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16 pages, 1195 KiB

Open AccessArticle

Gut Microbiota Patterns Predicting Long-Term Weight Loss Success in Individuals with Obesity Undergoing Nonsurgical Therapy

by Stephan C. Bischoff, Nguyen K. Nguyen, Benjamin Seethaler, Julia Beisner, Philipp Kügler and Thorsten Stefan

Nutrients 2022, 14(15), 3182; https://doi.org/10.3390/nu14153182 - 3 Aug 2022

Cited by 8 | Viewed by 2218

Abstract

Background: The long-term success of nonsurgical weight reduction programs is variable; thus, predictors of outcome are of major interest. We hypothesized that the intestinal microbiota known to be linked with diet and obesity contain such predictive elements. Methods: Metagenome analysis by [...] Read more.

Background: The long-term success of nonsurgical weight reduction programs is variable; thus, predictors of outcome are of major interest. We hypothesized that the intestinal microbiota known to be linked with diet and obesity contain such predictive elements. Methods: Metagenome analysis by shotgun sequencing of stool DNA was performed in a cohort of 15 adults with obesity (mean body mass index 43.1 kg/m²) who underwent a one-year multidisciplinary weight loss program and another year of follow-up. Eight individuals were persistently successful (mean relative weight loss 18.2%), and seven individuals were not successful (0.2%). The relationship between relative abundancies of bacterial genera/species and changes in relative weight loss or body mass index was studied using three different statistical modeling methods. Results: When combining the predictor variables selected by the applied statistical modeling, we identified seven bacterial genera and eight bacterial species as candidates for predicting success of weight loss. By classification of relative weight-loss predictions for each patient using 2–5 term models, 13 or 14 out of 15 individuals were predicted correctly. Conclusions: Our data strongly suggest that gut microbiota patterns allow individual prediction of long-term weight loss success. Prediction accuracy seems to be high but needs confirmation by larger prospective trials. Full article

(This article belongs to the Special Issue Weight Management Interventions: Predictors and Outcomes)

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15 pages, 1370 KiB

Open AccessArticle

Real-World Data of a Group-Based Formula Low Energy Diet Programme in Achieving Type 2 Diabetes Remission and Weight Loss in an Ethnically Diverse Population in the UK: A Service Evaluation

by Owen Marples, Laura Resca, Julija Plavska, Samina Hassan, Vibhuti Mistry, Ritwika Mallik and Adrian Brown

Nutrients 2022, 14(15), 3146; https://doi.org/10.3390/nu14153146 - 30 Jul 2022

Cited by 2 | Viewed by 3308

Abstract

(1) Background: Formula low energy diets (LED) are effective at inducing weight loss and type 2 diabetes (T2DM) remission. However, the effect of LED programmes in ethnic minority groups in the UK is unknown. (2) Methods: A service-evaluation was undertaken of a group-based [...] Read more.

(1) Background: Formula low energy diets (LED) are effective at inducing weight loss and type 2 diabetes (T2DM) remission. However, the effect of LED programmes in ethnic minority groups in the UK is unknown. (2) Methods: A service-evaluation was undertaken of a group-based LED, total diet replacement (TDR) programme in London, UK. The programme included: a 12-week TDR phase, 9-week food reintroduction and a 31-week weight maintenance phase and was delivered by a diabetes multi-disciplinary team. (3) Results: Between November 2018 and March 2020, 216 individuals were referred, 37 commenced the programme, with 29 completing (78%). The majority were of Black British (20%) ethnicity with a mean (SD) age of 50.4 (10.5) years, a body mass index of 34.4 (4.4) kg/m² and a T2DM duration of 4.2 (3.6) years. At 12 months, 65.7% achieved T2DM remission, with a mean bodyweight loss of 11.6 (8.9) kg. Completers lost 15.8 (5.3) kg, with 31.4% of participants achieving ≥15 kg weight loss. Quality of life measures showed significant improvements. (4) Conclusions: This service evaluation shows for the first time in the UK that a group-based formula LED programme can be effective in achieving T2DM remission and weight loss in an ethnical diverse population. Full article

(This article belongs to the Special Issue Weight Management Interventions: Predictors and Outcomes)

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17 pages, 1244 KiB

Open AccessArticle

Vitamin D Levels as an Important Predictor for Type 2 Diabetes Mellitus and Weight Regain Post-Sleeve Gastrectomy

by Alanoud Aladel, Alice M. Murphy, Jenny Abraham, Neha Shah, Thomas M. Barber, Graham Ball, Vinod Menon, Milan K. Piya and Philip G. McTernan

Nutrients 2022, 14(10), 2052; https://doi.org/10.3390/nu14102052 - 13 May 2022

Cited by 1 | Viewed by 2796

Abstract

Weight Loss Surgery (WLS), including sleeve-gastrectomy (SG), results in significant weight loss and improved metabolic health in severe obesity (BMI ≥ 35 kg/m²). Previous studies suggest post-operative health benefits are impacted by nutrient deficiencies, such as Vitamin D (25(OH)D) deficiency, while [...] Read more.

Weight Loss Surgery (WLS), including sleeve-gastrectomy (SG), results in significant weight loss and improved metabolic health in severe obesity (BMI ≥ 35 kg/m²). Previous studies suggest post-operative health benefits are impacted by nutrient deficiencies, such as Vitamin D (25(OH)D) deficiency, while it is currently unknown whether nutrient levels may actually predict post-surgery outcomes. As such, this study investigated whether 25(OH)D levels could predict metabolic improvements in patients who underwent SG. Patients with severe obesity (n = 309; 75% female) undergoing SG participated in this ethics-approved, non-randomized retrospective cohort study. Anthropometry, clinical data, 25(OH)D levels and serum markers were collected at baseline, 6-, 12- and 18-months post-surgery. SG surgery resulted in significant improvements in metabolic health at 6- and 12-months post-surgery compared with baseline, as expected. Patients with higher baseline 25(OH)D had significantly lower HbA1c levels post-surgery (p < 0.01) and better post-surgical T2DM outcomes, including reduced weight regain (p < 0.05). Further analysis revealed that baseline 25(OH)D could predict HbA1c levels, weight regain and T2DM remission one-year post-surgery, accounting for 7.5% of HbA1c divergence (p < 0.01). These data highlight that higher circulating 25(OH)D levels are associated with significant metabolic health improvements post-surgery, notably, that such baseline levels are able to predict those who attain T2DM remission. This highlights the importance of 25(OH)D as a predictive biomarker of post-surgery benefits. Full article

(This article belongs to the Special Issue Weight Management Interventions: Predictors and Outcomes)

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14 pages, 332 KiB

Open AccessArticle

Determinants of Acceptance of Weight Management Applications in Overweight and Obese Individuals: Using an Extended Unified Theory of Acceptance and Use of Technology Model

by Alexander Bäuerle, Anna-Lena Frewer, Vanessa Rentrop, Lynik Chantal Schüren, Marco Niedergethmann, Julia Lortz, Eva-Maria Skoda and Martin Teufel

Nutrients 2022, 14(9), 1968; https://doi.org/10.3390/nu14091968 - 8 May 2022

Cited by 10 | Viewed by 2190

Abstract

Overweight and obesity carry a tremendous burden in terms of physiological and psychological comorbidities. There is a great variety of weight management applications to support weight reduction, but a systematical analysis of individuals’ needs and requirements to adopt sustaining lifestyle changes is missing [...] Read more.

Overweight and obesity carry a tremendous burden in terms of physiological and psychological comorbidities. There is a great variety of weight management applications to support weight reduction, but a systematical analysis of individuals’ needs and requirements to adopt sustaining lifestyle changes is missing so far. This study aimed to assess the acceptance of such applications and its underlying predictors in individuals with overweight/obesity. A cross-sectional study was conducted, including 439 overweight/obese individuals. Health-related internet use and acceptance of weight management applications were examined using a modified questionnaire based on the Unified Theory of Acceptance and Use of Technology (UTAUT). The general acceptance of weight management applications was high, with significant age differences. Compared to older individuals, younger ones showed a higher acceptance. BMI was not significantly associated with acceptance. Besides psychometric data and eHealth-related data, performance expectancy, effort expectancy, and social influence proved to be significant predictors for acceptance. The total variance explanation provided by the extended UTAUT model was 61.2%. The knowledge of the influencing factors on acceptance might be useful in developing, optimizing, and establishing weight management applications. For determining acceptance and its predictors of weight management applications, the UTAUT model is a valid approach. Full article

(This article belongs to the Special Issue Weight Management Interventions: Predictors and Outcomes)

12 pages, 581 KiB

Open AccessArticle

Clinical Use of the Edmonton Obesity Staging System for the Assessment of Weight Management Outcomes in People with Class 3 Obesity

by Raymond Kodsi, Ritesh Chimoriya, David Medveczky, Kathy Grudzinskas, Evan Atlantis, Abd A. Tahrani, Nic Kormas and Milan K. Piya

Nutrients 2022, 14(5), 967; https://doi.org/10.3390/nu14050967 - 24 Feb 2022

Cited by 6 | Viewed by 4608

Abstract

We aimed to assess weight loss and metabolic outcomes by severity of weight-related complications following an intensive non-surgical weight management program (WMP) in an Australian public hospital. A retrospective cohort study of all patients aged ≥18 years with body mass index (BMI) ≥ [...] Read more.

We aimed to assess weight loss and metabolic outcomes by severity of weight-related complications following an intensive non-surgical weight management program (WMP) in an Australian public hospital. A retrospective cohort study of all patients aged ≥18 years with body mass index (BMI) ≥ 40 enrolled in the WMP during March 2018–March 2019 with 12-month follow-up information were stratified using the Edmonton Obesity Staging System (EOSS). Of 178 patients enrolled in the WMP, 112 (62.9%) completed at least 12 months’ treatment. Most patients (96.6%) met EOSS-2 (56.7%) or EOSS-3 (39.9%) criteria for analysis. Both groups lost significant weight from baseline to 12 months; EOSS-2: 139.4 ± 31.8 kg vs. 131.8 ± 31.8 kg (p < 0.001) and EOSS-3: 141.4 ± 24.2 kg vs. 129.8 ± 24.3 kg (p < 0.001). After adjusting for baseline age, sex and employment status, mean weight loss was similar but a greater proportion of EOSS-3 achieved >10% weight loss compared to EOSS-2, (40% vs. 15.9%, p = 0.024). Changes in metabolic parameters including HbA1c, BP and lipids did not differ between EOSS-2 and 3. Despite increased clinical severity, adult patients with class 3 obesity achieved clinically meaningful weight loss and similar improvements in metabolic parameters compared to patients with less severe complications after 12 months in an intensive non-surgical WMP. Full article

(This article belongs to the Special Issue Weight Management Interventions: Predictors and Outcomes)

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11 pages, 714 KiB

Open AccessArticle

Incorporating Post-Cessation Weight-Control Coaching into Smoking Cessation Therapy to Reduce Type 2 Diabetes Risk

by Chien-Hsieh Chiang, Yi-Han Sheu, Fei-Ran Guo, Wan-Wan Lin, Guan-Ru Chen and Kuo-Chin Huang

Nutrients 2021, 13(10), 3360; https://doi.org/10.3390/nu13103360 - 25 Sep 2021

Viewed by 2099

Abstract

Post-cessation weight gain (PCWG) facilitates short-term type 2 diabetes (T2D) risk in prediabetic smokers in the absence of complementary measures. In this shared decision-making-based non-randomized controlled trial, prediabetic smokers joined the Fight Tobacco and Stay Fit (FIT2) program or received usual care. The [...] Read more.

Post-cessation weight gain (PCWG) facilitates short-term type 2 diabetes (T2D) risk in prediabetic smokers in the absence of complementary measures. In this shared decision-making-based non-randomized controlled trial, prediabetic smokers joined the Fight Tobacco and Stay Fit (FIT2) program or received usual care. The 16-week FIT2 program combined smoking cessation therapy with individualized coaching in diet and physical activity strategies for PCWG restriction (NCT01926041 at ClinicalTrials.gov). During a mean follow-up period of 1316 days, 217 participants (36.8%) developed T2D, and 68 (11.5%) regressed to normoglycemia. In the intention-to-treat analysis (n = 589), the FIT2 program was associated with a reduced T2D risk (HR, 0.58; 95% CI, 0.40–0.84) and a higher probability of regression to normoglycemia (HR, 1.91; 95% CI, 1.04–3.53) compared with usual care. The post-program quitters were at lower T2D risk (HR, 0.63; 95% CI, 0.44–0.92) and were more likely to regress to normoglycemia (HR, 1.83; 95% CI, 1.01–3.30) compared with the controls in the time-varying analysis (n = 532). We demonstrated that the FIT2 program was negatively associated with long-term T2D risk and positively associated with the probability of regression to normoglycemia compared with usual care. To prevent T2D development, we recommend simultaneously promoting smoking abstinence and lifestyle coaching for PCWG restriction. Full article

(This article belongs to the Special Issue Weight Management Interventions: Predictors and Outcomes)

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Other

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18 pages, 1223 KiB

Open AccessSystematic Review

Psychological Interventions and Bariatric Surgery among People with Clinically Severe Obesity—A Systematic Review with Bayesian Meta-Analysis

by Dawid Storman, Mateusz Jan Świerz, Monika Storman, Katarzyna Weronika Jasińska, Paweł Jemioło and Małgorzata Maria Bała

Nutrients 2022, 14(8), 1592; https://doi.org/10.3390/nu14081592 - 12 Apr 2022

Cited by 6 | Viewed by 2585

Abstract

Aim: To assess the effectiveness of perioperative psychological interventions provided to patients with clinically severe obesity undergoing bariatric surgery regarding weight loss, BMI, quality of life, and psychosocial health using the Bayesian approach. Methods: We considered randomised trials that assessed the beneficial and [...] Read more.

Aim: To assess the effectiveness of perioperative psychological interventions provided to patients with clinically severe obesity undergoing bariatric surgery regarding weight loss, BMI, quality of life, and psychosocial health using the Bayesian approach. Methods: We considered randomised trials that assessed the beneficial and harmful effects of perioperative psychological interventions in people with clinically severe obesity undergoing bariatric surgery. We searched four data sources from inception to 3 October 2021. The authors independently selected studies for inclusion, extracted data, and assessed the risk of bias. We conducted a meta-analysis using a Bayesian approach. PROSPERO: CRD42017077724. Results: Of 13,355 identified records, we included nine studies (published in 27 papers with 1060 participants (365 males; 693 females, 2 people with missing data)). Perioperative psychological interventions may provide little or no benefit for BMI (the last reported follow-up: MD [95% credible intervals] = −0.58 [−1.32, 0.15]; BF₀₁ = 0.65; 7 studies; very low certainty of evidence) and weight loss (the last reported follow-up: MD = −0.50 [−2.21, 0.77]; BF₀₁ = 1.24, 9 studies, very low certainty of evidence). Regarding psychosocial outcomes, the direction of the effect was mainly inconsistent, and the certainty of the evidence was low to very low. Conclusions: Evidence is anecdotal according to Bayesian factors and uncertain whether perioperative psychological interventions may affect weight-related and psychosocial outcomes in people with clinically severe obesity undergoing bariatric surgery. As the results are ambiguous, we suggest conducting more high-quality studies in the field to estimate the true effect, its direction, and improve confidence in the body of evidence. Full article

(This article belongs to the Special Issue Weight Management Interventions: Predictors and Outcomes)

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19 pages, 3156 KiB

Open AccessSystematic Review

Reduction of Major Adverse Cardiovascular Events (MACE) after Bariatric Surgery in Patients with Obesity and Cardiovascular Diseases: A Systematic Review and Meta-Analysis

by Andryanto Sutanto, Citrawati Dyah Kencono Wungu, Hendri Susilo and Henry Sutanto

Nutrients 2021, 13(10), 3568; https://doi.org/10.3390/nu13103568 - 12 Oct 2021

Cited by 28 | Viewed by 5150

Abstract

Cardiovascular diseases (CVDs) are the leading cause of death worldwide and obesity is a major risk factor that increases the morbidity and mortality of CVDs. Lifestyle modifications (e.g., diet control, physical exercise and behavioral changes) have been the first-line managements of obesity for [...] Read more.

Cardiovascular diseases (CVDs) are the leading cause of death worldwide and obesity is a major risk factor that increases the morbidity and mortality of CVDs. Lifestyle modifications (e.g., diet control, physical exercise and behavioral changes) have been the first-line managements of obesity for decades. Nonetheless, when such interventions fail, pharmacotherapies and bariatric surgery are considered. Interestingly, a sudden weight loss (e.g., due to bariatric surgery) could also increase mortality. Thus, it remains unclear whether the bariatric surgery-associated weight reduction in patients with obesity and CVDs is beneficial for the reduction of Major Adverse Cardiovascular Events (MACE). Here, we performed a systematic literature search and meta-analysis of published studies comparing MACE in patients with obesity and CVDs who underwent bariatric surgery with control patients (no surgery). Eleven studies, with a total of 1,772,305 patients, which consisted of 74,042 patients who underwent any form of bariatric surgery and 1,698,263 patients with no surgery, were included in the systematic review. Next, the studies’ data, including odds ratio (OR) and adjusted hazard ratio (aHR), were pooled and analyzed in a meta-analysis using a random effect model. The meta-analysis of ten studies showed that the bariatric surgery group had significantly lower odds of MACE as compared to no surgery (OR = 0.49; 95% CI 0.40–0.60; p < 0.00001; I² = 93%) and the adjustment to confounding variables in nine studies revealed consistent results (aHR = 0.57; 95% CI 0.49–0.66; p < 0.00001; I² = 73%), suggesting the benefit of bariatric surgery in reducing the occurrence of MACE in patients with obesity and CVDs (PROSPERO ID: CRD42021274343). Full article

(This article belongs to the Special Issue Weight Management Interventions: Predictors and Outcomes)

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