Microbiome-Targeted Therapies as an Adjunct to Traditional Weight Loss Interventions: A Systematic Review and Meta-Analysis.

Objective: This study evaluated the effect of microbiome-targeted therapies (pre-, pro-, and synbiotics) on weight loss and other anthropometric outcomes when delivered as an adjunct to traditional weight loss interventions in overweight and obese adults. Methods: A systematic review of three databases (Medline [PubMed], Embase, and the Cochrane Central Register of Controlled Trials) was performed to identify randomized controlled trials published between January 1, 2010 and December 31, 2020, that evaluated anthropometric outcomes following microbiome-targeted supplements in combination with dietary or dietary and exercise interventions. The pooled mean difference (MD) between treatment and control groups was calculated using a random effects model. Results: Twenty-one trials with 1233 adult participants (76.4% female) with overweight or obesity were included. Separate meta-analyses were conducted for probiotics (n=11 trials) and synbiotics (n=10 trials) on each anthropometric outcome; prebiotics were excluded as only a single study was found. Patient characteristics and methodologies varied widely between studies. All studies incorporated some degree of caloric restriction, while only six studies included recommendations for adjunct exercise. Compared with dietary or dietary and exercise interventions only, probiotics resulted in reductions in body weight (MD: -0.73 kg; 95% confidence interval [CI]: -1.02 to -0.44, p < 0.001), fat mass (MD: -0.61 kg; 95% CI: -0.77 to -0.45; p<0.001) and waist circumference (MD: -0.53 cm; 95% CI: -0.99 to -0.07, p=0.024) while synbiotics resulted in reductions in fat mass (MD: -1.53 kg; 95% CI: -2.95 to -0.12, p=0.034) and waist circumference (MD: -1.31 cm; 95% CI: -2.05 to -0.57, p<0.001). Conclusion: This analysis indicates that microbiome-targeted supplements may enhance weight loss and other obesity outcomes in adults when delivered as an adjunct to dietary or dietary and exercise interventions. Personalized therapy to include microbiome-targeted supplements may help to optimize weight loss in overweight and obese individuals.

A systematic review of outcomes following residential treatment for eating disorders.

OBJECTIVE: Residential centres for the treatment of eating disorders are becoming increasingly common, yet data following residential care are scarce. We reviewed outcomes of residential treatment for eating disorders across all diagnoses, age groups and genders. A secondary goal was to identify treatment elements and patient characteristics that predicted a greater response to treatment. METHOD: Peer-reviewed studies published in the last 20 years were identified through a systematic search of the electronic databases PubMed and Cochrane Library. RESULTS: Nineteen open-label studies reporting changes between admission and discharge were included in this review. Most took an eclectic approach to treatment, integrating elements from several different techniques without a unifying theoretical framework. All studies reported improvements in most outcomes at discharge, including changes in eating disorders psychopathology, weight, depression, anxiety and quality of life. Eight studies reported outcomes at some interval after discharge, with largely positive outcomes. CONCLUSIONS: While residential care was associated with consistently positive outcomes, the variability in program characteristics and poor quality of research designs prevent firm conclusions from being drawn about their efficacy. Future research should include controlled studies that evaluate specific theoretical approaches and program elements, include long-term follow-up, and compare residential care to other treatment settings.

A systematic review and narrative synthesis of interventions for uncomplicated obesity: weight loss, well-being and impact on eating disorders.

OBJECTIVE: Most weight loss research focuses on weight as the primary outcome, often to the exclusion of other physiological or psychological measures. This study aims to provide a holistic evaluation of the effects from weight loss interventions for individuals with obesity by examining the physiological, psychological and eating disorders outcomes from these interventions. METHODS: Databases Medline, PsycInfo and Cochrane Library (2011-2016) were searched for randomised controlled trials and systematic reviews of obesity treatments (dietary, exercise, behavioural, psychological, pharmacological or surgical). Data extracted included study features, risk of bias, study outcomes, and an assessment of treatment impacts on physical, psychological or eating disorder outcomes. RESULTS: From 3628 novel records, 134 studies met all inclusion criteria and were evaluated in this review. Lifestyle interventions had the strongest evidence base as a first-line approach, with escalation to pharmacotherapy and bariatric surgery in more severe or complicated cases. Quality of life was the most common psychological outcome measure, and improved in all cases where it was assessed, across all intervention types. Behavioural, psychological and lifestyle interventions for weight loss led to improvements in cognitive restraint, control over eating and binge eating, while bariatric surgery led to improvements in eating behaviour and body image that were not sustained over the long-term. DISCUSSION: Numerous treatment strategies have been trialled to assist people to lose weight and many of these are effective over the short-term. Quality of life, and to a lesser degree depression, anxiety and psychosocial function, often improve alongside weight loss. Weight loss is also associated with improvements in eating disorder psychopathology and related measures, although overall, eating disorder outcomes are rarely assessed. Further research and between-sector collaboration is required to address the significant overlap in risk factors, diagnoses and treatment outcomes between obesity and eating disorders.

Place avoidance learning and memory in a jumping spider.

Using a conditioned passive place avoidance paradigm, we investigated the relative importance of three experimental parameters on learning and memory in a salticid, Servaea incana. Spiders encountered an aversive electric shock stimulus paired with one side of a two-sided arena. Our three parameters were the ecological relevance of the visual stimulus, the time interval between trials and the time interval before test. We paired electric shock with either a black or white visual stimulus, as prior studies in our laboratory have demonstrated that S. incana prefer dark 'safe' regions to light ones. We additionally evaluated the influence of two temporal features (time interval between trials and time interval before test) on learning and memory. Spiders exposed to the shock stimulus learned to associate shock with the visual background cue, but the extent to which they did so was dependent on which visual stimulus was present and the time interval between trials. Spiders trained with a long interval between trials (24 h) maintained performance throughout training, whereas spiders trained with a short interval (10 min) maintained performance only when the safe side was black. When the safe side was white, performance worsened steadily over time. There was no difference between spiders tested after a short (10 min) or long (24 h) interval before test. These results suggest that the ecological relevance of the stimuli used and the duration of the interval between trials can influence learning and memory in jumping spiders.

Electric shock for aversion training of jumping spiders: towards an arachnid model of avoidance learning.

Electric shock is used widely as an aversive stimulus in conditioning experiments, yet little attention has been given to its physiological effects and their consequences for bioassays. In the present study, we provide a detailed characterization of how electric shock affects the mobility and behaviour of Servaea incana, a jumping spider. We begin with four mobility assays and then narrow our focus to a single effective assay with which we assess performance and behaviour. Based on our findings, we suggest a voltage range that may be employed as an aversive stimulus while minimizing decrements in physical performance and other aspects of behaviour. Additionally, we outline a novel method for constructing electric shock platforms that overcome some of the constraints of traditional methods while being highly effective and easily modifiable to suit the study animal and experimental context. Finally, as a demonstration of the viability of our aversive stimulus in a passive avoidance conditioning task, we successfully train spiders to associate a dark compartment with electric shock. Future research using electric shock as an aversive stimulus with terrestrial invertebrates such as spiders and insects may benefit from the flexible and reliable methods outlined in the present study.