OBJECTIVE: To investigate whether astragalus polysaccharides (APS) combined with berberine (BBR) can reduce high-fat diet (HFD)-induced obesity in mice. METHODS: Except for normal mice, 32 HFD-induced obese mice were randomized into HFD, APS (1,000 mg/kg APS), BBR (200 mg/kg BBR), and APS plus BBR (1,000 mg/kg APS plus 200 mg/kg BBR) groups, respectively. After 6-week treatment (once daily by gavage), the obesity phenotype and pharmacodynamic effects were evaluated by histopathological examination of epididymal fat, liver, and colon using hematoxylin-eosin staining and serum biochemical analyses by an automated chemistry analyzer. The feces were collected at the 12 th week, and taxonomic and functional profiles of gut microbiota were analyzed by 16S ribosomal ribonucleic acid (16S rRNA) sequencing. RESULTS: Compared with HFD group, the average body weight of APS plus BBR group was decreased (P<0.01), accompanied with the reduced fat accumulation, enhanced colonic integrity, insulin sensitivity and glucose homeostasis (P<0.05 or P<0.01). Importantly, APS combined with BBR treatment was more effective than APS or BBR alone in improving HFD-induced insulin resistance (P<0.05 or P<0.01). 16S rRNA sequence-based analysis of fecal samples demonstrated that APS combined with BBR treatment exhibited a better impact on HFD-induced gut microbiota dysbiosis, exclusively via the enriched abundances of Bacteroides, which corresponded to the large increase of predicted bacterial genes involved in carbohydrate metabolism. CONCLUSION APS combined with BBR may synergistically reduce obesity and modulate the gut microbiota in HFD-fed mice.
Mice ; Animals ; Diet, High-Fat ; Berberine/therapeutic use* ; Mice, Obese ; RNA, Ribosomal, 16S/genetics* ; Gastrointestinal Microbiome ; Obesity/drug therapy* ; Insulin Resistance ; Mice, Inbred C57BL

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: (1) definition and diagnosis of overweight and obesity in children and adolescents; (2) principles of treatment of pediatric obesity; (3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; (4) pharmacotherapy; and (5) bariatric surgery.
Adolescent ; Bariatric Surgery ; Child ; Diagnosis* ; Diet ; Drug Therapy ; Gastroenterology* ; Humans ; Korea ; Life Style ; Mental Health ; Obesity ; Overweight ; Pediatric Obesity*

Renal transplantation is one of the renal replacement therapies for patients with end-stage renal disease. The number of patients who receive renal transplantation is continuously increasing, and the use of immunosuppressive drugs that are essential after transplantation requires continuous nutritional management. In the early post-transplantation period, sufficient supply of nutrition in consideration of the increase in metabolic demand is necessary. The long-term nutritional management after transplantation requires nutritional interventions to prevent obesity, hyperlipidemia, hypertension, diabetes, and osteoporosis, which are the adverse effects associated with the use of immunosuppressive drugs. Department of Dietetics in Samsung Medical Center has been engaging with patients to conduct them about initial nutritional assessment and reassessment, description of therapeutic diet, nutrition education for kidney transplantation, and follow-up education after discharge. Nutritional intervention of kidney transplant patients should be carried out according to the post-transplantation period and the nutritional status of the patient. It is necessary to perform patient management according to the planned process.
Diet ; Dietetics ; Education ; Follow-Up Studies ; Humans ; Hyperlipidemias ; Hypertension ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Nutrition Assessment ; Nutritional Status ; Obesity ; Osteoporosis ; Renal Replacement Therapy

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: 1) definition and diagnosis of overweight and obesity in children and adolescents; 2) principles of treatment of pediatric obesity; 3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; 4) pharmacotherapy; and 5) bariatric surgery.
Adolescent ; Bariatric Surgery ; Child ; Diagnosis* ; Diet ; Drug Therapy ; Gastroenterology* ; Humans ; Korea ; Life Style ; Mental Health ; Obesity ; Overweight ; Pediatric Obesity*

Ossification of the posterior longitudinal ligament (OPLL) can be defined as an ectopic ossification in the tissues of spinal ligament showing a hyperostotic condition. OPLL is developed mostly in the cervical spine and clinical presentations of OPLL are majorly myelopathy and/or radiculopathy, with serious neurological pathology resulting in paralysis of extremities and disturbances of motility lowering the quality of life. OPLL is known to be an idiopathic and multifactorial disease, which genetic factors and non-genetic factors including diet, obesity, physical strain on the posterior longitudinal ligament, age, and diabetes mellitus, are involved into the pathogenesis. Up to now, surgical management by decompressing the spinal cord is regarded as standard treatment for OPLL, although there might be the risk of development of reprogression of ossification. The molecular pathogenesis and efficient therapeutic strategy, especially pharmacotherapy and/or preventive intervention, of OPLL has not been clearly elucidated and suggested. Therefore, in this review, we tried to give an overview to the present research results on OPLL, in order to shed light on the potential pharmacotherapy based on molecular pathophysiologic aspect of OPLL, especially on the genetic/genomic factors involved into the etiology of OPLL.
Diabetes Mellitus ; Diet ; Drug Therapy ; Extremities ; Ligaments ; Longitudinal Ligaments ; Obesity ; Ossification, Heterotopic ; Paralysis ; Pathology ; Quality of Life ; Radiculopathy ; Spinal Cord ; Spinal Cord Diseases ; Spine

OBJECTIVE: We aimed to explore how fermented barley extracts with Lactobacillus plantarum dy-1 (LFBE) affected the browning in adipocytes and obese rats. METHODS: In vitro, 3T3-L1 cells were induced by LFBE, raw barley extraction (RBE) and polyphenol compounds (PC) from LFBE to evaluate the adipocyte differentiation. In vivo, obese SD rats induced by high fat diet (HFD) were randomly divided into three groups treated with oral gavage: (a) normal control diet with distilled water, (b) HFD with distilled water, (c) HFD with 800 mg LFBE/kg body weight (bw). RESULTS: In vitro, LFBE and the PC in the extraction significantly inhibited adipogenesis and potentiated browning of 3T3-L1 preadipocytes, rather than RBE. In vivo, we observed remarkable decreases in the body weight, serum lipid levels, white adipose tissue (WAT) weights and cell sizes of brown adipose tissues (BAT) in the LFBE group after 10 weeks. LFBE group could gain more mass of interscapular BAT (IBAT) and promote the dehydrogenase activity in the mitochondria. And LFBE may potentiate process of the IBAT thermogenesis and epididymis adipose tissue (EAT) browning via activating the uncoupling protein 1 (UCP1)-dependent mechanism to suppress the obesity. CONCLUSION These results demonstrated that LFBE decreased obesity partly by increasing the BAT mass and the energy expenditure by activating BAT thermogenesis and WAT browning in a UCP1-dependent mechanism.
3T3 Cells ; Adipocytes ; drug effects ; physiology ; Adipose Tissue, Brown ; drug effects ; physiology ; Adipose Tissue, White ; drug effects ; physiology ; Animal Feed ; analysis ; Animals ; Anti-Obesity Agents ; administration & dosage ; metabolism ; Cell Differentiation ; drug effects ; Diet ; Fermentation ; Hordeum ; chemistry ; Lactobacillus plantarum ; chemistry ; Male ; Mice ; Obesity ; drug therapy ; genetics ; Plant Extracts ; chemistry ; Probiotics ; administration & dosage ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Uncoupling Protein 1 ; genetics ; metabolism

OBJECTIVE: To investigate the effects of different intensity intermittent exercise on the body function of obese rats, and to provide basis for the prevention and treatment of obesity. METHODS: Eighty SD rats were randomly divided into normal diet group (n=20) and high-fat diet group (n=60). After adaptive feeding for 8 weeks, 8 normal diet rats and 32 high-fat obese rats were selected for follow-up experiments. The experimental rats were randomly divided into 5 groups (n=8): control diet-sedentary (CS),with ordinary feed and without any exercise; high diet-sedentary (HS), with high-fat feed feeding and without any exercise; high diet-continual exercise(HC), 60 min/day,5 days/week with 6 weeks; high diet-long time-low frequency interval exercise(HLL), 30 min/time,twice/day (intermittent 6 h), 5 days/week with 6 weeks; high diet-short time-high frequency interval exercise(HSH), 20 min/ time, 3 times/d (intermittent 3 h), 5 days/week with 6 weeks. The training intensity of rats in each exercise group was 25 m/min. After 6 weeks, rats in each groups were weighed, and resting metabolic rate(RMR), fasting blood glucose(FBG), triglyceride(TG) and other biochemical indexes were detected, and fat and muscle weight were measured. RESULTS: Before experiment, there were no significant differences in RMR, FBG and TG in each groups(P＞0.05).The body weight of HSH, HLL, HC and HS groups was higher than that of CS group (P＜0.05). After the experiment, RMR of the HSH,HLL and HC groups was significantly higher than that of HS and CS groups (P＜0.05), but without significant difference among the HSH,HLL and HC groups (P＞0.05).The body weight of HSH, HLL and HC groups was significantly lower than that of HS group (P＜0.05), but the three groups was not significant (P＞0.05); perirenal fat(PF), idymis fat(EF), perirenal fat/weight(PF/W) and epididymis fat/weight(EF/W) of HSH, HLL, HC group were significantly lower than those of HS group (P＜0.01), while there was no statistical difference among the three groups (P＞0.05). There was no significant difference in gastrocnemius(GM) and quadricep(QF) of each group (P＞0.05), gastrocnemius/weight(GM/W) and quadriceps/weight (QF/W) in HSH,HLL and HC groups were higher than those of HS group (P＜0.05),while there was no significant difference among HSH,HLL and HC groups (P＞0.05);FEB,TG of HSH,HLL,HC group were lower than those of CS and HS group (P＜0.05),but the difference with HS group was more significant (P＜0.01),there was no significant difference among training groups(P＞0.05). CONCLUSION 6 weeks of intermittent exercise of different intensity had a good intervention effect on the body composition of obese rats, and high diet-short time-high frequency interval exercise (HSH) may be more effective.
Animals ; Body Composition ; Body Weight ; Diet, High-Fat ; Male ; Obesity ; therapy ; Physical Conditioning, Animal ; Random Allocation ; Rats ; Rats, Sprague-Dawley

Globally, the problem of obesity is increasing, and the prevalence of obesity in Korea is also rising rapidly. Obesity is a risk factor for cardiometabolic diseases including type 2 diabetes mellitus, hypertension, cardiovascular disease, and some types of cancer. Therefore, prevention of various metabolic diseases or symptom relief through effective treatment of obesity is a very important problem. According to the obesity guidelines of the Obesity Society of Korea in 2018, obesity medication is recommended for patients with a body mass index (BMI) of 30 kg/m² or more or a BMI of 27 kg/m² or more, and one or more obesity accompanying diseases (type 2 diabetes, hypertension, dyslipidemia). In this case, it is recommended that the basic treatment for obesity (diet, exercise, and behavior therapy) should be performed in parallel with Saxenda® treatment. The glucagon-like peptide 1 analogue, Saxenda®, has been validated as a long-term effective and safe treatment for obesity, and is expected to be a promising drug for the treatment of obesity and the prevention of pre-diabetes in the future. However, in Korea, where non-standard obesity treatments are widely practiced, it is necessary to improve the health of obese patients by being treated with Saxenda® along with diet, exercise and behavior therapy.
Behavior Therapy ; Body Mass Index ; Cardiovascular Diseases ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diet ; Glucagon-Like Peptide 1 ; Humans ; Hypertension ; Korea ; Metabolic Diseases ; Metabolism ; Obesity ; Prevalence ; Risk Factors ; Specialization

Diet-related behavioral modification for healthy eating and lifestyle is required to improve childhood obesity. The present study aimed to develop customized nutritional intervention protocol and education program to find barriers to adhere healthy diet and lifestyle for moderate to severe obese children and adolescents and their families. Theoretical framework approaches can be used to change behavior and achieve goals. Previous studies that described the relationship between behavioral modification and nutrition education theory were reviewed. The social cognitive theory and transtheoretical model were employed with behavioral changes to target a healthful diet and lifestyle. The nutrition care process (NCP) model was adopted to customize nutrition care for the participants. Customized nutritional intervention protocol was developed following as the four steps of the NCP. Firstly, nutrition status of the participants was assessed by the nutrition expert. Nutrition problems were described as “inadequate energy intake,” “overweight/obesity,” or “food and nutrition-related knowledge deficit.” All nutrition sessions were designed for nutrition intervention to give nutritional knowledge and a practical mission in real life for individual goal setting and self-control. Meal planning, portion control, healthy snack selection and cooking with fruits and vegetables were consisted of five components of the nutrition education session. During each session, the participants and their families were interviewed by a nutrition expert for monitoring and evaluating diet-related goal setting and achievement. A theoretical and evidence-based nutritional intervention was developed for the secondary to tertiary prevention of childhood obesity. This nutrition intervention protocol and program might be helpful for the further research on childhood obesity. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0002111
Adolescent ; Behavior Therapy ; Child ; Cooking ; Diet ; Eating ; Education ; Fruit ; Humans ; Information Services ; Life Style ; Meals ; Nutrition Assessment ; Nutritional Status ; Pediatric Obesity ; Self-Control ; Snacks ; Tertiary Prevention ; Vegetables

The paradigm of chronic liver diseases has been shifting. Although hepatitis B and C viral infections are still the main causes of liver cirrhosis and hepatocellular carcinoma (HCC), the introduction of effective antiviral drugs may control or cure them in the near future. In contrast, the burden of nonalcoholic fatty liver disease (NAFLD) has been increasing for decades, and 25 to 30% of the general population in Korea is estimated to have NAFLD. Over 10% of NAFLD patients may have nonalcoholic steatohepatitis (NASH), a severe form of NAFLD. NASH can progress to cirrhosis and HCC. NASH is currently the second leading cause to be placed on the liver transplantation list in the United States. NAFLD is associated with obesity, type 2 diabetes, dyslipidemia, and metabolic syndrome. The pathophysiology is complex and associated with lipotoxicity, inflammatory cytokines, apoptosis, and insulin resistance. The only proven effective treatment is weight reduction by diet and exercise. However, this may not be effective for advanced fibrosis or cirrhosis. Therefore, effective drugs are urgently needed for treating these conditions. Unfortunately, no drugs have been approved for the treatment of NASH. Many pharmaceutical companies are trying to develop new drugs for the treatment of NASH. Some of them are in phase 2 or 3 clinical trials. Here, pharmacologic therapies in clinical trials, as well as the basic principles of drug therapy, will be reviewed, focusing on pathophysiology.
Antiviral Agents ; Apoptosis ; Carcinoma, Hepatocellular ; Cytokines ; Diet ; Drug Therapy ; Dyslipidemias ; Fibrosis ; Hepatitis B ; Humans ; Insulin Resistance ; Korea ; Liver Cirrhosis ; Liver Diseases ; Liver Transplantation ; Non-alcoholic Fatty Liver Disease ; Obesity ; United States ; Weight Loss