Catherine G. Coughlin, Emilie S. Zoltick, Fatima Cody Stanford, Mei-Sing Ong
Objective
The objective of this study was to examine the representation of historically marginalized racial and ethnic groups in pediatric obesity clinical trials.
Methods
We performed a cross-sectional analysis of clinical trials in pediatric obesity (participants aged ≤18 years) that were registered in ClinicalTrials.gov, were completed from January 2013 to August 2023, and were conducted in the United States. We quantified disparities in trial enrollment by calculating the enrollment-prevalence disparity (EPD) for each racial and ethnic group.
Results
A total of 260 trials met eligibility criteria, of which 128 trials (49.2%) reported race and/or ethnicity data. Enrollment of White, Hispanic, and Black children roughly reflects disease burden in these populations. However, relative to disease burden, Asian (EPD, −3.7%; IQR, −3.7% to 1.8%; p < 0.0001), American Indian and Alaska Native (EPD, −2.1%; IQR, −2.1% to −2.1%; p < 0.0001), and Native Hawaiian or other Pacific Islander (EPD, −0.6%; IQR, −0.6% to −0.6%; p < 0.0001) children were significantly underrepresented in these trials.
Conclusions
With the exception of Black and Hispanic children, historically marginalized racial groups were underrepresented in pediatric obesity trials, signifying a need to improve diversity of participants in these trials. Additionally, there are substantial gaps in the documentation of race and ethnicity information. Concerted efforts are needed to ensure adequate reporting of race and ethnicity information in clinical trials.
{"title":"Racial and ethnic disparities in clinical trials for pediatric obesity","authors":"Catherine G. Coughlin, Emilie S. Zoltick, Fatima Cody Stanford, Mei-Sing Ong","doi":"10.1002/oby.24228","DOIUrl":"10.1002/oby.24228","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to examine the representation of historically marginalized racial and ethnic groups in pediatric obesity clinical trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a cross-sectional analysis of clinical trials in pediatric obesity (participants aged ≤18 years) that were registered in ClinicalTrials.gov, were completed from January 2013 to August 2023, and were conducted in the United States. We quantified disparities in trial enrollment by calculating the enrollment-prevalence disparity (EPD) for each racial and ethnic group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 260 trials met eligibility criteria, of which 128 trials (49.2%) reported race and/or ethnicity data. Enrollment of White, Hispanic, and Black children roughly reflects disease burden in these populations. However, relative to disease burden, Asian (EPD, −3.7%; IQR, −3.7% to 1.8%; <i>p</i> < 0.0001), American Indian and Alaska Native (EPD, −2.1%; IQR, −2.1% to −2.1%; <i>p</i> < 0.0001), and Native Hawaiian or other Pacific Islander (EPD, −0.6%; IQR, −0.6% to −0.6%; <i>p</i> < 0.0001) children were significantly underrepresented in these trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>With the exception of Black and Hispanic children, historically marginalized racial groups were underrepresented in pediatric obesity trials, signifying a need to improve diversity of participants in these trials. Additionally, there are substantial gaps in the documentation of race and ethnicity information. Concerted efforts are needed to ensure adequate reporting of race and ethnicity information in clinical trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 3","pages":"560-566"},"PeriodicalIF":4.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jamy D. Ard, Donna H. Ryan, Patrick M. O'Neil, Robert F. Kushner, Holly R. Wyatt, Harold E. Bays, Frank L. Greenway, John M. Jakicic, Sharon Leonard, Yael Kenan, Eti Ganon-Elazar, Thomas A. Wadden
Objective
The objective of this study was to investigate the efficacy and safety of the Epitomee capsule versus placebo as an adjunct to high-intensity lifestyle intervention in participants with overweight or obesity.
Methods
The Randomized Evaluation of Efficacy and Safety of the Epitomee Capsule Trial (RESET) was a prospective, double-blind, placebo-controlled pivotal trial in adults with baseline BMI of 27.0 to 40.0 kg/m2. The co-primary endpoints at week 24 were percentage change from baseline in body weight for the Epitomee and placebo groups and proportion of Epitomee-treated patients achieving ≥5% weight loss compared with a 35% threshold. The primary safety endpoint was the incidence of device-related serious adverse events.
Results
A total of 138 participants received Epitomee and 141 received placebo. Mean (SD) change in body weight from baseline was −6.6% (6.5%) with Epitomee and −4.6% ( 4.7%) with placebo; least-squares means were −6.1% (0.6%) and −4.2% (0.6%), respectively (p = 0.0054). Fifty-six percent of Epitomee-treated participants attained ≥5% weight loss from baseline, which was significantly greater than the 35% predefined threshold (p < 0.0001). Twenty-seven percent of Epitomee-treated and eleven percent of placebo-treated participants achieved ≥10% weight loss. Adverse event rates were similar between the groups. No device-related serious adverse events occurred.
Conclusions
The Epitomee capsule is a safe and efficacious nonpharmacological option for weight management with potential broad application in participants with overweight or obesity.
{"title":"Efficacy and safety of a novel oral hydrogel capsule in adults with overweight or obesity: the pivotal randomized RESET study","authors":"Jamy D. Ard, Donna H. Ryan, Patrick M. O'Neil, Robert F. Kushner, Holly R. Wyatt, Harold E. Bays, Frank L. Greenway, John M. Jakicic, Sharon Leonard, Yael Kenan, Eti Ganon-Elazar, Thomas A. Wadden","doi":"10.1002/oby.24240","DOIUrl":"10.1002/oby.24240","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to investigate the efficacy and safety of the Epitomee capsule versus placebo as an adjunct to high-intensity lifestyle intervention in participants with overweight or obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Randomized Evaluation of Efficacy and Safety of the Epitomee Capsule Trial (RESET) was a prospective, double-blind, placebo-controlled pivotal trial in adults with baseline BMI of 27.0 to 40.0 kg/m<sup>2</sup>. The co-primary endpoints at week 24 were percentage change from baseline in body weight for the Epitomee and placebo groups and proportion of Epitomee-treated patients achieving ≥5% weight loss compared with a 35% threshold. The primary safety endpoint was the incidence of device-related serious adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 138 participants received Epitomee and 141 received placebo. Mean (SD) change in body weight from baseline was −6.6% (6.5%) with Epitomee and −4.6% ( 4.7%) with placebo; least-squares means were −6.1% (0.6%) and −4.2% (0.6%), respectively (<i>p</i> = 0.0054). Fifty-six percent of Epitomee-treated participants attained ≥5% weight loss from baseline, which was significantly greater than the 35% predefined threshold (<i>p</i> < 0.0001). Twenty-seven percent of Epitomee-treated and eleven percent of placebo-treated participants achieved ≥10% weight loss. Adverse event rates were similar between the groups. No device-related serious adverse events occurred.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Epitomee capsule is a safe and efficacious nonpharmacological option for weight management with potential broad application in participants with overweight or obesity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 3","pages":"500-511"},"PeriodicalIF":4.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.24240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hadia Nawaz, Haneul Lee, Sumin Kang, Hayoon Kim, Wooki Kim, Gwang-woong Go
Objective
Both alternate-day fasting (ADF) and calorie restriction (CR) are effective weight loss strategies. However, most individuals find it difficult to adhere to CR. Furthermore, CR can induce an excessive loss of not only fat but also muscle mass. This study aimed to compare the effects of ADF and pair-feeding (PF) CR on metabolic pathways underlying obesity in mice with high-fat diet (HFD)-induced obesity.
Methods
Male C57BL/6N Tac mice (n = 10 per group) were fed an HFD for 8 weeks to establish a diet-induced obesity model. Mice were then continued on the HFD with either alternate-day access to food or PF for the next 8 weeks. We measured body weight, adiposity, plasma biomarkers, and molecular mechanisms involving lipolysis and autophagy.
Results
Both ADF and PF resulted in comparable weight and fat loss. Compared with PF, ADF showed a significant reduction in liver weight and hepatic triglyceride levels. ADF significantly increased plasma ketone body levels and white adipose tissue lipolysis. Compared with PF, ADF tended to activate autophagy elongation and autophagosome formation, which were insignificant.
Conclusions
These findings indicated that ADF is a promising intervention for metabolic diseases, potentially due to its superior efficacy in promoting ketogenesis and lipolysis compared with PF.
{"title":"Alternate-day fasting enhanced weight loss and metabolic benefits over pair-fed calorie restriction in obese mice","authors":"Hadia Nawaz, Haneul Lee, Sumin Kang, Hayoon Kim, Wooki Kim, Gwang-woong Go","doi":"10.1002/oby.24211","DOIUrl":"10.1002/oby.24211","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Both alternate-day fasting (ADF) and calorie restriction (CR) are effective weight loss strategies. However, most individuals find it difficult to adhere to CR. Furthermore, CR can induce an excessive loss of not only fat but also muscle mass. This study aimed to compare the effects of ADF and pair-feeding (PF) CR on metabolic pathways underlying obesity in mice with high-fat diet (HFD)-induced obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Male C57BL/6N Tac mice (<i>n</i> = 10 per group) were fed an HFD for 8 weeks to establish a diet-induced obesity model. Mice were then continued on the HFD with either alternate-day access to food or PF for the next 8 weeks. We measured body weight, adiposity, plasma biomarkers, and molecular mechanisms involving lipolysis and autophagy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both ADF and PF resulted in comparable weight and fat loss. Compared with PF, ADF showed a significant reduction in liver weight and hepatic triglyceride levels. ADF significantly increased plasma ketone body levels and white adipose tissue lipolysis. Compared with PF, ADF tended to activate autophagy elongation and autophagosome formation, which were insignificant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings indicated that ADF is a promising intervention for metabolic diseases, potentially due to its superior efficacy in promoting ketogenesis and lipolysis compared with PF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 3","pages":"512-521"},"PeriodicalIF":4.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca Palmer, Rebecca H. Neiberg, Kristen M. Beavers, Steven E. Kahn, Denise K. Houston, Lynne Wagenknecht, Karen C. Johnson, Henry J. Pownall, Mark A. Espeland, For the Action for Health in Diabetes (Look AHEAD) Aging Study Group
Objective
The objective of this study was to elucidate associations between adiposity reduction and changes in HbA1c and insulin use among adults with type 2 diabetes and overweight or obesity.
Methods
Changes in BMI, waist circumference, and total percent fat mass were obtained over 8 years among 1316 individuals (aged 45–76 years) enrolled in the Look AHEAD (Action for Health in Diabetes) clinical trial of weight loss. Generalized linear models were used to assess relationships between 5% decreases in adiposity measures with glycated hemoglobin (HbA1c) and insulin use over time.
Results
A 5% reduction in total percent fat was associated with 0.15% (95% CI: 0.12%–0.18%) lower mean HbA1c. Similarly, 5% reductions in waist circumference and BMI were also associated with slightly lower mean HbA1c: 0.16% (95% CI: 0.13%–0.19%) and 0.13% (95% CI: 0.11%–0.16%), respectively. These reductions were associated with lower odds of insulin use over time, ranging from 21% lower odds for a 5% reduction in percent body fat to 32% lower odds for 5% reductions in waist circumference and BMI. Associations were evident across subgroups defined by sex, diabetes duration, obesity status, and intervention assignment.
Conclusions
Reductions in adiposity are associated with stabilized and slightly lower HbA1c and a marked reduction in the need for insulin therapy. These benefits generalize across clinical subgroups.
{"title":"Associations between decreases in adiposity and reductions in HbA1c and insulin use in the Look AHEAD cohort","authors":"Rebecca Palmer, Rebecca H. Neiberg, Kristen M. Beavers, Steven E. Kahn, Denise K. Houston, Lynne Wagenknecht, Karen C. Johnson, Henry J. Pownall, Mark A. Espeland, For the Action for Health in Diabetes (Look AHEAD) Aging Study Group","doi":"10.1002/oby.24242","DOIUrl":"10.1002/oby.24242","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to elucidate associations between adiposity reduction and changes in HbA1c and insulin use among adults with type 2 diabetes and overweight or obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Changes in BMI, waist circumference, and total percent fat mass were obtained over 8 years among 1316 individuals (aged 45–76 years) enrolled in the Look AHEAD (Action for Health in Diabetes) clinical trial of weight loss. Generalized linear models were used to assess relationships between 5% decreases in adiposity measures with glycated hemoglobin (HbA1c) and insulin use over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A 5% reduction in total percent fat was associated with 0.15% (95% CI: 0.12%–0.18%) lower mean HbA1c. Similarly, 5% reductions in waist circumference and BMI were also associated with slightly lower mean HbA1c: 0.16% (95% CI: 0.13%–0.19%) and 0.13% (95% CI: 0.11%–0.16%), respectively. These reductions were associated with lower odds of insulin use over time, ranging from 21% lower odds for a 5% reduction in percent body fat to 32% lower odds for 5% reductions in waist circumference and BMI. Associations were evident across subgroups defined by sex, diabetes duration, obesity status, and intervention assignment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Reductions in adiposity are associated with stabilized and slightly lower HbA1c and a marked reduction in the need for insulin therapy. These benefits generalize across clinical subgroups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 3","pages":"612-620"},"PeriodicalIF":4.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.24242","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The objective of this study was to investigate underlying mechanisms of long-term effective weight loss after laparoscopic sleeve gastrectomy (LSG) and effects on the medial orbitofrontal cortex (mOFC) and cognition.
Methods
A total of 18 individuals with obesity (BMI ≥ 30 kg/m2) underwent LSG. Clinical data, cognitive scores, and brain magnetic resonance imaging scans were evaluated before LSG and 12 months after LSG. We employed voxel-based morphometry analysis and seed-based resting-state functional connectivity (RSFC) analysis to assess LSG-induced structural and functional changes in mOFC. Partial correlation analysis and univariate and multivariate linear regression models were used to explore associations among biochemical indexes, neuroimaging, cognition, and weight loss.
Results
No significant improvement in general cognition was found after LSG. Decreases in gray matter volume of the bilateral mOFC and increases in RSFC of the right mOFC were observed 12 months after LSG. Weight loss was associated with RSFC, general cognitive scores, and triglyceride changes. Multivariate linear regression model revealed gray matter volume of the left mOFC and working memory scores at baseline explained 55.2% of the variation in weight loss.
Conclusions
These findings suggest that mOFC imaging and cognitive scores could serve as biomarkers for predicting persistent weight loss after LSG, which provides a solid foundation for a potential target for neuromodulation research.
{"title":"Medial orbitofrontal cortex structure, function, and cognition associates with weight loss for laparoscopic sleeve gastrectomy","authors":"Xin Li, Wen Zhang, Yan Bi, Yanjie Duan, Xitai Sun, Jiu Chen, Xin Zhang, Zhou Zhang, Zhengyang Zhu, Bing Zhang","doi":"10.1002/oby.24207","DOIUrl":"10.1002/oby.24207","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to investigate underlying mechanisms of long-term effective weight loss after laparoscopic sleeve gastrectomy (LSG) and effects on the medial orbitofrontal cortex (mOFC) and cognition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 18 individuals with obesity (BMI ≥ 30 kg/m<sup>2</sup>) underwent LSG. Clinical data, cognitive scores, and brain magnetic resonance imaging scans were evaluated before LSG and 12 months after LSG. We employed voxel-based morphometry analysis and seed-based resting-state functional connectivity (RSFC) analysis to assess LSG-induced structural and functional changes in mOFC. Partial correlation analysis and univariate and multivariate linear regression models were used to explore associations among biochemical indexes, neuroimaging, cognition, and weight loss.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant improvement in general cognition was found after LSG. Decreases in gray matter volume of the bilateral mOFC and increases in RSFC of the right mOFC were observed 12 months after LSG. Weight loss was associated with RSFC, general cognitive scores, and triglyceride changes. Multivariate linear regression model revealed gray matter volume of the left mOFC and working memory scores at baseline explained 55.2% of the variation in weight loss.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that mOFC imaging and cognitive scores could serve as biomarkers for predicting persistent weight loss after LSG, which provides a solid foundation for a potential target for neuromodulation research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 2","pages":"308-320"},"PeriodicalIF":4.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zhengting Liang, Huibo Qin, Binbin Su, Yanping Bao, Michael V. Vitiello, Gang Hu, Yunhe Wang
Objective
The objective was to evaluate the longitudinal patterns of central and general obesity, identify their genetic and behavioral risk determinants, and investigate the association of distinct obesity trajectories beyond middle age with subsequent cognitive decline and the risk of developing dementia in late life.
Methods
Using a nationally representative, longitudinal, community-based cohort, we examined trajectory patterns of obesity over a 14-year span beyond middle age employing latent mixture modeling. We then evaluated their relationship with subsequent cognitive decline through linear mixed models and with the risk of developing dementia using Cox models, adjusting for confounding variables.
Results
Among the 4751 eligible participants (mean age, 58.7 [SD 8.1] years; 57% female), our analysis identified five distinct BMI trajectories and four WC trajectories spanning a 14-year period. In comparison with individuals in the low-stable BMI group, characterized by a consistent and healthy body weight (range, 22.8–22.9 kg/m2), those in the high-stable group, maintaining a stable obesity status (range, 34.3–35.4 kg/m2), exhibited an elevated risk of developing dementia (odds ratio [OR], 1.43; 95% CI: 1.02 to 2.00) and experienced a more accelerated cognitive decline over 6 years (difference in 6-year decline, −0.11 SD [95% CI: −0.18 to −0.03]). Similarly, when compared with participants in the low-stable WC group, indicating a stable and healthy WC (range, 76–79 cm), those in the high-increasing WC group, showing an increasing trend (range, 115–122 cm), demonstrated an increased risk of developing dementia (OR, 1.57, 95% CI: 1.01 to 2.49) and experienced a swifter cognitive decline (OR: −0.18 [95% CI: −0.28 to −0.07]).
Conclusions
General and central obesity trajectories beyond midlife with persistently high or increasing patterns were significantly associated with an increased risk of developing cognitive decline and dementia in late life. Longitudinal obesity patterns may assist in precise identification of older adults at risk of developing cognitive impairment for targeted intervention.
{"title":"Trajectories of general and central obesity beyond middle age in relation to late-life cognitive decline and dementia","authors":"Zhengting Liang, Huibo Qin, Binbin Su, Yanping Bao, Michael V. Vitiello, Gang Hu, Yunhe Wang","doi":"10.1002/oby.24208","DOIUrl":"10.1002/oby.24208","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective was to evaluate the longitudinal patterns of central and general obesity, identify their genetic and behavioral risk determinants, and investigate the association of distinct obesity trajectories beyond middle age with subsequent cognitive decline and the risk of developing dementia in late life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a nationally representative, longitudinal, community-based cohort, we examined trajectory patterns of obesity over a 14-year span beyond middle age employing latent mixture modeling. We then evaluated their relationship with subsequent cognitive decline through linear mixed models and with the risk of developing dementia using Cox models, adjusting for confounding variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 4751 eligible participants (mean age, 58.7 [SD 8.1] years; 57% female), our analysis identified five distinct BMI trajectories and four WC trajectories spanning a 14-year period. In comparison with individuals in the low-stable BMI group, characterized by a consistent and healthy body weight (range, 22.8–22.9 kg/m<sup>2</sup>), those in the high-stable group, maintaining a stable obesity status (range, 34.3–35.4 kg/m<sup>2</sup>), exhibited an elevated risk of developing dementia (odds ratio [OR], 1.43; 95% CI: 1.02 to 2.00) and experienced a more accelerated cognitive decline over 6 years (difference in 6-year decline, −0.11 SD [95% CI: −0.18 to −0.03]). Similarly, when compared with participants in the low-stable WC group, indicating a stable and healthy WC (range, 76–79 cm), those in the high-increasing WC group, showing an increasing trend (range, 115–122 cm), demonstrated an increased risk of developing dementia (OR, 1.57, 95% CI: 1.01 to 2.49) and experienced a swifter cognitive decline (OR: −0.18 [95% CI: −0.28 to −0.07]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>General and central obesity trajectories beyond midlife with persistently high or increasing patterns were significantly associated with an increased risk of developing cognitive decline and dementia in late life. Longitudinal obesity patterns may assist in precise identification of older adults at risk of developing cognitive impairment for targeted intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 2","pages":"405-415"},"PeriodicalIF":4.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Calorie labeling laws: who is affected and why?","authors":"Charles Courtemanche","doi":"10.1002/oby.24237","DOIUrl":"10.1002/oby.24237","url":null,"abstract":"","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 2","pages":"223-224"},"PeriodicalIF":4.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ammara Aqeel, Melissa C. Kay, Jun Zeng, Brianna L. Petrone, Chengxin Yang, Tracy Truong, Covington B. Brown, Sharon Jiang, Veronica M. Carrion, Stephanie Bryant, Michelle C. Kirtley, Cody D. Neshteruk, Sarah C. Armstrong, Lawrence A. David
Objective
We assessed the impact of a food-provisioning intervention on diet quality in children with obesity.
Methods
Participants (n = 33, aged 6–11 years) were randomly assigned to either usual care (intensive health behavior and lifestyle treatment) or intervention (usual care + food provisioning; high-fiber, low-dairy diet) for 4 weeks. The primary outcome was a change in child diet quality at Week 4. Secondary outcomes were changes in weight, food insecurity, gut microbiome composition (16S ribosomal RNA), and dietary intake, measured via an objective DNA-based biomarker (i.e., FoodSeq). Genomic dietary data were analyzed against a larger pediatric adolescent obesity cohort (n = 195, aged 10–18 years) from similar households.
Results
Intervention demonstrated changes across all assessed diet components and was more effective than usual care in increasing whole grain (β = 0.20, 95% CI: 0.05 to 0.34; p = 0.013) and fiber (β = 2.52, 95% CI: 1.28 to 3.76; p < 0.001) and decreasing dairy (β = −1.31, 95% CI: −2.02 to −0.60; p = 0.001). FoodSeq results, highly concordant with grocery orders (adjusted R2 = 0.65; p < 0.001), indicated a dietary shift toward low-energy-density plant taxa in the intervention relative to a prior survey of diet in a related cohort (β = 8.64, 95% CI: 5.18 to 12.14; p < 0.001). No significant changes were observed in microbiome, weight, or food insecurity.
Conclusions
Our study supports the potential of dietitian-guided food provisioning for improving diet quality in children with obesity and demonstrates an objective genomic approach for evaluating dietary shifts.
{"title":"Grocery intervention and DNA-based assessment to improve diet quality in pediatric obesity: a pilot randomized controlled study","authors":"Ammara Aqeel, Melissa C. Kay, Jun Zeng, Brianna L. Petrone, Chengxin Yang, Tracy Truong, Covington B. Brown, Sharon Jiang, Veronica M. Carrion, Stephanie Bryant, Michelle C. Kirtley, Cody D. Neshteruk, Sarah C. Armstrong, Lawrence A. David","doi":"10.1002/oby.24205","DOIUrl":"10.1002/oby.24205","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We assessed the impact of a food-provisioning intervention on diet quality in children with obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 33, aged 6–11 years) were randomly assigned to either usual care (intensive health behavior and lifestyle treatment) or intervention (usual care + food provisioning; high-fiber, low-dairy diet) for 4 weeks. The primary outcome was a change in child diet quality at Week 4. Secondary outcomes were changes in weight, food insecurity, gut microbiome composition (16S ribosomal RNA), and dietary intake, measured via an objective DNA-based biomarker (i.e., FoodSeq). Genomic dietary data were analyzed against a larger pediatric adolescent obesity cohort (<i>n</i> = 195, aged 10–18 years) from similar households.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Intervention demonstrated changes across all assessed diet components and was more effective than usual care in increasing whole grain (β = 0.20, 95% CI: 0.05 to 0.34; <i>p</i> = 0.013) and fiber (β = 2.52, 95% CI: 1.28 to 3.76; <i>p</i> < 0.001) and decreasing dairy (β = −1.31, 95% CI: −2.02 to −0.60; <i>p</i> = 0.001). FoodSeq results, highly concordant with grocery orders (adjusted <i>R</i><sup>2</sup> = 0.65; <i>p</i> < 0.001), indicated a dietary shift toward low-energy-density plant taxa in the intervention relative to a prior survey of diet in a related cohort (β = 8.64, 95% CI: 5.18 to 12.14; <i>p</i> < 0.001). No significant changes were observed in microbiome, weight, or food insecurity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study supports the potential of dietitian-guided food provisioning for improving diet quality in children with obesity and demonstrates an objective genomic approach for evaluating dietary shifts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 2","pages":"331-345"},"PeriodicalIF":4.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kenny Arbuckle, Reema Sharma, Frannie E. Drake, Abigail Usiyevich, Sarah Usman, Bridget A. Matikainen-Ankney
Objective
Obesogenic diets induce persistent changes in physical activity and motivation. It remains unclear whether these behavioral changes are driven by weight gain or exposure to obesogenic diets themselves. We investigated how exposure to a high-fat diet (HFD) in the absence of obesity affected physical activity, food motivation, and circadian patterns in mice.
Methods
C57Bl6/J mice were given ~80% of their daily calories in an HFD, known as isocaloric feeding, along with ad libitum access to laboratory chow. Weekly weights, physical activity levels, circadian patterns, operant behavior, and peripheral blood metabolic markers were measured to determine how an isocaloric HFD affected behavior and physiology. Following this period, the same cohort was exposed to an ad libitum HFD to monitor changes in weight gain and physical activity.
Results
An isocaloric HFD did not significantly increase weight or change physical activity levels. An isocaloric HFD decreased motivation for sucrose pellets but did not alter weight gain with ad libitum HFD exposure.
Conclusions
An isocaloric HFD was associated with decreased motivation for sucrose, as observed in reports of rodent models of obesity. These findings suggest that exposure to an obesogenic diet, even in the absence of significant weight gain, can induce behavioral changes associated with obesity.
{"title":"Isocaloric high-fat diet decreases motivation in the absence of obesity","authors":"Kenny Arbuckle, Reema Sharma, Frannie E. Drake, Abigail Usiyevich, Sarah Usman, Bridget A. Matikainen-Ankney","doi":"10.1002/oby.24227","DOIUrl":"10.1002/oby.24227","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Obesogenic diets induce persistent changes in physical activity and motivation. It remains unclear whether these behavioral changes are driven by weight gain or exposure to obesogenic diets themselves. We investigated how exposure to a high-fat diet (HFD) in the absence of obesity affected physical activity, food motivation, and circadian patterns in mice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>C57Bl6/J mice were given ~80% of their daily calories in an HFD, known as isocaloric feeding, along with ad libitum access to laboratory chow. Weekly weights, physical activity levels, circadian patterns, operant behavior, and peripheral blood metabolic markers were measured to determine how an isocaloric HFD affected behavior and physiology. Following this period, the same cohort was exposed to an ad libitum HFD to monitor changes in weight gain and physical activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>An isocaloric HFD did not significantly increase weight or change physical activity levels. An isocaloric HFD decreased motivation for sucrose pellets but did not alter weight gain with ad libitum HFD exposure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An isocaloric HFD was associated with decreased motivation for sucrose, as observed in reports of rodent models of obesity. These findings suggest that exposure to an obesogenic diet, even in the absence of significant weight gain, can induce behavioral changes associated with obesity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 2","pages":"243-249"},"PeriodicalIF":4.2,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thiamine deficiency is common after bariatric surgery, but patients with obesity may be deficient in thiamine even before surgery. The purpose of this research was to determine the prevalence of thiamine deficiency in patients with obesity at a medical weight-management clinic and assess the relationship between recent weight loss and thiamine deficiency.
Methods
For this observational study, medical records were reviewed for patients (n = 146) at the nonsurgical obesity medicine and preoperative bariatric surgery clinic at a Veterans Affairs Medical Center between January 1, 2012, and January 31, 2019. Thiamine deficiency was defined as a value less than the test reference range. χ2 tests were used to assess differences in thiamine deficiency by race, gender, and type 2 diabetes status. Logistic regression was used to evaluate the relationship between weight loss and thiamine deficiency.
Results
Thiamine deficiency was found in 32.2% of patients. There were no differences in the prevalence of deficiency by gender, race, or type 2 diabetes status. Weight loss was associated with increased risk for deficiency, although this was not statistically significant (odds ratio = 2.04, 95% CI: 0.79–5.27).
Conclusions
Approximately one-third of patients evaluated had a test result indicating thiamine deficiency. All people with obesity may benefit from additional nutritional screening.
{"title":"Thiamine deficiency in US veterans with obesity","authors":"Elizabeth Costello, Jennifer Kerns","doi":"10.1002/oby.24210","DOIUrl":"10.1002/oby.24210","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Thiamine deficiency is common after bariatric surgery, but patients with obesity may be deficient in thiamine even before surgery. The purpose of this research was to determine the prevalence of thiamine deficiency in patients with obesity at a medical weight-management clinic and assess the relationship between recent weight loss and thiamine deficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>For this observational study, medical records were reviewed for patients (<i>n</i> = 146) at the nonsurgical obesity medicine and preoperative bariatric surgery clinic at a Veterans Affairs Medical Center between January 1, 2012, and January 31, 2019. Thiamine deficiency was defined as a value less than the test reference range. χ<sup>2</sup> tests were used to assess differences in thiamine deficiency by race, gender, and type 2 diabetes status. Logistic regression was used to evaluate the relationship between weight loss and thiamine deficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thiamine deficiency was found in 32.2% of patients. There were no differences in the prevalence of deficiency by gender, race, or type 2 diabetes status. Weight loss was associated with increased risk for deficiency, although this was not statistically significant (odds ratio = 2.04, 95% CI: 0.79–5.27).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Approximately one-third of patients evaluated had a test result indicating thiamine deficiency. All people with obesity may benefit from additional nutritional screening.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 2","pages":"416-421"},"PeriodicalIF":4.2,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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