Obesities, Volume 2, Issue 3 (September 2022) – 8 articles

The present study aimed to identify the prevalence of risk and protective factors for noncommunicable disease (NCDs) among Brazilian adults with pre-obesity and obesity and compare it to that of non-overweight adults in the country. Data from the National Health Survey (NHS) 2013 (n = 40,942) and 2019 (n = 87,678) were used. Nutritional status was described for 2013 and 2019 according to sociodemographic characteristics, health conditions, and risk and protective factors for NCDs. Poisson regression models were used to analyze the crude and adjusted prevalence of risk and protective factors for NCDs with nutritional status in both years. Adults with pre-obesity and obesity were more likely to perform risk factors related to sedentary behavior (prolonged screen time) and less leisure-time physical activity (among adults with obesity) and active commuting (among adults with pre-obesity and obesity) and alcohol abuse. However, among adults with pre-obesity and obesity, a lower prevalence was observed in relation to the regular consumption of sweets and smoking. The identified risk and protective factors had a similar prevalence between 2013 and 2019. Brazilian adults with pre-obesity and obesity presented worrisome scenarios regarding risk and protective factor for NCDs. Full article

Metabolic diseases caused by gene and unhealthy living habits are increasing, which seriously threaten the life of people worldwide. Moreover, the microbiome has been shown to play an active role in the prevention and treatment of metabolic diseases. However, reliable evidence on renalase gene (Rnls), as a common gene related to metabolic diseases, is still lacking with regard to the influence on the microbiome. Hence, we investigated the effect of a normal diet (ND) and a high-fat diet (HFD) on the gut microbiota of Rnls knockout (Rnls^−/−) and wild-type (Rnls^+/+) mice. At the end of the 8-week experiment, DNA samples were extracted from fresh feces, and the composition of microbiota was profiled. The species in Rnls^+/+-ND group were Bifidobacterium pseudolongum and Lactobacillus reuteri. Conversely, the species in Rnls^−/−-ND group belonged to the genera Lactobacillus and Turicibacter. The HFD changed the ratio of Firmicutes/Bacteroidetes; while the bacteria in the Rnls^+/+-HFD and Rnls^−/−-HFD groups were different. Overall, this study not only revealed the composition of microbiota in Rnls^−/− mice, but also indicated that Rnls and the bacteria related to Rnls may be new candidates in the prevention and diagnosis of metabolic diseases at an early stage. Full article

Background: Moderate weight loss of 5–10% is considered a realistically achievable weight loss goal and is associated with decreased risk of obesity-related health complications. However, individuals tend to expect that they will lose as much as 20–30% of their body weight when they start a behavioral weight loss program. Current research is limited on how these expectations change over time during weight loss and the consequences of adjusting one’s expectations in a more realistic direction, particularly on a CBT-based program. Method: Therefore, this prospective cohort study evaluated whether individuals adjusted their weight loss expectations over time during real-world use of a mobile CBT-based behavior-change program (Noom Weight) and how this adjustment related to weight loss outcomes, as well as how the amount of adjustment depended on program engagement. Participants had recently signed up for Noom Weight and reported their weight, expectations for weight loss, and psychological well-being at baseline and six months. Engagement was automatically recorded by the program. Results: We found that after using Noom Weight for six months, participants’ expectations became more realistic (i.e., significantly decreased) compared to baseline (−5.77, s.e. = 0.57, p < 0.001), and this downward adjustment was associated with greater weight loss (b = 1.80, 95% CI 1.21–2.38, p < 0.001). Higher program engagement, particularly reading articles focused on CBT-based principles, was associated with greater decreases in expectations over time (b = −0.007, t = −2.22, p = 0.03). Conclusions: The results suggest that CBT-based principles may aid in adjusting weight loss expectations to more realistic levels and that such adjustment is associated with positive weight outcomes. Future research should build on these results by evaluating adjustment in weight loss expectations over time, rather than solely expectations at baseline. Full article

(1) Background: Obesity has become an important public health problem worldwide, and its characterization as a chronic disease reflects the impact of a complex and multifactorial condition. The treatment for obesity is based on lifestyle interventions that induce a negative energy balance. However, adherence to a lifestyle intervention is a challenge for many overweight and obese people. Thus, pharmacotherapy in the management of obesity is used to increase patient adherence to lifestyle changes and overcome the biological adaptations that occur with weight loss. Among these drugs, liraglutide stands out. Liraglutide is an analog of human glucagon-like peptide-1 (GLP-1), a hormone that regulates glucose-dependent insulin secretion, and glucagon release. (2) Results: Liraglutide appears to be effective in weight reduction and glycemic control in diabetic and obese patients, and combination of liraglutide and exercise can also bring benefits in weight loss. Furthermore, the combination of liraglutide and physical exercise can prevent adverse effects observed in the administration of liraglutide. (3) Conclusions: liraglutide seems to contribute to cardiometabolic improvement in obese individuals with or without diabetes, and the combination of liraglutide and physical exercise can prevent adverse effects observed in the administration of liraglutide. Full article

Adverse childhood experiences (ACEs) may predict markers of neurocognitive performance (i.e., executive function; EF) and brain health/plasticity (i.e., brain-derived neurotrophic factor; BDNF). This pilot examined: (1) ACES history and current EF performance, (2) ACEs history and current BDNF levels, and (3) current EF performance and BDNF levels. We hypothesized that higher ACEs would be associated with lower EF scores and that these patterns would be associated with serum BDNF levels. Given the pilot nature of the study, emphasis was placed on effect size vs. significance. Participants were 37 middle-aged women. Higher ACEs were not directly associated with EF scores (β = 0.08, p = 0.635) but showed potentially meaningful negative beta coefficients with proBDNF levels (β = −0.22, p = 0.200) and positive coefficients with mature BDNF (β = 0.28, p = 0.094). EF scores and proBDNF showed a positive relationship that did not reach significance (r = 0.28, p = 0.100) similar to EF scores and mature BDNF (r = 0.14, p = 0.406). In a modest pilot sample of middle-aged women with excess weight, higher ACEs were potentially associated with lower proBDNF and higher mature BDNF. Larger follow-up studies are warranted given the size of the detected coefficients and theoretical implications of ACEs and obesity as neurocognitively toxic for brain health and performance. Full article

Non-traditional settings, such as schools, early childhood education programs, and healthcare clinics, can play a critical role in preventing obesity by providing free and nutritious food outside of food pantries to households that are experiencing low or very low food security, particularly during emergency situations. This evaluation study describes a low-income population that attended free food and produce distribution events during the COVID-19 pandemic. In 2021, a cross-sectional survey was administered to this group (n = 1498) to assess their food security status, fruit and vegetable (F+V) consumption, and prevalence of chronic disease condition(s). Program and event assessments were carried out using descriptive, bivariate, and multivariable logistic regression analyses. More than a quarter (26%) of the participants attended the free food events for the first time. Approximately 70% reported some level of low food security, 57% to 64% did not meet F+V intake recommendations, and 37% had a diet-related chronic disease condition. In the adjusted models, households with very low food security had lower odds of meeting F+V recommendations (aOR, 0.41, 95% CI, 0.28, 0.58 and aOR, 0.27, 95% CI, 0.19, 0.39, respectively) and higher odds of having a chronic condition (aOR, 3.49, 95% CI, 2.34, 5.20) than those with high or marginal food security. Given these experiences, future research should examine how safety net food assistance programs can incorporate alternative service/distribution models to improve the nutritional value of the foods they offer. Full article

Objectives: To characterize a group of university students in social isolation regarding their eating behaviors and to investigate whether dieters have a tendency to engage in binge-eating. Study Design: Cross-sectional study carried out during Brazil’s first months of social isolation. Methods: University students filled out the Eating Attitudes Test—EAT, the Binge-eating Scale—BES, and the Hay questionnaire. In addition, the current research also evaluated food cravings (FC) and intuitive eating. Student’s t-test was used to compare the effect sizes (Cohen’s d) between groups. Results: More than 90% of participants were isolated from academic activities, and 68% reported significant dietary change. Those who dieted (n = 57) were less confident in signs of hunger and satiety (d = −0.9, p < 0.001) and had higher binge-eating and FC levels than those who did not diet. Conclusions: Data reinforces the high prevalence of risk for eating disorders in university students, the impact of dieting on FC, and intuitive eating during social isolation. Full article

Obesity incidence is rising worldwide, including women of reproductive age, contributing to increased gestations in which Maternal Obesity (MO) occurs. Offspring born to obese mothers present an increased predisposition to develop metabolic (e.g., obesity, diabetes) and cardiovascular disease (CVD). The developmental programming of the metabolic dysfunction in MO offspring can initiate in utero. The different availability of metabolic substrates, namely glucose, can modulate cellular growth, proliferation, and differentiation, resulting in different levels of tissue maturation and function. We defined the remodelling of these early processes as the first hit of metabolic disease programming. Among these, adipocyte early differentiation and gut dysbiosis are initial repercussions occurring in MO offspring, contributing to -tissue-specific dysfunction. The second hit of disease programming can be related to the endocrine–metabolic axis dysregulation. The endocrine–metabolic axis consists of multi-organ communication through the release of factors that are able to regulate the metabolic fate of cells of organs involved in physiological metabolic homeostasis. Upon adipose tissue and gut early dysregulation, these organs’ endocrine function can be programmed to the disrupted release of multiple factors (e.g., adiponectin, leptin, glucagon-like peptide). This can be perceived as a natural mechanism to overcome metabolic frailty in an attempt to prevent or postpone organ-specific disease. However, the action of these hormones on other tissues may potentiate metabolic dysfunction or even trigger disease in organs (liver, pancreas, heart) that were also programmed in utero for early disease. A second phase of the endocrine–metabolic dysregulation happens when the affected organs (e.g., liver and pancreas) self-produce an endocrine response, affecting all of the involved tissues and resulting in a new balance of the endocrine–metabolic axis. Altogether, the second hit exacerbates the organ-specific susceptibility to disease due to the new metabolic environment. The developmental programming of the endocrine–metabolic axis can start a vicious cycle of metabolic adaptations due to the release of factors, leading to an endocrine response that can jeopardize the organism’s function. Diseases programmed by MO can be boosted by endocrine dysregulation, namely Non-Alcoholic Fatty Liver Disease, Non-Alcoholic Fatty Pancreas Disease, and the aggravation of the adipose tissue and gut dysfunction. Chronic metabolic dysregulation can also predispose MO offspring to CVD through the modulation of the endocrine environment and/or the metabolic status. To cease the vicious cycle of MO disease transmission among generations and-provide preventive and specialized prenatal and postnatal care to MO offspring, it is necessary to understand the molecular mechanisms underlying the MO-related disease development. In this review, we summarize most of the developmental programming molecular events of the endocrine–metabolic axis described on the offspring exposed to MO, providing a brief overview of the potential mechanisms that predispose MO offspring to metabolic disease, and discuss the programming of the endocrine–metabolic axis as a plausible mechanism for metabolic disease predisposition in MO offspring. Full article