively). Canagliflozin was generally well tolerated. A greater proportion of patients with T2DM achieved reductions in both HbA1c and body weight, and more patients with HbA1c and body weight reductions achieved HbA1c <7.0% and body weight reduction ≥5% with canagliflozin versus sitagliptin over 52 weeks. www.ClinicalTrials.gov identifiers are NCT01106677; NCT01137812.

Vehicle Weight Reduction Study

DOT National Transportation Integrated Search

1981-03-01

This report studies the potential for primary weight reduction of a 1979 Oldsmobile Omega X-body four-door sedan, by substituting aluminum components for iron and steel components where suitable. A secondary weight reduction is mentioned but is not d...

Development of a lightweight nickel electrode

NASA Technical Reports Server (NTRS)

Britton, D. L.; Reid, M. A.

1984-01-01

Nickel electrodes made using lightweight plastic plaque are about half the weight of electrodes made from state of the art sintered nickel plaque. This weight reduction would result in a significant improvement in the energy density of batteries using nickel electrodes (nickel hydrogen, nickel cadmium and nickel zinc). These lightweight electrodes are suitably conductive and yield comparable capacities (as high as 0.25 AH/gm (0.048 AH/sq cm)) after formation. These lightweight electrodes also show excellent discharge performance at high rates.

Amiodarone-induced hyperthyroidism during massive weight loss following gastric bypass.

PubMed

Bourron, Olivier; Ciangura, Cécile; Bouillot, Jean-Luc; Massias, Laurent; Poitou, Christine; Oppert, Jean-Michel

2007-11-01

Gastric bypass is increasingly used in morbidly obese patients to achieve significant reduction of body weight and fat mass and concurrent improvement in co-morbidities. We report the case of a 53-year-old male patient (141 kg, BMI 50 kg/m2), successfully treated by amiodarone for supraventricular arrythmia, who underwent Roux-en-Y gastric bypass (RYGBP). 6 months after surgery, he had lost 45% of his preoperative weight (44.8% of weight loss was lean mass) and developed amiodarone-induced subclinical hyperthyroidism. We hypothesize the following sequence of events: weight loss after RYGBP, therefore fat loss, decrease in distribution volume of amiodarone inducing iodine overload and hyperthyroidism, reinforcing weight loss and particularly loss of lean mass. This report emphasizes the importance of careful monitoring of weight and body composition changes after RYGBP. In this situation, checking thyroid status is recommended, especially when there is a history of thyroid disease or potentially toxic thyroid medication.

Cardiovascular risk reduction and weight management at a hospital-based postpartum preeclampsia clinic.

PubMed

Janmohamed, Rahim; Montgomery-Fajic, Erin; Sia, Winnie; Germaine, Debbie; Wilkie, Jodi; Khurana, Rshmi; Nerenberg, Kara A

2015-04-01

Women who develop preeclampsia during pregnancy are at high risk of developing future chronic diseases, including premature cardiovascular disease. We have established an interdisciplinary clinic that aims to prevent cardiovascular disease through educational counselling focused on lifestyle modifications in the early postpartum period. The objective of this study was to evaluate changes in weight and cardiovascular risk factors in participating women after six months of attendance at the clinic. We conducted a retrospective chart review of women who had a pregnancy complicated by preeclampsia, and who subsequently attended the Postpartum Preeclampsia Clinic. Study subjects had baseline assessments of lifestyle, physical, and laboratory parameters. Individualized goals for cardiovascular risk reduction and lifestyle were established, centering on physical activity and dietary modifications. The primary outcome was change in weight. Over the study period, 21 women were seen for a minimum of six months of follow-up. At an average (± SD) of 4.4 ± 1.4 months postpartum, subjects showed a non-significant improvement in weight (mean weight loss of 0.4 ± 4.5 kg) and BMI (mean decrease in BMI 0.1 ± 1.7 kg/m2). Physical activity improved significantly, from 14% of subjects participating in physical activity before pregnancy to 76% at a mean of 4.4 months postpartum. This study has demonstrated the early benefits of a longitudinal interdisciplinary intervention with counselling about lifestyle modifications for prevention of cardiovascular disease in women with recent preeclampsia. A study with a larger sample size and longer duration of follow-up is planned to confirm these findings.

Adherence to low‐carbohydrate and low‐fat diets in relation to weight loss and cardiovascular risk factors

PubMed Central

Yao, L.; Reynolds, K.; Niu, T.; Li, S.; Whelton, P. K.; He, J.; Steffen, L. M.; Bazzano, L. A.

2016-01-01

Summary Objective A low‐carbohydrate diet can reduce body weight and some cardiovascular disease risk factors more than a low‐fat diet, but differential adherence may play a role in these effects. Methods Data were used from 148 adults who participated in a 12‐month clinical trial examining the effect of a low‐carbohydrate diet (<40 g d−1) and a low‐fat diet (<30% fat and <7% saturated fat) on weight and cardiovascular disease risk factors. We compared attendance at counselling sessions, deviation from nutrient goals, urinary ketone presence and composite scores representing the overall adherence based on the distribution of these individual indicators between two interventions. Results Composite scores were similar between the two groups. A one‐interquartile‐range increase in composite score representing better adherence to a low‐carbohydrate diet was associated with 2.2 kg or 2.3% greater weight loss, 1.1 greater reduction in percent fat mass and 1.3 greater increase in proportion of lean mass. Indicators of adherence to a low‐fat diet were not associated with changes in weight, fat mass or lean mass. Conclusions Despite comparable adherence between groups, a low‐carbohydrate diet was associated with greater reductions in body weight and improvement in body composition, while a low‐fat diet was not associated with weight loss. PMID:27114827

Bariatric Surgery Promising in Migraine Control: a Controlled Trial on Weight Loss and Its Effect on Migraine Headache.

PubMed

Razeghi Jahromi, Soodeh; Abolhasani, Maryam; Ghorbani, Zeinab; Sadre-Jahani, Solmaz; Alizadeh, Zahra; Talebpour, Mohammad; Meysamie, Alipasha; Togha, Mansoureh

2018-01-01

There is evidence that substantial weight loss through bariatric surgery (BS) may result in short-term improvement of migraine severity. However, it still remains to be seen whether smaller amounts of weight loss have a similar effect on migraine headache. This study has been designed to compare the effects of weight reduction through BS and non-surgical modifications. Migraine characteristics were assessed at 1 month before (T0), 1 month (T1), and 6 months (T2) after BS (vertical sleeve gastrectomy (VSG) (n = 25) or behavioral therapy (BT) (n = 26) in obese women (aged 18-60 years) with migraine headache. Migraine was diagnosed using the International Classification of Headache Disorders (ICHDIIβ) criteria. There was significant reduction in the visual analog scale (VAS) from the baseline to T1 and T2 in both groups. The number of migraine-free days showed a significant increase within each group (p < 0.001). The BS group had a significant reduction in attack duration (p < 0.001) while there were no changes observed within the BT group. Following the adjustment of ANCOVA models for baseline values of migraine characteristics, age, changes in weight, BMI, body fat, and fat-free mass from T0 to T2, the BS group showed statistically significant lower VAS and duration of migraine attacks and a significantly higher number of migraine-free days than the BT group at T1 and T2 (p ≤ 0.028). Our results indicated that far before significant weight reduction after BS (VSG), there was marked alleviation in the severity and duration of migraine and a significant increase in the number of migraine-free days in obese female migraineurs. However, the effects in the BT group were not comparable with the effects in the BS group.

Rapid rather than gradual weight reduction impairs hemorheological parameters of Taekwondo athletes through reduction in RBC-NOS activation.

PubMed

Yang, Woo Hwi; Heine, Oliver; Pauly, Sebastian; Kim, Pilsang; Bloch, Wilhelm; Mester, Joachim; Grau, Marijke

2015-01-01

Rapid weight reduction is part of the pre-competition routine and has been shown to negatively affect psychological and physiological performance of Taekwondo (TKD) athletes. This is caused by a reduction of the body water and an electrolyte imbalance. So far, it is unknown whether weight reduction also affects hemorheological properties and hemorheology-influencing nitric oxide (NO) signaling, important for oxygen supply to the muscles and organs. For this purpose, ten male TKD athletes reduced their body weight by 5% within four days (rapid weight reduction, RWR). After a recovery phase, athletes reduced body weight by 5% within four weeks (gradual weight reduction, GWR). Each intervention was preceded by two baseline measurements and followed by a simulated competition. Basal blood parameters (red blood cell (RBC) count, hemoglobin concentration, hematocrit, mean corpuscular volume, mean cellular hemoglobin and mean cellular hemoglobin concentration), RBC-NO synthase activation, RBC nitrite as marker for NO synthesis, RBC deformability and aggregation parameters were determined on a total of eight investigation days. Basal blood parameters were not affected by the two interventions. In contrast to GWR, RWR decreased activation of RBC-NO synthase, RBC nitrite, respective NO concentration and RBC deformability. Additionally, RWR increased RBC aggregation and disaggregation threshold. The results point out that a rapid weight reduction negatively affects hemorheological parameters and NO signaling in RBC which might limit performance capacity. Thus, GWR should be preferred to achieve the desired weight prior to a competition to avoid these negative effects.

Isocaloric fructose restriction and metabolic improvement in children with obesity and metabolic syndrome.

PubMed

Lustig, Robert H; Mulligan, Kathleen; Noworolski, Susan M; Tai, Viva W; Wen, Michael J; Erkin-Cakmak, Ayca; Gugliucci, Alejandro; Schwarz, Jean-Marc

2016-02-01

Dietary fructose is implicated in metabolic syndrome, but intervention studies are confounded by positive caloric balance, changes in adiposity, or artifactually high amounts. This study determined whether isocaloric substitution of starch for sugar would improve metabolic parameters in Latino (n = 27) and African-American (n = 16) children with obesity and metabolic syndrome. Participants consumed a diet for 9 days to deliver comparable percentages of protein, fat, and carbohydrate as their self-reported diet; however, dietary sugar was reduced from 28% to 10% and substituted with starch. Participants recorded daily weights, with calories adjusted for weight maintenance. Participants underwent dual-energy X-ray absorptiometry and oral glucose tolerance testing on Days 0 and 10. Biochemical analyses were controlled for weight change by repeated measures ANCOVA. Reductions in diastolic blood pressure (-5 mmHg; P = 0.002), lactate (-0.3 mmol/L; P < 0.001), triglyceride, and LDL-cholesterol (-46% and -0.3 mmol/L; P < 0.001) were noted. Glucose tolerance and hyperinsulinemia improved (P < 0.001). Weight reduced by 0.9 ± 0.2 kg (P < 0.001) and fat-free mass by 0.6 kg (P = 0.04). Post hoc sensitivity analysis demonstrates that results in the subcohort that did not lose weight (n = 10) were directionally consistent. Isocaloric fructose restriction improved surrogate metabolic parameters in children with obesity and metabolic syndrome irrespective of weight change. © 2015 The Obesity Society.

[Motivation for weight loss among weight loss treatment participants].

PubMed

Czeglédi, Edit

2017-12-01

Unrealistic expectations about weight goal and about weight loss-related benefits can hinder the effort for a successful long-term weight control. To explore weight loss-related goals and their background among overweight/obese patients. Study sample consisted of patients who participated in the inpatient weight loss treatment in the Lipidological Department of Szent Imre Hospital (n = 339, 19% men). Mean age: 50.2 years (SD = 13.47 years), mean BMI: 38.6 (SD = 7.58). self-reported anthropometric data, type and number of treated illnesses, Goals and Relative Weights Questionnaire, Motivations for Weight Loss Scale, Body Shape Questionnaire. Participants would feel disappointed with a possible 10% weight loss in a half-year time span. The acceptable weight loss percentage was higher among women, younger participants and among those who had more excess weight. Motivation regarding the increase in social desirability by weight loss is in association with body dissatisfaction, health related motivation is in association with the number of treated illnesses. Our results are contributing to the understanding of motivational factors behind weight reduction efforts, considering these can improve treatment success rates. Orv Hetil. 2017; 158(49): 1960-1967.

Intermittent fasting vs daily calorie restriction for type 2 diabetes prevention: a review of human findings.

PubMed

Barnosky, Adrienne R; Hoddy, Kristin K; Unterman, Terry G; Varady, Krista A

2014-10-01

Intermittent fasting (IF) regimens have gained considerable popularity in recent years, as some people find these diets easier to follow than traditional calorie restriction (CR) approaches. IF involves restricting energy intake on 1-3 d/wk, and eating freely on the nonrestriction days. Alternate day fasting (ADF) is a subclass of IF, which consists of a "fast day" (75% energy restriction) alternating with a "feed day" (ad libitum food consumption). Recent findings suggest that IF and ADF are equally as effective as CR for weight loss and cardioprotection. What remains unclear, however, is whether IF/ADF elicits comparable improvements in diabetes risk indicators, when compared with CR. Accordingly, the goal of this review was to compare the effects of IF and ADF with daily CR on body weight, fasting glucose, fasting insulin, and insulin sensitivity in overweight and obese adults. Results reveal superior decreases in body weight by CR vs IF/ADF regimens, yet comparable reductions in visceral fat mass, fasting insulin, and insulin resistance. None of the interventions produced clinically meaningful reductions in glucose concentrations. Taken together, these preliminary findings show promise for the use of IF and ADF as alternatives to CR for weight loss and type 2 diabetes risk reduction in overweight and obese populations, but more research is required before solid conclusions can be reached. Copyright © 2014 Elsevier Inc. All rights reserved.

Robust Reductions of Excess Weight and Hyperphagia by Beloranib in Rat Models of Genetic and Hypothalamic Obesity.

PubMed

Elfers, Clinton T; Roth, Christian L

2017-01-01

Hypothalamic lesions or deficient melanocortin (MC) signaling via MC4 receptor (MC4r) mutations often lead to hyperphagia and severe treatment-resistant obesity. We tested the methionine aminopeptidase 2-inhibitor beloranib (ZGN-440) in 2 male rat models of obesity, one modeling hypothalamic obesity with a combined medial hypothalamic lesion (CMHL) and the other modeling a monogenic form of obesity with MC4r mutations (MC4r knockout [MC4rKO]). In CMHL rats (age 3 months), postsurgery excess weight gain was significantly inhibited (ZGN-440, 0.2 ± 0.7 g/d; vehicle, 3.8 ± 0.6 g/d; P < 0.001) during 12 days of ZGN-440 treatment (0.1 mg/kg daily subcutaneously) together with a 30% reduction of daily food intake vs vehicle injection. In addition, ZGN-440 treatment improved glucose tolerance and reduced plasma insulin, and circulating levels of α-melanocyte stimulating hormone were increased. Serum lipid levels did not differ significantly in ZGN-440-treated vs vehicle-treated rats. Similar results were found in MC4rKO rats: ZGN-440 treatment (14-21 d) was associated with significant reductions of body weight gain (MC4rKO, -1.7 ± 0.6 vs 2.8 ± 0.4 g/d; lean wild-type controls, -0.7 ± 0.2 vs 1.7 ± 0.7 g/d; ZGN-440 vs vehicle, respectively), reduction of food intake (MC4rKO, -28%; lean controls, -7.5%), and insulin resistance, whereas circulating levels of interleukin-1β did not change. In both obesity models, body temperature and locomotor activity were not affected by ZGN-440 treatment. In conclusion, the robust reduction of body weight in response to ZGN-440 observed in rats with severe obesity is related to a strong reduction of food intake that is likely related to changes in the central regulation of feeding. Copyright © 2017 by the Endocrine Society.

Evaluation of an education and training intervention to reduce health care waste in a tertiary hospital in Spain.

PubMed

Mosquera, Margarita; Andrés-Prado, Maria José; Rodríguez-Caravaca, Gil; Latasa, Pello; Mosquera, Marta E G

2014-08-01

In recent decades there has been a significant increase in waste generation. Training interventions in advanced health care waste management can improve the segregation of regulated medical waste and reduce volume and costs. We carried out a quasi-experimental intervention study with before and after training session analysis to compare waste segregation. Descriptive analysis of the segregated health care waste and an evaluation of the quality of segregation were done. A comparison of monthly average waste to assess the effectiveness of the educational intervention was performed. After the intervention, there was a significant reduction in the monthly average health care waste volume of 6.2%. Statistically significant differences in the infectious waste and genotoxic/pharmaceutical waste weight segregated before and after the intervention (P < .05) were found. Because of the health care waste weight reduction and the improvement of waste classification, a savings cost of €125,205 was achieved. The health care waste management training improves biomedical waste segregation at the hospital, reducing the health care waste volume and costs as an added value. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Program adherence and effectiveness of a commercial nutrition program: the metabolic balance study.

PubMed

Meffert, Cornelia; Gerdes, Nikolaus

2010-01-01

Objective. To assess the effectiveness of a commercial nutrition program in improving weight, blood lipids, and health-related quality of life (HRQOL). Methods. Prospective observational study with followup after 1, 3, 6, and 12 months with data from questionnaires and blood samples. Subjects. After 12 months, we had data from 524 subjects (= 60.6% of the initial samples). 84.1% of the subjects were women. The average BMI at baseline was 30.3 (SD = 5.7). Results. After 12 months, the average weight loss was 6.8 kg (SD = 7.1 kg). Program adherence declined over time but was still high after 12 months and showed a positive linear correlation with weight loss. Relevant blood parameters as well as HRQOL improved significantly. Conclusion. After 12 months, nearly two thirds of the samples had achieved >5% reduction of their initial weights. The high degree of program adherence is probably due to personal counseling and individually designed nutrition plans provided by the program.

Impact of bariatric surgery on female reproduction.

PubMed

Merhi, Zaher O

2009-11-01

To evaluate the current literature on the impact and potential mechanisms of surgical weight loss on female reproduction, with a focus on changes in reproductive hormone profile, fertility status, measures of ovarian reserve, efficacy of oral contraception, sexuality, and pregnancy. Appraisal of articles relevant to surgical weight loss and female reproduction. The altered reproductive hormone profile associated with morbid obesity seems to reverse, either partially or totally, after surgical weight loss. Although bariatric surgery seems to improve fertility status and many of the complications associated with obesity in pregnancy, it may be linked to oral contraceptive failure. Although müllerian-inhibiting substance is a direct measure of ovarian reserve, its level changes with obesity and after surgical weight loss. There is a decrease or no change in the risk of miscarriage after bariatric surgery. An improvement in sexual function may follow dramatic surgical weight reduction; however, the possibility of a detrimental influence afterward can occur. The increasing popularity of bariatric surgery in reproductive-age women calls for greater clinician awareness of its impact on female reproduction.

Hypersonic airbreathing vehicle conceptual design (focus on aero-space plane)

NASA Technical Reports Server (NTRS)

Hunt, James L.; Martin, John G.

1989-01-01

The airbreathing single stage to orbit (SSTO) vehicle design environment is variable-rich, intricately networked and sensitivity intensive. As such, it represents a tremondous technology challenge. Creating a viable design will require sophisticated configuration/synthesis and the synergistic integration of advanced technologies across the discipline spectrum. In design exercises, reductions in the fuel weight-fraction requirements projected for an orbital vehicle concept can result from improvements in aerodynamics/controls, propulsion efficiencies and trajectory optimization; also, gains in the fuel weight-fraction achievable for such a concept can result from improvements in structural design, heat management techniques, and material properties. As these technology advances take place, closure on a viable vehicle design will be realizable.

A Weight-Loss Diet Including Coffee-Derived Mannooligosaccharides Enhances Adipose Tissue Loss in Overweight Men but Not Women

PubMed Central

St-Onge, Marie-Pierre; Salinardi, Taylor; Herron-Rubin, Kristin; Black, Richard M.

2013-01-01

Mannooligosaccharides (MOS), extracted from coffee, have been shown to promote a decrease in body fat when consumed as part of free-living, weight-maintaining diets. Our objective was to determine if MOS consumption (4 g/day), in conjunction with a weight-loss diet, would lead to greater reductions in adipose tissue compartments than placebo. We conducted a double-blind, placebo-controlled weight-loss study in which 60 overweight men and women consumed study beverages and received weekly group counseling for 12 weeks. Weight and blood pressure were measured weekly, and adipose tissue distribution was assessed at baseline and at end point using magnetic resonance imaging. A total of 54 subjects completed the study. Men consuming the MOS beverage had greater loss of body weight than men consuming the Placebo beverage (−6.0 ± 0.6% vs. −2.3 ± 0.5%, respectively, P < 0.05). Men consuming the MOS beverage also had reductions in total body volume (P < 0.0001), total (P < 0.0001), subcutaneous (P < 0.0001), and visceral (P < 0.05) adipose tissue that were greater than changes observed in those consuming the Placebo beverage. In women, changes in body weight and adipose tissue compartments were not different between groups. Adding coffee-derived MOS to a weight-loss diet enhanced both weight and adipose tissue losses in men, suggesting a potential functional use of MOS for weight management and improvement in adipose tissue distribution. More studies are needed to investigate the apparent gender difference in response to MOS consumption. PMID:21938072

Nutritional management in women with polycystic ovary syndrome: A review study.

PubMed

Faghfoori, Zeinab; Fazelian, Siavash; Shadnoush, Mahdi; Goodarzi, Reza

2017-11-01

Polycystic ovary syndrome (PCOS) is endocrine disorder in women of reproductive age, which leads to reproductive, hormonal and metabolic abnormalities. Due to the presence of insulin resistance, PCOS increases the risk of chronic diseases like type 2 diabetes, hypertension, lipid disorders, cardiovascular diseases and malignancies such as breast and endometrial cancer. The actual cause of this syndrome is unknown but environmental factors such as dietary habits play an important role in prevention and treatment and lifestyle modifications are the most important therapeutic strategies in these patients. The approach of the diet therapy in these patients must be to reach specific goals such as improving insulin resistance, metabolic and reproductive functions that will be possible through the design of low-calorie diet to achieve weight loss or maintaining a healthy weight, limit the intake of simple sugars and refined carbohydrates and intake foods with a low glycemic index, reduction of saturated and trans fatty acids and attention to possible deficiencies such as vitamin D, chromium and omega-3. Given the prevalence of overweight and obesity and insulin resistance, a relatively low reduction in weight, about 5%, can improve problems such as insulin resistance, high levels of androgens, reproductive system dysfunctions and fertility in these women. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

[Project to improve abdominal obesity in day care ward psychiatric patients].

PubMed

Liu, Yu-Chieh; Wang, Hui-Yu; Huang, Hui-Ling; Chen, Min-Li

2011-06-01

Over half (57.14%) of patients in our ward suffer from abdominal obesity. This rate is on a continuing upward trend. Reasons for such obesity include lack of physical activity classes, inadequate physical activity, high calorie diets and unhealthy eating habits, chronic diseases and drug side effects, poor motivation to reduce weight, and lack of crisis awareness of abdominal obesity. This project was designed to lessen the problem of abdominal obesity among psychiatric day care inpatients. Resolution measures implemented included: (1) arranging aerobic exercise classes; (2) scheduling classes to teach patients healthy diet habits and knowledge regarding diseases and drugs; (3) holding a waistline reduction competition; (4) displaying health education bulletin boards; (5) holding a quiz contest with prizes for correct answers. The eight abdominally obese patients in the ward achieved an average waist circumference reduction of 2.9 cm and the overall abdominal obesity rate in the ward fell to 35.7%. BMI, eating habits, and awareness of weight loss importance and motivation all improved. The outcome achieved targeted project objectives. We recommend the integration of obesity prevention into routine ward activities and quality control indicators. Nurses should provide patients with weight loss concepts, regularly monitor risk factors, and encourage patient family cooperation to maintain medical care quality.

Effects of orlistat vs. metformin on weight loss-related clinical variables in women with PCOS: systematic review and meta-analysis.

PubMed

Graff, S K; Mario, F M; Ziegelmann, P; Spritzer, P M

2016-06-01

The aim of this study was to assess the effects of orlistat on weight loss-related clinical variables in overweight/obese women with polycystic ovary syndrome (PCOS) and to compare treatment with orlistat vs. metformin in this group. We conducted a systematic review and meta-analysis of the evidence about the use of orlistat in women with PCOS. We searched the literature published until May 2015 in MEDLINE, Cochrane Central Register of Controlled Trials and LILACS. Of 3951 studies identified, nine were included in the systematic review (three prospective, non-randomised studies and six randomised control trials). Eight studies used the Rotterdam criteria and 1 used NIH criteria to diagnose PCOS. Data suggest that orlistat promotes a significant reduction in BMI/weight in overweight/obese PCOS women. Eight studies evaluated orlistat impact on testosterone. Seven reported an improvement in testosterone levels. Eight studies evaluated impact on insulin resistance, and five reported improvement. Finally, five studies evaluated impact on lipid profile, and four reported improvement. Three randomised control trials were included in the fixed effects model meta-analysis for a total of 121 women with PCOS. Orlistat and metformin had similar positive effects on BMI (-0.65%, 95% CI: -2.03 to 0.73), HOMA (-3.60%, 95% CI: -16.99 to 9.78), testosterone (-2.08%, 95% CI: -13.08 to 8.93) and insulin (-5.51%, 95% CI: -22.27 to 11.26). The present results suggest that orlistat leads to significant reduction in BMI/body weight in PCOS. In addition, the available evidence indicates that orlistat and metformin have similar effects in reducing BMI, HOMA, testosterone and insulin in overweight/obese PCOS women. This study was registered in PROSPERO under number CRD42014012877. © 2016 John Wiley & Sons Ltd.

Why does walking economy improve after weight loss in obese adolescents?

PubMed

Peyrot, Nicolas; Thivel, David; Isacco, Laurie; Morin, Jean-Benoît; Belli, Alain; Duche, Pascale

2012-04-01

This study tested the hypothesis that the increase in walking economy (i.e., decrease in net metabolic rate per kilogram) after weight loss in obese adolescents is induced by a lower metabolic rate required to support the lower body weight and maintain balance during walking. Sixteen obese adolescent boys and girls were tested before and after a weight reduction program. Body composition and oxygen uptake while standing and walking at four preset speeds (0.75, 1, 1.25, and 1.5 m·s⁻¹) and at the preferred speed were quantified. Net metabolic rate and gross metabolic cost of walking-versus-speed relationships were determined. A three-compartment model was used to distinguish the respective parts of the metabolic rate associated with standing (compartment 1), maintaining balance and supporting body weight during walking (compartment 2), and muscle contractions required to move the center of mass and limbs (compartment 3). Standing metabolic rate per kilogram (compartment 1) significantly increased after weight loss, whereas net metabolic rate per kilogram during walking decreased by 9% on average across speeds. Consequently, the gross metabolic cost of walking per unit of distance-versus-speed relationship and hence preferred walking speeds did not change with weight loss. Compartment 2 of the model was significantly lower after weight loss, whereas compartment 3 did not change. The model showed that the improvement in walking economy after weight loss in obese adolescents was likely related to the lower metabolic rate of the isometric muscular contractions required to support the lower body weight and maintain balance during walking. Contrastingly, the part of the total metabolic rate associated with muscle contractions required to move the center of mass and limbs did not seem to be related to the improvement in walking economy in weight-reduced individuals.

An RCT of Nurse Coaching vs. Herbal CAM for Soldier Weight Reduction

DTIC Science & Technology

2015-12-08

Coaching vs. Herbal CAM for Soldier Weight Reduction 5b. GRANT NUMBER HT9404-12-1-TS03 5c. PROGRAM ELEMENT NUMBER N/A 6. AUTHOR(S) 5d...coaching intervention and an herbal supplement for Service Member (SM) weight reduction over a 12-week period to evaluate their effectiveness...Title of Research Study or Evidence-Based Practice (EBP) Project An RCT of Nurse Coaching vs. Herbal CAM for Soldier Weight Reduction Period of Award

Atherosclerosis and cardiac function assessment in low-density lipoprotein receptor-deficient mice undergoing body weight cycling.

PubMed

McMillen, T S; Minami, E; Leboeuf, R C

2013-06-24

Obesity has become an epidemic in many countries and is supporting a billion dollar industry involved in promoting weight loss through diet, exercise and surgical procedures. Because of difficulties in maintaining body weight reduction, a pattern of weight cycling often occurs (so called 'yo-yo' dieting) that may result in deleterious outcomes to health. There is controversy about cardiovascular benefits of yo-yo dieting, and an animal model is needed to better understand the contributions of major diet and body weight changes on heart and vascular functions. Our purpose is to determine the effects of weight cycling on cardiac function and atherosclerosis development in a mouse model. We used low-density lipoprotein receptor-deficient mice due to their sensitivity to metabolic syndrome and cardiovascular diseases when fed high-fat diets. Alternating ad libitum feeding of high-fat and low-fat (rodent chow) diets was used to instigate weight cycling during a 29-week period. Glucose tolerance and insulin sensitivity tests were done at 22 and 24 weeks, echocardiograms at 25 weeks and atherosclerosis and plasma lipoproteins assessed at 29 weeks. Mice subjected to weight cycling showed improvements in glucose homeostasis during the weight loss cycle. Weight-cycled mice showed a reduction in the severity of atherosclerosis as compared with high-fat diet-fed mice. However, atherosclerosis still persisted in weight-cycled mice as compared with mice fed rodent chow. Cardiac function was impaired in weight-cycled mice and matched with that of mice fed only the high-fat diet. This model provides an initial structure in which to begin detailed studies of diet, calorie restriction and surgical modifications on energy balance and metabolic diseases. This model also shows differential effects of yo-yo dieting on metabolic syndrome and cardiovascular diseases.

Changes in body weight and food choice in those attempting smoking cessation: a cluster randomised controlled trial

PubMed Central

2012-01-01

Background Fear of weight gain is a barrier to smoking cessation and significant cause of relapse for many people. The provision of nutritional advice as part of a smoking cessation programme may assist some in smoking cessation and perhaps limit weight gain. The aim of this study was to determine the effect of a structured programme of dietary advice on weight change and food choice, in adults attempting smoking cessation. Methods Cluster randomised controlled design. Classes randomised to intervention commenced a 24-week intervention, focussed on improving food choice and minimising weight gain. Classes randomised to control received “usual care”. Results Twenty-seven classes in Greater Glasgow were randomised between January and August 2008. Analysis, including those who continued to smoke, showed that actual weight gain and percentage weight gain was similar in both groups. Examination of data for those successful at giving up smoking showed greater mean weight gain in intervention subjects (3.9 (SD 3.1) vs. 2.7 (SD 3.7) kg). Between group differences were not significant (p = 0.23, 95% CI −0.9 to 3.5). In comparison to baseline improved consumption of fruit and vegetables and breakfast cereal were reported in the intervention group. A higher percentage of control participants continued smoking (74% vs. 66%). Conclusions The intervention was not successful at minimising weight gain in comparison to control but was successful in facilitating some sustained improvements in the dietary habits of intervention participants. Improved quit rates in the intervention group suggest that continued contact with advisors may have reduced anxieties regarding weight gain and encouraged cessation despite weight gain. Research should continue in this area as evidence suggests that the negative effects of obesity could outweigh the health benefits achieved through reductions in smoking prevalence. Trial registration Current Controlled Trials ISRCTN73824458 PMID:22642755

Experiences with three different fiber supplements in weight reduction.

PubMed

Birketvedt, Grethe Støa; Shimshi, Mona; Erling, Thom; Florholmen, Jon

2005-01-01

Fiber supplements added to a caloric diet have additional effects on weight reduction in overweight subjects. The aim of this study was to compare the effect of various commercial fiber supplements (glucomannan, guar gum and alginate) on weight reduction in healthy overweight subjects. One hundred and seventy six men and women were included to receive either active fiber substance or placebo in randomized placebo-controlled studies. The fiber supplements consisted of the viscous fibers glucomannan (Chrombalance), glucomannan and guar gum (Appe-Trim) and glucomannan, guar gum and alginat (Glucosahl). All fiber supplements plus a balanced 1200 kcal diet induced significantly weight reduction more than placebo and diet alone, during a five week observation period. However, there were no significant differences between the different fibers in their ability to induce weight reduction, which was approximately 0.8 kg/week (3.8 +/- 0.9, 4.4 +/- 2.0, 4.1 +/- 0.6 in the Chrombalance, Appe-Trim and Glucosahl group, respectively). Glucomannan induced body weight reduction in healthy overweight subjects, whereas the addition of guar gum and alginate did not seem to cause additional loss of weight.

Metformin reduces body weight gain and improves glucose intolerance in high-fat diet-fed C57BL/6J mice.

PubMed

Matsui, Yukari; Hirasawa, Yasushi; Sugiura, Takahiro; Toyoshi, Tohru; Kyuki, Kohei; Ito, Mikio

2010-01-01

In an acute treatment experiment, metformin (150, 300 mg/kg, per os (p.o.)) markedly reduced the consumption of a high-fat diet (HFD) (45 kcal% fat-containing diet) for 2 h after the HFD was given to the fasted male C57BL/6J (B6) mice. In addition, metformin at a higher dose increased plasma active glucagon-like peptide-1 (GLP-1) levels at 1 h after the HFD was given. On the other hand, pioglitazone (12 mg/kg, p.o.) slightly increased the food intake but did not affect active GLP-1 levels when given at 6 and 12 mg/kg, p.o. In a long-team experiment for 9 weeks, metformin treatment (0.25, 0.5% in the HFD) resulted in reduction of body weight gain and HFD intake. When wet weights of various body fat pads of each mouse were measured at 9 weeks after treatment, metformin markedly decreased these weights. However, pioglitazone treatment (0.01, 0.02% in the HFD) did not have obvious effects on these parameters. Oral glucose tolerance test was carried out after 20-h fasting at 4 weeks post-treatment. Whereas metformin treatment (0.25, 0.5%) markedly improved glucose intolerance, pioglitazone treatment (0.02%) slightly improved this parameter. At 9 weeks, both metformin and pioglitazone markedly improved hyperglycemia and hyperinsulinemia. Metformin treatment also improved hyperleptinemia, whereas pioglitazone was ineffective. These results indicate that metformin reduces body weight gain and improves glucose intolerance in HFD-induced obese diabetic B6 mice.

Effect of a high monounsaturated vs high polyunsaturated fat hypocaloric diets in nonalcoholic fatty liver disease.

PubMed

Aller, R; de Luis, D A; Izaola, O; de la Fuente, B; Bachiller, R

2014-01-01

Hyperaminotransferasemia is an important problem in obese patients. We decide to examine the changes in hyperaminotransferasemia after weight reduction in obese patients with and without NAFLD secondary to a high monounsaturated fat vs. a high polyunsaturated fat hypocaloric diets. A population of 306 obese patients was randomly allocated to two groups: Diet M (high monounsaturated fat hypocaloric diet) and Diet P (high polyunsaturated fat hypocaloric diet). Patients were classified as group I (obese subjects; n=262) when serum ALT activity was normal or group II (NAFLD patients; n=44) when serum ALT activity was (≥ 43 UI/L). In NAFLD group with diet M, BMI, weight, fat mass, waist circumference, systolic blood pressure, total cholesterol, LDL cholesterol), insulin and HOMA-R decreased. In NAFLD group with diet P, BMI, weight, fat mass, waist circumference, systolic blood pressure, total cholesterol, LDL cholesterol), insulin and HOMA-R decreased, too. In NAFLD group, alanine aminotransferase [(diet M) -20.3±19.2 UI/L vs. (diet P) -14.2±20.1 UI/L], aspartate aminotransferase [(diet M) -11.3±12.2 UI/L vs. (diet P) -11.1±10.1 UI/L], and gammaglutamyl transferase [(diet M) -18.1±12.2 UI/L vs. (diet P) -10.9±20.1 UI/L] improved with both diets. We showed that weight reduction secondary to two hypocaloric diets was associated with improvement in hypertransaminasemia and insulin resistance in NAFLD patients.

Training response inhibition to food is associated with weight loss and reduced energy intake

PubMed Central

Lawrence, Natalia S.; O'Sullivan, Jamie; Parslow, David; Javaid, Mahmood; Adams, Rachel C.; Chambers, Christopher D.; Kos, Katarina; Verbruggen, Frederick

2015-01-01

The majority of adults in the UK and US are overweight or obese due to multiple factors including excess energy intake. Training people to inhibit simple motor responses (key presses) to high-energy density food pictures reduces intake in laboratory studies. We examined whether online response inhibition training reduced real-world food consumption and weight in a community sample of adults who were predominantly overweight or obese (N = 83). Participants were allocated in a randomised, double-blind design to receive four 10-min sessions of either active or control go/no-go training in which either high-energy density snack foods (active) or non-food stimuli (control) were associated with no-go signals. Participants' weight, energy intake (calculated from 24-h food diaries), daily snacking frequency and subjective food evaluations were measured for one week pre- and post-intervention. Participants also provided self-reported weight and monthly snacking frequency at pre-intervention screening, and one month and six months after completing the study. Participants in the active relative to control condition showed significant weight loss, reductions in daily energy intake and a reduction in rated liking of high-energy density (no-go) foods from the pre-to post-intervention week. There were no changes in self-reported daily snacking frequency. At longer-term follow-up, the active group showed significant reductions in self-reported weight at six months, whilst both groups reported significantly less snacking at one- and six-months. Excellent rates of adherence (97%) and positive feedback about the training suggest that this intervention is acceptable and has the potential to improve public health by reducing energy intake and overweight. PMID:26122756

Influence of obesity and surgical weight loss on thyroid hormone levels.

PubMed

Chikunguwo, Silas; Brethauer, Stacy; Nirujogi, Vijaya; Pitt, Tracy; Udomsawaengsup, Suthep; Chand, Bipan; Schauer, Philip

2007-01-01

The pathophysiologic relationship between morbid obesity and thyroid hormones is not well understood. The goal of this study was to evaluate the influence of obesity and weight reduction after bariatric surgery on thyroid hormone levels. Patients who underwent gastric bypass or adjustable gastric banding at our institution, had no previous diagnosis of thyroid disorder, were not taking medication that could affect the thyroid function evaluation, and who were nonsmokers were included in this retrospective evaluation. The association between the thyroid-stimulating hormone (TSH) and free thyroxine (T(4)) levels and body mass index (BMI), and the influence of weight loss after bariatric surgery on these hormones were investigated at different points (preoperatively and 6 and 12 months after bariatric surgery). A total of 86 patients met the study criteria. The TSH levels correlated positively with BMI (P <.001, r = .91) within the BMI range of 30-67 kg/m(2). The mean BMI change from 49 to 32 kg/m(2) after bariatric surgery was associated with a mean reduction in the TSH level from 4.5 to 1.9 microU/mL. Free T(4) showed no association with BMI and was not significantly influenced by weight loss. Before bariatric surgery, 10.5% of the subjects had laboratory values consistent with subclinical hypothyroidism. After bariatric surgery, 100% of these patients experienced significant weight reduction with simultaneous resolution of their subclinical hypothyroidism. The results of our study have demonstrated a statistically significant positive association between serum TSH within the normal range and BMI. No association was found between BMI and free T(4) serum levels. The prevalence of subclinical hypothyroidism in study group was 10.5%. Weight loss after bariatric surgery improved or normalized thyroid hormone levels.

Effect of liraglutide 3.0 mg in individuals with obesity and moderate or severe obstructive sleep apnea: the SCALE Sleep Apnea randomized clinical trial.

PubMed

Blackman, A; Foster, G D; Zammit, G; Rosenberg, R; Aronne, L; Wadden, T; Claudius, B; Jensen, C B; Mignot, E

2016-08-01

Obesity is strongly associated with prevalence of obstructive sleep apnea (OSA), and weight loss has been shown to reduce disease severity. To investigate whether liraglutide 3.0 mg reduces OSA severity compared with placebo using the primary end point of change in apnea-hypopnea index (AHI) after 32 weeks. Liraglutide's weight loss efficacy was also examined. In this randomized, double-blind trial, non-diabetic participants with obesity who had moderate (AHI 15-29.9 events h(-1)) or severe (AHI ⩾30 events h(-1)) OSA and were unwilling/unable to use continuous positive airway pressure therapy were randomized for 32 weeks to liraglutide 3.0 mg (n=180) or placebo (n=179), both as adjunct to diet (500 kcal day(-1) deficit) and exercise. Baseline characteristics were similar between groups (mean age 48.5 years, males 71.9%, AHI 49.2 events h(-1), severe OSA 67.1%, body weight 117.6 kg, body mass index 39.1 kg m(-2), prediabetes 63.2%, HbA1c 5.7%). After 32 weeks, the mean reduction in AHI was greater with liraglutide than with placebo (-12.2 vs -6.1 events h(-1), estimated treatment difference: -6.1 events h(-1) (95% confidence interval (CI), -11.0 to -1.2), P=0.0150). Liraglutide produced greater mean percentage weight loss compared with placebo (-5.7% vs -1.6%, estimated treatment difference: -4.2% (95% CI, -5.2 to -3.1%), P<0.0001). A statistically significant association between the degree of weight loss and improvement in OSA end points (P<0.01, all) was demonstrated post hoc. Greater reductions in glycated hemoglobin (HbA1c) and systolic blood pressure (SBP) were seen with liraglutide versus placebo (both P<0.001). The safety profile of liraglutide 3.0 mg was similar to that seen with doses ⩽1.8 mg. As an adjunct to diet and exercise, liraglutide 3.0 mg was generally well tolerated and produced significantly greater reductions than placebo in AHI, body weight, SBP and HbA1c in participants with obesity and moderate/severe OSA. The results confirm that weight loss improves OSA-related parameters.

Effects on Physical Health of a Multicomponent Programme for Overweight and Obesity for Adults with Intellectual Disabilities.

PubMed

Martínez-Zaragoza, Fermín; Campillo-Martínez, José M; Ato-García, Manuel

2016-05-01

Overweight and obesity are major health risk factors in people with intellectual disabilities. The aim of this study was to test the effectiveness of a multicomponent programme (physical activity, diet and motivation) for overweight and obesity in adults with intellectual disabilities. A quasi-experimental design with repeated-measures and non-equivalent control group (n = 33, n = 31) was used. The programme was conducted over 17 weeks, with follow-up at 6 months in a sample of Spanish adults with a mild and moderate intellectual disability from a community occupational day centre, aged from 23 to 50, 40.6% of which were women. A significant reduction in weight and diastolic blood pressure was obtained over time, and this reduction was maintained in the follow-up for weight. Reduction in heart rate was only marginally significant. The treatment was effective in reducing overweight and obesity, improving cardiovascular capacity and therefore the physical health of the participants. © 2015 John Wiley & Sons Ltd.

[Effects of low molecular weight organic acids on redox reactions of mercury].

PubMed

Zhao, Shi-Bo; Sun, Rong-Guo; Wang, Ding-Yong; Wang, Xiao-Wen; Zhang, Cheng

2014-06-01

To study the effects of the main component of vegetation root exudates-low molecular weight organic acids on the redox reactions of mercury, laboratory experiments were conducted to investigate the roles of tartaric, citric, and succinic acid in the redox reactions of mercury, and to analyze their interaction mechanism. The results indicated that tartaric acid significantly stimulated the mercury reduction reaction, while citric acid had inhibitory effect. Succinic acid improved the reduction rate at low concentration, and inhibited the reaction at high concentration. The mercury reduction rate by tartaric acid treatment was second-order with respect to Hg2+ concentration, ranging from 0.0014 L x (ng x min)(-1) to 0.005 6 L x (ng x min)(-1). All three organic acids showed a capacity for oxidating Hg(0) in the early stage, but the oxidized Hg(0) was subsequently reduced. The oxidation capacity of the three organic acids was in the order of citric acid > tartaric acid > succinic acid.

Integrated Application of Active Controls (IAAC) technology to an advanced subsonic transport project: Wing planform study and final configuration selection

NASA Technical Reports Server (NTRS)

1981-01-01

This report summarizes the Wing Planform Study Task and Final Configuration Selection of the Integrated Application of Active Controls (IAAC) Technology Project within the Energy Efficient Transport Program. Application of Active Controls Technology (ACT) in combination with increased wing span resulted in significant improvements over the Conventional Baseline Configuration (Baseline) and the Initial ACT Configuration previously established. The configurations use the same levels of technology (except for ACT), takeoff gross weight, and payload as the Baseline. The Final ACT Configuration (Model 768-107) incorporates pitch-augmented stability (which enabled an approximately 10% aft shift in cruise center of gravity and a 45% reduction in horizontal tail sizes), lateral/directional-augmented stability, an angle-of-attack limiter, and wing-load alleviation. Flutter-mode control was not beneficial for this configuration. This resulted in an 890 kg (1960 lb) reduction in airplane takeoff gross weight and a 9.8% improvement in cruise lift/drag. At the Baseline mission range (3590 km) (1938 nmi), this amounts to 10% block fuel reduction. Good takeoff performance at high-altitude airports on a hot day was also achieved. Results of this task strongly indicate that the IAAC Project should proceed with the Final ACT evaluation and begin the required control system development and testing.

The Effects of Body Acupuncture on Obesity: Anthropometric Parameters, Lipid Profile, and Inflammatory and Immunologic Markers

PubMed Central

Abdi, Hamid; Zhao, Baixiao; Darbandi, Mahsa; Ghayour-Mobarhan, Majid; Tavallaie, Shima; Rahsepar, Amir Ali; Parizadeh, Seyyed Mohammad Reza; Safariyan, Mohammad; Nemati, Mohsen; Mohammadi, Maryam; Abbasi-Parizad, Parisa; Darbandi, Sara; Akhlaghi, Saeed; Ferns, Gordon A. A.

2012-01-01

A randomized controlled clinical trial in 196 obese subjects was performed to examine the effectiveness of body acupuncture on body weight loss, lipid profile and immunogenic and inflammatory markers. Subjects received authentic (cases) or sham (controls) acupuncture for 6 weeks in combination with a low-calorie diet. In the following 6 weeks, they received the low-calorie diet alone. Subjects were assessed at the beginning, 6 and 12 weeks later. Heat shock protein (Hsps)-27, 60, 65, 70 antibody titers and high sensitivity C-reactive protein (hs-CRP) levels were also assessed. A significant reduction in measures of adiposity and improvement in lipid profile were observed in both groups, but the levels of anti-Hsp-antibodies decreased in cases only. A reduction in anthropometric and lipid profile in cases were sustained in the second period, however, only changes in lipid profile were observed in the control group. Anti-Hsp-antibodies and hs-CRP levels continued to be reduced in cases but in controls only the reduction in hs-CRP remained. Changes in anthropometric parameters, lipid profile, and anti-Hsp-antibodies were more evident in cases. Body acupuncture in combination with diet restriction was effective in enhancing weight loss and improving dyslipidemia. PMID:22649299

Effect of a hypocaloric diet with a commercial formula in weight loss and quality of life in obese patients with chronic osteoarthritis.

PubMed

de Luis, D A; Izaola, O; García Alonso, M; Aller, R; Cabezas, G; de la Fuente, B

2012-01-01

The aim of our study was to evaluate in patients with obesity and chronic osteoarthritis the impact on quality of life and metabolic control of a dietary intervention with a hypocaloric commercial formula. A sample of 55 obese patients with chronic osteoarthritis was enrolled. The study consisted of a 12-week weight reduction program where the participants received an oral diet replaced with 2 bricks of Optisource Plus®. In order to assess the effect of weight loss on different parameters, patients were divided in two groups by the median of weight loss percentage (9%); group 1 (< 9%) and group 2 (> 9%). In group 2, patients showed an improvement in total SF-36 score (4.0 ± 6.1 points), physical function domain of SF 36 (1.8 ± 3.4 points), role physical domain of SF 36 (0.6 ± 1.6 points) and vitality domain of SF 36 (2.7 ± 4.6 points) improved. Total score of WOMAC test (- 8.2 ± 15.0 points), function domain of WOMAC test (- 6.5 ± 10.6 points) and stiffness domain of WOMAC test (-0.7 ± 2.1 points) improved, too. The effect on metabolic response, functionality and quality of life was better in patients with a percentage of weight loss > 9% than patients with a lower weight loss.

The Effect of Weight Reduction on the Blood and Urine Measurements of College Wrestlers.

ERIC Educational Resources Information Center

Segurson, Jack

It has been suggested that the weight reduction practices of wrestlers results in kidney and liver problems. To observe the effect of wrestlers' weight reduction, diagnostic tests for kidney and liver problems were done on the blood and urine samples of 22 college wrestlers over the course of a wrestling season. Results obtained after reduction to…

Is two days of intermittent energy restriction per week a feasible weight loss approach in obese males? A randomised pilot study.

PubMed

Conley, Marguerite; Le Fevre, Lauren; Haywood, Cilla; Proietto, Joseph

2018-02-01

The 5:2 diet (two non-consecutive days of 2460 KJ (600 calories) and 5 days of ad libitum eating per week) is becoming increasingly popular. This pilot study aimed to determine whether the 5:2 diet can achieve ≥5% weight loss and greater improvements in weight and biochemical markers than a standard energy-restricted diet (SERD) in obese male war veterans. A total of 24 participants were randomised to consume either the 5:2 diet or a SERD (2050 KJ (500 calorie) reduction per day) for 6 months. Weight, waist circumference (WC), fasting blood glucose, blood lipids, blood pressure and dietary intake were measured at baseline, 3 and 6 months by a blinded investigator. After 6 months, participants in both groups significantly reduced body weight (P = <0.001), WC (P = <0.001) and systolic blood pressure (P = 0.001). Mean weight loss was 5.3 ± 3.0 kg (5.5 ± 3.2%) for the 5:2 group and 5.5 ± 4.3 kg (5.4 ± 4.2%) for the SERD group. Mean WC reduction for the 5:2 group was 8.0 ± 4.5 and 6.4 ± 5.8 cm for the SERD group. There was no significant difference in the amount of weight loss or WC reduction between diet groups. There was no significant change in diastolic blood pressure, fasting blood glucose or blood lipids in either dietary group. Results suggest that the 5:2 diet is a successful but not superior weight loss approach in male war veterans when compared to a SERD. Future research is needed to determine the long-term effectiveness of the 5:2 diet and its effectiveness in other population groups. © 2017 Dietitians Association of Australia.

The influence of diet and/or exercise and parental compliance on health-related quality of life in obese children.

PubMed

Yackobovitch-Gavan, Michal; Nagelberg, Nessia; Phillip, Moshe; Ashkenazi-Hoffnung, Liat; Hershkovitz, Eli; Shalitin, Shlomit

2009-06-01

Recent findings of a direct association of obesity and impaired health-related quality of life (HRQOL) in children suggest a need for early weight-management interventions that address psychosocial issues and lifestyle. Our aim was to compare the effects of exercise, diet, or diet + exercise on HRQOL in obese children. We hypothesized that HRQOL will improve as a result of the weight-loss intervention and will be correlated with the amount of weight loss achieved by each of the intervention groups. A total of 162 children aged 6 to 11 years with a body mass index (BMI) exceeding the 95th percentile were randomly allocated to a 12-week regimens of diet, exercise, or diet + exercise. Weight, height, and percent fat mass were measured, and parents completed the Pediatric Quality of Life Inventory (PedsQL) 4.0 at baseline and at the end of the intervention. The reductions in BMI were significantly greater in the diet and diet + exercise groups than in the exercise group. Pediatric Quality of Life Inventory scores improved significantly, with no differences among the groups. A greater reduction in BMI occurred in children whose parents completed the PedsQL at baseline (n = 105) than in children whose parents did not (n = 15) (-1.8 +/- 1.3 vs -1.0 +/- 1.5; P = .048) and in children whose parents completed the PedsQL at the end of the intervention (n = 73) than in children whose parents did not (n = 47) (-2.0 +/- 1.3 vs -1.3 +/- 1.3; P = .013). Weight-management programs that promote a healthy eating and physical activity can serve as an effective tool to improve the low HRQOL of obese children. Parental compliance is an important factor and may be assessed by the parents' cooperativeness in completing questionnaires.

Understanding and managing disturbances in insulin metabolism and body weight in women with polycystic ovary syndrome.

PubMed

Moran, L; Norman, R J

2004-10-01

Polycystic ovary syndrome (PCOS) is a common clinical and metabolic condition in women of reproductive age. It is associated with short-term reproductive and long-term metabolic dysfunction. Treatment has traditionally focused on fertility and hormonal therapy. However, general obesity, central obesity and insulin resistance are strongly implicated in its aetiology and improving these factors has proved highly successful in some clinical situations, reducing the need for costly assisted reproduction. A low-fat, high-carbohydrate diet is thought to improve insulin sensitivity, aid in weight loss and reduction of metabolic and reproductive symptoms and improve the long-term maintenance of a reduced weight. However, there has been recent community interest in adopting a protocol advocating a moderate increase in dietary protein for improving weight loss and PCOS symptoms. Altering the glycaemic index of the diet has also received considerable attention as a regime for promoting satiety and reducing metabolic risk factors for type 2 diabetes mellitus and cardiovascular disease. Exercise and other lifestyle changes are essential for altering the short- and long-term effects of PCOS. It is vital that the efficacy of these strategies is assessed so that accurate medical and dietetic advice can be given both to patients and to the health-care community.

Whey Protein Components - Lactalbumin and Lactoferrin - Improve Energy Balance and Metabolism.

PubMed

Zapata, Rizaldy C; Singh, Arashdeep; Pezeshki, Adel; Nibber, Traj; Chelikani, Prasanth K

2017-08-30

Whey protein promotes weight loss and improves diabetic control, however, less is known of its bioactive components that produce such benefits. We compared the effects of normal protein (control) diet with high protein diets containing whey, or its fractions lactalbumin and lactoferrin, on energy balance and metabolism. Diet-induced obese rats were randomized to isocaloric diets: Control, Whey, Lactalbumin, Lactoferrin, or pair-fed to lactoferrin. Whey and lactalbumin produced transient hypophagia, whereas lactoferrin caused prolonged hypophagia; the hypophagia was likely due to decreased preference. Lactalbumin decreased weight and fat gain. Notably, lactoferrin produced sustained weight and fat loss, and attenuated the reduction in energy expenditure associated with calorie restriction. Lactalbumin and lactoferrin decreased plasma leptin and insulin, and lactalbumin increased peptide YY. Whey, lactalbumin and lactoferrin improved glucose clearance partly through differential upregulation of glucoregulatory transcripts in the liver and skeletal muscle. Interestingly, lactalbumin and lactoferrin decreased hepatic lipidosis partly through downregulation of lipogenic and/or upregulation of β-oxidation transcripts, and differentially modulated cecal bacterial populations. Our findings demonstrate that protein quantity and quality are important for improving energy balance. Dietary lactalbumin and lactoferrin improved energy balance and metabolism, and decreased adiposity, with the effects of lactoferrin being partly independent of caloric intake.

Effects of replacing diet beverages with water on weight loss and weight maintenance: 18-month follow-up, randomized clinical trial.

PubMed

Madjd, A; Taylor, M A; Delavari, A; Malekzadeh, R; Macdonald, I A; Farshchi, H R

2018-04-01

Beneficial effects of replacing diet beverages (DBs) with water on weight loss, during a 24-week hypoenergetic diet were previously observed. However, it is not known whether this difference is sustained during a subsequent 12-month weight maintenance period. To evaluate effects of replacing DBs with water on body weight maintenance over a 12-month period in participants who undertook a 6-month weight loss plan. Seventy-one obese and overweight adult women (body mass index (BMI): 27-40 kg m -2 ; age: 18-50 years) who usually consumed DBs in their diet were randomly assigned to either substitute water for DBs (water group: 35) or continue drinking DBs five times per week (DBs group: 36) after their lunch for the 6-month weight loss intervention and subsequent 12-month weight maintenance program. A total of 71 participants who were randomly assigned were included in the study by using an intention-to-treat analysis. Greater additional weight loss (mean±s.d.) in the water group was observed compared with the DBs group after the 12-month follow-up period (-1.7±2.8 vs -0.1±2.7 kg, P=0.001). BMI decreased more in the water group than in the DBs group (-0.7±1 vs -0.05±1.1 kg m - 2 , P=0.003). There was also a greater reduction in fasting insulin levels (-0.5±1.4 vs -0.02±1.5 mmol l -1 , P=0.023), better improvement in homeostasis model assessment of insulin resistance (-0.2±0.4 vs -0.1±0.3, P=0.013) and a greater decrease in 2-h postprandial plasma glucose (-0.2±0.3 vs -0.1±0.3 mmol l -1 , P<0.001) in the water group compared with the DBs over the 12-month weight maintenance period. Replacement of DBs with water after the main meal in women who were regular users of DBs may cause further weight reduction during a 12-month weight maintenance program. It may also offer benefits in carbohydrate metabolism including improvement of insulin resistance over the long-term weight maintenance period.

The adjunctive use of metformin to treat or prevent atypical antipsychotic-induced weight gain: a review.

PubMed

Khan, Ahsan Y; Macaluso, Matthew; McHale, Robert J; Dahmen, Megan M; Girrens, Kathrine; Ali, Faryal

2010-09-01

Patients with schizophrenia have a greater incidence of being overweight or obese compared with the general population. Such individuals are often treated with second-generation (atypical) antipsychotics (SGAs), which are associated with weight gain, dyslipidemia, and other metabolic derangements. As a result, frequent monitoring of weight and other metabolic parameters is recommended. In addition, several pharmacologic strategies to help prevent or reduce SGA-induced weight gain have been proposed. Despite this, clinicians often struggle to manage obesity and metabolic issues in such patients. Metformin has attracted attention as a potential treatment option because it is thought to result in weight reduction and improved glycemic control in obese patients with and without type 2 diabetes mellitus. This article focuses on relevant pharmacologic aspects of metformin and reviews currently available evidence on the use of metformin as an augmentation agent for the treatment or prevention of SGA-induced weight gain.

Guided SAR image despeckling with probabilistic non local weights

NASA Astrophysics Data System (ADS)

Gokul, Jithin; Nair, Madhu S.; Rajan, Jeny

2017-12-01

SAR images are generally corrupted by granular disturbances called speckle, which makes visual analysis and detail extraction a difficult task. Non Local despeckling techniques with probabilistic similarity has been a recent trend in SAR despeckling. To achieve effective speckle suppression without compromising detail preservation, we propose an improvement for the existing Generalized Guided Filter with Bayesian Non-Local Means (GGF-BNLM) method. The proposed method (Guided SAR Image Despeckling with Probabilistic Non Local Weights) replaces parametric constants based on heuristics in GGF-BNLM method with dynamically derived values based on the image statistics for weight computation. Proposed changes make GGF-BNLM method adaptive and as a result, significant improvement is achieved in terms of performance. Experimental analysis on SAR images shows excellent speckle reduction without compromising feature preservation when compared to GGF-BNLM method. Results are also compared with other state-of-the-art and classic SAR depseckling techniques to demonstrate the effectiveness of the proposed method.

MO-DE-207A-10: One-Step CT Reconstruction for Metal Artifact Reduction by a Modification of Penalized Weighted Least-Squares (PWLS)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, H; Chen, J

Purpose: Metal objects create severe artifacts in kilo-voltage (kV) CT image reconstructions due to the high attenuation coefficients of high atomic number objects. Most of the techniques devised to reduce this artifact utilize a two-step approach, which do not reliably yield the qualified reconstructed images. Thus, for accuracy and simplicity, this work presents a one-step reconstruction method based on a modified penalized weighted least-squares (PWLS) technique. Methods: Existing techniques for metal artifact reduction mostly adopt a two-step approach, which conduct additional reconstruction with the modified projection data from the initial reconstruction. This procedure does not consistently perform well due tomore » the uncertainties in manipulating the metal-contaminated projection data by thresholding and linear interpolation. This study proposes a one-step reconstruction process using a new PWLS operation with total-variation (TV) minimization, while not manipulating the projection. The PWLS for CT reconstruction has been investigated using a pre-defined weight, based on the variance of the projection datum at each detector bin. It works well when reconstructing CT images from metal-free projection data, which does not appropriately penalize metal-contaminated projection data. The proposed work defines the weight at each projection element under the assumption of a Poisson random variable. This small modification using element-wise penalization has a large impact in reducing metal artifacts. For evaluation, the proposed technique was assessed with two noisy, metal-contaminated digital phantoms, against the existing PWLS with TV minimization and the two-step approach. Result: The proposed PWLS with TV minimization greatly improved the metal artifact reduction, relative to the other techniques, by watching the results. Numerically, the new approach lowered the normalized root-mean-square error about 30 and 60% for the two cases, respectively, compared to the two-step method. Conclusion: A new PWLS operation shows promise for improving metal artifact reduction in CT imaging, as well as simplifying the reconstructing procedure.« less

Diet and exercise for weight loss: a review of current issues.

PubMed

Volek, Jeff S; Vanheest, Jaci L; Forsythe, Cassandra E

2005-01-01

Obesity is a fast growing epidemic that is primarily due to environmental influences. Nutrition and exercise represent modifiable factors with a major impact on energy balance. Despite considerable research, there remains continued debate regarding the energy content and the optimal macronutrient distribution for promoting healthy and effective weight loss. Low-fat diets have been advised for many years to reduce obesity. However, their effectiveness has been recently challenged, partly because the prevalence of obesity continues to rise despite reductions in fat intake. There are also concerns regarding the methodology of clinical trials showing benefits of fat reduction on weight loss. Although often viewed as a fad diet, very low-carbohydrate (ketogenic) diets are very popular and several recent clinical trials indicate they are more effective at promoting short-term weight loss and improving characteristics of the metabolic syndrome than low-fat diets. However, there is a need to obtain long-term safety and efficacy data. Clearly, weight loss can be achieved with a variety of diet interventions but the effects on other health-related aspects also need to be considered and studied in more detail. Exercise can have positive effects on weight loss, weight control and overall general health, although debate exists concerning the most effective mode, duration and intensity of exercise required to achieve these effects. Importantly, any effective weight control treatment must consider a life-long plan or there will likely be weight regain. Perhaps the most challenging, but rewarding, question that faces researchers is how to predict individual responses to diet and exercise interventions.

Aircraft energy efficiency. Overview

NASA Technical Reports Server (NTRS)

1981-01-01

Six advanced technology development projects that could cut fuel consumption of future civil air transports by as much as 50 percent are highlighted. These include improved engine components; better engine design; thin short blades for turboprop aircaft; using composite primary structures for weight reduction; the use of supercritical wings, higher aspect ratio, and winglets for improved aerodynamics; active controls; and laminar flow control. The time span of each of the six efforts and NASA's expected expenditures are also discussed.

Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial.

PubMed

Wing, Rena R

2010-09-27

Lifestyle interventions produce short-term improvements in glycemia and cardiovascular disease (CVD) risk factors in individuals with type 2 diabetes mellitus, but no long-term data are available. We examined the effects of lifestyle intervention on changes in weight, fitness, and CVD risk factors during a 4-year study. The Look AHEAD (Action for Health in Diabetes) trial is a multicenter randomized clinical trial comparing the effects of an intensive lifestyle intervention (ILI) and diabetes support and education (DSE; the control group) on the incidence of major CVD events in 5145 overweight or obese individuals (59.5% female; mean age, 58.7 years) with type 2 diabetes mellitus. More than 93% of participants provided outcomes data at each annual assessment. Averaged across 4 years, ILI participants had a greater percentage of weight loss than DSE participants (-6.15% vs -0.88%; P < .001) and greater improvements in treadmill fitness (12.74% vs 1.96%; P < .001), hemoglobin A(1c) level (-0.36% vs -0.09%; P < .001), systolic (-5.33 vs -2.97 mm Hg; P < .001) and diastolic (-2.92 vs -2.48 mm Hg; P = .01) blood pressure, and levels of high-density lipoprotein cholesterol (3.67 vs 1.97 mg/dL; P < .001) and triglycerides (-25.56 vs -19.75 mg/dL; P < .001). Reductions in low-density lipoprotein cholesterol levels were greater in DSE than ILI participants (-11.27 vs -12.84 mg/dL; P = .009) owing to greater use of medications to lower lipid levels in the DSE group. At 4 years, ILI participants maintained greater improvements than DSE participants in weight, fitness, hemoglobin A(1c) levels, systolic blood pressure, and high-density lipoprotein cholesterol levels. Intensive lifestyle intervention can produce sustained weight loss and improvements in fitness, glycemic control, and CVD risk factors in individuals with type 2 diabetes. Whether these differences in risk factors translate to reduction in CVD events will ultimately be addressed by the Look AHEAD trial. clinicaltrials.gov Identifier: NCT00017953.

[Obesity and heart failure].

PubMed

Weismann, D; Wiedmann, S; Bala, M; Frantz, S; Fassnacht, M

2015-02-01

Obesity is an important risk factor for the development of heart failure. In normotensive obese patients, a reduced peripheral resistance is typically observed and is accompanied by an increased fluid volume and an increase in cardiac work, resulting in hypertrophy and diastolic heart failure, which can be visualized with echocardiography. However, in the presence of arterial hypertension cardiac geometry is not different to hypertensive heart disease without obesity. Furthermore, the typical changes found with obesity, such as reduced peripheral resistance and increased blood volume, are no longer present. Obstructive sleep apnea (OSA) is very common in obesity and warrants screening but levels of the heart failure marker N-terminal pro-brain natriuretic peptide (NT-ProBNP) might be misleading as the values are lower in obesity than in normal weight controls. Body weight reduction is advisable but difficult to achieve and much more difficult to maintain. Furthermore, diet and exercise has not been proven to enhance life expectancy in obesity. However, with bariatric surgery, long-term weight reduction can be achieved and mortality can be reduced. With effective weight loss and improved clinical outcome after bariatric surgery, treatment of obesity has shifted much more into focus. Regardless of technical challenges in the work-up of obese patients, clinical symptoms suggestive of cardiac disorders warrant prompt investigation with standard techniques following recommendations as established for normal weight patients.

Interior noise reduction in a large civil helicopter

NASA Technical Reports Server (NTRS)

Howlett, J. T.; Clevenson, S. A.; Rypf, J. A.; Snyder, W. J.

1977-01-01

The results of an evaluation of the effectiveness of current noise reduction technology in attaining acceptable levels of interior noise in a large (about 20,000 kg) passenger-carrying helicopter are presented. The helicopter studied is a modified CH-53A with a specially designed, acoustically treated passenger cabin. The acoustic treatment reduced the average A-weighted interior noise levels from 115 db to 87 db. The study suggests selected improvements in the acoustic treatment which could result in additional reduction in cabin noise levels. The resulting levels would be only slightly greater than the interior noise levels of current narrow-body jet transports.

The Role of Motivation in Family-Based Guided Self-Help Treatment for Pediatric Obesity

PubMed Central

Norman, Gregory J.; Crow, Scott J.; Rock, Cheryl L.; Boutelle, Kerri N.

2014-01-01

Abstract Background: Identifying factors associated with effective treatment for childhood obesity is important to improving weight loss outcomes. The current study investigated whether child or parent motivation throughout the course of treatment predicted reductions in BMI. Methods: Fifty 8- to 12-year-old children with overweight and obesity (BMI percentiles 85–98%) and their parents participated in a guided self-help weight loss program, which included 12 brief sessions across 5 months. Parents and interventionists reported on child and parent motivation level at each session. Multilevel slopes-as-outcome models were used to examine growth trajectories for both child and parent BMI across sessions. Results: Greater interventionist-rated child motivation predicted greater reductions in child BMI; parent motivation did not. However, interventionist-rated parent motivation predicted greater reductions in parent BMI, and its impact on BMI became more pronounced over the course of treatment, such that sustained motivation was more important than initial motivation. Children who were older, Latino, or who had lower initial BMIs had slower reductions in BMI. Conclusions: This study suggests that motivation may be an important predictor of reduced BMI in child obesity treatment, with sustained motivation being more important than initial motivation. In particular, interventionist-rated, but not parent-rated, motivation is a robust predictor of child and parent BMI outcomes. Future research may evaluate whether motivational interventions can enhance outcome, with particular attention to improving outcomes for Latino children. PMID:25181608

Participation and cardiovascular risk reduction in a voluntary worksite nutrition and physical activity program

PubMed Central

Thorndike, Anne N.; Healey, Erica; Sonnenberg, Lillian; Regan, Susan

2010-01-01

Objective In a cohort of employees participating in a worksite nutrition and physical activity program, we compared program completion and changes in cardiovascular risk factors by baseline body mass index. Methods In 2007, 774 employees enrolled in a 10 week program at a hospital in Boston, MA. Program completion and change in weight, cholesterol, and blood pressure were compared between obese (BMI≥30), overweight (BMI=25–29.9), and normal weight (BMI<25) participants. Results At baseline, 63% were obese or overweight and had higher blood pressure and cholesterol compared to normal weight participants. Program completion was 82% and did not differ by BMI. Mean weight loss was 1.9 kg at end of program (p<0.001) and 0.4 kg at 1 year (p=0.002). At end of program, participants with BMI≥30 lost 3.0% body weight vs. 2.7% for BMI=25–29.9 and 1.7% for BMI<25 (p<0.001), but weight loss at 1 year did not differ by BMI. Mean cholesterol and blood pressure were lower at end of program and 1 year (p all <0.005) but did not differ by BMI. Conclusions Worksite programs can successfully initiate cardiovascular risk reduction among employees, but more intensive interventions are needed to make significant improvements in the health of higher risk obese employees. PMID:21130804

Propulsion Investigation for Zero and Near-Zero Emissions Aircraft

NASA Technical Reports Server (NTRS)

Snyder, Christopher A.; Berton, Jeffrey J.; Brown, Gerald v.; Dolce, James L.; Dravid, Marayan V.; Eichenberg, Dennis J.; Freeh, Joshua E.; Gallo, Christopher A.; Jones, Scott M.; Kundu, Krishna P.;

The Impact of Weight and Fat Mass Loss and Increased Physical Activity on Physical Function in Overweight, Postmenopausal Women: Results from the WOMAN Study

PubMed Central

Gabriel, Kelley Pettee; Conroy, Molly B.; Schmid, Kendra K.; Storti, Kristi L.; High, Robin R.; Underwood, Darcy A.; Kriska, Andrea M.; Kuller, Lewis H.

2011-01-01

Objective To determine whether changes in leisure time physical activity (LTPA) and body composition reflect concomitant changes in 400 m walk time. Methods Data were collected at the baseline and 48 month visits in Women on the Move through Activity and Nutrition Study. At baseline, participants (n=508) were randomized to the Lifestyle Intervention (LC) or Health Education (HE) group. The LC intervention focused on weight (7–10%) and waist circumference reduction through healthy lifestyle behavior change. Change in walk time over 48 months was the primary outcome. Secondary measures included change in LTPA and body composition measures including, body weight, BMI, waist circumference (WC), and dual energy x-ray absorptiometry-derived fat and lean mass. Results Increased LTPA and reductions in body weight, BMI, WC, and fat mass were associated with decreased walk time from baseline to 48 months (p<0.01). After stratification by group, LTPA was no longer significantly related to walk time in the HE group. Conclusions Increased LTPA and weight loss resulted in improved physical function, as measured by the 400 m walk, in a group of overweight, post-menopausal women. These findings support the utility of the 400 m walk to evaluate progress in physical activity or weight loss programs. PMID:21705864

The impact of weight and fat mass loss and increased physical activity on physical function in overweight, postmenopausal women: results from the Women on the Move Through Activity and Nutrition study.

PubMed

Gabriel, Kelley K Pettee; Conroy, Molly B; Schmid, Kendra K; Storti, Kristi L; High, Robin R; Underwood, Darcy A; Kriska, Andrea M; Kuller, Lewis H

2011-07-01

The aim of this study was to determine whether changes in leisure time physical activity (LTPA) and body composition reflect concomitant changes in 400-meter walk time. Data were collected at the baseline and 48-month visits in the Women on the Move Through Activity and Nutrition study. At baseline, participants (n = 508) were randomized to the lifestyle intervention or health education group. The lifestyle intervention focused on weight (7%-10%) and waist circumference reduction through healthy lifestyle behavior change. Change in walk time over 48 months was the primary outcome. Secondary measures included change in LTPA and body composition measures including, body weight, body mass index, waist circumference, and dual-energy x-ray absorptiometry--derived fat and lean mass. Increased LTPA and reductions in body weight, body mass index, waist circumference, and fat mass were associated with decreased walk time from baseline to 48 months (P < 0.01). After stratification by group, LTPA was no longer significantly related to walk time in the health education group. Increased LTPA and weight loss resulted in improved physical function, as measured by the 400-meter walk, in a group of overweight, postmenopausal women. These findings support the use of the 400-meter walk to evaluate progress in physical activity or weight loss programs.

Quality improvement in childhood obesity management through the maintenance of certification process.

PubMed

Huang, Jeannie S; Chun, Stanford; Sandhu, Amanpreet; Terrones, Laura

2013-11-01

To assess the Health and Obesity: Prevention and Education (HOPE) Curriculum Project, a web-based clinician education program that promotes appropriate screening, prevention, and management of weight among youth by pediatric practitioners, based on the 2007 Expert Committee recommendations. The project currently provides Maintenance of Certification (MOC) Part 4 credit through the American Board of Pediatrics. Participants identified themselves to the HOPE MOC Part 4 program. Enrollees were required to complete all continuing medical education modules (10.5 hours). Knowledge acquisition and self-reported confidence levels related to screening, prevention, and management practices of pediatric obesity were measured using preknowledge and postknowledge questionnaires. Participants were also required to perform a quality improvement project and submit practice performance data from repeated medical chart reviews over time. Knowledge acquisition, self-efficacy, and practice performance data were analyzed using repeated-measures analyses. The 51 participants demonstrated significant improvements in knowledge acquisition and self-efficacy scores after viewing individual modules. In addition, participants demonstrated significant improvements in measured clinical compliance with recommended practices over time. Participation in the HOPE MOC Part 4 program appeared to improve knowledge acquisition, self-efficacy, and physician compliance with recommended practice recommendations for the screening, prevention, and management of pediatric obesity. Further data are required to determine whether such practice-based improvements translate into actual reduction in patient weight and/or reduction in health-related costs related to overweight and obesity in youth. Copyright © 2013 Mosby, Inc. All rights reserved.

Predictors of long term weight loss maintenance in patients at high risk of type 2 diabetes participating in a lifestyle intervention program in primary health care: The DE-PLAN study.

PubMed

Gilis-Januszewska, Aleksandra; Barengo, Noël C; Lindström, Jaana; Wójtowicz, Ewa; Acosta, Tania; Tuomilehto, Jaakko; Schwarz, Peter E H; Piwońska-Solska, Beata; Szybiński, Zbigniew; Windak, Adam; Hubalewska-Dydejczyk, Alicja

2018-01-01

Lifestyle interventions in type 2 diabetes (DM2) prevention implementation studies can be effective and lasting. Long-term weight loss maintenance enhances the intervention effect through a significant decrease in diabetes incidence over time. Our objective was to identify factors predicting long-term successful weight reduction maintenance achieved during a DM2 prevention program in patients with high DM2 risk in primary health care. Study participants (n = 263), middle-aged, slightly obese with baseline increased DM2 risk (Finnish Diabetes Risk Score (FINDRISC)>14), but no diabetes were invited to receive 11 lifestyle counselling sessions, guided physical activity sessions and motivational support during 10-months. The study participants had three clinical examinations during the study (baseline, one and three years). Stepwise regression analysis was used to determine demographic, clinical, and lifestyle predictors of weight reduction maintenance two years after the discontinuation of the intervention. Out of 105 patients who completed all three examinations (baseline age 56.6 (standard deviation (SD) = 10.7), body mass index 31.1 kg/m2 (SD = 4.9), FINDRISC 18.6 (SD = 3.1)), 73 patients (70%) showed weight loss during the intervention (mean weight loss 4.2 kg, SD = 5.1). The total weight loss achieved in the maintainers (27 of 73 study participants) two years after the intervention had finished was 6.54 kg (4.47 kg+2.0 kg). The non-maintainers, on the other hand, returned to their initial weight at the start of the intervention (+0.21 kg). In multivariable analysis baseline history of increased glucose (odds ratio (OR) = 3.7; 95% confidence interval (CI) 1.0-13.6) and reduction of total fat in diet during follow-up (OR = 4.3; 95% CI 1.5-12.2) were independent predictors of successful weight loss. Further studies exploring predictors of weight loss maintenance in diabetes prevention are needed to help health care providers to redesign interventions and improve long-term outcomes of real life interventions.

Equivalent reductions in body weight during the Beef WISE Study: beef's role in weight improvement, satisfaction and energy.

PubMed

Sayer, R D; Speaker, K J; Pan, Z; Peters, J C; Wyatt, H R; Hill, J O

2017-09-01

The objective of this randomized equivalence trial was to determine the impact of consuming lean beef as part of a high protein (HP) weight-reducing diet on changes in body weight, body composition and cardiometabolic health. A total of 120 adults (99 female) with overweight or obesity (BMI: 35.7 ± 7.0 kg m -2 ) were randomly assigned to consume either a HP diet with ≥4 weekly servings of lean beef (B; n  = 60) or a HP diet restricted in all red meats (NB; n  = 60) during a 16-week weight loss intervention. Body weight was reduced by 7.8 ± 5.9% in B and 7.7 ± 5.5% in NB ( p  < 0.01 for both). Changes in percent body weight were equivalent between B and NB (mean difference: 0.06%, 90% confidence interval: (-1.7, 1.8)). Fat mass was reduced in both groups ( p  < 0.01; B: 8.0 ± 0.6 kg, NB: 8.6 ± 0.6 kg), while lean mass was not reduced in either group. Improvements in markers of cardiometabolic health (total cholesterol, low-density lipoprotein cholesterol, triglycerides and blood pressure) were not different between B and NB. Results of this study demonstrate that HP diets - either rich or restricted in red meat intakes - are effective for decreasing body weight and improving body composition and cardiometabolic health.

Simulated reductions in consumption of sugar-sweetened beverages improves dietary in Lower Mississippi Delta adults

USDA-ARS?s Scientific Manuscript database

While the effects of replacing sugar-sweetened beverages with water on energy intake and body weight have been reported, little is known about how these replacements affect diet quality. We simulated the effects of replacing sugar-sweetened beverages with tap water on the diet quality of Lower Miss...

Effects of walking or resistance training on weight loss maintenance in obese, middle-aged men: a randomized trial.

PubMed

Borg, P; Kukkonen-Harjula, K; Fogelholm, M; Pasanen, M

2002-05-01

To investigate whether walking or resistance training improves weight maintenance after weight loss when added to dietary counselling. Two months' weight reduction with very-low-energy-diet (VLED) followed by randomization into three groups (control, walking, resistance training) for 6 months' weight maintenance (WM) program and 23 months' unsupervised follow-up. During VLED and WM all groups received similar dietary counselling. The main inclusion criteria were BMI >30 kg/m(2), waist>100 cm and physical inactivity (exercise < or = once a week). Ninety healthy, obese (mean BMI 32.9 kg/m(2) and waist 112.5 cm), 35-50 y-old men started the study and 68 were measured at the end of the study. Weight and body composition assessed by underwater weighing. Exercise diaries and dietary records to assess energy balance. During VLED the mean body weight decreased from 106.0 (s.d. 9.9) kg to 91.7 (9.4) kg. Weight was regained mostly during follow-up and in the end of the study the mean weight in groups was 99.9-102.0 kg. Exercise training did not improve short or long-term weight maintenance when compared to the control group. However, resistance training attenuated the regain of body fat mass during WM (P=0.0l), but not during follow-up. In the combined groups the estimated total energy expenditure (EE) of reported physical activity was associated with less weight regain during WM. EE of 10.1 MJ/week was associated with maintaining weight after weight loss. EE of physical activity tended to decrease after WM in exercise groups due to poor long-term adherence to prescribed exercise. Energy intake seemed to increase during follow-up. Exercise training of moderate dose did not seem to improve long-term weight maintenance because of poor adherence to prescribed exercise.

Evaluation of a long-endurance-surveillance remotely-piloted vehicle with and without laminar flow control

NASA Technical Reports Server (NTRS)

Turriziani, R. V.; Lovell, W. A.; Price, J. E.; Quartero, C. B.; Washburn, S. F.

1979-01-01

Two aircraft were evaluated, using a derated TF34-GE-100 turbofan engine one with laminar flow control (LFC) and one without. The mission of the remotely piloted vehicles (RPV) is one of high-altitude loiter at maximum endurance. With the LFC system maximum mission time increased by 6.7 percent, L/D in the loiter phase improved 14.2 percent, and the minimum parasite drag of the wing was reduced by 65 percent resulting in a 37 percent reduction for the total airplane. Except for the minimum parasite drag of the wing, the preceding benefits include the offsetting effects of weight increase, suction power requirements, and drag of the wing-mounted suction pods. In a supplementary study using a scaled-down, rather than derated, version of the engine, on the LFC configuration, a 17.6 percent increase in mission time over the airplane without LFC and an incremental time increase of 10.2 percent over the LFC airplane with derated engine were attained. This improvement was due principally to reductions in both weight and drag of the scaled engine.

Vegetarian Diets in the Prevention and Management of Diabetes and Its Complications.

PubMed

Pawlak, Roman

2017-05-01

IN BRIEF Epidemiological studies have found a lower prevalence of type 2 diabetes among vegetarians compared to nonvegetarians. This reduced risk is likely a function of improved weight status, higher intake of dietary fiber, and the absence of animal protein and heme iron in the diet. Interventional studies have shown that vegetarian diets, especially a vegan diet, are effective tools in glycemic control and that these diets control plasma glucose to a greater level than do control diets, including diets traditionally recommended for patients with diabetes (e.g., diets based on carbohydrate counting). Vegetarian diets are associated with improvement in secondary outcomes such as weight reduction, serum lipid profile, and blood pressure. Studies indicate that vegetarian diets can be universally used in type 2 diabetes prevention and as tools to improve blood glucose management.

Vegetarian Diets in the Prevention and Management of Diabetes and Its Complications

PubMed Central

2017-01-01

IN BRIEF Epidemiological studies have found a lower prevalence of type 2 diabetes among vegetarians compared to nonvegetarians. This reduced risk is likely a function of improved weight status, higher intake of dietary fiber, and the absence of animal protein and heme iron in the diet. Interventional studies have shown that vegetarian diets, especially a vegan diet, are effective tools in glycemic control and that these diets control plasma glucose to a greater level than do control diets, including diets traditionally recommended for patients with diabetes (e.g., diets based on carbohydrate counting). Vegetarian diets are associated with improvement in secondary outcomes such as weight reduction, serum lipid profile, and blood pressure. Studies indicate that vegetarian diets can be universally used in type 2 diabetes prevention and as tools to improve blood glucose management. PMID:28588373

Walnut consumption in a weight reduction intervention: effects on body weight, biological measures, blood pressure and satiety.

PubMed

Rock, Cheryl L; Flatt, Shirley W; Barkai, Hava-Shoshana; Pakiz, Bilge; Heath, Dennis D

2017-12-04

Dietary strategies that help patients adhere to a weight reduction diet may increase the likelihood of weight loss maintenance and improved long-term health outcomes. Regular nut consumption has been associated with better weight management and less adiposity. The objective of this study was to compare the effects of a walnut-enriched reduced-energy diet to a standard reduced-energy-density diet on weight, cardiovascular disease risk factors, and satiety. Overweight and obese men and women (n = 100) were randomly assigned to a standard reduced-energy-density diet or a walnut-enriched (15% of energy) reduced-energy diet in the context of a behavioral weight loss intervention. Measurements were obtained at baseline and 3- and 6-month clinic visits. Participants rated hunger, fullness and anticipated prospective consumption at 3 time points during the intervention. Body measurements, blood pressure, physical activity, lipids, tocopherols and fatty acids were analyzed using repeated measures mixed models. Both study groups reduced body weight, body mass index and waist circumference (time effect p < 0.001 for each). Change in weight was -9.4 (0.9)% vs. -8.9 (0.7)% (mean [SE]), for the standard vs. walnut-enriched diet groups, respectively. Systolic blood pressure decreased in both groups at 3 months, but only the walnut-enriched diet group maintained a lower systolic blood pressure at 6 months. The walnut-enriched diet group, but not the standard reduced-energy-density diet group, reduced total cholesterol and low-density lipoprotein cholesterol (LDL-C) at 6 months, from 203 to 194 mg/dL and 121 to 112 mg/dL, respectively (p < 0.05). Self-reported satiety was similar in the groups. These findings provide further evidence that a walnut-enriched reduced-energy diet can promote weight loss that is comparable to a standard reduced-energy-density diet in the context of a behavioral weight loss intervention. Although weight loss in response to both dietary strategies was associated with improvements in cardiovascular disease risk factors, the walnut-enriched diet promoted more favorable effects on LDL-C and systolic blood pressure. The trial is registered at ( NCT02501889 ).

The effects of exercise-induced weight loss on appetite-related peptides and motivation to eat.

PubMed

Martins, C; Kulseng, B; King, N A; Holst, J J; Blundell, J E

2010-04-01

The magnitude of exercise-induced weight loss depends on the extent of compensatory responses. An increase in energy intake is likely to result from changes in the appetite control system toward an orexigenic environment; however, few studies have measured how exercise impacts on both orexigenic and anorexigenic peptides. The aim of the study was to investigate the effects of medium-term exercise on fasting/postprandial levels of appetite-related hormones and subjective appetite sensations in overweight/obese individuals. We conducted a longitudinal study in a university research center. Twenty-two sedentary overweight/obese individuals (age, 36.9 +/- 8.3 yr; body mass index, 31.3 +/- 3.3 kg/m(2)) took part in a 12-wk supervised exercise programme (five times per week, 75% maximal heart rate) and were requested not to change their food intake during the study. We measured changes in body weight and fasting/postprandial plasma levels of glucose, insulin, total ghrelin, acylated ghrelin (AG), peptide YY, and glucagon-like peptide-1 and feelings of appetite. Exercise resulted in a significant reduction in body weight and fasting insulin and an increase in AG plasma levels and fasting hunger sensations. A significant reduction in postprandial insulin plasma levels and a tendency toward an increase in the delayed release of glucagon-like peptide-1 (90-180 min) were also observed after exercise, as well as a significant increase (127%) in the suppression of AG postprandially. Exercise-induced weight loss is associated with physiological and biopsychological changes toward an increased drive to eat in the fasting state. However, this seems to be balanced by an improved satiety response to a meal and improved sensitivity of the appetite control system.

Reductions in knee joint forces with weight loss are attenuated by gait adaptations in class III obesity.

PubMed

DeVita, Paul; Rider, Patrick; Hortobágyi, Tibor

2016-03-01

A consensus exists that high knee joint forces are a precursor to knee osteoarthritis and weight loss reduces these forces. Because large weight loss also leads to increased step length and walking velocity, knee contact forces may be reduced less than predicted by the magnitude of weight loss. The purpose was to determine the effects of weight loss on knee muscle and joint loads during walking in Class III obese adults. We determined through motion capture, force platform measures and biomechanical modeling the effects of weight loss produced by gastric bypass surgery over one year on knee muscle and joint loads during walking at a standard, controlled velocity and at self-selected walking velocities. Weight loss equaling 412 N or 34% of initial body weight reduced maximum knee compressive force by 824 N or 67% of initial body weight when walking at the controlled velocity. These changes represent a 2:1 reduction in knee force relative to weight loss when walking velocity is constrained to the baseline value. However, behavioral adaptations including increased stride length and walking velocity in the self-selected velocity condition attenuated this effect by ∼50% leading to a 392 N or 32% initial body weight reduction in compressive force in the knee joint. Thus, unconstrained walking elicited approximately 1:1 ratio of reduction in knee force relative to weight loss and is more indicative of walking behavior than the standard velocity condition. In conclusion, massive weight loss produces dramatic reductions in knee forces during walking but when patients stride out and walk faster, these favorable reductions become substantially attenuated. Copyright © 2016 Elsevier B.V. All rights reserved.

Body contouring surgery following bariatric surgery and dietetically induced massive weight reduction: a risk analysis.

PubMed

de Kerviler, S; Hüsler, R; Banic, A; Constantinescu, M A

2009-05-01

This study analyzed the impact of weight reduction method, preoperative, and intraoperative variables on the outcome of reconstructive body contouring surgery following massive weight reduction. All patients presenting with a maximal BMI >/=35 kg/m(2) before weight reduction who underwent body contouring surgery of the trunk following massive weight loss (excess body mass index loss (EBMIL) >/= 30%) between January 2002 and June 2007 were retrospectively analyzed. Incomplete records or follow-up led to exclusion. Statistical analysis focused on weight reduction method and pre-, intra-, and postoperative risk factors. The outcome was compared to current literature results. A total of 104 patients were included (87 female and 17 male; mean age 47.9 years). Massive weight reduction was achieved through bariatric surgery in 62 patients (59.6%) and dietetically in 42 patients (40.4%). Dietetically achieved excess body mass index loss (EBMIL) was 94.20% and in this cohort higher than surgically induced reduction EBMIL 80.80% (p < 0.01). Bariatric surgery did not present increased risks for complications for the secondary body contouring procedures. The observed complications (26.9%) were analyzed for risk factors. Total tissue resection weight was a significant risk factor (p < 0.05). Preoperative BMI had an impact on infections (p < 0.05). No impact on the postoperative outcome was detected in EBMIL, maximal BMI, smoking, hemoglobin, blood loss, body contouring technique or operation time. Corrective procedures were performed in 11 patients (10.6%). The results were compared to recent data. Bariatric surgery does not increase risks for complications in subsequent body contouring procedures when compared to massive dietetic weight reduction.

Random matrix theory filters and currency portfolio optimisation

NASA Astrophysics Data System (ADS)

Daly, J.; Crane, M.; Ruskin, H. J.

2010-04-01

Random matrix theory (RMT) filters have recently been shown to improve the optimisation of financial portfolios. This paper studies the effect of three RMT filters on realised portfolio risk, using bootstrap analysis and out-of-sample testing. We considered the case of a foreign exchange and commodity portfolio, weighted towards foreign exchange, and consisting of 39 assets. This was intended to test the limits of RMT filtering, which is more obviously applicable to portfolios with larger numbers of assets. We considered both equally and exponentially weighted covariance matrices, and observed that, despite the small number of assets involved, RMT filters reduced risk in a way that was consistent with a much larger S&P 500 portfolio. The exponential weightings indicated showed good consistency with the value suggested by Riskmetrics, in contrast to previous results involving stocks. This decay factor, along with the low number of past moves preferred in the filtered, equally weighted case, displayed a trend towards models which were reactive to recent market changes. On testing portfolios with fewer assets, RMT filtering provided less or no overall risk reduction. In particular, no long term out-of-sample risk reduction was observed for a portfolio consisting of 15 major currencies and commodities.

Effect of caloric restriction on gut permeability, inflammation markers, and fecal microbiota in obese women.

PubMed

Ott, Beate; Skurk, Thomas; Hastreiter, Ljiljana; Lagkouvardos, Ilias; Fischer, Sandra; Büttner, Janine; Kellerer, Teresa; Clavel, Thomas; Rychlik, Michael; Haller, Dirk; Hauner, Hans

2017-09-20

Recent findings suggest an association between obesity, loss of gut barrier function and changes in microbiota profiles. Our primary objective was to examine the effect of caloric restriction and subsequent weight reduction on gut permeability in obese women. The impact on inflammatory markers and fecal microbiota was also investigated. The 4-week very-low calorie diet (VLCD, 800 kcal/day) induced a mean weight loss of 6.9 ± 1.9 kg accompanied by a reduction in HOMA-IR (Homeostasis model assessment-insulin resistance), fasting plasma glucose and insulin, plasma leptin, and leptin gene expression in subcutaneous adipose tissue. Plasma high-molecular weight adiponectin (HMW adiponectin) was significantly increased after VLCD. Plasma levels of high-sensitivity C-reactive protein (hsCRP) and lipopolysaccharide-binding protein (LBP) were significantly decreased after 28 days of VLCD. Using three different methods, gut paracellular permeability was decreased after VLCD. These changes in clinical parameters were not associated with major consistent changes in dominant bacterial communities in feces. In summary, a 4-week caloric restriction resulted in significant weight loss, improved gut barrier integrity and reduced systemic inflammation in obese women.

Does dairy calcium intake enhance weight loss among overweight diabetic patients?

PubMed

Shahar, Danit R; Abel, Relly; Elhayany, Asher; Vardi, Hillel; Fraser, Drora

2007-03-01

To examine the effect of dairy calcium consumption on weight loss and improvement in cardiovascular disease (CVD) and diabetes indicators among overweight diabetic patients. This was an ancillary study of a 6-month randomized clinical trial assessing the effect of three isocaloric diets in type 2 diabetic patients: 1) mixed glycemic index carbohydrate diet, 2) low-glycemic index diet, and 3) modified Mediterranean diet. Low-fat dairy product consumption varied within and across the groups by personal choice. Dietary intake, weight, CVD risk factors, and diabetes indexes were measured at baseline and at 6 months. A total of 259 diabetic patients were recruited with an average BMI >31 kg/m2 and mean age of 55 years. No difference was found at baseline between the intervention groups in CVD risk factors, diabetes indicators, macronutrient intake, and nutrient intake from dairy products. Dairy calcium intake was associated with percentage of weight loss. Among the high tertile of dairy calcium intake, the odds ratio for weight loss of >8% was 2.4, P = 0.04, compared with the first tertile, after controlling for nondairy calcium intake, diet type, and the change in energy intake from baseline. No association was noted between dairy calcium and other health indexes except for triglyceride levels. A diet rich in dairy calcium intake enhances weight reduction in type 2 diabetic patients. Such a diet could be tried in diabetic patients, especially those with difficulty adhering to other weight reduction diets.

Effects of sodium bicarbonate and albumin on the in vitro water-holding capacity and some physiological properties of Trigonella foenum graecum L. galactomannan in rats.

PubMed

Dakam, William; Shang, Judith; Agbor, Gabriel; Oben, Julius

2007-03-01

This study seeks to improve the beneficial effects of fenugreek (Trigonella foenum graecum L.) galactomannan (GM) in lowering the plasma lipid profile and weight. Three different combinations of diets were prepared with fenugreek GM--(a) fenugreek GM + water (GM); (b) fenugreek GM + sodium bicarbonate (GMB); and (c) fenugreek GM + bicarbonate + albumin (GMBA)--and their in vitro water retention capacity and in vivo lipid-lowering effect were studied. Distilled water and sodium bicarbonate were used as controls. The sodium bicarbonate significantly increased the in vitro water-holding capacity of fenugreek GM (49.1 +/- 8.7 vs. 21.6 +/- 0.9 g of water/g of dry weight, P < .01). Administration by oral intubation of the combination GMBA to male albino Wistar rats (250 mg/kg of body weight) over a 4-week period was the most effective in reducing body weight (-27.0 +/- 0.4%, P < .001). Within this period, the combinations GMBA and GMB brought about the most significant reduction in the levels of plasma total cholesterol (P < .005). The GMBA combination was also the most effective in reducing levels of plasma low-density lipoprotein cholesterol (P < .001) and the atherogenicity indices. GM, GMB, and GMBA brought about significant (P < .01, .001, and .001, respectively) increases in the plasma high-density lipoprotein cholesterol levels, with the highest increase coming with GMBA. A significant increase in plasma triglycerides (P < .05) was brought about by the GMBA combination, probably resulting from the rapid reduction of body weight observed. Food intake was reduced by GM, GMB, and GMBA, while water intake increased in that order. The GMB combination significantly reduced transit time (P < .01) compared to GM. On the other hand, GMB and GMBA improved glycemic control, compared to GM. We conclude that albumin and sodium bicarbonate have the ability to improve some beneficial physiological effects of fenugreek GM. This finding could have applications in the areas of human obesity, weight loss, and the control of blood lipids.

Efficacy of a novel herbal formulation for weight loss demonstrated in a 16-week randomized, double-blind, placebo-controlled clinical trial with healthy overweight adults.

PubMed

Dixit, Kashinath; Kamath, Dinesh Venkata; Alluri, Krishnaraju Venkata; Davis, Barbara A

2018-06-19

LI85008F is a novel, proprietary herbal blend containing extracts of Moringa oleifera and Murraya koeingii leaves plus extract of Curcuma longa root. Weight loss efficacy of LI85008F was first demonstrated in obese adults and has now been re-evaluated in healthy overweight adults via a 16-week randomized, double-blind, placebo-controlled clinical study. One hundred and forty overweight participants (Body mass index 27 to 29.9 kg/m 2 , 29.3% male; ages 21-50 years) were randomized into placebo (n = 70) and LI85008F (n = 70) groups. The participants received either 900 mg/day of LI85008F in two divided doses or two identical placebo capsules. In addition, participants were counseled to follow approximately 1800 kcal/day diet and to engage in walking for 30 min, 5 days/week throughout the study. At the end of the trial period, the LI85008F supplemented group showed significant reductions in body weight (5.36±1.769 vs. 0.87±1.381kg; p<0.0001) and BMI (2.05±0.693 vs. 0.34 ±0.559 kg/m 2 ; p<0.0001), compared with placebo. Significant reductions in waist and hip circumferences, and a 2.08-fold reduction of waist/hip ratio, were noted in the LI85008F supplemented group. LI85008F supplementation also resulted in significant improvements in lipid profiles, compared with the placebo; LDL cholesterol decreased, while HDL cholesterol increased, resulting in a significantly improved LDL/HDL ratio. No major adverse events were reported by the participants in the study duration. The unique herbal extract blend LI85008F, combined with modest calorie restriction and physical activity, is well-tolerated, safe, and effective for weight management in overweight men and women. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

[Educational nutritional intervention as an effective tool for changing eating habits and body weight among those who practice physical activities].

PubMed

Teixeira, Pryscila Dryelle Sousa; Reis, Bruna Zavarize; Vieira, Diva Aliete dos Santos; Costa, Dayanne da; Costa, Jamille Oliveira; Raposo, Oscar Felipe Falcão; Wartha, Elma Regina Silva de Andrade; Netto, Raquel Simões Mendes

2013-02-01

The scope of this study was to evaluate the effectiveness of two methods of educational nutritional intervention together with women who practice regular physical activities by fostering the adoption of healthy eating habits. The study population consisted of 52 women aged between 19 and 59 who frequented the Academia da Cidade Program in Aracaju in the State of Sergipe. The study was a randomized comparison of two intervention groups and was of the pre-test/post-test variety. The educational activities were based on two protocols - one less intensive (P1 Group) and one more intensive (P2 Group) - over a period of two months. The variables analyzed were nutritional knowledge, anthropometric measurements and changes in eating habits. The changes identified were improvement in eating habits and reduction in weight and Body Mass Index for the P2 group. The modifications identified referred mainly to increased consumption of fruit and vegetables, reduction of fat in cooking, reduction in the volume of food eaten per meal and increased meal frequency. In relation to nutritional knowledge, only 2 of the 12 questions showed significant changes. The most intensive method proved effective in changing dietary habits leading to weight loss.

Application of composites to the selective reinforcement of metallic aerospace structures. [application of structural design criteria for weight reduction

NASA Technical Reports Server (NTRS)

Brooks, W. A., Jr.; Mathauser, E. E.; Pride, R. A.

1972-01-01

The use of composite materials to selectively reinforce metallic structures provides a low-cost way to reduce weight and a means of minimizing the risks usually associated with the introduction of new materials. An overview is presented of the NASA Langley Research Center programs to identify the advantages and to develop the potential of the selective reinforcement approach to the use of composites. These programs have shown that selective reinforcement provides excellent strength and stiffness improvements to metallic structures. Significant weight savings can be obtained in a cost effective manner. Flight service programs which have been initiated to validate further the merits of selective reinforcement are described.

Multifactorial intervention for children with asthma and overweight (Mikado): study design of a randomised controlled trial.

PubMed

Willeboordse, Maartje; van de Kant, Kim D G; de Laat, Maroeska N; van Schayck, Onno C P; Mulkens, Sandra; Dompeling, Edward

2013-05-21

In children, the prevalence's of both obesity and asthma are disconcertingly high. Asthmatic children with obesity are characterised by less asthma control and a high need for asthma medication. As the obese asthmatic child is becoming more common in the clinical setting and the disease burden of the asthma-obesity phenotype is high, there is an increasing need for effective treatment in these children. In adults, weight reduction resulted in improved lung function, better asthma control and less need for asthma medication. In children this is hardly studied. The Mikado study aims to evaluate the effectiveness of a long term multifactorial weight reduction intervention, on asthma characteristics in children with asthma and a high body weight. The Mikado study is a two-armed, randomised controlled trial. In total, 104 participants will be recruited via online questionnaires, pulmonary paediatricians, the youth department of the Municipal Health Services and cohorts of existing studies. All participants will be aged 6-16 years, will have current asthma, a Body Mass Index in the overweight or obesity range, and no serious comorbidities (such as diabetes, heart diseases). Participants in the intervention arm will receive a multifactorial intervention of 18 months consisting of sessions concerning sports, parental involvement, individual counselling and lifestyle advices including dietary advices and cognitive behavioural therapy. The control group will receive usual care. The primary outcome variables will include Forced Expiratory Volume in one second and Body Mass Index - Standard Deviation Score. Secondary outcomes will include other lung function parameters (including dynamic and static lung function parameters), asthma control, asthma-specific quality of life, use of asthma medication and markers of systemic inflammation and airway inflammation. In this randomised controlled trial we will study the potential of a multifactorial weight reduction intervention to improve asthma-related outcome measures in asthmatic children with overweight. Moreover, it will provide information about the underlying mechanisms in the relationship between asthma and a high body weight in children. These findings can contribute to optimal management programs and better clinical guidelines for children with asthma and overweight. Clinicaltrial.gov NCT00998413.

Lifestyle intervention reduces body weight and improves cardiometabolic risk factors in worksites.

PubMed

Salinardi, Taylor C; Batra, Payal; Roberts, Susan B; Urban, Lorien E; Robinson, Lisa M; Pittas, Anastassios G; Lichtenstein, Alice H; Deckersbach, Thilo; Saltzman, Edward; Das, Sai Krupa

2013-04-01

Worksites are potentially effective locations for obesity control because they provide opportunities for group intervention and social support. Studies are needed to identify effective interventions in these settings. We examined the effects of a multicomponent lifestyle intervention on weight loss and prevention of regain in 4 worksites (2 intervention and 2 control sites). Overweight and obese employees (n = 133) enrolled in this pilot worksite-randomized controlled trial with a 0-6-mo weight-loss phase and a 6-12-mo structured weight-maintenance phase. The intervention combined recommendations to consume a reduced-energy, low-glycemic load, high-fiber diet with behavioral change education. Outcome measurements included changes in body weight and cardiometabolic risk factors. The mean ± SEM weight loss was substantial in intervention participants, whereas control subjects gained weight (-8.0 ± 0.7 compared with +0.9 ± 0.5 kg, respectively; P < 0.001), and 89% of participants completed the weight-loss phase. Intervention effects were not significant at the 0.05 level but would have been at the 0.10 level (P = 0.08) in a mixed model in which the worksite nested within group was a random factor. There were also significant improvements in cardiometabolic risk factors in intervention compared with control subjects regarding fasting total cholesterol, glucose, systolic blood pressure, and diastolic blood pressure (P ≤ 0.02 for each). No significant weight regain was observed in participants who enrolled in the structured weight-maintenance program (0.5 ± 0.7 kg; P = 0.65), and overweight and obese employees in intervention worksites who were not enrolled in the weight-loss program lost weight compared with subjects in control worksites (-1.3 ± 0.5 compared with +0.7 ± 0.2 kg, respectively; P = 0.02). Worksites can be effective for achieving clinically important reductions in body weight and improved cardiometabolic risk factors. This trial was registered at clinicaltrials.gov as NCT01470222.

Contrasting Sleeve Gastrectomy with Lifestyle Modification Therapy in the Treatment of Polycystic Ovary Syndrome.

PubMed

Wang, Kaijing; Jiang, Qixin; Zhi, Yunqing; Zhu, Zhe; Zhou, Zhuqing; Xie, Yanting; Yin, Xiaoqi; Lu, Aiguo

2015-06-01

To explore the feasibility of sleeve gastrectomy (SG) as a treatment for polycystic ovary syndrome (PCOS) and its potential to improve clinical efficacy in PCOS patients with symptoms of oligomenorrhea. Twenty-four obese patients with PCOS underwent laparoscopic SG. Simultaneously, 24 obese patients with PCOS received lifestyle modification therapy (LMT). Follow-ups were conducted at 3-6 months. Weight loss, menstruation, and improvements in hirsutism and metabolic symptoms were compared. In the SG group, 20 patients were restored to normal menstrual cycles and ovulation at 3-6 months after surgery. Their average androgen levels decreased significantly following surgery (P=.012). Conversely, only 6 patients in the LMT group were restored to normal menstrual cycles and ovulation after receiving 3 months of treatment. Their average preoperative and postoperative androgen levels showed a nonstatistically significant decrease (P>.05). Compared with the LMT group, the SG group showed more pronounced improvements in menstruation. Additionally, body mass and body mass index were significantly reduced in patients in the SG group 3 months after the surgeries, with maximum weight loss observed at approximately 6 months after surgery. Patients who received LMT showed a gradual weight reduction such that body mass decreased significantly after 3 months (P<. 001). Compared with patients in the LMT group, patients in the SG group showed greater weight loss results (P<.0001). In patients with PCOS, SG resulted in more marked weight loss and better improvements in clinical symptoms compared with LMT.

Management of diabetes across the course of disease: minimizing obesity-associated complications.

PubMed

Apovian, Caroline M

2011-01-01

Obesity increases the risk for developing type 2 diabetes mellitus (T2DM) and this in turn correlates with an elevated probability of long-term diabetes complications once diabetes is established. Interventions aimed at lowering weight via changes in diet and lifestyle have repeatedly been shown to improve glycemic control in patients with T2DM and even to reverse early disease. Weight gain, a potential side effect of treatment for patients with T2DM, is also an important concern, and it has been noted that weight increases associated with antidiabetes therapy may blunt cardiovascular risk reductions achieved by decreasing blood glucose. Among older agents, metformin and acarbose have the lowest risk for weight gain, while sulfonylureas, meglitinides, and thiazolidinediones are all associated with weight increases. Clinical trial results have also consistently demonstrated that treatment with glucagon-like peptide-1 receptor agonists and amylin lowers weight, and that dipeptidyl peptidase-4 inhibitors are weight neutral in patients with T2DM. Conventional human insulin formulations are known to increase weight in patients with T2DM. However, some insulin analogs, particularly insulin detemir, have lower liability for this adverse event. The use of both pharmacologic and surgical therapies aimed at treating obesity rather than lowering blood glucose have the potential to improve glycemic control and even resolve T2DM in some patients.

Effects of fine particulate matter and its constituents on low birth weight among full-term infants in California

DOE Office of Scientific and Technical Information (OSTI.GOV)

Basu, Rupa, E-mail: Rupa.Basu@oehha.ca.gov; Harris, Maria; Sie, Lillian

Relationships between prenatal exposure to fine particles (PM{sub 2.5}) and birth weight have been observed previously. Few studies have investigated specific constituents of PM{sub 2.5}, which may identify sources and major contributors of risk. We examined the effects of trimester and full gestational prenatal exposures to PM{sub 2.5} mass and 23 PM{sub 2.5} constituents on birth weight among 646,296 term births in California between 2000 and 2006. We used linear and logistic regression models to assess associations between exposures and birth weight and risk of low birth weight (LBW; <2500 g), respectively. Models were adjusted for individual demographic characteristics, apparentmore » temperature, month and year of birth, region, and socioeconomic indicators. Higher full gestational exposures to PM{sub 2.5} mass and several PM{sub 2.5} constituents were significantly associated with reductions in term birth weight. The largest reductions in birth weight were associated with exposure to vanadium, sulfur, sulfate, iron, elemental carbon, titanium, manganese, bromine, ammonium, zinc, and copper. Several of these PM{sub 2.5} constituents were associated with increased risk of term LBW. Reductions in birth weight were generally larger among younger mothers and varied by race/ethnicity. Exposure to specific constituents of PM{sub 2.5}, especially traffic-related particles, sulfur constituents, and metals, were associated with decreased birth weight in California. -- Highlights: • Examine full gestational and trimester fine particle and its constituents on term birth weight. • Fine particles and several of its constituents associated with birth weight reductions. • Largest reductions for traffic-related particles, sulfur constituents, and metals. • Greater birth weight reductions for younger mothers, and varied by race/ethnicity.« less

Associations between weight change and biomarkers of cardiometabolic risk in South Asians: secondary analyses of the PODOSA Trial

PubMed Central

Welsh, Paul; Cezard, Genevieve; Gill, Jason M.R.; Wallia, Sunita; Douglas, Anne; Sheikh, Aziz; Wild, Sarah H.; Tuomilehto, Jaakko; McKnight, John; Murray, Gordon; Bhopal, Raj; Lean, Mike; Sattar, Naveed

2016-01-01

Background/Objectives The association of weight changes with cardiometabolic biomarkers in South Asians has been sparsely studied. Subjects/Methods We measured cardiometabolic biomarkers at baseline and after 3 years in the Prevention of Diabetes and Obesity in South Asians (PODOSA) Trial. We investigated the effect of a lifestyle intervention on biomarkers in the randomised groups. In addition, treating the population as a single cohort, we estimated the association between change in weight and change in biomarkers. Results Complete data were available at baseline and 3 years in 151 participants. At 3 years there was an adjusted mean reduction of 1·44kg (95% CI 0.18 to 2.71) in weight and 1.59cm (95% CI 0.08 to 3.09) in waist circumference in the intervention, compared with control, arm. There was no clear evidence of difference between intervention and control arms in change of mean value of any biomarker. As a single cohort, every 1kg weight reduction during follow-up was associated with a reduction in triglycerides (−1.3%, p=0.048), ALT (−2.5%, p=0.032), GGT (−2.2%, p=0.040), leptin (−6.5%, p<0.0001), insulin (−3.7% p<0.001), fasting glucose (−0.8%, p<0.001), 2-hour glucose (−2.3%, p<0.001) and HOMA-IR (−4.5%, p<0.001).There was no evidence of associations with other lipid measures, t-PA, markers of inflammation, or blood pressure. Conclusions We demonstrate that modest weight decrease in SAs is associated with improvements in markers of total and ectopic fat as well as insulin resistance and glycaemia in South Asians at risk of diabetes. Future trials with more intensive weight change are needed to extend these findings. PMID:26927315

Associations between weight change and biomarkers of cardiometabolic risk in South Asians: secondary analyses of the PODOSA trial.

PubMed

Welsh, P; Cezard, G; Gill, J M; Wallia, S; Douglas, A; Sheikh, A; Wild, S H; Tuomilehto, J; McKnight, J; Murray, G; Bhopal, R; Lean, M E; Sattar, N

2016-06-01

The association of weight changes with cardiometabolic biomarkers in South Asians has been sparsely studied. We measured cardiometabolic biomarkers at baseline and after 3 years in the Prevention of Diabetes and Obesity in South Asians Trial. We investigated the effect of a lifestyle intervention on biomarkers in the randomized groups. In addition, treating the population as a single cohort, we estimated the association between change in weight and change in biomarkers. Complete data were available at baseline and after 3 years in 151 participants. At 3 years, there was an adjusted mean reduction of 1·44 kg (95% confidence interval (95% CI): 0.18-2.71) in weight and 1.59 cm (95% CI: 0.08-3.09) in waist circumference in the intervention arm as compared with the control arm. There was no clear evidence of difference between the intervention and control arms in change of mean value of any biomarker. As a single cohort, every 1 kg weight reduction during follow-up was associated with a reduction in triglycerides (-1.3%, P=0.048), alanine aminotransferase (-2.5%, P=0.032), gamma-glutamyl transferase (-2.2%, P=0.040), leptin (-6.5%, P<0.0001), insulin (-3.7%, P=0.0005), fasting glucose (-0.8%, P=0.0071), 2-h glucose (-2.3%, P=0.0002) and Homeostatic Model Assessment of insulin resistance (HOMA-IR: -4.5%, P=0.0002). There was no evidence of associations with other lipid measures, tissue plasminogen activator, markers of inflammation or blood pressure. We demonstrate that modest weight decrease in SAs is associated with improvements in markers of total and ectopic fat as well as insulin resistance and glycaemia in South Asians at risk of diabetes. Future trials with more intensive weight change are needed to extend these findings.

Weight loss on an energy-restricted, low-fat, sugar-containing diet in overweight sedentary men.

PubMed

Drummond, Sandra; Dixon, Kathryn; Griffin, Jane; De Looy, Anne

2004-06-01

With the increasing prevalence of obesity in the United Kingdom, the search for an effective weight reducing diet is a priority in helping to reverse this trend. A 12-week dietary intervention study was carried out to test the effectiveness of an energy-restricted, low-fat, sugar-containing diet on weight loss in sedentary overweight men. The study also aimed to assess eating behaviour, to measure change in attitude towards sugar-containing foods and to measure the impact of the study on perceived quality of life. Subjects were recruited from three UK cities; Edinburgh, Birmingham and London. Seventy-six men, aged between 25 and 60 years, completed the study. Baseline diets were assessed by a 7-day diet diary. Compliance to the subsequent dietary advice was measured on four occasions post intervention, by 4-day diaries. Measures of body weight status were also monitored. Eating behaviour, attitudes towards sugar-containing foods and quality of life were assessed by questionnaire. Significant reductions in body weight (5.2%), body fat (11.2%) and waist:hip ratio (3%) were observed following reported dietary changes that included a reduction in reported energy intake of 3.2 MJ/day (770 kcal/day), a reduction in the percent energy from fat (from 38.1% to 26.2%), an increase in the percent energy from total carbohydrate (from 44.4% to 54%) and from protein (from 17.3% to 20.6%). Subjects scored relatively highly for dietary restraint and emotional eating, and were strongly influenced by external eating cues. On completion of the 12-week study, subjects had a more positive attitude towards sugar-containing foods and perceived an improved quality of life. It is concluded, therefore, that including sugar-containing foods in a weight-reducing diet may be an effective strategy to achieve a palatable, low-fat, high-carbohydrate diet, which promotes weight loss in overweight individuals.

Intramedullary osteosynthesis versus plate osteosynthesis in subtrochanteric fractures.

PubMed

Burnei, C; Popescu, Gh; Barbu, D; Capraru, F

2011-11-14

Due to an ever-aging population and a growing prevalence of osteoporosis and motor vehicle accidents, the number of subtrochanteric fractures is increasing worldwide. The choice of the appropriate implant continues to be critical for fixation of unstable hip fractures. The subtrochanteric region has certain anatomical and biomechanical features that can make fractures in this region difficult to treat. The preferred type of device is a matter of debate. Increased understandings of biomechanical characteristics of the hip and improvement of the implant materials have reduced the incidence of complications. The surgeons choose between the two methods according to Seinsheimer's classification and also to their personal preferences. As a general principle, the open reduction and internal fixation were performed in stable fractures, and the closed reduction and internal fixation were performed in unstable fractures. The advantages of intramedullary nailing consist in a small skin incision, lower operating times, preservation of fracture hematoma and the possibility of early weight bearing. The disadvantages consist in a difficult closed reduction due to important muscular forces, although the nail can be used as a reduction instrument, and higher implant cost. In open reduction internal fixation techniques, the advantage is represented by anatomical reduction which, in our opinion, is not necessary. The disadvantages are represented by: higher operating time, demanding surgery, large devascularization, higher infection rates, late weight bearing, medial instability, refracture after plate removal and inesthetic approach.

Intramedullary osteosynthesis versus plate osteosynthesis in subtrochanteric fractures

PubMed Central

Burnei, C; Popescu, Gh; Barbu, D; Capraru, F

2011-01-01

Due to an ever-aging population and a growing prevalence of osteoporosis and motor vehicle accidents, the number of subtrochanteric fractures is increasing worldwide. The choice of the appropriate implant continues to be critical for fixation of unstable hip fractures. The subtrochanteric region has certain anatomical and biomechanical features that can make fractures in this region difficult to treat. The preferred type of device is a matter of debate. Increased understandings of biomechanical characteristics of the hip and improvement of the implant materials have reduced the incidence of complications. The surgeons choose between the two methods according to Seinsheimer's classification and also to their personal preferences. As a general principle, the open reduction and internal fixation were performed in stable fractures, and the closed reduction and internal fixation were performed in unstable fractures. The advantages of intramedullary nailing consist in a small skin incision, lower operating times, preservation of fracture hematoma and the possibility of early weight bearing. The disadvantages consist in a difficult closed reduction due to important muscular forces, although the nail can be used as a reduction instrument, and higher implant cost. In open reduction internal fixation techniques, the advantage is represented by anatomical reduction which, in our opinion, is not necessary. The disadvantages are represented by: higher operating time, demanding surgery, large devascularization, higher infection rates, late weight bearing, medial instability, refracture after plate removal and inesthetic approach. PMID:22514563

Impact of smoke-free legislation on perinatal and infant mortality: a national quasi-experimental study

PubMed Central

Been, Jasper V; Mackay, Daniel F; Millett, Christopher; Pell, Jill P; van Schayck, Onno CP; Sheikh, Aziz

2015-01-01

Smoke-free legislation is associated with improved early-life outcomes; however its impact on perinatal survival is unclear. We linked individual-level data with death certificates for all registered singletons births in England (1995–2011). We used interrupted time series logistic regression analysis to study changes in key adverse perinatal events following the July 2007 national, comprehensive smoke-free legislation. We studied 52,163 stillbirths and 10,238,950 live-births. Smoke-free legislation was associated with an immediate 7.8% (95%CI 3.5–11.8; p < 0.001) reduction in stillbirth, a 3.9% (95%CI 2.6–5.1; p < 0.001) reduction in low birth weight, and a 7.6% (95%CI 3.4–11.7; p = 0.001) reduction in neonatal mortality. No significant impact on SIDS was observed. Using a counterfactual scenario, we estimated that in the first four years following smoke-free legislation, 991 stillbirths, 5,470 cases of low birth weight, and 430 neonatal deaths were prevented. In conclusion, smoke-free legislation in England was associated with clinically important reductions in severe adverse perinatal outcomes. PMID:26268789

Predictors of health-related quality of life changes after lifestyle intervention in persons at risk of type 2 diabetes mellitus.

PubMed

Nilsen, Vegard; Bakke, Per Sigvald; Rohde, Gudrun; Gallefoss, Frode

2014-11-01

To assess health-related quality of life (HRQOL) of subjects at risk of type 2 diabetes undergoing lifestyle intervention, and predictors for improved HRQOL. The Finnish Diabetes Risk Score was used by general practitioners to identify individuals at risk. Low-intensity interventions with an 18-month follow-up were employed. HRQOL was assessed using the SF-36 at baseline and compared with results from a general Norwegian population survey and further at 6 and 18 months. Simple and multiple linear regression analyses were applied to identify predictors of changes in HRQOL of clinical importance. Two hundred and thirteen participants (50 % women; mean age: 46 years, mean body mass index: 37) were included: 182 returned for 18-month follow-up, of whom 172 completed the HRQOL questionnaire. HRQOL was reduced with clinical significance compared with general Norwegians. The mean changes in HRQOL from the baseline to the follow-up were not of clinical importance. However, one out of three individuals achieved a moderate or large clinical improvement in HRQOL. The best determinant for improved HRQOL was obtained for a composite, clinically significant lifestyle change, i.e. both a weight reduction of at least 5 % and an improvement in exercise capacity of at least 10 %, which was associated with an improvement in five out of the eight SF-36 domains. Subjects at risk of type 2 diabetes report a clinically important reduction in HRQOL compared with general Norwegians. The best predictor of improved HRQOL was a small weight loss combined with a small improvement in aerobic capacity.

Application of Analytic Hierarchy Process (AHP) in the analysis of the fuel efficiency in the automobile industry with the utilization of Natural Fiber Polymer Composites (NFPC)

NASA Astrophysics Data System (ADS)

Jayamani, E.; Perera, D. S.; Soon, K. H.; Bakri, M. K. B.

2017-04-01

A systematic method of material analysis aiming for fuel efficiency improvement with the utilization of natural fiber reinforced polymer matrix composites in the automobile industry is proposed. A multi-factor based decision criteria with Analytical Hierarchy Process (AHP) was used and executed through MATLAB to achieve improved fuel efficiency through the weight reduction of vehicular components by effective comparison between two engine hood designs. The reduction was simulated by utilizing natural fiber polymer composites with thermoplastic polypropylene (PP) as the matrix polymer and benchmarked against a synthetic based composite component. Results showed that PP with 35% of flax fiber loading achieved a 0.4% improvement in fuel efficiency, and it was the highest among the 27 candidate fibers.

Lung volume reduction surgery in bronchopulmonary dysplasia.

PubMed

Siaplaouras, J; Heckmann, M; Reiss, I; Schaible, T; Waag, K L; Gortner, L

2003-06-01

We report on a female preterm infant of 29 wk gestational age, who developed acquired lobar emphysema after prolonged artificial ventilation secondary to respiratory disease syndrome and bronchopulmonary dysplasia. The infant underwent atypical segmentectomy at the age of 12 mo because of life-threatening hypoxaemia with pulmonary hypertension and failure of conservative treatment. Lung volume reduction surgery (LVRS) dramatically improved the respiratory function and resulted in adequate weight gain and psychomotor development. In selected cases LVRS can be an option for lobar emphysema in premature infants with severe bronchopulmonary dysplasia.

Automotive battery energy density — past, present and future

NASA Astrophysics Data System (ADS)

Peters, K.

Energy and power densities of automotive batteries at engine starting rates have doubled over the past twenty years. Most recent improvements can be credited to the use of both very thin plates with optimized grid design and low-resistance polyethylene separators with a thin backweb and a reduced rib height. Opportunities for further improvements using the same design approach and similar processing techniques are limited. The effect of some recent innovative developments on weight reduction and performance improvement are reviewed, together with possible changes to the electrical system of vehicles.

Improving the breed - Shuttle development

NASA Technical Reports Server (NTRS)

Brand, V.

1985-01-01

An evaluation is made of design improvements that have been made to the Space Shuttle System, and the performance gains obtained; the most important of these stem from efforts to refine procedures for rendezvous with stricken satellites, in order to repair them. Ascent performance has been improved through Space Shuttle Main Engine thrust improvements and external tank weight reductions. On-orbit living convenience has been enhanced by the addition of small sleeping compartments and a galley. Greater flexibility has been obtained for reentry and landing maneuvers. Attention is given to problems which continue to be posed by the thermal protection tiles.

AN ASSESSMENT OF MCNP WEIGHT WINDOWS

DOE Office of Scientific and Technical Information (OSTI.GOV)

J. S. HENDRICKS; C. N. CULBERTSON

2000-01-01

The weight window variance reduction method in the general-purpose Monte Carlo N-Particle radiation transport code MCNPTM has recently been rewritten. In particular, it is now possible to generate weight window importance functions on a superimposed mesh, eliminating the need to subdivide geometries for variance reduction purposes. Our assessment addresses the following questions: (1) Does the new MCNP4C treatment utilize weight windows as well as the former MCNP4B treatment? (2) Does the new MCNP4C weight window generator generate importance functions as well as MCNP4B? (3) How do superimposed mesh weight windows compare to cell-based weight windows? (4) What are the shortcomingsmore » of the new MCNP4C weight window generator? Our assessment was carried out with five neutron and photon shielding problems chosen for their demanding variance reduction requirements. The problems were an oil well logging problem, the Oak Ridge fusion shielding benchmark problem, a photon skyshine problem, an air-over-ground problem, and a sample problem for variance reduction.« less

Perceptions of Strategies for Successful Weight Loss in Persons with Serious Mental Illness Participating in a Behavioral Weight Loss Intervention: A Qualitative Study

PubMed Central

Vazin, Roza; McGinty, Emma E.; Dickerson, Faith; Dalcin, Arlene; Goldsholl, Stacy; Enriquez, Meghan Oefinger; Jerome, Gerald J.; Gennusa, Joseph V.; Daumit, Gail L.

2016-01-01

Objective The purpose of this study was to describe perceptions of weight loss strategies, benefits, and barriers among persons with serious mental illness who lost weight in the ACHIEVE behavioral weight loss intervention. Methods Semi-structured interviews with 20 ACHIEVE participants were conducted and analyzed using an inductive coding approach. Results Participants perceived tailored exercise sessions, social support, and dietary strategies taught in ACHIEVE – such as reducing portion sizes and avoiding sugar-sweetened beverages – as useful weight loss strategies. Health benefits, improved physical appearance, self-efficacy, and enhanced ability to perform activities of daily living were commonly cited benefits of intervention participation and weight loss. Some participants reported challenges with giving up snack food and reducing portion sizes, and barriers to exercise related to medical conditions. Conclusions and Implications for Practice There is emerging evidence that behavioral weight loss interventions can lead to clinically meaningful reductions in body weight among persons with serious mental illness. The perspective of persons with serious mental illness regarding strategies for, benefits of, and barriers to weight loss during participation in behavioral weight loss programs provide insight into which elements of multicomponent interventions such as ACHIEVE are most effective. The results of this study suggest that tailored exercise programs, social support, and emphasis on non-clinical benefits of intervention participation, such as improvements in self-efficacy and the ability to participate more actively in family and community activities, are promising facilitators of engagement and success in behavioral weight loss interventions for the population with serious mental illness. PMID:27054900

Smoking in pregnancy in West Virginia: does cessation/reduction improve perinatal outcomes?

PubMed

Seybold, Dara J; Broce, Mike; Siegel, Eric; Findley, Joseph; Calhoun, Byron C

2012-01-01

To determine if pregnant women decreasing/quitting tobacco use will have improved fetal outcomes. Retrospective analysis of pregnant smokers from 6/1/2006-12/31/2007 who received prenatal care and delivered at a tertiary medical care center in West Virginia. Variables analyzed included birth certificate data linked to intervention program survey data. Patients were divided into four study groups: <8 cigarettes/day-no reduction, <8 cigarettes/day-reduction, ≥8 cigarettes/day-no reduction, and ≥8 cigarettes/day-reduction. Analysis performed using ANOVA one-way test for continuous variables and Chi-square for categorical variables. Inclusion criteria met by 250 patients. Twelve women (4.8%) quit smoking; 150 (60%) reduced; 27 (10.8%) increased; and 61 (24.4%) had no change. Comparing the four study groups for pre-term births (<37 weeks), 25% percent occurred in ≥8 no reduction group while 10% occurred in ≥8 with reduction group (P = 0.026). The high rate of preterm birth (25%) in the non-reducing group depended on 2 factors: (1) ≥8 cigarettes/day at beginning and (2) no reduction by the end of prenatal care. Finally, there was a statistically significant difference in birth weights between the two groups: ≥8 cigarettes/day with no reduction (2,872.6 g) versus <8 cigarettes/day with reduction (3,212.4 g) (P = 0.028). Smoking reduction/cessation lowered risk of pre-term delivery (<37 weeks) twofold. Encouraging patients who smoke ≥8 cigarettes/day during pregnancy to decrease/quit prior to delivery provides significant clinical benefit by decreasing the likelihood of preterm birth. These findings support tobacco cessation efforts as a means to improve birth outcome.

Update on the effects of physical activity on insulin sensitivity in humans

PubMed Central

Bird, Stephen R; Hawley, John A

2016-01-01

Purpose and methods This review presents established knowledge on the effects of physical activity (PA) on whole-body insulin sensitivity (SI) and summarises the findings of recent (2013–2016) studies. Discussion and conclusions Recent studies provide further evidence to support the notion that regular PA reduces the risk of insulin resistance, metabolic syndrome and type 2 diabetes, and SI improves when individuals comply with exercise and/or PA guidelines. Many studies indicate a dose response, with higher energy expenditures and higher exercise intensities, including high intensity interval training (HIIT), producing greater benefits on whole-body SI, although these findings are not unanimous. Aerobic exercise interventions can improve SI without an associated increase in cardiorespiratory fitness as measured by maximal or peak oxygen consumption. Both aerobic and resistance exercise can induce improvements in glycaemic regulation, with some suggestions that exercise regimens including both may be more efficacious than either exercise mode alone. Some studies report exercise-induced benefits to SI that are independent of habitual diet and weight loss, while others indicate an association with fat reduction, hence the debate over the relative importance of PA and weight loss continues. During exercise, muscle contraction stimulated improvements in SI are associated with increases in AMPK activity, which deactivates TCB1D1, promoting GLUT4 translocation to the cell membrane and thereby increasing glucose uptake. Postexercise, increases in Akt deactivate TCB1D4 and thereby increase GLUT4 translocation to the cell membrane. The reduction in intramuscular saturated fatty acids and concomitant reductions in ceramides, but not diacylglycerols, provide a potential link between intramuscular lipid content and SI. Increased skeletal muscle capillarisation provides another independent adaptation through which SI is improved, as does enhanced β cell activity. Recent studies are combining exercise interventions with dietary and feeding manipulations to investigate the potential for augmenting the exercise-induced improvements in SI and glycaemic control. PMID:28879026

Update on the effects of physical activity on insulin sensitivity in humans.

PubMed

Bird, Stephen R; Hawley, John A

2016-01-01

This review presents established knowledge on the effects of physical activity (PA) on whole-body insulin sensitivity (SI) and summarises the findings of recent (2013-2016) studies. Recent studies provide further evidence to support the notion that regular PA reduces the risk of insulin resistance, metabolic syndrome and type 2 diabetes, and SI improves when individuals comply with exercise and/or PA guidelines. Many studies indicate a dose response, with higher energy expenditures and higher exercise intensities, including high intensity interval training (HIIT), producing greater benefits on whole-body SI, although these findings are not unanimous. Aerobic exercise interventions can improve SI without an associated increase in cardiorespiratory fitness as measured by maximal or peak oxygen consumption. Both aerobic and resistance exercise can induce improvements in glycaemic regulation, with some suggestions that exercise regimens including both may be more efficacious than either exercise mode alone. Some studies report exercise-induced benefits to SI that are independent of habitual diet and weight loss, while others indicate an association with fat reduction, hence the debate over the relative importance of PA and weight loss continues. During exercise, muscle contraction stimulated improvements in SI are associated with increases in AMPK activity, which deactivates TCB1D1, promoting GLUT4 translocation to the cell membrane and thereby increasing glucose uptake. Postexercise, increases in Akt deactivate TCB1D4 and thereby increase GLUT4 translocation to the cell membrane. The reduction in intramuscular saturated fatty acids and concomitant reductions in ceramides, but not diacylglycerols, provide a potential link between intramuscular lipid content and SI. Increased skeletal muscle capillarisation provides another independent adaptation through which SI is improved, as does enhanced β cell activity. Recent studies are combining exercise interventions with dietary and feeding manipulations to investigate the potential for augmenting the exercise-induced improvements in SI and glycaemic control.

Dynamics of intrapericardial and extrapericardial fat tissues during long-term, dietary-induced, moderate weight loss.

PubMed

Tsaban, Gal; Wolak, Arik; Avni-Hassid, Hila; Gepner, Yftach; Shelef, Ilan; Henkin, Yaakov; Schwarzfuchs, Dan; Cohen, Noa; Bril, Nitzan; Rein, Michal; Serfaty, Dana; Kenigsbuch, Shira; Tene, Lilac; Zelicha, Hila; Yaskolka-Meir, Anat; Komy, Oded; Bilitzky, Avital; Chassidim, Yoash; Ceglarek, Uta; Stumvoll, Michael; Blüher, Matthias; Thiery, Joachim; Dicker, Dror; Rudich, Assaf; Stampfer, Meir J; Shai, Iris

2017-10-01

Background: In view of evidence linking pericardial fat accumulation with increased cardiovascular disease risk, strategies to reduce its burden are needed. Data comparing the effects of specific long-term dietary interventions on pericardial fat tissue mobilization are sparse. Objective: We sought to evaluate intrapericardial-fat (IPF) and extrapericardial-fat (EPF) changes during weight-loss interventions by different dietary regimens. Design: During 18 mo of a randomized controlled trial, we compared a Mediterranean/low-carbohydrate (MED/LC) diet plus 28 g walnuts/d with a calorically equal low-fat (LF) diet among randomly assigned participants with moderate abdominal obesity. We performed whole-body MRI and volumetrically quantified IPF and EPF among 80 participants to follow the 18-mo changes. Results: The participants [mean age: 48.6 y; mean body mass index (BMI; in kg/m 2 ); 31.7; 90% men] had baseline IPF and EPF (mean ± SD) volumes of 172.4 ± 53.3 mL and 194.9 ± 71.5 mL, respectively. The 18-mo moderate weight loss of 3.7 kg was similar in both groups, but the reduction in waist circumference was higher in the MED/LC group (-6.9 ± 6.6 cm) than in the LF diet group (-2.3 ± 6.5 cm; P = 0.01). After 18 mo, the IPF volume had reduced twice as much in the MED/LC group compared with the LF group [-37 ± 26.2 mL (-22% ± 15%) compared with -15.5 ± 26.2 mL (-8% ± 15%), respectively; P < 0.05, after adjustment for changes in weight or visceral adipose tissue]. The EPF volume had reduced similarly in both groups [-41.6 ± 30.2 mL (-23% ± 16%) in the MED/LC group compared with -37.9 ± 28.3 mL (-19% ± 14%) in the LF group; P > 0.1]. After controlling for weight loss, IPF and EPF volume reduction paralleled changes in lipid profile but not with improved glycemic profile variables: the IPF relative reduction was associated with a decrease in triglycerides (TGs) (β = 0.090; 95% CI: 0.026, 0.154; P = 0.007) and the ratio of TGs to high-density lipoprotein (HDL) cholesterol (β = 2.689; 95% CI: 0.373, 5.003; P = 0.024), and the EPF relative reduction was associated with an increase in HDL cholesterol (β = -0.452; 95% CI: -0.880, -0.023; P = 0.039) and a decrease in total cholesterol and HDL cholesterol (β = 3.766; 95% CI: 1.092, 6.440; P = 0.007). Conclusions: Moderate but persistent dietary-induced weight loss substantially decreased both IPF and EPF volumes. Reduction of pericardial adipose tissues is independently associated with an improved lipid profile. The Mediterranean diet, rich in unsaturated fats and restricted carbohydrates, is superior to an LF diet in terms of the IPF burden reduction. This trial was registered at clinicaltrials.gov as NCT01530724. © 2017 American Society for Nutrition.

[Weight loss via drug therapy].

PubMed

Wirth, A

2003-03-01

Obesity and its associated diseases are an increasing challenge in medicine. A change in lifestyle is usually the first step with modifications in nutrition, physical activity and behavior. However, most of obese patients are not able to follow such a treatment regimen for a longer period of time. If they do not lose > 5% of initial weight within 3-6 months, pharmacological intervention should be taken into account. Orlistat, a gastro-intestinal lipase inhibitor, enhances fat excretion thereby reducing energy uptake and body fat. Studies up to 4 years document a net weight loss of 3-5 kg, all cardiovascular risk factors are reduced. Sibutramine, a serotonin- and noradrenalin reuptake inhibitor, promotes satiety and stimulates energy expenditure. Within one year a net weight reduction of 4-6 kg is achieved and morbidity as well as quality of life are improved. For both drugs no end-point outcomes are available so far. The anti-obesity drugs orlistat and sibutramine are useful tools for overweight and obese patients as an adjunct to lifestyle changes. Under the supervision of experienced physicians the combined treatment consisting of non-pharmacological and pharmacological methods reduces body weight in more than half of the patients and improves morbidity and quality of life.

Causes and patterns of referral to a tertiary, multidisciplinary program for the treatment of childhood obesity.

PubMed

Yaeger-Yarom, Gili; Nemet, Dan; Eliakim, Alon

2011-01-01

Despite the childhood obesity epidemic, few obese children receive therapy and relatively few weight management multidisciplinary programs exist. The objective of this study was to examine the patterns and causes for obese children referrals to a tertiary multidisciplinary childhood obesity treatment program. A total of 227 children (10.6 +/- 2.6 years; 108 boys, 119 girls) were evaluated at the beginning of the programs for personal and familial demographic and anthropometric details, the referring agent to the program, and the main reasons for participation and for the child's desire to lose weight. The majority of participants had an obese family member (83%), in particular an obese parent (62%). The majority of patients were self-referred (86.8%), mainly by their mothers (74%). Only a small fraction were referred by healthcare providers (15.4%). The desire to improve appearance (44.5%), social/psychological issues (39.2%) and the will to improve fitness (29.5%) were the main reasons for joining the program. Understanding the motives for participation and referral patterns can improve recruitment and participation of obese children in weight reduction intervention programs.

Effects of Eating Fresh Lean Pork on Cardiometabolic Health Parameters

PubMed Central

Murphy, Karen J.; Thomson, Rebecca L.; Coates, Alison M.; Buckley, Jonathan D.; Howe, Peter R. C.

2012-01-01

High protein meat-based diets are commonly promoted for weight loss, supposedly by increasing satiety and energy expenditure. Pork is a good source of protein however little information on the metabolic effects of pork consumption exists. This pilot study aimed to examine whether regular consumption of fresh lean pork could improve body composition and cardiovascular risk factors in a 6 month parallel intervention trial. 164 overweight adults (mean BMI 32) were randomly assigned to incorporate up to 1 kg pork/week by substituting for other foods or maintain their habitual diet (control). Plasma levels of lipids, glucose and insulin, BMI, waist/hip circumference, blood pressure, heart rate and arterial compliance were measured at baseline and 3 and 6 months. Body composition was determined using dual energy X-ray absorptiometry. A total of 144 volunteers completed and volunteers in the pork group increased their intake 10 fold by substituting pork for mainly beef and chicken. After 3 months, there were significant (p ≤ 0.01) reductions in weight, BMI, waist circumference, % body fat, fat mass and abdominal fat in the pork group relative to controls, which persisted for 6 months. There was no change in lean mass, indicating that the reduction in weight was due to loss of fat mass. There were no significant effects on other metabolic parameters. Regular consumption of lean fresh pork may improve body composition. PMID:22852059

The effect of diet and exercise on markers of endothelial function in overweight and obese women with polycystic ovary syndrome.

PubMed

Thomson, R L; Brinkworth, G D; Noakes, M; Clifton, P M; Norman, R J; Buckley, J D

2012-07-01

Women with polycystic ovary syndrome (PCOS) present with vascular abnormalities, including elevated markers of endothelial dysfunction. There is limited evidence for the effect of lifestyle modification and weight loss on these markers. The aim of this study was to determine if 20 weeks of a high-protein energy-restricted diet with or without exercise in women with PCOS could improve endothelial function. This is a secondary analysis of a subset of 50 overweight/obese women with PCOS (age: 30.3 ± 6.3 years; BMI: 36.5 ± 5.7 kg/m(2)) from a previous study. Participants were randomly assigned by computer generation to one of three 20-week interventions: diet only (DO; n = 14, ≈ 6000 kJ/day), diet and aerobic exercise (DA; n = 16, ≈ 6000 kJ/day and five walking sessions/week) and diet and combined aerobic-resistance exercise (DC; n = 20, ≈ 6000 kJ/day, three walking and two strength sessions/week). At Weeks 0 and 20, weight, markers of endothelial function [vascular cell adhesion molecule-1 (sVCAM-1), inter-cellular adhesion molecule-1 (sICAM-1), plasminogen activator inhibitor-1 (PAI-1) and asymmetric dimethylarginine (ADMA)], insulin resistance and hormonal profile were assessed. All three treatments resulted in significant weight loss (DO 7.9 ± 1.2%, DA 11.0 ± 1.6%, DC 8.8 ± 1.1; P < 0.001 for time; P = 0.6 time × treatment). sVCAM-1, sICAM-1 and PAI-1 levels decreased with weight loss (P≤ 0.01), with no differences between treatments (P ≥ 0.4). ADMA levels did not change significantly (P = 0.06). Testosterone, sex hormone-binding globulin and the free androgen index (FAI) and insulin resistance also improved (P < 0.001) with no differences between treatments (P ≥ 0.2). Reductions in sVCAM-1 were correlated to reductions in testosterone (r = 0.32, P = 0.03) and FAI (r = 0.33, P = 0.02) as well as weight loss (r= 0.44, P = 0.002). Weight loss was also associated with reductions in sICAM-1 (r= 0.37, P = 0.008). Exercise training provided no additional benefit to following a high-protein, hypocaloric diet on markers of endothelial function in overweight/obese women with PCOS.

[Pharmacotherapy of obesity].

PubMed

Rotthoff, Thomas; Scherbaum, Werner A

2006-12-01

Long-term success in obesity therapy is difficult to obtain, therefore drug therapy appears to be helpful. Until today, end-point studies for obesity drugs beyond the improvement of individual surrogate parameters are still missing. For all available drugs, medical treatment can be recommended only for a limited period of time due to the data of the studies and under consideration of side effects. Although a weight reduction leads to an improvement of cardiovascular risk factors and hence a reduction of cardiovascular morbidity and mortality should be expected, no study could prove it so far. Despite the positive influence on individual surrogate parameters, the use of the present available therapies appears underwhelming. In this overview the approved substances and perspectives of new therapeutic concepts are represented.

A comprehensive review of the pharmacodynamics of the SGLT2 inhibitor empagliflozin in animals and humans

PubMed Central

Michel, Martin C.

2018-01-01

Empagliflozin (formerly known as BI 10773) is a potent, competitive, and selective inhibitor of the sodium glucose transporter SGLT2, which mediates glucose reabsorption in the early proximal tubule and most of the glucose reabsorption by the kidney, overall. Accordingly, empagliflozin treatment increased urinary glucose excretion. This has been observed across multiple species including humans and was reported under euglycemic conditions, in obesity and, most importantly, in type 2 diabetic patients and multiple animal models of type 2 diabetes and of type 1 diabetes. This led to a reduction in blood glucose, smaller blood glucose excursions during oral glucose tolerance tests, and, upon chronic treatment, a reduction in HbA1c in animal models and patients. In rodents, such effects were observed in early and late phases of experimental diabetes and were associated with preservation of pancreatic β-cell function. Combination studies in animals demonstrated that beneficial metabolic effects of empagliflozin may also manifest when added to other types of anti-hyperglycemic treatments including linagliptin and pioglitazone. While some anti-hyperglycemic drugs lead to weight gain, empagliflozin treatment was associated with reduced body weight in normoglycemic obese and non-obese animals despite an increased food intake, largely due to a loss of adipose tissue; on the other hand, empagliflozin preserved body weight in models of type 1 diabetes. Empagliflozin improved endothelial dysfunction in diabetic rats and arterial stiffness, reduced blood pressure in diabetic patients, and attenuated early signs of nephropathy in diabetic animal models. Taken together, the SGLT2 inhibitor empagliflozin improves glucose metabolism by enhancing urinary glucose excretion; upon chronic administration, at least in animal models, the reductions in blood glucose levels are associated with beneficial effects on cardiovascular and renal complications of diabetes. PMID:26108304

Does Post-operative Psychotherapy Contribute to Improved Comorbidities in Bariatric Patients with Borderline Personality Disorder Traits and Bulimia Tendencies? A Prospective Study.

PubMed

Gallé, Francesca; Maida, Pietro; Cirella, Assunta; Giuliano, Elena; Belfiore, Patrizia; Liguori, Giorgio

2017-07-01

Borderline personality disorder (BPD) and eating disorders may affect the outcomes of bariatric surgery. This study was aimed to evaluate the influence of a post-operative dialectical behavioral therapy (DBT) intervention on weight loss and comorbidities in a sample of comorbid obese Italian patients with BPD traits and bulimia tendencies who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic adjustable gastric banding (LAGB). One hundred fifty-four LRYGB or LAGB patients showing BPD and bulimia traits and type II diabetes, hypertension, and/or sleep apnea (OSAS) voluntarily adhered to DBT (n = 72) or treatment as usual (n = 82) for 12 months after surgery. Total weight loss (%TWL) and remission/improvement of comorbidities were considered as outcomes. Differences between treatment groups and between LRYGB and LAGB subgroups were evaluated through Student's t test for TWL and chi-square test for comorbidities. DBT was more effective than treatment as usual (TAU) in reducing weight loss (p < .001). Reduction of comorbidities was higher in patients treated with DBT, as for diabetes (p = .68), hypertension (p = .02), and OSAS (p = .03). LRYGB outcomes seem to be significantly better than those of LAGB, mainly in TAU group. Our findings confirm the effectiveness of DBT in enhancing post-bariatric weight loss and reduction of comorbidities in patients showing BPD traits and bulimia tendencies. Further in-depth investigations and a longer follow-up are needed to strengthen these results.

Effects of Naltrexone Sustained- Release/Bupropion Sustained-Release Combination Therapy on Body Weight and Glycemic Parameters in Overweight and Obese Patients With Type 2 Diabetes

PubMed Central

Hollander, Priscilla; Gupta, Alok K.; Plodkowski, Raymond; Greenway, Frank; Bays, Harold; Burns, Colleen; Klassen, Preston; Fujioka, Ken

2013-01-01

OBJECTIVE To assess the efficacy and safety of 32 mg naltrexone sustained-release (SR)/360 mg bupropion SR (NB) in overweight/obese individuals with type 2 diabetes with or without background oral antidiabetes drugs. RESEARCH DESIGN AND METHODS This was a 56-week, double-blind, placebo-controlled study in which 505 patients received standardized lifestyle intervention and were randomized 2:1 to NB or placebo. Coprimary end points were percent weight change and achievement of ≥5% weight loss. Secondary end points included achievement of HbA1c <7% (53 mmol/mol), achievement of weight loss ≥10%, and change in HbA1c, waist circumference, fasting blood glucose, and lipids. RESULTS In the modified intent-to-treat population (54% female, 80% Caucasian, and mean age 54 years, weight 106 kg, BMI 37 kg/m2, and HbA1c 8.0% [64 mmol/mol]), NB resulted in significantly greater weight reduction (−5.0 vs. −1.8%; P < 0.001) and proportion of patients achieving ≥5% weight loss (44.5 vs. 18.9%, P < 0.001) compared with placebo. NB also resulted in significantly greater HbA1c reduction (−0.6 vs. −0.1% [6.6 vs. 1.1 mmol/mol]; P < 0.001), percent of patients achieving HbA1c <7% (53 mmol/mol) (44.1 vs. 26.3%; P < 0.001), and improvement in triglycerides and HDL cholesterol compared with placebo. NB was associated with higher incidence of nausea (42.3 vs. 7.1%), constipation (17.7 vs. 7.1%), and vomiting (18.3 vs. 3.6%). No difference was observed between groups in the incidence of depression, suicidal ideation, or hypoglycemia. CONCLUSIONS NB therapy in overweight/obese patients with type 2 diabetes induced weight loss, which was associated with improvements in glycemic control and select cardiovascular risk factors and was generally well tolerated with a safety profile similar to that in patients without diabetes. PMID:24144653

Combining Pharmacological and Psychological Treatments for Binge Eating Disorder: Current Status, Limitations, and Future Directions.

PubMed

Grilo, Carlos M; Reas, Deborah L; Mitchell, James E

2016-06-01

Binge eating disorder (BED) is characterized by recurrent binge eating and marked distress about binge eating without the extreme compensatory behaviors for weight control that characterize other eating disorders. BED is prevalent, associated strongly with obesity, and is associated with heightened levels of psychological, psychiatric, and medical concerns. This article provides an overview of randomized controlled treatments for combined psychological and pharmacological treatment of BED to inform current clinical practice and future treatment research. In contrast to the prevalence and significance of BED, to date, limited research has been performed on combining psychological and pharmacological treatments for BED to enhance outcomes. Our review here found that combining certain medications with cognitive behavioral therapy (CBT) or behavioral weight loss (BWL) interventions produces superior outcomes to pharmacotherapy only but does not substantially improve outcomes achieved with CBT/BWL only. One medication (orlistat) has improved weight losses with CBT/BWL albeit minimally, and only one medication (topiramate) has enhanced reductions achieved with CBT in both binge eating and weight. Implications for future research are discussed.

Equivalent reductions in body weight during the Beef WISE Study: beef's role in weight improvement, satisfaction and energy

PubMed Central

Sayer, R. D.; Speaker, K. J.; Pan, Z.; Peters, J. C.; Wyatt, H. R.

2017-01-01

Summary Objective The objective of this randomized equivalence trial was to determine the impact of consuming lean beef as part of a high protein (HP) weight‐reducing diet on changes in body weight, body composition and cardiometabolic health. Methods A total of 120 adults (99 female) with overweight or obesity (BMI: 35.7 ± 7.0 kg m−2) were randomly assigned to consume either a HP diet with ≥4 weekly servings of lean beef (B; n = 60) or a HP diet restricted in all red meats (NB; n = 60) during a 16‐week weight loss intervention. Results Body weight was reduced by 7.8 ± 5.9% in B and 7.7 ± 5.5% in NB (p < 0.01 for both). Changes in percent body weight were equivalent between B and NB (mean difference: 0.06%, 90% confidence interval: (−1.7, 1.8)). Fat mass was reduced in both groups (p < 0.01; B: 8.0 ± 0.6 kg, NB: 8.6 ± 0.6 kg), while lean mass was not reduced in either group. Improvements in markers of cardiometabolic health (total cholesterol, low‐density lipoprotein cholesterol, triglycerides and blood pressure) were not different between B and NB. Conclusion Results of this study demonstrate that HP diets – either rich or restricted in red meat intakes – are effective for decreasing body weight and improving body composition and cardiometabolic health. PMID:29071106

Effects of Liraglutide on Weight Loss, Fat Distribution, and β-Cell Function in Obese Subjects With Prediabetes or Early Type 2 Diabetes.

PubMed

Santilli, Francesca; Simeone, Paola G; Guagnano, Maria T; Leo, Marika; Maccarone, Marica T; Di Castelnuovo, Augusto; Sborgia, Cristina; Bonadonna, Riccardo C; Angelucci, Ermanno; Federico, Virginia; Cianfarani, Stefano; Manzoli, Lamberto; Davì, Giovanni; Tartaro, Armando; Consoli, Agostino

2017-11-01

Obesity is associated with an increased risk of type 2 diabetes and cardiovascular complications. The risk depends significantly on adipose tissue distribution. Liraglutide, a glucagon-like peptide 1 analog, is associated with weight loss, improved glycemic control, and reduced cardiovascular risk. We determined whether an equal degree of weight loss by liraglutide or lifestyle changes has a different impact on subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in obese subjects with prediabetes or early type 2 diabetes. Sixty-two metformin-treated obese subjects with prediabetes or newly diagnosed type 2 diabetes, were randomized to liraglutide (1.8 mg/day) or lifestyle counseling. Changes in SAT and VAT levels (determined by abdominal MRI), insulin sensitivity (according to the Matsuda index), and β-cell function (β-index) were assessed during a multiple-sampling oral glucose tolerance test; and circulating levels of IGF-I and IGF-II were assessed before and after a comparable weight loss (7% of initial body weight). After comparable weight loss, achieved by 20 patients per arm, and superimposable glycemic control, as reflected by HbA 1c level ( P = 0.60), reduction in VAT was significantly higher in the liraglutide arm than in the lifestyle arm ( P = 0.028), in parallel with a greater improvement in β-index ( P = 0.021). No differences were observed in SAT reduction ( P = 0.64). IGF-II serum levels were significantly increased ( P = 0.024) only with liraglutide administration, and the increase in IGF-II levels correlated with both a decrease in VAT (ρ = -0.435, P = 0.056) and an increase in the β-index (ρ = 0.55, P = 0.012). Liraglutide effects on visceral obesity and β-cell function might provide a rationale for using this molecule in obese subjects in an early phase of glucose metabolism dysregulation natural history. © 2017 by the American Diabetes Association.

Probing bias reduction to improve comparability of lint cotton water and moisture contents at moisture equilibrium

USDA-ARS?s Scientific Manuscript database

The Karl Fischer Titration (KFT) reference method is specific for water in lint cotton and was designed for samples conditioned to moisture equilibrium, thus limiting its biases. There is a standard method for moisture content – weight loss – by oven drying (OD), just not for equilibrium moisture c...

Performance Steel Castings

DTIC Science & Technology

2012-09-30

Development of Sand Properties 103 Advanced Modeling Dataset.. 105 High Strength Low Alloy (HSLA) Steels 107 Steel Casting and Engineering Support...to achieve the performance goals required for new systems. The dramatic reduction in weight and increase in capability will require high performance...for improved weapon system reliability. SFSA developed innovative casting design and manufacturing processes for high performance parts. SFSA is

A self-management intervention for African Americans with comorbid diabetes and hypertension: a pilot randomized controlled trial.

PubMed

Lynch, Elizabeth B; Liebman, Rebecca; Ventrelle, Jennifer; Avery, Elizabeth F; Richardson, DeJuran

2014-05-29

The objective of this pilot 6-month randomized controlled trial was to determine the effectiveness of an intensive, community-based, group intervention that focused on diet, physical activity, and peer support for reducing weight among urban-dwelling African Americans with comorbid type 2 diabetes and hypertension. Sixty-one participants were randomized into an intervention or control group. The 6-month intervention consisted of 18 group sessions led by a dietitian in a community setting and weekly telephone calls from a peer supporter. The intervention featured culturally tailored nutrition education, behavioral skills training, and social support focused on changes to diet and physical activity. The control group consisted of two 3-hour group sessions of diabetes self-management education taught by a community health worker. Outcome measures were assessed at baseline and 6 months. The primary outcome was achievement of a 5% weight reduction at 6 months. A secondary outcome was achievement of a 0.5 percentage-point reduction in hemoglobin A1c (HbA1c). Groups did not differ in achievement of the weight-loss goal. Intervention participants lost a mean of 2.8 kg (P = .01); control participants did not lose a significant amount of weight. A greater proportion of intervention (50.0%) than control (21.4%) participants reduced HbA1c by 0.5 percentage points or more at 6 months (P = .03). The intervention was more effective than usual care (short-term diabetes education) at improving glycemic control, but not weight, in low-income African Americans with comorbid diabetes and hypertension. A community-based 6-month group class with culturally tailored education, behavioral skills training, and peer support can lead to a clinically significant reduction in HbA1c.

Hunger, Food Cravings, and Diet Satisfaction are Related to Changes in Body Weight During a 6-Month Behavioral Weight Loss Intervention: The Beef WISE Study.

PubMed

Sayer, R Drew; Peters, John C; Pan, Zhaoxing; Wyatt, Holly R; Hill, James O

2018-05-31

Previously published findings from the Beef WISE Study (Beef's Role in Weight Improvement, Satisfaction, and Energy) indicated equivalent weight loss between two energy-restricted higher protein (HP) diets: A HP diet with ≥4 weekly servings of lean beef (B; n = 60) and a HP diet restricted in all red meats (NB; n = 60). Long-term adherence to dietary prescriptions is critical for weight management but may be adversely affected by changes in appetite, food cravings, and diet satisfaction that often accompany weight loss. A secondary a priori aim of the Beef WISE Study was to compare subjective ratings of appetite (hunger and fullness), food cravings, and diet satisfaction (compliance, satisfaction, and deprivation) between the diets and determine whether these factors influenced weight loss. Subjective appetite, food cravings, and diet satisfaction ratings were collected throughout the intervention, and body weight was measured at the baseline, after the weight loss intervention (week 16), and after an eight-week follow-up period (week 24). Hunger and cravings were reduced during weight loss compared to the baseline, while fullness was not different from the baseline. The reduction in cravings was greater for B vs. NB at week 16 only. Higher deprivation ratings during weight loss were reported in NB vs. B at weeks 16 and 24, but participants in both groups reported high levels of compliance and diet satisfaction with no difference between groups. Independent of group assignment, higher baseline hunger and cravings were associated with less weight loss, and greater diet compliance, diet satisfaction, and lower feelings of deprivation were associated with greater weight loss. Strategies to promote reduced feelings of hunger, cravings, and deprivation may increase adherence to dietary prescriptions and improve behavioral weight loss outcomes.

[The reduction of stroke risk, risk of myocardial infarction and death by healthy diet and physical activity].

PubMed

Droste, D W; Keipes, M

2013-01-01

There is no doubt that a healthy diet and regular physical activity improve risk factors for cerebro-cardio-vascular disease and death. However, there is less evidence from prospective randomised controlled trials that they also reduce the actual risk of stroke, myocardial infarction and death. The only evidence from randomised controlled trials is, that a mediterranean diet with nuts and/or native olive oil considerably reduces stroke risk by 47% respectively 31%, however not the risk of myocardial infarction and death. A low-fat diet, a low-salt diet, and the addition of omega-3 fatty acids have no influence. In case of severe obesity with a BMI of > 34-38 kg/m2, weight reduction is the priority, if necessary by means of bariatric surgery. In longitudinal studies mortality (-29%), stroke (-34%), and myocardial infarction (-29%) could thus be reduced. Regular physical activity, whether endurance or more intense activity, leads to weight loss and improved vascular risk factors. An independent impact on stroke, myocardial infarction and mortality has not yet been demonstrated in prospective studies (double-blinding being impossible). Nevertheless, several epidemiological meta-analyses with observation durations of 4 to 28 years using data of up to 880 000 persons, indicate that there is a 2-3 fold risk reduction of cerebro-cardio-vascular death and global mortality in people with regular physical activity versus sedentary behaviour.

Circumference reduction and cellulite treatment with a TriPollar radiofrequency device: a pilot study.

PubMed

Manuskiatti, W; Wachirakaphan, C; Lektrakul, N; Varothai, S

2009-07-01

A wide variety of treatments for circumference reduction and cellulite are available, but most procedures offer suboptimal clinical effect and/or delayed therapeutic outcome. Objective To determine the safety and efficacy of the TriPollar radiofrequency device for cellulite treatment and circumference reduction. Thirty-nine females with cellulite received eight weekly TriPollar treatments. Treatment areas included the abdomen, thighs, buttocks and arms. Subjects were evaluated using standardized photographs and measurements of body weight, circumference, subcutaneous thickness, and skin elasticity of the treatment sites at baseline, immediately after and 4 weeks after the final treatment. Physicians' evaluation of clinical improvement scores using a quartile grading scale was recorded. Thirty-seven patients (95%) completed the treatment protocol. There was significant circumference reduction of 3.5 and 1.7 cm at the abdomen (P = 0.002) and thigh (P = 0.002) regions, respectively. At 4 weeks after the last treatment, the average circumferential reductions of the abdomen and thighs were sustained. No significant circumferential reductions of the buttocks and arms at the last treatment visit compared to baseline were demonstrated (P = 0.138 and 0.152, respectively). Quartile grading scores correlating to approximately 50% improvement in cellulite appearance were noted. Tripollar radiofrequency provided beneficial effects on the reduction of abdomen and thigh circumference and cellulite appearance.

Treatment of cellulite with a bipolar radiofrequency, infrared heat, and pulsatile suction device: a pilot study.

PubMed

Wanitphakdeedecha, Rungsima; Manuskiatti, Woraphong

2006-12-01

Very few therapeutic options have proven effective in the treatment of cellulite. To evaluate the effectiveness and adverse effects of a bipolar radiofrequency (RF), infrared (IR) heat and pulsatile suction device for the treatment of cellulite. Twelve subjects were treated with the RF-light-based device. All subjects were treated twice weekly for a total number of eight to nine treatments. Subjects were evaluated using standardized photographs, and measurements of body weight and circumference of treatment sites at baseline, immediately after the last treatment, and four weeks and one year after the last treatment. Clinical improvement scores of comparable photographs using a quartile grading scale (0 = <25%, 1 = 25-50%, 2 = 51-75%, 3 = >75% improvement) were judged independently by two non-treating dermatologists after the series of treatment. The average body weights at baseline, immediately after the last treatment, and four weeks and one year after the complete treatment were 56.30, 56.05, 56.23, and 56.53 kg, respectively. The average circumferential reductions of the abdomen and thigh at the last treatment visit were 5.17 +/- 1.04 cm (6.32%+/- 1.82%) and 3.50 +/- 2.16 cm (6.23 +/- 3.58%), respectively. At four weeks after the last treatment, the average circumferential reductions of the abdomen and thigh were sustained at 3.17 +/- 2.75 cm (4.04%+/- 3.69%) and 3.50 +/- 2.04 cm (6.26%+/- 3.52%), respectively. At one year follow-up visit, the average circumferential reductions of the abdomen and thigh were maintained at 3.83 +/- 0.76 cm (4.64%+/- 1.15%) and 3.13 +/- 3.54 (5.50%+/- 6.12%), respectively. Average clinical improvement scores of the abdomen and thigh after the series of treatments were 0.75 (corresponding to approximately 25% improvement), and 1.75 (corresponding to approximately 50% improvement), respectively. A bipolar RF, IR heat and pulsatile suction device provides a beneficial effect on reduction of abdomen and thigh circumference, and smoothening of the cellulite.

Novel Interventions to Reduce Stress and Overeating in Overweight Pregnant Women: A Feasibility Study.

PubMed

Laraia, B A; Adler, N E; Coleman-Phox, K; Vieten, C; Mellin, L; Kristeller, J L; Thomas, M; Stotland, N E; Lustig, R H; Dallman, M F; Hecht, F M; Bush, N R; de Groat, C L; Epel, E

2018-05-01

Background High stress and depression during pregnancy are risk factors for worsened health trajectories for both mother and offspring. This is also true for pre-pregnancy obesity and excessive gestational weight gain. Reducing stress and depression may be one path to prevent excessive caloric intake and gestational weight gain. Study Purpose We tested the feasibility of two novel interventions aimed at reducing stress and overeating during pregnancy. Reflecting different theoretical underpinnings, the interventions target different mechanisms. Mindful Moms Training (MMT) uses mindfulness to improve awareness and acceptance of experiences and promote conscious rather than automatic behavior choices. Emotional Brain Training (EBT) uses active coping to change perceptions of negative experience and promote positive affective states. Methods Forty-six overweight/obese low-income women were assigned to either MMT (n = 24) or EBT (n = 22) for an 8-week feasibility study. Pre-post changes in perceived stress, eating and presumed mechanisms were assessed. Results Women reported high levels of stress at baseline. Both interventions were well attended and demonstrated clinically significant pre-post reductions in stress, depressive symptoms, and improved eating behaviors. MMT significantly decreased experiential avoidance, whereas EBT significantly increased positive reappraisal; these changes were marginally significantly different by group. Conclusions This feasibility study found that both interventions promoted meaningful reductions in stress and depressive symptoms and improved reported eating behaviors in a high-risk group of pregnant women. Each intervention has a potentially different pathway-acceptance for MMT and reappraisal for EBT. Larger studies are needed to test efficacy on longer term reductions in stress and overeating.

A Pilot Study of Randomized, Head-to-Head of Metformin Versus Topiramate in Obese People With Schizophrenia.

PubMed

Peng, Po-Jui; Ho, Pei-Shen; Tsai, Chia-Kuang; Huang, San-Yuan; Liang, Chih-Sung

A number of research studies support the weight loss effects of metformin and topiramate for obese people with schizophrenia. However, only a few studies have addressed the sustainability of the body weight reduction after discontinuation of these drugs. Moreover, head-to-head studies are still lacking. The study aims to evaluate and compare the efficacy of metformin and topiramate in weight reduction and weight maintenance after discontinuation of these drugs in obese people with schizophrenia. Twenty-two obese inpatients with schizophrenia were recruited and randomized into the metformin group (n = 11; daily dose, 1000 mg) and the topiramate group (n = 11; daily dose, 100 mg). A head-to-head, fixed-dose, and single-blinded design was used. Ten obese patients with schizophrenia of similar sex as that of the treated group were included as the control group. After a 4-month treatment, the metformin group showed a body weight reduction of 3.8 kg, and the topiramate group showed a reduction of 2.7 kg. However, the reduction could be sustained only in the metformin group at 3 and 9 months after metformin discontinuation. Interestingly, 3 months after treatment discontinuation, leptin levels showed a reduction in both metformin (baseline, 25.3 ± 14.7, week 7: 5.7 ± 3.7 ng/mL) and topiramate (baseline: 28.4 ± 16.1, week 7: 9.2 ± 15.5 ng/mL) groups. The trend of weight changes supports the superiority of metformin at 1000 mg/d over topiramate at 100 mg/d in weight reduction and weight maintenance.

Examining the psychological pathways to behavior change in a group-based lifestyle program to prevent type 2 diabetes.

PubMed

Critchley, Christine R; Hardie, Elizabeth A; Moore, Susan M

2012-04-01

To examine the psychological process of lifestyle change among adults at risk for type 2 diabetes. A randomized control trial in which 307 volunteers (intervention, n = 208; wait control, n = 99) diagnosed with prediabetes completed a six-session group-based intervention to promote healthier living. Participants' motivation to change, diet and exercise self-efficacy, mood, knowledge about diabetes, activity levels, healthy eating, waist circumference, and weight were assessed before and after the program. Participation in the program was associated with significant increases in healthy eating and physical activity, reductions in waist and weight, and improvements in motivation, positive mood, self-efficacy, and knowledge. Examination of the pathways to lifestyle change showed that the educational aspect of the program increased activity levels because it increased diabetes knowledge and improved mood. Eating behavior was not mediated by any of the psychological variables. Improvements in diet and physical activity were, in turn, directly associated with changes in weight and waist circumference. Although the program significantly improved motivation, self-efficacy, and mood, its impact on knowledge uniquely explained the increase in physical activity. Group-based programs that are tailored to lifestyle behaviors may provide a cost-effective method of diabetes prevention, but more research is needed to explain why they improve healthy eating.

Reducing Vehicle Weight and Improving U.S. Energy Efficiency Using Integrated Computational Materials Engineering

NASA Astrophysics Data System (ADS)

Joost, William J.

2012-09-01

Transportation accounts for approximately 28% of U.S. energy consumption with the majority of transportation energy derived from petroleum sources. Many technologies such as vehicle electrification, advanced combustion, and advanced fuels can reduce transportation energy consumption by improving the efficiency of cars and trucks. Lightweight materials are another important technology that can improve passenger vehicle fuel efficiency by 6-8% for each 10% reduction in weight while also making electric and alternative vehicles more competitive. Despite the opportunities for improved efficiency, widespread deployment of lightweight materials for automotive structures is hampered by technology gaps most often associated with performance, manufacturability, and cost. In this report, the impact of reduced vehicle weight on energy efficiency is discussed with a particular emphasis on quantitative relationships determined by several researchers. The most promising lightweight materials systems are described along with a brief review of the most significant technical barriers to their implementation. For each material system, the development of accurate material models is critical to support simulation-intensive processing and structural design for vehicles; improved models also contribute to an integrated computational materials engineering (ICME) approach for addressing technical barriers and accelerating deployment. The value of computational techniques is described by considering recent ICME and computational materials science success stories with an emphasis on applying problem-specific methods.

Loss of 50% of excess weight using a very low energy diet improves insulin-stimulated glucose disposal and skeletal muscle insulin signalling in obese insulin-treated type 2 diabetic patients.

PubMed

Jazet, I M; Schaart, G; Gastaldelli, A; Ferrannini, E; Hesselink, M K; Schrauwen, P; Romijn, J A; Maassen, J A; Pijl, H; Ouwens, D M; Meinders, A E

2008-02-01

Both energy restriction (ER) per se and weight loss improve glucose metabolism in obese insulin-treated type 2 diabetic patients. Short-term ER decreases basal endogenous glucose production (EGP) but not glucose disposal. In contrast the blood glucose-lowering mechanism of long-term ER with substantial weight loss has not been fully elucidated. The aim of this study was to investigate the effect of loss of 50% of excess weight [50% excess weight reduction (EWR)] on EGP, whole-body insulin sensitivity and the disturbed myocellular insulin-signalling pathway in ten obese insulin-treated type 2 diabetic patients. A euglycaemic-hyperinsulinaemic clamp with stable isotopes ([6,6-(2)H2]glucose and [2H5]glycerol) combined with skeletal muscle biopsies was performed during a very low energy diet (VLED; 1,883 kJ/day) on day 2 and again after 50% EWR. Oral blood glucose-lowering agents and insulin were discontinued 3 weeks prior to the VLED and at the start of the VLED, respectively. Loss of 50% EWR (20.3+/-2.2 kg from day 2 to day of 50% EWR) normalised basal EGP and improved insulin sensitivity, especially insulin-stimulated glucose disposal (18.8+/-2.0 to 39.1+/-2.8 micromol kg fat-free mass(-1) min(-1), p=0.001). The latter was accompanied by improved insulin signalling at the level of the recently discovered protein kinase B/Akt substrates AS160 and PRAS40 along with a decrease in intramyocellular lipid (IMCL) content. Considerable weight loss in obese, insulin-treated type 2 diabetic patients normalises basal EGP and improves insulin sensitivity resulting from an improvement in insulin signal transduction in skeletal muscle. The decrease in IMCL might contribute to this effect.

Participation and cardiovascular risk reduction in a voluntary worksite nutrition and physical activity program.

PubMed

Thorndike, Anne N; Healey, Erica; Sonnenberg, Lillian; Regan, Susan

2011-02-01

In a cohort of employees participating in a worksite nutrition and physical activity program, we compared program completion and changes in cardiovascular risk factors by baseline body mass index. In 2007, 774 employees enrolled in a 10 week program at a hospital in Boston, Massachusetts. Program completion and change in weight, cholesterol, and blood pressure were compared between obese (body mass index≥30), overweight (body mass index=25-29.9), and normal weight (body mass index<25) participants. At baseline, 63% were obese or overweight and had higher blood pressure and cholesterol compared to normal weight participants. Program completion was 82% and did not differ by body mass index. Mean weight loss was 1.9 kg at end of program (p<0.001) and 0.4 kg at 1 year (p=0.002). At end of program, participants with body mass index≥30 lost 3.0% body weight vs. 2.7% for body mass index=25-29.9 and 1.7% for body mass index<25 (p<0.001), but weight loss at 1 year did not differ by body mass index. Mean cholesterol and blood pressure were lower at end of program and 1 year (all, p<0.005) but did not differ by body mass index. Worksite programs can successfully initiate cardiovascular risk reduction among employees, but more intensive interventions are needed to make significant improvements in the health of higher risk obese employees. Copyright © 2010 Elsevier Inc. All rights reserved.

Measuring weight outcomes for obesity intervention strategies: the case of a sugar-sweetened beverage tax.

PubMed

Lin, Biing-Hwan; Smith, Travis A; Lee, Jonq-Ying; Hall, Kevin D

2011-12-01

Taxing unhealthy foods has been proposed as a means to improve diet and health by reducing calorie intake and raising funds to combat obesity, particularly sugar-sweetened beverages (SSBs). A growing number of studies have examined the effects of such food taxes, but few have estimated the weight-loss effects. Typically, a static model of 3500 calories for one pound of body weight is used, and the main objective of the study is to demonstrate its bias. To accomplish the objective, we estimate income-segmented beverage demand systems to examine the potential effects of a SSB tax. Elasticity estimates and a hypothetical 20 percent effective tax rate (or about 0.5 cent per ounce) are applied to beverage intake data from a nationally representative survey, and we find an average daily reduction of 34-47 calories among adults and 40-51 calories among children. The tax-induced energy reductions are translated into weight loss using both static and dynamic calorie-to-weight models. Results demonstrate that the static model significantly overestimates the weight loss from reduced energy intake by 63 percent in year one, 346 percent in year five, and 764 percent in year 10, which leads to unrealistic expectations for obesity intervention strategies. The tax is estimated to generate $5.8 billion a year in revenue and is found to be regressive, although it represents about 1 percent of household food and beverage spending. Published by Elsevier B.V.

Effects on weight loss in adults of replacing diet beverages with water during a hypoenergetic diet: a randomized, 24-wk clinical trial.

PubMed

Madjd, Ameneh; Taylor, Moira A; Delavari, Alireza; Malekzadeh, Reza; Macdonald, Ian A; Farshchi, Hamid R

2015-12-01

Obese people believe that drinking diet beverages (DBs) may be a simple strategy to achieve weight loss. However, nutritionists advise drinking water when attempting to lose weight. It is unclear how important drinking water instead of DBs is during a weight-loss program. In this study, we compared the effect on weight loss of either replacing DBs with water or continuing to consume DBs in adults during a 24-wk weight-loss program. Overweight and obese women [n = 89; body mass index (BMI; in kg/m(2)): 27-40; age: 18-50 y] who usually consumed DBs in their diet were asked to either substitute water for DBs (water group) or continue drinking DBs 5 times/wk after their lunch for 24 wk (DB group) while on a weight-loss program. Sixty-two participants (71%) completed the trial (32 in the DB group, 30 in the water group). Baseline variables were not statistically significantly different between groups. A statistically significant reduction in anthropometric measurements and statistically significant improvements in cardiometabolic risk characteristics were observed over 24 wk in both groups. Compared with the DB group, the water group had a greater decrease in weight (mean ± SD: water: -8.8 ± 1.9 kg; DBs: -7.6 ± 2.1 kg; P = 0.015, time × group), fasting insulin (mean ± SD: water: -2.84 ± 0.77 mU/L; DBs: -1.78 ± 1.25 mU/L, P < 0.001), homeostasis model assessment of insulin resistance (mean ± SD: water: -0.097 ± 0.049; DBs: -0.057 ± 0.042, P < 0.001), and 2-h postprandial glucose (mean ± SD: water: -1.02 ± 0.25 mmol/L; DBs: -0.72 ± 0.27 mmol/L; P < 0.001) over the 24 wk. However, there was no significant time × group interaction for waist circumference, fasting plasma glucose, and lipid profiles within both groups over 24 wk. Replacement of DBs with water after the main meal may lead to greater weight reduction during a weight-loss program. It may also offer clinical benefits to improve insulin resistance. This trial was registered at www.irct.ir/ as IRCT201402177754N5. © 2015 American Society for Nutrition.

Body weight reduction and metformin: Roles in polycystic ovary syndrome.

PubMed

Al-Nozha, Omar; Habib, Fawziah; Mojaddidi, Moaz; El-Bab, Mohamed Fath

2013-04-01

Polycystic ovary syndrome (PCOS) is a common problem in women at fertile age. A prospective study was conducted to clarify the pathophysiological responses during an application of insulin sensitizer, metformin and weight reduction therapy at the Gynecology Center in Ohud hospital, in AL-Madinah AL-Munawarah, Kingdom of Saudi Arabia. Twenty healthy women served as controls and 180 PCOS women divided into three groups participated in the study. First group was treated with Clomid citrate 100mg/day from the 2nd day of menses to the 6th day plus gonadotrophin from day three to the 13th. Group II was treated as group I plus 850mg metformin twice a day and group III was treated as group I plus weight reduction. Clinical symptoms, menstrual pattern, hirsutism, blood glucose, body mass index, waist-to-hip ratio, insulin, hormonal, and lipid profiles were assessed pre- and post treatment. Insulin resistance was calculated. PCOS women had significantly higher values than the healthy women in most of the measurements. Metformin and weight reduction therapy resulted in a significant decrease in the fasting insulin, glucose/insulin ratio and HOMA-IR. Metformin and weight reduction therapy resulted in a significant decrease in the lipid parameters, testosterone, LH/FSH ratio, SHBG, and prolactin levels. HOMA-IR was significantly higher in women with PCOS. HOMA-IR was positively correlated with testosterone, estradiol, TG, total cholesterol and LDL-cholesterol parameters, and negatively correlated with HDL-cholesterol and FSH levels. Metformin therapy and weight reduction had favorable influences on the basic metabolic and hormonal profiles in women with PCOS and that metformin and lifestyle modification (weight reduction via diet restriction or exercise) resulted in a significantly greater weight loss than hormonal therapy alone. Metformin and weight reduction therapy decreased also hyperandrogenism and insulin resistance. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Metabolic Parameters, Weight Loss, and Comorbidities 4 Years After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy.

PubMed

Lager, Corey J; Esfandiari, Nazanene H; Luo, Yingying; Subauste, Angela R; Kraftson, Andrew T; Brown, Morton B; Varban, Oliver A; Meral, Rasimcan; Cassidy, Ruth B; Nay, Catherine K; Lockwood, Amy L; Bellers, Darlene; Buda, Colleen M; Oral, Elif A

2018-06-16

Sleeve gastrectomy (LSG) is now the predominant bariatric surgery performed, yet there is limited long-term data comparing important outcomes between LSG and Roux-en-Y gastric bypass (RYGB). This study compares weight loss and impact on comorbidities of the two procedures. We retrospectively evaluated weight, blood pressure, hemoglobin A1c, cholesterol, and medication use for hypertension, diabetes, and hyperlipidemia at 1-4 years post-operatively in 380 patients who underwent RYGB and 334 patients who underwent LSG at the University of Michigan from January 2008 to November 2013. Follow-up rates from 714 patients initially were 657 (92%), 556 (78%), 507 (71%), and 498 (70%) at 1-4 years post-operatively. Baseline characteristics were similar except for higher weight and BMI in LSG. There was greater weight loss with RYGB vs. LSG at all points. Hemoglobin A1c and total cholesterol improved more in RYGB vs. LSG at 4 years. There was greater remission of hypertension and discontinuation of all medications for hypertension and diabetes with RYGB at 4 years. Weight loss, reduction in medications for hypertension and diabetes, improvements in markers of diabetes and hyperlipidemia, and remission rates of hypertension were superior with RYGB vs. LSG 4 years post-operatively. Choice of bariatric procedures should be tailored to surgical risk, comorbidities, and weight loss goals.

Light Duty Truck Weight Reduction Evaluation

DOT National Transportation Integrated Search

1980-10-01

The objectives of this program were to identify the weight reduction potential of pickup trucks, vans, and utility vehicles less than or equal to 8500 lb. gross vehicle weight through design modification, redesign, and material substitution; and more...

Morinda citrifolia L. leaf extract prevent weight gain in Sprague-Dawley rats fed a high fat diet.

PubMed

Jambocus, Najla Gooda Sahib; Ismail, Amin; Khatib, Alfi; Mahomoodally, Fawzi; Saari, Nazamid; Mumtaz, Muhammad Waseem; Hamid, Azizah Abdul

2017-01-01

Background : Morinda citrifolia L. is widely used as a folk medicinal food plant to manage a panoply of diseases, though no concrete reports on its potential anti-obesity activity. This study aimed to evaluate the potential of M. citrifolia leaf extracts (MLE60) in the prevention of weight gain in vivo and establish its phytochemical profile. Design : Male Sprague-Dawley rats were divided into groups based on a normal diet (ND) or high fat diet (HFD), with or without MLE60 supplementation (150 and 350 mg/kg body weight) and assessed for any reduction in weight gain. Plasma leptin, insulin, adiponectin, and ghrelin of all groups were determined. 1 H NMR and LCMS methods were employed for phytochemical profiling of MLE60. Results : The supplementation of MLE60 did not affect food intake indicating that appetite suppression might not be the main anti-obesity mechanism involved. In the treated groups, MLE60 prevented weight gain, most likely through an inhibition of pancreatic and lipoprotein activity with a positive influence on the lipid profiles and a reduction in LDL levels . MLE60 also attenuated visceral fat deposition in treated subjects with improvement in the plasma levels of obesity-linked factors . 1 Spectral analysis showed the presence of several bioactive compounds with rutin being more predominant. Conclusion : MLE60 shows promise as an anti-obesity agents and warrants further research.

Comparison of the effect of different modalities of physical exercise on functionality and anthropometric measurements in community-dwelling older women.

PubMed

Vasconcelos, Ana Paula Sena Lomba; Cardozo, Diogo Correia; Lucchetti, Alessandra Lamas Granero; Lucchetti, Giancarlo

2016-10-01

The present study aims to assess the effect of different modalities of physical exercises ("Functional Gymnastics"-FG, "Resistance Training"-RT and "Pilates combined with Hydrogymnastics"-PCH) on functional capacity and anthropometric measurements of 148 older women (60 years old or more). A comparative observational study was conducted. Functional and anthropometric measurements were assessed at baseline and after 16 weeks. All groups assessed showed significant changes between baseline and post-training. On the comparison of pre and post-training, differences in anthropometric measurements but not in functional test performance were found. The PCH had greater weight loss compared to the FG and RT, reduction in BMI compared to the FG and RT; reduction in waist compared to the FG and RT, and in hip compared to the RT. Although all groups improved, Pilates/Hydrogymnastics combination was more strongly associated with reductions in weight, BMI, waist and hip measurements but not functionality, than other modalities. These results highlight the role of combination physical exercise training in older women. Copyright © 2016 Elsevier Ltd. All rights reserved.

Self-efficacy and dietary fat reduction behaviors in obese African-American and white mothers.

PubMed

Chang, Mei-Wei; Brown, Roger L; Baumann, Linda J; Nitzke, Susan A

2008-05-01

This study examined the influence of weight management and education on five types of fat reduction behaviors mediated through three task-specific domains of self-efficacy among young, low-income obese African-American and white mothers. It also investigated interaction of race with the relationships between weight management, education, self-efficacy, and fat reduction behaviors. A sample of obese African-American and white mothers was recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Wisconsin. Participants reported their weight management status, education, self-efficacy for eating low-fat food, and fat reduction behaviors. For both racial groups, weight management status predicted low-fat food substitution and meat modification behaviors; education predicted meat modification behavior. Three task-specific domains of self-efficacy (negative mood, positive mood, and food availability) predicted different types of fat reduction behaviors and differed by race. Weight management influenced behaviors of low-fat food substitution, meat modification, and fried-food avoidance, mediated partially through self-efficacies of negative mood (African Americans), positive mood (African Americans, whites), and food availability (African Americans). Race affected the relationships between weight management, education, three task-specific domains of self-efficacy, and five types of fat reduction behaviors. Self-efficacies operated differentially for African Americans and whites. Thus, strategies to address specific fat reduction behaviors have the potential to be more effective when tailored to specific individual characteristics such as racial background, history of weight management strategies and task-specific domains of self-efficacy.

Low glycaemic index diets improve glucose tolerance and body weight in women with previous history of gestational diabetes: a six months randomized trial.

PubMed

Shyam, Sangeetha; Arshad, Fatimah; Abdul Ghani, Rohana; Wahab, Norasyikin A; Safii, Nik Shanita; Nisak, Mohd Yusof Barakatun; Chinna, Karuthan; Kamaruddin, Nor Azmi

2013-05-24

Gestational Diabetes Mellitus (GDM) increases risks for type 2 diabetes and weight management is recommended to reduce the risk. Conventional dietary recommendations (energy-restricted, low fat) have limited success in women with previous GDM. The effect of lowering Glycaemic Index (GI) in managing glycaemic variables and body weight in women post-GDM is unknown. To evaluate the effects of conventional dietary recommendations administered with and without additional low-GI education, in the management of glucose tolerance and body weight in Asian women with previous GDM. Seventy seven Asian, non-diabetic women with previous GDM, between 20- 40y were randomised into Conventional healthy dietary recommendation (CHDR) and low GI (LGI) groups. CHDR received conventional dietary recommendations only (energy restricted, low in fat and refined sugars, high-fibre). LGI group received advice on lowering GI in addition. Fasting and 2-h post-load blood glucose after 75 g oral glucose tolerance test (2HPP) were measured at baseline and 6 months after intervention. Anthropometry and dietary intake were assessed at baseline, three and six months after intervention. The study is registered at the Malaysian National Medical Research Register (NMRR) with Research ID: 5183. After 6 months, significant reductions in body weight, BMI and waist-to-hip ratio were observed only in LGI group (P<0.05). Mean BMI changes were significantly different between groups (LGI vs. CHDR: -0.6 vs. 0 kg/m2, P= 0.03). More subjects achieved weight loss ≥5% in LGI compared to CHDR group (33% vs. 8%, P=0.01). Changes in 2HPP were significantly different between groups (LGI vs. CHDR: median (IQR): -0.2(2.8) vs. +0.8 (2.0) mmol/L, P=0.025). Subjects with baseline fasting insulin≥2 μIU/ml had greater 2HPP reductions in LGI group compared to those in the CHDR group (-1.9±0.42 vs. +1.31±1.4 mmol/L, P<0.001). After 6 months, LGI group diets showed significantly lower GI (57±5 vs. 64±6, P<0.001), GL (122±33 vs. 142±35, P=0.04) and higher fibre content (17±4 vs.13±4 g, P<0.001). Caloric intakes were comparable between groups. In women post-GDM, lowering GI of healthy diets resulted in significant improvements in glucose tolerance and body weight reduction as compared to conventional low-fat diets with similar energy prescription.

Low glycaemic index diets improve glucose tolerance and body weight in women with previous history of gestational diabetes: a six months randomized trial

PubMed Central

2013-01-01

Background Gestational Diabetes Mellitus (GDM) increases risks for type 2 diabetes and weight management is recommended to reduce the risk. Conventional dietary recommendations (energy-restricted, low fat) have limited success in women with previous GDM. The effect of lowering Glycaemic Index (GI) in managing glycaemic variables and body weight in women post-GDM is unknown. Objective To evaluate the effects of conventional dietary recommendations administered with and without additional low-GI education, in the management of glucose tolerance and body weight in Asian women with previous GDM. Method Seventy seven Asian, non-diabetic women with previous GDM, between 20- 40y were randomised into Conventional healthy dietary recommendation (CHDR) and low GI (LGI) groups. CHDR received conventional dietary recommendations only (energy restricted, low in fat and refined sugars, high-fibre). LGI group received advice on lowering GI in addition. Fasting and 2-h post-load blood glucose after 75 g oral glucose tolerance test (2HPP) were measured at baseline and 6 months after intervention. Anthropometry and dietary intake were assessed at baseline, three and six months after intervention. The study is registered at the Malaysian National Medical Research Register (NMRR) with Research ID: 5183. Results After 6 months, significant reductions in body weight, BMI and waist-to-hip ratio were observed only in LGI group (P<0.05). Mean BMI changes were significantly different between groups (LGI vs. CHDR: -0.6 vs. 0 kg/m2, P= 0.03). More subjects achieved weight loss ≥5% in LGI compared to CHDR group (33% vs. 8%, P=0.01). Changes in 2HPP were significantly different between groups (LGI vs. CHDR: median (IQR): -0.2(2.8) vs. +0.8 (2.0) mmol/L, P=0.025). Subjects with baseline fasting insulin≥2 μIU/ml had greater 2HPP reductions in LGI group compared to those in the CHDR group (−1.9±0.42 vs. +1.31±1.4 mmol/L, P<0.001). After 6 months, LGI group diets showed significantly lower GI (57±5 vs. 64±6, P<0.001), GL (122±33 vs. 142±35, P=0.04) and higher fibre content (17±4 vs.13±4 g, P<0.001). Caloric intakes were comparable between groups. Conclusion In women post-GDM, lowering GI of healthy diets resulted in significant improvements in glucose tolerance and body weight reduction as compared to conventional low-fat diets with similar energy prescription. PMID:23705645

Changes in diet quality in a randomized weight loss trial in breast cancer survivors: the lifestyle, exercise, and nutrition (LEAN) study.

PubMed

Anderson, Chelsea; Harrigan, Maura; George, Stephanie M; Ferrucci, Leah M; Sanft, Tara; Irwin, Melinda L; Cartmel, Brenda

2016-01-01

Obesity is associated with increased breast cancer recurrence and mortality. Though some post-diagnosis weight loss interventions have achieved weight loss outcomes, it is unclear whether they also improve diet quality. In the Lifestyle, Exercise, and Nutrition (LEAN) study, overweight or obese breast cancer survivors were randomized to either usual care group ( n =33) or the 6-month lifestyle intervention ( n =67). Dietary intake was assessed at baseline and 6 months using a validated food frequency questionnaire, and overall diet quality was calculated using the Healthy Eating Index (HEI)-2010 (range 0-100). Intervention effects on diet were evaluated with generalized linear models. Among the 81 participants (51 intervention, 30 usual care) with dietary data, the mean baseline HEI score was 70.5 (s.d.=8.8) and was improved at 6 months (intervention group=6.8 point increase vs usual care=3.1, P =0.09). Intervention group participants achieved greater reductions in percent of energy from total fat (-4.2% vs -1.2%; P =0.013) and saturated fat (-2.2% vs -1.1%; P =0.003), and greater increases in fiber (4.8 g per 1000 kcal vs 1.3 g per 1000 kcal; P =0.007) and fruit (0.5 servings vs 0.0 servings; P =0.006) intake. Intervention group participants who lost ⩾5% body weight ( n =27) demonstrated significantly greater improvements in HEI score (10.4 vs 2.8) than those who lost <5% ( n =23). The intervention increased fruit and fiber intake and decreased percent energy from fat, and those with greater weight loss achieved greater increases in overall diet quality. These findings support the ability of a weight loss intervention to improve diet among breast cancer survivors.

An intensive behavioral weight loss intervention and hot flushes in women.

PubMed

Huang, Alison J; Subak, Leslee L; Wing, Rena; West, Delia Smith; Hernandez, Alexandra L; Macer, Judy; Grady, Deborah

2010-07-12

Higher body mass index is associated with worse hot flushes during menopause but the effect of weight loss on flushing is unclear. Self-administered questionnaires were used to assess bothersome hot flushes in a 6-month randomized controlled trial of an intensive behavioral weight loss program (intervention) vs a structured health education program (control) in 338 women who were overweight or obese and had urinary incontinence. Weight, body mass index, abdominal circumference, physical activity, calorie intake, blood pressure, and physical and mental functioning were assessed at baseline and at 6 months. Repeated-measures proportional odds models examined intervention effects on bothersome hot flushes and potential mediating factors. Approximately half of participants (n = 154) were at least slightly bothered by hot flushes at baseline. Among these women, the intervention was associated with greater improvement in bothersome flushes vs control (odds ratio [OR] for improvement by 1 Likert category, 2.25; 95% confidence interval [CI], 1.20-4.21). Reductions in weight (OR, 1.32; 95% CI, 1.08-1.61; per 5-kg decrease), body mass index (1.17; 1.05-1.30; per 1-point decrease), and abdominal circumference (1.32; 1.07-1.64; per 5-cm decrease) were each associated with improvement in flushing, but changes in physical activity, calorie intake, blood pressure, and physical and mental functioning were not related. The effect of the intervention on flushing was modestly diminished after adjustment for multiple potential mediators (OR, 1.92; 95% CI, 0.95-3.89). Among women who were overweight or obese and had bothersome hot flushes, an intensive behavioral weight loss intervention resulted in improvement in flushing relative to control. Trial Registration clinicaltrials.gov Identifier: NCT00091988.

Examining behavioral processes through which lifestyle interventions promote weight loss: results from PREMIER.

PubMed

Fitzpatrick, Stephanie L; Bandeen-Roche, Karen; Stevens, Victor J; Coughlin, Janelle W; Rubin, Richard R; Brantley, Phillip J; Funk, Kristine L; Svetkey, Laura P; Jerome, Gerald J; Dalcin, Arlene; Charleston, Jeanne; Appel, Lawrence J

2014-04-01

To examine the behavioral processes through which lifestyle interventions impacted weight loss. The analyses were limited to overweight and obese Black and White adults randomized to a PREMIER lifestyle intervention (N = 501). Structural equation modeling was conducted to test the direct and indirect relationships of session attendance, days of self-monitoring diet and exercise, change in diet composition and exercise, and 6-month weight change. Greater session attendance was associated with increased self-monitoring, which was in turn significantly related to reduction in percent energy from total fat consumed. Change in percent energy from fat and self-monitoring was associated with 6-month percent change in weight. Both a decrease in fat intake and increase in self-monitoring are potential mediators of the relationship between attendance and weight change. The findings provide a reasonable model that suggests regular session attendance and use of behavioral strategies like self-monitoring are associated with improved behavioral outcomes that are associated with weight loss. Copyright © 2013 The Obesity Society.

Using synchronous distance-education technology to deliver a weight management intervention.

PubMed

Dunn, Carolyn; Whetstone, Lauren MacKenzie; Kolasa, Kathryn M; Jayaratne, K S U; Thomas, Cathy; Aggarwal, Surabhi; Nordby, Kelly; Riley, Kenisha E M

2014-01-01

To compare the effectiveness of online delivery of a weight management program using synchronous (real-time), distance-education technology to in-person delivery. Synchronous, distance-education technology was used to conduct weekly sessions for participants with a live instructor. Program effectiveness was indicated by changes in weight, body mass index (BMI), waist circumference, and confidence in ability to eat healthy and be physically active. Online class participants (n = 398) had significantly greater reductions in BMI, weight, and waist circumference than in-person class participants (n = 1,313). Physical activity confidence increased more for in-person than online class participants. There was no difference for healthy eating confidence. This project demonstrates the feasibility of using synchronous distance-education technology to deliver a weight management program. Synchronous online delivery could be employed with no loss to improvements in BMI, weight, and waist circumference. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Effect of Dietary Weight Loss on Menstrual Regularity in Obese Young Adult Women with Polycystic Ovary Syndrome.

PubMed

Marzouk, Tayseer M; Sayed Ahmed, Waleed A

2015-12-01

To investigate the effect of dietary weight loss on menstrual regularity in obese adolescent women with polycystic ovary syndrome (PCOS). A randomized controlled trial was held at the Faculty of Nursing, Mansoura University, and the Obesity Clinic of the Rheumatology Department at Mansoura University Hospitals between July 2011 and January 2013. Sixty adolescent women with PCOS, body mass index (BMI) greater than 30, and complaints of menstrual irregularities were included in this study. Enrolled women were divided equally and randomly into 2 groups: intervention and control groups. Women in the intervention group (n = 30) were subject to an intensive dietary educational program with instructions to follow a conventional energy restricted diet, whereas women in the control group were instructed to follow the same healthy diet of the first group without calorie restriction. Menstrual regularity, weight loss, the effect on waist circumference, and hirsutism score. The 2 groups were initially matched in average body weight, BMI, hirsutism score, and waist circumference. Six months later, there were significant decreases in all parameters in the weight reduction group. In addition, more menstrual episodes were recorded in the weight reduction compared with the control group (3.1 ± 1.2 vs. 2.3 ± 1.3; P = .010). Also, BMI, waist circumference, and hirsutism score were all significantly decreased at the end of the study. Dietary weight loss in adolescent women with PCOS resulted in significant improvement in menstrual regularity, BMI, waist circumference, and hirsutism score. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

C-reactive protein before and after weight loss in overweight women with and without polycystic ovary syndrome.

PubMed

Moran, Lisa J; Noakes, Manny; Clifton, Peter M; Wittert, Gary A; Belobrajdic, Damien P; Norman, Robert J

2007-08-01

Polycystic ovary syndrome (PCOS) is associated with reproductive and metabolic abnormalities. It is unknown whether overweight women with and without PCOS achieve similar benefits from weight loss for cardiovascular risk factors. Overweight body mass index-matched women with (n = 15) and without (n = 17) PCOS (weight, 95.3 +/- 17.6 kg; body mass index, 35.6 +/- 5.3 kg/m(2), mean +/- sd) followed an 8-wk weight loss regime. All subjects had similar reductions in weight (3.9 +/- 3.6 kg, 3.8%, vs. 4.5 +/- 4.1 kg, 4.7%, respectively, for PCOS and non-PCOS), waist circumference, fat mass, triglycerides, free testosterone, and fasting and postprandial insulin. At baseline, C-reactive protein (CRP) between groups was not significantly different (5.5 +/- 3.1 mg/liter for PCOS vs. 4.9 +/- 3.0 mg/liter for non-PCOS). There was a significant interaction between PCOS status and CRP (P = 0.016) such that CRP decreased with weight loss for non-PCOS women (-1.2 +/- 1.8 mg/liter; P = 0.025) but not for PCOS women. For all women, the change in CRP correlated with the change in weight (r = 0.560; P = 0.003), fat mass (r = 0.477; P = 0.016), and postprandial insulin (r = 0.402; P = 0.046). Adiponectin, IL-6, and TNF-alpha were not significantly different between groups before or after weight loss. Only subjects with baseline CRP levels below the median (4.52 mg/liter) showed increases in adiponectin (0.98 +/- 1.3 microg/liter) (P = 0.015) and greater reductions in triglycerides (P = 0.001) with weight loss. A 4-5% weight loss improved lipid, glucose, and insulin profiles in women with and without PCOS. This degree of weight loss was not effective in lowering CRP concentrations in PCOS women, suggesting that greater weight loss is required in this group to achieve equivalent cardiovascular benefit to non-PCOS women.

Evaluation of Invisalign treatment effectiveness and efficiency compared with conventional fixed appliances using the Peer Assessment Rating index.

PubMed

Gu, Jiafeng; Tang, Jack Shengyu; Skulski, Brennan; Fields, Henry W; Beck, F Michael; Firestone, Allen R; Kim, Do-Gyoon; Deguchi, Toru

2017-02-01

The purpose of this retrospective case-control study was to compare the treatment effectiveness and efficiency of the Invisalign system with conventional fixed appliances in treating orthodontic patients with mild to moderate malocclusion in a graduate orthodontic clinic. Using the peer assessment rating (PAR) index, we evaluated pretreatment and posttreatment records of 48 Invisalign patients and 48 fixed appliances patients. The 2 groups of patients were controlled for general characteristics and initial severity of malocclusion. We analyzed treatment outcome, duration, and improvement between the Invisalign and fixed appliances groups. The average pretreatment PAR scores (United Kingdom weighting) were 20.81 for Invisalign and 22.79 for fixed appliances (P = 1.0000). Posttreatment weighted PAR scores between Invisalign and fixed appliances were not statistically different (P = 0.7420). On average, the Invisalign patients finished 5.7 months faster than did those with fixed appliances (P = 0.0040). The weighted PAR score reduction with treatment was not statistically different between the Invisalign and fixed appliances groups (P = 0.4573). All patients in both groups had more than a 30% reduction in the PAR scores. Logistic regression analysis indicated that the odds of achieving "great improvement" in the Invisalign group were 0.329 times the odds of achieving "great improvement" in the fixed appliances group after controlling for age (P = 0.0150). Our data showed that both Invisalign and fixed appliances were able to improve the malocclusion. Invisalign patients finished treatment faster than did those with fixed appliances. However, it appears that Invisalign may not be as effective as fixed appliances in achieving "great improvement" in a malocclusion. This study might help clinicians to determine appropriate patients for Invisalign treatment. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Salivary cortisol levels are associated with outcomes of weight reduction therapy in obese Japanese patients.

PubMed

Himeno, Akihiro; Satoh-Asahara, Noriko; Usui, Takeshi; Wada, Hiromichi; Tochiya, Mayu; Kono, Shigeo; Yamada-Goto, Nobuko; Katsuura, Goro; Hasegawa, Koji; Nakao, Kazuwa; Shimatsu, Akira

2012-02-01

Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis can increase the risk of cardiovascular disease (CVD). However, the detailed relationships of HPA axis activity with weight reduction and CVD risk factors in obese patients have not been examined. This study was designed to elucidate the associations of salivary cortisol levels with weight reduction and CVD risk factors in obese patients. As a marker of HPA axis activity, we measured the morning salivary cortisol levels of 83 obese Japanese outpatients. We also examined metabolic parameters, inflammatory markers, and indicators of arterial stiffness, that is, the pulse wave velocity and cardio-ankle vascular index. All 83 obese patients underwent 3-month weight reduction therapy with lifestyle modification. At the baseline, multivariate regression analysis revealed that only logarithmic transformation of C-reactive protein (β = 0.258, P < .05) and cardio-ankle vascular index (β = 0.233, P < .05) were independent determinants of the salivary cortisol levels. However, other metabolic parameters were not significantly associated with the salivary cortisol levels. In addition, lower salivary cortisol levels and higher body weight at the baseline were the only independent determinants of successful weight loss through the weight reduction therapy (P < .01). The present study demonstrates that the baseline morning salivary cortisol levels are significantly associated with the levels of an inflammatory marker, arterial stiffness, and successful weight reduction in obese patients. Therefore, salivary cortisol could be a useful marker for assessing and managing body weight and CVD risk factors in obese patients. Copyright © 2012 Elsevier Inc. All rights reserved.

Comparable Attenuation of Sympathetic Nervous System Activity in Obese Subjects with Normal Glucose Tolerance, Impaired Glucose Tolerance, and Treatment Naïve Type 2 Diabetes following Equivalent Weight Loss

PubMed Central

Straznicky, Nora E.; Grima, Mariee T.; Sari, Carolina I.; Lambert, Elisabeth A.; Phillips, Sarah E.; Eikelis, Nina; Mariani, Justin A.; Kobayashi, Daisuke; Hering, Dagmara; Dixon, John B.; Lambert, Gavin W.

2016-01-01

Background and Purpose: Elevated sympathetic nervous system (SNS) activity is a characteristic of obesity and type 2 diabetes (T2D) that contributes to target organ damage and cardiovascular risk. In this study we examined whether baseline metabolic status influences the degree of sympathoinhibition attained following equivalent dietary weight loss. Methods: Un-medicated obese individuals categorized as normal glucose tolerant (NGT, n = 15), impaired glucose tolerant (IGT, n = 24), and newly-diagnosed T2D (n = 15) consumed a hypocaloric diet (29% fat, 23% protein, 45% carbohydrate) for 4-months. The three groups were matched for baseline age (56 ± 1 years), body mass index (BMI, 32.9 ± 0.7 kg/m2), and gender. Clinical measurements included whole-body norepinephrine kinetics, muscle sympathetic nerve activity (MSNA, by microneurography), spontaneous cardiac baroreflex sensitivity (BRS), and oral glucose tolerance test. Results: Weight loss averaged −7.5 ± 0.8, −8.1 ± 0.5, and −8.0 ± 0.9% of body weight in NGT, IGT, and T2D groups, respectively. T2D subjects had significantly greater reductions in fasting glucose, 2-h glucose and glucose area under the curve (AUC0−120) compared to NGT and IGT (group effect, P <0.001). Insulinogenic index decreased in IGT and NGT groups and increased in T2D (group × time, P = 0.04). The magnitude of reduction in MSNA (−7 ± 3, −8 ± 4, −15 ± 4 burst/100 hb, respectively) and whole-body norepinephrine spillover rate (−28 ± 8, −18 ± 6, and −25 ± 7%, respectively), time effect both P <0.001, did not differ between groups. After adjustment for age and change in body weight, Δ insulin AUC0−120 was independently associated with reduction in arterial norepinephrine concentration, whilst Δ LDL-cholesterol and improvement in BRS were independently associated with decrease in MSNA. Conclusions: Equivalent weight loss through hypocaloric diet is accompanied by similar sympathoinhibition in matched obese subjects with different baseline glucose tolerance. Attenuation of hyperinsulinemia and hyperlipidemia, rather than glycemic indices, is associated with reduction in SNS activity following weight loss intervention. PMID:27857694

Taking weight-loss supplements may elicit liberation from dietary control. A laboratory experiment.

PubMed

Chang, Yevvon Yi-Chi; Chiou, Wen-Bin

2014-01-01

Given that changes in diet and exercise habits are difficult to initiate and maintain, the use of weight-loss supplements has become an appealing alternative approach to weight management for many individuals. The current research examined whether the use of weight-loss supplements induced overly optimistic assessments of progress toward weight reduction, leading to psychological abdication of dietary regulation. Participants were randomly assigned to take either an identified placebo or a purported weight-loss supplement (actually the same placebo). Each participant reported perceived progress toward weight reduction following the manipulation. Consumption of snacks in a taste test and choice of sugary drinks were recorded. The results showed that participants receiving a purported supplement ate more in a taste task and preferred larger quantities of sugar in their reward drinks than did controls. Mediation analysis supported that the perception of progress toward weight reduction contributed to the liberating effect. Using weight-loss supplements may increase perceived progress toward weight reduction but decrease dietary self-regulation. These thought-provoking findings can serve as a basis for educating the public about the myth that they are free to feel liberated from the need to regulate their eating when using weight-loss supplements. Copyright © 2013 Elsevier Ltd. All rights reserved.

Targeting DMPK with Antisense Oligonucleotide Improves Muscle Strength in Myotonic Dystrophy Type 1 Mice.

PubMed

Jauvin, Dominic; Chrétien, Jessina; Pandey, Sanjay K; Martineau, Laurie; Revillod, Lucille; Bassez, Guillaume; Lachon, Aline; MacLeod, A Robert; Gourdon, Geneviève; Wheeler, Thurman M; Thornton, Charles A; Bennett, C Frank; Puymirat, Jack

2017-06-16

Myotonic dystrophy type 1 (DM1), a dominant hereditary muscular dystrophy, is caused by an abnormal expansion of a (CTG) n trinucleotide repeat in the 3' UTR of the human dystrophia myotonica protein kinase (DMPK) gene. As a consequence, mutant transcripts containing expanded CUG repeats are retained in nuclear foci and alter the function of splicing regulatory factors members of the MBNL and CELF families, resulting in alternative splicing misregulation of specific transcripts in affected DM1 tissues. In the present study, we treated DMSXL mice systemically with a 2'-4'-constrained, ethyl-modified (ISIS 486178) antisense oligonucleotide (ASO) targeted to the 3' UTR of the DMPK gene, which led to a 70% reduction in CUG exp RNA abundance and foci in different skeletal muscles and a 30% reduction in the heart. Furthermore, treatment with ISIS 486178 ASO improved body weight, muscle strength, and muscle histology, whereas no overt toxicity was detected. This is evidence that the reduction of CUG exp RNA improves muscle strength in DM1, suggesting that muscle weakness in DM1 patients may be improved following elimination of toxic RNAs. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Two Improved Algorithms for Envelope and Wavefront Reduction

NASA Technical Reports Server (NTRS)

Kumfert, Gary; Pothen, Alex

1997-01-01

Two algorithms for reordering sparse, symmetric matrices or undirected graphs to reduce envelope and wavefront are considered. The first is a combinatorial algorithm introduced by Sloan and further developed by Duff, Reid, and Scott; we describe enhancements to the Sloan algorithm that improve its quality and reduce its run time. Our test problems fall into two classes with differing asymptotic behavior of their envelope parameters as a function of the weights in the Sloan algorithm. We describe an efficient 0(nlogn + m) time implementation of the Sloan algorithm, where n is the number of rows (vertices), and m is the number of nonzeros (edges). On a collection of test problems, the improved Sloan algorithm required, on the average, only twice the time required by the simpler Reverse Cuthill-Mckee algorithm while improving the mean square wavefront by a factor of three. The second algorithm is a hybrid that combines a spectral algorithm for envelope and wavefront reduction with a refinement step that uses a modified Sloan algorithm. The hybrid algorithm reduces the envelope size and mean square wavefront obtained from the Sloan algorithm at the cost of greater running times. We illustrate how these reductions translate into tangible benefits for frontal Cholesky factorization and incomplete factorization preconditioning.

Risk aversion and willingness to pay for water quality: The case of non-farm rural residents.

PubMed

Larue, Bruno; West, Gale E; Singbo, Alphonse; Tamini, Lota Dabio

2017-07-15

Stated choice experiments are used to investigate the economic valuation of rural residents living in the province of Quebec for water quality improvements. In Quebec, rural residents played an important role in the setting of stricter environmental regulations. Unlike most stated choice experiments about the valuation of improvements in water quality, this study explicitly accounts for risk in the design and analysis of choice experiments. Risk in phosphorus and coliform reductions is introduced through a three-point uniform distribution in the choice sets. The results show greater support for constant absolute risk aversion preferences than for constant relative risk aversion. Rural residents value coliform and phosphorus reductions and the more educated ones are particularly willing to see the government tax farmers and taxpayers to secure such reductions. As the science improves and risk in water quality outcomes decrease and as the political weight of non-farm rural residents increase, it should be easier for governments to replace voluntary cost-share programs by polluter-payer programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Reactive Oxygen Species Response to Exercise Training and Weight Loss in Sedentary Overweight and Obese Female Adults.

PubMed

Bianchi, Vittorio E; Ribisl, Paul M

2015-01-01

Reactive oxygen species (ROS) are implicated in cardiovascular disease and in the pathogenesis of type 2 diabetes and its complications, and it has been shown to increase insulin resistance. The purpose of this study was to examine the effect of aerobic exercise training and weight loss on ROS in overweight and obese patients as applied in a community clinical setting. Fifty healthy female clinic patients (M ± SEM: age, 41.0 ± 1.8 years; body mass index, 28.2 ± 0.8 kg/m2), free of cardiovascular events and not on drug therapy were evaluated before and after 3 months of dietary restriction (∼150 to 300 kcal/day deficit) and aerobic training (3 days/week for 1 hour at ∼75% VO2max). Measures included ROS, maximal power (kg/min) on cycle ergometry, postexercise heart rate recovery responses at 1 and 2 minutes, and selected anthropometric and hematologic variables. Significant (P < .01) improvements were observed after aerobic training and weight loss in body weight in kilograms (-7.1%); maximal power in kg/min (+32.6%), ROS in U.CARR (Carratelli units) (-25.7%); and heart rate recovery 1 minute in beats per minute (-37.6%) following the program. Significant improvements were also noted in other anthropometric, cardiovascular, and hematologic measures. A 12-week program of nutritional and exercise intervention in overweight/obese sedentary women improves levels of oxidative stress when accompanied by weight loss and improved fitness. More than restricted caloric intake, physical activity at a relatively high intensity was effective in improving cardiovascular risk markers. The reduction in ROS may be an additional mechanism by which physical activity may contribute to preventing metabolic syndrome and subsequent atherosclerotic disease.

Changes to dietary intake during a 12-week commercial web-based weight loss program: a randomized controlled trial.

PubMed

Hutchesson, M J; Collins, C E; Morgan, P J; Watson, J F; Guest, M; Callister, R

2014-01-01

The primary aim of this secondary analysis was to compare changes in dietary intake among participants randomized to two versions of a 12-week commercial web-based weight loss program (basic or enhanced) with a waiting-list control. An additional investigation compared changes in dietary intake of successful participants (weight loss ≥5%) with those not successful. Dietary intake was assessed at baseline and 12 weeks using a validated 120-item semiquantitative food frequency questionnaire. Adults (n=268, 60% female participants, body mass index 32.1 ± 3.9) classified as plausible reporters of energy intake were included in the analyses. Analysis of covariance with baseline observations carried forward for drop-outs (n=38) was used. The basic and enhanced groups significantly increased their percentage of energy contribution from fruits and reduced energy-dense, nutrient-poor foods compared with controls (P<0.001). Successful participants (n=49) reported superior improvements in dietary intake including greater reductions in the mean daily energy intake (P<0.001), the percentage of energy from energy-dense, nutrient-poor foods (-12.0% E vs -4.3% E, P<0.001) and greater increases in the energy contribution from fruits (P<0.001), vegetables (P=0.003) and breads/cereals (P=0.02). Use of a commercial web-based weight loss program facilitated some improvements in the dietary intake. The enhanced web-based tools appeared not to have generated greater improvements in reported dietary intake, compared with the basic or control groups. Those who achieved a weight loss of ≥5% improved their dietary intake in line with the program recommendations and dietary guidelines. Further research to determine web-based components that may improve success and the reasons why programs are successful for some participants is required.

Effect of nano/micro B4C and SiC particles on fracture properties of aluminum 7075 particulate composites under chevron-notch plane strain fracture toughness test

NASA Astrophysics Data System (ADS)

Morovvati, M. R.; Lalehpour, A.; Esmaeilzare, A.

2016-12-01

Reinforcing aluminum with SiC and B4C nano/micro particles can lead to a more efficient material in terms of strength and light weight. The influence of adding these particles to an aluminum 7075 matrix is investigated using chevron-notch fracture toughness test method. The reinforcing factors are type, size (micro/nano), and weight percent of the particles. The fracture parameters are maximum load, notch opening displacement, the work up to fracture and chevron notch plane strain fracture toughness. The findings demonstrate that addition of micro and nano size particles improves the fracture properties; however, increasing the weight percent of the particles leads to increase of fracture properties up to a certain level and after that due to agglomeration of the particles, the improvement does not happen for both particle types and size categories. Agglomeration of particles at higher amounts of reinforcing particles results in improper distribution of particles and reduction in mechanical properties.

The effects of oxytocin on eating behaviour and metabolism in humans.

PubMed

Lawson, Elizabeth A

2017-12-01

Oxytocin, a hypothalamic hormone that is secreted directly into the brain and enters the peripheral circulation through the posterior pituitary gland, regulates a range of physiologic processes, including eating behaviour and metabolism. In rodents and nonhuman primates, chronic oxytocin administration leads to sustained weight reduction by reducing food intake, increasing energy expenditure and inducing lipolysis. Oxytocin might improve glucose homeostasis, independently of its effects on weight. Clinical studies are beginning to translate these important preclinical findings to humans. This Review describes key data linking oxytocin to eating behaviour and metabolism in humans. For example, a single intranasal dose of oxytocin can reduce caloric intake, increase fat oxidation and improve insulin sensitivity in men. Furthermore, a pilot study of 8 weeks of oxytocin treatment in adults with obesity or overweight led to substantial weight loss. Together, these data support further investigation of interventions that target pathways involving oxytocin as potential therapeutics in metabolic disorders, including obesity and diabetes mellitus. Therapeutic considerations and areas for further research are also discussed.

An experimental therapeutics test of whether adding dissonance-induction activities improves the effectiveness of a selective obesity and eating disorder prevention program.

PubMed

Stice, E; Rohde, P; Shaw, H; Gau, J M

2018-03-01

Compare the Healthy Weight obesity and eating disorder prevention program, which promotes participant-driven gradual lifestyle changes to bring energy intake and expenditure into balance, to a new intervention, Project Health, which adds activities to create cognitive dissonance about unhealthy eating, a sedentary lifestyle, and excess body fat, and an obesity education video-control condition. College students at risk for both outcomes because of weight concerns (N=364, 72% female) were randomized to condition, completing pretest, posttest, and 6, 12 and 24-month follow-up assessments. Project Health participants showed significantly smaller increases in measured body mass index (BMI) through 2-year follow-up than both Healthy Weight participants and controls (both d=-0.18), and significantly lower onset of overweight/obesity over 2-year follow-up than Healthy Weight participants and controls (13 vs 21% and 22%). Healthy Weight and Project Health participants showed significantly greater eating disorder symptom reductions than controls through 2-year follow-up. Healthy Weight and Project Health participants showed marginally lower eating disorder onset over follow-up than controls (3 and 3% vs 8% respectively). The reduced increases in BMI and future overweight/obesity onset for Project Health relative to both an active matched intervention and a minimal intervention control condition are noteworthy, especially given the short 6-h intervention duration. The reduction in eating disorder symptoms for Healthy Weight and Project Health relative to controls was also encouraging. Results suggest that adding dissonance-induction activities increased weight loss effects. Yet, effects for both were generally small and the eating disorder onset prevention effects were only marginal, potentially because intervention groups included both sexes, which reduced eating disorder incidence and sensitivity.

Has the Time Come to Be More Aggressive With Bariatric Surgery in Obese Patients With Chronic Systolic Heart Failure?

PubMed

Vest, Amanda R

2018-06-01

Obesity is a strong risk factor for the development of heart failure (HF). Diet, exercise, and weight-loss pharmacotherapies have limited potential to achieve significant and sustainable weight loss, especially in patients with symptomatic systolic HF. This review seeks to determine the role of bariatric surgery for patients with systolic HF and obesity. Bariatric surgeries such as the laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) represent the most successful long-term strategy for achieving weight loss and diabetes and hypertension remission in the general obese population. These benefits translate to reductions in cardiovascular events and mortality, as well as improvements in myocardial structure and function. There is also now data supporting the safety of LSG or RYGB in patients with systolic dysfunction and a reduction in HF admissions post-operatively. Current literature and clinical experience suggest that the most appropriate bariatric surgery candidates with HF are patients aged < 50-60 years, with severely depressed systolic function and NYHA II-III symptoms, who have failed non-surgical strategies and have a high likelihood of future cardiac transplantation candidacy after weight loss. This review seeks to determine the role of bariatric surgery for patients with systolic HF and obesity.

Pasta supplemented with isolated lupin protein fractions reduces body weight gain and food intake of rats and decreases plasma glucose concentration upon glucose overload trial.

PubMed

Capraro, Jessica; Magni, Chiara; Scarafoni, Alessio; Caramanico, Rosita; Rossi, Filippo; Morlacchini, Mauro; Duranti, Marcello

2014-02-01

The supplementation of foods with biologically active compounds can be a powerful approach for improving diet and well being. In this study we separately included in pasta matrices a concentrate of γ-conglutin, a glucose-lowering protein from Lupinus albus seeds, an isolate of the other main lupin storage proteins and ovalbumin, at a ratio corresponding to 125 mg of pure protein in 100 g of pasta. With these products we fed rats made hyperglycaemic, for 3 weeks. Among the most relevant changes measured in body and blood parameters were: (i) a significant reduction in food intake of rats fed γ-conglutin concentrate supplemented pasta and a significant limitation in the body weight increase in rats fed α, β and δ-conglutin isolate supplemented pasta, while the food conversion indices were unchanged; (ii) a reduction in glycaemia upon glucose overload trial, especially in the γ-conglutin concentrate supplemented pasta fed animals, at a dose of 45 mg per kg body weight. The correlations among the measured parameters are discussed. Overall, the results evidence the potentiality of supplementing traditional foods with exogenous nutraceutical seed proteins to control body weight gain and glycaemia.

A primary care based healthy-eating and active living education session for weight reduction in the pre-diabetic population.

PubMed

Weir, Daniala L; Johnson, Steven T; Mundt, Clark; Bray, Dianne; Taylor, Lorian; Eurich, Dean T; Johnson, Jeffrey A

2014-12-01

Many studies have demonstrated the effectiveness of primary prevention strategies in type 2 diabetes, however, questions remain around the feasibility of high resource, intensive interventions within a healthcare setting. We report the results of a dietitian-led pre-diabetes education session targeting healthy eating and active living as strategies for weight reduction. Participants were asked to complete a baseline questionnaire prior to completing the pre-diabetes education session and were sent follow-up questionnaires at 3 and 6 months. Differences between participants at baseline, 3 and 6 months were determined using χ(2), t-tests and ANOVA. Of the 211 participants asked to fill out baseline questionnaires, 45 participants completed questionnaires at baseline, 3 months and 6 months. Although we observed general trends towards improvements in diet, physical activity and weight related behaviours among the 45 completers, no significant changes were observed among participants between questionnaire periods. A "one-off", theory-guided group education session may be insufficient to support lifestyle modifications in the context of weight management in a pre-diabetic population. Further evaluation of the efficacy and feasibility of the PCN as a setting for lifestyle intervention is required. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Morphological, biochemical, histological, and ultrastructural protective effects of misoprostol on cisplatin induced-hepatotoxicity in adult male rats.

PubMed

Nasr, Ashraf Y

2013-12-01

To investigate the possible protective effect of misoprostol on cisplatin-induced hepatotoxicity. Four-equal sized groups (control, cisplatin-treated, misoprostol-treated, combined misoprostol, and cisplatin-treated) adult male Wistar rats (6 each) were used in this study. Body weight, liver weight, and liver weight/body weight ratio was calculated. Blood samples were obtained from the hearts of rats to determine the levels of total serum bilirubin (TSB), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and albumin. Liver specimens were prepared for both light and electron microscopes. The study was carried out between June 2012 and April 2013 at the Anatomy Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt, and the Department of Anatomy, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. A single cisplatin dose (7.5 mg/kg intraperitoneally) resulted in significant elevation of AST, ALT, and TSB serum levels, and a significant reduction of serum albumin level, body weight, liver weight, and liver weight/body weight ratio. A combination of misoprostol (200 ug/kg/day) with cisplatin improved most of the previous parameters. Examination of specimens by both light and electron microscopes revealed pericentral hepatic necrosis, periportal fibrosis, dilatation, and congestion of central vein and blood sinusoids, diminished glycogen content, degenerated mitochondria, vesicular dilated rough endoplasmic reticulum, and nuclear changes in cisplatin-treated rats. Oral intake of misoprostol with cisplatin improved many of these changes. The results indicate that misoprostol may have a protective effect on cisplatin-induced hepatotoxicity.

Hydrotherapy: An innovative treatment for obese Malaysians

NASA Astrophysics Data System (ADS)

Noordin, M. Hazim M.; Ahmad, Hartini; Baharin, Shamsuddin

2015-12-01

Malaysia is ranked as a country with the most obese population in the Southeast Asia region, and placed sixth in the Asia Pacific. Obesity does not only influence the persons' mobility and quality of health, but could also link to medical leaves and absenteeism affecting the overall workforce productivity and efficiency. Routine physical activity is essential for good health and it is particularly important for those who are trying to lose weight or to maintain a healthy weight. However, it is disheartening to note that only 32.6 percent Malaysians above the age of 15 are involved in physical exercise or vigorous sports. There is an emergence of many types of hydrotherapy system, which are either active or passive and these can be at hospital settings, public places or in individual homes. Such hydrotherapy, if properly programmed can promote the physical activity amongst the obese in Malaysia. Current research on the use of active and passive hydrotherapy for obesity treatment was carried out. Subjects of both sexes and diverse age ranges, immersed themselves in a heated pool within hospital setting and in a bath tubs with high energy turbulent movement of medium temperature water. These hydrotherapy sessions provide a form of physical exercise in water as compared to on the land exercise. The findings of the hydrotherapy sessions have shown encouraging results. Quantitative data was analysed, with the help of descriptive statistics and paired sample t-test. Qualitative data was analysed manually with help of thematic analysis and specialised qualitative assessment software. This study reveals that hydrotherapy has improved patient's mobility, flexibility and exercise capability. Results reveal the reduction in the weight of subjects, with both quantitative and qualitative data results show that Hydrotherapy improved the quality of life in term of body pain reduction and general health improvement. Therefore, it can be concluded that the hydrotherapy can be seen as extensions of exercise and one of the methods in reducing body fat and weight.

Antifungal Efficacy of Caspofungin (MK-0991) in Experimental Pulmonary Aspergillosis in Persistently Neutropenic Rabbits: Pharmacokinetics, Drug Disposition, and Relationship to Galactomannan Antigenemia

PubMed Central

Petraitiene, Ruta; Petraitis, Vidmantas; Groll, Andreas H.; Sein, Tin; Schaufele, Robert L.; Francesconi, Andrea; Bacher, John; Avila, Nilo A.; Walsh, Thomas J.

2002-01-01

The antifungal efficacy, pharmacokinetics, and safety of caspofungin (CAS) were investigated in the treatment and prophylaxis of invasive pulmonary aspergillosis due to Aspergillus fumigatus in persistently neutropenic rabbits. Antifungal therapy consisted of 1, 3, or 6 mg of CAS/kg of body weight/day (CAS1, CAS3, and CAS6, respectively) or 1 mg of deoxycholate amphotericin B (AMB)/kg/day intravenously for 12 days starting 24 h after endotracheal inoculation. Prophylaxis (CAS1) was initiated 4 days before endotracheal inoculation. Rabbits treated with CAS had significant improvement in survival and reduction in organism-mediated pulmonary injury (OMPI) measured by pulmonary infarct score and total lung weight (P < 0.01). However, animals treated with CAS demonstrated a paradoxical trend toward increased residual fungal burden (log CFU per gram) and increased serum galactomannan antigen index (GMI) despite improved survival. Rabbits receiving prophylactic CAS1 also showed significant improvement in survival and reduction in OMPI (P < 0.01), but there was no effect on residual fungal burden. In vitro tetrazolium salt hyphal damage assays and histologic studies demonstrated that CAS had concentration- and dose-dependent effects on hyphal structural integrity. In parallel with a decline in GMI, AMB significantly reduced the pulmonary tissue burden of A. fumigatus (P ≤ 0.01). The CAS1, CAS3, and CAS6 dose regimens demonstrated dose-proportional exposure and maintained drug levels in plasma above the MIC for the entire 24-h dosing interval at doses that were ≥3 mg/kg/day. As serial galactomannan antigen levels may be used for therapeutic monitoring, one should be aware that profoundly neutropenic patients receiving echinocandins for aspergillosis might have persistent galactomannan antigenemia despite clinical improvement. CAS improved survival, reduced pulmonary injury, and caused dose-dependent hyphal damage but with no reduction in residual fungal burden or galactomannan antigenemia in persistently neutropenic rabbits with invasive pulmonary aspergillosis. PMID:11751105

Lifestyle Therapy for the Management of Atrial Fibrillation.

PubMed

Abdul-Aziz, Ahmad A; Altawil, Mahmoud; Lyon, Amanda; MacEachern, Mark; Richardson, Caroline R; Rubenfire, Melvyn; Pelosi, Frank; Jackson, Elizabeth A

2018-05-01

Atrial fibrillation (AF) is a common arrhythmia associated with increased risk of morbidity and mortality. There is evidence that lifestyle interventions may serve as complementary treatments to reduce AF burden. The objective of this review was to summarize the efficacy of lifestyle interventions for the management of AF. Studies which included patients with systolic heart failure (ejection fraction ≤40%), and those limited to an examination of vigorous physical activity were excluded from our search. Studies were identified through a search of the following databases: MEDLINE, EMBASE, CINAHIL, and PubMed, run from inception through August 2016. All studies were graded for quality using the Oxford Centre for Evidence-based Medicine recommendations. Meta-analyses of the studies were not performed due to the heterogeneity of the studies. From a total of 1,811 publications, 10 articles were identified and included. Selected publications included 1 study on yoga, 2 studies on acupuncture, 3 studies that examined weight loss programs, and 4 studies that evaluated the impact of moderate physical activity. Yoga was associated with less symptomatic AF episodes and improved quality of life. Acupuncture was associated with reduced AF occurrence in patients with persistent and paroxysmal AF. Weight loss was associated with a significant reduction AF burden and symptoms. Moderate exercise resulted in greater arrhythmia free survival and a mean reduction in AF burden. In conclusion, evidence exists to suggest that yoga, weight loss, and moderate exercise are associated with reductions in AF burden and symptoms. Evidence is greatest for weight loss and moderate exercise. Copyright © 2018 Elsevier Inc. All rights reserved.

Improved IR detectors to swap heavy systems for SWaP

NASA Astrophysics Data System (ADS)

Manissadjian, Alain; Rubaldo, Laurent; Rebeil, Yann; Kerlain, Alexandre; Brellier, Delphine; Mollard, Laurent

2012-06-01

Cooled IR technologies are challenged for answering new system needs like the compactness and the reduction of cryopower which is a key feature for the SWaP (Size, Weight and Power) requirements. Over the last years, SOFRADIR has improved its HgCdTe technology, with effect on dark current reduction, opening the way for High Operating Temperature (HOT) systems that can get rid of the 80K temperature constraint, and therefore releases the Stirling cooler engine power consumption. Performances of the 640×512 15μm pitch LW detector working above 100K will be presented. A compact 640×512 15μm pitch MW detector presenting high EO performance above 130K with cut-off wavelength above 5.0μm has been developed. Its different performances with respect to the market requirements for SWaP will be discussed. High performance compact systems will make no compromise on detector resolution. The pixel pitch reduction is the answer for resolution enhancement with size reduction. We will therefore also discuss the ongoing developments and market needs for SWaP systems.

Diabetes prevention and control in the workplace: a pilot project for county employees.

PubMed

Barham, Kalleen; West, Susan; Trief, Paula; Morrow, Cynthia; Wade, Michael; Weinstock, Ruth S

2011-01-01

To improve nutrition and physical activity of county employees and promote weight loss. Random assignment to begin the program when first offered or after 3 months ("wait control" group). Worksite. Onondaga County employees (n = 45) at risk for diabetes (n = 35) or with diabetes (n = 10). Mean (±SD) age = 51.2 (± 8.0) years and body mass index (BMI) = 37.3 ± (6.8 kg/m). Twelve weekly healthy lifestyle sessions based on the Diabetes Prevention Program curriculum, followed by monthly sessions for up to 12 months. Medical: Weight, BMI, waist circumference, blood pressure, fasting glucose, lipid, and hemoglobin A1c levels. Psychosocial/behavioral: Health-related quality of life Short Form-12, Impact of Weight on Quality of Life Scale), physical activity (International Physical Activity Questionnaire), eating behavior (3-Factor Eating Questionnaire, National Cancer Institute Fat Screener), job satisfaction. The intervention group lost significant weight compared to the wait control group over the first 3 months (mean [95% CI], -2.23 kg [-3.5 to 0.97]) vs [+ 0.73 kg (+0.17 to +1.28)], with a decrease in BMI (P < .001) and waist circumference (P = .004), an increase in physical activity (International Physical Activity Questionnaire, P = .011) and lower dietary fat intake (P = .018). Over 12 months, 22.5% (9/40) lost more than 5% body weight and 12.5% (5/40) lost more than 7% body weight. After the first 3 months, there was gradual partial weight regain but reduction in waist circumference was maintained. The intervention group demonstrated significant improvement in Impact of Weight on Quality of Life Scale (P < .001), 3-Factor Eating (cognitive restraint P < .001, uncontrolled eating P = .003, and emotional eating P = .001), International Physical Activity Questionnaire (P = .011), and Short Form-12 Physical Component Summary (P = .048). No improvements were observed in blood pressure, lipid, hemoglobin A1c, or glucose levels. Job satisfaction was inversely related to BMI at baseline (P = .001) with a trend for improvement with the modest weight loss. A worksite intervention program can help government employees adopt healthier lifestyles and achieve modest weight loss.

Cooking fuel choices and garbage burning practices as determinants of birth weight: a cross-sectional study in Accra, Ghana

PubMed Central

2012-01-01

Background Effect of indoor air pollution (IAP) on birth weight remains largely unexplored but yet purported as the most important environmental exposure for pregnant women in developing countries due to the effects of second-hand smoke. We investigated the associations between the determinants of indoor air quality in households and birth weight. Methods A cross-sectional study of 592 mothers and their newborns using postnatal services at the Korle Bu Teaching Hospital located in Accra, Ghana was conducted in 2010 to collect information on characteristics of indoor environment and other potential determinants of fetal growth. Birth weight was recorded from hospital records. Results Household cooking fuel choices and garbage burning practices were determinants of birth weight. Multivariate linear regression analysis adjusting for age, social class, marital status and gravidity of mothers, and sex of neonate resulted in a 243g (95% CI: 496, 11) and 178g (95% CI: 421, 65) reduction in birth weight for use of charcoal, and garbage burning respectively compared with use of LPG only. The estimated reductions in birth weight was not statistically significant. Applying the ordinal scale exposure parameter nonetheless revealed a significant exposure-response relationship between maternal exposures from charcoal use and garbage burning, and birth weight. Generalized linear models adjusting for confounders resulted in a 41% (risk ratio [RR] = 1.41; 95% CI: 0.62, 3.23) and 195% (RR=2.95; 95% CI: 1.10, 7.92) increase in the risk of low birth weight (LBW) for use of charcoal, and garbage burning respectively compared with use of LPG only. A combination of charcoal use and household garbage burning during pregnancy on fetal growth resulted in a 429g (95% CI: 259, 599) reduction in birth weight and 316% (RR=4.16; 95% CI: 2.02, 8.59) excess risk of LBW. Sensitivity analysis performed by restricting the analysis to term births produced similar results. Conclusions Maternal use of charcoal as a cooking fuel during pregnancy and burning of garbage at home are strong determinants of average fetal growth and risk of LBW. Efforts to reduce maternal exposures to IAP are thus important to improve birth outcomes. PMID:23075225

Comparison of the effects of 52 weeks weight loss with either a high-protein or high-carbohydrate diet on body composition and cardiometabolic risk factors in overweight and obese males.

PubMed

Wycherley, T P; Brinkworth, G D; Clifton, P M; Noakes, M

2012-08-13

A high-protein (HP), low-fat weight-loss diet may be advantageous for improving cardiometabolic health outcomes and body composition. To date, only limited research has been conducted in male participants. To evaluate the medium to long-term effects of two, low-fat, hypocaloric diets differing in carbohydrate:protein ratio on body composition and cardiometabolic health outcomes in overweight and obese males. One hundred and twenty males (age 50.8±9.3 (s.d.) years, body mass index 33.0±3.9 kg m(-2)) were randomly assigned and consumed a low-fat, isocaloric, energy-restricted diet (7 MJ per day) with either HP (protein:carbohydrate:fat %energy, 35:40:25) or high carbohydrate (HC; 17:58:25). Body weight, body composition and cardiometabolic risk factors were assessed at baseline and after 12 and 52 weeks. Sixty-eight participants completed the study (HP, n=33; HC, n=35). At 1 year both the groups experienced similar reductions in body weight (HP, -12.3±8.0 kg (-12%); HC, -10.9±8.6 kg (-11%); P=0.83 time × group interaction) and fat mass (-9.9±6.0 kg (-27%) vs -7.3±5.8 kg (-22%); P=0.11). Participants who consumed the HP diet lost less fat-free mass (-2.6±3.7 kg (-4%) vs -3.8±4.7 kg (-6%); P<0.01). Both groups experienced similar increases in high-density lipoprotein cholesterol (8%) and reductions in total cholesterol (-7%), low-density lipoprotein cholesterol (-9%), triglycerides (-24%), glucose (-3%), insulin (-38%), blood pressure (-7/-12%) and C-reactive protein (-29%), (P0.14). In overweight and obese men, both a HP and HC diet reduced body weight and improved cardiometabolic risk factors. Consumption of a HP diet was more effective for improving body composition compared with an HC diet.

Damage-Tolerant Fan Casings for Jet Engines

NASA Technical Reports Server (NTRS)

2006-01-01

All turbofan engines work on the same principle. A large fan at the front of the engine draws air in. A portion of the air enters the compressor, but a greater portion passes on the outside of the engine this is called bypass air. The air that enters the compressor then passes through several stages of rotating fan blades that compress the air more, and then it passes into the combustor. In the combustor, fuel is injected into the airstream, and the fuel-air mixture is ignited. The hot gasses produced expand rapidly to the rear, and the engine reacts by moving forward. If there is a flaw in the system, such as an unexpected obstruction, the fan blade can break, spin off, and harm other engine components. Fan casings, therefore, need to be strong enough to contain errant blades and damage-tolerant to withstand the punishment of a loose blade-turned-projectile. NASA has spearheaded research into improving jet engine fan casings, ultimately discovering a cost-effective approach to manufacturing damage-tolerant fan cases that also boast significant weight reduction. In an aircraft, weight reduction translates directly into fuel burn savings, increased payload, and greater aircraft range. This technology increases safety and structural integrity; is an attractive, viable option for engine manufacturers, because of the low-cost manufacturing; and it is a practical alternative for customers, as it has the added cost saving benefits of the weight reduction.

The role of protein in weight loss and maintenance.

PubMed

Leidy, Heather J; Clifton, Peter M; Astrup, Arne; Wycherley, Thomas P; Westerterp-Plantenga, Margriet S; Luscombe-Marsh, Natalie D; Woods, Stephen C; Mattes, Richard D

2015-04-29

Over the past 20 y, higher-protein diets have been touted as a successful strategy to prevent or treat obesity through improvements in body weight management. These improvements are thought to be due, in part, to modulations in energy metabolism, appetite, and energy intake. Recent evidence also supports higher-protein diets for improvements in cardiometabolic risk factors. This article provides an overview of the literature that explores the mechanisms of action after acute protein consumption and the clinical health outcomes after consumption of long-term, higher-protein diets. Several meta-analyses of shorter-term, tightly controlled feeding studies showed greater weight loss, fat mass loss, and preservation of lean mass after higher-protein energy-restriction diets than after lower-protein energy-restriction diets. Reductions in triglycerides, blood pressure, and waist circumference were also reported. In addition, a review of the acute feeding trials confirms a modest satiety effect, including greater perceived fullness and elevated satiety hormones after higher-protein meals but does not support an effect on energy intake at the next eating occasion. Although shorter-term, tightly controlled feeding studies consistently identified benefits with increased protein consumption, longer-term studies produced limited and conflicting findings; nevertheless, a recent meta-analysis showed persistent benefits of a higher-protein weight-loss diet on body weight and fat mass. Dietary compliance appears to be the primary contributor to the discrepant findings because improvements in weight management were detected in those who adhered to the prescribed higher-protein regimen, whereas those who did not adhere to the diet had no marked improvements. Collectively, these data suggest that higher-protein diets that contain between 1.2 and 1.6 g protein · kg -1 · d -1 and potentially include meal-specific protein quantities of at least ∼25-30 g protein/meal provide improvements in appetite, body weight management, cardiometabolic risk factors, or all of these health outcomes; however, further strategies to increase dietary compliance with long-term dietary interventions are warranted. © 2015 American Society for Nutrition.

Acute weight gain, gender, and therapeutic response to antipsychotics in the treatment of patients with schizophrenia

PubMed Central

Ascher-Svanum, Haya; Stensland, Michael; Zhao, Zhongyun; Kinon, Bruce J

2005-01-01

Background Previous research indicated that women are more vulnerable than men to adverse psychological consequences of weight gain. Other research has suggested that weight gain experienced during antipsychotic therapy may also psychologically impact women more negatively. This study assessed the impact of acute treatment-emergent weight gain on clinical and functional outcomes of patients with schizophrenia by patient gender and antipsychotic treatment (olanzapine or haloperidol). Methods Data were drawn from the acute phase (first 6-weeks) of a double-blind randomized clinical trial of olanzapine versus haloperidol in the treatment of 1296 men and 700 women with schizophrenia-spectrum disorders. The associations between weight change and change in core schizophrenia symptoms, depressive symptoms, and functional status were examined post-hoc for men and women and for each medication group. Core schizophrenia symptoms (positive and negative) were measured with the Brief Psychiatric Rating Scale (BPRS), depressive symptoms with the BPRS Anxiety/Depression Scale and the Montgomery-Asberg Depression Rating Scale, and functional status with the mental and physical component scores on the Medical Outcome Survey-Short Form 36. Statistical analysis included methods that controlled for treatment duration. Results Weight gain during 6-week treatment with olanzapine and haloperidol was significantly associated with improvements in core schizophrenia symptoms, depressive symptoms, mental functioning, and physical functioning for men and women alike. The conditional probability of clinical response (20% reduction in core schizophrenia symptom), given a clinically significant weight gain (at least 7% of baseline weight), showed that about half of the patients who lost weight responded to treatment, whereas three-quarters of the patients who had a clinically significant weight gain responded to treatment. The positive associations between therapeutic response and weight gain were similar for the olanzapine and haloperidol treatment groups. Improved outcomes were, however, more pronounced for the olanzapine-treated patients, and more olanzapine-treated patients gained weight. Conclusions The findings of significant relationships between treatment-emergent weight gain and improvements in clinical and functional status at 6-weeks suggest that patients who have greater treatment-emergent weight gain are more likely to benefit from treatment with olanzapine or haloperidol regardless of gender. PMID:15649317

A methodology framework for weighting genetic traits that impact greenhouse gas emission intensities in selection indexes.

PubMed

Amer, P R; Hely, F S; Quinton, C D; Cromie, A R

2018-01-01

A methodological framework was presented for deriving weightings to be applied in selection indexes to account for the impact genetic change in traits will have on greenhouse gas emissions intensities (EIs). Although the emission component of the breeding goal was defined as the ratio of total emissions relative to a weighted combination of farm outputs, the resulting trait-weighting factors can be applied as linear weightings in a way that augments any existing breeding objective before consideration of EI. Calculus was used to define the parameters and assumptions required to link each trait change to the expected changes in EI for an animal production system. Four key components were identified. The potential impact of the trait on relative numbers of emitting animals per breeding female first has a direct effect on emission output but, second, also has a dilution effect from the extra output associated with the extra animals. Third, each genetic trait can potentially change the amount of emissions generated per animal and, finally, the potential impact of the trait on product output is accounted for. Emission intensity weightings derived from this equation require further modifications to integrate them into an existing breeding objective. These include accounting for different timing and frequency of trait expressions as well as a weighting factor to determine the degree of selection emphasis that is diverted away from improving farm profitability in order to achieve gains in EI. The methodology was demonstrated using a simple application to dairy cattle breeding in Ireland to quantify gains in EI reduction from existing genetic trends in milk production as well as in fertility and survival traits. Most gains were identified as coming through the dilution effect of genetic increases in milk protein per cow, although gains from genetic improvements in survival by reducing emissions from herd replacements were also significant. Emission intensities in the Irish dairy industry were estimated to be reduced by ~5% in the last 10 years because of genetic trends in production, fertility and survival traits, and a further 15% reduction was projected over the next 15 years because of an observed acceleration of genetic trends.

Effect of Using Different Vehicle Weight Groups on the Estimated Relationship Between Mass Reduction and U.S. Societal Fatality Risk per Vehicle Miles of Travel

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wenzel, Tom P.

This report recalculates the estimated relationship between vehicle mass and societal fatality risk, using alternative groupings by vehicle weight, to test whether the trend of decreasing fatality risk from mass reduction as case vehicle mass increases, holds over smaller increments of the range in case vehicle masses. The NHTSA baseline regression model estimates the relationship using for two weight groups for cars and light trucks; we re-estimated the mass reduction coefficients using four, six, and eight bins of vehicle mass. The estimated effect of mass reduction on societal fatality risk was not consistent over the range in vehicle masses inmore » these weight bins. These results suggest that the relationship indicated by the NHTSA baseline model is a result of other, unmeasured attributes of the mix of vehicles in the lighter vs. heavier weight bins, and not necessarily the result of a correlation between mass reduction and societal fatality risk. An analysis of the average vehicle, driver, and crash characteristics across the various weight groupings did not reveal any strong trends that might explain the lack of a consistent trend of decreasing fatality risk from mass reduction in heavier vehicles.« less

Technology development status at McDonnell Douglas

NASA Technical Reports Server (NTRS)

Rowe, W. T.

1981-01-01

The significant technology items of the Concorde and the conceptual MCD baseline advanced supersonic transport are compared. The four major improvements are in the areas of range performance, structures (materials), aerodynamics, and in community noise. Presentation charts show aerodynamic efficiency; the reoptimized wing; low scale lift/drag ratio; control systems; structural modeling and analysis; weight and cost comparisons for superplasticity diffusion bonded titanium sandwich structures and for aluminum brazed titanium honeycomb structures; operating cost reduction; suppressor nozzles; noise reduction and range; the bicone inlet; a market summary; environmental issues; high priority items; the titanium wing and fuselage test components; and technology validation.

Single Crystal Casting with Fluidized Carbon Bed Cooling: A Process Innovation for Quality Improvement and Cost Reduction

NASA Astrophysics Data System (ADS)

Hofmeister, M.; Franke, M. M.; Koerner, C.; Singer, R. F.

2017-12-01

Superalloy gas turbine blades are being produced by investment casting and directional solidification. A new process, Fluidized Carbon Bed Cooling (FCBC), has been developed and is now being optimized in a prototype casting unit with 10 kg pouring weight. In early test runs with still rather simple mold cluster geometries, a reduction of the primary dendrite arm spacing of around 40 pct compared to the standard radiation cooling process (HRS) could be demonstrated. The improvement is mainly attributed to higher temperature gradients driving solidification, made possible by a functioning Dynamic Baffle. Compared to earlier development efforts in the literature, contamination of the melt and damage to the equipment are avoided using carbon-based fluidized bed materials and the so-called "counter pressure concept."

Beneficial effect of high energy intake at lunch rather than dinner on weight loss in healthy obese women in a weight-loss program: a randomized clinical trial.

PubMed

Madjd, Ameneh; Taylor, Moira A; Delavari, Alireza; Malekzadeh, Reza; Macdonald, Ian A; Farshchi, Hamid R

2016-10-01

The association between the time of nutrient intake and health has been described in a few studies. To our knowledge, no study has evaluated the relation between high energy intakes at lunch compared with at dinner on weight loss in overweight and obese subjects. We compared the effect of high energy intake at lunch with that at dinner on weight loss and cardiometabolic risk factors in women during a weight-loss program. Overweight and obese women [n = 80; body mass index (BMI; in kg/m 2 ): 27-35; age: 18-45 y] were asked to eat either a main meal at lunch (LM) or a main meal at dinner (DM) for 12 wk while in a weight-loss program. A total of 80 participants were randomly assigned to one of 2 intervention groups. Sixty-nine subjects (86%) completed the trial (34 subjects in the DM group, and 35 subjects in the LM group). Baseline variables were not significantly different between groups. A significant reduction in anthropometric measurements and significant improvements in cardiometabolic risk characteristics were observed over 12 wk in both groups. Compared with the DM group, the LM group had greater mean ± SD reductions in weight (LM: -5.85 ± 1.96 kg; DM: -4.35 ± 1.98 kg; P = 0.003), BMI (LM: 2.27± 0.76; DM: 1.68 ± 0.76; P = 0.003), homeostasis model assessment of insulin resistance (LM: -0.66 ± 0.33; DM: -0.46 ± 0.24; P = 0.001), and fasting insulin (LM: -2.01 ± 1.10 mIU/mL; DM: -1.16 ± 0.72 mIU/mL; P < 0.001) after 12 wk. However, there were no significant differences for fasting plasma glucose and lipid profiles within both groups after 12 wk. The consumption of higher energy intake at lunch compared with at dinner may result in favorable changes in weight loss in overweight and obese women after a weight-loss program of 12 wk. The consumption may also offer clinical benefits to improve insulin resistance. This trial was registered at clinicaltrials.gov as NCT02399280. © 2016 American Society for Nutrition.

Comprehensive nutrition and lifestyle education improves weight loss and physical activity in Hispanic Americans following gastric bypass surgery: a randomized controlled trial.

PubMed

Nijamkin, Monica Petasne; Campa, Adriana; Sosa, Jorge; Baum, Marianna; Himburg, Susan; Johnson, Paulette

2012-03-01

As morbid obesity increasingly affects Hispanic Americans, the incidence of bariatric procedures among this population is rising. Despite this, prospective research on the effects of comprehensive postoperative education-centered interventions on weight loss and physical activity focused on Hispanic Americans is lacking. To examine whether a comprehensive nutrition education and behavior modification intervention improves weight loss and physical activity in Hispanic Americans with obesity following Roux-en-Y gastric bypass surgery (RYGB). A prospective randomized-controlled trial was conducted between November 2008 and April 2010. At 6 months following RYGB, 144 Hispanic Americans with obesity were randomly assigned to a comprehensive nutrition and lifestyle educational intervention (n=72) or a noncomprehensive approach (comparison group n=72). Those in the comprehensive group received education sessions every other week for 6 weeks in small groups and frequent contact with a registered dietitian. Those in the comparison group received brief, printed healthy lifestyle guidelines. Patients were reassessed at 12 months following surgery. Main outcome measures were excess weight loss and physical activity changes over time. Statistical analyses used t test, ?(2) test, Wilcoxon signed rank, Mann-Whitney U test, and intent-to-treat analysis, significance P<0.05. Participants (mean age 44.5 ± 13.5 years) were mainly Cuban-born women (83.3%). Mean preoperative excess weight and body mass index (calculated as kg/m(2)) were 72.20 ± 27.81 kg and 49.26 ± 9.06, respectively. At 12 months following surgery, both groups lost weight significantly, but comprehensive group participants experienced greater excess weight loss (80% vs 64% from preoperative excess weight; P<0.001) and greater body mass index reduction (6.48 ± 4.37 vs 3.63 ± 3.41; P<0.001) than comparison group participants. Comprehensive group participants were significantly more involved in physical activity (+14 min/wk vs ?4 min/wk; P<0.001) than comparison group participants. Mean protein intake was significantly lower in the comparison group than that in the comprehensive group (P<0.024). Findings support the importance of comprehensive nutrition education for achieving more effective weight reduction in Hispanic Americans following RYGB. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

A quality improvement initiative to reduce necrotizing enterocolitis across hospital systems.

PubMed

Nathan, Amy T; Ward, Laura; Schibler, Kurt; Moyer, Laurel; South, Andrew; Kaplan, Heather C

2018-04-20

Necrotizing enterocolitis (NEC) is a devastating intestinal disease in premature infants. Local rates of NEC were unacceptably high. We hypothesized that utilizing quality improvement methodology to standardize care and apply evidence-based practices would reduce our rate of NEC. A multidisciplinary team used the model for improvement to prioritize interventions. Three neonatal intensive care units (NICUs) developed a standardized feeding protocol for very low birth weight (VLBW) infants, and employed strategies to increase the use of human milk, maximize intestinal perfusion, and promote a healthy microbiome. The primary outcome measure, NEC in VLBW infants, decreased from 0.17 cases/100 VLBW patient days to 0.029, an 83% reduction, while the compliance with a standardized feeding protocol improved. Through reliable implementation of evidence-based practices, this project reduced the regional rate of NEC by 83%. A key outcome and primary driver of success was standardization across multiple NICUs, resulting in consistent application of best practices and reduction in variation.

Increased blood levels of persistent organic pollutants (POP) in obese individuals after weight loss-A review.

PubMed

Jansen, Aina; Lyche, Jan L; Polder, Anuschka; Aaseth, Jan; Skaug, Marit Aralt

2017-01-01

Lipophilic persistent organic pollutants (POP) are stored in adipose tissue. Following rapid weight loss such as when induced by bariatric surgery, an increased release of potential harmful lipophilic compounds into the blood circulation may occur. Weight reduction is recommended for overweight and obese individuals in order to decrease risk of weight-related health problems. However, in cases of significant weight reduction POP become mobilized chemicals and consequently may adversely affect health, including endocrine disruption. The objective of the present investigation was to estimate quantitatively the level of mobilization of POP following weight loss over time. According to literature search criteria, 17 studies were identified with 2061 participants. Data from 5 of the studies with 270 participants were used to assess the change in blood levels of POP in percent per kilogram weight loss. Weight loss in the included studies varied from 4.4 to 64.8 kg. In all studies, the majority of POP concentrations in blood were found to rise following weight reduction. Blood concentrations following weight reduction were elevated by 2-4% per kilogram weight loss for most POP examined. The increased POP levels were still elevated 12 mo after intervention. Most research in this field, including animal studies, is carried out on a single compound or group of selected compounds, not taking the "cocktail effect" into consideration. This does not reflect the true range of POP to which humans are actually exposed. Few chronic investigations have been published and, in particular, few studies were available that compared the increase in POP concentrations with clinical consequences as individuals lost weight. These limitations call for caution in interpreting results. The benefits of losing weight still far outweigh the potential adverse health risks. However, further studies are recommended to determine the clinical significance of increased blood levels of POPs following rapid and excessive weight loss, particularly for women attending weight reduction treatment before pregnancy.

Trends in birth weight-specific and -adjusted infant mortality rates in Taiwan between 2004 and 2011.

PubMed

Liang, Fu-Wen; Chou, Hung-Chieh; Chiou, Shu-Ti; Chen, Li-Hua; Wu, Mei-Hwan; Lue, Hung-Chi; Chiang, Tung-Liang; Lu, Tsung-Hsueh

2018-06-01

A yearly increase in the proportion of very low birth weight (VLBW) live births has resulted in the slowdown of decreasing trends in crude infant mortality rates (IMRs). In this study, we examined the trends in birth weight-specific as well as birth weight-adjusted IMRs in Taiwan. We linked three nationwide datasets, namely the National Birth Reporting Database, National Birth Certification Registry, and National Death Certification Registry databases, to calculate the IMRs according to the birth weight category. Trend tests and mortality rate ratios in the periods 2010-2011 and 2004-2005 were used to examine the extent of reduction in birth weight-specific and birth weight-adjusted IMRs. The proportion of VLBW (<1500 g) infants among live births increased from 0.78% in 2004-2005 to 0.89% in 2010-2011, thus exhibiting a 15% increase. The extents of the decreases in birth weight-specific IMRs in the 500-999, 1000-1499, 1500-1999, 2000-2499, and 2500-2999 g birth weight categories were 15%, 33%, 43%, 30%, and 28%, respectively, from 2004-2005 to 2010-2011. The reduction in IMR in each birth weight category was larger than the reduction in the crude IMR (13%). By contrast, the IMR in the <500 g birth weight category exhibited a 56% increase during the study period. The IMRs were calculated by excluding all live births with a birth weight of <500 g. The birth weight-adjusted IMRs, which were calculated using a standard birth weight distribution structure for adjustment, exhibited similar extent reductions. In countries with an increasing proportion of VLBW live births, birth weight-specific or -adjusted IMRs are more appropriate than other indices for accurately assessing the real extent of reduction in IMRs. Copyright © 2017. Published by Elsevier B.V.

Modeling Reduction of Uranium U(VI) under Variable Sulfate Concentrations by Sulfate-Reducing Bacteria

PubMed Central

Spear, John R.; Figueroa, Linda A.; Honeyman, Bruce D.

2000-01-01

The kinetics for the reduction of sulfate alone and for concurrent uranium [U(VI)] and sulfate reduction, by mixed and pure cultures of sulfate-reducing bacteria (SRB) at 21 ± 3°C were studied. The mixed culture contained the SRB Desulfovibrio vulgaris along with a Clostridium sp. determined via 16S ribosomal DNA analysis. The pure culture was Desulfovibrio desulfuricans (ATCC 7757). A zero-order model best fit the data for the reduction of sulfate from 0.1 to 10 mM. A lag time occurred below cell concentrations of 0.1 mg (dry weight) of cells/ml. For the mixed culture, average values for the maximum specific reaction rate, Vmax, ranged from 2.4 ± 0.2 μmol of sulfate/mg (dry weight) of SRB · h−1) at 0.25 mM sulfate to 5.0 ± 1.1 μmol of sulfate/mg (dry weight) of SRB · h−1 at 10 mM sulfate (average cell concentration, 0.52 mg [dry weight]/ml). For the pure culture, Vmax was 1.6 ± 0.2 μmol of sulfate/mg (dry weight) of SRB · h−1 at 1 mM sulfate (0.29 mg [dry weight] of cells/ml). When both electron acceptors were present, sulfate reduction remained zero order for both cultures, while uranium reduction was first order, with rate constants of 0.071 ± 0.003 mg (dry weight) of cells/ml · min−1 for the mixed culture and 0.137 ± 0.016 mg (dry weight) of cells/ml · min−1 (U0 = 1 mM) for the D. desulfuricans culture. Both cultures exhibited a faster rate of uranium reduction in the presence of sulfate and no lag time until the onset of U reduction in contrast to U alone. This kinetics information can be used to design an SRB-dominated biotreatment scheme for the removal of U(VI) from an aqueous source. PMID:10966381

Weight reduction does not induce an undesirable decrease in muscle mass, muscle strength, or physical performance in men with obesity: a pilot study.

PubMed

Kim, Bokun; Tsujimoto, Takehiko; So, Rina; Zhao, Xiaoguang; Oh, Sechang; Tanaka, Kiyoji

2017-12-31

To date, there have been no reports on whether weight reduction causes decreases in muscle mass, muscle strength, or physical performance that could lead to health problems. Thus, in this pilot study, we investigated the appropriateness of the changes in muscle mass, muscle strength and physical performance after weight reduction. Obese men who completed a weight reduction program to decrease and maintain a body mass index (BMI) of less than 25 kg/m2 for one year were recruited for the study. One year after the completion of a weight reduction program, the participants' muscle mass, muscle strength, and physical performance were compared with those in a reference group composed of individuals whose BMI was less than 25 kg/m2. Whole-body scanning was performed using dual-energy X-ray absorptiometry to analyze muscle mass. Handgrip strength and knee extensor strength were measured to evaluate arm and leg muscle strength, respectively. For physical performance, a jump test was employed. The results showed that the biceps, triceps, subscapular, and suprailiac areas of professional fashion models were significantly thinner than those of women in general (p<.001), and that their waist size was also significantly smaller (p<.001). However, hip circumference showed no significant difference. Body mass index, waist-to-hip ratio, and body fat (%) in professional fashion models were significantly lower than those in women in general (p<.001), while the body density in professional fashion models was significantly greater (p<0.001). Weight reduction participants showed an average reduction in body weight of -16.47%. Normalized arm muscle mass and handgrip strength were significantly greater in the weight reduction group than in the reference group; however, no significant differences were detected between the two groups with respect to the other variables. After one year, there were no significant differences between the two groups. ©2017 The Korean Society for Exercise Nutrition

Variables associated with HbA1c and weight reductions when adding liraglutide to multiple daily insulin injections in persons with type 2 diabetes (MDI Liraglutide trial 3).

PubMed

Dahlqvist, Sofia; Ahlén, Elsa; Filipsson, Karin; Gustafsson, Thomas; Hirsch, Irl B; Tuomilehto, Jaakko; Imberg, Henrik; Ahrén, Bo; Attvall, Stig; Lind, Marcus

2018-01-01

To evaluate variables associated with hemoglobin A1c (HbA1c) and weight reduction when adding liraglutide to persons with type 2 diabetes treated with multiple daily insulin injections (MDI). This was a reanalysis of a previous trial where 124 patients were enrolled in a double-blind, placebo-controlled, multicenter randomized trial carried out over 24 weeks. Predictors for effect on change in HbA1c and weight were analyzed within the treatment group and with concurrent interaction analyses. Correlation analyses for change in HbA1c and weight from baseline to week 24 were made. The mean age at baseline was 63.7 years, 64.8% were men, the mean number of insulin injections was 4.4 per day, the mean daily insulin dose was 105 units and the mean HbA1c was 74.5 mmol/mol (9.0%). The mean HbA1c and weight reductions were 12.3 mmol/mol (1.13%; P<0.001) and 3.8 kg (P<0.001) greater in liraglutide than placebo-treated persons. There was no significant predictor for greater effect on HbA1c that existed in all analyses (univariate, multivariate and interaction analyses against controls). For a greater weight reduction when adding liraglutide, a lower HbA1c level at baseline was a predictor (liraglutide group P=0.002, P=0.020 for liraglutide group vs placebo). During follow-up in the liraglutide group, no significant correlation was found between change in weight and change in HbA1c (r=0.09, P=0.46), whereas a correlation existed between weight and insulin dose reduction (r=0.44, P<0.001). Weight reduction becomes greater when adding liraglutide in patients with type 2 diabetes treated with MDI who had a lower HbA1c level compared with those with a higher HbA1c level. There was no correlation between reductions in HbA1c and weight when liraglutide was added, that is, different patient groups responded with HbA1c and weight reductions. EudraCT nr: 2012-001941-42.

The Role of Pulses in the Dietary Management of Diabetes.

PubMed

Ramdath, Dan; Renwick, Simone; Duncan, Alison M

2016-08-01

Pulses are highly nutritious foods that are included as part of Canada's Food Guide to promote healthful eating, and they have established health benefits that can contribute to the dietary management of diabetes. A review of studies that have examined the effects of pulse consumption on health outcomes, integral to the management of diabetes, provides credible evidence for improvements in glycemic control, reduction of blood lipids and regulation of body weight. Results from acute feeding trials suggest that postprandial blood glucose response is significantly attenuated by a single pulse serving of between three-quarters and 1 cup. At lower doses, pulses attenuate postprandial blood glucose response more than similar amounts of starchy foods. Long-term pulse consumption of 5 cups per week appears to result consistently in improvements in glycemic control. There is high-quality evidence that supports a role for pulse consumption in the reduction of risk for cardiovascular disease; this provides a sound rationale for the regular incorporation of pulses at about two-thirds of a cup daily in the management of hyperlipidemia in persons with type 2 diabetes. Pulse consumption can contribute to improving satiety, reducing food intake and regulating body weight, which can reduce obesity risk and, in turn, improve diabetes management. Collectively, available evidence provides very good support for a role of regular pulse consumption in the prevention and management of diabetes. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

The Impact of a Weight Loss Intervention on Diet Quality and Eating Behaviours in People with Obesity and COPD.

PubMed

McLoughlin, Rebecca F; McDonald, Vanessa M; Gibson, Peter G; Scott, Hayley A; Hensley, Michael J; MacDonald-Wicks, Lesley; Wood, Lisa G

2017-10-20

There is a paucity of evidence to guide clinicians about appropriate management strategies for people with obesity and Chronic Obstructive Pulmonary Disease (COPD). We have recently published results from the first weight loss intervention in adults (>18 years) with obesity (body mass index; BMI ≥ 30 kg/m²) and COPD, using a low-calorie diet coupled with a partial meal replacement plan and resistance exercise training, which resulted in a 6.4% reduction in weight while maintaining skeletal muscle mass and improving health status. This sub-study aims to evaluate the intervention by (a) examining changes in dietary intake and nutritional biomarkers and (b) examining predictors of weight loss. Dietary intake was evaluated using four-day food diaries, and analysis of plasma fatty acids and plasma carotenoids as biomarkers of dietary fat intake and fruit and vegetable intake, respectively. Twenty-eight obese COPD subjects ( n = 17 males, n = 11 females) with a mean (standard deviation; SD) age of 67.6 (6.3) years completed the 12-week weight loss intervention. Pre-intervention, mean (SD) BMI was 36.3 (4.6) kg/m². Micronutrient intake improved from pre- to post-intervention, with the percentage of subjects meeting the Nutrient Reference Values increased for all micronutrients. Post-intervention, significant decreases in total ( p = 0.009) and saturated fat intake ( p = 0.037), and corresponding decreases in total ( p = 0.007) and saturated plasma fatty acids ( p = 0.003) were observed. There was a trend towards higher total carotenoids post-intervention ( p = 0.078). Older age ( p = 0.025), higher pre-intervention uncontrolled eating ( p < 0.001) and plasma carotenoids ( p = 0.009) predicted weight loss. This demonstrates the efficacy of a weight loss intervention in improving diet quality of obese COPD adults.

Nutritional education through internet-delivered menu plans among adults with type 2 diabetes mellitus: pilot study.

PubMed

Bader, Abeer; Gougeon, Réjeanne; Joseph, Lawrence; Da Costa, Deborah; Dasgupta, Kaberi

2013-10-11

A potential barrier to weight loss and vascular risk reduction is difficulty in operationalizing dietary education into a concrete plan. Although a variety of Internet-based software tools are now available to address this issue, there has been little formal evaluation of these tools. The aim of this single-arm pilot study is to determine the effect of a 24-week Internet-based menu-planning program, by examining pre- to postintervention changes in the body weight, blood pressure, and glycemia, specifically among overweight adults with type 2 diabetes mellitus (DM2), a clinical population at high risk for vascular diseases. A total of 33 adults with DM2 were recruited by collaborating registered dietitians to a 24-week Internet-based menu-planning program. Individualized dietary prescriptions were operationalized into weekly Internet-delivered menu plans through an adapted version of a commercially available service. Adherence was defined as logging into the program at least once per week for a minimum of 18 of the 24 weeks. Multiple imputations were used for missing data. Using baseline and postintervention assessments, we calculated the weight changes (mean, 95% CI) and investigated the corresponding effects (linear regression models) on blood pressure (systolic, diastolic) and hemoglobin A1C (ie, glycemia). The mean age was 58 (SD 7) years and the mean baseline body mass index was 34.4 (SD 4.6) kg/m(2). The results of this study showed that ≥5% weight reduction was achieved by 6/33 participants (18%) and by 5/18 adherent participants (28%). A mean weight change of -2.0% (95% CI -2.6 to -1.4) was observed, with changes occurring in the adherent (-3.6%, 95% CI -4.5 to -2.8) but not in the nonadherent (0%, 95% CI -0.6 to 0.7). It was found that each 1% reduction in body weight was associated with a -2.4 mmHg change in systolic (95% CI -3.5 to -1.2) and a -0.8 mmHg change in diastolic blood pressure (95% CI -1.4 to -0.2). Percent weight change was not found to be related to changes in A1C. In adults with DM2, an Internet-based menu-planning program has the potential to lead to clinically important weight reductions in more than one quarter of those who adhere, with corresponding improvements in blood pressure.

The Effects of Sleeve Gastrectomy and Gastric Bypass on Branched-Chain Amino Acid Metabolism 1 Year After Bariatric Surgery.

PubMed

Tan, Hong Chang; Khoo, Chin Meng; Tan, Matthew Zhen-Wei; Kovalik, Jean-Paul; Ng, Alvin Choong Meng; Eng, Alvin Kim Hock; Lai, Oi Fah; Ching, Jian Hong; Tham, Kwang Wei; Pasupathy, Shanker

2016-08-01

Weight loss, early after Roux-en-Y gastric bypass (GB) surgery, is associated with reduced concentrations of plasma branched-chain amino acids (BCAAs) and improved insulin sensitivity. Herein, we evaluated whether changes in BCAAs and insulin sensitivity persist with weight stabilization (1 year) after GB or sleeve gastrectomy (SG). We prospectively examined 22 severely obese patients (mean age 40.6 ± 2.1 years, BMI 38.8 ± 1.3 kg/m(2), and 59.1 % female) who underwent SG (n = 12) or GB (n = 10) for morbid obesity. Body fat composition was measured with dual X-Ray absorptiometry and abdominal fat volume with computed tomography. BCAAs and acylcarnitines were profiled using liquid chromatography with tandem mass spectrometry. Insulin resistance was calculated using the homeostasis model assessment for insulin resistance (HOMA-IR) formula. At 1-year follow-up, the decrease in BMI, body weight, total fat mass (TFM), fat free mass, and visceral adipose tissue (VAT) was similar between SG and GB. HOMA-IR was associated with BCAA concentrations, and both were decreased equally in both surgical groups. In multivariate analysis with BCAAs, TFM, and VAT as independent factors, only VAT remained significantly associated with insulin resistance. The metabolic benefits from bariatric surgery, including the changes in BCAA profile, are comparable between SG and GB. The reduction in BCAAs and improvement in the AC profiles after bariatric surgery persists up to 12 months after surgery and may not be surgical related but is influenced primarily by the amount of weight loss, in particular the reduction in visceral adiposity.

Rapid response predicts 12-month post-treatment outcomes in binge-eating disorder: theoretical and clinical implications

PubMed Central

Grilo, C. M.; White, M. A.; Wilson, G. T.; Gueorguieva, R.; Masheb, R. M.

2011-01-01

Background We examined rapid response in obese patients with binge-eating disorder (BED) in a clinical trial testing cognitive behavioral therapy (CBT) and behavioral weight loss (BWL). Method Altogether, 90 participants were randomly assigned to CBT or BWL. Assessments were performed at baseline, throughout and post-treatment and at 6- and 12-month follow-ups. Rapid response, defined as ≥70% reduction in binge eating by week four, was determined by receiver operating characteristic curves and used to predict outcomes. Results Rapid response characterized 57% of participants (67% of CBT, 47% of BWL) and was unrelated to most baseline variables. Rapid response predicted greater improvements across outcomes but had different prognostic significance and distinct time courses for CBT versus BWL. Patients receiving CBT did comparably well regardless of rapid response in terms of reduced binge eating and eating disorder psychopathology but did not achieve weight loss. Among patients receiving BWL, those without rapid response failed to improve further. However, those with rapid response were significantly more likely to achieve binge-eating remission (62% v. 13%) and greater reductions in binge-eating frequency, eating disorder psychopathology and weight loss. Conclusions Rapid response to treatment in BED has prognostic significance through 12-month follow-up, provides evidence for treatment specificity and has clinical implications for stepped-care treatment models for BED. Rapid responders who receive BWL benefit in terms of both binge eating and short-term weight loss. Collectively, these findings suggest that BWL might be a candidate for initial intervention in stepped-care models with an evaluation of progress after 1 month to identify non-rapid responders who could be advised to consider a switch to a specialized treatment. PMID:21923964

Effects of Low-Carbohydrate Diets Versus Low-Fat Diets on Metabolic Risk Factors: A Meta-Analysis of Randomized Controlled Clinical Trials

PubMed Central

Hu, Tian; Mills, Katherine T.; Yao, Lu; Demanelis, Kathryn; Eloustaz, Mohamed; Yancy, William S.; Kelly, Tanika N.; He, Jiang; Bazzano, Lydia A.

2012-01-01

The effects of low-carbohydrate diets (≤45% of energy from carbohydrates) versus low-fat diets (≤30% of energy from fat) on metabolic risk factors were compared in a meta-analysis of randomized controlled trials. Twenty-three trials from multiple countries with a total of 2,788 participants met the predetermined eligibility criteria (from January 1, 1966 to June 20, 2011) and were included in the analyses. Data abstraction was conducted in duplicate by independent investigators. Both low-carbohydrate and low-fat diets lowered weight and improved metabolic risk factors. Compared with participants on low-fat diets, persons on low-carbohydrate diets experienced a slightly but statistically significantly lower reduction in total cholesterol (2.7 mg/dL; 95% confidence interval: 0.8, 4.6), and low density lipoprotein cholesterol (3.7 mg/dL; 95% confidence interval: 1.0, 6.4), but a greater increase in high density lipoprotein cholesterol (3.3 mg/dL; 95% confidence interval: 1.9, 4.7) and a greater decrease in triglycerides (−14.0 mg/dL; 95% confidence interval: −19.4, −8.7). Reductions in body weight, waist circumference and other metabolic risk factors were not significantly different between the 2 diets. These findings suggest that low-carbohydrate diets are at least as effective as low-fat diets at reducing weight and improving metabolic risk factors. Low-carbohydrate diets could be recommended to obese persons with abnormal metabolic risk factors for the purpose of weight loss. Studies demonstrating long-term effects of low-carbohydrate diets on cardiovascular events were warranted. PMID:23035144

The effect of a cinnamon-, chromium- and magnesium-formulated honey on glycaemic control, weight loss and lipid parameters in type 2 diabetes: an open-label cross-over randomised controlled trial.

PubMed

Whitfield, Patricia; Parry-Strong, Amber; Walsh, Emily; Weatherall, Mark; Krebs, Jeremy D

2016-04-01

This randomised controlled trial assessed the acute and long-term effects of daily supplementation of kanuka honey, formulated with cinnamon, chromium and magnesium on glucose metabolism, weight and lipid parameters in individuals with type 2 diabetes. Twelve individuals with type 2 diabetes received 53.5 g of a formulated honey and a control (non-formulated) kanuka honey in a random order for 40 days, using cross-over design. Fasting glucose, insulin, HbA1c, lipids and anthropometric measures were measured at baseline and end of treatment. A meal tolerance test was performed at baseline to assess acute metabolic response. There was no statistically significant difference in acute glucose metabolism between treatment groups, as measured by the Matsuda index and AUC for glucose and insulin. After the 40-day intervention with honey, fasting glucose did not differ significantly between the two treatments (95 % CI -2.6 to 0.07). There was no statistically significant change in HbA1c or fasting insulin. There was a statistically significant reduction in total cholesterol by -0.29 mmol/L (95 % CI -0.57 to -0.23), LDL cholesterol by -0.29 mmol/L (95 % CI -0.57 to -0.23) and weight by -2.2 kg (95 % CI -4.2 to -0.1). There was a trend towards increased HDL and reduced systolic blood pressure in the intervention treatment. The addition of cinnamon, chromium and magnesium supplementation to kanuka honey was not associated with a significant improvement in glucose metabolism or glycaemic control in individuals with type 2 diabetes. Use of the formulated honey was associated with a reduction in weight and improvements in lipid parameters, and should be investigated further.

Effect of lifestyle improvement program on the biomarkers of adiposity, inflammation and gut hormones in overweight/obese Asian Indians with prediabetes.

PubMed

Gokulakrishnan, Kuppan; Ranjani, Harish; Weber, Mary Beth; Pandey, Gautam Kumar; Anjana, Ranjit Mohan; Balasubramanyam, Muthuswamy; Prabhakaran, Dorairaj; Tandon, Nikhil; Narayan, K M; Mohan, Viswanathan

2017-09-01

While lifestyle modification is known to offer several metabolic benefits, there is paucity of comprehensive data on changes in biomarkers of adiposity, inflammation as well as gut hormones. We investigated these biomarkers in overweight/obese individuals with prediabetes randomized to either 4 months of a lifestyle improvement program or standard care and followed them up for a year. Participants [standard care and intervention arm (n = 75 each)] were randomly selected from the Diabetes Community Lifestyle Improvement Program trial. Glycemic and lipid control and anthropometric measurements were assessed by standard protocols. Adipokines, inflammatory markers and gut hormones were measured using multiplex and standard ELISA kits. Along with modest benefits in primary outcomes (glycemic and lipid control and weight reduction), participants in the intervention group showed significant reductions (p < 0.001) in plasma levels of leptin (17.6%), TNF-α (35%), IL-6 (33.3%), MCP-1 (22.3%) and PYY (28.3%) and increased levels of adiponectin (33.1%) and ghrelin (23.6%) at the end of 4 months of lifestyle intervention. The changes were independent of weight and persisted even at 1 year of follow-up. In contrast, participants from the standard care arm did not show any statistically significant improvements on the above parameters. Participants who underwent an intensive lifestyle improvement program showed metabolic benefits as well as favorable beneficial changes in systemic levels of adipokines, cytokines and gut hormones, not only during the intervention period, but also during 12-month follow-up period.

Impact of a Web-based worksite health promotion program on absenteeism.

PubMed

Niessen, Maurice A J; Kraaijenhagen, Roderik A; Dijkgraaf, Marcel G W; Van Pelt, Danielle; Van Kalken, Coen K; Peek, Niels

2012-04-01

To evaluate the effect of participation in a comprehensive, Web-based worksite health promotion program on absenteeism. Study population consists of Dutch workers employed at a large financial services company. Linear regression was used to assess the impact of program attendance on the difference between baseline and follow-up absenteeism rates, controlling for gender, age, job level, years of employment, and noncompletion of the program. Data from 20,797 individuals were analyzed; 3826 individuals enrolled in the program during the study period. A 20.3% reduction in absenteeism was shown among program attendees compared with nonparticipants during a median follow-up period of 23.3 months. Participating in the worksite health promotion program led to an immediate reduction in absenteeism. Improved psychological well-being, increased exercise, and weight reduction are possible pathways toward this reduction.

Weight Reduction Potential of Automobiles and Light Trucks: 1980 Summary Source Document

DOT National Transportation Integrated Search

1981-06-01

This report provides an assessment of the potential of weight reduction for passenger cars and light trucks (including pickup trucks, vans, and utility vehicles of GVWR up to 8500 pounds) in the post-1985 period. Vehicle characteristics and weight re...

Determinants of Successful Weight Loss After Using a Commercial Web-Based Weight Reduction Program for Six Months: Cohort Study

PubMed Central

Postrach, Elisa; Aspalter, Rosa; Elbelt, Ulf; Koller, Michael; Longin, Rita; Schulzke, Jörg-Dieter

2013-01-01

Background The Internet is widely available and commonly used for health information; therefore, Web-based weight loss programs could provide support to large parts of the population in self-guided weight loss. Previous studies showed that Web-based weight loss interventions can be effective, depending on the quality of the program. The most effective program tools are visual progress charts or tools for the self-monitoring of weight, diet, and exercises. KiloCoach, a commercial program currently available in German-speaking countries, incorporates these features. A previous investigation showed that the program effectively supports users in losing weight. Objective We investigated weight loss dynamics stratified by weight loss success after 6-month use of KiloCoach. Furthermore, we analyzed possible associations between intensity of program use and weight loss. The results are intended for tailoring user recommendations for weight-loss Internet platforms. Methods Datasets of KiloCoach users (January 1, 2008 to December 31, 2011) who actively used the platform for 6 months or more were assigned to this retrospective analysis. Users (N=479) were 42.2% men, mean age of 44.0 years (SD 11.7), with a mean body mass index (BMI) of 31.7 kg/m2 (SD 3.2). Based on the weight loss achieved after 6 months, 3 success groups were generated. The unsuccessful group lost <5%, the moderate success group lost 5%-9.9%, and the high success group lost ≥10% of their baseline body weight. At baseline, the unsuccessful (n=261, 54.5%), moderate success (n=133, 27.8%), and high success (n=85, 17.8%) groups were similar in age, weight, BMI, and gender distribution. Results After 6 months, the unsuccessful group lost 1.2% (SD 2.4), the moderate success group lost 7.4% (SD 1.5), and the high success group lost 14.2% (SD 3.8) of their initial weight (P<.001). Multivariate regression showed that early weight loss (weeks 3-4), the total number of dietary protocols, and the total number of weight entries were independent predictors for 6-month weight reduction (all P<.001) explaining 52% of the variance in weight reduction. Sensitivity analysis by baseline carried forward method confirmed all independent predictors of 6-month weight loss and reduced the model fit by only 11%. The high success group lost weight faster and maintained weight loss more efficiently than the other groups (P<.001). Early weight loss was associated with weight maintenance after 1 year and 2 years (both P<.001). Weight dynamics did not differ between men and women over 6 months when adjusted for baseline and usage parameters (P=.91). The percentage of male long-term users was unusually high (42.2%). Conclusions Our results suggest that early weight loss and close program adherence (ie, 5 dietary protocols per week and weekly entering of current weight), especially in the early phase of program usage, can improve weight loss outcome. PMID:24126250

Understanding the inter-relationship between improved glycaemic control, hypoglycaemia and weight change within a long-term economic model.

PubMed

McEwan, P; Evans, M; Kan, H; Bergenheim, K

2010-05-01

Current guidelines for the management of type 2 diabetes advocate the attainment of sustained near normal glycaemia levels. Metformin is widely accepted as the treatment of choice for the initiation of pharmacotherapy; however, secondary failure of oral monotherapy occurs in 60% of patients resulting in the need for multiple pharmacotherapies. Therapy-related consequences of treatment, such as weight gain and hypoglycaemia impact on the cost-effectiveness profile of various agents. We therefore sought to ascertain the respective contribution of hypoglycaemia, weight change and improved blood glucose control on second-line therapy options added to metformin. This study uses a simulation model designed to evaluate the cost utility of new therapies in a population of patients with type 2 diabetes mellitus. Standard model outputs include incidence of micro- and macrovascular complications and diabetes-specific and all-cause mortality. The mean discounted quality-adjusted life year (QALY) predicted by the model was 12.31 years. Reducing Glycosylated haemoglobin (HbA1c) by 1% gave a predicted gain of 0.413 QALYs per patient. A 3-kg weight loss and 30% reduction in hypoglycaemia frequency produced a combined QALY gain of 0.355, whereas the reverse gave a QALY decrement of 0.356. The results of this analysis quantify the QALY decrement that may result from adverse therapy effects. The beneficial effects of improved glycaemic control on QALYs may be offset by characteristic treatment-specific adverse effects, such as weight gain and hypoglycaemia frequency.

Obesity in black adolescent girls: a controlled clinical trial of treatment by diet, behavior modification, and parental support.

PubMed

Wadden, T A; Stunkard, A J; Rich, L; Rubin, C J; Sweidel, G; McKinney, S

1990-03-01

Recent findings indicate that nearly 50% of black American women are obese and that adolescence is a critical period for the development of their obesity. This study investigated the efficacy of a behavioral weight control program in 36 black female adolescents with a mean age of 14.0 years, weight of 95.0 kg, and height of 163.2 cm. All subjects participated in the same 16-week program but had different levels of parent participation: (1) child alone with no parent participation; (2) mother and child treated in the same session; and (3) mother and child treated in separate but concurrent session. At the end of the 16-week program, children in the three conditions lost 1.6, 3.7, and 3.1 kg, respectively. Differences among conditions were not statistically significant; however, a secondary analysis revealed that the greater the number of sessions attended by mothers, the greater their daughters' weight losses. Weight reduction was associated with significant improvements in body composition, serum total cholesterol concentrations, and psychological status. Results are discussed in terms of the need to improve the maintenance of weight loss in adolescents and to explore possible differences between black and white females in their preferred body types.

Metabolic factors, adipose tissue, and plasminogen activator inhibitor-1 levels in type 2 diabetes: findings from the look AHEAD study.

PubMed

Belalcazar, L Maria; Ballantyne, Christie M; Lang, Wei; Haffner, Steven M; Rushing, Julia; Schwenke, Dawn C; Pi-Sunyer, F Xavier; Tracy, Russell P

2011-07-01

Plasminogen activator inhibitor-1 (PAI-1) production by adipose tissue is increased in obesity, and its circulating levels are high in type 2 diabetes. PAI-1 increases cardiovascular risk by favoring clot stability, interfering with vascular remodeling, or both. We investigated in obese diabetic persons whether an intensive lifestyle intervention for weight loss (ILI) would decrease PAI-1 levels independently of weight loss and whether PAI-1 reduction would be associated with changes in fibrinogen, an acute phase reactant, or fibrin fragment D-dimer (D-dimer), a marker of ambient coagulation balance. We examined 1-year changes in PAI-1, D-dimer, and fibrinogen levels; adiposity; fitness; glucose; and lipid control with ILI in 1817 participants from Look AHEAD, a randomized trial investigating the effects of ILI, compared with usual care, on cardiovascular events in overweight or obese diabetic persons. Median PAI-1 levels decreased 29% with ILI and 2.5% with usual care (P < 0.0001). Improvements in fitness, glucose control, and high-density lipoprotein cholesterol were associated with decreased PAI-1, independently of weight loss (P = 0.03 for fitness, P < 0.0001 for others). Fibrinogen and D-dimer remained unchanged. Reductions in PAI-1 levels with ILI in obese diabetic individuals may reflect an improvement in adipose tissue health that could affect cardiovascular risk without changing fibrinogen or d-dimer levels. Clinical Trial Registration- URL: http://clinicaltrials.gov/ct2/show/NCT00017953. Unique identifier: NCT00017953.

Successful weight reduction and maintenance by using a smartphone application in those with overweight and obesity.

PubMed

Chin, Sang Ouk; Keum, Changwon; Woo, Junghoon; Park, Jehwan; Choi, Hyung Jin; Woo, Jeong-Taek; Rhee, Sang Youl

2016-11-07

A discrepancy exists with regard to the effect of smartphone applications (apps) on weight reduction due to the several limitations of previous studies. This is a retrospective cohort study, aimed to investigate the effectiveness of a smartphone app on weight reduction in obese or overweight individuals, based on the complete enumeration study that utilized the clinical and logging data entered by Noom Coach app users between October 2012 and April 2014. A total of 35,921 participants were included in the analysis, of whom 77.9% reported a decrease in body weight while they were using the app (median 267 days; interquartile range = 182). Dinner input frequency was the most important factor for successful weight loss (OR = 10.69; 95% CI = 6.20-19.53; p < 0.001), and more frequent input of weight significantly decreased the possibility of experiencing the yo-yo effect (OR = 0.59, 95% CI = 0.39-0.89; p < 0.001). This study demonstrated the clinical utility of an app for successful weight reduction in the majority of the app users; the effects were more significant for individuals who monitored their weight and diet more frequently.

Improving Inhibitory Control Abilities (ImpulsE)-A Promising Approach to Treat Impulsive Eating?

PubMed

Preuss, Hanna; Pinnow, Marlies; Schnicker, Katja; Legenbauer, Tanja

2017-11-01

Although there is preliminary evidence that inhibitory control training improves impulsive eating, less is known about the effects on eating behaviour and weight loss in clinical samples. Sixty-nine treatment-seeking adults with obesity (binge-eating disorder 33.3%; other specific feeding and eating disorders 40.6%) were randomly blockwise allocated to ImpulsE, an intervention to improve inhibitory control and emotion regulation abilities or a guideline-appropriate cognitive behavioural therapy (CBT)-based treatment as usual. Self-reported and performance-based impulsivity, eating disorder pathology and BMI were compared at baseline (T1), post-treatment (T2) and 1- or 3-month follow-up. ImpulsE led to better food-specific inhibition performance (p = .004), but groups did not differ regarding improvements in global Eating Disorder Examination Questionnaire (EDE-Q) score at T2. At 3-month follow-up, binge eaters benefited most from ImpulsE (p = .028) and completers of ImpulsE demonstrated a significantly greater weight reduction (p = .030). The current findings propose ImpulsE as a promising approach to treat obesity, illustrating acceptability and additional benefits for course of weight. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

QUALITY OF LIFE AFTER VERTICAL GASTRECTOMY EVALUATED BY THE BAROS QUESTIONNAIRE

PubMed Central

VARGAS, Guilherme Pedroso; MENDES, Giselle Abigail; Pinto, Rinaldo Danesi

2017-01-01

ABSTRACT Background : The satisfactory outcome in the surgical treatment of obesity must include, in addition to weight loss, a significant change in the pre-existing comorbidities and in the quality of life of the patients. Aim : To evaluate the quality of life in the late postoperative period in patients that underwent videolaparoscopic sleeve gastrectomy. Methods : Was applied the questionnaire “Bariatric Analysis and Reporting Outcome System” (BAROS) in patients that underwent videolaparoscopic sleeve gastrectomy. Results : A total of 47 patients between 21-60 years old were evaluated. The total mean of the BMI before surgery was 43.06±5.87 kg/m². The average percentage of the reduction of excess weight after surgery was 85.46±23.6%. The score obtained by patients in the questionnaire about the improvement in the quality of life showed excellent (36.17%), very good (40.43%), good (21.28%) and reasonable (2.13%) results. There was clinical improvement after surgery in all comorbidities investigated. Conclusion : BAROS showed excellent results in 36.17%, very good in 40.43%, good in 21.28% and reasonable in 2.13%. The weight loss was critical to improve the quality of life and offered the resolution or clinical improvement in all of the investigated comorbidities. PMID:29340547

Exercise leads to faster postural reflexes, improved balance and mobility, and fewer falls in older persons with chronic stroke.

PubMed

Marigold, Daniel S; Eng, Janice J; Dawson, Andrew S; Inglis, J Timothy; Harris, Jocelyn E; Gylfadóttir, Sif

2005-03-01

To determine the effect of two different community-based group exercise programs on functional balance, mobility, postural reflexes, and falls in older adults with chronic stroke. A randomized, clinical trial. Community center. Sixty-one community-dwelling older adults with chronic stroke. Participants were randomly assigned to an agility (n=30) or stretching/weight-shifting (n=31) exercise group. Both groups exercised three times a week for 10 weeks. Participants were assessed before, immediately after, and 1 month after the intervention for Berg Balance, Timed Up and Go, step reaction time, Activities-specific Balance Confidence, and Nottingham Health Profile. Testing of standing postural reflexes and induced falls evoked by a translating platform was also performed. In addition, falls in the community were tracked for 1 year from the start of the interventions. Although exercise led to improvements in all clinical outcome measures for both groups, the agility group demonstrated greater improvement in step reaction time and paretic rectus femoris postural reflex onset latency than the stretching/weight-shifting group. In addition, the agility group experienced fewer induced falls on the platform. Group exercise programs that include agility or stretching/weight shifting exercises improve postural reflexes, functional balance, and mobility and may lead to a reduction of falls in older adults with stroke.

The effect of load reductions on repetition performance for commonly performed multijoint resistance exercises.

PubMed

Willardson, Jeffrey M; Simão, Roberto; Fontana, Fabio E

2012-11-01

The purpose of this study was to compare 4 different loading schemes for the free weight bench press, wide grip front lat pull-down, and free weight back squat to determine the extent of progressive load reductions necessary to maintain repetition performance. Thirty-two recreationally trained women (age = 29.34 ± 4.58 years, body mass = 59.61 ± 4.72 kg, height = 162.06 ± 4.04 cm) performed 4 resistance exercise sessions that involved 3 sets of the free weight bench press, wide grip front lat pull-down, and free weight back squat, performed in this exercise order during all 4 sessions. Each of the 4 sessions was conducted under different randomly ordered loading schemes, including (a) a constant 10 repetition maximum (RM) load for all 3 sets and for all 3 exercises, (b) a 5% reduction after the first and second sets for all the 3 exercises, (c) a 10% reduction after the first and second sets for all the 3 exercises, and (d) a 15% reduction after the first and second sets for all the 3 exercises. The results indicated that for the wide grip front lat pull-down and free weight back squat, a 10% load reduction was necessary after the first and second sets to accomplish 10 repetitions on all the 3 sets. For the free weight bench press, a load reduction between 10 and 15% was necessary; specifically, a 10% reduction was insufficient and a 15% reduction was excessive, as evidenced by significantly >10 repetitions on the second and third sets for this exercise (p ≤ 0.05). In conclusion, the results of this study indicate that a resistance training prescription that involves 1-minute rest intervals between multiple 10RM sets does require load reductions to maintain repetition performance. Practitioners might apply these results by considering an approximate 10% load reduction after the first and second sets for the exercises examined, when training women of similar characteristics as in this study.

MRI artifact reduction and quality improvement in the upper abdomen with PROPELLER and prospective acquisition correction (PACE) technique.

PubMed

Hirokawa, Yuusuke; Isoda, Hiroyoshi; Maetani, Yoji S; Arizono, Shigeki; Shimada, Kotaro; Togashi, Kaori

2008-10-01

The purpose of this study was to evaluate the effectiveness of the periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER [BLADE in the MR systems from Siemens Medical Solutions]) with a respiratory compensation technique for motion correction, image noise reduction, improved sharpness of liver edge, and image quality of the upper abdomen. Twenty healthy adult volunteers with a mean age of 28 years (age range, 23-42 years) underwent upper abdominal MRI with a 1.5-T scanner. For each subject, fat-saturated T2-weighted turbo spin-echo (TSE) sequences with respiratory compensation (prospective acquisition correction [PACE]) were performed with and without the BLADE technique. Ghosting artifact, artifacts except ghosting artifact such as respiratory motion and bowel movement, sharpness of liver edge, image noise, and overall image quality were evaluated visually by three radiologists using a 5-point scale for qualitative analysis. The Wilcoxon's signed rank test was used to determine whether a significant difference existed between images with and without BLADE. A p value less than 0.05 was considered to be statistically significant. In the BLADE images, image artifacts, sharpness of liver edge, image noise, and overall image quality were significantly improved (p < 0.001). With the BLADE technique, T2-weighted TSE images of the upper abdomen could provide reduced image artifacts including ghosting artifact and image noise and provide better image quality.

The role of weight loss and exercise in correcting skeletal muscle mitochondrial abnormalities in obesity, diabetes and aging.

PubMed

Toledo, Frederico G S; Goodpaster, Bret H

2013-10-15

Mitochondria within skeletal muscle have been implicated in insulin resistance of obesity and type 2 diabetes mellitus as well as impaired muscle function with normal aging. Evaluating the potential of interventions to improve mitochondria is clearly relevant to the prevention or treatment of metabolic diseases and age-related dysfunction. This review provides an overview and critical evaluation of the effects of weight loss and exercise interventions on skeletal muscle mitochondria, along with implications for insulin resistance, obesity, type 2 diabetes and aging. The available literature strongly suggests that the lower mitochondrial capacity associated with obesity, type 2 diabetes and aging is not an irreversible lesion. However, weight loss does not appear to affect this response, even when the weight loss is extreme. In contrast, increasing physical activity improves mitochondrial content and perhaps the function of individual mitochondrion. Despite the consistent effect of exercise to improve mitochondrial capacity, studies mechanistically linking mitochondria to insulin resistance, reductions in intramyocellular lipid or improvement in muscle function remain inconclusive. In summary, studies of diet and exercise training have advanced our understanding of the link between mitochondrial oxidative capacity and insulin resistance in obesity, type 2 diabetes and aging. Nevertheless, additional inquiry is necessary to establish the significance and clinical relevance of those perturbations, which could lead to targeted therapies for a myriad of conditions and diseases involving mitochondria. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Monte Carlo isotopic inventory analysis for complex nuclear systems

NASA Astrophysics Data System (ADS)

Phruksarojanakun, Phiphat

Monte Carlo Inventory Simulation Engine (MCise) is a newly developed method for calculating isotopic inventory of materials. It offers the promise of modeling materials with complex processes and irradiation histories, which pose challenges for current, deterministic tools, and has strong analogies to Monte Carlo (MC) neutral particle transport. The analog method, including considerations for simple, complex and loop flows, is fully developed. In addition, six variance reduction tools provide unique capabilities of MCise to improve statistical precision of MC simulations. Forced Reaction forces an atom to undergo a desired number of reactions in a given irradiation environment. Biased Reaction Branching primarily focuses on improving statistical results of the isotopes that are produced from rare reaction pathways. Biased Source Sampling aims at increasing frequencies of sampling rare initial isotopes as the starting particles. Reaction Path Splitting increases the population by splitting the atom at each reaction point, creating one new atom for each decay or transmutation product. Delta Tracking is recommended for high-frequency pulsing to reduce the computing time. Lastly, Weight Window is introduced as a strategy to decrease large deviations of weight due to the uses of variance reduction techniques. A figure of merit is necessary to compare the efficiency of different variance reduction techniques. A number of possibilities for figure of merit are explored, two of which are robust and subsequently used. One is based on the relative error of a known target isotope (1/R 2T) and the other on the overall detection limit corrected by the relative error (1/DkR 2T). An automated Adaptive Variance-reduction Adjustment (AVA) tool is developed to iteratively define parameters for some variance reduction techniques in a problem with a target isotope. Sample problems demonstrate that AVA improves both precision and accuracy of a target result in an efficient manner. Potential applications of MCise include molten salt fueled reactors and liquid breeders in fusion blankets. As an example, the inventory analysis of a liquid actinide fuel in the In-Zinerator, a sub-critical power reactor driven by a fusion source, is examined. The result reassures MCise as a reliable tool for inventory analysis of complex nuclear systems.

The impact of supervised weight loss and intentional weight regain on sex hormone binding globulin and testosterone in premenopausal women.

PubMed

Aubuchon, Mira; Liu, Ying; Petroski, Gregory F; Thomas, Tom R; Polotsky, Alex J

2016-08-01

What is the impact of intentional weight loss and regain on serum androgens in women? We conducted an ancillary analysis of prospectively collected samples from a randomized controlled trial. The trial involved supervised 10% weight loss (8.5 kg on average) with diet and exercise over 4-6 months followed by supervised intentional regain of 50% of the lost weight (4.6 kg on average) over 4-6 months. Participants were randomized prior to the partial weight regain component to either continuation or cessation of endurance exercise. Analytic sample included 30 obese premenopausal women (mean age of 40 ± 5.9 years, mean baseline body mass index (BMI) of 32.9 ± 4.2 kg/m(2)) with metabolic syndrome. We evaluated sex hormone binding globulin (SHBG), total testosterone (T), free androgen index (FAI), and high molecular weight adiponectin (HMWAdp). Insulin, homeostasis model assessment (HOMA), and quantitative insulin sensitivity check index (QUICKI), and visceral adipose tissue (VAT) measured in the original trial were reanalyzed for the current analytic sample. Insulin, HOMA, and QUICKI improved with weight loss and were maintained despite weight regain. Log-transformed SHBG significantly increased from baseline to weight loss, and then significantly decreased with weight regain. LogFAI and logVAT decreased similarly and increased with weight loss followed by weight regain. No changes were found in logT and LogHMWAdp. There was no significant difference in any tested parameters by exercise between the groups. SHBG showed prominent sensitivity to body mass fluctuations, as reduction with controlled intentional weight regain showed an inverse relationship to VAT and occurred despite stable HMWAdp and sustained improvements with insulin resistance. FAI showed opposite changes to SHBG, while T did not change significantly with weight. Continued exercise during weight regain did not appear to impact these findings.

Materials

NASA Technical Reports Server (NTRS)

Glaessgen, Edward H.; Schoeppner, Gregory A.

2006-01-01

NASA Langley Research Center has successfully developed an electron beam freeform fabrication (EBF3) process, a rapid metal deposition process that works efficiently with a variety of weldable alloys. The EBF3 process can be used to build a complex, unitized part in a layer-additive fashion, although the more immediate payoff is for use as a manufacturing process for adding details to components fabricated from simplified castings and forgings or plate products. The EBF3 process produces structural metallic parts with strengths comparable to that of wrought product forms and has been demonstrated on aluminum, titanium, and nickel-based alloys to date. The EBF3 process introduces metal wire feedstock into a molten pool that is created and sustained using a focused electron beam in a vacuum environment. Operation in a vacuum ensures a clean process environment and eliminates the need for a consumable shield gas. Advanced metal manufacturing methods such as EBF3 are being explored for fabrication and repair of aerospace structures, offering potential for improvements in cost, weight, and performance to enhance mission success for aircraft, launch vehicles, and spacecraft. Near-term applications of the EBF3 process are most likely to be implemented for cost reduction and lead time reduction through addition of details onto simplified preforms (casting or forging). This is particularly attractive for components with protruding details that would require a significantly large volume of material to be machined away from an oversized forging, offering significant reductions to the buy-to-fly ratio. Future far-term applications promise improved structural efficiency through reduced weight and improved performance by exploiting the layer-additive nature of the EBF3 process to fabricate tailored unitized structures with functionally graded microstructures and compositions.

Improving lower limb weight distribution asymmetry during the squat using Nintendo Wii Balance Boards and real-time feedback.

PubMed

McGough, Rian; Paterson, Kade; Bradshaw, Elizabeth J; Bryant, Adam L; Clark, Ross A

2012-01-01

Weight-bearing asymmetry (WBA) may be detrimental to performance and could increase the risk of injury; however, detecting and reducing it is difficult in a field setting. This study assessed whether a portable and simple-to-use system designed with multiple Nintendo Wii Balance Boards (NWBBs) and customized software can be used to evaluate and improve WBA. Fifteen elite Australian Rules Footballers and 32 age-matched, untrained participants were tested for measures of WBA while squatting. The NWBB and customized software provided real-time visual feedback of WBA during half of the trials. Outcome measures included the mean mass difference (MMD) between limbs, interlimb symmetry index (SI), and percentage of time spent favoring a single limb (TFSL). Significant reductions in MMD (p = 0.028) and SI (p = 0.007) with visual feedback were observed for the entire group data. Subgroup analysis revealed significant reductions in MMD (p = 0.047) and SI (p = 0.026) with visual feedback in the untrained sample; however, the reductions in the trained sample were nonsignificant. The trained group showed significantly less WBA for TFSL under both visual conditions (no feedback: p = 0.015, feedback: p = 0.017). Correlation analysis revealed that participants with high levels of WBA had the greatest response to feedback (p < 0.001, ρ = 0.557). In conclusion, WBA exists in healthy untrained adults, and these asymmetries can be reduced using real-time visual feedback provided by an NWBB-based system. Healthy, well-trained professional athletes do not possess the same magnitude of WBA. Inexpensive, portable, and widely available gaming technology may be used to evaluate and improve WBA in clinical and sporting settings.

Potential for Automobile Weight Reduction Outlook as of 1975-1976

DOT National Transportation Integrated Search

1978-08-01

A study has been carried out to evaluate the potential for weight reduction of automobiles. It is concluded that automobiles of lighter weight than those current (1976 models) in the domestic market may be built in each of three size classes, 4, 5, a...

Changes of renal sinus fat and renal parenchymal fat during an 18-month randomized weight loss trial.

PubMed

Zelicha, Hila; Schwarzfuchs, Dan; Shelef, Ilan; Gepner, Yftach; Tsaban, Gal; Tene, Lilac; Yaskolka Meir, Anat; Bilitzky, Avital; Komy, Oded; Cohen, Noa; Bril, Nitzan; Rein, Michal; Serfaty, Dana; Kenigsbuch, Shira; Chassidim, Yoash; Sarusi, Benjamin; Thiery, Joachim; Ceglarek, Uta; Stumvoll, Michael; Blüher, Matthias; Haviv, Yosef S; Stampfer, Meir J; Rudich, Assaf; Shai, Iris

2018-08-01

Data regarding the role of kidney adiposity, its clinical implications, and its dynamics during weight-loss are sparse. We investigated the effect of long-term weight-loss induced intervention diets on dynamics of renal-sinus-fat, an ectopic fat depot, and %renal-parenchymal-fat, lipid accumulation within the renal parenchyma. We randomized 278 participants with abdominal obesity/dyslipidemia to low-fat or Mediterranean/low-carbohydrate diets, with or without exercise. We quantified renal-sinus-fat and %renal-parenchymal-fat by whole body magnetic-resonance-imaging. Participants (age = 48 years; 89% men; body-mass-index = 31 kg/m 2 ) had 86% retention to the trial after 18 months. Both increased renal-sinus-fat and %renal-parenchymal-fat were directly associated with hypertension, and with higher abdominal deep-subcutaneous-adipose-tissue and visceral-adipose-tissue (p of trend < 0.05 for all) after adjustment for body weight. Higher renal-sinus-fat was associated with lower estimated-glomerular-filtration-rate and with higher microalbuminuria and %HbA1C beyond body weight. After 18 months of intervention, overall renal-sinus-fat (-9%; p < 0.05 vs. baseline) but not %renal-parenchymal-fat (-1.7%; p = 0.13 vs. baseline) significantly decreased, and similarly across the intervention groups. Renal-sinus-fat and %renal-parenchymal-fat changes were correlated with weight-loss per-se (p < 0.05). In a model adjusted for age, sex, and visceral-adipose-tissue changes, 18 months reduction in renal-sinus-fat associated with decreased pancreatic, hepatic and cardiac fats (p < 0.05 for all) and with decreased cholesterol/high-density lipoprotein-cholesterol (HDL-c) (β = 0.13; p = 0.05), triglycerides/HDL-c (β = 0.13; p = 0.05), insulin (β = 0.12; p = 0.05) and gamma glutamyl transpeptidase (β = 0.24; p = 0.001), but not with improved renal function parameters or blood pressure. Decreased intake of sodium was associated with a reduction in %renal-parenchymal-fat, after adjustment for 18 months weight-loss (β = 0.15; p = 0.026) and hypertension (β = 0.14; p = 0.04). Renal-sinus-fat and renal-parenchymal-fat are fairly related to weight-loss. Decreased renal-sinus-fat is associated with improved hepatic parameters, independent of changes in weight or hepatic fat, rather than with improved renal function or blood pressure parameters. CLINICALTRIALS. NCT01530724. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Effects of a weight loss plus exercise program on physical function in overweight, older women: a randomized controlled trial.

PubMed

Anton, Stephen D; Manini, Todd M; Milsom, Vanessa A; Dubyak, Pamela; Cesari, Matteo; Cheng, Jing; Daniels, Michael J; Marsiske, Michael; Pahor, Marco; Leeuwenburgh, Christiaan; Perri, Michael G

2011-01-01

Obesity and a sedentary lifestyle are associated with physical impairments and biologic changes in older adults. Weight loss combined with exercise may reduce inflammation and improve physical functioning in overweight, sedentary, older adults. This study tested whether a weight loss program combined with moderate exercise could improve physical function in obese, older adult women. Participants (N = 34) were generally healthy, obese, older adult women (age range 55-79 years) with mild to moderate physical impairments (ie, functional limitations). Participants were randomly assigned to one of two groups for 24 weeks: (i) weight loss plus exercise (WL+E; n = 17; mean age = 63.7 years [4.5]) or (ii) educational control (n = 17; mean age = 63.7 [6.7]). In the WL+E group, participants attended a group-based weight management session plus three supervised exercise sessions within their community each week. During exercise sessions, participants engaged in brisk walking and lower-body resistance training of moderate intensity. Participants in the educational control group attended monthly health education lectures on topics relevant to older adults. Outcomes were: (i) body weight, (ii) walking speed (assessed by 400-meter walk test), (iii) the Short Physical Performance Battery (SPPB), and (iv) knee extension isokinetic strength. Participants randomized to the WL+E group lost significantly more weight than participants in the educational control group (5.95 [0.992] vs 0.23 [0.99] kg; P < 0.01). Additionally, the walking speed of participants in the WL+E group significantly increased compared with that of the control group (reduction in time on the 400-meter walk test = 44 seconds; P < 0.05). Scores on the SPPB improved in both the intervention and educational control groups from pre- to post-test (P < 0.05), with significant differences between groups (P = 0.02). Knee extension strength was maintained in both groups. Our findings suggest that a lifestyle-based weight loss program consisting of moderate caloric restriction plus moderate exercise can produce significant weight loss and improve physical function while maintaining muscle strength in obese, older adult women with mild to moderate physical impairments.

Effects of a weight loss plus exercise program on physical function in overweight, older women: a randomized controlled trial

PubMed Central

Anton, Stephen D; Manini, Todd M; Milsom, Vanessa A; Dubyak, Pamela; Cesari, Matteo; Cheng, Jing; Daniels, Michael J; Marsiske, Michael; Pahor, Marco; Leeuwenburgh, Christiaan; Perri, Michael G

2011-01-01

Background: Obesity and a sedentary lifestyle are associated with physical impairments and biologic changes in older adults. Weight loss combined with exercise may reduce inflammation and improve physical functioning in overweight, sedentary, older adults. This study tested whether a weight loss program combined with moderate exercise could improve physical function in obese, older adult women. Methods: Participants (N = 34) were generally healthy, obese, older adult women (age range 55–79 years) with mild to moderate physical impairments (ie, functional limitations). Participants were randomly assigned to one of two groups for 24 weeks: (i) weight loss plus exercise (WL+E; n = 17; mean age = 63.7 years [4.5]) or (ii) educational control (n = 17; mean age = 63.7 [6.7]). In the WL+E group, participants attended a group-based weight management session plus three supervised exercise sessions within their community each week. During exercise sessions, participants engaged in brisk walking and lower-body resistance training of moderate intensity. Participants in the educational control group attended monthly health education lectures on topics relevant to older adults. Outcomes were: (i) body weight, (ii) walking speed (assessed by 400-meter walk test), (iii) the Short Physical Performance Battery (SPPB), and (iv) knee extension isokinetic strength. Results: Participants randomized to the WL+E group lost significantly more weight than participants in the educational control group (5.95 [0.992] vs 0.23 [0.99] kg; P < 0.01). Additionally, the walking speed of participants in the WL+E group significantly increased compared with that of the control group (reduction in time on the 400-meter walk test = 44 seconds; P < 0.05). Scores on the SPPB improved in both the intervention and educational control groups from pre- to post-test (P < 0.05), with significant differences between groups (P = 0.02). Knee extension strength was maintained in both groups. Conclusion: Our findings suggest that a lifestyle-based weight loss program consisting of moderate caloric restriction plus moderate exercise can produce significant weight loss and improve physical function while maintaining muscle strength in obese, older adult women with mild to moderate physical impairments. PMID:21753869

Weight management program for treatment-emergent weight gain in olanzapine-treated patients with schizophrenia or schizoaffective disorder: A 12-week randomized controlled clinical trial.

PubMed

Kwon, Jun Soo; Choi, Jung-Seok; Bahk, Won-Myoung; Yoon Kim, Chang; Hyung Kim, Chan; Chul Shin, Young; Park, Byung-Joo; Geun Oh, Chang

2006-04-01

The main objective was to assess the efficacy of a weight management program designed for outpatients taking olanzapine for schizophrenia or schizoaffective disorder and to compare these patients with a randomized control group. The effects of the weight management program were also assessed with regard to safety and quality of life. Forty-eight patients were enrolled in a 12-week, randomized, multicenter weight management study. Thirty-three patients were randomly allocated to an intervention group in which they received olanzapine within a weight management program. Fifteen patients were allocated to a control group in which they were given olanzapine treatment as usual outpatients. Weight, body mass index (BMI), and measurements of safety and quality of life were evaluated. The study was conducted from January 7, 2003, to September 16, 2003. Thirty-six patients (75%) completed this study. We found significant differences in weight (-3.94 +/- 3.63 kg vs. -1.48 +/- 1.88 kg, p = .006) and BMI (-1.50 +/- 1.34 vs. -0.59 +/- 0.73, p = .007) change from baseline to endpoint between the intervention and control groups, respectively. Significant differences in weight reduction were initially observed at week 8 (p = .040). No significant differences were found with regard to the safety outcomes. When the ratio of low-density lipoproteins to high-density lipoproteins was calculated, change from baseline was greater in the intervention group than the control group (-0.19 vs. -0.04), but the difference was not statistically significant (p = .556). After the completion of the weight management program, there was a trend toward statistical difference in the physical health score changes between the weight management and control groups (1.12 in the intervention group vs. -0.93 in the control group, p = .067). The weight management program was effective in terms of weight reduction in patients with schizophrenia or schizoaffective disorder taking olanzapine and was also found to be safe in terms of psychiatric symptoms, vital signs, and laboratory data. In addition, such a weight management program might improve quality of life in patients with schizophrenia or schizoaffective disorder with respect to their physical well-being.

Aerobic exercise and weight loss reduce vascular markers of inflammation and improve insulin sensitivity in obese women.

PubMed

Ryan, Alice S; Ge, Shealinna; Blumenthal, Jacob B; Serra, Monica C; Prior, Steven J; Goldberg, Andrew P

2014-04-01

To examine the relationships between plasma and tissue markers of systemic and vascular inflammation and obesity and insulin resistance and determine the effects of aerobic exercise training plus weight loss (AEX+WL) and weight loss (WL) alone on these biomarkers. Prospective controlled study. Veterans Affairs Medical Center and University research setting. Overweight and obese sedentary postmenopausal women (N = 77). Six months, 3 d/wk AEX+WL (n = 37) or WL (n = 40). Total-body dual-energy X-ray absorptiometry, abdominal computed tomography, hyperinsulinemic-euglycemic clamps (a criterion standard method of assessing insulin sensitivity), adipose tissue biopsies (n = 28), and blood for homeostasis model assessment-insulin resistance, and soluble forms of intracellular adhesion molecule 1 (sICAM-1) and vascular cell adhesion molecule 1 (sVCAM-1), C-reactive protein (CRP), and serum amyloid A (SAA). Body weight (P < .001), percentage of fat (P < .001), visceral fat (P < .005), triglyceride levels (P < .001), and systolic blood pressure decreased comparably after WL and AEX+WL (P = .04). Maximal oxygen consumption increased 16% after AEX+WL (P < .001). Insulin resistance decreased in both groups (P = .005). Glucose utilization according to the clamp increased 10% (P = .04) with AEX+WL and 8% with WL (P = .07). AEX+WL decreased CRP by 29% (P < .001) and WL by 21% (P = .02). SAA levels decreased twice as much after AEX+WL (-19%, P = .02) as after WL (-9%, P = .08). Plasma sICAM-1 and sVCAM-1 levels did not change, but women with the greatest reduction in plasma sICAM-1 levels had the greatest reductions in fasting glucose (P = .02), insulin (P = .02), and insulin resistance (P = .004). Gluteal ICAM messenger ribonucleic acid levels decreased 27% after AEX+WL (P = .02) and did not change after WL. Obesity and insulin resistance worsen markers of systemic and vascular inflammation. A reduction in plasma sICAM-1 is important to improve insulin sensitivity. CRP, SAA, and tissue ICAM decrease with exercise and weight loss, suggesting that exercise training is a necessary component of lifestyle modification in obese postmenopausal women. © Published 2014. This article is a U.S. Government work and is in the public domain in the U.S.A.

Can exercise increase fitness and reduce weight in patients with schizophrenia and depression?

PubMed

Krogh, Jesper; Speyer, Helene; Nørgaard, Hans Christian Brix; Moltke, Ane; Nordentoft, Merete

2014-01-01

Psychiatric patients have a reduced life expectancy of 15-20 years compared with the general population. Most years of lost life are due to the excess mortality from somatic diseases. Sedentary lifestyle and medication is partly responsible for the high frequency of metabolic syndrome in this patient group and low levels of physical activity is associated with increased risk of cardiovascular disease, diabetes, and all-cause mortality. This study aimed to review trials allocating patients with either schizophrenia or depression to exercise interventions for effect on cardiovascular fitness, strength, and weight. We searched PubMed, Embase, and PsycINFO including randomized clinical trial allocating patients with either schizophrenia or depression to isolated exercise interventions. We identified five trials including patients with schizophrenia (n = 94) and found little evidence that exercise could increase cardiovascular fitness or decrease weight. Nine exercise trials for patients with depression (n = 892) were identified increasing cardiovascular fitness by 11-30% and strength by 33-37%. No evidence in favor of exercise for weight reduction was found. Based on the current evidence isolated exercise interventions are unlikely to improve cardiovascular fitness or induce weight loss in patients with schizophrenia. In patients with depression, exercise interventions are likely to induce clinically relevant short term effects, however, due to lack of reporting, little is known about the effect on weight reduction and cardiovascular fitness. Future exercise trials regarding patients with mental illness should preferably measure changes in cardiovascular strength, repetition maximum, and anthropometric outcomes. Ideally, participants should be assessed beyond the intervention to identify long lasting effects.

A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults123

PubMed Central

Stote, Kim S; Baer, David J; Spears, Karen; Paul, David R; Harris, G Keith; Rumpler, William V; Strycula, Pilar; Najjar, Samer S; Ferrucci, Luigi; Ingram, Donald K; Longo, Dan L; Mattson, Mark P

2009-01-01

Background Although consumption of 3 meals/d is the most common pattern of eating in industrialized countries, a scientific rationale for this meal frequency with respect to optimal health is lacking. A diet with less meal frequency can improve the health and extend the lifespan of laboratory animals, but its effect on humans has never been tested. Objective A pilot study was conducted to establish the effects of a reduced-meal-frequency diet on health indicators in healthy, normal-weight adults. Design The study was a randomized crossover design with two 8-wk treatment periods. During the treatment periods, subjects consumed all of the calories needed for weight maintenance in either 3 meals/d or 1 meal/d. Results Subjects who completed the study maintained their body weight within 2 kg of their initial weight throughout the 6-mo period. There were no significant effects of meal frequency on heart rate, body temperature, or most of the blood variables measured. However, when consuming 1 meal/d, subjects had a significant increase in hunger; a significant modification of body composition, including reductions in fat mass; significant increases in blood pressure and in total, LDL-, and HDL-cholesterol concentrations; and a significant decrease in concentrations of cortisol. Conclusions Normal-weight subjects are able to comply with a 1 meal/d diet. When meal frequency is decreased without a reduction in overall calorie intake, modest changes occur in body composition, some cardiovascular disease risk factors, and hematologic variables. Diurnal variations may affect outcomes. PMID:17413096

Metafitting: Weight optimization for least-squares fitting of PTTI data

NASA Technical Reports Server (NTRS)

Douglas, Rob J.; Boulanger, J.-S.

1995-01-01

For precise time intercomparisons between a master frequency standard and a slave time scale, we have found it useful to quantitatively compare different fitting strategies by examining the standard uncertainty in time or average frequency. It is particularly useful when designing procedures which use intermittent intercomparisons, with some parameterized fit used to interpolate or extrapolate from the calibrating intercomparisons. We use the term 'metafitting' for the choices that are made before a fitting procedure is operationally adopted. We present methods for calculating the standard uncertainty for general, weighted least-squares fits and a method for optimizing these weights for a general noise model suitable for many PTTI applications. We present the results of the metafitting of procedures for the use of a regular schedule of (hypothetical) high-accuracy frequency calibration of a maser time scale. We have identified a cumulative series of improvements that give a significant reduction of the expected standard uncertainty, compared to the simplest procedure of resetting the maser synthesizer after each calibration. The metafitting improvements presented include the optimum choice of weights for the calibration runs, optimized over a period of a week or 10 days.

Hybrid-Wing-Body Vehicle Composite Fuselage Analysis and Case Study

NASA Technical Reports Server (NTRS)

Mukhopadhyay, Vivek

2014-01-01

Recent progress in the structural analysis of a Hybrid Wing-Body (HWB) fuselage concept is presented with the objective of structural weight reduction under a set of critical design loads. This pressurized efficient HWB fuselage design is presently being investigated by the NASA Environmentally Responsible Aviation (ERA) project in collaboration with the Boeing Company, Huntington Beach. The Pultruded Rod-Stiffened Efficient Unitized Structure (PRSEUS) composite concept, developed at the Boeing Company, is approximately modeled for an analytical study and finite element analysis. Stiffened plate linear theories are employed for a parametric case study. Maximum deflection and stress levels are obtained with appropriate assumptions for a set of feasible stiffened panel configurations. An analytical parametric case study is presented to examine the effects of discrete stiffener spacing and skin thickness on structural weight, deflection and stress. A finite-element model (FEM) of an integrated fuselage section with bulkhead is developed for an independent assessment. Stress analysis and scenario based case studies are conducted for design improvement. The FEM model specific weight of the improved fuselage concept is computed and compared to previous studies, in order to assess the relative weight/strength advantages of this advanced composite airframe technology

Multi-material size optimization of a ladder frame chassis

NASA Astrophysics Data System (ADS)

Baker, Michael

The Corporate Average Fuel Economy (CAFE) is an American fuel standard that sets regulations on fuel economy in vehicles. This law ultimately shapes the development and design research for automakers. Reducing the weight of conventional cars offers a way to improve fuel efficiency. This research investigated the optimality of an automobile's ladder frame chassis (LFC) by conducting multi-objective optimization on the LFC in order to reduce the weight of the chassis. The focus of the design and optimization was a ladder frame chassis commonly used for mass production light motor vehicles with an open-top rear cargo area. This thesis is comprised of two major sections. The first looked to perform thickness optimization in the outer walls of the ladder frame. In the second section, many multi-material distributions, including steel and aluminium varieties, were investigated. A simplified model was used to do an initial hand calculation analysis of the problem. This was used to create a baseline validation to compare the theory with the modeling. A CAD model of the LFC was designed. From the CAD model, a finite element model was extracted and joined using weld and bolt connectors. Following this, a linear static analysis was performed to look at displacement and stresses when subjected to loading conditions that simulate harsh driving conditions. The analysis showed significant values of stress and displacement on the ends of the rails, suggesting improvements could be made elsewhere. An optimization scheme was used to find the values of an all steel frame an optimal thickness distribution was found. This provided a 13% weight reduction over the initial model. To advance the analysis a multi-material approach was used to push the weight savings even further. Several material distributions were analyzed and the lightest utilized aluminium in all but the most strenuous subjected components. This enabled a reduction in weight of 15% over the initial model, equivalent to approximately 1 mile per gallon (MPG) in fuel economy.

Unconditional Prenatal Income Supplement and Birth Outcomes.

PubMed

Brownell, Marni D; Chartier, Mariette J; Nickel, Nathan C; Chateau, Dan; Martens, Patricia J; Sarkar, Joykrishna; Burland, Elaine; Jutte, Douglas P; Taylor, Carole; Santos, Robert G; Katz, Alan

2016-06-01

Perinatal outcomes have improved in developed countries but remain poor for disadvantaged populations. We examined whether an unconditional income supplement to low-income pregnant women was associated with improved birth outcomes. This study included all mother-newborn pairs (2003-2010) in Manitoba, Canada, where the mother received prenatal social assistance, the infant was born in the hospital, and the pair had a risk screen (N = 14 591). Low-income women who received the income supplement (Healthy Baby Prenatal Benefit [HBPB], n = 10 738) were compared with low-income women who did not receive HBPB (n = 3853) on the following factors: low birth weight, preterm, small and large for gestational age, Apgar score, breastfeeding initiation, neonatal readmission, and newborn hospital length of stay (LOS). Covariates from risk screens were used to develop propensity scores and to balance differences between groups in regression models; γ sensitivity analyses were conducted to assess sensitivity to unmeasured confounding. Population-attributable and preventable fractions were calculated. HBPB was associated with reductions in low birth weight (aRR, 0.71 [95% CI, 0.63-0.81]), preterm births (aRR, 0.76 [95% CI, 0.69-0.84]) and small for gestational age births (aRR, 0.90 [95% CI, 0.81-0.99]) and increases in breastfeeding (aRR, 1.06 [95% CI, 1.03-1.09]) and large for gestational age births (aRR, 1.13 [95% CI, 1.05-1.23]). For vaginal births, HBPB was associated with shortened LOS (weighted mean, 2.86; P < .0001). Results for breastfeeding, low birth weight, preterm birth, and LOS were robust to unmeasured confounding. Reductions of 21% (95% CI, 13.6-28.3) for low birth weight births and 17.5% (95% CI, 11.2-23.8) for preterm births were associated with HBPB. Receipt of an unconditional prenatal income supplement was associated with positive outcomes. Placing conditions on income supplements may not be necessary to promote prenatal and perinatal health. Copyright © 2016 by the American Academy of Pediatrics.

Weight Changes and Metabolic Outcomes in Calorie-Restricted Obese Mice Fed High-Fat Diets Containing Corn or Flaxseed Oil: Physiological Role of Sugar Replacement with Polyphenol-Rich Grape.

PubMed

Ansar, Hastimansooreh; Zamaninour, Negar; Djazayery, Abolghassem; Pishva, Hamideh; Vafa, Mohammadreza; Mazaheri Nezhad Fard, Ramin; Dilmaghanian, Aydin; Mirzaei, Khadijeh; Shidfar, Farzad

2017-08-01

Because diet components are important during dieting in obesity treatment, we examined possible beneficial effects of substituting corn oil and sugar with flaxseed oil and grape in calorie-restricted high-fat diets on weight changes as well as improvement in some metabolic markers and related gene expression. Seventy-five C57BL/6J male mice were given free access to a high-fat (36% of energy from fat) diet containing corn oil plus sugar (CO + S). After 11 weeks, 15 mice were sacrificed and another 60 were divided among 4 high-fat diet groups with 30% calorie restriction (CR) for the next 12 weeks. The diets contained corn oil (CO) or flaxseed oil (FO) with sugar (S) or grape (G). Despite CR, a weight loss trend was observed only during the first 4 weeks in all groups. CR did not significantly increase SIRT1 gene expression. Higher liver weight was observed in mice consuming FO (p < 0.05). Proliferator-activated receptor gamma (PPARγ) expression decreased in FO + G-CR significantly and even with a reduction of adiposity and higher adiponectin levels, fasting blood sugar (FBS) was significantly higher than in CO + G-CR. Grape intake increased Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) expression and decreased insulin resistance in CO + G-CR. Sugar replacement with polyphenol-rich grape along with CR improved glucose homeostasis, and substituting corn oil with flaxseed oil in obese mice reduced fat mass, but even with no change in adiponectin levels it could not decrease insulin resistance. However, none of the food item combinations facilitated weight reduction in the long-term CR. Therefore, regardless of the total calorie intake, different diet components and fat contents may have unexpected effects on metabolic regulation.

Changes in lipid indices and body composition one year after laparoscopic gastrectomy: a prospective study.

PubMed

Lee, Soo Jin; Kim, Ji Young; Ha, Tae Kyung; Choi, Yun Young

2018-05-11

The purpose of this prospective study was to investigate changes in lipid indices associated with whole body composition during 1 year of follow-up after laparoscopic gastrectomy. Thirty-seven patients with benign and malignant gastric neoplasm who underwent laparoscopic gastrectomy were prospectively enrolled. None of the patients were treated with adjuvant chemotherapy. Lipid indices and body composition were measured preoperatively and at six and 12 months after laparoscopic gastrectomy. Lipid indices included total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). Body weight, fat and lean body mass (LBM) were measured by dual-energy X-ray absorptiometry and the change in fat and LBM in the trunk, arms and legs was compared. Body weight significantly decreased from 63.0 ± 11.1 kg preoperatively to 56.8 ± 10.6 kg 12 months after laparoscopic gastrectomy, with a mean of 7.1% (4.6 kg) weight loss. Fat and LBM loss contributed 68.4% (3.1 kg) and 30.1% (1.4 kg) of the total weight loss, respectively. In both the non-obese and obese groups, body weight, fat and LBM did not change significantly between 6 months and 12 months after gastrectomy. TC and LDL-C levels significantly decreased during the first six-month period and HDL-C significantly increased until 12 months after gastrectomy in the non-obese group. In the obese group, the degree of reduction in fat mass was significantly higher and the LBM/weight ratio significantly increased compared with the non-obese group. However, there was no significant change in lipid indices in the obese group. The TG level was significantly correlated with fat, especially with trunk fat. Gastrectomy resulted in improved lipid indices and a reduction in body weight, fat and LBM. The HDL-C significantly increased in the non-obese group for 1 year after gastrectomy and the reduction of TG level was positively correlated with fat, especially with trunk fat (IRB No. 2015-04-026. Registered 4 May 2015).

Dietary Intervention for Overweight and Obese Adults: Comparison of Low-Carbohydrate and Low-Fat Diets. A Meta-Analysis

PubMed Central

Sackner-Bernstein, Jonathan; Kanter, David; Kaul, Sanjay

2015-01-01

Background Reduced calorie, low fat diet is currently recommended diet for overweight and obese adults. Prior data suggest that low carbohydrate diets may also be a viable option for those who are overweight and obese. Purpose Compare the effects of low carbohydrate versus low fats diet on weight and atherosclerotic cardiovascular disease risk in overweight and obese patients. Data Sources Systematic literature review via PubMed (1966–2014). Study Selection Randomized controlled trials with ≥8 weeks follow up, comparing low carbohydrate (≤120gm carbohydrates/day) and low fat diet (≤30% energy from fat/day). Data Extraction Data were extracted and prepared for analysis using double data entry. Prior to identification of candidate publications, the outcomes of change in weight and metabolic factors were selected as defined by Cochrane Collaboration. Assessment of the effects of diets on predicted risk of atherosclerotic cardiovascular disease risk was added during the data collection phase. Data Synthesis 1797 patients were included from 17 trials with <1 year follow up in 12. Compared with low fat diet, low carbohydrate was associated with significantly greater reduction in weight (Δ = -2.0 kg, 95% CI: -3.1, -0.9) and significantly lower predicted risk of atherosclerotic cardiovascular disease events (p<0.03). Frequentist and Bayesian results were concordant. The probability of greater weight loss associated with low carbohydrate was >99% while the reduction in predicted risk favoring low carbohydrate was >98%. Limitations Lack of patient-level data and heterogeneity in dropout rates and outcomes reported. Conclusions This trial-level meta-analysis of randomized controlled trials comparing LoCHO diets with LoFAT diets in strictly adherent populations demonstrates that each diet was associated with significant weight loss and reduction in predicted risk of ASCVD events. However, LoCHO diet was associated with modest but significantly greater improvements in weight loss and predicted ASCVD risk in studies from 8 weeks to 24 months in duration. These results suggest that future evaluations of dietary guidelines should consider low carbohydrate diets as effective and safe intervention for weight management in the overweight and obese, although long-term effects require further investigation. PMID:26485706

Exploration of Two Training Paradigms Using Forced Induced Weight Shifting With the Tethered Pelvic Assist Device to Reduce Asymmetry in Individuals After Stroke: Case Reports.

PubMed

Bishop, Lauri; Khan, Moiz; Martelli, Dario; Quinn, Lori; Stein, Joel; Agrawal, Sunil

2017-10-01

Many robotic devices in rehabilitation incorporate an assist-as-needed haptic guidance paradigm to promote training. This error reduction model, while beneficial for skill acquisition, could be detrimental for long-term retention. Error augmentation (EA) models have been explored as alternatives. A robotic Tethered Pelvic Assist Device has been developed to study force application to the pelvis on gait and was used here to induce weight shift onto the paretic (error reduction) or nonparetic (error augmentation) limb during treadmill training. The purpose of these case reports is to examine effects of training with these two paradigms to reduce load force asymmetry during gait in two individuals after stroke (>6 mos). Participants presented with baseline gait asymmetry, although independent community ambulators. Participants underwent 1-hr trainings for 3 days using either the error reduction or error augmentation model. Outcomes included the Borg rating of perceived exertion scale for treatment tolerance and measures of force and stance symmetry. Both participants tolerated training. Force symmetry (measured on treadmill) improved from pretraining to posttraining (36.58% and 14.64% gains), however, with limited transfer to overground gait measures (stance symmetry gains of 9.74% and 16.21%). Training with the Tethered Pelvic Assist Device device proved feasible to improve force symmetry on the treadmill irrespective of training model. Future work should consider methods to increase transfer to overground gait.

Superomedial pedicle reduction mammaplasty: increased resection weight does not increase nipple necrosis.

PubMed

Brownlee, Pamela; Chesire, David; Crandall, Marie; Murray, John

2017-11-01

The superomedial pedicle (SMP) reduction mammaplasty offers several advantages over more traditional operative techniques, such as retained sensation to the nipple areola complex (NAC) and improved preservation of long-term breast shape. However, many surgeons believe that using the SMP can cause an increase in NAC necrosis rates up to 13.1%, especially in large volume reductions. The aims of this paper are to determine the rate of nipple necrosis when performing an SMP reduction mammaplasty at our institution and establish if there is a difference in those rates based on the weight of tissue removed. We then compared our overall rate of nipple necrosis to those found using a systematic review of literature involving other pedicles to determine if this technique is equivalent to more commonly used methods. We performed a retrospective chart review of patients who underwent breast reduction surgery using SMP at a single institution between May 1, 2013, and May 1, 2015. Each breast was counted separately, and the weight of the tissue removed was recorded. Six-mo follow-up data were analyzed using the chi-square analysis to compare rates of NAC necrosis among our patients and historical cohorts. One hundred thirty-five breasts (70 patients) met inclusion criteria. Patients had a mean resection weight per breast of 1016.7 g (±478.3). There was an NAC necrosis rate of 0% in the groups where 1200 g or less of tissue were removed and 2.3% (n = 1) in the group where greater than 1200 g of tissue were removed. We found no statistically significant difference in the rate of NAC necrosis with increased resection weights, (P = 0.32). The overall rate of NAC necrosis for this study was 0.7% per breast, which is equivalent to the rates found during the systematic review of literature. In this study, the SMP breast reduction technique shows a low rate of NAC. We found no statistically significant increase in NAC necrosis rates as the volume of tissue removed increases, and the SMP appears to have an overall rate of NAC necrosis similar to more commonly used pedicles. Although the results of this study may be related to patient selection or surgical technique, we believe that this pedicle preserves the breast's main blood supply so that less tissue ischemia occurs. Copyright © 2017 Elsevier Inc. All rights reserved.

Nontangent, Developed Contour Bulkheads for a Single-Stage Launch Vehicle

NASA Technical Reports Server (NTRS)

Wu, K. Chauncey; Lepsch, Roger A., Jr.

2000-01-01

Dry weights for single-stage launch vehicles that incorporate nontangent, developed contour bulkheads are estimated and compared to a baseline vehicle with 1.414 aspect ratio ellipsoidal bulkheads. Weights, volumes, and heights of optimized bulkhead designs are computed using a preliminary design bulkhead analysis code. The dry weights of vehicles that incorporate the optimized bulkheads are predicted using a vehicle weights and sizing code. Two optimization approaches are employed. A structural-level method, where the vehicle's three major bulkhead regions are optimized separately and then incorporated into a model for computation of the vehicle dry weight, predicts a reduction of4365 lb (2.2 %) from the 200,679-lb baseline vehicle dry weight. In the second, vehicle-level, approach, the vehicle dry weight is the objective function for the optimization. For the vehicle-level analysis, modified bulkhead designs are analyzed and incorporated into the weights model for computation of a dry weight. The optimizer simultaneously manipulates design variables for all three bulkheads to reduce the dry weight. The vehicle-level analysis predicts a dry weight reduction of 5129 lb, a 2.6% reduction from the baseline weight. Based on these results, nontangent, developed contour bulkheads may provide substantial weight savings for single stage vehicles.

lop-DWI: A Novel Scheme for Pre-Processing of Diffusion-Weighted Images in the Gradient Direction Domain.

PubMed

Sepehrband, Farshid; Choupan, Jeiran; Caruyer, Emmanuel; Kurniawan, Nyoman D; Gal, Yaniv; Tieng, Quang M; McMahon, Katie L; Vegh, Viktor; Reutens, David C; Yang, Zhengyi

2014-01-01

We describe and evaluate a pre-processing method based on a periodic spiral sampling of diffusion-gradient directions for high angular resolution diffusion magnetic resonance imaging. Our pre-processing method incorporates prior knowledge about the acquired diffusion-weighted signal, facilitating noise reduction. Periodic spiral sampling of gradient direction encodings results in an acquired signal in each voxel that is pseudo-periodic with characteristics that allow separation of low-frequency signal from high frequency noise. Consequently, it enhances local reconstruction of the orientation distribution function used to define fiber tracks in the brain. Denoising with periodic spiral sampling was tested using synthetic data and in vivo human brain images. The level of improvement in signal-to-noise ratio and in the accuracy of local reconstruction of fiber tracks was significantly improved using our method.

A System-Level Approach to Overweight and Obesity in the Veterans Health Administration.

PubMed

Raffa, Susan D; Maciejewski, Matthew L; Zimmerman, Lindsey E; Damschroder, Laura J; Estabrooks, Paul A; Ackermann, Ronald T; Tsai, Adam G; Histon, Trina; Goldstein, Michael G

2017-04-01

Healthcare systems are challenged by steady increases in the number of patients who are overweight and obese. Large-scale, evidence-based behavioral approaches for addressing overweight and obesity have been successfully implemented in systems such as the Veterans Health Administration (VHA). These population-based interventions target reduction in risk for obesity-associated conditions through lifestyle change and weight loss, and are associated with modest weight loss. Despite the fact that VHA has increased the overall reach of these behavioral interventions, the number of high-risk overweight and obese patients continues to rise. Recommendations for weight loss medications and bariatric surgery are included in clinical practice guidelines for the management of overweight and obesity, but these interventions are underutilized. During a recent state of the art conference on weight management held by VHA, subject matter experts identified challenges and gaps, as well as potential solutions and overarching policy recommendations, for implementing an integrated system-wide approach for improving population-based weight management.

Real-time depth camera tracking with geometrically stable weight algorithm

NASA Astrophysics Data System (ADS)

Fu, Xingyin; Zhu, Feng; Qi, Feng; Wang, Mingming

2017-03-01

We present an approach for real-time camera tracking with depth stream. Existing methods are prone to drift in sceneries without sufficient geometric information. First, we propose a new weight method for an iterative closest point algorithm commonly used in real-time dense mapping and tracking systems. By detecting uncertainty in pose and increasing weight of points that constrain unstable transformations, our system achieves accurate and robust trajectory estimation results. Our pipeline can be fully parallelized with GPU and incorporated into the current real-time depth camera tracking system seamlessly. Second, we compare the state-of-the-art weight algorithms and propose a weight degradation algorithm according to the measurement characteristics of a consumer depth camera. Third, we use Nvidia Kepler Shuffle instructions during warp and block reduction to improve the efficiency of our system. Results on the public TUM RGB-D database benchmark demonstrate that our camera tracking system achieves state-of-the-art results both in accuracy and efficiency.

Satiereal, a Crocus sativus L extract, reduces snacking and increases satiety in a randomized placebo-controlled study of mildly overweight, healthy women.

PubMed

Gout, Bernard; Bourges, Cédric; Paineau-Dubreuil, Séverine

2010-05-01

Snacking is an uncontrolled eating behavior, predisposing weight gain and obesity. It primarily affects the female population and is frequently associated with stress. We hypothesized that oral supplementation with Satiereal (Inoreal Ltd, Plerin, France), a novel extract of saffron stigma, may reduce snacking and enhance satiety through its suggested mood-improving effect, and thus contribute to weight loss. Healthy, mildly overweight women (N = 60) participated in this randomized, placebo-controlled, double-blind study that evaluated the efficacy of Satiereal supplementation on body weight changes over an 8-week period. Snacking frequency, the main secondary variable, was assessed by daily self-recording of episodes by the subjects in a nutrition diary. Twice a day, enrolled subjects consumed 1 capsule of Satiereal (176.5 mg extract per day (n = 31) or a matching placebo (n = 29). Caloric intake was left unrestricted during the study. At baseline, both groups were homogeneous for age, body weight, and snacking frequency. Satiereal caused a significantly greater body weight reduction than placebo after 8 weeks (P < .01). The mean snacking frequency was significantly decreased in the Satiereal group as compared with the placebo group (P < .05). Other anthropometric dimensions and vital signs remained almost unchanged in both groups. No subject withdrawal attributable to a product effect was reported throughout the trial, suggesting a good tolerability to Satiereal. Our results indicate that Satiereal consumption produces a reduction of snacking and creates a satiating effect that could contribute to body weight loss. The combination of an adequate diet with Satiereal supplementation might help subjects engaged in a weight loss program in achieving their objective. Copyright 2010 Elsevier Inc. All rights reserved.

[A telemetrically-guided program for weight reduction in overweight subjects (the SMART study)].

PubMed

Körtke, H; Frisch, S; Zittermann, A; Berthold, H K; El-Arousy, M; Götting, C; Kleesiek, K; Stehle, P; Körfer, R

2008-06-01

Compliance with weight reducing programs can be improved by intensive care and control. We tested a telemetrically-guided weight reduction program in overweight and obese persons. 200 outpatients (62 males) with a mean body mass index of 34 kg/m (2) and a mean age of 47 years participated in a prospective study for one year. During the first six months, telemetrical support (weight-transmission via Bluetooth (short range)-technology, 20-minutes telephone consultation with a nutritionist) was given weekly. After six months, participants were randomly assigned either to a group with further telemonitoring support (telemetric group) or to a group without contact to our clinic (control group). At baseline, and after six and twelve months, body weight, body composition (bioelectrical impedance analysis), and parameters of the metabolic syndrome were assessed at our clinic. 16 participants terminated the study prematurely during the first 6 months and 19 participants (10 from the telemetric group and 9 from the control group) during the second 6 months. According to the intention-to-treat principle, mean weight loss was 6.7 kg (p < 0,001), mean loss of body fat was 5.1 kg (p < 0,001), and mean loss of fat-free mass was 1.6 kg (p < 0,001) within the first six months. Moreover, metabolic and cardiovascular risk markers such as waist circumference, blood pressure, serum triglycerides and blood glucose declined significantly (p < 0,001). Prevalence of the metabolic syndrome fell from 49.5% to 42.0 % (p < 0,05). During the second six months body fat content, waist circumference, and blood glucose increased again in the control group but not in the telemetric group (p < 0,05-0,001). The telemetrically-guided weight loss program was a more efficacious measure than the less intensive support without telemonitoring.

Exploring the evidence base for Tier 3 weight management interventions for adults: a systematic review.

PubMed

Brown, T J; O'Malley, C; Blackshaw, J; Coulton, V; Tedstone, A; Summerbell, C; Ells, L J

2017-10-01

Specialist weight management services provide a treatment option for severe obesity. The objective of the study is to review the characteristics, impact and practice implications of specialist weight management services for adults in the UK. Systematic review: EMBASE, MEDLINE and PsycINFO were searched from January 2005 to March 2016 with supplementary searches. Adults with a body mass index of ≥40 kg m -2 , or ≥35 kg m -2 with comorbidity or ≥30 kg m -2 with type 2 diabetes and any study of multicomponent interventions, in any UK or Ireland setting, delivered by a specialist multidisciplinary team are the inclusion criteria. Fourteen studies in a variety of settings were included: 1 randomized controlled trial, 3 controlled and 10 observational studies. Mean baseline body mass index and age ranged from 40 to 54 kg m -2 and from 40 to 58 years. The studies were heterogeneous making comparisons of service characteristics difficult. Multidisciplinary team composition and eligibility criteria varied; dropout rates were high (43-62%). Statistically significant reduction in mean body mass index over time ranged from -1.4 to -3.1 kg m -2 and mean weight changes ranged from -2.2 to -12.4 kg. Completers achieving at least 5% reduction of initial body weight ranged from 32 to 51%. There was evidence for improved outcomes in diabetics. Specialist weight management services can demonstrate clinically significant weight loss and have an important role in supporting adults to manage severe and often complex forms of obesity. This review highlights important variations in provision and strongly indicates the need for further research into effective approaches to support severely obese adults. © 2017 World Obesity Federation.

Reduction of Sulfonylurea with the Initiation of Basal Insulin in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Undergoing Long-Term Sulfonylurea-Based Treatment.

PubMed

Yang, Yeoree; Shin, Jeong Ah; Yang, Hae Kyung; Lee, Seung Hwan; Ko, Seung Hyun; Ahn, Yu Bae; Yoon, Kun Ho; Cho, Jae Hyoung

2016-12-01

There were a limited number of studies about β-cell function after insulin initiation in patients exposed to long durations of sulfonylurea treatment. In this study, we aimed to evaluate the recovery of β-cell function and the efficacy of concurrent sulfonylurea use after the start of long-acting insulin. In this randomized controlled study, patients with type 2 diabetes mellitus (T2DM), receiving sulfonylurea for at least 2 years with glycosylated hemoglobin (HbA1c) >7%, were randomly assigned to two groups: sulfonylurea maintenance (SM) and sulfonylurea reduction (SR). Following a 75-g oral glucose tolerance test (OGTT), we administered long-acting basal insulin to the two groups. After a 6-month follow-up, we repeated the OGTT. Among 69 enrolled patients, 57 completed the study and were analyzed: 31 in the SM and 26 in the SR group. At baseline, there was no significant difference except for the longer duration of diabetes and lower triglycerides in the SR group. After 6 months, the HbA1c was similarly reduced in both groups, but there was little difference in the insulin dose. In addition, insulin secretion during OGTT was significantly increased by 20% to 30% in both groups. A significant weight gain was observed in the SM group only. The insulinogenic index was more significantly improved in the SR group. Long-acting basal insulin replacement could improve the glycemic status and restore β-cell function in the T2DM patients undergoing sulfonylurea-based treatment, irrespective of the sulfonylurea dose reduction. The dose reduction of the concurrent sulfonylurea might be beneficial with regard to weight grain.

Morinda citrifolia L. leaf extract prevent weight gain in Sprague-Dawley rats fed a high fat diet

PubMed Central

Jambocus, Najla Gooda Sahib; Ismail, Amin; Khatib, Alfi; Mahomoodally, Fawzi; Saari, Nazamid; Mumtaz, Muhammad Waseem; Hamid, Azizah Abdul

2017-01-01

ABSTRACT Background: Morinda citrifolia L. is widely used as a folk medicinal food plant to manage a panoply of diseases, though no concrete reports on its potential anti-obesity activity. This study aimed to evaluate the potential of M. citrifolia leaf extracts (MLE60) in the prevention of weight gain in vivo and establish its phytochemical profile. Design: Male Sprague-Dawley rats were divided into groups based on a normal diet (ND) or high fat diet (HFD), with or without MLE60 supplementation (150 and 350 mg/kg body weight) and assessed for any reduction in weight gain. Plasma leptin, insulin, adiponectin, and ghrelin of all groups were determined. 1H NMR and LCMS methods were employed for phytochemical profiling of MLE60. Results: The supplementation of MLE60 did not affect food intake indicating that appetite suppression might not be the main anti-obesity mechanism involved. In the treated groups, MLE60 prevented weight gain, most likely through an inhibition of pancreatic and lipoprotein activity with a positive influence on the lipid profiles and a reduction in LDL levels . MLE60 also attenuated visceral fat deposition in treated subjects with improvement in the plasma levels of obesity-linked factors . 1Spectral analysis showed the presence of several bioactive compounds with rutin being more predominant. Conclusion: MLE60 shows promise as an anti-obesity agents and warrants further research. PMID:28814950

Effectiveness of the online weight reduction program KiloCoach™ and comparison with other evaluated commercial direct intervention and online programs.

PubMed

Longin, Rita; Grasse, Marina; Aspalter, Rosa; Waldherr, Karin

2012-01-01

Preliminary results indicated effectiveness of the online weight reduction program KiloCoach. The current study presents a large collection of user data and compares KiloCoach with other evaluated commercial weight loss programs. Furthermore, potential factors influencing the effectiveness of internet weight loss programs should be identified. 4,310 data sets of KiloCoach users were available, 3,150 of them were suitable for further analysis. 946 program users were considered completers (at least 60 days of continuous protocol). For comparison with other programs, different subsamples were drawn that matched to the inclusion criteria of reference studies. On average, KiloCoach overweight and obese completers lost 4.5 % of initial body weight. KiloCoach was as effective as the commercial program Weight Watchers® after 1 year (6.4% vs. 5.3% weight loss; p = 0.11) and 2 years (5.1% vs. 3.2% weight loss; p = 0.15). KiloCoach proved to be more effective than other online programs (Viktklubb, eDiets.com) as well as an in-person behavioral program, but less effective than Vtrim®, an online behavioral program providing intensive support. In comparison to reference programs, KiloCoach proved to be effective for weight reduction. The effect of online weight reduction programs seems to depend on methods and features applied.

Polymeric Materials for Aerospace Power and Propulsion-NASA Glenn Overview

NASA Technical Reports Server (NTRS)

Meador, Michael A.

2008-01-01

Use of lightweight materials in aerospace power and propulsion components can lead to significant reductions in vehicle weight and improvements in performance and efficiency. Polymeric materials are well suited for many of these applications, but improvements in processability, durability and performance are required for their successful use in these components. Polymers Research at NASA Glenn is focused on utilizing a combination of traditional polymer science and engineering approaches and nanotechnology to develop new materials with enhanced processability, performance and durability. An overview of these efforts will be presented.

SHILAJIT: EVALUTION OF ITS EFFECTS ON BLOOD CHEMISTRY OF NORMAL HUMAN SUBJECTS

PubMed Central

Sharma, Praveen; Jha, Jagrati; Shrinivas, V.; Dwivedi, L.K.; Suresh, P.; Sinha, M.

2003-01-01

The effect of Shilajit on blood chemistry was studied in normal human volunteers. Administration of two gms of Shilajit for 45 days did not produced any significant change in physical parameters i.e. blood pressure, pulse rate and body weight and similarly no charge was observed in hematological parameters. A signification reduction in Serum Triglycerides, Serum cholesterol with simultaneous improvement in HDL Cholesterol was seen, besides Shilajit also improved antioxidant status of volunteers. Results of study suggest hypolipidemic and strong antioxidant activity of Shilajit. PMID:22557121

Shilajit: evalution of its effects on blood chemistry of normal human subjects.

PubMed

Sharma, Praveen; Jha, Jagrati; Shrinivas, V; Dwivedi, L K; Suresh, P; Sinha, M

2003-10-01

The effect of Shilajit on blood chemistry was studied in normal human volunteers. Administration of two gms of Shilajit for 45 days did not produced any significant change in physical parameters i.e. blood pressure, pulse rate and body weight and similarly no charge was observed in hematological parameters. A signification reduction in Serum Triglycerides, Serum cholesterol with simultaneous improvement in HDL Cholesterol was seen, besides Shilajit also improved antioxidant status of volunteers. Results of study suggest hypolipidemic and strong antioxidant activity of Shilajit.

A History of Bariatric Surgery: The Maturation of a Medical Discipline.

PubMed

Celio, Adam C; Pories, Walter J

2016-08-01

This article examines the progression of bariatric surgery since its creation more than 60 years ago with a focus on the effect of surgery on weight loss, comorbidity reduction, and safety. The success has been remarkable. It is possible to cure severe obesity, type 2 diabetes, and hyperlipidemia in addition to the many other manifestations of the metabolic syndrome with remarkable safety. Equally important are the opportunities for research afforded by the surgery and its outcomes. Until better treatments become available, bariatric surgery is the therapy of choice for patients with morbid obesity for weight control and comorbidity improvement. Copyright © 2016 Elsevier Inc. All rights reserved.

Ad libitum Mediterranean and Low Fat Diets both Significantly Reduce Hepatic Steatosis: a Randomized Controlled Trial.

PubMed

Properzi, Catherine; O'Sullivan, Therese A; Sherriff, Jill L; Ching, Helena L; Jeffrey, Garry P; Buckley, Rachel F; Tibballs, Jonathan; MacQuillan, Gerry C; Garas, George; Adams, Leon A

2018-05-05

Although diet induced weight loss is first-line treatment for patients with non-alcoholic fatty liver disease (NAFLD), long-term maintenance is difficult. The optimal diet for either improvement in NAFLD or associated cardio-metabolic risk factors regardless of weight loss, is unknown. We examined the effect of two ad libitum isocaloric diets [Mediterranean (MD) or Low Fat (LF)] on hepatic steatosis and cardio-metabolic risk factors. Subjects with NAFLD were randomized to a 12-week blinded dietary intervention (MD vs LF). Hepatic steatosis was determined via magnetic resonance spectroscopy (MRS). From a total of 56 subjects enrolled, 49 subjects completed the intervention and 48 were included for analysis. During the intervention, subjects on the MD had significantly higher total and monounsaturated fat but lower carbohydrate and sodium intakes compared to LF subjects (p<0.01). At week 12, hepatic steatosis had reduced significantly in both groups (p<0.01) and there was no difference in liver fat reduction between the groups (p=0.32), with mean (SD) relative reductions of 25.0% (±25.3%) in LF and 32.4% (±25.5%) in MD. Liver enzymes also improved significantly in both groups. Weight loss was minimal and not different between groups [-1.6 (±2.1)kg in LF vs -2.1 (±2.5)kg in MD, (p=0.52)]. Within-group improvements in the Framingham risk score, total cholesterol, serum triglyceride, and HbA1c were observed in the MD (all p<0.05) but not with the LF diet. Adherence was higher for the MD compared to LF (88% vs. 64%, p=0.048). Ad libitum low fat and Mediterranean diets both improve hepatic steatosis to a similar degree. This article is protected by copyright. All rights reserved. © 2018 by the American Association for the Study of Liver Diseases.

Preoperative weight loss program targeting women with overweight and hypertrophy of the breast - a pilot study.

PubMed

Geiker, N R W; Horn, J; Astrup, A

2017-04-01

Among women with hypertrophic breasts, the clear majority are overweight or obese. Owing to increased risk of complications, women with a body mass index (BMI) above 25 kg m -2 are precluded from reduction mammaplasty. The primary aim was to investigate if intensive weight loss could ready women with overweight for breast reduction surgery. Six women, all overweight [BMI 30.9 {28.5; 35.8} kg m -2 ] with symptomatic hypertrophy of the breast, were included a 12-week weight loss program. All women desired reduction mammaplasty and were motivated for preoperational weight loss. The first 8 weeks consisted of a formula-based diet supplying 800 kcal daily, in the subsequent 4 weeks regular foods were reintroduced increasing the intake to 1200 kcal daily. Five women completed the trial, and achieved a median (range) weight loss of 10.2 (6.5; 19) kg. Initial breast volume was 1100-2500 mL per breast, this was reduced by 300 (200; 500) mL after the intervention; equivalent to approximately 19%. Waist, hip, upper arm and thorax circumference were significantly reduced following weight loss. At end of study, all the women still suffered from symptomatic breast hypertrophy to substantiate reduction mammaplasty. Surgeries were performed 2 months thereafter. A 12-week intensive preoperative weight loss program enabled women with obesity for breast reduction surgery. Breast size was reduced proportionally more than total weight loss among women with hypertrophy. © 2017 World Obesity Federation.

[Strategies for successful weight reduction - focus on energy balance].

PubMed

Weck, M; Bornstein, S R; Barthel, A; Blüher, M

2012-10-01

The prevalence of obesity and related health problems is increasing worldwide and also in Germany. It is well known that substantial and sustained weight loss is difficult to accomplish. Therefore, a variety of studies has been performed in order to specify causes for weight gain and create hypotheses for better treatment options. Key factors of this problem are an adaptation of energy metabolism, especially resting metabolic rate (RMR), non-exercise thermogenesis and diet induced thermogenesis. The extremely high failure rate (> 80%) to keep the reduced weight after successful weight loss is due to adaptation processes of the body to maintain body energy stores. This so called "adaptive thermogenesis" is defined as a smaller than predicted change of energy expenditure in response to changes in energy balance. Adaptive thermogenesis appears to be a major reason for weight regain. The foremost objective of weight-loss programs is the reduction in body fat. However, a concomitant decline in lean tissue can frequently be observed. Since lean body mass (LBM) represents a key determinant of RMR it follows that a decrease in lean tissue could counteract the progress of weight loss. Therefore, with respect to long-term effectiveness of weight reduction programs, the loss of fat mass while maintaining LBM and RMR seems desirable. In this paper we will discuss the mechanisms of adaptive thermogenesis and develop therapeutic strategies with respect to avoiding weight regain successful weight reduction. © Georg Thieme Verlag KG Stuttgart · New York.

Reduction in obesity and coronary risk factors after high caloric exercise training in overweight coronary patients.

PubMed

Savage, Patrick D; Brochu, Martin; Poehlman, Eric T; Ades, Philip A

2003-08-01

The majority of patients with coronary heart disease (CHD) are overweight. However, little weight loss occurs with participation in a standard cardiac rehabilitation (CR) program. Fifteen overweight patients (average body mass index of 31.0 kg/m2) with CHD completed a 4-month exercise training program in a CR program. The exercise program consisted primarily of walking long duration (60-90 minutes per session) 5 to 7 days per week at a relatively low intensity of 50% to 60% of peak VO2. Measures of body composition by dual-energy x-ray absorptiometry, body fat distribution by computed tomography, plasma lipid-lipoprotein, glucose and insulin concentrations, and peak VO2 were obtained before and after the exercise intervention. Patients maintained an isocaloric diet throughout the study. Patients had reductions in total body weight (-4.6 kg), fat mass (-3.6 kg), percent body fat (-2.9%), and waist circumference (-5.6 cm) (all P <.001) while maintaining fat-free mass. Subcutaneous adipose tissue was reduced by 12% (P <.001) and visceral adipose tissue was lowered by 14% (P <.001). There were favorable changes in the lipid-metabolic profile with reductions in triglyceride levels (-23.7%), total cholesterol/HDL-C ratio (-14.3%), and fasting insulin levels (-22.3%) (all P <.05). Peak VO2 increased by 21.2% (P <.001). The present pilot study results suggest that a high caloric training exercise training program in the CR setting may be effective in promoting weight loss and improving coronary risk factors in overweight coronary patients. Although additional research with randomized control patients is needed, this alternative to traditional CR may be considered to maximize weight loss as part of a secondary prevention program.

Health promotion lifestyle interventions for weight management in psychosis: a systematic review and meta-analysis of randomised controlled trials.

PubMed

Bonfioli, Elena; Berti, Loretta; Goss, Claudia; Muraro, Francesca; Burti, Lorenzo

2012-07-12

Psychiatric patients have more physical health problems and much shorter life expectancies compared to the general population, due primarily to premature cardiovascular disease. A multi-causal model which includes a higher prevalence of risk factors has provided a valid explanation. It takes into consideration not only risks such as gender, age, and family history that are inherently non-modifiable, but also those such as obesity, smoking, diabetes, hypertension, and dyslipidemia that are modifiable through behavioural changes and improved care. Thus, it is crucial to focus on factors that increase cardiovascular risk. Obesity in particular has been associated with both the lifestyle habits and the side effects of antipsychotic medications. The present systematic review and meta-analysis aims at collecting and updating available evidence on the efficacy of non-pharmacological health promotion programmes for psychotic patients in randomised clinical trials. We systematically reviewed the randomised controlled trials from 1990 onward, in which psychoeducational and/or cognitive-behavioural interventions aimed at weight loss or prevention of weight gain in patients with psychosis had been compared to treatment as usual. We carried out a meta-analysis and pooled the results of the studies with Body Mass Index as primary outcome. The results of the meta-analysis show an effect toward the experimental group. At the end of the intervention phase there is a -0.98 kg/m(2) reduction in the mean Body Mass Index of psychotic subjects. Notably, prevention studies with individual psychoeducational programmes that include diet and/or physical activity seem to have the highest impact. When compared with treatment as usual in psychotic patients, preventive and individual lifestyle interventions that include diet and physical activity generally prove to be effective in reducing weight. Physical screening and monitoring programmes are well accepted by patients and can be implemented in a variety of settings. A weight loss of 0.98 points in the Body Mass Index corresponds to a loss of 3.12% of the initial weight. This percentage is below the 5% to 10% weight loss deemed sufficient to improve weight-related complications such as hypertension, type II diabetes, and dyslipidemia. However, it is reported that outcomes associated with metabolic risk factors may have greater health implications than weight changes alone. Therefore, in addition to weight reduction, the assessment of metabolic parameters to monitor other independent risk factors should also be integrated into physical health promotion and management in people with mental disorders.

Acute drug induced hepatitis secondary to a weight loss product purchased over the internet

PubMed Central

Joshi, Deepak; Cross, Tim JS; Wong, Voi Shim

2007-01-01

Background Many people now seek alternative methods of weight loss. The internet provides a readily available source of weight reduction products, the ingredients of which are often unclear. The authors describe a case of acute hepatitis in a 20 year old woman caused by such a product purchased over the internet. Case Presentation A 20-year old woman presented with a two day history of abdominal pain, vomiting and jaundice. There were no identifiable risk factors for chronic liver disease. Liver function tests demonstrated an acute hepatitis (aminoaspartate transaminase 1230 IU/L). A chronic liver disease screen was negative. The patient had started a weight loss product (Pro-Lean), purchased over the internet two weeks prior to presentation. The patient was treated conservatively, and improved. The sequence of events suggests an acute hepatitis caused by an herbal weight loss product. Conclusion This case report highlights the dangers of weight loss products available to the public over the internet, and the importance of asking specifically about alternative medicines in patients who present with an acute hepatitis. PMID:17597525

Effects of a popular exercise and weight loss program on weight loss, body composition, energy expenditure and health in obese women

PubMed Central

Kerksick, Chad; Thomas, Ashli; Campbell, Bill; Taylor, Lem; Wilborn, Colin; Marcello, Brandon; Roberts, Mike; Pfau, Emily; Grimstvedt, Megan; Opusunju, Jasmine; Magrans-Courtney, Teresa; Rasmussen, Christopher; Wilson, Ron; Kreider, Richard B

2009-01-01

Objective To determine the safety and efficacy of altering the ratio of carbohydrate and protein in low-energy diets in conjunction with a popular exercise program in obese women. Design Matched, prospective clinical intervention study to assess efficacy of varying ratios of carbohydrate and protein intake in conjunction with a regular exercise program. Participants One-hundred sixty one sedentary, obese, pre-menopausal women (38.5 ± 8.5 yrs, 164.2 ± 6.7 cm, 94.2 ± 18.8 kg, 34.9 ± 6.4 kg·m-2, 43.8 ± 4.2%) participated in this study. Participants were weight stable and not participating in additional weight loss programs. Methods Participants were assigned to either a no exercise + no diet control (CON), a no diet + exercise group (ND), or one of four diet + exercise groups (presented as kcals; % carbohydrate: protein: fat): 1) a high energy, high carbohydrate, low protein diet (HED) [2,600; 55:15:30%], 2) a very low carbohydrate, high protein diet (VLCHP) [1,200 kcals; 63:7:30%], 3) a low carbohydrate, moderate protein diet (LCMP) [1,200 kcals; 50:20:30%] and 4) a high carbohydrate, low protein diet (HCLP) [1,200 kcals; 55:15:30%]. Participants in exercise groups (all but CON) performed a pneumatic resistance-based, circuit training program under supervision three times per week. Measurements Anthropometric, body composition, resting energy expenditure (REE), fasting blood samples and muscular fitness assessments were examined at baseline and weeks 2, 10 and 14. Results All groups except CON experienced significant reductions (P < 0.05 – 0.001) in waist circumference over 14 weeks. VLCHP, LCHP and LPHC participants experienced similar but significant (P < 0.05 – 0.001) reductions in body mass when compared to other groups. Delta responses indicated that fat loss after 14 weeks was significantly greatest in VLCHP (95% CI: -5.2, -3.2 kg), LCMP (-4.0, -1.9 kg) and HCLP (-3.8, -2.1 kg) when compared to other groups. Subsequent reductions in % body fat were significantly greater in VLCHP, LCMP and HCLP participants. Initial dieting decreased (P < 0.05) relative REE similarly in all groups. All exercise groups significantly (P < 0.05) improved in muscular fitness, but these improvements were not different among groups. Favorable but non-significant mean changes occurred in lipid panels, glucose and HOMA-IR. Leptin levels decreased (P < 0.05) in all groups, except for CON, after two weeks of dieting and remained lower throughout the 14 week program. Exercise participation resulted in significant improvements in quality of life and body image. Conclusion Exercise alone (ND) appears to have minimal impact on measured outcomes with positive outcomes apparent when exercise is combined with a hypoenergetic diet. Greater improvements in waist circumference and body composition occurred when carbohydrate is replaced in the diet with protein. Weight loss in all diet groups (VLCHP, LCMP and HCLP) was primarily fat and stimulated improvements in markers of cardiovascular disease risk, body composition, energy expenditure and psychosocial parameters. PMID:19442301

Chitosan oligosaccharide improves the therapeutic efficacy of sitagliptin for the therapy of Chinese elderly patients with type 2 diabetes mellitus.

PubMed

Zhao, Lijie; Sun, Tingli; Wang, Lina

2017-01-01

Sitagliptin improves glycemic control in type 2 diabetes mellitus (T2DM) patients but its side effects are undesirable. Chitosan oligosaccharide (COS) is expected to improve the therapeutic result as a natural product. A total of 200 elderly T2DM patients were evenly assigned into four groups: sitagliptin group (SG), receiving sitagliptin 100 mg/day; COS group (CG), receiving COS 100 mg/day; combination therapy of sitagliptin and COS group (SCG), receiving both sitagliptin and COS 100 mg/day; and placebo group (PG), receiving placebo 100 mg/day. After 42-week therapy, biochemical indices and clinical parameters for the alterations from start points were analyzed. The related molecular mechanism was tested by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot at cell level. Lower risk of hypoglycemia was found in the SCG group when compared with SG and other groups ( P <0.05). More patients from the SCG group than other groups attained hemoglobin A1c (HbA1c) reduction >2.5% ( P <0.05). Weight reduction of 1.2±0.9, 2.6±0.8, 4.7±1.3, and 0.9±0.6 kg was observed in the patients from SG, CG, SCG, and PG groups, respectively ( P <0.05). The combined treatment of COS and sitagliptin presented better therapeutic results by improving insulin sensitivity, lipid profile, adiponectin levels, and glucagon-like peptide 1 and reducing side effects, insulin resistance, HbA1c, body mass index, resistin, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP) ( P <0.05). qRT-PCR and Western blot analysis also showed that COS treatment reduced the levels of resistin, TNF-α, and CRP, and increased the level of adiponectin. The combination of COS and sitagliptin provided better glycemic control with fewer side effects and with more weight reduction in the elderly participants with T2DM.

Chitosan oligosaccharide improves the therapeutic efficacy of sitagliptin for the therapy of Chinese elderly patients with type 2 diabetes mellitus

PubMed Central

Zhao, Lijie; Sun, Tingli; Wang, Lina

2017-01-01

Sitagliptin improves glycemic control in type 2 diabetes mellitus (T2DM) patients but its side effects are undesirable. Chitosan oligosaccharide (COS) is expected to improve the therapeutic result as a natural product. A total of 200 elderly T2DM patients were evenly assigned into four groups: sitagliptin group (SG), receiving sitagliptin 100 mg/day; COS group (CG), receiving COS 100 mg/day; combination therapy of sitagliptin and COS group (SCG), receiving both sitagliptin and COS 100 mg/day; and placebo group (PG), receiving placebo 100 mg/day. After 42-week therapy, biochemical indices and clinical parameters for the alterations from start points were analyzed. The related molecular mechanism was tested by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot at cell level. Lower risk of hypoglycemia was found in the SCG group when compared with SG and other groups (P<0.05). More patients from the SCG group than other groups attained hemoglobin A1c (HbA1c) reduction >2.5% (P<0.05). Weight reduction of 1.2±0.9, 2.6±0.8, 4.7±1.3, and 0.9±0.6 kg was observed in the patients from SG, CG, SCG, and PG groups, respectively (P<0.05). The combined treatment of COS and sitagliptin presented better therapeutic results by improving insulin sensitivity, lipid profile, adiponectin levels, and glucagon-like peptide 1 and reducing side effects, insulin resistance, HbA1c, body mass index, resistin, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP) (P<0.05). qRT-PCR and Western blot analysis also showed that COS treatment reduced the levels of resistin, TNF-α, and CRP, and increased the level of adiponectin. The combination of COS and sitagliptin provided better glycemic control with fewer side effects and with more weight reduction in the elderly participants with T2DM. PMID:28721055

Intentional Weight Loss and Changes in Symptoms of Depression: A Systematic Review and Meta-Analysis

PubMed Central

Fabricatore, Anthony N.; Wadden, Thomas A.; Higginbotham, Allison J.; Faulconbridge, Lucy F.; Nguyen, Allison M.; Heymsfield, Steven B.; Faith, Myles S.

2011-01-01

Objective Obesity is related to increased risk of several health complications, including depression. Many studies have reported improvements in mood with weight loss, but results have been equivocal. The present meta-analysis examined changes in symptoms of depression that were reported in trials of weight loss interventions. Between-groups comparisons of different weight loss methods (e.g., lifestyle modification, diet alone, pharmacotherapy) were examined, as were within-group changes for each treatment type. Method MEDLINE was searched for articles published between 1950 and January 2009. Several obesity-related terms were intersected with terms related to depression. Results were filtered to return only studies of human subjects, published in English. Of 5971 articles, 394 were randomized controlled trials. Articles were excluded if they did not report mean changes in weight or symptoms of depression, included children or persons with psychiatric disorders (other than depression), or provided insufficient data for analysis. Thirty-one studies (n = 7937) were included. Two authors independently extracted a description of each study treatment, sample characteristics, assessment methods, and changes in weight and symptoms of depression. Treatments were categorized as: lifestyle modification, non-dieting, dietary counseling, diet-alone, exercise-alone, pharmacotherapy, placebo, or control interventions. Results Random effects models found that lifestyle modification was superior to control and non-dieting interventions for reducing symptoms of depression, and marginally better than dietary counseling and exercise-alone programs. Exercise-alone programs were superior to controls. No differences were found for comparisons of pharmacologic agents and placebos. Within-group analyses found significant reductions in symptoms of depression for nearly all active interventions. A meta-regression found no relationship between changes in weight and changes in symptoms of depression in lifestyle modification interventions. Conclusions On average, obese individuals in weight loss trials experienced reductions in symptoms of depression. Future studies should examine incidence and resolution of clinically significant depressive disorders with weight loss interventions. PMID:21343903

Lorcaserin treatment allows for decreased number needed to treat for weight and glycemic parameters in week 12 responders with ≥5% weight loss.

PubMed

Handelsman, Yehuda; Fain, Randi; Wang, Zhixiao; Li, Xuan; Fujioka, Ken; Shanahan, William

2016-11-01

Lorcaserin is a serotonin 2C receptor agonist approved for chronic weight management. This analysis explores the number of patients needed to be treated (NNT) with lorcaserin for one more patient to achieve weight loss and glycemic goals. This is a post hoc analysis of three Phase 3 studies in adults with and without type 2 diabetes mellitus (T2DM) treated with lorcaserin 10 mg BID or placebo. NNT is reported for patients achieving ≥5% or ≥10% weight loss, achievement of either HbA1c <5.7% or FPG <100 mg/dL in patients with prediabetes, and reduction of HbA1c to <7% in patients with T2DM at Week 52. In the modified intention-to-treat (MITT) population, NNTs for ≥5% and ≥10% weight loss were 3.6 and 6.2 (without T2DM) and 4.3 and 7.5 (with T2DM); in Week 12 responders (≥5% weight loss at Week 12), NNTs were 1.7 and 2.6 (without T2DM) and 1.9 and 3.2 (with T2DM). In patients with prediabetes, NNTs to achieve HbA1c <5.7% were 9.9 (MITT) and 5.2 (Week 12 responders). In patients with T2DM, NNTs to achieve HbA1c <7% were 4.2 (MITT) and 2.3 (Week 12 responders). In addition to weight management, lorcaserin improved glycemic control in patients with prediabetes and facilitated targeted HbA1c reduction in patients with T2DM, especially for those who achieved ≥5% weight loss by Week 12. Assessment of treatment response at Week 12 is a valuable tool to achieve efficient use of healthcare resources. www.clinicaltrials.gov identifiers are NCT00395135, NCT00603291, and NCT00603902.

Do weight management interventions delivered by online social networks effectively improve body weight, body composition, and chronic disease risk factors? A systematic review.

PubMed

Willis, Erik A; Szabo-Reed, Amanda N; Ptomey, Lauren T; Steger, Felicia L; Honas, Jeffery J; Washburn, Richard A; Donnelly, Joseph E

2017-02-01

Introduction Currently, no systematic review/meta-analysis has examined studies that used online social networks (OSN) as a primary intervention platform. Therefore, the purpose of this review was to evaluate the effectiveness of weight management interventions delivered through OSN. Methods PubMed, EMBASE, PsycINFO, Web of Science, and Scopus were searched (January 1990-November 2015) for studies with data on the effect of OSNs on weight loss. Only primary source articles that utilized OSN as the main platform for delivery of weight management/healthy lifestyle interventions, were published in English language peer-reviewed journals, and reported outcome data on weight were eligible for inclusion in this systematic review. Five articles were included in this review. Results One-hundred percent of the studies ( n = 5) reported a reduction in baseline weight. Three of the five studies (60%) reported significant decreases in body weight when OSN was paired with health educator support. Only one study reported a clinical significant weight loss of ≥5%. Conclusion Using OSN for weight management is in its early stages of development and, while these few studies show promise, more research is needed to acquire information about optimizing these interventions to increase their efficacy.

Weight Reduction Techniques Adopted When Weight Standards are Enforced

DTIC Science & Technology

1993-01-01

ORGANIZATION NAME(S) AND ADDRESS(ES) 8, PERFORMING ORGANIZATION Military Nutrition Division REPORT NUMBER U. S. Army Research Institute of Environmental...affecting more soldiers than those Identified by the AWCP and possibly developing during a career In the Army. Nutrition /education programs should...that appeas to be Inevitable with aging and a career in the’Army. 14. SUBJECT TERMS 15. NUMBIEN OF PAGES Nutrition , weight reduction, Army weight

Successful weight reduction and maintenance by using a smartphone application in those with overweight and obesity

PubMed Central

Chin, Sang Ouk; Keum, Changwon; Woo, Junghoon; Park, Jehwan; Choi, Hyung Jin; Woo, Jeong-taek; Rhee, Sang Youl

2016-01-01

A discrepancy exists with regard to the effect of smartphone applications (apps) on weight reduction due to the several limitations of previous studies. This is a retrospective cohort study, aimed to investigate the effectiveness of a smartphone app on weight reduction in obese or overweight individuals, based on the complete enumeration study that utilized the clinical and logging data entered by Noom Coach app users between October 2012 and April 2014. A total of 35,921 participants were included in the analysis, of whom 77.9% reported a decrease in body weight while they were using the app (median 267 days; interquartile range = 182). Dinner input frequency was the most important factor for successful weight loss (OR = 10.69; 95% CI = 6.20–19.53; p < 0.001), and more frequent input of weight significantly decreased the possibility of experiencing the yo-yo effect (OR = 0.59, 95% CI = 0.39–0.89; p < 0.001). This study demonstrated the clinical utility of an app for successful weight reduction in the majority of the app users; the effects were more significant for individuals who monitored their weight and diet more frequently. PMID:27819345

Spectral CT with metal artifacts reduction software for improvement of tumor visibility in the vicinity of gold fiducial markers.

PubMed

Brook, Olga R; Gourtsoyianni, Sofia; Brook, Alexander; Mahadevan, Anand; Wilcox, Carol; Raptopoulos, Vassilios

2012-06-01

To evaluate spectral computed tomography (CT) with metal artifacts reduction software (MARS) for reduction of metal artifacts associated with gold fiducial seeds. Thirteen consecutive patients with 37 fiducial seeds implanted for radiation therapy of abdominal lesions were included in this HIPAA-compliant, institutional review board-approved prospective study. Six patients were women (46%) and seven were men (54%). The mean age was 61.1 years (median, 58 years; range, 29-78 years). Spectral imaging was used for arterial phase CT. Images were reconstructed with and without MARS in axial, coronal, and sagittal planes. Two radiologists independently reviewed reconstructions and selected the best image, graded the visibility of the tumor, and assessed the amount of artifacts in all planes. A linear-weighted κ statistic and Wilcoxon signed-rank test were used to assess interobserver variability. Histogram analysis with the Kolmogorov-Smirnov test was used for objective evaluation of artifacts reduction. Fiducial seeds were placed in pancreas (n = 5), liver (n = 7), periportal lymph nodes (n = 1), and gallbladder bed (n = 1). MARS-reconstructed images received a better grade than those with standard reconstruction in 60% and 65% of patients by the first and second radiologist, respectively. Tumor visibility was graded higher with standard versus MARS reconstruction (grade, 3.7 ± 1.0 vs 2.8 ± 1.1; P = .001). Reduction of blooming was noted on MARS-reconstructed images (P = .01). Amount of artifacts, for both any and near field, was significantly smaller on sagittal and coronal MARS-reconstructed images than on standard reconstructions (P < .001 for all comparisons). Far-field artifacts were more prominent on axial MARS-reconstructed images than on standard reconstructions (P < .01). Linear-weighted κ statistic showed moderate to perfect agreement between radiologists. CT number distribution was narrower with MARS than with standard reconstruction in 35 of 37 patients (P < .001). Spectral CT with use of MARS improved tumor visibility in the vicinity of gold fiducial seeds.

Alternative Fuels Data Center

Science.gov Websites

technology may exceed the state's gross vehicle weight limits by up to 400 pounds to compensate for the additional weight of the idle reduction technology. To be eligible for the weight exemption, the vehicle operator must be able to provide proof that the idle reduction technology is fully functional. (Reference

40 CFR 63.5830 - What are my options for meeting the standards for pultrusion operations subject to the 60 weight...

Code of Federal Regulations, 2010 CFR

2010-07-01

... standards for pultrusion operations subject to the 60 weight percent organic HAP emissions reductions... National Emissions Standards for Hazardous Air Pollutants: Reinforced Plastic Composites Production Options... operations subject to the 60 weight percent organic HAP emissions reductions requirement? You must use one or...

A Behavioral Weight Reduction Model for Moderately Mentally Retarded Adolescents.

ERIC Educational Resources Information Center

Rotatori, Anthony F.; And Others

1980-01-01

A behavioral weight reduction treatment and maintenance program for moderately mentally retarded adolescents which involves six phases from background information collection to followup relies on stimulus control procedures to modify eating behaviors. Data from pilot studies show an average weekly weight loss of .5 to 1 pound per S. (CL)

Comparison of arthroscopic reduction and percutaneous fixation and open reduction and internal fixation for tibial plateau fractures.

PubMed

Sun, Yufu; Sun, Kai; Jiang, Wenxue

2018-06-01

To conduct a meta-analysis with randomized controlled trials (RCTs) published in full text to demonstrate database to show the associations of perioperative, postoperative outcomes of arthroscopic reduction and percutaneous fixation(ARPF) and open reduction and internal fixation(ORIF) for tibial plateau fractures to provide the predictive diagnosis for clinic. Literature search was performed in PubMed, Embase, Web of Science and Cochrane Library for information from the earliest date of data collection to June 2017. RCTs comparing the benefits and risks of ARPF with those of ORIF in tibial plateau fractures were included. Statistical heterogeneity was quantitatively evaluated by X 2 test with the significance set P < 0.10 or I 2  > 50%. Seven RCTs consisting of 571 patients were included.(288 ARPF patients; 283 ORIF patients;). Pooled results showed that ORIF was related to a greater increase in operative time, incision length, hospital stay, perioperative complications, and full weight bearing compared with ARPF. The results showed that ARPF was related to a greater increase in ROM Rasmussen Scores compared with ORIF (WMD = 10.38; 95% CI, 8.31, 12.45; P < 0.10). This meta-analysis showed that arthroscopic reduction and percutaneous fixation for tibial plateau fractures, compared with open reduction and internal fixation, could demonstrate an decreased risk of perioperative and postoperative complications and improve clinical outcome in operative time, incision length, hospital stay, perioperative complications, full weight bearing and Rasmussen Scores. Copyright © 2018 Elsevier Ltd. All rights reserved.

Rheological effects of drag-reducing polymers improve cerebral blood flow and oxygenation after traumatic brain injury in rats.

PubMed

Bragin, Denis E; Kameneva, Marina V; Bragina, Olga A; Thomson, Susan; Statom, Gloria L; Lara, Devon A; Yang, Yirong; Nemoto, Edwin M

2017-03-01

Cerebral ischemia has been clearly demonstrated after traumatic brain injury (TBI); however, neuroprotective therapies have not focused on improvement of the cerebral microcirculation. Blood soluble drag-reducing polymers (DRP), prepared from high molecular weight polyethylene oxide, target impaired microvascular perfusion by altering the rheological properties of blood and, until our recent reports, has not been applied to the brain. We hypothesized that DRP improve cerebral microcirculation and oxygenation after TBI. DRP were studied in healthy and traumatized rat brains and compared to saline controls. Using in-vivo two-photon laser scanning microscopy over the parietal cortex, we showed that after TBI, nanomolar concentrations of intravascular DRP significantly enhanced microvascular perfusion and tissue oxygenation in peri-contusional areas, preserved blood-brain barrier integrity and protected neurons. The mechanisms of DRP effects were attributable to reduction of the near-vessel wall cell-free layer which increased near-wall blood flow velocity, microcirculatory volume flow, and number of erythrocytes entering capillaries, thereby reducing capillary stasis and tissue hypoxia as reflected by a reduction in NADH. Our results indicate that early reduction in CBF after TBI is mainly due to ischemia; however, metabolic depression of contused tissue could be also involved.

Improved engine performance via use of nickel ceramic composite coatings (NCC coat)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Funatani, K.; Kurosawa, K.; Fabiyi, P.A.

1994-09-01

In seeking to produce lightweight aluminum block based engines, a variety of metallurgical and surface modification techniques for cylinder bores, pistons and piston rings are available. This paper discusses these various alternative methods while placing particular emphasis on electroplated nickel ceramic composite coatings (NCC). NCC Coating properties are characterized by high hardness, high corrosion resistance, high temperature wear and scuff resistance and low frictional coefficients. The application of NCC Coatings in 2-stroke motorcycle and diesel engines has resulted in benefits in the following areas: elimination of cast iron liners; reduced cylinder wall temperature, engine weight and increased power; lowering ofmore » oil consumption; improved fuel economy; reduction in emissions; improved scuff and wear resistance on cylinder bores, pistons and piston rings; friction reduction; combating of piston ring groove microwelding and pound out; thermal barrier protection on diesel piston domes; reduction in carbon deposition on piston domes; reduced noise from piston slap; and ability to operate in corrosive environments. The sum of the above stated benefits holds much potential for contributing towards greater flexibility in materials selection for the design of lightweight, fuel efficient vehicles based upon the use of aluminum engines. 13 refs., 13 figs.« less

Modeling the Effect of Replacing Sugar-Sweetened Beverage Consumption with Water on Energy Intake, HBI Score, and Obesity Prevalence.

PubMed

Duffey, Kiyah J; Poti, Jennifer

2016-06-28

Sugar-sweetened beverages (SSB) contribute to excessive weight gain through added energy intake. Replacing SSB with water is one strategy that has shown promise in helping lower excessive energy intake. Using nationally representative data from US adults (n = 19,718) from NHANES 2007-2012 we examine the impact of replacing SSB with water on Healthy Beverage Index (HBI) scores and obesity prevalence. Replacing an 8-ounce serving of SSB with water lowered the percent of energy from beverages from 17% to 11% (among those consuming 1 serving SSB/day). Reductions in the percent energy from beverages were observed across all SSB consumption groups (1-2 servings/day and >2 servings/day). Among adults there was a 9% to 21% improvement in HBI score when one serving of water replaced one serving of SSB. Using previously published randomized controlled trials (RCT) and meta-analyses of measured weight loss we also predicted a reduction in the prevalence of obesity (observed: 35.2%; predicted 33.5%-34.9%, p < 0.05) and increase in the prevalence of normal weight (observed: 29.7%; high weight loss: 31.3%, p < 0.05). Our findings provide further epidemiologic evidence that water in the place of SSB can be used as a strategy to limit energy intake and help individuals meet beverage intake recommendations.

Weight management for type 2 diabetes mellitus: global cardiovascular risk reduction.

PubMed

Lee, Michelle; Aronne, Louis J

2007-02-19

Most patients with type 2 diabetes mellitus are overweight or obese, and the relation between obesity, especially of the visceral compartment, and the risk for developing diabetes is well recognized. Excessive adipose tissue is associated with insulin resistance as well as the increased expression of proinflammatory cytokines and prothrombotic factors, all of which contribute to elevating the risk for coronary artery disease (CAD). In particular, abdominal obesity, or excess visceral adiposity, has been linked to a cluster of risk factors (high blood pressure, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol, and impaired fasting glucose) that constitute the metabolic syndrome, the presence of which confers an increased risk for type 2 diabetes and cardiovascular disease. In fact, a large waist circumference, a surrogate measure of abdominal adiposity, is 1 of the main criteria for diagnosing the metabolic syndrome. Lifestyle modification is the first-line approach to the management of obesity and the metabolic syndrome. However, if patients are unable to achieve a weight loss of 5%-10% of initial body weight and improve cardiometabolic risk factors with lifestyle modification alone, physicians should consider using adjunctive long-term pharmacotherapy. A variety of approved and investigational pharmacologic agents, including sibutramine, orlistat, metformin, and rimonabant, have been shown to reduce weight and ameliorate metabolic syndrome components, thereby reducing cardiovascular risk. Such global risk reduction is crucial for patients with diabetes, in whom CAD is a major cause of mortality.

Modeling the Effect of Replacing Sugar-Sweetened Beverage Consumption with Water on Energy Intake, HBI Score, and Obesity Prevalence

PubMed Central

Duffey, Kiyah J.; Poti, Jennifer

2016-01-01

Sugar-sweetened beverages (SSB) contribute to excessive weight gain through added energy intake. Replacing SSB with water is one strategy that has shown promise in helping lower excessive energy intake. Using nationally representative data from US adults (n = 19,718) from NHANES 2007–2012 we examine the impact of replacing SSB with water on Healthy Beverage Index (HBI) scores and obesity prevalence. Replacing an 8-ounce serving of SSB with water lowered the percent of energy from beverages from 17% to 11% (among those consuming 1 serving SSB/day). Reductions in the percent energy from beverages were observed across all SSB consumption groups (1–2 servings/day and >2 servings/day). Among adults there was a 9% to 21% improvement in HBI score when one serving of water replaced one serving of SSB. Using previously published randomized controlled trials (RCT) and meta-analyses of measured weight loss we also predicted a reduction in the prevalence of obesity (observed: 35.2%; predicted 33.5%–34.9%, p < 0.05) and increase in the prevalence of normal weight (observed: 29.7%; high weight loss: 31.3%, p < 0.05). Our findings provide further epidemiologic evidence that water in the place of SSB can be used as a strategy to limit energy intake and help individuals meet beverage intake recommendations. PMID:27367719

The impact of reducing car weight on global emissions: the future fleet in Great Britain

NASA Astrophysics Data System (ADS)

Serrenho, André Cabrera; Norman, Jonathan B.; Allwood, Julian M.

2017-05-01

Current European policies define targets for future direct emissions of new car sales that foster a fast transition to electric drivetrain technologies. However, these targets do not consider the emissions produced in electricity generation and material production, and therefore fail to incentivise car manufacturers to consider the benefits of vehicle weight reduction. In this paper, we examine the potential benefits of limiting the average weight and altering the material composition of new cars in terms of global greenhouse gas emissions produced during the use phase, electricity generation and material production. We anticipate the emissions savings for the future car fleet in Great Britain until 2050 for various alternative futures, using a dynamic material flow analysis of ferrous metals and aluminium, and considering an evolving demand for car use. The results suggest that fostering vehicle weight reduction could produce greater cumulative emissions savings by 2050 than those obtained by incentivising a fast transition to electric drivetrains, unless there is an extreme decarbonization of the electricity grid. Savings promoted by weight reduction are immediate and do not depend on the pace of decarbonization of the electricity grid. Weight reduction may produce the greatest savings when mild steel in the car body is replaced with high-strength steel. This article is part of the themed issue 'Material demand reduction'.

Missing the target: including perspectives of women with overweight and obesity to inform stigma‐reduction strategies

PubMed Central

Himmelstein, M. S.; Gorin, A. A.; Suh, Y. J.

2017-01-01

Summary Objective Pervasive weight stigma and discrimination have led to ongoing calls for efforts to reduce this bias. Despite increasing research on stigma‐reduction strategies, perspectives of individuals who have experienced weight stigma have rarely been included to inform this research. The present study conducted a systematic examination of women with high body weight to assess their perspectives about a broad range of strategies to reduce weight‐based stigma. Methods Women with overweight or obesity (N = 461) completed an online survey in which they evaluated the importance, feasibility and potential impact of 35 stigma‐reduction strategies in diverse settings. Participants (91.5% who reported experiencing weight stigma) also completed self‐report measures assessing experienced and internalized weight stigma. Results Most participants assigned high importance to all stigma‐reduction strategies, with school‐based and healthcare approaches accruing the highest ratings. Adding weight stigma to existing anti‐harassment workplace training was rated as the most impactful and feasible strategy. The family environment was viewed as an important intervention target, regardless of participants' experienced or internalized stigma. Conclusion These findings underscore the importance of including people with stigmatized identities in stigma‐reduction research; their insights provide a necessary and valuable contribution that can inform ways to reduce weight‐based inequities and prioritize such efforts. PMID:28392929

Pragmatic replication trial of health promotion coaching for obesity in serious mental illness and maintenance of outcomes.

PubMed

Bartels, Stephen J; Pratt, Sarah I; Aschbrenner, Kelly A; Barre, Laura K; Naslund, John A; Wolfe, Rosemarie; Xie, Haiyi; McHugo, Gregory J; Jimenez, Daniel E; Jue, Ken; Feldman, James; Bird, Bruce L

2015-04-01

Few studies targeting obesity in serious mental illness have reported clinically significant risk reduction, and none have been replicated in community settings or demonstrated sustained outcomes after intervention withdrawal. The authors sought to replicate positive health outcomes demonstrated in a previous randomized effectiveness study of the In SHAPE program across urban community mental health organizations serving an ethnically diverse population. Persons with serious mental illness and a body mass index (BMI) >25 receiving services in three community mental health organizations were recruited and randomly assigned either to the 12-month In SHAPE program, which included membership in a public fitness club and weekly meetings with a health promotion coach, or to fitness club membership alone. The primary outcome measures were weight and cardiorespiratory fitness (as measured with the 6-minute walk test), assessed at baseline and at 3, 6, 9, 12, and 18 months. Participants (N=210) were ethnically diverse (46% were nonwhite), with a mean baseline BMI of 36.8 (SD=8.2). At 12 months, the In SHAPE group (N=104) had greater reduction in weight and improved fitness compared with the fitness club membership only group (N=106). Primary outcomes were maintained at 18 months. Approximately half of the In SHAPE group (51% at 12 months and 46% at 18 months) achieved clinically significant cardiovascular risk reduction (a weight loss ≥5% or an increase of >50 meters on the 6-minute walk test). This is the first replication study confirming the effectiveness of a health coaching intervention in achieving and sustaining clinically significant reductions in cardiovascular risk for overweight and obese persons with serious mental illness.

Weight loss reduces breast ductal fluid estrogens in obese postmenopausal women: a single arm intervention pilot study.

PubMed

Carpenter, Catherine L; Duvall, Karen; Jardack, Patricia; Li, Luyi; Henning, Susanne M; Li, Zhaoping; Heber, David

2012-12-05

Accumulation of excess body fat increases breast cancer risk after menopause. Whether the localized breast is differently influenced by adipose tissue compared to the rest of the body, has not been well studied. Our purpose was to demonstrate feasibility and preliminarily evaluate serum-based and localized breast biomarker changes resulting from a weight loss intervention among obese postmenopausal women. We conducted a 12-week pilot controlled dietary and exercise intervention among healthy obese postmenopausal women, collected serum and breast ductal fluid before and after the intervention, and estimated the association with systemic and localized biomarker changes. We recruited 7 obese (mean body mass index = 33.6 kg/m2) postmenopausal women. We collected samples at baseline and the 12th week for: anthropometry; phlebotomy; dual-energy x-ray absorptiometry (lean and fat mass); exercise fitness (maximum oxygen consumption (VO2Max); 1-repetition strength maximum); and breast ductal lavage. Changes from baseline occurred in body composition and exercise performance including fat mass loss (14% average drop), VO2Max (+36% increase) and strength improvement (+26%). Breast ductal fluid markers declined from baseline with estradiol showing a 24% reduction and IL-6 a 20% reduction. We also observed serum biomarker reductions from baseline including leptin (36% decline), estrone sulfate (-10%), estradiol (-25%), and Il-6 (-33%). Conduct of the diet and exercise intervention, collection of ductal fluid, and measurement of hormones and cytokines contained in the ductal fluid were all feasible. We preliminarily demonstrated estradiol and IL-6 reductions from baseline in both serum and breast ductal fluid among obese postmenopausal women who participated in the 12-week weight loss diet and exercise intervention.

Neurodevelopmental outcome of the premature infant.

PubMed

Stephens, Bonnie E; Vohr, Betty R

2009-06-01

Advances in antenatal medicine and neonatal intensive care have successfully resulted in improved survival rates of preterm infants. These improvements have been most dramatic in infants born extremely low birth weight (ELBW,

Reduction mammoplasty operative techniques for improved outcomes in the treatment of gigantomastia.

PubMed

Degeorge, Brent R; Colen, David L; Mericli, Alexander F; Drake, David B

2013-01-01

Gigantomastia, or excessive breast hypertrophy, which is broadly defined as macromastia requiring a surgical reduction of more than 1500 g of breast tissue per breast, poses a unique problem to the reconstructive surgeon. Various procedures have been described for reduction mammoplasty with specific skin incisions, patterns of breast parenchymal resection, and blood supply to the nipple-areolar complex; however, not all of these techniques can be directly applied in the setting of gigantomastia. We outline a simplified method for preoperative evaluation and operative technique, which has been optimized for the management of gigantomastia. A retrospective chart review of patients who have undergone reduction mammoplasty from 2006 to 2011 by a single surgeon at the University of Virginia was performed. Patients were subdivided based on weight of breast tissue resection into 2 groups: macromastia (<1500 g resection per breast) and gigantomastia (>1500 g resection per breast). Endpoints including patient demographics, operative techniques, and complication rates were recorded. The mean resection weights in the macromastia and gigantomastia groups, respectively, were 681 g ± 283 g and 2554 g ± 421 g. There were no differences in major complications between the 2 groups. The rate of free nipple graft utilization was not significantly different between the 2 groups. Our surgical approach to gigantomastia has advantages when applied to extremely large-volume breast reduction and provides both esthetic and reproducible results. The preoperative assessment and operative techniques described herein have been adapted to the management of gigantomastia to reduce the rates of surgical complications.

Gamified working memory training in overweight individuals reduces food intake but not body weight.

PubMed

Dassen, Fania C M; Houben, Katrijn; Van Breukelen, Gerard J P; Jansen, Anita

2018-05-01

Working Memory (WM) plays a crucial role in successful self-regulation of behavior, including weight regulation. Improving WM might therefore be a promising strategy to support weight loss. In the present study, overweight individuals with a desire to lose weight (N = 91) received an online lifestyle intervention, in conjunction with either 25 sessions of gamified WM training (experimental condition) or a sham training (control). Primary outcomes were Body Mass Index (BMI) and food intake at posttest. Secondary outcomes were executive functioning, self-control, eating style, eating psychopathology and healthy eating. Data were analyzed with mixed regression analyses with condition as between-subjects factor (experimental versus control) and time as within-subjects factor (baseline, posttest, FU1 after one month and FU2 after six months). Results revealed that the experimental condition increased their WM span more than control from pretest to posttest, and these gains were retained at FU1, though lost at FU2. No transfer effects of WM training to other executive functioning measures were found. During the bogus taste test at posttest, participants in the experimental condition consumed significantly less than participants in the control condition. However, both conditions showed a small reduction in BMI, improved eating style, reduced eating disorder pathology, and reported more self-control and a healthier eating pattern. In conclusion, the current results provide some evidence that WM training can improve eating behavior at the short term. However, the WM gains were short-lived, and the added value of WM training as an intervention to promote weight loss could not be established. Future studies should test the added value of WM training booster sessions to promote weight loss over a prolonged period of time. Copyright © 2017 Elsevier Ltd. All rights reserved.

Antidiabetic Effects of Gastric Banding Surgery in Morbidly Obese Patients with Type 2 Diabetes Mellitus.

PubMed

Kim, Yu-Jeng; Choi, Ha-Neul; Lee, Hong-Chan; Yim, Jung-Eun

2017-07-01

This study was performed to investigate the effect of gastric banding surgery on the improvement of glycated hemoglobin (HbA 1c ) of morbidly obese (MO) patients with type 2 diabetes mellitus (T2DM) with the consideration that obesity was associated with insulin resistance and T2DM. We retrospectively reviewed the medical records of 38 MO with T2DM patients and 50 MO patients. Pre-surgery and post-surgery data were analyzed a year later. The medical data from these patients, including sex, age, height, weight, body composition, HbA 1c , triglyceride, total cholesterol, aspartate transaminase (AST), and alanine transaminase (ALT) were measured. There were significant reductions of body weight and body mass index (BMI), body fat, body fat percentage, waist-hip ratio, visceral fat, and obesity in each group before and after gastric banding surgery. Results of AST, ALT, and HbA 1c had significant reductions in each group. For HbA 1c , treatment rate was 71% in the MO group with T2DM with significant reduction of 22.8%. It is thought that a gastric banding surgery is one of the breakthrough methods not only for weight loss but also for the prevention of complication of the obese patients with T2DM. Thus, gastric banding surgery could be effective in controlling HbA 1c in obese patients with type 2 diabetes mellitus.

FinalReport-DOE BES DMSE-UNR-QLi

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Qizhen

The primary goal of this project is to explore the fundamental deformation and failure mechanisms for magnesium with a hexagonal close packed (HCP) crystal structure. It is critical to perform this project for a number of reasons. First, magnesium is the lightest structural metal and its application in various structural components can save the final component weight. Second, the weight reduction from the usage of magnesium-based structural components in transportation vehicles such as automobiles and aircrafts can improve fuel efficiency and reduce the greenhouse gas emissions. Third, structural components often experience dynamic loading such as cyclic loading conditions. Fourth, magnesiummore » with a HCP crystal structure generally has its special deformation responses under loading conditions. This project investigated magnesium based materials (magnesium single crystal, pure polycrystalline magnesium, and some magnesium alloys) under various loading conditions, and also explored some processing routes to manipulate the microstructure and mechanical properties of magnesium. The research results were published in a number of articles and also disseminated through presentations in various conferences such as TMS annual meetings, MRS meetings, the international Plasticity conferences, the Pacific Rim International Congress on Advanced Materials and Processing, and AeroMat. In addition to the contribution to the research/academic community, this project is also beneficial to the general public. With the actual usage of magnesium in the passenger cars, the weight reduction and fuel consumption reduction will save the fuel bill of individual owners.« less

The Efficacy of Simultaneous Breast Reconstruction and Contralateral Balancing Procedures in Reducing the Need for Second Stage Operations

PubMed Central

Clarke-Pearson, Emily M; Vornovitsky, Michael; Dayan, Joseph H; Samson, William; Sultan, Mark R

2014-01-01

Background Patients having unilateral breast reconstruction often require a second stage procedure on the contralateral breast to improve symmetry. In order to provide immediate symmetry and minimize the frequency and extent of secondary procedures, we began performing simultaneous contralateral balancing operations at the time of initial reconstruction. This study examines the indications, safety, and efficacy of this approach. Methods One-hundred and two consecutive breast reconstructions with simultaneous contralateral balancing procedures were identified. Data included patient age, body mass index (BMI), type of reconstruction and balancing procedure, specimen weight, transfusion requirement, complications and additional surgery under anesthesia. Unpaired t-tests were used to compare BMI, specimen weight and need for non-autologous transfusion. Results Average patient age was 48 years. The majority had autologous tissue-only reconstructions (94%) and the rest prosthesis-based reconstructions (6%). Balancing procedures included reduction mammoplasty (50%), mastopexy (49%), and augmentation mammoplasty (1%). Average BMI was 27 and average reduction specimen was 340 grams. Non-autologous blood transfusion rate was 9%. There was no relationship between BMI or reduction specimen weight and need for transfusion. We performed secondary surgery in 24% of the autologous group and 100% of the prosthesis group. Revision rate for symmetry was 13% in the autologous group and 17% in the prosthesis group. Conclusions Performing balancing at the time of breast reconstruction is safe and most effective in autologous reconstructions, where 87% did not require a second operation for symmetry. PMID:25276646

Increased Free Testosterone Levels in Men with Uncontrolled Type 2 Diabetes Five Years After Randomization to Bariatric Surgery.

PubMed

Pham, Nathan H; Bena, James; Bhatt, Deepak L; Kennedy, Laurence; Schauer, Philip R; Kashyap, Sangeeta R

2018-01-01

Hypogonadism frequently occurs in male patients with type 2 diabetes (T2DM) and is linked to insulin resistance and inflammation. Testosterone levels rise acutely in obese patients following bariatric surgery, though long-term changes have not been investigated in a randomized controlled trial. This study evaluated obese men with T2DM randomized to either bariatric surgery or medical therapy. Testosterone, gonadotropins, body composition, insulin sensitivity, and inflammatory markers were evaluated in 32 patients at baseline and at 5 years. Surgical patients had 47.4% increase in free testosterone compared to medical therapy patients who had 2.2% decrease (P = 0.013). Increase in free testosterone correlated with reduction in body weight, high-sensitivity C-reactive protein (hsCRP), and leptin levels. Prolonged improvements in testosterone levels after bariatric surgery in T2DM are found to be related to reduction in body weight and adipogenic inflammation.

Coordinated Care Organizations: Neonatal and Infant Outcomes in Oregon.

PubMed

Harvey, S Marie; Oakley, Lisa P; Yoon, Jangho; Luck, Jeff

2017-11-01

In 2012, Oregon's Medicaid program implemented a comprehensive accountable care model delivered through coordinated care organizations (CCOs). Because CCOs are expected to improve utilization of services and health outcomes, neonatal and infant outcomes may be important indicators of their impact. Estimating difference-in-differences models, we compared prepost CCO changes in outcomes (e.g., low birth weight, abnormal conditions, 5-minute Apgar score, congenital anomalies, and infant mortality) between Medicaid and non-Medicaid births among 99,924 infants born in Oregon during 2011 and 2013. We further examined differences in the impact of CCOs by ethnicity and rurality. Following CCO implementation the likelihood of low birth weight and abnormal conditions decreased by 0.95% and 1.08%, a reduction of 13.4% and 10.4% compared with the pre-CCO level for Medicaid enrollees, respectively. These reductions could be predictive of lifelong health benefits for infants and lower costs for acute care and are, therefore, important markers of success for the CCO model.

Fixed ratio combinations of glucagon like peptide 1 receptor agonists with basal insulin: a systematic review and meta-analysis.

PubMed

Liakopoulou, Paraskevi; Liakos, Aris; Vasilakou, Despoina; Athanasiadou, Eleni; Bekiari, Eleni; Kazakos, Kyriakos; Tsapas, Apostolos

2017-06-01

Basal insulin controls primarily fasting plasma glucose but causes hypoglycaemia and weight gain, whilst glucagon like peptide 1 receptor agonists induce weight loss without increasing risk for hypoglycaemia. We conducted a systematic review and meta-analysis of randomised controlled trials to investigate the efficacy and safety of fixed ratio combinations of basal insulin with glucagon like peptide 1 receptor agonists. We searched Medline, Embase, and the Cochrane Library as well as conference abstracts up to December 2016. We assessed change in haemoglobin A 1c , body weight, and incidence of hypoglycaemia and gastrointestinal adverse events. We included eight studies with 5732 participants in the systematic review. Switch from basal insulin to fixed ratio combinations with a glucagon like peptide 1 receptor agonist was associated with 0.72% reduction in haemoglobin A 1c [95% confidence interval -1.03 to -0.41; I 2  = 93%] and 2.35 kg reduction in body weight (95% confidence interval -3.52 to -1.19; I 2  = 93%), reducing also risk for hypoglycaemia [odds ratio 0.70; 95% confidence interval 0.57 to 0.86; I 2  = 85%] but increasing incidence of nausea (odds ratio 6.89; 95% confidence interval 3.73-12.74; I 2  = 79%). Similarly, switching patients from treatment with a glucagon like peptide 1 receptor agonist to a fixed ratio combination with basal insulin was associated with 0.94% reduction in haemoglobin A 1c (95% confidence interval -1.11 to -0.77) and an increase in body weight by 2.89 kg (95% confidence interval 2.17-3.61). Fixed ratio combinations of basal insulin with glucagon like peptide 1 receptor agonists improve glycaemic control whilst balancing out risk for hypoglycaemia and gastrointestinal side effects.

The effect of a plant-based low-carbohydrate ("Eco-Atkins") diet on body weight and blood lipid concentrations in hyperlipidemic subjects.

PubMed

Jenkins, David J A; Wong, Julia M W; Kendall, Cyril W C; Esfahani, Amin; Ng, Vivian W Y; Leong, Tracy C K; Faulkner, Dorothea A; Vidgen, Ed; Greaves, Kathryn A; Paul, Gregory; Singer, William

2009-06-08

Low-carbohydrate, high-animal protein diets, which are advocated for weight loss, may not promote the desired reduction in low-density lipoprotein cholesterol (LDL-C) concentration. The effect of exchanging the animal proteins and fats for those of vegetable origin has not been tested. Our objective was to determine the effect on weight loss and LDL-C concentration of a low-carbohydrate diet high in vegetable proteins from gluten, soy, nuts, fruits, vegetables, cereals, and vegetable oils compared with a high-carbohydrate diet based on low-fat dairy and whole grain products. A total of 47 overweight hyperlipidemic men and women consumed either (1) a low-carbohydrate (26% of total calories), high-vegetable protein (31% from gluten, soy, nuts, fruit, vegetables, and cereals), and vegetable oil (43%) plant-based diet or (2) a high-carbohydrate lacto-ovo vegetarian diet (58% carbohydrate, 16% protein, and 25% fat) for 4 weeks each in a parallel study design. The study food was provided at 60% of calorie requirements. Of the 47 subjects, 44 (94%) (test, n = 22 [92%]; control, n = 22 [96%]) completed the study. Weight loss was similar for both diets (approximately 4.0 kg). However, reductions in LDL-C concentration and total cholesterol-HDL-C and apolipoprotein B-apolipoprotein AI ratios were greater for the low-carbohydrate compared with the high-carbohydrate diet (-8.1% [P = .002], -8.7% [P = .004], and -9.6% [P = .001], respectively). Reductions in systolic and diastolic blood pressure were also seen (-1.9% [P = .052] and -2.4% [P = .02], respectively). A low-carbohydrate plant-based diet has lipid-lowering advantages over a high-carbohydrate, low-fat weight-loss diet in improving heart disease risk factors not seen with conventional low-fat diets with animal products.

Very low calorie diet without aspartame in obese subjects: improved metabolic control after 4 weeks treatment.

PubMed

Norén, Erik; Forssell, Henrik

2014-07-28

Very low calorie diet (VLCD) is routinely used in programs for treatment of obesity and before bariatric surgery in order to reduce risk of postoperative complications. Aspartame, an artificial sweetener, is commonly used in VLCD and is well approved as a food additive without any adverse effects. The development of a new fructose containing VLCD formula without aspartame raises questions as to effects on glucose and lipid control. As part of an ongoing study of a novel bariatric surgery procedure, twenty-five obese subjects with mean body mass index (BMI) 39.8 kg/m2 and mean age of 48.8 years enrolled in a single center observational study. Seven subjects presented with type 2 diabetes mellitus. The subjects underwent four weeks dietary treatment with VLCD Slanka (Slanka). Blood samples including fasting plasma glucose, HbA1c, cholesterol and triglycerides were performed at start and after four weeks of diet. Blood pressure and weight were noted. All subjects completed the diet without any adverse events. Mean weight reduction was 8.2 kg with 95% confidence interval 7.1-9.2 kg (p = 0.001). Excess weight (i.e. proportion of weight exceeding BMI 25) loss decreased by median 19.5% (inter quartile range (IQR) 16,8-24,2). Median fasting plasma glucose was at inclusion 5,6 mmol/l (IQR 5,3-6,8) and after diet 4.8 mmol/l (IQR 4,6-5,2) (p = 0.001). Median HbA1c changed from 39 mmol/mol (IQR 37-44) to 37 mmol/mol (IQR 35-43) (p = 0.001). There was also significant reduction in cholesterol and triglyceride levels as well as in systolic blood pressure. Changes in other monitored blood chemistry values were without clinical importance. Four weeks treatment with fructose containing VLCD of obese subjects preparing for bariatric surgery gave a substantial weight reduction without any significant negative metabolic effects.

Swipe out Stroke: Feasibility and efficacy of using a smart-phone based mobile application to improve compliance with weight loss in obese minority stroke patients and their carers.

PubMed

Ifejika, Nneka Lotea; Noser, Elizabeth Anne; Grotta, James C; Savitz, Sean I

2016-07-01

Swipe out Stroke (SOS) examines the use of a smartphone-based mobile application to reduce obesity in high-risk minority stroke patients. At record-high levels in the United States, obesity disproportionately affects minorities and is highly correlated with cerebrovascular disease. Unfortunately, structured weight loss programs are expensive, and compliance significantly decreases upon program completion. Mobile health (mHealth) technology is an innovative, cost-effective way to bridge this gap. Minorities spend over 4.5 billion dollars annually on consumer electronics, making studies that utilize mHealth applications ideal for health promotion and disease prevention. SOS is a prospective, randomized-controlled trial with open blinded endpoint comparing an mHealth based dietary intervention to usual care to facilitate weight reduction. Ischemic and hemorrhagic stroke survivors and their carers are recruited from the acute care service of a Houston-based comprehensive stroke center. A neurorehabilitation physician or vascular neurologist meets with participants during the index hospitalization, a baseline clinic visit, followed by visits at 1, 3, and 6 month intervals. The SOS Team focuses on feasible modifications to the Southern dietary pattern (fried foods, fatty foods, added fats, eggs, processed meats, such as bacon and ham, organ meats (e.g., liver), and sweetened drinks) and caloric restriction to facilitate a 5% reduction in total body weight. Practical barriers to adherence are addressed, such as access to transportation, financial limitations, and depression. The primary dependent measure is a reduction of total body weight. Secondary outcomes include systolic blood pressure, hemoglobin A1c, low-density lipoprotein, triglycerides, and Factor VIII. SOS will determine whether a Phase III effectiveness trial of a smartphone-based mobile application to address obesity-related health disparities is warranted throughout the Southeastern United States (Stroke Belt). © 2016 World Stroke Organization.

The role of bariatric surgery in the management of nonalcoholic fatty liver disease and metabolic syndrome.

PubMed

Aguilar-Olivos, Nancy E; Almeda-Valdes, Paloma; Aguilar-Salinas, Carlos A; Uribe, Misael; Méndez-Sánchez, Nahum

2016-08-01

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. NAFLD is strongly associated with obesity and metabolic syndrome (MetS). Current treatment of NAFLD is based on weight reduction. Bariatric surgery is the most effective treatment for morbid obesity and its associated metabolic comorbidities. There is evidence indicating that bariatric surgery improves histological and biochemical parameters of NAFLD, but currently is not considered a treatment option for NAFLD. The aim of this work is to review the evidence for the effects of bariatric surgery on NAFLD and the MetS. We found that insulin resistance, alterations in glucose metabolism, hypertension, plasma lipids, transaminases, liver steatosis, steatohepatitis and fibrosis improve after bariatric surgery. Weight loss and improvement of NAFLD are greater after RYGB than after other interventions. These findings were obtained from retrospective or cohort studies. There are no studies designed to evaluate liver-specific mortality, liver transplantation, or quality of life. Patients with indications for bariatric surgery will benefit from the improvements in the MetS and NAFLD. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluation of a 12-week lifestyle education intervention with or without partial meal replacement in Thai adults with obesity and metabolic syndrome: a randomised trial.

PubMed

Chaiyasoot, Kusuma; Sarasak, Rungnapha; Pheungruang, Banchamaphon; Dawilai, Suwitcha; Pramyothin, Pornpoj; Boonyasiri, Adhiratha; Supapueng, Orawan; Jassil, Friedrich C; Yamwong, Preyanuj; Batterham, Rachel L

2018-04-25

There have been no studies examining the efficacy of meal replacement (MR) on weight loss and metabolic syndrome (MS) improvement in Southeast Asians. Thus, we undertook a 12-week randomised trial to evaluate the effect of a lifestyle education intervention alone (LEI) or with partial MR (LEI + MR) in obese Thai adults with MS. A total of 110 patients were randomised to receive either LEI or LEI + MR. Both groups received LEI to achieve weight loss. LEI + MR group additionally received two MR daily to replace either breakfast, lunch or dinner. Mean ± SE body mass index of all participants was 34.6 ± 0.6 kg/m 2 , mean ± SE age was 42.5 ± 1.1 years and 83% of patients were female. Both groups were compared for anthropometric and cardiometabolic indices at 12-week. Body weight was also compared at weeks 38 and 64. At 12 weeks, both groups exhibited statistically significant percentage weight loss (%WL) compared to initial weight but greater %WL was observed in LEI + MR compared to LEI, 2.9% vs. 1.5%, respectively (p < 0.05). MS criteria such as waist circumference and blood pressure improved significantly in both groups compared to baseline. However, improvement in fasting plasma glucose (FPG) was only significant in LEI + MR, and more participants with impaired FPG at baseline in LEI + MR (42.9%) than LEI (19%) returned to normal FPG at 12 weeks (p < 0.05). HbA 1c , fasting insulin and HOMA-IR in LEI + MR were significantly lower than with LEI. At the end of the 12-week intervention period, 16% of participants no longer fulfilled MS criteria. A statistically significant weight loss from baseline persisted until 38 weeks but no longer reached statistically significant difference between groups CONCLUSIONS: LEI and LEI + MR were acceptable and led to improvement in weight and MS. LEI + MR group exhibited additional weight reduction and glycemic benefits at 12 weeks.

Digital Light Processing update: status and future applications

NASA Astrophysics Data System (ADS)

Hornbeck, Larry J.

1999-05-01

Digital Light Processing (DLP) projection displays based on the Digital Micromirror Device (DMD) were introduced to the market in 1996. Less than 3 years later, DLP-based projectors are found in such diverse applications as mobile, conference room, video wall, home theater, and large-venue. They provide high-quality, seamless, all-digital images that have exceptional stability as well as freedom from both flicker and image lag. Marked improvements have been made in the image quality of DLP-based projection display, including brightness, resolution, contrast ratio, and border image. DLP-based mobile projectors that weighted about 27 pounds in 1996 now weight only about 7 pounds. This weight reduction has been responsible for the definition of an entirely new projector class, the ultraportable. New applications are being developed for this important new projection display technology; these include digital photofinishing for high process speed minilab and maxilab applications and DLP Cinema for the digital delivery of films to audiences around the world. This paper describes the status of DLP-based projection display technology, including its manufacturing, performance improvements, and new applications, with emphasis on DLP Cinema.