Day 3 :
Biography:
Maria Derylo, DNP, MSN, APN-BC, received her BSN degree from Ryerson University, Toronto, Ontario, Canada, Master’s at D’Youville College in Buffalo, NY, Post-master’s Adult Nurse Practitioner Certifi cate from University of Nebraska Medical Center, Omaha, and her Doctor of Nursing Practice from Case Western Reserve University in Cleveland, Ohio. She worked as Nursing Faculty at University of Nebraska Medical Center, and in Northern Illinois University, DeKalb, IL. Currently, she serves as full time faculty at the Loyola University. She practices as Adult Nurse Practitioner at the family practice comprehensive health services, primary care centers in Chicago, Illinois. She served as a speaker and poster presenter at the numerous national and international conferences. Her research interests are obesity, diabetes, cardiovascular diseases, carcinoid and health care system.
Abstract:
Obesity is a global epidemic with far reaching medical and social consequences. Th is presentation will provide participants with the opportunity to explore every facet of obesity care in one place operational, scientifi c, clinical and business. The goal of this presentation is to engage health care providers in learning about the medical wellness, weight loss and expose them to cutting-edge clinical and research approaches for the recognition, treatment and prevention of obesity. The information is focused on improving patient’s total wellness by utilizing clinical research and evidence-based strategies to address the myriad of comorbid conditions related to obesity to help practitioners to treat the whole person, not just obesity. Resources and tools that are needed to develop comprehensive weight management program will be presented. Th e following topics will be addressed: Basic Science and Obesity, Obesity Algorithm, Obesity defi ned as a disease, Obesity as a multifactorial disease, Obesity Management Goals, Obesity Classifi cation, Adiposopathy, Stress and Obesity, Patient Evaluation: history, physical exam, laboratory and diagnostic testing, Treatment, concurrent medications, The impact of the Aff ordable Care Act on obesity treatment, Health risks associated with obesity, Weight-management technologies, Endocrine disorders and obesity, Pharmacologic options for obesity, Addiction related strategies that can be used to improve weight loss outcomes, Comprehensive, evidence-based, personalized care for patients to reverse diabetes, cardiovascular issues, and many other high risk, high cost medical conditions.
Keynote Forum
Emmanuel Mukwevho
North West University, South Africa
Keynote: Calmodulin dependent protein kinase (CaMK)II activation by exercise regulates NRF-1 and its target lipid oxidizing target gene, Cpt-1 in rat skeletal muscle
Time : 11:05-11:45
Biography:
Emmanuel Mukwevho has completed his PhD in 2010 from University of Cape Town, South Africa in Anatomy and Cell Biology. He is an Associate Professor of Biochemistry at North West University, South Africa. He has published both nationally and internationally in reputed journals and his specialty is in Obesity and Diabetes where he led the Diabetes & Obesity Therapeutics Research group at North West University.
Abstract:
Regular exercise increases oxidation of fatty acids in skeletal muscle. Exercise activates Calmodulin-dependent protein kinase (CaMK)II, resulting in increased mitochondrial oxidative capacity. As such, exercise can curb accumulation of excess lipids in adipose and intramuscular tissues that may result in obesity/type 2 diabetes. Lipid metabolism mainly occurs in mitochondria regulated by NRF-1 and is controlled by a set of mitochondrial enzymes. For example, Carnitine palmitoyltransferase (CPT)-1 is a rate-limiting enzyme in mitochondrial lipid oxidation that regulates the transport of long chain fatty acids across the mitochondrial membrane, resulting in ATP synthesis. On the other hand, acetyl-CoA carboxylase (ACC)-1 is a mitochondrial enzyme that promotes lipid synthesis by providing malonyl CoA substrate for the biosynthesis of fatty acids. NRF-1 is the major transcriptional factor of the mitochondria, the site for ATP generation from carbohydrates and lipids. As such, mitochondrial dysfunction is crucial in metabolism of the cell. In order to investigate the amount of NRF-1 bound Cpt-1, ChIP assay performed. Exercise showed that the amount of NRF-1 bound Cpt-1 was ~1.3 fold increase compared with the control group. The exercise + KN93 group did not show any signifi cant change compared with the exercise group. This result indicates that exercise-induced CaMKII activation increase the amount of NRF-1 bound Cpt-1. With respective to
gene transcription, exercise group showed ~7.8 fold increase compared with the control group. Cpt-1 gene expression of the exercise + KN93 group showed signifi cant decrease compared with the exercise group. Cpt-1 gene expression of the exercise + KN93 was similar to the control group. Th is result shows that CaMKII activation increase Cpt-1 gene expression in rat skeletal muscle. With respect to mitochondrial integrity, mitochondria size of the exercise group increased by ~3.0 fold compared with the control group, whereas the exercise + KN93 group showed signifi cant decrease compared with the exercise group. Using TEM we show that exercise-induced CaMKII activation increases mitochondria size in rat skeletal muscle and its integrity.
- 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.
- 7. Endocrinal & Hormonal Obesity 8. Obesity During Pregnancy- Health Complications 9. Obesity Medications 10. Liposuction & advanced weightloss treatments 11. Statistical & Clinical Analysis
Session Introduction
Yi- Hao Yu
Greenwich Hospital, USA
Title: Does hedonic hunger lead to hedonic obesity?
Biography:
Dr. Yu is an endocrinologist of NEMG, Yale-New Haven Health System, Connecticut, USA. He is the medical director of endocrinology at CBNH, Greenwich Hospital. Previously, he held several university faculty positions and served as director of the Nutrition Services at Columbia Presbyterian Hospital, director of the nutrition fellowship program at Columbia University, and Medical Director of Discovery Medicine & Clinical Pharmacology at Bristol-Myers Squibb Company. Dr. Yu received his MD and PhD from NUY School of Medicine. He has published about 20 original research papers and many reviews/book chapters in the field of diabetes, obesity, and associated metabolic disorders.
Abstract:
It becomes increasingly evident that hedonic overeating plays a very important role in the current obesity epidemic. "Hedonic hunger" denotes a state where the "hunger" is present not because of the need for energy repletion (e.g., 4-6 hours after consuming a regular meal) or due to a long-term energy deficit (e.g., having lost 20 lbs and is recovering from an acute illness), but it is generated by a pure pleasure of ingesting foods even in the presence of energy surplus. A neuronal network responsible for hedonic hunger/overeating is distinguishable from the one that operates on the metabolic signals to replete energy. Hedonic hunger and eating is independent of energy status and is controlled by a different set of signaling molecules. However, hedonic hunger/overeating is not equivalent to weight gain or obesity. There exist strong metabolic mechanisms to maintain energy balance and keep body weight in check. While our "free will" can be an overriding determinant of how much we eat at a given moment (e.g., we may eat twice as much as the usual meal when eating out with friends or in a party) and how much calories we burn at a given time (e.g., we may spend one extra hour in the gym to train for an upcoming competition), we always tend to return to our usual state of energy reserve (i.e., zero net change in energy reserve). Under the normal physiological condition, our body weight, roughly correlated with our energy reserve or fat mass, is amazingly stable over a long time period, despite the constant short-term fluctuations. Because of the strong homeostatic metabolic mechanisms, the day-to-day or week-to-week fluctuation of energy fluxes is rarely consequential in terms of the long term net weight changes. Then, is the hedonic overeating any different from all other causes of short-term fluctuation, or is it a cause of sustained weight gain and obesity? Current data suggest that hedonic overeating in a significant number of people does translate into sustained weight gains and obesity. This form of obesity, i.e., hedonic obesity, is characterized by a consistently elevated metabolic rate that exceeds the normal value expected for a person with the same weight, a distinctive feature from another form of obesity, metabolic obesity. In this presentation, we discuss hedonic obesity in relationship to hedonic hunger, and whether the latter is an obligatory and/or sufficient factor for the development of hedonic obesity.
- 12. Psychological and Social Factors causing Obesity 13. Control and Prevention of Obesity 14. Exercise and Lifestyle Changes 15. Yoga and Naturopathy
Biography:
Dr. Derylo received her BSN degree from Ryerson University, Toronto, Ontario, Canada, masters at D’Youville College in Buffalo, NY, post-master’s Adult Nurse Practitioner certificate from University of Nebraska Medical Center, Omaha, and her Doctor of Nursing Practice from Case Western Reserve University in Cleveland, Ohio. She worked as Nursing Faculty at University of Nebraska Medical Center, and in Northern Illinois University, DeKalb, IL. Currently she serves as full time faculty at the Loyola University. She practices as adult nurse practitioner at the Family Practice Comprehensive Health Services, primary care centers in Chicago, Illinois. She served as a speaker and poster presenter at the numerous National and International Conferences. Research interests are Obesity, Diabetes, cardiovascular diseases, Carcinoid and Health Care System.
Abstract:
Obesity is a global epidemic with far reaching medical and social consequences. This presentation will provide participants with the opportunity to explore every facet of obesity care in one place- operational, scientific, clinical and business. The goal of this presentation is to engage health care providers in learning about the medical wellness, weight loss and expose them to cutting-edge clinical and research approaches for the recognition, treatment and prevention of obesity. The information is focused on improving patient’s total wellness by utilizing clinical research and evidence-based strategies to address the myriad of comorbid conditions related to obesity to help practitioners to treat the whole person- not just obesity. Resources and tools that are needed to develop comprehensive weight management program will be presented. The following topics will be addressed: o Basic Science and Obesity o Obesity Algorithm o Obesity defined as a disease o Obesity as a Multifactorial disease o Obesity Management Goals o Obesity Classification o Adiposopathy o Stress and Obesity o Patient Evaluation: history, physical exam, laboratory and diagnostic testing o Treatment, Concurrent medications o The impact of the Affordable Care Act on obesity treatment o Health risks associated with obesity o Weight-management technologies o Endocrine disorders and obesity o Pharmacologic options for obesity o Addiction related strategies that can be used to improve weight loss outcomes o Comprehensive, evidence-based, personalized care for patients to reverse diabetes, cardiovascular issues, and many other high risk, high cost medical conditions.
Efosa Odigie
University of Benin, Nigeria
Title: Effects of Oral and Subcutaneous Administration of Roselle Calyx (H. sabdariffa) Extract on Weight management and Controls.
Biography:
ODIGIE, Bolaji Efosa is currently pursuing his Ph.D. in Medical Laboratory Science (Histopathology/Cytopathology) Specialization at the University of Nigeria, Nsukka. His research interest focuses on Comparative and Experimental Pathology, and Cervical Cytology with a particular interest in abnormal cervical lesions and deleterious effects of medicinal plants (herbal therapy) in humans at the cellular level. He has over 18 publications in reputed and peer reviewed journals on the above subjects. He is the coordinator of the Sexual Health Concerns for the Commercial Sex Workers (SHCCSWs) Research Group in University of Benin, Nigeria. He is married to pretty Osarogie Joyce and blessed with Cherub and Saraphina.
Abstract:
Roselle (Hibiscus sabdariffa L., family Malvaceae) is consumed in Nigeria as a refreshing drink and for therapeutic purposes. This study was to examine the effects of H. sabdariffa calyx extract on the body and organ weight of Albino rats. The second goal was to compare the effects on the target organs via routes of administration (oral against subcutaneous). Sixty Albino rats of both sexes with an average weight of 204.14±2.1g (Mean±S.E.M) were assigned by sex, age and weight to a control group (VA and VB) and test groups (IA to IVA and IB to IVB). Empirical measurements on body weight was conducted prior to and after the experiment. They were administered with varying concentrations of the extract by oral and subcutaneous routes (10 to 50mg/kg) for 30 days at 2 days interval. On day 31, all rats were sacrificed by anaesthetization. The internal organs were excised, weighed, grossed and fixed in Bouin’s solution for 48hrs prior to histological processing. Sections were obtained at 3-5microns and stained with Mayer’s haematoxylin and eosin for light microscopy. No comparable changes are observed histologically. However, gross effects on the organs and body weight of experimental animals showed significant reduction when compared to the control (VA and VB) and test groups (IA to IVA and IB to IVB). In comparison, with the oral administration, empirical measurement showed a massive weight loss in the high dose treated animals (both routes of administration) but are marked in the oral route. Therefore, this study suggests that H. sabdariffa calyx extracts may be used for weight management and control. However, further studies are required to examine the biochemical and hematological effects in Albino rats.
Gina Cleo
Bond University, Australia
Title: Do making habits or breaking habits influence weight loss and weight loss maintenance? A randomised controlled trial.
Biography:
Gina Cleo is completing her PhD at Australia’s Bond University, Center of Evidence Based Practice. She is a passionate dietitian specialising in advancing research in otder to help in understanding the mechanisms relating to weight loss maintenance.
Abstract:
BACKGROUND: Despite the significance placed on lifestyle interventions for obesity management, around 40% of weight loss is regained over the first year following treatment, and much of the rest over the next three years. Two psychological concepts (habitual behaviour and automaticity) have been suggested as the most plausible explanation of this overwhelming lack of long-term weight loss success. METHOD: We evaluated the efficacy of two interventions that explore these theories: Ten Top Tips (10TT) and Do Something Different (DSD). 10TT promotes automaticity; this is the ability to perform tasks without awareness or deliberation. Therefore, diet and exercise related behaviours become automatic or habitual. Conversely DSD promotes behavioural flexibility. This program disrupts daily routines by assigning an individual with unstructured tasks to perform. Behavioural flexibility therefore has an inverse relationship with automaticity and is defined as the measure of an individual’s range of mindful behaviours. Men and women (n = 75), aged 51 + 6 (s.d.) years with body mass index 34.5 + 4.1 kg/m² were randomised to 12-week 10TT, DSD or no treatment control. Active intervention participants underwent 12 weeks of the program with 12-months follow-up. RESULTS: We collected data for weight, BMI, waist circumference as well as habitual behaviour and wellbeing. After 12 weeks intervention, weight loss averaged 4.6kg in the 10TT group, 4.1kg in the DSD group and 1.3kg in the control group. There was significant improvement in wellbeing in the 10TT and DSD groups.
- Control & Prevention of Obesity | Exercise and lifestyle changes | Yoga and Naturopathy
Chair
Gerry Leisman
The National Institute for Brain and Rehabilitation Sciences, Israel
Co-Chair
Yi-Hao Yu
Greenwich Hospital, USA
Session Introduction
Andrea Romani
Case Western Reserve University, USA
Title: Mg2+ deficiency results in increased intra-hepatic cortisol production through the H6PD/11- β-HSD1 machinery: Role of NF-kB and inflammatory cytokines
Time : 12:25-12:55
Biography:
Andrea Romani, MD, PhD, obtained his Medical Degree from the University of Siena, Italy and his PhD from the University of Turin, Italy. Upon completing his Postdoctoral studies under Dr. Scarpa, he joined the faculty in the Department of Physiology and Biophysics, Case Western Reserve University, where he is currently Associate Professor. He has published almost 90 peer review articles in high profi le journals together with numerous invited reviews and book chapters. He is currently serving as an Editorial Board Member for Archives of Biochemistry and Biophysics, Magnesium Research, World Journal of Gastro-Intestinal Physio-Pathology among others.
Abstract:
Tissue and serum Mg2+ defi ciency have been observed in several endocrine pathologies including diabetes and metabolic syndrome, but it is still undefi ned to which extent an altered Mg2+ homeostasis contributes to the onset of these pathologies and/or their complications. In the present study, we report that Mg2+ defi cient hepatocyte exhibit an increased entry of G6P into the endoplasmic reticulum, where the substrate is oxidized by the H6PD to generate NADPH. As H6PD operates in conjunction with 11β-HSD1, the increased level of NADPH is utilized by the latter enzyme to convert inactive cortisone to active cortisol. Administration of cortisone to Mg2+ defi cient hepatocytes results in a marked production of cortisol, which in turn enhances gluconeogenesis and alters intrahepatic fatty acid synthesis, thus increasing intrahepatic triglyceride levels. Protein and mRNA expression of H6PD and 11β-HSD1 are both increased 3-4 fold in Mg2+ defi cient cells. Mg2+ defi cient hepatocytes also exhibit decreased insulin responsiveness, which is further compromised by cortisol production. Returning cellular Mg2+ content to its physiological levels, results in a dramatic decrease in cortisol production, and in the progressive renormalization of expression and activity of H6P, 11β-HSD1, and cortisol-responsive genes. Investigation into the underlying mechanism of action suggest that under Mg2+ defi cient conditions 11β-HSD1 expression and activity increase as a consequence of increased nuclear translocation of NF-kB and increased expression of infl ammatory cytokines (namely IL-1β and/or TNFα). Taken together, our results suggest that by increasing H6PD and 11β-HSD1 activity and expression, Mg2+ deficiency sets the conditions for an increased intrahepatic production of cortisol and decreased insulin responsiveness. Th is altered hormonal balance can play a major role in the onset and progression of the metabolic syndrome and its associated complications.
Donald E Wesson
Texas A&M HSC College of Medicine, USA
Title: Treatment of metabolic acidosis in chronic kidney disease yields better weight control with fruits and vegetables than with currently recommended sodium-based alkali therapy
Time : 13:55-14:25
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 S C 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. He earned 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: Current guidelines recommend sodium-based alkali therapy for metabolic acidosis in chronic kidney disease (CKD) but recent data support that base-producing fruits and vegetables (F+V) also improve metabolic acidosis in CKD. Because CKD increases cardiovascular risk, weight reduction in overweight CKD patients appears desirable given its cardiovascular and other benefi ts. A diet high in F+V might promote weight reduction as well as improve metabolic acidosis in CKD.
Methods: We randomized 108 subjects with CKD stage 3 estimated glomerular fi ltration rate (30-59 ml/min/1.73 m2), metabolic acidosis with plasma total CO2 (PTCO2) >22 but <24 mM, and baseline BMI >25 as follows: F+V (n=36) added to reduce dietary potential renal acid load (PRAL) 50%, oral NaHCO3 (HCO3, n=36) to reduce PRAL 50%, or no alkali (Usual Care, n=36). All received standard kidney protection measures and were followed for 5 years.
Results: Baseline PTCO2 (23.0±0.6, 23.1±0.6, and 23.0±0.5, p=0.62) and BMI (28.8±2.1, 28.3±2.0, and 28.2±2.1, p=0.45) were not diff erent among F+V, HCO3, and Usual Care, respectively. Five-year PTCO2 was higher in HCO3 (23.9±0.4 mM) and F+V (23.8±0.4 mM) than Usual Care (21.9±0.4 mM, p <0.01 vs. HCO3 and F+V). By contrast, fi ve-year BMI was lower (p<0.03) in F+V (26.6±1.7) than both HCO3 (28.4±1.9) and Usual Care (27.8±1.7).
Conclusions: Treating CKD patients with either NaHCO3 or F+V improved metabolic acidosis similarly but BMI was lowest with F+V. Better weight control with F+V than NaHCO3, the latter being the currently recommended treatment option, supports F+V as the preferred treatment strategy for metabolic acidosis in overweight CKD patients.
Yi-Hao Yu
Greenwich Hospital, USA
Title: Treatment modalities potentially suitable for patients with hedonic obesity
Time : 14:25-14:55
Biography:
Yi-Hao Yu is an Endocrinologist of Northeast Medical Group, Yale-New Haven Health System, Connecticut, USA. He is 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 scientific journals and many reviews/book chapters in the fi eld of “Diabetes, obesity and associated metabolic disorders”.
Abstract:
Hedonic obesity is caused by persistent overeating driven by hedonic hunger resulting from dysfunctional neural circuitries that govern reward and emotion. Excessive food intake in this case is a consequence of complicated food-seeking behavior to achieve reward and satisfaction, rather than to meet energy needs. If there were non-caloric foods that can satisfy patients’ hedonic needs without adding calories, there would be no obesity issue in this subpopulation of patients. This is in contrast to metabolic obesity, in which the obese weight is sustained because of the increased caloric needs demanded by an elevated body weight set point. In metabolic obesity, if patients take in less calories than what are required to maintain the homeostatic set point, their bodies would respond by conserving energy and constantly seeking for more calories; they would be constantly hungry until the obese body weight is restored. In this presentation, I'll discuss some of the future treatment options, mostly still in the pipeline at this time which would allow food intake to satisfy hedonic needs and reward but prevent excessive caloric assimilation. Th ese treatment options will most likely be successful in the subpopulation of patients who have hedonic obesity.
Zhong Chen
Shanghai Jiao Tong University, PR China
Title: Statins usage, exercise and coronary artery disease
Time : 14:55-15:25
Biography:
Zhong Chen has completed his PhD from Nanjing Medical University, China. He is the Executive Director of Department of Cardiology at Shanghai Jiao Tong University Affi liated Sixth People’s Hospital, East Campus. He has published more than 20 papers in reputed journals and also serves as an Editorial Board Member of two international journals.
Abstract:
Coronary artery disease (CAD) is one of the major causes of death in most of the western countries and the largest developing country, China. More importantly, the prevalence of obesity and type-2 diabetes is increasing rapidly in China. Patients with diabetes have an increased incidence of atherosclerotic cardiovascular disease. Patients with CAD and diabetes belong to a very-highrisk population, which deserves more attention from doctors, health professionals and the public. Cholesterol-lowering therapy with statins in primary and secondary prevention cardiovascular diseases have been well verifi ed and acknowledged by many guidelines and low-density lipoprotein cholesterol (LDL-C) control is still the first target goal. However, knowledge gap and under-use of statins still exist. Physical activity has been proved to be associated with reduced risk and increased survival of CAD and increased risk of sudden cardiac death (SCD). Th is inconsistency deserves further investigation. Thus we try to review the available literatures and further discuss this topic.
Munira Alghafaily
King Saud University, Saudi Arabia
Title: Is BMI ≥50 kg/m2 a predictor of higher morbidity during doing laparoscopic sleeve gastrectomy? An observational study at King Khalid University Hospital Saudi Arabian experience
Time : 15:25-15:55
Biography:
Munira Alghafaily is a fi nal year Medical student at King Saud University, Saudi Arabia. She is currently works in the areas of Cardiology, Gastroenterology and Laparoscopic Sleeve Gastrectomy.
Abstract:
Objectives: Th is study was to assess operative and post-operative complications, of laparoscopic sleeve gastrectomy (LSG), in superobese and compare it to morbid obese on in KKUH, Saudi Arabia.
Methods: We reviewed the 708 medical records of consecutive patients who underwent LSG surgery at KKUH from 2009 till 2015. Then, we compared our SMO (BMI≥50 kg/m2) patients data results to (our /international reports) MO (BMI<50 kg/m2) patients category who underwent LSG.
Results: Male sex was predominant in SMO (63.6%). Both groups had homogeneous baseline characteristics and comorbidities except sleep apnea which was higher in SMO. Th ere was no signifi cant diff erence in the duration of operation, length of stay, and recovery room time between the two groups. Mean number of trocars was 4 for both groups. HDU admission: 62 (28.6%) patients of SMO and 32 patients of MO. No conversion to open or documented intraoperative complications in both groups. For post-operative complications: has developed in 6% of patients in SMO included 1.4% of patients developed leakage, and 10 patients developed bleeding in the drain. On the other hand, 4.3% of patients in MO had developed complications, includes, (2.2%) patients developed
leak, 2% patients developed bleeding that four patients only needed blood transfusion. Th ere was no surgical mortality.
Conclusion: Th ere’s no signifi cant diff erence in the duration of operation, number of trocars and intra operative complication between SMO and MO. Th e BMI ≥50 kg/m2 is not a predictor of higher morbidity during doing LSG if done in a tertiary care center with dedicated bariatric center services.
- Weight Loss Nutrition | Obesity-Health Risks | Current research on Obesity
Chair
Edita Stokić
Clinical Center of Vojvodina, Serbia
Co-Chair
Emmanuel Mukwevho
North West University, South Africa
Session Introduction
Gerry Leisman
The National Institute for Brain and Rehabilitation Sciences, Israel
Title: Motor-cognitive interactions in the nervous system: Obesity and sedentary behavior dumbs down cognitive function in childhood
Time : 11:45-12:15
Biography:
Gerry Leisman is the Director and Professor of the National Institute for Brain and Rehabilitation Sciences in Nazareth, Israel and Professor of Restorative Neurology at Universidad de Ciencias Médicas Facultad Manuel Fajardo, Havana, Cuba. He has examined self-organizing systems in the nervous system applied to cognitive functions in memory, kinesiology, optimization, consciousness, and autism. He has applied optimization strategies to movement, gait, and cognition. In the 1970’s, he was one of the fi rst to identify functional disconnectivities in the brain. His work in rehabilitation sciences, has applied the tools of Industrial Engineering to those with developmental disabilities.
Abstract:
Objectives: To demonstrate that motor and cognitive processes are not separate, but likely share similar evolutionary history.
Methods: We review data that motor processes contribute to cognitive function.
Results: Motor and cognitive processes have dynamical bidirectional relationships. Rodent research has revealed that exercise influences the striatum by increasing dopamine signaling and angiogenesis. In children, higher aerobic fi tness levels are associated with greater hippocampal volumes, superior performance on tasks of attentional and interference control, and elevated event-related brain potential indices of executive function.
Conclusions: We endeavor to integrate the Neurosciences, Cognitive Psychology and Biomechanics in providing a fundamental understanding of the relation between intention, decision-making, and movement in the context of functional connectivity, awareness, attention, and action. Evidence, the SMA is involved in the organization of motor sequences based on plans, the PM is involved in the preparation of a specifi c action, the prefrontal cortex is involved in the initiation and in the temporal organization of action, and the cerebellum is involved in the temporal control of action sequences. All these regions show anticipatory activity in relation to a forthcoming action. Motor cognition relies on a multicomponent system, with many distinct processes occurring simultaneously in diff erent brain regions that support diff erent neural networks. Th e lack of movement represented in offi ce work and youngsters fettered to video games reduces the ability to formulate eff ective connectivities. Because children are becoming increasingly overweight, unhealthy and unfi t, understanding the neurocognitive benefi ts of an active lifestyle during childhood has important public health and educational implications.
Vaclav Bunc
Charles University, Czech Republic
Title: Effect of physical exercise in girls differing in body mass
Time : 12:15-12:45
Biography:
Vaclav Bunc has earned his PhD from TU Prague (1979). He is the Vice-dean of Faculty of PE at Sport Charles University Prague. His main research topics are: obesity management, application of mathematical methods and models in PE and sport, evaluation of physical fi tness, exercise physiology, functional and physical testing in laboratory and fi eld, body composition, BIA methods, moving regimes for prevention. He has published more than 350 papers in Czech and internationally reputed journals and serving as an Editorial Board Member of repute.
Abstract:
Obesity is a growing problem in Czech Republic today, as it is in many countries. Alongside a range of health problems associated with increased body mass (BM) is an important limiting factor for realization of regular physical exercise and qualitative life style. Th e study goal was to assess the eff ect of movement intervention in girls diff ering in BM. Study was carried out on 62 girls with normal BM (mean age = 12.6±2.2 years; BM = 47.8±3.0 kg; height = 157.9±4.1 cm), 48 overweight girls (12.6±2.3; 61.9±3.1; 158.4±4.5) and 42 obese girls (12.8±2.7; 72.6±3.6; 157.4±4.0). Body composition was assessed by bioimpedance method using prediction equations that are valid for the Czech child population, functional variables were determined on a treadmill. Th e energy content of weekly movement program for girls with normal BM ranged from 1390 kcal to 2720 kcal (mean 1990±330 kcal) in children with overweight from 1630 kcal to 2380 kcal (1940±240 kcal) and in obese children from 1910 kcal to 2580 kcal (2280±310 kcal). Relative changes in %BF ranged from 15.6% in obese to 16.4% in normal BM and in VO2 peak from 13.9% in normal BM to 15.7% in obese. In girls diff ering in BM have absolute changes in followed parameters like a result of imposed intervention substantively and statistically signifi cant. On the contrary, diff erences in relative terms are non-signifi cant. We can conclude that an exercise program with a similar energy content, form and intensity causes the similar changes in BC and in motor and functional performance in girls, differing in BM.