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International Journal of Environmental... Aug 2022A ketogenic diet, characterized by low calories with high levels of fat, adequate levels of protein, and low levels of carbohydrates, has beneficial effects on body... (Meta-Analysis)
Meta-Analysis Review
Ketogenic Diet Benefits to Weight Loss, Glycemic Control, and Lipid Profiles in Overweight Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trails.
A ketogenic diet, characterized by low calories with high levels of fat, adequate levels of protein, and low levels of carbohydrates, has beneficial effects on body weight control in overweight patients. In the present study, a meta-analysis was conducted to investigate the role of a ketogenic diet in body weight control and glycemic management in overweight patients with type 2 diabetes mellitus (T2DM). In summary, we systematically reviewed articles from the Embase, PubMed, Web of Science and Cochrane Library databases and obtained eight randomized controlled trials for meta-analysis. The results show that a ketogenic diet had significantly beneficial effects on the loss of body weight (SMD, -5.63, = 0.008), the reduction of waist circumference (SMD, -2.32, = 0.04), lowering glycated hemoglobin (SMD, -0.38, = 0.0008) and triglycerides (SMD, -0.36, = 0.0001), and increasing high-density lipoproteins (SMD, 0.28, = 0.003). Overall, these results suggest that a ketogenic diet may be an effective dietary intervention for body weight and glycemic control, as well as improved lipid profiles in overweight patients with T2DM. Hence, a ketogenic diet can be recommended for the therapeutic intervention of overweight patients with T2DM.
Topics: Blood Glucose; Body Weight; Diabetes Mellitus, Type 2; Diet, Ketogenic; Glycemic Control; Humans; Overweight; Triglycerides; Weight Loss
PubMed: 36012064
DOI: 10.3390/ijerph191610429 -
Frontiers in Endocrinology 2021Obesity is a complex multifactorial disease that accumulated excess body fat leads to negative effects on health. Obesity continues to accelerate resulting in an... (Review)
Review
Obesity is a complex multifactorial disease that accumulated excess body fat leads to negative effects on health. Obesity continues to accelerate resulting in an unprecedented epidemic that shows no significant signs of slowing down any time soon. Raised body mass index (BMI) is a risk factor for noncommunicable diseases such as diabetes, cardiovascular diseases, and musculoskeletal disorders, resulting in dramatic decrease of life quality and expectancy. The main cause of obesity is long-term energy imbalance between consumed calories and expended calories. Here, we explore the biological mechanisms of obesity with the aim of providing actionable treatment strategies to achieve a healthy body weight from nature to nurture. This review summarizes the global trends in obesity with a special focus on the pathogenesis of obesity from genetic factors to epigenetic factors, from social environmental factors to microenvironment factors. Against this background, we discuss several possible intervention strategies to minimize BMI.
Topics: Adipose Tissue; Animals; Body Mass Index; Body Weight; Energy Intake; Humans; Obesity; Risk Factors
PubMed: 34552557
DOI: 10.3389/fendo.2021.706978 -
Gastroenterology May 2017Weight changes are accompanied by imbalances between calorie intake and expenditure. This fact is often misinterpreted to suggest that obesity is caused by gluttony and... (Review)
Review
Weight changes are accompanied by imbalances between calorie intake and expenditure. This fact is often misinterpreted to suggest that obesity is caused by gluttony and sloth and can be treated by simply advising people to eat less and move more. Rather various components of energy balance are dynamically interrelated and weight loss is resisted by counterbalancing physiological processes. While low-carbohydrate diets have been suggested to partially subvert these processes by increasing energy expenditure and promoting fat loss, our meta-analysis of 32 controlled feeding studies with isocaloric substitution of carbohydrate for fat found that both energy expenditure (26 kcal/d; P <.0001) and fat loss (16 g/d; P <.0001) were greater with lower fat diets. We review the components of energy balance and the mechanisms acting to resist weight loss in the context of static, settling point, and set-point models of body weight regulation, with the set-point model being most commensurate with current data.
Topics: Body Weight Maintenance; Diet; Energy Intake; Energy Metabolism; Exercise; Feedback, Physiological; Humans; Models, Biological; Obesity; Rest; Thermogenesis; Weight Loss
PubMed: 28193517
DOI: 10.1053/j.gastro.2017.01.052 -
European Journal of Internal Medicine Nov 2021Weight regain following weight loss is frequent problem that people with obesity face. This weight recidivism is often attributed to the lack of compliance with... (Review)
Review
Weight regain following weight loss is frequent problem that people with obesity face. This weight recidivism is often attributed to the lack of compliance with appropriate food habits and exercise. On the contrary, it is known that body weight and fat mass are regulated by numerous physiological mechanisms, far beyond voluntary food intake and physical exercise. Thus, the aim of this paper is to review the main peripheral and central mechanisms involved in weight regain. Gut hormone secretion profiles impact upon predisposition to weight regain according to an individual variability, although it is recognised a usual pattern of compensatory changes: a reduction in anorectic hormones secretion and an increase in orexigenic hormone. These changes lead to both increased appetite and reward value of food leading to increased energye intake. In addition, resting energy expenditure after weight loss is lower than expected according to body composition changes. This gap between observed and predicted energy expenditure following weight loss is named metabolic adaptation, which has been suggested to explain partly weight regain. This complicated scenario, beyond patient motivation, makes weight regain a challenge in long-term management interventions in patients with obesity.
Topics: Body Weight; Energy Intake; Energy Metabolism; Humans; Obesity; Weight Gain; Weight Loss
PubMed: 33461826
DOI: 10.1016/j.ejim.2021.01.002 -
Current Obesity Reports Dec 2016Metabolic adaptation to weight changes relates to body weight control, obesity and malnutrition. Adaptive thermogenesis (AT) refers to changes in resting and non-resting... (Review)
Review
Metabolic adaptation to weight changes relates to body weight control, obesity and malnutrition. Adaptive thermogenesis (AT) refers to changes in resting and non-resting energy expenditure (REE and nREE) which are independent from changes in fat-free mass (FFM) and FFM composition. AT differs in response to changes in energy balance. With negative energy balance, AT is directed towards energy sparing. It relates to a reset of biological defence of body weight and mainly refers to REE. After weight loss, AT of nREE adds to weight maintenance. During overfeeding, energy dissipation is explained by AT of the nREE component only. As to body weight regulation during weight loss, AT relates to two different set points with a settling between them. During early weight loss, the first set is related to depleted glycogen stores associated with the fall in insulin secretion where AT adds to meet brain's energy needs. During maintenance of reduced weight, the second set is related to low leptin levels keeping energy expenditure low to prevent triglyceride stores getting too low which is a risk for some basic biological functions (e.g., reproduction). Innovative topics of AT in humans are on its definition and assessment, its dynamics related to weight loss and its constitutional and neuro-endocrine determinants.
Topics: Body Composition; Diet, Reducing; Energy Metabolism; Humans; Obesity; Weight Gain; Weight Loss
PubMed: 27739007
DOI: 10.1007/s13679-016-0237-4 -
CA: a Cancer Journal For Clinicians Mar 2019The prevalence of excess body weight and the associated cancer burden have been rising over the past several decades globally. Between 1975 and 2016, the prevalence of... (Review)
Review
The prevalence of excess body weight and the associated cancer burden have been rising over the past several decades globally. Between 1975 and 2016, the prevalence of excess body weight in adults-defined as a body mass index (BMI) ≥ 25 kg/m -increased from nearly 21% in men and 24% in women to approximately 40% in both sexes. Notably, the prevalence of obesity (BMI ≥ 30 kg/m ) quadrupled in men, from 3% to 12%, and more than doubled in women, from 7% to 16%. This change, combined with population growth, resulted in a more than 6-fold increase in the number of obese adults, from 100 to 671 million. The largest absolute increase in obesity occurred among men and boys in high-income Western countries and among women and girls in Central Asia, the Middle East, and North Africa. The simultaneous rise in excess body weight in almost all countries is thought to be driven largely by changes in the global food system, which promotes energy-dense, nutrient-poor foods, alongside reduced opportunities for physical activity. In 2012, excess body weight accounted for approximately 3.9% of all cancers (544,300 cases) with proportion varying from less than 1% in low-income countries to 7% or 8% in some high-income Western countries and in Middle Eastern and Northern African countries. The attributable burden by sex was higher for women (368,500 cases) than for men (175,800 cases). Given the pandemic proportion of excess body weight in high-income countries and the increasing prevalence in low- and middle-income countries, the global cancer burden attributable to this condition is likely to increase in the future. There is emerging consensus on opportunities for obesity control through the multisectoral coordinated implementation of core policy actions to promote an environment conducive to a healthy diet and active living. The rapid increase in both the prevalence of excess body weight and the associated cancer burden highlights the need for a rejuvenated focus on identifying, implementing, and evaluating interventions to prevent and control excess body weight.
Topics: Body Mass Index; Cost of Illness; Female; Global Health; Humans; Male; Neoplasms; Obesity; Overweight; Prevalence; Risk Factors; Sex Factors
PubMed: 30548482
DOI: 10.3322/caac.21499 -
Journal of Basic and Clinical... Jan 2017The global prevalence of obesity has increased considerably in the last two decades. Obesity is caused by an imbalance between energy intake (EI) and energy expenditure... (Review)
Review
The global prevalence of obesity has increased considerably in the last two decades. Obesity is caused by an imbalance between energy intake (EI) and energy expenditure (EE), and thus negative energy balance is required to bring about weight loss, which can be achieved by either decreasing EI or increasing EE. Caffeine has been found to influence the energy balance by increasing EE and decreasing EI, therefore, it can potentially be useful as a body weight regulator. Caffeine improves weight maintenance through thermogenesis, fat oxidation, and EI. The sympathetic nervous system is involved in the regulation of energy balance and lipolysis (breakdown of lipids to glycerol and free fatty acids) and the sympathetic innervation of white adipose tissue may play an important role in the regulation of total body fat. This article reviews the current knowledge on the thermogenic properties of caffeine, and its effects on appetite and EI in relation to energy balance and body weight regulation.
Topics: Animals; Anti-Obesity Agents; Appetite; Body Weight; Caffeine; Energy Intake; Energy Metabolism; Humans; Obesity; Treatment Outcome
PubMed: 27824614
DOI: 10.1515/jbcpp-2016-0090 -
Nutrients Apr 2022We conducted a systematic review and meta-analysis of randomized clinical trials and pilot trial studies to compare the effectiveness of intermittent fasting (IF) and... (Meta-Analysis)
Meta-Analysis
We conducted a systematic review and meta-analysis of randomized clinical trials and pilot trial studies to compare the effectiveness of intermittent fasting (IF) and continuous calorie restriction (CCR) in overweight and obese people. The parameters included body mass index (BMI), body weight, and other metabolism-related indicators. A systematic search in PubMed, Embase, Cochrane Library, and Web of Science was conducted up to January 2022. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to measure the effectiveness. Publication bias was assessed using Egger's test. The stability of the results was evaluated using sensitivity analyses. The significance of body weight change (SMD = -0.21, 95% CI (-0.40, -0.02) = 0.028) was more significant after IF than CCR. There was no significant difference in BMI (SMD = 0.02, 95% CI (-0.16, 0.20) = 0.848) between IF and CCR. These findings suggest that IF may be superior to CCR for weight loss in some respects.
Topics: Body Weight; Caloric Restriction; Fasting; Humans; Overweight; Weight Loss
PubMed: 35565749
DOI: 10.3390/nu14091781 -
The American Journal of Clinical... May 2008Obesity, with its comorbidities such as metabolic syndrome and cardiovascular diseases, is a major public health concern. To address this problem, it is imperative to... (Review)
Review
Obesity, with its comorbidities such as metabolic syndrome and cardiovascular diseases, is a major public health concern. To address this problem, it is imperative to identify treatment interventions that target a variety of short- and long-term mechanisms. Although any dietary or lifestyle change must be personalized, controlled energy intake in association with a moderately elevated protein intake may represent an effective and practical weight-loss strategy. Potential beneficial outcomes associated with protein ingestion include the following: 1) increased satiety--protein generally increases satiety to a greater extent than carbohydrate or fat and may facilitate a reduction in energy consumption under ad libitum dietary conditions; 2) increased thermogenesis--higher-protein diets are associated with increased thermogenesis, which also influences satiety and augments energy expenditure (in the longer term, increased thermogenesis contributes to the relatively low-energy efficiency of protein); and 3) maintenance or accretion of fat-free mass--in some individuals, a moderately higher protein diet may provide a stimulatory effect on muscle protein anabolism, favoring the retention of lean muscle mass while improving metabolic profile. Nevertheless, any potential benefits associated with a moderately elevated protein intake must be evaluated in the light of customary dietary practices and individual variability.
Topics: Body Composition; Body Weight; Dietary Proteins; Energy Intake; Humans; Obesity; Satiation; Thermogenesis
PubMed: 18469287
DOI: 10.1093/ajcn/87.5.1558S -
International Journal of Obesity (2005) Aug 2015Obesity is a major global health problem and predisposes individuals to several comorbidities that can affect life expectancy. Interventions based on lifestyle... (Review)
Review
Obesity is a major global health problem and predisposes individuals to several comorbidities that can affect life expectancy. Interventions based on lifestyle modification (for example, improved diet and exercise) are integral components in the management of obesity. However, although weight loss can be achieved through dietary restriction and/or increased physical activity, over the long term many individuals regain weight. The aim of this article is to review the research into the processes and mechanisms that underpin weight regain after weight loss and comment on future strategies to address them. Maintenance of body weight is regulated by the interaction of a number of processes, encompassing homoeostatic, environmental and behavioural factors. In homoeostatic regulation, the hypothalamus has a central role in integrating signals regarding food intake, energy balance and body weight, while an 'obesogenic' environment and behavioural patterns exert effects on the amount and type of food intake and physical activity. The roles of other environmental factors are also now being considered, including sleep debt and iatrogenic effects of medications, many of which warrant further investigation. Unfortunately, physiological adaptations to weight loss favour weight regain. These changes include perturbations in the levels of circulating appetite-related hormones and energy homoeostasis, in addition to alterations in nutrient metabolism and subjective appetite. To maintain weight loss, individuals must adhere to behaviours that counteract physiological adaptations and other factors favouring weight regain. It is difficult to overcome physiology with behaviour. Weight loss medications and surgery change the physiology of body weight regulation and are the best chance for long-term success. An increased understanding of the physiology of weight loss and regain will underpin the development of future strategies to support overweight and obese individuals in their efforts to achieve and maintain weight loss.
Topics: Adaptation, Physiological; Comorbidity; Diet, Reducing; Energy Intake; Energy Metabolism; Exercise; Homeostasis; Humans; Obesity; Social Environment; Weight Gain; Weight Loss
PubMed: 25896063
DOI: 10.1038/ijo.2015.59