Obesity Science & Practice最新文献

Objective: A Western diet is associated with obesity, and the link between parental and offsprings' obesity is unclear. Among mice, this study examined how parents' Western diets affect their male offspring's obesity risk. This study further explored whether early exposure to obesogenic diets from either parent influences offsprings' long-term weight gain.

Methods: Three-week-old C57BL6/NTac mice were assigned to a Western diet (WD) or control diet (CD), given from six to 14 weeks old. Adults from these dietary groups were then mated to create four breeding combinations: CD/CD, CD/WD, WD/CD, and WD/WD. Weight gain trajectories were studied in parents (P) and offspring (F1), along with gene expression in four tissues of male offspring. Non-linear mixed effect modeling and q-mode PCA were used to assess the influence of sex, litter size, and parental diet on gene expression, before describing gene expression in more detail.

Results: Offsprings' weight gain was mainly influenced by sex and litter size, with no significant impact from parental diet. At the same time, gene expression differences among offspring, particularly between WD/WD and CD/CD offspring, were linked to genes associated with inflammation, stress response, and other obesity-relevant processes.

Conclusions: Obegenesic diet of two parents with obesity, rather than only one, likely alters the risks of metabolic disease in male mice even at normal weights.

Objective: Healthcare is one of the primary contexts in which people experience weight stigma (social devaluation due to body weight), especially in gynecological care, where people's bodies are exposed. Thus, people may feel especially vulnerable to negative evaluations from healthcare providers due to their weight, given the physical exposure which accompanies a breast exam, abdominal palpitations, and a pap-smear or cervical exam. The existing literature examining weight stigma in obstetrics and gynecology has focused almost exclusively on pregnant or postpartum women. The only research on weight stigma during routine gynecological care is based on qualitative studies with small samples.

Methods: Participants (N = 1087; cisgender women) were sampled on Qualtrics, and quotas were set to reflect the most recent US census. The women reported their experiences with gynecological care and then were asked to qualitatively describe what they most recently encountered.

Results: Overall, 14% of the women in this sample had experienced weight stigma in reproductive or gynecological care at least once, and about 5% of this sample reported that this occurred frequently. Participants with higher body weights (≥ 30 kg/m²) were more likely to report frequent weight stigma in gynecological care. A few participants reported more serious experiences, such as misdiagnosis, environmental or systemic weight stigma, and provider reluctance to perform a pelvic exam.

Conclusions: Women experience weight stigma in routine gynecological care, and future research should continue investigating the effects of these experiences.

Background: Few prior interventions for obesity have focused on reward-related eating. Researchers developed a mobile health mindfulness-based intervention, Eat Right Now (ERN), for improving reward related eating; ERN has not yet been feasibility tested as a weight loss intervention.

Objective: To obtain 6-month pilot and feasibility data in patients using the ERN intervention alone or with asynchronous coaching.

Methods: A 6-month, two-arm pilot and feasibility randomized trial was conducted involving 20 adults with a BMI ≥ 25 kg/m² recruited from Kaiser Permanente Washington. Participants were randomized to ERN alone or ERN plus individualized coaching. Weight loss was assessed via a Wi-Fi-enabled digital scale.

Results: Among the 20 randomized participants, 17 (85%) started the intervention and remained enrolled in six months. Among these, 82% (14/17) had weight data captured by a Wi-Fi scale and 70.5% (12/17) completed follow-up questionnaires at the 6-month time point. The coached ERN participants had 4.3% weight loss (95% confidence interval (CI): 2.3%, 6.3%) and uncoached participants had 3.6% weight loss (95% CI: 1.2%, 5.9%). Participants in both approaches reported reductions in reward-related eating.

Conclusions: This pilot randomized trial of ERN demonstrates the feasibility and acceptability of the intervention for the majority of both the coached and uncoached groups. Further efforts are needed to ensure high retention and data capture in future studies.

Background: Clinical decision support systems (CDSS) are electronic health record tools that support practitioners' decision-making at the point-of-care. CDSS may aid clinical care but are not often centered on patients or practitioners.

Aims: To develop and preliminarily test a CDSS designed to support evidence-based obesity treatment, promote a patient-centered experience, and integrate with clinical workflows.

Materials & methods: The CDSS allowed patients to complete a pre-visit questionnaire via the patient portal, which activated multiple elements for the primary care practitioner (PCP). A 3-month proof-of-concept study was conducted among 10 PCPs at 5 clinics to determine usefulness, usability, and acceptability through validated surveys (mean score ≥ 2.5 signified positive outcome; max 5). Using t-tests, pre-post differences in PCPs' frequency of self-reported clinical practices (1-never; 5-always) were examined.

Results: Most PCPs were physicians with mean experience of 10.8 years (SD 7.5). Overall, mean scores for usefulness, usability, and acceptability were 3.2 (SD 0.8), 3.5 (SD 0.9), and 3.6 (SD 0.9), respectively. PCPs reported significant increases in three key clinical practices-counseling on behavioral interventions (3.1 vs. 3.9 [p < 0.01]), referring to weight-loss programs (2.8 vs. 3.5 [p < 0.01]), and discussing anti-obesity medications (3.3 vs. 3.8 [p = 0.02]).

Conclusion: This weight management CDSS was useful and usable for PCPs and improved obesity-related practice habits. Future studies need to evaluate its impact on patient outcomes.

Objective: This study aimed to examine how anti-fat attitudes and attitudes toward obesity management influence orthopedic surgeons' treatment preferences for patients with obesity who are candidates for elective total knee arthroplasty (TKA).

Methods: A cross-sectional survey was conducted among 150 orthopedic surgeons using a web-based questionnaire. The survey included four sections: socio-demographic data, the Antifat Attitudes Questionnaire (AFA) assessing biases related to obesity (dislike, fear of fatness, and beliefs about willpower), an adapted questionnaire on attitudes toward obesity management, and a custom section on treatment preferences.

Results: The sample had a mean age of 43.4 years (SD = 9.7) and was predominantly male (70.7%). Participants exhibited moderate anti-fat attitudes alongside positive views on obesity management. Stronger anti-fat attitudes correlated with a preference for conservative treatments over surgery (r = 0.45 to r = 0.29, p < 0.001), whereas supportive attitudes toward obesity management were associated with less preference for conservative treatment (r = -0.53, p < 0.001). Male surgeons demonstrated higher anti-fat attitudes and a greater inclination for conservative treatment than female surgeons. Regression analysis identified attitudes toward obesity management as a significant predictor of treatment preferences (β = -0.54, p < 0.001).

Conclusion: Findings highlight the impact of weight stigma on clinical decision-making and emphasise the need for increased awareness and education to ensure equitable access to TKA for patients with obesity.

Background: Patients perceive high levels of weight prejudice, stigma, and discrimination within health systems, affecting their ability to manage their obesity and related chronic conditions. Scientific and patient obesity associations worldwide have prioritized the reduction of weight stigma to improve patient experiences in health systems and overall health outcomes. Since a significant proportion of the population is now living with multiple chronic diseases related to obesity, healthcare systems must shift toward multi-disease management frameworks incorporating person-centered and non-stigmatizing clinical conversations. Motivational Interviewing (MI) has the potential to transform clinical interactions by using non-stigmatizing language, communication, and practices. Studies using MI in obesity management have solely focused on weight loss outcomes, while other patient experience related outcomes would also be relevant to evaluate.

Methods: A narrative review was undertaken to critically analyze the potential impact of MI on obesity and chronic disease management practices and experiences.

Findings: An analysis and contextualization of the MI theoretical framework for obesity management, based on the philosophy of motivational spirit, was reviewed, assessing micro skills or strategies.

Conclusion: MI may assist healthcare professionals conduct non-stigmatizing clinical conversations in accordance with basic principles of collaborative therapeutic alliances. A proposal for research considerations that can help illuminate the potential for of MI in obesity management is also outlined.

Background: Obesity and dyslipidemia are interconnected complex conditions and their prevalence differs across different geographical regions. As a major risk factor for cardiovascular diseases, dyslipidemia is often misdiagnosed and inadequately treated, highlighting the need for region-specific public health policies. Therefore, the objective of this study was to examine the associations between BMI and dyslipidemia in the Prospective Epidemiological Research Studies in Iran (PERSIAN) Guilan Cohort study (PGCS) population.

Methods: This cross-sectional study analyzed the demographic and biochemical data from 10,519 participants of the PGCS population. Participants were divided into two groups with and without dyslipidemia and were compared based on BMI. Data analysis was performed in SPSS v16 with a significance level of < 0.05.

Results: The average age of the participants was 51.52 ± 8.90 years. The prevalence of dyslipidemia in all participants was equal to 75.83%. Among those with dyslipidemia, 41.18% and 35.39% had overweight and obesity, respectively. There was a positive association between BMI and the prevalence of dyslipidemia (unadjusted OR = 1.09, 95% confidence interval (CI): 1.08-1.10) (p < 0.01), indicating that for a one-unit increase in participants' BMI, the probability of having dyslipidemia increased by 9%, which remained statistically significant even after adjusting. Analysis of dyslipidemia components and BMI revealed a significant association between elevated TG and cholesterol, as well as low HDL levels and higher BMI (unadjusted OR = 1.04, 1.01, and 1.09, respectively) (p < 0.01). However, this was not statistically significant for high LDL levels (unadjusted OR = 1.01) (p = 0.05).

Conclusion: Given the high prevalence of dyslipidemia in our studied region and its strong association with obesity, prioritizing obesity management in public health decision-making is vital. Greater focus should be given on accessing and modifying the components of dyslipidemia, particularly LDL particles, as a potentially significant research target to prevent the mismanagement of dyslipidemia in individuals with obesity.

Background: Behavioral weight loss (WL) interventions typically follow standard diet and activity prescriptions for intervention duration to produce an energy deficit. Though average weight losses in these programs are clinically meaningful, there is heterogeneity in weight outcomes. Personalized diet and activity prescriptions may help increase the potency of WL programs by reducing this heterogeneity.

Methods: This 12-week pilot study randomized participants (n = 35; BMI 34.6 ± 4.9 kg/m², 34% with HbA1c 5.7%-6.4%) in a 3:1 ratio to a Personalized Behavioral Weight Loss (PBWL) or standard BWL and compared the feasibility and efficacy of these approaches. Both groups received a study mobile app, smart scale, activity tracker, and weekly telephone coaching sessions; PBWL participants received a continuous glucose monitoring device. PBWL participants had goals for 1) macronutrient composition (low fat or carbohydrate), 2) meal frequency (3 meals or meals and snacks), and 3) activity focus (daily or weekly goal); they experimented with different 3-part prescriptions, in random order and combination, for the first 4 weeks then picked their 3 goals to follow for weeks 5-12.

Results: Study retention (100%) and satisfaction were high. Mean 3-month weight loss (kg) was greater in PBWL (-7.08 (0.74)) than BWL (-3.79 (0.84), P = 0.03); 74% of PBWL and 63% of BWL participants were "optimizers" who achieved a 5% weight loss at 3 months. PBWL optimizers lost more weight (-8.66 (0.66)) than BWL optimizers (-4.76 (0.43), p < 0.001).

Conclusions: Experimentally-derived personalized prescriptions supported greater 12-week weight loss than standard recommendations. Trial Registration: ClinicalTrials.gov NCT04639076.

Background: The rising prevalence of obesity and type 2 diabetes (T2DM) is a significant public health concern, particularly in low- and middle-income countries. This study aimed to explore the association between physical activity levels, overweight/obesity, and T2DM in a nationwide survey of Nepalese adults.

Methods: This was a secondary analysis of the 2019 non-communicable diseases (NCD) risk factors STEPS survey conducted in Nepal. Demographic and anthropometric data, body mass index (BMI) and T2DM status were collected along with assessment of physical activity using Global Physical Activity Questionnaire (GPAQ). A two-stage data analysis was conducted, first using descriptive statistics to summarize participant characteristics and differences across BMI and T2DM status, and then applying multivariate analyses to assess associations between physical activity levels, BMI and T2DM.

Results: Of the 5284 participants included, 28.0% had overweight/obesity, 5.8% had obesity, and 6.5% had T2DM. The mean age of the participants was 40.1 years (95% CI: 39.8-40.6), and 63.9% were female. The overall physical activity energy expenditure was higher in the lean group (BMI < 25 kg/m²) compared to the those with overweight/obesity, and among participants without T2DM compared to those with T2DM. Sedentary behavior was more common among individuals with overweight/obesity and T2DM. A higher proportion of participants with low physical activity was observed in the overweight/obesity group compared to the lean group (8.9% vs. 6.3%) and the T2DM group compared to the non-T2DM group (11.7% vs. 6.7%). Low physical activity was associated with overweight/obesity (OR:1.4; 95% CI:1.1-1.8), obesity (OR:2.1; 95% CI:1.5-2.3), T2DM (OR:1.6; 95% CI:1.1-2.3) and T2DM in the presence of obesity (OR:3.6; 95% CI:1.7-7.8).

Conclusion: This study highlights the low rates of physical activity and higher rates of sedentary behavior among adults with overweight/obesity and T2DM in Nepal. Public health interventions promoting physical activity and reducing sedentary behavior may help reduce the burden of these NCDs.

Introduction: The association of screen time and physical activity with body weight in children has been investigated in cross-sectional and prospective studies, as well as randomized controlled trials. The present study extends previous research by examining how longitudinal within-person changes in screen time and physical activity relate to changes in Body Mass Index (BMI) in children, and how changes in screen time and physical activity relate to each other.

Methods: The data for the present study came from the PIER Youth Study. Data were collected from 971 children and their parents at two time points approximately 1 year apart. A multilevel modeling approach with measurement occasions nested within children was used to model changes in BMI across age.

Results: Within a child, a change in daily hours of TV viewing was associated with a corresponding change in BMI, whereas a change in daily hours of physical activity was associated with an opposite change in BMI. Within-person correlations between changes in screen time and physical activity were small but positive.

Conclusion: The present findings have important implications for interventions to reduce and prevent childhood overweight and obesity. Specifically, interventions should focus on both reducing daily TV viewing and promoting physical activity.