Self-efficacy improves weight loss in overweight/obese postmenopausal women during a 6-month weight loss intervention

The objective was to examine the relationship between self-efficacy and subsequent weight loss during a 6-month weight loss intervention in 90 white early postmenopausal healthy women. We hypothesized that participants with higher self-efficacy scores, either at baseline or follow-up, would lose more weight than those with lower scores. Each participant received a balanced meal plan with reduced energy intake. Nutritional and behavioral sessions were provided every 2 weeks during the first 3 months. Weight and height were measured at baseline, every 2 weeks in the first 3 months, and at month 6. Three-day dietary and physical activity records and Weight Efficacy Lifestyle Questionnaire were completed at the same intervals. At month 6, participants lost 3.6 ± 4.1 kg or 4.4% (mean ± SD) and decreased in weight from 82.2 ± 11.1 kg to 77.6 ± 11.4 kg (P < .001). When participants were divided into groups based on weight loss success (<5% or ≥5% of initial weight), logistic regression (controlling for age, energy intake, physical activity, attendance at group sessions, and previous weight loss attempts) demonstrated that higher self-efficacy for the Availability of Food subscale of Weight Efficacy Lifestyle Questionnaire (95% confidence interval, 1.03-1.17) and total self-efficacy (95% confidence interval, 1.00-1.04) were associated with a greater likelihood of losing 5% or more of initial weight. Overall, participants who had higher total self-efficacy and self-efficacy to resist eating when food was available were able to lose more weight. Therefore, cognitive-behavioral efforts promoting self-efficacy may be useful for bolstering individual's confidence to resist eating under various conditions and thereby improve weight loss outcomes.     

Reduction of visceral adipose tissue during weight loss

OBJECTIVE: The aims of the present study were to retrospectively: (1) compare how weight loss affects the reduction of adipose tissue from three different sites between men and women; and (2) to verify whether gender differences in the reduction of adipose tissue are influenced by changes in fat mass (FM) and initial levels of fat in different compartments. DESIGN: Double-blind randomized treatment with fenfluramine once daily coupled to a non-macronutrient specific energy restriction. SUBJECTS: Seventeen obese men (age 43.9+/-1.5 and body mass index (BMI) 34.3+/-0.7) and 17 obese women (age 41.2+/-1.2 and BMI 35.7+/-0.6). INTERVENTIONS: Subjects were given fenfluramine (60 mg) or placebo once daily and were also subjected to a non-macronurient specific energy restriction of -2.9 MJ/day (-700 kcal/day) for 15 weeks. RESULTS: Body weight, FM, fat-free mass (FFM), waist circumference, BMI, as well as visceral (VAT), subcutaneous abdominal (SAT) and thigh (TAT) adipose tissue were all significantly reduced. Men lost significantly more VAT (-41.6%) than SAT (-22.5%), or than TAT (-20.5%) while no site difference in fat loss was observed in women when changes were calculated as a percentage of initial levels. Men lost about twice as much fat from the VAT compartment than did women (P<0.05), even after having considered changes in FM as a potential covariate. In absolute values, TAT was reduced to a lesser extent in men than in women. However, when initial levels of respective fat depots were also taken into account, gender differences in VAT and TAT loss were no longer statistically significant. CONCLUSION: These results suggest that gender differences in VAT reduction during weight loss are independent of changes in FM. However, once initial levels of VAT are also taken into account, gender differences in the reduction of this tissue during weight loss are no longer apparent.     

L-Carnitine supplementation combined with aerobic training does not promote weight loss in moderately obese women

L-Carnitine (L-C) transports fatty acids into mitochondria for oxidation and is marketed as a weight loss supplement. In a double-blind investigation to test the weight loss efficacy of L-C, 36 moderately overweight premenopausal women were pair matched on Body Mass Index (BMI) and randomly assigned to two groups (N = 18). For 8 weeks the L-C group ingested 2 g twice daily of L-C, while the placebo (P) group ingested the same amount of lactose. All subjects walked for 30 min (60-70% maximum heart rate) 4 days/week. Body composition, resting energy expenditure (REE) and substrate utilization were estimated before and after treatment. For the subjects who completed the study (15 P, 13 L-C), no significant changes in mean total body mass (TBM), fat mass FM, and resting lipid utilization occurred over time, nor were there any significant differences between groups for any variable. Conversely REE increased significantly for all subjects, but no between group differences existed. Five of the L-C group experienced nausea or diarrhea and consequently did not complete the study. Eight weeks of L-C ingestion and walking did not significantly alter the TBM or FM of overweight women, thereby casting doubt on the efficacy of L-C supplementation for weight loss.     

Maintenance of weight loss in obese subjects.

The records of a selected group of 215 subjects who had successfully lost surplus weight were followed-up for periods of one to six years. Mean initial weight was 131% of standard (19.5 kg surplus) and the mean time taken to achieve 'goal weight' was 7.05 months (range two to 20 months) at a mean rate of 2.9 kg per month (range 1.85 to 5 kg). Altogether 121 subjects (56.3%) maintained goal weights within plus or minus 2.3 kg of goal; 79 subjects (36.7%) maintained within plus or minus 4.5 kg. At time of examination of the records, 39 subjects (18.8%) had maintained constant weight for more than four years, 22 subjects (10.6%) for three to four years, 65 subjects (31.4%) for two to three years, 58 subjects (28.5%) for one to two years, and 23 subjects (11.1%) for periods of up to one year.     

Diets containing Sophora japonica L. prevent weight gain in high-fat diet-induced obese mice

Obesity, a worldwide epidemic, is associated with metabolic diseases such as insulin resistance, dyslipidemia, hypertension, and heart disease. Many strategies, including natural alternative antiobesity agents, have been widely used to prevent obesity. Polyphenolic compounds and flavonoids from natural products are shown to inhibit adipogenesis. Because mature fruits of Sophora japonica L. were previously shown to contain antiadipogenic compounds, we hypothesized that diets with mature fruits of S japonica L. would prevent body weight gain in high-fat diet–induced obesity. Four-week-old mice were fed either a control high-fat diet, or high-fat diet containing 1% or 5% of S japonica L. for 4 weeks. The administration of S japonica L. fed in combination with a 30% high-fat diet significantly decreased body weight gain. S japonica L. also reduced serum and hepatic triglyceride, serum total, and high-density lipoprotein cholesterol. Consistent with the effects of lowering glucose level and fat mass, S japonica L. caused a decrease in the number of large adipocytes and a concomitant increase in the number of small adipocytes, which may explain at least in part the antiobesity effects of S japonica L. Together, these data provide evidence for roles of S japonica L. in the control of body weight and obesity-related metabolic diseases.     

Beta-oxidation of linoleate in obese men undergoing weight loss

BACKGROUND: In animals, the whole-body content and accumulation of linoleate can be measured and compared with its intake to determine linoleate beta-oxidation. This method can also provide quantitative information about the beta-oxidation of linoleate in humans. OBJECTIVES: The objectives of the study were to 1) use the wholebody fatty acid balance method to quantify whole-body concentrations of linoleate in humans, 2) estimate the distribution of linoleate between adipose and lean tissue, and 3) assess the effect of weight loss on linoleate stores and beta-oxidation in obese humans. DESIGN: Nine healthy obese men underwent supervised weight loss for 112 d (16 wk). Magnetic resonance imaging data and fatty acid profiles from fat biopsies were both used to determine linoleate stores in adipose and lean tissue and in the whole body. Linoleate beta-oxidation was calculated as intake - (accumulation + excretion). RESULTS: Mean weight loss was 13 kg and linoleate intake was 24 +/- 6 mmol/d over the study period. Whole-body loss of linoleate was 37 +/- 18 mmol/d, or 28% of the level before weight loss. Combining the intake and whole-body loss of linoleate resulted in linoleate beta-oxidation exceeding intake by 2.5-fold during the weight-loss period. CONCLUSIONS: All dietary linoleate is beta-oxidized and at least an equivalent amount of linoleate is lost from the body during moderate weight loss in obese men. The method studied permits the assessment of long-term changes in linoleate homeostasis in obese humans and may be useful in determining the risk of linoleate deficiency in other conditions.     

Intensive lifestyle intervention combined with the choice of pharmacotherapy improves weight loss and cardiac risk factors in the obese

Background Obesity is on the increase yet within the National Health Service (NHS) treatment approaches differ greatly and service is patchy. Our aim was to compare current practice within a general dietetic clinic with a new clinic developed specifically for patients of higher morbidity risk. Methods Locally referred patients to the dieticians from within or without Hammersmith Hospitals NHS Trust of higher morbidity risk were invited to attend a new Lifestyle Clinic. Treatment was of a contractual nature and included more time with the dietitian, the offer of pharmacotherapy if appropriate and an emphasis on achieving a realistic weight loss of 10% within a 6‐month period. Cognitive behavioural strategies were utilized focusing on achieving changes in dietary intake and physical activity levels. Results A total of 103 patients have been enrolled of whom 34 have been discharged before completion of the clinic programme. Twenty‐six patients have completed (18 started pharmocotherapy with Orlistat and eight remained on lifestyle advice only), with the remainder still attending the Lifestyle Clinic. The results for these 26 patients demonstrate clinically significant benefits with regard to exercise tolerance390.8 ± 37.5 m vs. 473 ± 46.6 m (P < 0.001), waist measurement 121.5 ± 4.4 cm vs. 110.9 ± 3.6 cm (P < 0.001), and total cholesterol : HDL ratio 1.17 ± 0.05 mmol L^?1 vs. 1.27 ± 0.07 mmol L^?1 (P < 0.05). A weight loss comparison with historical data collected in the general dietetic clinic achieves a 7.8 ± 0.7 kg reduction in weight (with pharmocotherapy 8.96 ± 0.98 kg, with lifestyle only 5.23 ± 0.657) vs. 1.7 ± 0.4 kg (P < 0.05). Conclusion Lifestyle clinics facilitate beneficial lifestyle changes which impact positively on morbidity risk factors demonstrating an improvement on current service offered within the NHS. There is an obvious resource implication of offering an intensive management package. There is need for a randomized control trial with analysis to evaluate whether there is cost benefit from this type of intervention.     

Calcium and dairy acceleration of weight and fat loss during energy restriction in obese adults

OBJECTIVE: Increasing 1,25-dihydroxyvitamin D in response to low-calcium diets stimulates adipocyte Ca2+ influx and, as a consequence, stimulates lipogenesis, suppresses lipolysis, and increases lipid accumulation, whereas increasing dietary calcium inhibits these effects and markedly accelerates fat loss in mice subjected to caloric restriction. Our objective was to determine the effects of increasing dietary calcium in the face of caloric restriction in humans. RESEARCH METHODS AND PROCEDURES: We performed a randomized, placebo-controlled trial in 32 obese adults. Patients were maintained for 24 weeks on balanced deficit diets (500 kcal/d deficit) and randomized to a standard diet (400 to 500 mg of dietary calcium/d supplemented with placebo), a high-calcium diet (standard diet supplemented with 800 mg of calcium/d), or high-dairy diet (1200 to 1300 mg of dietary calcium/d supplemented with placebo). RESULTS: Patients assigned to the standard diet lost 6.4 +/- 2.5% of their body weight, which was increased by 26% (to 8.6 +/- 1.1%) on the high-calcium diet and 70% (to 10.9 +/- 1.6% of body weight) on the high-dairy diet (p < 0.01). Fat loss was similarly augmented by the high-calcium and high-dairy diets, by 38% and 64%, respectively (p < 0.01). Moreover, fat loss from the trunk region represented 19.0 +/- 7.9% of total fat loss on the low-calcium diet, and this fraction was increased to 50.1 +/- 6.4% and 66.2 +/- 3.0% on the high-calcium and high-dairy diets, respectively (p < 0.001). DISCUSSION: Increasing dietary calcium significantly augmented weight and fat loss secondary to caloric restriction and increased the percentage of fat lost from the trunk region, whereas dairy products exerted a substantially greater effect.     

分阶段减重模式对超重肥胖女性减重效果的研究

目的 探讨分阶段减重模式对超重肥胖女性减重效果,为临床减重方案提供依据。方法 选取2021年1—6月在青岛市妇女儿童医院营养门诊减重的无器质疾病的超重肥胖女性46例作为研究对象,采用一阶段极低碳水化合物饮食2周,二阶段限能量平衡饮食4周,期间配合有氧、抗阻力运动。监测干预前后减重者体重、形态学指标、体成分指标的变化。数据采用重复测量方差分析进行统计学分析。结果 46例减重者经过两阶段的饮食及运动干预,体重（F = 343.033,P＜0.001）、体质指数（body mass index,BMI）（F = 331.302,P＜0.001）、腰围（F = 124.360,P＜0.001）、臀围（F = 80.558,P＜0.001）、腰臀比（F = 8.325,P = 0.002）、体脂肪（F = 255.959,P＜0.001）、内脏脂肪面积（F = 123.372,P＜0.001）、体脂率（F = 134.714,P＜0.001）均下降,差异具有统计学意义。结论 分阶段减重模式可以明显降低超重肥胖女性的体重,改善体成分,为临床减重提供思路。     

Family characteristics affect rates of weight loss in obese children

Results of weight reduction programs for obese children have rarely been reported. No existing data describe the family characteristics associated with weight reduction. We treated 71 obese children, aged 7–13 years as outpatients during a one year period. Children and their parents were seen in separate groups. Treatment included nutrition education, hypocaloric diets, and behavior modification. Less than one-third of the patients completed the program. Mean weight loss during the program was 1.4 kg. One-third of our patients lost more than 2.5 kg; 11% lost more than 5.0 kg.Rates of weight loss were asoociated with parental obesity, and, independently, with parental marital status. The effect of parental obesity was independent of the sex of the parent or child. Birth order, family size and the severity of obesity had no significant effect on either rates of or absolute weight losses. These results indicate that family variables are associated with both the onset and course of childhood obesity. Because comparative studies of therapy have usually involved small numbers of patients, their results may have been confounded by the effects of parental obesity and marital status on weight loss.     

Effect of weight loss on bone metabolism in postmenopausal obese women with osteoarthritis

BackgroundThe choice of hypocaloric diets in obesity can affect bone health.AimsThe aim of this study is to assess the effect of a hypocaloric diet in postmenopausal obese women and to determine the influence of weight reduction on bone metabolism.MethodsThis was a non-randomised, single-treatment study in 96 postmenopausal women with a body mass index (BMI) greater than 35 kg/m² and osteoarthritis. The patients received a formula diet with two intake levels of a normocaloric hyperproteic formula (1035 kcal (25% protein)). Anthropometry and biochemistry with CrossLaps, osteocalcin, parathyroid hormone (PTH) and 25-OH vitamin D were measured. Consumption of protein, calcium and vitamin D were determined at the beginning of and 3 and 6 months into the study. The response to treatment was compared (high-responder (HR): weight loss greater than 15%, and low-responder (LR): weight loss less than 15%).ResultsThe mean age was 64.2 (7.5) years. After 6 months of treatment, a weight loss of 10.2% (8.2–13.8) was observed. There was a significant increase in vitamin D (HR: 21.8% (36.2) vs. LR: 22.7% (36.9), p = 0.93) and CrossLaps (HR: 26.8% (19.5–35.2)) vs. LR: 13.3% (?6.1 to 27.9), p = 0.01). The loss of more than 15% of initial body weight was an independent risk factor for an increase in CrossLaps (OR: 4.22 (1.1–16.8), p = 0.04).ConclusionsIn postmenopausal obese women, weight loss was associated with an increase in the biochemical parameters of bone resorption. The increase in resorption parameters was related to the magnitude of weight loss.