Therapeutic effect of low-carbohydrate diet and lifestyle intervention on patients with lean nonalcoholic fatty liver disease / 临床肝胆病杂志

ObjectiveTo investigate the therapeutic effect of low-carbohydrate diet and online lifestyle intervention on patients with lean nonalcoholic fatty liver disease （NAFLD）. MethodsThis study was conducted among 53 patients with lean NAFLD who attended Department of Infectious Diseases in Peking University Shenzhen Hospital and Shenzhen Qianhai Shekou Free Trade Zone Hospital from December 2019 to March 2021， and the patients were given low-carbohydrate diet for calorie restriction ［total calorie intake was calculated based on basal metabolic rate （BMR） and physical activity level （PAL） and was restricted within （BMR×95%×PAL-1 000） kcal to （BMR×95%×PAL-500） kcal， and carbohydrate ratio fluctuated between 10% and 55%］ and lifestyle interventions for 8 weeks. An online software was used for supervision and follow-up， and the patients were observed in terms of treatment outcome and safety. The patients were compared in terms of controlled attenuation parameter （CAP）， liver stiffness measurement （LSM）， Anthropometric parameters， blood biochemistry， urinary protein， and urine ketone body before and after intervention. The patients were followed up after 1 year to measure body weight and body mass index （BMI）. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the paired-sample Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous； the chi-square test was used for comparison of categorical data between groups. ResultsAfter 8 weeks of intervention， CAP decreased from 304.47±31.91 db/m to 242.43±26.74 db/m， LSM decreased from 7.43±2.41 kPa to 6.36±1.79 kPa， and body weight decreased from 64.29±7.37 kg to 60.24±7.08 kg （t=11.25，3.72， and 14.07， all P<0.001）. Of all patients， 25 （47.2%） had disappearance of fatty liver， and abnormal LSM in 12 patients （63.2%） returned to normal； 52 patients （98.1%） had a mean reduction of 4.05±2.32 kg in body weight. The degree of reduction in CAP increased with the degree of reduction in body weight. After intervention， there were significant reductions in BMI， waist circumference， hip circumference， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， gamma-glutamyl transpeptidase （GGT）， uric acid， fasting blood glucose， triglyceride （TG）， total cholesterol （TC）， and low-density lipoprotein （LDL） and a significant increase in high-density lipoprotein （t=12.85， 13.77， 10.28， 7.64， 6.21， 8.35， 6.83， 6.31， 7.4， 4.97， 5.95， and -2.21， all P<0.05）. The patients with abnormal ALT， AST， GGT， uric acid， fasting blood glucose， TG， TC， and LDL at baseline which returned to normal after intervention accounted for 75%， 100%， 81.8%， 57.1%， 100%， 66.7%， 73.5%， and 85.3%， respectively. There were no significant changes in blood urea nitrogen， serum creatinine， urine protein， and urine ketone body （all P>0.05）. There was no rebound in body weight and BMI after 1 year of follow-up （P>0.05）. There were no gastrointestinal reactions during intervention or follow-up. ConclusionLow-carbohydrate diet and lifestyle intervention can improve liver fat content， liver function， and blood lipid parameters in patients with lean NAFLD， with good safety.

Effect of acupuncture on serum PYY and nesfatin-1 in obese patients with insulin resistance / 针灸推拿医学（英文版）

Objective: To observe the effect of acupuncture on serum peptide YY (PYY) and nesfatin-1 in obese patients with insulin resistance. Methods: Ninety-eight obese patients with insulin resistance were divided into a control group and an observation group by the random number table method, with 49 cases in each group. The control group received exercise and dietary interventions, and the observation group received additional acupuncture treatment to the exercise and dietary interventions. The body mass index (BMI), body fat percentage, fasting insulin (FINS), fasting plasma glucose (FPG), homeostasis model assessment for insulin resistance (HOMA-IR), triglyceride (TG), total cholesterol (TC), and serum PYY and nesfatin-1 levels were compared before and after treatment. The efficacy was evaluated after treatment. Results: The total effective rate was significantly higher in the observation group than in the control group (P<0.05). After treatment, the BMI, body fat percentage, and serum TG and TC levels decreased significantly in both groups (P<0.05), and were significantly lower in the observation group than those in the control group (P<0.05). The FINS, FPG, HOMA-IR, and serum PYY and nesfatin-1 levels of the control group were not significantly changed after treatment (P>0.05). The FINS, FPG and HOMA-IR of the observation group decreased significantly after treatment (P<0.05), and were lower than those in the control group (P<0.05). The serum PYY and nesfatin-1 levels of the observation group increased significantly after treatment (P<0.05), and were higher than those in the control group (P<0.05). Conclusion: Based on exercise and dietary interventions, acupuncture is effective for obese patients with insulin resistance. It can reduce the BMI, body fat percentage, blood lipids, blood glucose, and serum insulin levels and improve insulin resistance. The action may be associated with the up-regulation of serum PYY and nesfatin-1.

Effects of curcumin on cardiovascular risk factors in obese and overweight adolescent girls: a randomized clinical trial

ABSTRACT BACKGROUND: Obese adolescents are at higher risk of development of cardiovascular risk factors and obesity in later life. Dietary intake of antioxidants, particularly curcumin, as an active ingredient of turmeric extract, may have noticeable effects on obesity and its important complications such as cardiovascular risk factors. Therefore, the aim of this study was to assess the effects of curcumin supplementation on cardiovascular risk factors among overweight and obese female adolescents. DESIGN AND SETTING: Randomized placebo-controlled clinical trial; Pediatric Cardiovascular Research Center, Isfahan, Iran. METHODS: 60 adolescent girls (aged 13-18 years) were randomly assigned to receive either placebo or intervention. The adolescents were asked to consume one 500 mg tablet per day, containing either standardized 95% turmeric extract or placebo, and to undergo a weight maintenance or a mild weight loss diet for 10 weeks. Anthropometric and biochemical indices were assessed at the baseline and the end of the intervention. RESULTS: Curcumin supplementation had beneficial effects on body mass index (P = 0.019), waist circumference (P = 0.008), hip circumference (P = 0.030), high-density lipoprotein levels (P = 0.042) and triglyceride/high-density lipoprotein ratio (P = 0.021). However, in univariate analysis of covariance, no significant differences were found between the intervention and placebo groups after 10 weeks of supplementation (P > 0.05). CONCLUSIONS: Prescription of curcumin supplementation along with use of a slight weight loss diet might have beneficial effects on some cardiovascular risk factors among overweight and obese female adolescents. Larger clinical trials with higher curcumin doses and longer duration are needed to confirm the results from the current study. CLINICAL TRIAL REGISTRATION: IRCT20171107037302N1

Restricción alimentaria intermitente: repercusiones en la regulación de la homeostasis energética hipotalámica y tejido adiposo / Intermittent food restriction: repercussions in the regulation of hypothalamic energy homeostasis and adipose tissue

La práctica de restricción alimentaria intermitente (RAI) bien como sus variaciones, es utilizada por individuos con intensión de pérdida de masa corporal. Existen evidencias científicas favorables a esta práctica; no obstante, son insuficientes los estudios que muestren las consecuencias a largo plazo y sus repercusiones en el control de la homeostasis energética en el sistema nervioso central (SNC). Considerando su creciente utilización, tanto como su recomendación y además de la controversia existente en la bibliografía, la presente revisión tiene como objetivo mostrar los efectos de la RAI sobre la regulación central de la homeostasis energética registrados en la literatura.

The practice of intermittent food restriction (IFR) along its variations, is used by individuals with an intentional loss of body mass. There is scientific evidence favorable to this practice; however, studies showing the long term consequences and their impact on the control of energy homeostasis at the level of the central nervous system (CNS) are insufficient. Considering the increase in its use, as well as in its recommendation and the great controversy existing in the bibliography, the present review aims to show the effects of RAI on the central regulation of energy homeostasis reported in the literature.

Body Weight Perception, Mental Health, and Weight Control Behavior in Normal Weight Adolescents: Based on the Korea National Health and Nutrition Examination Survey 2013-2015

PURPOSE: The aim of this study was to assess the body weight perception of adolescents and to investigate the difference between mental health and weight control behavior according to body weight perception. METHODS: Study data on 12–18 years old adolescents with normal BMI was obtained from the 6th Korea National Health and Nutrition Examination Survey (2013–2015). Rao-Scott Chi-square test and ANOVA were used for the analysis. RESULTS: The percentage of adolescents with a misperception of body weight was 43.3%, and their subjective health status (p=.013), stress perception (p=.001), and depression (p=.001) were worse than for adolescents who had the correct perception of their body weight. The percentage of adolescents who were trying to lose weight while perceiving their body weight as normal was 36.9%. Body weight control behavior had significant differences according to dietary intake (frequency of eating dinner (p=.015)), energy intake (p=.004), and carbohydrate intake (p<.001), but there was no significant difference according to exercise. CONCLUSION: Parents, school teachers, and nurses should make efforts to ensure that Korean adolescents perceive their body weight correctly, and prevent unhealthy weight control behaviors.

Research on army cadres population weight scientific intervention management mode and effect / 中华健康管理学杂志

Objective To look for suitable short-term weight loss and long-term maintenance method for army cadres. Method A total of 142 patients with simple overweight and obesity were randomly selected as the research subjects, and were followed up for 2 years, 130 of them were valid for analysis, 97 were male, and 33 female, age 27-59 years, average(47.41±7.55)years. SPSS 16.0 was used for analysis. Repeated measurements analysis of variance was used for data analysis, K-related samples nonparametric test was used for enumeration data. Result The army cadres population weight intervention management model was divided into three stages. They were respectively intensified weight loss stage for 6 months, the consolidation of weight loss for 6 months, and self-management stage maintained for 12 months, totally 24 months. Variance analysis results showed that after two years of focused intervention and health management, the body mass index(BMI)fell from(27.42 ± 2.81)kg/m2 to(24.69 ± 2.63)kg/m2 (F=2 649.945, P<0.05), waist circumference decreased from(91.09±8.24)cm to(85.26±7.76)cm(F=1 207.248, P<0.05). Nonparametric test results showed that after two years intervention management the behavior patterns concerning physical exercise became better. Exercisers increased from 33.8%to 73.3%(H=68.448, P<0.05); proportion of smoking decreased from 38.5% to 20.0%(H=33.692, P<0.05); drinking alcohol decreased from 50.8%to 20.8%(H=59.128, P<0.05);high salt diet decreased from 39.2%to 23.1%(H=31.722, P<0.05);high-fat diet decreased from 46.2%to 27.7%(H=41.571, P<0.05). Conclusion The practice showed that the short-term intensified weight loss, long-term maintenance, exercise and psychological intervention, changed the cadres population from passive to active on the weight control and self-management with remarkable effects, therefore such intervention is worthy of promoting.

Influence of sibutramine on heart rate in obese patients: systematic review / Influência da sibutramina na frequência cardíaca de pacientes obesos: revisão sistemática

Cardiovascular alterations are part of the obesity-related metabolic syndrome. The objective of this study was to verify the effect of sibutramine on obese patients heart rate. Systematic review of randomized clinical trials performed in the Brazilian Cochrane center, in obese patients, on use of sibutramine or placebo. Outcome: change in heart rate. Electronic database searched: Cochrane library, Medline, LILACS, Pubmed. There were no language, date, or other restrictions. Two reviewers made data collection and extraction, who independently obtained full articles of all eligible papers. Four studies provided dichotomous data for a meta-analysis, the outcome of which was favorable to placebo: relative risk (RR) 3.73, confidence interval (CI) 2.07 to 6.73, risk difference (RD) of 0.13, number needed to harm (NNH) of 7. Ten studies presented continuous data for a meta-analysis, the result of which was favorable to placebo: mean difference (MD) of 7.24, CI of 6.22-8.26. The use of sibutramine in obese patients significantly affects the heart rate.

Alterações cardiovasculares são parte da síndrome metabólica relacionada à obesidade. O objetivo deste estudo foi verificar a influência da sibutramina sobre a frequência cardíaca em pacientes obesos.Revisão sistemática de ensaios clínicos randomizados realizados no centro Cochrane do Brasil em pacientes obesos em uso de sibutramina ou placebo. Desfecho: alteração da frequência cardíaca. Banco de dados eletrônico pesquisados: Cochrane Library, Medline, LILACS, Pubmed. Não houve restrições quanto a idioma, data, ou outras restrições. Coleta de dados e extração foi realizada por dois revisores, que de forma independente obteve artigos na íntegra de todos os estudos elegíveis. Quatro estudos forneceram dados dicotômicos para uma meta-análise, cujo resultado foi favorável ao placebo:risco relativo (RR) 3,73, intervalo de confiança (IC) 2,07-6,73, diferença de risco (DR) de 0.13, número necessário para causar lesão (NNL) de 7. Dez estudos apresentaram dados contínuos para uma metanálise, cujo resultado foi favorável ao placebo: diferença média (DM) de 7,24, IC de 6,22-8,26. O uso da sibutramina em pacientes obesos afeta significativamente a frequência cardíaca.

Effect of lifestyle quantilization based-weight management on overweight or obesity occupational groups / 中华健康管理学杂志

Objective To study the effects of lifestyle quantilization based-weight management on overweight or obesity police officers.Methods One hundred and seven overweight or obesity police officers received lifestyle quantilization based-weight management (i.e.Jinbi weight management) and were then assigned to the excellent performance group (group A,n =50),good performance group (group B,n =42)and loss to follow-up group (group C,n =15).Dietary habits,body weight,height,waist circumference (WC),blood pressure (BP),total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C) and fasting plasma glucose (FPG) were measured before and after the intervention.After 8 weeks' intervention,the changes of above parameters were recored.Student's t test was used for data analysis.Results Of group A and B,83 reported weight loss (group A t =13.31,group B t =5.04 ; both P ＜ 0.05).In group A,body weight,body mass index (BMI),WC,body fat and visceral fat index were significantly decreased,in contrast to body water (t values were 13.31,13.72,10.8,8.59,6.83 and-6.62,respectively; all P ＜ 0.05).However,there were no significant changes of BP,FPG,TC,TG,LDL-C and HDL-C in group A.Following intervention,daily dietary energy intake of group A was reduced by 74.1 k J,fat intake was decreased by 11.6 g,energy ratio of dietary fat was decreased by 1.8％,energy ratio of cereal was increased by 4.2％,and sodium chloride and cooking oil was decreased by 1.3 g and 10 g,respectively.Conclusion Lifestyle quantilization based-weight management shows effectiveness among overweight or obese police officers,and thus may be recommended for other functional communities.

Effects of the weight reduction with the caloric restriction on cellular and humoral immunity in athletes / 体力科学

To investigate the effects of caloric restriction combined with physical training on the immunity in athletes, some cellular and humoral immune functions were examined in 9 young female athletes before and after a caloric restriction program. The control group consisted of 7 age-matched female non-athletes who were not on diet. The athletes continued their exercise trainings as usual and ate low-caloric diets (1, 300 kcal/day : including 60 g/day of protein) for 2 weeks. They reduced their body weights by 3.1% and their body fats by 18.2% at the end of the program. As the marker of nutritional condition, serum levels of pre-albumin and retinol binding protein were measured. Both of them at the end of 2 weeks were slightly decreased, but did not reach statistical significance, these athletes, however, showed slight hemoconcentrations after the caloric restriction program combined with physical exercise. Therefore, the total amounts of those two substances were supposed to be significantly decreased. The phagocytic activities of blood monocytes against sheep erythrocytes opsonized with IgG and saccharomyces cerevisiae yeast in the athletes were already higher than those in controls, even before the caloric restriction. After reducing their body weights, those phagocytic activities were significantly decreased (p<0.01, respectively) to the same levels of those activities in controls. The blastgenic response of T lymphocytes isolated from the athletes to the phytohaemagglutinin was also higher than the response in controls before the caloric restriction, and continued the same levels during the caloric restriction period. The complement activity and the serum concentrations of IgG, IgM, and IgA in athletes were not different from those in controls before and after the caloric restriction. The concentration of fibronectin in sera of the athletes were significantly decreased after the caloric restriction program (p<0.05) ; however, these concentrations were not significantly different from those in sera of controls. We concluded that even a moderate caloric restriction program might reduce some immune functions in the athletes continuing their daily physical trainings. The deterioration in immunity, however, might not affect their health, because those functions in the athletes of this study had been originally enhanced, and maintained the normal range after a moderate weight reduction.