Obesity最新文献

{"title":"The various associations between whole /regional fat mass and trajectory of cardiometabolic diseases: a nonlinear multistate model","authors":"Xinming Xu,&nbsp;Yi Guo,&nbsp;Lili Huang,&nbsp;Berty Ruping Song,&nbsp;Dan Chen,&nbsp;Fangfang Weng,&nbsp;Xueying Zheng,&nbsp;Yu Wen,&nbsp;Zhenyu Wu,&nbsp;Xiang Gao,&nbsp;Liang Sun","doi":"10.1002/oby.24185","DOIUrl":"10.1002/oby.24185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to investigate the association of whole body/regional fat mass (FM) with cardiometabolic disease (CMD) trajectory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a prospective analysis using the UK Biobank. The FM index (FMI), a surrogate for whole body FM, and regional FM (i.e., arm, leg, and trunk) were examined as exposures. A nonlinear multistate framework was used to evaluate the association  between whole/regional FM and CMD trajectory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 423,966 participants (mean age 56.1 [SD 8.10] years, 43.9% men) with a median follow-up of 13.5 years, varied associations were identified between whole/regional FM and transitions in the CMD trajectory. Upper body FM (i.e., arm and trunk) exhibited significant positive J-shaped associations in the transitions from first CMD (FCMD) or cardiometabolic multimorbidity to death; however, FMI and leg FM demonstrated L-shaped associations. Leg FM played a beneficial role in the transition from FCMD to death, with a hazard ratio of 0.950 (95% CI: 0.931–0.968) per 1 kg.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Body fat composition and distribution revealed various associations with CMD trajectory, highlighting their clinical importance. Upper body FM among those participants with FCMD or cardiometabolic multimorbidity demonstrated positive J-shaped associations toward death, providing no evidence of the “obesity paradox.”</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"198-208"},"PeriodicalIF":4.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological attributes and eating behaviors in 5- to 12-year-old children during periods of stress","authors":"Cecilia Sena,&nbsp;Julia Della Torre,&nbsp;Eshita Garg,&nbsp;Hao Zheng,&nbsp;Ivette Partida,&nbsp;Shaleen K. Thaker,&nbsp;Jennifer Woo Baidal,&nbsp;Deborah V. Shamsian,&nbsp;John C. Rausch,&nbsp;Vidhu V. Thaker","doi":"10.1002/oby.24197","DOIUrl":"10.1002/oby.24197","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to investigate the association between psychological attributes and obesogenic behaviors in children during the period of COVID-19 pandemic-induced stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational study collected data from caregivers of 5- to 12-year-old children from three diverse groups assessing sociodemographic, economic, and perceived stress, along with the Strengths and Difficulties Questionnaire (SDQ) and the Family Eating and Activity Habits Questionnaire, revised (FEAHQ-R), in October 2020 and June 2021. The outcome measures were SDQ and FEAHQ-R scores. The SDQ subscales were compared with US child norms. Linear mixed models were used to examine the association between the SDQ subscales and FEAHQ-R domains, adjusting for socioeconomic covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 361 families (496 children) completed the SDQ and FEAHQ-R. The SDQ subscale scores were higher than those of age/gender norms (<i>p</i> = 0.006–&lt;0.001). Eating style (<i>p</i> &lt; 0.001) and food stimulus exposure scores (<i>p</i> = 0.005–0.01) were associated with the SDQ subscales, but not satiety response. Perceived stress was a significant covariate (<i>p</i> &lt; 0.01). The baseline obesity status of the children was not statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Psychological stress is associated with higher hedonic behavior in children. Food stimulus exposure and leisure access can be targeted for intervention during periods of prolonged stress.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"134-145"},"PeriodicalIF":4.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.24197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor by Athinarayanan","authors":"Jaime P. Almandoz,&nbsp;Thomas A. Wadden,&nbsp;Colleen Tewksbury,&nbsp;Caroline M. Apovian,&nbsp;Angela Fitch,&nbsp;Jamy D. Ard,&nbsp;Zhaoping Li,&nbsp;Jesse Richards,&nbsp;W. Scott Butsch,&nbsp;Irina Jouravskaya,&nbsp;Kadie S. Vanderman,&nbsp;Lisa M. Neff","doi":"10.1002/oby.24191","DOIUrl":"10.1002/oby.24191","url":null,"abstract":"&lt;p&gt;&lt;b&gt;TO THE EDITOR:&lt;/b&gt; We thank Dr. Athinarayanan for her interest in our review [&lt;span&gt;(1)&lt;/span&gt;] and appreciate the opportunity to respond.&lt;/p&gt;&lt;p&gt;We agree that patients face many challenges maintaining long-term body weight reduction, including widespread misconceptions regarding the long-term effectiveness of lifestyle interventions for obesity, along with the body's physiological response to weight loss, which can lead to reduced energy expenditure and increased appetite [&lt;span&gt;(2)&lt;/span&gt;]. Limited access to treatment is also a barrier to successful long-term weight management [&lt;span&gt;(3)&lt;/span&gt;]. However, we dispute Dr. Athinarayanan's suggestion that dietary carbohydrate restriction (or any other lifestyle intervention) is a proven, effective strategy for weight maintenance after treatment with antiobesity medications (AOMs). Evidence from numerous randomized controlled trials (RCTs) shows that, even with ongoing lifestyle counseling, weight regain is typically observed after AOM cessation [&lt;span&gt;(1)&lt;/span&gt;]. Accordingly, long-term use of pharmacotherapy is recommended for weight maintenance [&lt;span&gt;(1)&lt;/span&gt;]; therefore, weight management after deprescription was outside of the scope of our review.&lt;/p&gt;&lt;p&gt;Our review recommended a variety of healthy dietary patterns for patients treated with AOMs and highlighted the importance of individualized lifestyle goals. A low-carbohydrate diet was not excluded from our recommendations, and we provided guidance for clinicians whose patients prefer this dietary pattern. However, when considering the potential impacts of dietary patterns on long-term health outcomes such as cardiovascular disease and mortality, there is more evidence to support a recommendation for moderate-carbohydrate dietary patterns such as the Mediterranean and healthy plant-based diets [&lt;span&gt;(1, 4)&lt;/span&gt;]. Indeed, we feel that the strength of the evidence to specifically recommend a low-carbohydrate dietary pattern is low. The carbohydrate-insulin model is an interesting but controversial theoretical model that is challenged by scientific evidence that supports alternate theories of obesity pathophysiology [&lt;span&gt;(2, 5)&lt;/span&gt;]. As evidence of the efficacy of low-carbohydrate dietary patterns on weight maintenance, Dr. Athinarayanan cites nonrandomized studies, including a report from the National Weight Control Registry, a prospective cohort study of individuals who, prior to study entry, had maintained a weight reduction of at least 30 lb for 1 year or more. Of note, only 11% of registry participants reported losing weight with a low-carbohydrate dietary approach [&lt;span&gt;(6)&lt;/span&gt;]. We appreciate the work of Dr. Athinarayanan and colleagues, which includes descriptive, nonrandomized studies of outcomes among patients with type 2 diabetes who self-selected a telehealth-based continuous care program leveraging a low-carbohydrate dietary pattern [&lt;span&gt;(7, 8)&lt;/span&gt;]. We also appreciate their recent retrospective analysis of th","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"9-11"},"PeriodicalIF":4.2,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to “Nutritional considerations with antiobesity medications”","authors":"Shaminie J. Athinarayanan","doi":"10.1002/oby.24187","DOIUrl":"10.1002/oby.24187","url":null,"abstract":"","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"7-8"},"PeriodicalIF":4.2,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DNA methylation in cord blood partially mediates the effects of prepregnancy BMI on early childhood offspring BMI","authors":"Alice Maguolo,&nbsp;Josefine Jönsson,&nbsp;Alexander Perfilyev,&nbsp;Marlena Maziarz,&nbsp;Allan Vaag,&nbsp;Emma Malchau Carlsen,&nbsp;Kirsten Nørgaard,&nbsp;Paul W. Franks,&nbsp;Kristina M. Renault,&nbsp;Charlotte Ling","doi":"10.1002/oby.24174","DOIUrl":"10.1002/oby.24174","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We investigated whether prepregnancy BMI (prePregBMI) in women with obesity was associated with differential DNA methylation (DNAm) in cord blood (CB) and whether DNAm may mediate the association of prePregBMI and early childhood BMI <i>z</i> score (BMIz).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From the Treatment of Obese Pregnant Women (TOP) study, 232 mother–child pairs were included. We conducted an epigenome-wide association study on prePregBMI and CB DNAm (450k array), followed by causal mediation analyses to test whether DNAm may mediate effects of prePregBMI on  BMIz at age 36 months (BMIz36).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DNAm at 5345 CpG sites annotated to 2842 genes, which were overrepresented in biological processes linked to carbohydrate metabolism and plasma lipoprotein particle clearance, was associated with prePregBMI (false discovery rate &lt; 10%). Causal mediation analyses of 168 methylation sites associated with BMIz36 (<i>p</i> &lt; 0.05) and overlapping with the 5345 prePregBMI-associated sites identified two sites on <i>SYT7</i> and <i>DEAF1</i>, partially mediating the effect of prePregBMI on BMIz36 (<i>p</i> ≤ 0.01). After cross-validation, a methylation risk score including these two sites could predict the highest quartile of BMIz36 and fat mass (in grams) with area under the curve = 0.72 (95% CI: 0.58–0.85) and area under the curve = 0.71 (95% CI: 0.58–0.85), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CB DNAm at birth may partially mediate effects of prePregBMI on early childhood BMIz36, supporting its plausible role in influencing individual future obesity risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"177-189"},"PeriodicalIF":4.2,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Early changes in the gut microbiota are associated with weight outcomes over 2 years following metabolic and bariatric surgery”","authors":"","doi":"10.1002/oby.24209","DOIUrl":"10.1002/oby.24209","url":null,"abstract":"<p>\u0000 <span>Steffen, KJ</span>, <span>Sorgen, AA</span>, <span>Fodor, AA</span>, et al. <span>Early changes in the gut microbiota are associated with weight outcomes over 2 years following metabolic and bariatric surgery</span>. <i>Obesity (Silver Spring)</i> <span>2024</span>; <span>32</span>: <span>1985</span>–<span>1997</span>.</p><p>On pages 1992 and 1995, panels from Figures 4 and 7 were inadvertently omitted. Below are the correct figures.</p><p>We apologize for this error.</p>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 2","pages":"422-423"},"PeriodicalIF":4.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.24209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daily glucose variability is associated with intrahepatic fat content, β cell sensitivity, and biomarkers of glycolysis in youth with obesity","authors":"Emiliano Barbieri,&nbsp;Jacopo Bonet,&nbsp;Delaney Fox,&nbsp;Rafaela Nelson,&nbsp;Michael B. Nelson,&nbsp;Loretta Nelson,&nbsp;Cristina Fernandez,&nbsp;Michelle Van Name,&nbsp;Stephanie Samuels,&nbsp;Sonia Caprio,&nbsp;Mohammad Sabati,&nbsp;Alfonso Galderisi,&nbsp;Jennifer Sherr,&nbsp;Chiara Dalla Man,&nbsp;Nicola Santoro","doi":"10.1002/oby.24175","DOIUrl":"10.1002/oby.24175","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Pediatric obesity is associated with insulin resistance, which, in turn, impacts glucose and lipid metabolism. This study sought to assess how glucose variability relates to intrahepatic fat content, β cell insulin sensitivity, and glycolysis in youth with obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 27 youth with obesity (11 girls, BMI percentile, median [25th–75th percentiles]: 99.0 [97.9–99.0]) wore a continuous glucose monitoring device for 10 days and underwent a 3-h oral glucose tolerance test. β cell function was assessed using the oral minimal model, and liver proton density fat fraction was measured by magnetic resonance imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Average sensor-derived glucose and glucose standard deviation (STDEV) and coefficient of variation (CV) were associated with liver proton density fat fraction (<i>p</i> = 0.0130, <i>p</i> = 0.0005, and <i>p</i> = 0.0028, respectively). First-phase insulin secretion, basal insulin secretion, and insulin sensitivity were associated with STDEV (<i>p</i> = 0.0344, <i>p</i> = 0.0091, and <i>p</i> = 0.0031, respectively) and CV (<i>p</i> = 0.0128, <i>p</i> = 0.0012, and <i>p</i> = 0.0022, respectively). STDEV and CV were also associated with 2-h glucose (<i>p</i> = 0.0067 and <i>p</i> = 0.0324, respectively) and plasma lactate (<i>p</i> = 0.0030 and <i>p</i> = 0.0123, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Daily glucose variability is associated with the degree of intrahepatic fat content, postprandial glucose, and plasma lactate concentrations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"116-124"},"PeriodicalIF":4.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming underestimation of the share of colorectal cancer cases attributable to excess weight: a population-based study","authors":"Marko Mandic,&nbsp;Fatemeh Safizadeh,&nbsp;Michael Hoffmeister,&nbsp;Hermann Brenner","doi":"10.1002/oby.24164","DOIUrl":"10.1002/oby.24164","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Previous research may have underestimated the relationship between overweight/obesity and colorectal cancer (CRC) risk by overlooking important potential sources of bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used data from a large, population-based case–control study encompassing 7098 CRC cases and 5757 age- and sex-matched controls with comprehensive information on risk factors, including self-reported body weight. Multivariate logistic regression was used to assess the associations of BMI with CRC risk before and after considering prediagnostic weight loss, history of lower gastrointestinal endoscopy, and potentially increased CRC risk beneath the overweight threshold (BMI 25 kg/m²). Subsequently, population attributable fractions were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the standard analysis evaluating the BMI-CRC association, in which none of the three aforementioned factors was considered, the fraction of CRC cases attributable to overweight and obesity was estimated to be 11.5%. This finding is consistent with estimates from previous studies, which mostly did not consider any of the three factors. However, when all three factors were considered in the analysis, a higher BMI was estimated to account for 23.4% of all CRC cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Careful consideration of important sources of bias suggests that a substantially larger share of the CRC burden may be attributable to excess weight than previously thought.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"156-163"},"PeriodicalIF":4.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation effectiveness of an antenatal lifestyle intervention to optimize gestational weight gain in women with obesity","authors":"Rebecca F. Goldstein,&nbsp;Jacqueline A. Boyle,&nbsp;Shamil D. Cooray,&nbsp;Anju E. Joham,&nbsp;Alison L. Fitz-Gerald,&nbsp;Joanne Enticott,&nbsp;Cheryce L. Harrison,&nbsp;Helena J. Teede","doi":"10.1002/oby.24192","DOIUrl":"10.1002/oby.24192","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to evaluate a lifestyle intervention implemented into routine antenatal care to optimize gestational weight gain (GWG) and outcomes using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was an embedded pragmatic behavioral intervention delivered by a health coach and supported by a physician over five sessions for women with a prepregnancy BMI between 25 and 43 kg/m² who were &lt;23 weeks' gestation in an Australian maternity service. Both intervention and standard care received routine antenatal care. The primary outcome was effectiveness in reducing excess GWG, and the secondary outcomes were reach, adoption, implementation, and maintenance and maternal and neonatal outcomes using the RE-AIM framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For the “Reach” aspect, 90% of eligible women were included (<i>N</i> = 404; <i>n</i> = 202 intervention and <i>n</i> = 202 standard care). For the “Efficacy” aspect, there were no differences in proportion exceeding GWG recommendations or mean GWG between groups. Secondary analysis excluding women with gestational diabetes showed that a lower proportion of women in the intervention group had GWG above recommendations (β coefficient 0.51, 95% CI: 0.27 to 0.97; <i>p</i> = 0.04), with less GWG (β coefficient −1.93 kg, 95% CI: −3.63 to −0.24; <i>p</i> = 0.03). For the “Adoption” aspect, qualitative analysis of staff/participants demonstrated strong support for service. For the “Implementation” aspect, strong fidelity (implementation according to study plan) and staff/participant acceptability were observed. Finally, for the “Maintenance” aspect, the program has continued for 4 years with plans/funding for scale-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lifestyle intervention did not alter the overall proportion with excess GWG or total GWG. Secondary analysis, excluding women with gestational diabetes mellitus, showed less GWG. This demonstrates implementation and maintenance of the intervention in routine antenatal care, generating new knowledge within the RE-AIM framework.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"54-66"},"PeriodicalIF":4.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 enhances β-cell response to protein ingestion and bariatric surgery amplifies it","authors":"Maria Rayas,&nbsp;Samantha Pezzica,&nbsp;Henri Honka,&nbsp;Fabrizia Carli,&nbsp;Richard Peterson,&nbsp;Ralph DeFronzo,&nbsp;Amalia Gastaldelli,&nbsp;Marzieh Salehi","doi":"10.1002/oby.24182","DOIUrl":"10.1002/oby.24182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The glycemic-independent actions of glucagon-like peptide-1 (GLP-1) in the prandial state in humans are unknown. We examined the contribution of GLP-1 to β-cell secretory response (primary endpoint) and glucose metabolism during protein ingestion under basal glycemia, as well as whether these responses are affected by rerouted gut after gastric bypass (GB) or sleeve gastrectomy (SG).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Insulin secretion rate (ISR) and glucose fluxes during a 50-g oral protein load were compared among 10 nondiabetic individuals with GB, 9 with SG, and 7 non-operated controls (CN), with and without intravenous infusion of exendin(9-39) (Ex-9), a GLP-1 receptor (GLP-1R) antagonist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Blocking GLP-1R increased glucose before and after protein ingestion and decreased β-cell sensitivity to glucose in the first 30 min of protein ingestion in all three groups (<i>p</i> &lt; 0.05). Reduction in the premeal ISR by Ex-9 infusion was only observed in CN, whereas diminished prandial ISR_3h by GLP-1R blockade was only observed in GB and SG (<i>p</i> &lt; 0.05 for interaction). GLP-1R blockade enhanced post-protein insulin action in GB and SG, but not in CN, and exaggerated endogenous glucose production only GB (<i>p</i> &lt; 0.05 for interaction).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings are consistent with both pancreatic and extra-pancreatic roles for GLP-1 during protein ingestion in humans that are exaggerated by bariatric surgery.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"104-115"},"PeriodicalIF":4.2,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.24182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}