Effect of obesity treatments on eating behavior: psychosocial interventions versus surgical interventions. A systematic review

Objective

(1) To use available research data to estimate the amount of change in eating behavior following obesity treatment; (2) To examine how this change relates to the amount of change in weight loss after treatment and at follow up. A meta-analysis was conducted in September 2009.

Methods

Studies were identified through a computer search of articles in the PubMed and PsychInfo databases. Key terms entered were obesity, treatment, and eating behavior. Effect sizes (Glass d) were calculated according to published procedures.

Results

Eighteen studies met the inclusion and exclusion criteria, grouped into two categories: psychosocial interventions and surgical interventions. For psychosocial interventions, we found a medium effect size on eating behavior (d = .73, CI = (.66, .90)), and a low effect size on weight (d = .32, CI = (.28, .36)) at posttreatment and a low effect size for both outcomes at follow-up (for eating behavior d = .47, CI = (.45, .49), for weight d = .37, (CI = .18, .56)). For surgical interventions we found large effect sizes on both outcomes (for eating behavior d = 1.84, CI = (1.26, 2.42); for weight d = 1.40, CI = (1.25, 1.65)).

Conclusions

Surgical interventions have superior results to psychosocial interventions, on both weight loss and eating behavior. Implications for treatment of obesity are discussed.     

Short-term isocaloric manipulation of carbohydrate intake: effect on subsequent ad libitum energy intake

Background  

Isocaloric manipulation of carbohydrate or fat intake could alter subsequent ad libitum food intake.     

Shortening of gestational length among native-born and immigrants in Spain (1997–2008)

During the last decade there have been significant socio-demographic changes in Spain with potential impact on gestational length. The aim of the study was to describe the evolution of gestational age during 1997–2008, separately for native-born and immigrant population, in order to assess their contribution to the overall pattern of gestational length. A cross-sectional study of 5,018,229 singleton births born between 1997 and 2008 was carried out. The annual mean of gestational age was calculated and compared by means of ANOVA test, globally and also separately for natives and immigrants. Proportions of deliveries by gestational age and maternal characteristics were calculated in 4 periods and compared by means of Chi-square tests. Crude and adjusted multinomial logistic regression models were fitted separately for native-born and immigrant women. Our results show that in the last 12 years a progressive shortening in the mean gestational age has taken place in Spain. While the overall decrease of gestational length along the period was 1.5 days, closer to that in Spanish women (1.3 days), it was 2.3 days among immigrants. In both groups this shortening was mainly due to an increase in the proportion of 37–39 weeks deliveries at the expense of a substantial decrease in those with 40 weeks. These trends remained after controlling for known confounding variables such as maternal age, parity and occupation. Further analysis of its causes and public health implications are recommended.     

Unusual pneumoconiosis in two patients with heavy print toner,and paper dust exposure

Workers in a print shop are exposed to photocopier toner dust and paper dust over a prolonged period of time. However, there are only rare case reports of toner and paper dust induced lung damage in humans. We reviewed our consultation files for a period of 30 years from 1987 to 2018 to look for cases with a diagnosis of giant cell interstitial pneumonia (GIP), printer toner exposure and paper dust exposure resulting in lung disease. There were two cases which met our inclusion criteria. Slides, clinical histories and imaging were reviewed. Both the patients had worked in print shops, and had no history of exposure to hard metals. Patient 1 presented with shortness of breath and cough over several months, while patient 2 was asymptomatic at presentation. Both the patients underwent surgical lung biopsies. Histopathologic examination from both the cases showed a spectrum of pathology, including features of GIP, desquamative interstitial pneumonia, chronic bronchiolitis with lymphoid hyperplasia, and particulate matter consistent with toner. Energy dispersive spectroscopy was performed on one case, and it revealed no cobalt or tungsten particles. The unusual combination of findings is very suggestive that toner particles with or without paper dust exposure were responsible for the pathologic changes in the lungs of these patients. This possibility should be explored further with additional patients who work in print shops where they are exposed to paper dust and paper toner and have signs or symptoms of diffuse lung disease.     

Coping with the stress of parental depression II: adolescent and parent reports of coping and adjustment.

This study examined associations between adolescents' self-reports and parents' reports of adolescents' exposure to family stress, coping, and symptoms of anxiety/depression and aggression in a sample of 78 adolescent offspring of depressed parents. Significant cross-informant correlations were found between adolescents' reports of family stress, their stress responses, and their coping and parents' reports of adolescents' symptoms of anxiety/depression and aggression, but not between parents' reports of adolescents' stress and coping and adolescents' self-reported symptoms. Adolescents' reports of secondary control engagement coping and involuntary engagement stress responses mediated the relation between adolescents' reports of parental stress and parents' reports of adolescents' anxiety/depression symptoms. Moderate levels of correspondence were found in the correlations between parent and adolescent reports of adolescents' exposure to stress, coping, stress responses, and symptoms even after controlling for parents' current depressive symptoms. However, depressed parents reported higher levels of symptoms of anxiety/depression and aggression and more family stress than did their adolescent offspring. Implications for future research on coping and adjustment in offspring of depressed parents are highlighted.     

Gene expression profiles of poor-prognosis primary breast cancer correlate with survival

The extensive heterogeneity of breast cancer complicates the precise assessment of tumour aggressiveness, making therapeutic decisions difficult and treatments inappropriate in some cases. Consequently, the long-term metastasis-free survival rate of patients receiving adjuvant chemotherapy is only 60%. There is a genuine need to identify parameters that might accurately predict the effectiveness of this treatment for each patient. Using cDNA arrays, we profiled tumour samples from 55 women with poor-prognosis breast cancer treated with adjuvant anthracycline-based chemotherapy. Gene expression monitoring was applied to a set of about 1000 candidate cancer genes. Differences in expression profiles provided molecular evidence of the clinical heterogeneity of disease. First, we confirmed the capacity of a 23-gene predictor set, identified in a previous study, to distinguish between tumours associated with different survival. Second, using a refined gene set derived from the previous one, we distinguished, among the 55 clinically homogeneous tumours, three classes with significantly different clinical outcome: 5-year overall survival and metastasis-free survival rates were respectively 100% and 75% in the first class, 65% and 56% in the second and 40% and 20% in the third. This discrimination resulted from the differential expression of two clusters of genes encoding proteins with diverse functions, including the estrogen receptor (ER). Another finding was the identification of two ER-positive tumour subgroups with different survival. These results indicate that gene expression profiling can predict clinical outcome and lead to a more precise classification of breast tumours. Furthermore, the characterization of discriminator genes might accelerate the development of new specific and alternative therapies, allowing more rationally tailored treatments that are potentially more efficient and less toxic.     

Prevalence and Perception of Childhood Obesity in California’s Farmworker Communities

In California’s central valley, childhood obesity rates are above the national average. The majority of families living in the rural, agricultural communities of this region are immigrant of Mexican heritage, and face numerous social and environmental challenges. Demographic and anthropometric data were collected from a population of Mexican-heritage children 3–8 years (N?=?609) and families (N?=?466) living in two central valley communities. Overall, 45?% of children and 82?% of mothers were classified as overweight or obese. Multivariable analyses indicated that mother’s BMI and acculturation level were positively associated with child BMI z-score. Most children classified as overweight or obese (92?% and 53?%, respectively) were perceived as having ‘normal’ weight by their mothers. Childhood obesity remains a major public health issue in Mexican-heritage, central valley communities. Our model indicates that mother’s BMI is predictor of child obesity, and parents tend to underestimate their child’s weight status. These findings highlight a need for family-targeted and culturally-tailored approaches to address relevant perceptions of obesity and risk factors in these communities.     

Yohimbine-induced alterations in alpha(2)-adrenoceptors in kidney regions of the spontaneously hypertensive rats: an autoradiographic analysis

We have tested the hypothesis that a pharmacologically determined alteration in renal alpha(2)-adrenoceptor (alpha(2)-AR) density might be a pathophysiologically important factor of genetic hypertension in the spontaneously hypertensive rats (SHRs). First, we compared he regional distribution and biochemical parameters of alpha(2)-ARs in SHRs and Wistar-Kyoto (WKY) rats, using the full agonist [(3)H]UK 14304. Secondly, we evaluated the effect of selective blockade and stimulation of alpha(2)-ARs on the development of hypertension and on renal alpha(2)-AR density and regional distribution in SHRs. [(3)H]UK 14304 binding was distributed predominantly over the outer medulla, less abundantly over the inner medulla and was almost absent from the renal cortex. Renal alpha(2)-ARs were found to be increased in SHRs at the ages tested compared with their respective controls and the increase was completely localized to the outer medulla. In these rats, blood pressures immediately before sacrifice were significantly higher in the hypertensive group compared with normotensive controls. The daily administration of SK&F 86466 or clonidine significantly decreased the blood pressure but the autoradiographic studies showed that the prolonged administration of yohimbine to rats for two weeks resulted in a large increase in the density of alpha(2)-ARs in some areas of the rat kidney but not in others. Taken together these data do not support the hypothesis that alteration in renal alpha(2)-ARs (as measured by autoradiography) is crucial for the maintenance of hypertension in the SHR model.