1,720,979 research outputs found
ESPEN research fellowship
No full textSPECIFIC AIMS:
We hypothesize that a moderate 8-10% weight loss in metabolically-abnormal normal-weight (MANW) will improve i) multi-organ insulin sensitivity, evaluated by using the hyperinsulinemic-euglycemic clamp procedure, in conjunction with stable isotopically-labeled tracer infusion, to measure insulin-mediated suppression of glucose production, insulin mediated-suppression of free fatty acid (FFA) rate of appearance (Ra) in plasma, insulin-stimulated glucose disposal, ii) dyslipidemia, evaluated by assessing plasma lipid, plasma triglyceride and HDL concentrations, and iii) intrahepatic triglyceride (IHTG) content, evaluated by magnetic resonance spectroscopy (MRS). iv) We also want to characterize MANW gut microbiota profile before and after weight loss
Healthy lifestyle and Mediterranean-diet: fighting against obesity for healthy aging and cancer prevention
No full textObesity has nearly tripled since 1975 worldwide, with 39% of adults being overweight in 2016, while 13% were obese. Non-communicable diseases (NCDs) are responsible for 74% of all deaths globally, with cardiovascular diseases accounting for most NCD deaths, followed by cancers, chronic respiratory diseases and diabetes. All the NCDs are related to obesity and most of the risk factors recognized that can be considered preventable: tobacco use, physical inactivity, alcohol abuse and unhealthy diets. The aim of this PhD project is to uncover some links between obesity or overweight and cancer, one of the leading causes for mortality among the NCDs, specifically focusing on breast cancer for the exploratory project of this thesis. Healthy lifestyle, including both healthy diet and physical activity engagement, improve body composition and nutritional status at different levels and can be considered pivotal for cancer and metabolic disease prevention and treatment. In 2010, the Mediterranean diet (MD) was recognized as an Intangible Cultural Heritage of Humanity by the United Nations Educational, Scientific and Cultural Organization (UNESCO). Before and since then, increasing evidence supported the MD as one of the most effective healthy pattern for the prevention of NCDs, raising the scientific attention to a cultural pattern synthetized graphically by an iconic Pyramid. Additionally, Mediterranean lifestyle emphasize together with a healthy dietary pattern, regular physical exercise, which constitutes another key pillar for health promotion.Health-promoting effects of exercise remain poorly understood together with the mechanisms regulating cellular senescence, a state of irreversible growth arrest. Long-term moderate calorie restriction and endurance exercise training can decelerate biological aging, promoting visceral fat loss, reducing inflammation and oxidative stress, helping with prevention of cancer, particularly breast cancer. Moreover, during the years of this project the pandemic outbreak of Sars-Cov2 gave the opportunity to show how obesity, adipose tissue excess and also muscle mass depletion can be important not only for NCDs prevention, but also in the fight against communicable disease. In the end, aiming to fight obesity and cancer, we present the results on metabolic improvements after 2 years of weight management through the implementation of Mediterranean diet in breast cancer survivors, with anexploratory analysis of the dropouts to identify possible predictors that can interfere with a long- term compliance to weight loss protocols
Will calorie restriction work in humans?
Full text linkCalorie Restriction (CR) without malnutrition slows aging and increases average and maximal lifespan in simple model organisms and rodents. In rhesus monkeys long-term CR reduces the incidence of type 2 diabetes, cardiovascular disease and cancer, and protects against age-associated sarcopenia and neurodegeneration. However, so far CR significantly increased average lifespan only in the Wisconsin, but not in the NIA monkey study. Differences in diet composition and study design between the 2 on-going trials may explain the discrepancies in survival and disease. Nevertheless, many of the metabolic and hormonal adaptations that are typical of the long-lived CR rodents did not occur in either the NIA or WNPRC CR monkeys. Whether or not CR will extend lifespan in humans is not yet known, but accumulating data indicate that moderate CR with adequate nutrition has a powerful protective effect against obesity, type 2 diabetes, inflammation, hypertension, cardiovascular disease and reduces metabolic risk factors associated with cancer. Moreover, CR in human beings improves markers of cardiovascular aging, and rejuvenates the skeletal muscle transcriptional profile. More studies are needed to understand the interactions between CR, diet composition, exercise, and other environmental and psychological factors on metabolic and molecular pathways that regulate health and longevity
Preoperative weight loss by noninvasive approach in patients with obesity scheduled for bariatric and metabolic surgery: an update narrative review of indications and results available until 2024
No full textMetabolic and bariatric surgery (MBS) is the most effective treatment for severe obesity and its metabolic complications. Currently, most MBSs are performed laparoscopically. However, high weight associated with an enlarged liver (especially the left lobe liver section, LLLS) may complicate the technical aspects of this surgery. Therefore, before MBS, moderate preoperative weight loss (PreopWL), and reduction in LLLS are desirable. Moreover, studies are inconclusive regarding which is the best approach to apply. This narrative review aimed to describe the current scientific evidence on the effect of a noninvasive approach, such as dietary or pharmacotherapy or space-occupying devices on PreopWL, peri-operative complications, hospital length of stay, and post-operative complications in patients with obesity scheduled for MBS. We conducted a literature search and screening for relevant publications from January 2010 to June 2024. We found that PreopWL before MBS is helpful for both patients and surgeons, as it leads to various benefits, such as a decrease in body weight and LLLS size, a lower risk of intra- and post-operative complications, shorter surgery times, and reduced hospital stays. In this context, concerning dietary approaches, several dietary protocols have been introduced over time, among which very low-calorie diets and very low energy ketogenic therapy are widely prescribed; however, larger randomized-controlled trials (RCTs) with well-defined dietary protocols are necessary to make definitive conclusions. Obesity management medications, such as the lipase inhibitor orlistat, phentermine/topiramate, naltrexone/bupropion, the glucagon-like peptide-1 receptor agonists (GLP-1RAs) liraglutide and semaglutide, and the novel dual glucose dependent insulinotropic peptide (GIP)/GLP-1 receptor agonist tirzepatide, has shown to be effective in promoting PreopWL before MBS; however, larger, well-designed RCTs are needed to establish optimal treatment protocols and assess their true benefits in patients scheduled for MBS. Space-occupying devices such as the swallowable intragastric balloon and hydrogel capsules, represent a promising tools but further research is essential to confirm their role
Dietary Intervention and Nutritional Counseling
No full textThe dietary treatment for weight loss in overweight and obesity has been approached in many different dietary models. Nevertheless, beside the size of weight loss, the main outcomes should be mostly the improvement of body composition (loss of body fat and preservation of lean body mass), long-term maintenance, nutritional quality of the diet, lower risk for chronic diseases (better metabolic parameters), improvement in quality of life and psychological well-being. The most popular diets have been analyzed: High protein diets (HPD); Low-carbohydrate diets (LChoD) and Low Glycaemic Index or Load diets (LGID); Low-Fat diets (LFD); Low Calorie Diet (LCD) and Very low-calorie diet (VLCD); Ketogenic diets (KD). In the end, the criteria for the development of a balanced dietary treatment in obese patient are discussed as a result of a critical analysis of the different dietary patterns described. Several evidences lead to the conclusion that the Mediterranean dietary pattern better respects the clinical guidelines for overweight and obesity treatment. In order to achieve a good compliance and the subsequently long-term results, the multidisciplinary approach, based on nutritional counseling, physical activity, together with the cognitive-behavioral therapy, is the only reasonable therapeutic option
La Qualità della Vita (QoL) in soggetti affetti da obesità di grado elevato: ruolo dell’Educazione Terapeutica (ET)
No full textPremesse: recenti revisioni della letteratura dimostrano che il decremento ponderale è correlato ad un
significativo miglioramento della QoL, valutata attraverso SF36, sotto il profilo somatico ma non mentale, con
possibili ripercussioni sull’esito del trattamento a medio e lungo termine.
Obiettivi: valutare, attraverso uno studio pilota, il ruolo di un intervento di gruppo multidisciplinare, definito
Educazione alla Scelta e Consapevolezza, basato sui principi dell’ET (Report of a WHO Working Group
1998), nell’aiutare i pazienti obesi, con o senza binge eating, a migliorare i propri comportamenti alimentari e
la QoL.
Metodi: 70 soggetti obesi (13M-45,9±9,8aa-BMI43,4±8,4kg/m2; 57F-46,5±11,2aa-BMI42,4±7,4kg/m2) sono
stati reclutati presso il C.A.S.C.O.; sono stati rilevati colesterolo totale, C-LDL, C-HDL,trigliceridi e glicemia
e analizzate le abitudini alimentari mediante FFQ; è stato delineato il profilo psicologico attraverso test SCL90
e BES e valutata la QoL attraverso SF36. Tutti i parametri sono stati valutati all’arruolamento (T0) e dopo 8
incontri di gruppo di ET a cadenza quindicinale (T8). Le differenze sono state confrontate assumendo un p
value < 0.05.
Risultati: al T8 si osserva un significativo miglioramento di tutti i parametri ematochimici esaminati e dello
score SF36 in entrambe le aree della QoL, somatica (57,1±23,4 vs 67,9±21,1) e mentale (58,7±21,7 vs
71,6±21); le scale di somatizzazione, ossessione-compulsione, ipersensibilità interpersonale e depressione
dell’SCL90, che al T0 presentano uno score >1 (patologico) risultano normalizzate, e lo score BES, borderline
al T0 (17,1±9,1) migliora significativamente al T8 (8,3±7,18); l’eccessivo consumo di alimenti di origine
animale e dolci si riduce significativamente, mentre aumenta l’assunzione di pesce, legumi, ortaggi e frutta,
sebbene il decremento ponderale risulti di soli 3,2±4,16 kg (BMI -1,19±1,55 kg/m2), senza differenze
statisticamente significative tra i 2 sessi.
Conclusioni: il percorso di ET ha determinato un significativo miglioramento della QoL, sia sotto il profilo
mentale che somatico, nonché delle abitudini alimentari. Tale risultato assume particolare rilevanza in
relazione al modesto decremento ponderale, riconducibile alla scarsa motivazione e dichiarata resistenza che i
soggetti hanno mostrato all’intervento dietoterapico. Occorre sottolineare la necessità di ottimizzare
l’integrazione del lavoro di nutrizionisti e psicologi, individuando nuove strategie d’intervento dietoterapico,
incentrate sul counseling, da utilizzare durante il percorso di ET
Long-term intensive endurance exercise training is associated to reduced markers of cellular senescence in the colon mucosa of older adults
Full text linkRegular endurance exercise training is an effective intervention for the maintenance of metabolic health and the prevention of many age-associated chronic diseases. Several metabolic and inflammatory factors are involved in the health-promoting effects of exercise training, but regulatory mechanisms remain poorly understood. Cellular senescence-a state of irreversible growth arrest-is considered a basic mechanism of aging. Senescent cells accumulate over time and promote a variety of age-related pathologies from neurodegenerative disorders to cancer. Whether long-term intensive exercise training affect the accumulation of age-associated cellular senescence is still unclear. Here, we show that the classical senescence markers p16 and IL-6 were markedly higher in the colon mucosa of middle-aged and older overweight adults than in young sedentary individuals, but this upregulation was significantly blunted in age-matched endurance runners. Interestingly, we observe a linear correlation between the level of p16 and the triglycerides to HDL ratio, a marker of colon adenoma risk and cardiometabolic dysfunction. Our data suggest that chronic high-volume high-intensity endurance exercise can play a role in preventing the accumulation of senescent cells in cancer-prone tissues like colon mucosa with age. Future studies are warranted to elucidate if other tissues are also affected, and what are the molecular and cellular mechanisms that mediate the senopreventative effects of different forms of exercise training.</p
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
- …
