Objective: To explore the effect of three interventions including caloric restriction, rope-skipping exercise and caloric restriction combined with rope-skipping exercise on cardiometabolic risk factors in overweight or obese college students. Methods: This study was a pilot randomized controlled trial. Overweight or obese students who met the inclusion criteria were recruited at Sun Yat-sen University in September 2019 and were randomly divided into four groups: caloric restriction group (CR), rope-skipping group (RS), combined group (CR-RS) and control group (CT). The intervention in each group lasted 8 weeks, specifically: the daily energy intake of CR was 100% to 110% of the basal metabolic energy; RS was instructed to rope three times a week, and CR-RS combined caloric restriction with rope-skipping. At the baseline and end of 8-week intervention, basic information, anthropometric indicators and fasting vein blood of students were collected. Paired t test and Wilcoxon paired-samples signed rank test were used for comparison before and after intervention, and analysis of covariance was used for comparison between groups after intervention. Results: A total of 29 students completed the trial and were included in the final analysis (7, 9, 7 and 6 students in CR, RS, CR-RS and CT, respectively). The mean age of students were (19.00±1.00) years, including 11 males and 18 females. The baseline characteristics of four groups were comparable. After 8 weeks of intervention, compared with CT, there was an increase in the body fat percentage and fat mass index in CR and CR-RS (P<0.05). Insulin level decreased in CR-RS (P<0.05). Systolic blood pressure in CR and diastolic blood pressure in CR-RS were higher (P<0.05). Compared with baseline, fat mass index decreased in CR (P<0.05), while body weight, BMI, and fat mass index decreased in CR-RS (P<0.05). Conclusion: It is suggested that the caloric restriction alone and calorie restriction combined with rope-skipping exercise can benefit overweight or obese college students with cardiometabolic risk factors.
Adolescent ; Adult ; Caloric Restriction ; Cardiometabolic Risk Factors ; Female ; Humans ; Insulins ; Male ; Obesity ; Overweight ; Students ; Weight Loss/physiology* ; Young Adult

OBJECTIVETo investigate the effect of laparoscopic sleeve gastrectomy(LSG) on sex hormone in male patients with severe obesity.

METHODSRetrospective analysis was performed in 31 male patient with severe obese [body mass index(BMI) ≥28 kg/m, obesity group] who underwent LSG in Shanghai Tenth People's Hospital of Tongji University from December 2012 to May 2016. The anthropometric parameters(weight, BMI, waist circumference, hip circumference, waist-hip ratio, body fat percentage), glucose metabolic indices [fasting plasma glucose(FPG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), homeostasis model assessment-insulin resistance index(HOMA-IR)], and sex hormone parameters [estradiol(E2), total testosterone (TT), follicle-stimulating hormone (FSH) and luteinizing hormone (LH)] were collected preoperatively and 1, 3, 6 months postoperatively. In addition, 31 healthy male volunteers with normal BMI were consecutively recruited in this study as control group. The above-mentioned parameters were also determined in control group. Changes of these variables before and after surgery were analyzed. Pearson method was used to analyze the correlation of TT with anthropometric parameters and glucose metabolic indices before and after surgery.

RESULTSThe average age of patients in obesity and control group was (32.9±9.7) (18 to 56) years and (30.7±8.9) (18 to 49) years. Compared to the control group, obesity group had significantly higher anthropometric parameters and glucose metabolic indices before surgery (all P<0.05). In obesity group, the anthropometric and glucose metabolic indices significantly decreased at 1 to 6 months after surgery compared to those before surgery (all P<0.05). At 1 month after surgery, the anthropometric parameters and glucose metabolic indices in obesity group were significantly higher than those in control group (all P<0.05). At 3, and 6 months after surgery, there were no significant differences in glucose metabolic indices between obesity and control group (all P>0.05), while the anthropometric parameters in obesity group were still significantly higher than those in control group(all P<0.05). The sex hormone parameters in control and obesity group before surgery were as follows: E2: (100.2±23.5) pmol/L and (129.2±81.9) pmol/L; TT: (18.0±4.9) nmol/L and (8.4±4.5) nmol/L; FSH: (4.5±3.1) IU/L and (4.3±2.5) IU/L; LH: (4.4±1.7) IU/L and (5.3±2.6) IU/L. Compared to control group, the TT level of obese patients before surgery significantly decreased(P=0.000), while no significant differences were observed in the levels of E2, FSH, and LH(all P>0.05). The TT levels were significantly increased at 1, 3, 6 months after surgery[(13.1±7.0), (13.6±5.7), (21.0±19.3) nmol/L, respectively, all P<0.05] and the E2 level was significantly decreased at 6 months after surgery [(91.4±44.9) pmol/L, P<0.05], while no significant differences were observed at 1 and 3 months after surgery (all P>0.05). Furthermore, the FSH and LH levels did not exhibit significant change at 1, 3, and 6 months after surgery compared to those before surgery (all P>0.05). At 1 month after surgery, no significant correlations were examined in the change value of TT levels (▹TT) with the changes of BMI(▹BMI), FPG(▹FPG), FINS(▹FINS), HOMA-IR(▹HOMA-IR), and E2(▹E2) (all P>0.05). At 3 months after surgery, ▹TT was negatively correlated with ▹BMI (r=-0.441, P=0.015), ▹FINS (r=-0.375, P=0.041), and ▹HOMA-IR(r=-0.397, P=0.030), but not correlated with ▹FPG and ▹E2 (all P>0.05). At 6 months after surgery, ▹TT was negatively correlated with ▹BMI(r=-0.510, P=0.018) and ▹HOMA-IR (r=-0.435, P=0.049), but not correlated with ▹FPG, ▹FINS and ▹E2 (all P>0.05).

CONCLUSIONSMale severe obese patients are accompanied with abnormal sex hormone levels. LSG has a significant effect on weight loss and blood glucose improvement, and may ameliorate the sex hormone unbalance by improving the insulin resistance in men with severe obesity.

Adult ; Bariatric Surgery ; Blood Glucose ; physiology ; Body Mass Index ; Body Weights and Measures ; China ; Estradiol ; blood ; physiology ; Fasting ; blood ; Follicle Stimulating Hormone ; blood ; physiology ; Follow-Up Studies ; Gastrectomy ; Glycated Hemoglobin A ; physiology ; Humans ; Insulin ; blood ; physiology ; Insulin Resistance ; physiology ; Luteinizing Hormone ; blood ; physiology ; Male ; Obesity, Morbid ; surgery ; Retrospective Studies ; Testosterone ; blood ; physiology ; Treatment Outcome ; Weight Loss ; physiology

OBJECTIVETo evaluate the effect of laparoscopic sleeve gastrectomy(LSG) on type 2 diabetes mellitus (T2DM) in patient with a body mass index(BMI) less than 40 kg/m.

METHODSTwenty four obese patients with T2DM and BMI less than 40 kg/mreceived LSG between 1 January 2011 and 1 September 2013 at the Department of General Surgery in Chinese PLA General Hospital. The clinical data and 3-year follow-up outcomes regarding weight loss and remission of diabetes were retrospectively analyzed.

RESULTSThere were 10 males and 14 females with a median age of 40.8(35 to 48) years. The preoperative body weight and BMI was(99.9±15.0) kg and (34.4±2.8) kg/m, respectively. The median duration of type 2 diabetes was 4.3(2 to 15) years. The preoperative fasting blood glucose and glycosylated hemoglobin(HbAlc) was (11.4±1.3) mmol/L and (8.7±0.8)%, respectively. All these patients were preoperatively diagnosed as T2DM by the multidisciplinary experts of the surgical treatment team for obesity and diabetes in our center. All these patients were eligible for surgical treatment through the screening and evaluation by the multidisciplinary joint outpatient service. All the procedures were successfully completed without conversion to laparotomy. There were no severe postoperative complications. The mean fasting blood glucose was (6.4±1.8) mmol/L, (6.1±1.7) mmol/L, (6.0±1.5) mmol/L, (5.9±1.4) mmol/L and (6.0±1.4) mmol/L, respectively, at 6, 9, 12, 24 and 36 months after operation. The mean HbA1c in the same observation intervals was (6.6±1.1)%, (6.2±1.2)%, (6.1±1.2)%, (6.0±1.3)% and (6.1±1.3)%, respectively. The body weight was (89.4±11.4) kg, (86.3±10.6) kg, (83.1±10.2) kg,(80.6±9.8) kg and (81.3±10.1) kg, respectively. The corresponding BMI was (30.8±1.6) kg/m, (29.8±1.5) kg/m, (28.7±1.5) kg/m, (27.8±1.8) kg/mand (28.1±1.8) kg/m, respectively. The %EWL was (36.7±8.7)%, (47.6±12.5)%, (58.8±16.4)%, (67.2±20.3)% and (64.8±21.5)%, respectively. The overall remission rate of diabetes at 6, 9, 12, 24 and 36 months was 50.0%(12/24), 79.2%(19/24), 70.8%(17/24), 66.7%(16/24) and 62.5%(15/24), respectively. The complete remission rate was 33.3%(8/24), 50.0%(12/24), 54.2%(13/24), 45.8%(11/24) and 50.0%(12/24), respectively. For patients with a duration of T2DM shorter than 5 years, the overall remission rate at 9, 12 and 24 months after operation was 10/10, 9/10 and 9/10, respectively, significantly higher than that of patients with a duration of 11-15 years (2/6, 2/6 and 2/6, Fisher's exact tests, P=0.008, 0.036 and 0.036, respectively).

CONCLUSIONThe present study confirms the efficacy of LSG in the treatment of T2DM patients with a BMI less than 40 kg/m.

Adult ; Bariatric Surgery ; methods ; Blood Glucose ; physiology ; Body Mass Index ; Diabetes Mellitus, Type 2 ; surgery ; Female ; Gastrectomy ; Glycated Hemoglobin A ; physiology ; Humans ; Laparoscopy ; Male ; Middle Aged ; Obesity ; surgery ; Postoperative Complications ; Remission Induction ; methods ; Retrospective Studies ; Treatment Outcome ; Weight Loss

OBJECTIVETo investigate acrylamide (ACR)-induced subacute neurotoxic effects on the central nervous system (CNS) at the synapse level in rats.

METHODSThirty-six Sprague Dawley (SD) rats were randomized into three groups, (1) a 30 mg/kg ACR-treated group, (2) a 50 mg/kg ACR-treated group, and (3) a normal saline (NS)-treated control group. Body weight and neurological changes were recorded each day. At the end of the test, cerebral cortex and cerebellum tissues were harvested and viewed using light and electron microscopy. Additionally, the expression of Synapsin I and P-Synapsin I in the cerebral cortex and cerebellum were investigated.

RESULTSThe 50 mg/kg ACR-treated rats showed a significant reduction in body weight compared with untreated individuals (P < 0.05). Rats exposed to ACR showed a significant increase in gait scores compared with the NS control group (P < 0.05). Histological examination indicated neuronal structural damage in the 50 mg/kg ACR treatment group. The active zone distance (AZD) and the nearest neighbor distance (NND) of synaptic vesicles in the cerebral cortex and cerebellum were increased in both the 30 mg/kg and 50 mg/kg ACR treatment groups. The ratio of the distribution of synaptic vesicles in the readily releasable pool (RRP) was decreased. Furthermore, the expression levels of Synapsin I and P-Synapsin I in the cerebral cortex and cerebellum were decreased in both the 30 mg/kg and 50 mg/kg ACR treatment groups.

CONCLUSIONSubacute ACR exposure contributes to neuropathy in the rat CNS. Functional damage of synaptic proteins and vesicles may be a mechanism of ACR neurotoxicity.

Acrylamide ; toxicity ; Animals ; Cerebellum ; cytology ; drug effects ; Cerebral Cortex ; cytology ; drug effects ; Drug Administration Schedule ; Gait ; Gene Expression Regulation ; drug effects ; Male ; Neurons ; drug effects ; Neurotoxicity Syndromes ; pathology ; Rats ; Rats, Sprague-Dawley ; Synapses ; drug effects ; Synapsins ; genetics ; metabolism ; Synaptic Vesicles ; drug effects ; physiology ; Weight Loss ; drug effects

Along with the soaring prevalence of obesity and type 2 diabetes mellitus (T2DM) globally, metabolic and bariatric surgery (MBS) has been rapidly developing into a major surgical subspecialty. However, the indications, benefits and potential risks of MBS are still controversial so far. In September 2015, the 2nd Diabetes Surgery Summit (DSS-II() was successfully convened, and later on an international joint statement on metabolic surgery in the treatment algorithm for T2DM was released based upon the consensus reached in DSS-II(, aiming to serve as a new global clinical guideline. The DSS-II( joint statement was initiated and endorsed by 5 leading international diabetes organizations, including American Diabetes Association (ADA), International Diabetes Federation (IDF), Chinese Diabetes Society (CDS), Diabetes India, as well as Diabetes UK, and was developed by an expert committee comprised of 48 international authorities as voting delegates. Up to the date of publication, the DSS-II( statement has been officially endorsed by 45 international professional associations/societies, including 30 non-surgical and 15 surgical organizations. In this statement, the following six aspects were recommended to differentiate MBS from traditional bariatric surgery: 1)The primary goal of MBS is to treat T2DM and to reduce the risk of T2DM complications; 2) In addition to a 50% or more of excess weight loss and normalization of glycemia, outcomes of diabetes complications should also be considered as clinical endpoints of MBS; 3) For patient selection, body mass index (BMI), T2DM treatment, as well as long-term risks versus benefits, including its effects on cardiovascular events (CVD), should all be considered; 4) T2DM and its complications, as well as pancreatic function reserve should be assessed pre-operatively; 5) Major surgical options include laparoscopic Roux-en-Y gastric bypass (LRYGB), laparoscopic sleeve gastrectomy (LSG), laparoscopic adjustable gastric banding (LAGB), and bilio-pancreatic diversion with duodenal switch(BPD-DS). BPD-DS has the best outcome in T2DM remission followed by LRYGB, LSG and LAGB; 6) Glycemic variation should be intensively monitored, and if needed, managed following surgery. Clinical follow-up should be conducted at least once every six months within two years after surgery. For patients achieving complete remission from T2DM, diabetes complications should still be monitored within five years after surgery with the same frequency and protocols as pre-operatively.
Aftercare ; standards ; Bariatric Surgery ; methods ; standards ; Biliopancreatic Diversion ; Blood Glucose ; physiology ; Body Mass Index ; Diabetes Mellitus, Type 2 ; surgery ; Disease Management ; Gastrectomy ; Gastric Bypass ; Gastroplasty ; Humans ; Hyperglycemia ; surgery ; Laparoscopy ; Obesity ; surgery ; Patient Care Planning ; standards ; Practice Guidelines as Topic ; standards ; Remission Induction ; methods ; Treatment Outcome ; Weight Loss

Adolescent ; Body Mass Index ; Female ; Humans ; Male ; Obesity ; epidemiology ; prevention & control ; therapy ; Risk Factors ; Self-Control ; Weight Loss ; physiology

Excess energy intake, without a compensatory increase of energy expenditure, leads to obesity. Several molecules are involved in energy homeostasis regulation and new ones are being discovered constantly. Appetite regulating hormones such as ghrelin, peptide tyrosine-tyrosine and amylin or incretins such as the gastric inhibitory polypeptide have been studied extensively while other molecules such as fibroblast growth factor 21, chemerin, irisin, secreted frizzle-related protein-4, total bile acids, and heme oxygenase-1 have been linked to energy homeostasis regulation more recently and the specific role of each one of them has not been fully elucidated. This mini review focuses on the above mentioned molecules and discusses them in relation to their regulation by the macronutrient composition of the diet as well as diet-induced weight loss.
Appetite ; Bile Acids and Salts ; Diet ; Energy Intake ; Energy Metabolism ; Fibroblast Growth Factors ; Gastric Inhibitory Polypeptide ; Ghrelin ; Heme Oxygenase-1 ; Homeostasis* ; Incretins ; Islet Amyloid Polypeptide ; Obesity ; Physiology* ; Weight Loss*

OBJECTIVETo explore the effect of weight-loss for overweight or obese population under the health management programs, and to provide evidence for the development of safe and effective weight-loss programs.

METHODS738 participants who resided in Beijing longer than one year, under 22 to 55 years of age, with BMI≥24 kg/m(2) and without organic diseases were voluntarily recruited, from September 1(st) to October 15(th) 2013. All the participants were randomly divided into general management group or under health management group, in which all the subjects received intervention measures for 6 months. Anthropometry and body composition were measured at baseline and 6 months for all the subjects. Weight-loss effect from the health management programs was evaluated through analyzing the changes on weight and body fat.

RESULTS618 participants completed the follow-up process, including 321 in the general management group and 297 in the health management group. 6 months after the intervention process, values of weight and body fat rate in the two groups appeared both significantly lower than that at the baseline levels. Difference before and after the intervention program was statistically significant (P<0.001). However, the differences of those with reduction value as 2.19 kg or 2.19% among health management group were higher than that in the general management group, which were 0.97 kg and 1.28% respectively, with difference statistically significant (P<0.001). The effective rate of 24.2% loss-weight and the 52.5% losing rate on body fat among the health management group were both higher than 11.8% and 34.3%, seen in the general management group, respectively, with difference statistically significant (P<0.001).

CONCLUSIONThe healthy management programs could effectively control the weight and body fate rate among the overweight or obese adults.

Adipose Tissue ; Adult ; Behavior Therapy ; Body Composition ; Body Mass Index ; China ; Exercise ; Feeding Behavior ; Female ; Humans ; Middle Aged ; Obesity ; prevention & control ; Overweight ; Risk Reduction Behavior ; Treatment Outcome ; Weight Loss ; physiology ; Weight Reduction Programs ; methods

INTRODUCTIONMillions of Muslim patients with diabetes mellitus (DM) fast during Ramadan. However, little is known about the metabolic impact of Ramadan fasting. We aimed to study the changes in body composition and metabolic profile in this group of patients.

MATERIALS AND METHODSWe studied 29 Southeast Asian Muslim patients with type 2 diabetes; all underwent pre-Ramadan education. Study variables were weight change, body composition (using multifrequency bioimpedance method, InBody S20®, Biospace, South Korea), blood pressure (BP), glycated haemoglobin (HbA1c), fasting lipid profile, and caloric intake assessment using FoodWorks® nutrient analysis software.

RESULTSTwenty-three subjects fasted ≥15 days; mean ± SD: 57 ± 11 years; 52% were males. HbA1c improved significantly (8.6 ± 2.4% pre-Ramadan vs 8.0 ± 2.3% end-Ramadan, P = 0.017). Despite similar body weight, there was reduction in body fat mass (BFM) (30.9 ± 11 kg vs 29.2 ± 12.2 kg, P = 0.013). Multivariate analysis suggested that the reduction in HbA1c was attributed by reduction in BFM (β = -0.196, P = 0.034). There was no change in visceral adiposity (visceral fat area (VFA)) but stratification by gender showed a reduction amongst females (137.6 ± 24.5 cm2 to 132.5 ± 25.7 cm2, P = 0.017). These changes occurred despite similar total caloric intake (1473.9 ± 565.4 kcal vs 1473.1 ± 460.4 kcal, P = 0.995), and proportion of carbohydrate (55.4 ± 6.3% vs 53.3 ± 7.5%, P = 0.25) and protein intake (17.6 ± 4.1% vs 17.3 ± 5.4%, P = 0.792), before and during Ramadan respectively, but with increased proportion of fat intake (11.9 ± 2.4% vs 13 ± 11.7%, P = 0.04). Seven out of 23 patients had medications adjusted to avert symptomatic hypoglycaemia but none of the patients developed severe hypoglycaemia.

CONCLUSIONRamadan fasting can be practiced safely with prior patient education and medication adjustment. It also confers modest benefits on metabolic profile and body composition, especially among females.

Adult ; Aged ; Biomarkers ; blood ; Blood Glucose ; metabolism ; Body Composition ; Body Mass Index ; Diabetes Mellitus, Type 2 ; blood ; physiopathology ; Energy Intake ; Fasting ; physiology ; Female ; Glycated Hemoglobin A ; metabolism ; Holidays ; Humans ; Islam ; Male ; Middle Aged ; Multivariate Analysis ; Prospective Studies ; Sex Factors ; Singapore ; Weight Gain ; Weight Loss

Overweight or obesity has become a serious public health problem in the world, scientists are concentrating their efforts on exploring novel ways to treat obesity. Nowadays, the availabilities of bariatric surgery and pharmacotherapy have enhanced obesity treatment, but it should has support from diet, physical exercise and lifestyle modification, especially the functional food. Resistant starch, an indigestible starch, has been studied for years for its beneficial effects on regulating blood glucose level and lipid metabolism. The aim of this review is to summarize the effect of resistant starch on weight loss and the possible mechanisms. According to numerous previous studies it could be concluded that resistant starch can reduce fat accumulation, enhance insulin sensitivity, regulate blood glucose level and lipid metabolism. Recent investigations have focused on the possible associations between resistant starch and incretins as well as gut microbiota. Resistant starch seems to be a promising dietary fiber for the prevention or treatment of obesity and its related diseases.
Dietary Carbohydrates ; metabolism ; Dietary Fiber ; metabolism ; therapeutic use ; Gastrointestinal Tract ; microbiology ; physiology ; Microbiota ; Obesity ; diet therapy ; prevention & control ; Starch ; metabolism ; Weight Loss