Day 1 :
Keynote Forum
Andrea M P Romani
Case Western Reserve University, USA
Keynote: Metabolic syndrome and its worldwide epidemics: How hepatic inflammation and hepatic dysmetabolism consort to determine obesity, NAFLD and insulin resistance
Time : 10:00-10:40
Biography:
Andrea M P Romani completed his Medical Degree from University of Siena, Italy and his PhD from University of Turin, Italy. After completing his Post-doctoral studies under Dr. Scarpa, he joined the Faculty in Department of Physiology and Biophysics at Case Western Reserve University, where he is currently an Associate Professor. He has published over 90 peer reviewed articles in high profile journals together with numerous invited reviews and book chapters on “The role of mammalian magnesium homeostasis in health and disease”. He is currently serving as an Editorial Board Member and Reviewer for numerous international journals.
Abstract:
The last 30 years have registered a progressive and dramatic increase in the incidence of obesity in both developed and developing countries. Metabolic syndrome represents one of the most commonly diagnosed conditions associated with obesity, and it has been identified as predisposing to major cardiovascular complications as well as various forms of cancer including liver, colon and breast cancer among others. Currently, 35.5 to 45% of the adult population, also adolescents and children, are affected by obesity and clinical parameters typical of metabolic syndrome with some marked differences in terms of age of onset and race, ethnicity and gender predisposition. According to the latest releases from the WHO, it is estimated that approximately one billion people worldwide are obese and near 500 million are diabetic, or at risk of developing diabetes. The underlying causes of increased obesity incidence are not completely understood, it is presently difficult to establish short- and long-term health guidelines and therapeutic approaches that can help containing the progression and possibly reversing the uptrend of obesity, metabolic syndrome, and their complications. The term ‘metabolic syndrome’ encompasses several clinical and hematic metabolic factors that altogether raise significantly the risk for heart disease, stroke, diabetes and the particular forms of cancer mentioned above. Liver steatosis, with or without inflammation (steatohepatitis) and progression to NAFLD is considered pathognomonic of metabolic syndrome, and represents the most common clinical manifestation of the disease. While the etiology of metabolic syndrome is most likely multi-facet, the condition is characterized by a major lipid dysmetabolism within liver and adipose tissue as well as systemically, connotations that it shares with T2DM. Inflammation is a key component of both pathologies, in that enhanced levels of inflammatory cytokines have been observed in the circulation and within specific organs, in which they may impair insulin responsiveness and systemic glucose homeostasis. Altogether, metabolic syndrome, NAFLD, obesity and insulin resistance pose major financial and health burdens on the affected individuals, and the medical and productive systems of the various countries. The predisposition to the various associated complications and the financial costs relative to their treatments argue for the necessity to better understand the causes responsible for the onset of metabolic syndrome and its complications and to identify more effective therapeutic and dietary approaches.
Keynote Forum
Donald E Wesson
Texas A&M HSC College of Medicine, USA
Keynote: Title: Successful weight management in an underserved population through the group lifestyle balance (GLB) program
Time : 11:00-11:40
Biography:
Donald E Wesson, MD, FACP is currently Professor of Medicine and the Vice Dean of Texas A&M University College of Medicine in Temple, Texas. Prior to this position, he was the SC Arnett Professor of Medicine and Chairman of the Department of Internal Medicine and Physiology at Texas Tech University Health Sciences Center and had been Associate Professor of Medicine at the Baylor College of Medicine where he was Assistant Chief of the Nephrology Section at the Houston VA Hospital. He received his undergraduate degree from the Massachusetts Institute of Technology. Heearned his Medical degree from Washington University School of Medicine and completed his Residency and Internship at Baylor College of Medicine. He is the recipient of multiple Teaching Awards at Baylor and Texas Tech.
Abstract:
Background: Weight management strategies have been comparatively less successful in individuals from low socio-economic status (SES) communities which are medically under-served. We explored the weight management eff ectiveness of Group Life Balance, (GLB) a strategy adapted from University of Pittsburgh School of Public Health and applied at the Diabetes Health Wellness Institute, a population health initiative of Baylor Scott and White Health which operates in a low SES community of Dallas, Texas.
Methods: Th e GLB program emphasizes incorporating small, sustainable changes into the lives of participants to build selfeffi cacy and encourage them to leverage aspects of their current lifestyle toward healthy behaviors. Th e program does not specify a given “diet” but instead emphasizes a daily fat gram budget which participants manage within their current eating patterns. Th e program also emphasizes incorporation into their current lifestyle incremental that increases in physical activity of their choice to a weekly goal of 150 minutes. Tools such as food and activity log assist participants to achieve these goals over 3-month duration.
Results: Th e GLB program participants experienced an average 5.1% weight loss with an attrition rate of only 8%. Program participation was also associated with improved healthy behaviors of the family of participants.
Conclusions: In this low SES population, the GLB program with its emphasis on incremental changes in current lifestyles of participants toward healthy behaviors appears to be an eff ective weight management strategy for them and appears to improve healthy behaviors of their families as a collateral benefit.
Keynote Forum
Yi-Hao Yu
Greenwich Hospital, USA
Keynote: Towards individualized therapy for obesity: A heterogeneous disorder
Time : 11:40-12:20
Biography:
Yi-Hao Yu is an Endocrinologist of Northeast Medical Group, Yale-New Haven Health System, Connecticut, USA. He is the Medical Director of Center for Behavioral & Nutrition Health and Inpatient Diabetes Program at Greenwich Hospital. Previously, he was faculty of several universities and served as Director of Nutrition Services at Columbia Presbyterian Hospital, Director of Nutrition Fellowship Program at Columbia University and Medical Director of Discovery Medicine & Clinical Pharmacology at Bristol-Myers Squibb Company. He completed his MD and PhD at NYU School of Medicine. He has published more than 20 original research papers in the top-notch medical and scientifi c journals and many reviews/book chapters in the fi eld of “Diabetes, obesity and associated metabolic disorders”.
Abstract:
Obesity is a heterogeneous disorder of various causes. To make treatment most eff ective, therapy must be tailored to individuals who manifest obesity with diff erent underlying etiologies. Monogenic forms of obesity are rare, but some of them where correction of the underlying defect is attainable provide opportunities for showcasing individualized treatment principles and favorable outcomes. The common forms of obesity are polygenic in nature. While the exact genetic defects in the affected individuals are not known, most of them manifest as predominantly metabolic obesity or hedonic obesity, which should be treated diff erentially with tailored interventions whenever possible. More importantly at this time, we advocate that existing therapies and treatment modalities under development be evaluated for their optimal therapeutic effi cacy separately in patients with metabolic obesity and those with hedonic obesity.
- Obesity Medication | Endocrinal & Hormonal Obesity|Liposuction & Advanced Weightloss Treatments
Chair
Andrea Romani
Case Western Reserve University, USA
Co-Chair
Donald E Wesson
Texas A&M HSC College of Medicine, USA
Session Introduction
Lynn Cialdella-Kam
Case Western Reserve University, USA
Title: Flavonoids: Examination of the evidence as a potential treatment strategy for obesity
Time : 12:20-12:50
Biography:
Lynn Cialdella Kam is an Assistant Professor in Nutrition at Case Western Reserve University. She is engaged in undergraduate and graduate research, teaching, and advising with a focus on sports nutrition, wellness, and women's health. Her research examines the health consequences of chronic energy imbalance (i.e., obesity, disordered eating, and intense exercise training). She received her PhD in Nutrition from Oregon State University, her Masters in Exercise Physiology from The University of Texas at Austin, and her MBA from The University of Chicago Booth School of Business. She completed her postdoctoral research in sports nutrition at Appalachian State University and is a licensed and registered dietitian nutritionist.
Abstract:
Dietary changes and exercise are important strategies to prevent and treat obesity, but the long-term implementation of these lifestyle changes are often unsuccessful. Thus, alternative nutritional approaches are needed. Flavonoids, which are natural chemicals found in foods such as berries, tea, and apples, may attenuate the effects of obesity such as inflammation, oxidative stress, and glucose intolerance based on in vitro and animal studies. Research in humans validating these findings are limited. In intervention studies using flavonoid mixtures, traditional biomarkers of inflammation, oxidative stress, and cardiovascular health have been unaltered. However, supplementation with flavonoids have been associated with changes in gene expression and metabolites in humans supporting a potential role for attenuating inflammation and enhance immune function at the tissue level. Evidence from in vitro, animal, and human studies flavonoid supplementation in obesity will be reviewed with a discussion on clinical applications.
Karin Hermoni
Lycored, USA
Title: Standardized and patented lycored nutrient complexTM supports cardiovascular health: A randomized placebo controlled trial
Time : 13:50-14:20
Biography:
Karin Hermoni is the Lycored Nutrient ComplexTM category Manager at Lycored. She holds a PhD degree in Biochemistry from Ben Gurion University in Israel. Her research has focused on the effects of phytonutrients and specifically tomato carotenoids on various aspects of human health. She has published numerous papers and written many articles for the public on carotenoids, many of which are available online.
Abstract:
Obesity is associated with chronic low grade inflammation and oxidative stress as well as increased risk for cardiovascular risk. The effects of tomato carotenoids on parameters related to cardiovascular health such as blood pressure, endothelial function, inflammation and oxidative stress have been the subject of on-going research. More specifically serum carotenoid levels are increasingly studied as highly predictive markers for oxidized LDL, now considered the most dangerous form of cholesterol. The objective of this clinical study was to investigate the effects of standardized and patented Lycored Nutrient Complex (LNC) for heart on post-prandial lipid and sugar profiles. Consumption of a fat containing meal causes stress reactions that include a transient rise in triglycerides as well as an elevation in glucose and insulin levels. Oxidative stress related to fat consumption has been suggested as a major contributor in the pathogenesis of atherosclerosis along with other chronic disease states such as diabetes and obesity. One mechanism is the increased oxidation of LDL cholesterol, which promotes plaque formation and increases cardiovascular risk. In this study, 150 healthy men and women were supplemented for 2 weeks with LNC or placebo. At the end of the supplementation period subjects consumed a fat containing meal and parameters related to lipid and sugar profiles as well as oxidized LDL levels were evaluated. Subjects who consumed LNC had significantly reduced levels of oxidized LDL compared to the placebo group. Moreover, insulin levels were reduced following supplementation. A beneficial trend was also observed for post-meal glucose levels. This study suggests carotenoids, and in particular LNC, has a favorable effect on cardiovascular health and management of fat consumption induced oxidative stress. This protective effect is extremely relevant for subjects who are at increased cardiovascular risk such as those struggling with obesity and weight management.
Shenghui Wu
Biostatistics, University of Texas Health Science Center, San Antonio, USA
Title: Metabolic health has greater impact on diabetes than simple overweight/obese in Mexican-Americans
Time : 14:20-14:50
Biography:
Shenghui Wu has completed her PhD from the Chinese University of Hong Kong, MD from the Southeast University and postdoctoral training from the Vanderbilt University School of Medicine. She is an assistant professor of University of Texas Health Science Center at San Antonio, Department of Epidemiology & Biostatistics. She has published more than 40 papers in reputed journals and has been serving as an editorial board member.
Abstract:
The risk of type 2 diabetes associated with overweight/obesity appears to be influenced by the coexistence of other metabolic abnormalities. We compared the risk for diabetes in each of 4 categories of metabolic health and BMI. Participants were drawn from the Cameron County Hispanic Cohort, a randomly selected Mexican American cohort in Texas on the US-Mexico border. Subjects were divided into 4 phenotypes according to metabolic health and BMI: metabolically healthy normal weight, metabolically healthy overweight/obese, metabolically unhealthy normal weight and metabolically unhealthy overweight/obese. Metabolic health was defined as having less than 2 metabolic abnormalities. Overweight/obese status was assessed by BMI higher than 25 kg/m2. Diabetes was defined by the 2010 ADA definition or by being on a diabetic medication. Among 3,247 participants, 878 were diagnosed with diabetes. The odds ratio for diabetes risk was 2.25 in the metabolically healthy overweight/obese phenotype (95% CI 1.34, 3.79), 3.78 (95% CI 1.57, 9.09) in the metabolically unhealthy normal weight phenotype and 5.39 (95% CI 3.16, 9.20) in metabolically unhealthy overweight/obese phenotype after adjusting for confounding factors compared with the metabolically healthy normal weight phenotype. Cubic spline modeling showed that the risk of diabetes with age was higher in the metabolically unhealthy than the metabolically healthy phenotype regardless of overweight/obesity status. Metabolically unhealthy subjects showed significantly increased risk for diabetes compared with metabolically healthy subjects, regardless of their weight. Greater focus on metabolic health appears to be a more effective target for prevention and control of diabetes than emphasis on weight loss alone.
Mesfin Yimam
Unigen Inc., USA
Title: Appetite suppression and anti-obesity effect of a botanical composition composed of Morus alba, Yerba mate and Magnolia officinalis
Time : 14:50-15:20
Biography:
Mesfi n Yimam is a Senior Scientist with diverse experiences in Pharmaceutics and Veterinary Medicine. He is a board certifi ed DVM with MS in Pharmaceutics from University of Washington in Seattle, Washington where he studied identifying and characterizing primate P-glycoprotein and illustrating target specifi c drug delivery. He has published more than 30 peer reviewed articles, co-invented multiple issued and pending patents, presented his work in a range of scientifi c conferences and he is also an Editorial Board Member for 5 reputable journals for scientifi c peer reviewed publications.
Abstract:
Morus alba, Yerba mate and Magnolia offi cinalis extracts were standardized to yield a composition designated as UP601. Appetite suppression activity of UP601 (230 and 350 mg/kg) was tested in acute feed intake rat model. Effi cacy was evaluated at 300, 450 and 600 mg/kg in the high-fat-high-fructose (HFF) and 1.3 g/kg in the High-fat-diet (HFD) induced models for 7 weeks. Orlistat at 40 mg/kg/day was used as a positive control in both models. Body compositions of mice were assessed using DEXA scan. Insulin, leptin and ghrelin levels were determined. Serum biomarkers were measured. Histopathological analysis was performed for microscopic non-alcoholic steatohepatitis (NASH) scoring. Marked acute hypophagia with 81.8, 75.3, 43.9, and 30.9% reductions in food intake at 2, 4, 6, and 24 hours were observed for UP601. Statistically signifi cant changes in body weight (decreased by 9.1, 19.6 and 25.6% compared to the HFF group at week-7) were observed for mice treated with UP601 at 300, 450 and 600 mg/kg, respectively. 75.9% and 46.8% reductions in insulin and leptin, respectively, 4.2-fold increase in ghrelin level, in the HFD group; reductions of 9.1, 16.9, and 18.6% in total cholesterol; 45.0, 55.0, 63.6% in triglyceride; and 34.8, 37.1 and 41.6% in LDL were observed for UP601 at 300, 450 and 600 mg/kg, respectively, in the HFF group. From the DEXA scan analysis, a percentage body fat of 18.9%, 47.8%, 46.1% and 30.4% were found for mice treated with normal control, HFD, Orlistat and UP601, respectively in the HFD group. Statistically signifi cant improvements in NASH scores in steatosis, lobular infl ammation and hepatocellular ballooning were also observed for mice treated with UP601. UP601, a standardized botanical composition from Morus alba, Yerba mate and Magnolia offi cinalis could be used as a natural alternative for appetite suppression and a healthy body weight management.
Jose Eduardo Corrente
University of Sao Paulo State–UNESP, Brazil
Title: Association between functional capacity and nutritional status for older people
Time : 15:40-16:10
Biography:
Jose Eduardo Corrente has completed his Under-graduation in Mathematics and MSc and PhD in Biostatistics. He is an Associate Professor at Biostatistics Department - University of Sao Paulo State - UNESP, and his fi eld of research is Epidemiology of third age. His main projects are in quality of life, lifestyle and nutritional aspects for older people with respect to eating patterns and adequate intake as well as publications in reputed journals.
Abstract:
Functional capacity is the condition of an individual living independently and the lack of it for preparation and eating food is a factor that can result in malnutrition and deserves the attention of professionals and family member. Th en, the aim of this paper is to evaluate the relationship between nutritional status and functional capacity for older adults. Epidemiological cross-sectional study using a representative sample of older adults (368 subjects) selected from a previous study about quality of life in a Botucatu city, São Paulo, Brazil. Sociodemographic and morbidities questionnaires, activities of daily and instrumental living (ADL and IADL) and anthropometric variables were measured. 62.6% of the older were women, 44.68% were hypertensive, 28.81% were diabetic and 15.51 had hypercholesterolemia. 94.24% and 92.42% of the older were fully independent for ADL and IADL, respectively. There were associations between ADL with marital status and schooling. For IADL, there were associations between marital status, schooling and heart disease. Regarding anthropometry weight, height, arm muscle circumference, corrected arm muscle circumference and waist circumference were higher in men compared to women (p <0.05). Th e average values of triceps skinfold thickness behaved in the opposite way, being higher in women (p<0.0001). According to body mass index (BMI), 12.23% were underweight, 36.41% normal weight and 51.36% overweight. Among men, 20.00% were underweight, 35.36% normal weight and 44.44% overweight. Related to waist circumference (WC), it was found that 76.63% were altered being 62.06% among women and 37.94 among men. No signifi cant association was found between nutritional status and ADL. A logistic regression model was fi tted considering BMI and WC as a response. It was found IADL as a protective factor, as a risk factor for dependence. As a conclusion, low weight and increased waist circumference have infl uence in a functional capacity of older adults according to the instrumental activities daily living (IADL).
Horia Al Mawlawi
Prince Sultan Military Medical City, Saudi Arabia
Title: Childhood obesity
Time : 16:10-17:00
Biography:
Horia Al Mawlawi has completed her Graduation and Post-graduation from King Abdulaziz University. She is working now in Prince Sultan Military Medical City, Jedda as Instructor. She has published so many papers.
Abstract:
Childhood obesity is a major public health crisis nationally and internationally. Th e prevalence of childhood obesity has increased over few years in all pediatric age groups in both the sexes. Approximately 22 million children under 5 years of age are over-weight across the world. Th e number of overweight children and adolescents has doubled in last 2 to 3 decades in the world. World Health Organization on childhood obesity has found 41 million children under 5 years either obese or over-weight as of 2014. However more than 90% of cases are idiopathic and less than 10% are associated with hormonal or genetic causes. Th e idiopathic mainly caused is by imbalance between calorie intake and calories utilized. High calorie density and fat content of modern diet and lack of physical activity is associated with increased risk of obesity. Physical, psychological and social health problems are caused due to child health obesity. Co-morbidities associated with obesity and overweight are similar in children as in adult population and also elevated blood pressure, dyslipidemia and high prevalence insulin resistance and type-2 diabetes appear as frequent complication in the overweight and obese pediatric population. Approaches in the prevention and treatment of childhood overweight and obesity are urgently required including healthy diet and physical activity. When lifestyle modifi cation is insuffi cient to reach weight loss and complication of obesity aff ects child health, pharmacotherapy is recommended for age more than 10 years. Bariatric surgery is reserved for carefully selected subgroup of young children with obesity related co-morbid condition that threaten the child health where lifestyle and medication have been evaluated but found not be eff ective.