Effect of Weight Self-Stigma on Quality of Life and Dietary Habits among Adult Students in Riyadh, Saudi Arabia.

Weight self-stigma (WSS) is a personal experience of negative self-evaluations, perceived discrimination, and shame about body weight. Studies suggested that WSS could negatively affect quality of life, eating behavior, and psychological outcomes. WSS has been linked with a number of obesogenic health outcomes that complicate weight loss interventions. Thus, this study aimed to examine the effect of WSS on the quality of life and dietary habits among adult students. A sample of 385 students from Riyadh universities participated in this cross-sectional study and completed three online questionnaires: the WSS questionnaire, the WHO quality of life questionnaire, and a dietary habit questionnaire. The average age of participants was 24 ± 6.74, and the majority were female (78.4%). Results demonstrated a negative association between all QOL domains and WSS (p < 0.001). Moreover, higher BMI is associated with increased self-devaluation and fear of enacted stigma (p < 0.001). There was also a negative link between both quality and quantity of food with WSS (p < 0.01). No significant difference was seen in study outcomes concerning gender. The findings of this study suggest the importance of increasing awareness about the negative impact of WSS and developing social policies to prevent or decrease it. Additionally, multidisciplinary teams, especially dietitians, should be more aware of WSS when dealing with overweight and obese individuals.

Gastric Myoelectric Activity and Body Composition Changes during Weight Loss via Sleeve Gastrectomy and Lifestyle Modification: Prospective Cohort Study.

The capability of bariatric surgery (BS) and lifestyle intervention (LSI) in ameliorating obesity-associated altered gastric myoelectric activity (GMA) in relation to body composition is underinvestigated. This work studied GMA during weight loss via sleeve gastrectomy and multimodal lifestyle intervention. Seventy-nine participants with morbid obesity were assigned into three groups: bariatric surgery (BS group, n = 27), in which laparoscopic sleeve gastrectomy was performed; lifestyle intervention (LS group, n = 22), in which a calorie-deficit balanced diet with gradual physical activity and personalized behavioral modification were carried out; and waitlist control (C group, n = 30). For all participants, multichannel electrogastrography (EGG) with water-load testing and bioelectric impedance body composition analysis were done at baseline, after three months, and at six months. In the BS group, the water-load volume was decreased but without improvement in the bradygastria. In the LS group, preprandial bradygastria were reduced and some postprandial normogastria were increased throughout the study period. Except for fat-free mass and total body water, the parameters of body composition changes were superior in the BS group. In the LS group, the amount of fat-mass loss was negatively correlated with bradygastria times and positively correlated with preprandial and the early postprandial average dominant frequency (ADF). In addition, in the BS group, fat-mass loss was positively correlated with the ADF at late postprandial times. In conclusion, compared to BS, LS produced moderate normalization of GMA with the preservation of fat-free mass. The GMA changes were significantly associated with the amount of fat loss, regardless of the method of obesity management.

Systematic Review of Mindfulness-Based Interventions for Weight Management Among Pre- and Post-bariatric Surgery Patients.

Context: Bariatric surgery has been an effective treatment for severe obesity. However, it can be challenging for bariatric-surgery patients to reach and maintain long-term weight loss. Behavioral interventions may be beneficial in reducing weight and improving the psychological outcomes of bariatric patients. Objective: The review intended to evaluate the benefits of mindfulness training for weight management among pre- and postoperative, bariatric-surgery patients and to help determine the design of the most effective mindfulness program for them. Design: The research team performed a systematic narrative review by searching the Medline, Excerpta Medica Database (EMBASE), PsycINFO, Web of Knowledge, PubMed, and CENTRAL databases. The search terms included mindfulness-based therapy, stress reduction, relaxation therapy, meditation, and acceptance and commitment therapy. Eligible studies included those using interventions that examined the impact of mindfulness on weight loss for bariatric-surgery patients. Due to the heterogeneity of the included studies, the research team conducted a narrative synthesis rather than a meta-analysis. Setting: The review took place in the Community Health Sciences Department at the College of Applied Medical Sciences of King Saud University in Riyadh, Kingdom of Saudi Arabia. Outcome Measures: Primary outcomes included indicators of body-weight change, such as kilograms, pounds, or BMIs. Secondary outcomes included changes: (1) in eating behavior, such as in binge eating, grazing behavior, craving behavior, and emotional eating, (2) in caloric intake, (3) in mental health, including a reduction in anxiety or depression, (4) in quality of life, (5) mindfulness acceptability and practice, (6) in physical activity, and (7) in glycated hemoglobin (HbA1c). Results: The research team included eight studies in the review. One study aimed to explore the impact of mindfulness on pre-operative patients, and the remaining seven studies measured the impact among postoperative individuals. Most studies suggested that mindfulness-based interventions can have a positive impact on weight outcomes and eating behaviors. The team also found promising effects for mental health outcomes, including anxiety and depression. It's important to note that the included studies reported no strategies that examined treatment fidelity and the monitoring of an intervention's delivery. Conclusions: Preliminary results suggest that mindfulness-based interventions can be useful in tackling eating disorders and in promoting weight loss among bariatric individuals. Further studies are warranted in this area to make explicit recommendations that inform pre- and post-bariatric guidelines. The field needs further well-developed studies to understand the impact of mindfulness on weight loss in the long term.

Association of Gastric Myoelectric Activity with Dietary Intakes, Substrate Utilization, and Energy Expenditure in Adults with Obesity.

Obesity can modulate gastric myoelectric activity (GMA); however, the relationship of GMA with nutrient intakes and substrate utilization in adults with obesity is lacking. We examined the association of dietary intakes, energy expenditure, and substrate utilization with the GMA. Participants (n = 115, 18−60 y) were divided into healthy weight (HW, n = 24), overweight (OW, n = 29), obese (OB, n = 41) and morbidly obese (MO, n = 21). Two-day multi-pass 24 h recalls were conducted. The GMA was measured by multichannel electrogastrography (EGG) with water-load (WL) testing. Resting metabolic rate (RMR) and percentages of substrate utilization were measured by indirect calorimetry. In the HW, protein intake was directly correlated with average dominant frequency (ADF) and with WL volume, while in obese participants and the MO subgroup, WL volume correlated with carbohydrate intake. In participants with obesity, ADF was positively correlated with fiber intake. In participants with obesity and the OB subgroup, RMR was positively correlated with water-load volume (r = 0.39 and 0.37, p < 0.05). The ADF showed negative correlations with percent of fat utilization and positive correlations with percent of CHO utilization in non-obese groups. However, protein utilization showed inverse correlation in all obese groups. In conclusion, these distinctive associations suggest that certain dietary compositions and dieting regimens impact GMA patterns.

Association of Gastric Myoelectrical Activity With Ghrelin, Gastrin, and Irisin in Adults With Metabolically Healthy and Unhealthy Obesity.

Background and Objective: Functional disturbances of gastric myoelectrical activity (GMA) might exist in obesity. However, studies on its association with the gastric hormones in obesity phenotypes are lacking. The objective was to study the association of GMA with the serum levels of key gastric hormones in different obesity phenotypes. Methods: A total of 139 adults (31.00 ± 11.12 years) were classified into different metabolic phenotypes of obesity: 1) normal weight-lean (NWL group): BMI <25 kg/m2 and the fat-mass index (FMI) ≤9.7 kg/m2 in females and ≤6.3 kg/m2 in males; 2) metabolically obese normal weight (MONW group): BMI <25 kg/m2 and FMI >9.7 kg/m2 in females and >6.3 kg/m2 in males; 3) metabolically healthy obese (MHO group): BMI ≥25 and FMI ≤9.7 kg/m2 in females and ≤6.3 kg/m2 in males; and 4) metabolically unhealthy obese (MUO group): BMI ≥25 and FMI >9.7 kg/m2 in females and >6.3 kg/m2 in males. The GMA was measured at the baseline and post-prandial state using a multichannel electrogastrography with a water load satiety test. The average power distribution by the frequency region and the average dominant frequency were used for analysis. Anthropometric measurements and bioelectric impedance analysis were performed to calculate the FMI and fat-free mass index (FFMI). Serum levels of ghrelin, gastrin, and irisin were measured by ELISA kits according to the manufacturer's protocol. Results: Compared to the NWL group, gastrin and ghrelin levels were significantly low in the MUO participants, while irisin was significantly high. The EGG showed significantly lower baseline and 20-min normogastria frequencies in the MHO and MUO groups. In the MHO group, baseline duodenal frequency was positively correlated with the gastrin level, while normogastria times were positively associated with the irisin level and negatively associated with the ghrelin level. In the MUO group, percentages of bradygastria frequencies at 10, 20, and 30 min were positively correlated with the BMI and FFMI. This bradygastria was correlated positively with the irisin level and negatively with the ghrelin level. Conclusion: The EGG patterns might be associated with obesity-related gastric hormones in different obesity phenotypes. EGG may be a promising clinical tool in obesity assessment. The association of the EGG patterns with hormonal levels needs further investigation for potential practical uses.

Physicians' Knowledge of Clinical Nutrition Discipline in Riyadh Saudi Arabia.

BACKGROUND: Nutrition plays a major role in the prevention and management of diet-related disease. With the absence of clinical nutrition dietitians, physicians are considered responsible for prescribing nutritional support. Identifying weaknesses in nutritional knowledge among Saudi physicians may provide guidance to improve their nutritional knowledge. METHODS: A cross-sectional study that used an anonymous electronic questionnaire to investigate physicians' knowledge of the clinical nutrition discipline. In addition to demographics, the questionnaire consisted of 15 questions covering six areas in the clinical nutrition discipline (macro- and micronutrients, nutrition and chronic diseases, nutrition and metabolic diseases, nutrition care process, nutrition support therapy, and research). For continuous variables, independent t-tests and one-way ANOVA were used. RESULTS: A total of 332 had completed the questionnaire and were included in the study. Most of the physicians were Saudi (87%), male (73.5%), aged between 26 and 35 years (63.3%), and without health problems (56.3%). The mean score of the physicians' knowledge was 5.3 ± 1.97 out of 15. Physicians who reported that they received some sort of nutritional training or course (M = 5.57, SD = 2.08) scored significantly more than physicians who did not (M = 5.10, SD = 1.86); t(330) = -2.174, p = 0.30. CONCLUSIONS: Nutrition should be reinforced as an important component of continuing medical education. There is a need for hiring more dietitians in health care settings in Saudi Arabia as an integral part of a multidisciplinary team delivering medical care services.

The Effect of Curcumin Supplementation on Anthropometric Measures among Overweight or Obese Adults.

Over the past decades, the worldwide prevalence of obesity has dramatically increased, thus posing a serious public health threat. Obesity is associated with the development of comorbid conditions and psychological disorders. Several lifestyle interventions have been proposed to tackle obesity; however, long-term maintenance of these interventions often proves challenging. In addition, among the different types of diets there is still a debate about the optimal macronutrient composition that will achieve the best results in weight loss. Recently, several commonly used spices such as pepper, ginger, and curcumin have been shown to play a beneficial role in obesity management. Therefore, exploring the effects of certain herbs or dietary spices on obesity may be promising. Among these spices, curcumin, which is the primary component of the spice turmeric, has gained great interest for its multiple health benefits. Several randomized controlled trials have investigated the potential favorable effects of curcumin supplementation on anthropometric measures. The aim of this review is to evaluate the effect of curcumin supplementation on the anthropometric indices among overweight or obese adults.