Day 1 :
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
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.
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.
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
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.
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.
Greenwich Hospital, USA
Time : 11:40-12:20
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”.
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.