scholarly journals Metabolic and Hepatic Effects of Energy-Reduced Anti-Inflammatory Diet in Younger Adults with Obesity

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Gordana Kenđel Jovanović ◽  
Ines Mrakovcic-Sutic ◽  
Sandra Pavičić Žeželj ◽  
Indira Benjak Horvat ◽  
Lucia Šuša ◽  
...  
Keyword(s):  
Weight Loss ◽  
Liver Disease ◽  
Controlled Trial ◽  
Significant Weight Loss ◽  
Younger Adults ◽  
Inflammatory Status ◽  
Tnf Α ◽  
Liver Parameters ◽  
Anti Inflammatory ◽  
Hs Crp

Background. Associated with epidemics of obesity, nonalcoholic fatty liver disease (NAFLD) is becoming the most prevalent liver disease worldwide. The cornerstone of therapy for NAFLD is lifestyle intervention, mainly focused on weight loss. Significant weight loss results from energy-restricted diets, regardless of macronutrient distribution. An anti-inflammatory diet was related to lower odds of NAFLD among daily alcohol drinkers and individuals with metabolic syndrome. This study aims to evaluate the effect of an energy-reduced anti-inflammatory diet on liver status in younger adults with obesity after a 6-month follow-up. Methods. A two-arm randomized controlled trial surveyed 81 participants’ (mean age, 43 years) anthropometric and body composition changes. Metabolic status was determined with glycaemic and lipid status, inflammatory status with hs-CRP, IL-6, and TNF-α, and liver status with liver enzymes, NAFLD-FLS, FLI, and FIB-4 indices. The inflammatory potential of the diet was assessed by the Dietary Inflammatory Index, DII®. Results. Energy-restricted anti-inflammatory diet resulted in significant weight loss (−7.1%, p  < 0.001), in reducing the visceral adiposity (−22.3%, p  < 0.001), metabolic (HOMA-IR, −15.5%; total cholesterol, −5.3%; LDL-C, −4.6%; triglycerides, −12.2%), and inflammatory biomarkers (hs-CRP, −29.5%; IL-6, −18.2%; TNF-α, −34.2%), with significant improvement of liver parameters (NAFLD-FLS, −143.4%; FLI, −14.3%; FIB-4, −2.5%). Conclusion. The study showed the effectiveness of the anti-inflammatory diet with significant improvement of liver parameters in younger adults with obesity, which may reinforce the effectiveness of nutrition-based lifestyle programs, with an anti-inflammatory dietary approach for the treatment and resolution of NAFLD.

scholarly journals Complex Coronary Instent Chronic Total Occlusion Lesions: Oxidative Stress, Inflammation, and Coronary Stent Lengths

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Xia Li ◽  
Dianxuan Guo ◽  
Ying Chen ◽  
Youdong Hu ◽  
Fenglin Zhang
Keyword(s):  
Oxidative Stress ◽  
Elderly Patients ◽  
Chronic Total Occlusion ◽  
The Elderly ◽  
Inflammatory Biomarkers ◽  
Total Occlusion ◽  
Inflammatory Status ◽  
Tnf Α ◽  
Anti Inflammatory ◽  
Hs Crp

The oxidative stress and inflammation played the key roles in the development of atherosclerotic coronary plaques. However, the relationships between pro/antioxidant, pro/anti-inflammatory status, and complex coronary instent chronic total occlusion lesions were not clear in the elderly patients with very long stent implantations. We tried to evaluate the roles of pro/antioxidant and pro/anti-inflammatory biomarkers in the diagnosis of complex reocclusion lesions in elderly patients after coronary stenting. We evaluated the expression levels of acrolein (ACR), malondialdehyde (MDA), high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), superoxide dismutase 3 (SOD3), paraoxonase-1 (PON-1), endothelial nitric oxide synthase (eNOS), and stromal cell-derived factor-1α (SDF-1α) in the elderly patients with very long stent implantations and complex reocclusion lesions. Levels of ACR, MDA, hs-CRP, and TNF-α were remarkably increased ( P < 0.001 ), and levels of SOD3, PON-1, eNOS, and SDF-1α were decreased significantly ( P < 0.001 ) in the elderly patients with very long stents and complex reocclusion lesions. The prooxidant and proinflammatory biomarkers were remarkably increased, as well as antioxidant and anti-inflammatory biomarkers were decreased significantly in the elderly patients with very long stent implantations and complex reocclusion lesions after coronary stenting. In conclusion, these findings indicated that the imbalance between prooxidant/proinflammatory and antioxidant/anti-inflammatory status was associated with complex reocclusion lesions, suggesting that oxidative stress and inflammation played the key roles in progression of complex reocclusion lesions in the elderly patients with very long stent implantations.

scholarly journals The Effect of Tribulus Terrestris Supplementation on Inflammation, Oxidative Stress and Performance of Recreational Runners: Study Protocol for a Double-Blind Randomized Controlled Trial

2021 ◽  
Author(s):  
Marzieh Nejati ◽  
Parvin Dehghan ◽  
Mostapha Khani
Keyword(s):  
Oxidative Stress ◽  
High Intensity ◽  
Controlled Trial ◽  
Sport Performance ◽  
Tribulus Terrestris ◽  
Double Blind ◽  
Inflammatory Status ◽  
Recreational Runners ◽  
Anti Inflammatory ◽  
Exercise Induced

Abstract Background: High intensity and endurance exercises lead to exercise-induced oxidative stress (EIOS), exercise-induced muscle damage (EIMD), and inflammation, which are the influencing factors on muscle soreness, localized swelling, and sport performance. Therefore, the purpose of this study is to determine the effectiveness of Tribulus terrestris (TT) as an herbal supplement with antioxidant and anti-inflammatory properties on the nutritional, oxidative stress, and anti/inflammatory status, as well as the sport performance of recreational runners.Methods/design: This study is a double-blind, randomized, placebo-controlled trial, which will be conducted among recreational runners of Tabriz stadiums, Iran. Thirty-four recreational runners will be selected, and participants will be assigned randomly to two groups: to receive 500 mg TT supplement or placebo capsules twice daily for two weeks. Both groups will do the high-intensity interval training (HIIT) workouts during the study. Baseline and post-intervention body composition, muscle fatigue, and soreness parameters will be assessed. In addition, assessment of malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), creatine kinase (CK), lactate dehydrogenase (LDH), insulin-like growth factor-1 (IGF-1) and brain-derived neurotrophic factor (BDNF) will be done during three blood samplings.Discussion: This study will be the first to assess the potential effects of TT in recreational runners. Our results will contribute to the growing body of knowledge regarding TT supplementation on the nutritional, oxidative stress, anti/inflammatory status and sport performance in recreational runners.Trial registration: Iranian Registry of Clinical Trials (www.irct.ir) (ID: IRCT20150205020965N8). Registration date: 13 February 2021.

scholarly journals Anti-inflammatory dietary intervention improved metabolic profile and body composition of obese adults

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Gordana Kenđel Jovanović ◽  
Sandra Pavičić Žeželj ◽  
Sanja Klobučar Majanović ◽  
Ines Mrakovčić Šutić ◽  
Greta Krešić
Keyword(s):  
Insulin Resistance ◽  
Body Composition ◽  
Body Weight ◽  
Intervention Study ◽  
Dietary Intervention ◽  
Homa Index ◽  
Obese Patients ◽  
Inflammatory Status ◽  
Anti Inflammatory ◽  
Hs Crp

AbstractIt has become evident that chronic low-grade inflammation associated with excess adipose tissue plays an important role in the etiology of insulin resistance and other obesity related metabolic disturbances. Weight loss intervention focusing on anti-inflammatory dietary modification might help to attenuate and eventually reverse these disturbances. In this random case-control nutrition intervention study we hypothesized that obese patients will improve their inflammatory and metabolic status together with body composition following anti-inflammatory diet during 24 weeks. Body composition parameters of 42 obese patients, who completed the study, were determined by bioelectrical impedance analysis (Seca®, mBCA 515 Medical Body Composition Analyzer). Their inflammatory status was assessed with high-sensitivity C-reactive protein (hs-CRP), and insulin resistance with HOMA index. The inflammatory potential of their diet was assessed by the Dietary Inflammatory Index (DII®), based on 37 food parameters which derived from 123-item food frequency questionnaire. A positive DII® designates a diet with pro-inflammatory potential, while negative DII® designates a diet with anti-inflammatory potential. Data and z-scores were analyzed with Statistica v13.3 (StatSoft Inc., Tulsa, USA) for baseline and study end parameters differences. Obtained results have shown that, at the end of study, the patients significantly reduced their body weight (-3.3 %, p < 0.001), BMI (-3.2 %, p < 0.001), waist circumference (-1.9 %, p < 0.001), total (-3.3 %, p < 0.001) and visceral body fat (-10.4 %, p < 0.001), total (-3.1 %, p < 0.001) and extracellular water (-2.9 %, p < 0.001). The patients also significantly reduced hs-CRP (-37.7 %, p = 0.0025). Although we observed noteworthy -10.7 % reduction of HOMA index, this finding did not reach statistical significance (p = 0.862). The inflammatory potential of patients’ diet changed significantly from -0.45 to -1.73 on average (p < 0.001). With presented dietary intervention study it could be concluded that the change of the diet toward more anti-inflammatory milieu had significant influence on body weight, total and visceral body fat reduction. Consequently, those changes could have been involved in observed significant improvement of their inflammatory status. However, mild reduction of insulin resistance and rather small study group pointed out the need for further studies with more comprehensive dietary intervention.

scholarly journals Pro-Inflammatory and Pro-Oxidative Changes during Nilotinib Treatment in CML Patients: Results of a Prospective Multicenter Front-Line TKIs Study (KIARO Study)

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1479-1479
Author(s):  
Anna Sicuranza ◽  
Ilaria Ferrigno ◽  
Elisabetta Abruzzese ◽  
Alessandra Iurlo ◽  
Sara Galimberti ◽  
...  
Keyword(s):  
Inflammatory Cytokines ◽  
Kinase Inhibitors ◽  
Active Role ◽  
Inflammatory Status ◽  
Increased Risk ◽  
Formal Statistical Analysis ◽  
Anti Inflammatory ◽  
Hs Crp ◽  
Tki Treatment

Abstract Background: Tyrosine kinase inhibitors (TKI) may offer a normal life expectancy to Chronic Myeloid Leukemia (CML) patients. However, during treatment with nilotinib, a higher than expected incidence of arterial occlusive events (AOEs) was observed. We retrospectively showed an "inflammatory status" during nilotinib treatment that may explain this increased incidence of AOEs. Here, we report results of a prospective multicenter (KIARO) study including 186 CML patients (89 imatinib, 59 nilotinib, 38 dasatinib) in which pro/anti-inflammatory cytokines were measured at diagnosis and during treatment, with the aim to investigate potential changes in each patient's inflammatory status possibly favoring AOEs. Aims: The aims of this study are: 1) to analyze prospectively inflammation status during TKI treatment; 2) to record AOEs; 3) to calculate the SCORE and evaluate its predictive role for AOEs; 4) to analyze possible associations of AOEs with altered inflammation status. Methods: Inflammatory status was evaluated by measuring IL6, IL10, TNFα, oxLDL and hs-CRP plasma levels at diagnosis and during treatment (+1, +3, +6, +12 months); additionally, clinical and biochemical pro-atherothrombotic profiles and the 10-year SCORE chart were also evaluated. Results: 186 newly-diagnosed CML patients starting either imatinib, nilotinib or dasatinib treatment, entered this study. Regarding the inflammation status, we observed that TNFα and IL6 levels were high at diagnosis and decreased during the first 12 months of treatment regardless the type of TKI; instead, IL10 levels were comparable among the 3 TKI cohorts at baseline, but showed a remarkably different evolution during treatment. In fact, IL10 levels were significantly higher after 6 and 12 months of imatinib (p=0.012 and p=0.009, respectively) and dasatinib (p=0.032 and p=0.014, respectively) compared to nilotinib. Consequently, TNFα/IL10 ratio was significantly higher in nilotinib cohort at 6 and 12 months respect to imatinib (p=0.044 at 6 months and p=0.041 at 12 months) and dasatinib (p=0.040 at 6 months and p=0.044 at 12 months). As well, IL6/IL10 ratio was significantly higher in nilotinib cohort compared to imatinib and dasatinib both at 6 (p=0.042 and p=0.049, respectively) and 12 months (p=0.040 and p=0.041, respectively) (Figure 1). OxLDL levels were similar in the 3 groups for the first 6 months. At 12 months we detected a significant increase of oxLDL levels in the nilotinib cohort (p=0.041), respect to imatinib and dasatinib. We did not find significant differences in hs-CRP levels across the 3 TKIs, although a trend for higher levels was observed in nilotinib cohort. Overall, these results suggest a TKI-driven pro-inflammatory status in nilotinib treated patients. After a median follow-up of 23.3 months of TKI treatment, 10 patients (5.4%) suffered an AOE, specifically: 6 ACS, 2 PAOD, 1 TIA and 1 stroke. 5 events (50%) occurred in patients treated with nilotinib, either in first line (4 patients) or in third line (1 patient, after failure following brief treatment with imatinib and dasatinib). In this subgroup of 10 patients experiencing an AOE, we observed a trend of increased IL6 and TNFα median values both at diagnosis and at each time point, compared with the remaining no-AOE patients. IL10 and oxLDL had similar median concentrations in both AOE and no-AOE cohorts, except for oxLDL at 12 months which resulted higher in patients who experienced AOEs. Moreover, regarding AOEs, nilotinib treatment showed a 3.1 times increased risk compared to other TKIs (HR 3.1, 95% CI 2.6-4.4 p&lt; 0.001), whereas 10-year SCORE was not predictive in the whole cohort (HR 0.6, 95% CI 0.33-0.94 p= 0.094) or in any subgroup (imatinib HR 0.8, 95% CI 0.49-1.03 p= 0.067; nilotinib HR 0.4, 95% CI 0.29-0.76 p= 0.112, dasatinib HR 0.6, 95% CI 0.37-0.92 p= 0.082). Conclusions: Our results showed a pro-inflammatory/oxidative milieu increasing along treatment with nilotinib compared with imatinib or dasatinib, as demonstrated by higher IL6/IL10 and TNFα/IL10 ratios, higher levels of oxLDL and a trend for higher hs-CRP only in nilotinib cohort. However, due to the low number of observed events, a formal statistical analysis for any association between AOEs and pro/anti-inflammatory cytokines levels was not possible. Therefore, a longer follow-up is needed to further confirm the active role of nilotinib in AOEs pathogenesis. Figure 1 Figure 1. Disclosures Abruzzese: Incyte: Consultancy, Honoraria; Novartis: Consultancy, Honoraria; Pfizer: Consultancy, Honoraria; Bristol Myers Squibb: Consultancy, Honoraria. Galimberti: Incyte: Speakers Bureau; AbbVie, Janssen: Honoraria, Other: Travel grants. Stagno: Pfizer: Consultancy, Honoraria, Other: Support for attending meetings and/or travel; InCyte: Consultancy, Honoraria; Novartis: Consultancy, Honoraria, Other: Support for attending meetings and/or travel, Research Funding.

scholarly journals Mobile Delivery of the Diabetes Prevention Program in People With Prediabetes: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Tatiana Toro-Ramos ◽  
Andreas Michaelides ◽  
Maria Anton ◽  
Zulekha Karim ◽  
Leah Kang-Oh ◽  
...  
Keyword(s):  
Weight Loss ◽  
Randomized Controlled Trial ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Controlled Trial ◽  
Intervention Group ◽  
Diabetes Prevention Program ◽  
Control Group ◽  
Significant Weight Loss ◽  
Randomized Controlled

BACKGROUND The Centers for Disease Control and Prevention (CDC) diabetes prevention program (DPP) has formed the foundation for Type 2 Diabetes Mellitus (T2DM) prevention efforts and lifestyle change modifications in multiple care settings. To our knowledge, no randomized controlled trial has verified the efficacy of a fully mobile version of CDC’s diabetes prevention program (DPP). OBJECTIVE This study aimed to investigate the long-term weight loss and glycemic efficacy of a mobile-delivered DPP compared with a control group receiving usual medical care. METHODS Adults with prediabetes (N=202) were recruited from a clinic and randomized to either a mobile-delivered, coach-guided DPP (Noom) or a control group that received regular medical care including a paper-based DPP curriculum and no formal intervention. The intervention group learned how to use the Noom program, how to interact with their coach, and the importance of maintaining motivation. They had access to an interactive coach-to-participant interface and group messaging, daily challenges for behavior change, DPP-based education articles, food logging, and automated feedback. Primary outcomes included changes in weight and hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) levels at 6 and 12 months, respectively. Exploratory secondary outcomes included program engagement as a predictor of changes in weight and HbA<sub>1c</sub> levels. RESULTS A total of 202 participants were recruited and randomized into the intervention (n=101) or control group (n=99). In the intention-to-treat (ITT) analyses, changes in the participants’ weight and BMI were significantly different at 6 months between the intervention and control groups, but there was no difference in HbA<sub>1c</sub> levels (mean difference 0.004%, SE 0.05; <i>P</i>=.94). Weight and BMI were lower in the intervention group by −2.64 kg (SE 0.71; <i>P</i>&lt;.001) and −0.99 kg/m2 (SE 0.29; <i>P</i>=.001), respectively. These differences persisted at 12 months. However, in the analyses that did not involve ITT, program completers achieved a significant weight loss of 5.6% (SE 0.81; <i>P</i>&lt;.001) at 6 months, maintaining 4.7% (SE 0.88; <i>P</i>&lt;.001) of their weight loss at 12 months. The control group lost −0.15% at 6 months (SE 0.64; <i>P</i>=.85) and gained 0.33% (SE 0.70; <i>P</i>=.63) at 12 months. Those randomized to the intervention group who did not start the program had no meaningful weight or HbA<sub>1c</sub> level change, similar to the control group. At 1 year, the intervention group showed a 0.23% reduction in HbA<sub>1c</sub> levels; those who completed the intervention showed a 0.28% reduction. Those assigned to the control group had a 0.16% reduction in HbA<sub>1c</sub> levels. CONCLUSIONS This novel mobile-delivered DPP achieved significant weight loss reductions for up to 1 year compared with usual care. This type of intervention reduces the risk of overt diabetes without the added barriers of in-person interventions. CLINICALTRIAL ClinicalTrials.gov NCT03865342; https://clinicaltrials.gov/ct2/show/NCT03865342

scholarly journals Obesity and inflammation: the effects of weight loss

2008 ◽  
Vol 21 (2) ◽  
pp. 117-133 ◽  
Author(s):  
L. Kirsty Forsythe ◽  
Julie M. W. Wallace ◽  
M. Barbara E. Livingstone
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Inflammatory Marker ◽  
Present Review ◽  
Low Grade ◽  
Surgical Interventions ◽  
Inflammatory Status ◽  
Tnf Α ◽  
Induce Weight Loss ◽  
Inflammatory Profile

Following the discovery of TNF-α and leptin as secretory products of adipocytes in the early 1990s, subsequent obesity research focused on the new functional role of adipose tissue, as an active endocrine organ. Many more inflammatory peptides have been linked to adiposity, which ultimately characterised obesity as a state of low-grade systemic inflammation, or ‘metaflammation’ which may link obesity to its co-morbidities. The aim of the present review is to examine the effects of weight loss on inflammation in overweight and obese, but otherwise healthy, populations. Studies were broadly classified into four types (diet, physical activity, diet and physical activity combined, and surgical interventions) and discussed according to the method used to induce weight loss. All studies measured at least one obesity-related inflammatory marker (ORIM). The overall finding from the present review is that weight loss does improve inflammation in terms of both the inflammatory (C-reactive protein, TNF-α, IL-6 and leptin) and anti-inflammatory (adiponectin) ORIM. Within this, the greatest improvements in ORIM are observed in studies achieving a weight loss of at least 10 %. However, a number of methodological issues have been identified as potential limitations within the literature including the sex and age of subjects, sample size, study duration and the assessment of body composition. In conclusion, although a period of weight loss per se is capable of reversing the unfavourable inflammatory profile evident in the obese state, further studies are required to determine the time needed, in which a reduced weight is maintained, in order to benefit from improved inflammatory status long term.

P4409Cardiorespiratory fitness is inversely associated with the inflammatory status in the general population

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Lehnert ◽  
S Gross ◽  
S E Baumeister ◽  
R Ewert ◽  
S Glaeser ◽  
...  
Keyword(s):  
Oxygen Uptake ◽  
Chronic Inflammation ◽  
Population Based ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Inverse Association ◽  
Inflammatory Status ◽  
Cardioprotective Effects ◽  
Anti Inflammatory ◽  
Hs Crp

Abstract Background/Introduction Low-grade systemic chronic inflammation is a major risk factor for cardiometabolic diseases. Higher physical activity has athero- and cardioprotective effects, potentially through its anti-inflammatory properties. However, the relation between resting inflammatory status and cardiorespiratory fitness (CRF) in population-based settings remains to be elucidated. While previous research has shown inverse associations between CRF and high-sensitive C-reactive protein (hs-CRP) levels, relations with other inflammatory markers are not yet well examined. Purpose We assessed the relation between markers of CRF (i.e. maximal oxygen uptake [VO2peak], oxygen uptake at the anaerobic threshold [VO2@AT], oxygen pulse [O2HRmax] and maximal workload [max. Watt]) and hs-CRP as well as total white blood cell (WBC), monocyte, neutrophil, lymphocyte, eosinophil and basophil counts. Methods Data of the population-based cohort Study of Health in Pomerania (SHIP) was used (n=1,481; 51% male; age range 20–81 years). CRF was assessed using standardized cardio-pulmonary exercise testing (CPET) according to a modified Jones protocol. The Dimension Vista 500 analytical system was used to measure hs-CRP concentrations. Fluorescence-activated cell sorting was used to assess total as well as subpopulation WBC count. We excluded subjects with missing data, anti-rheumatic/steroid/anti-inflammatory medication as well as chronic inflammatory and hepatic diseases, gastritis, hepatitis infection, severe renal disease, chronic lung disease, asthma, chronic bronchitis, previous myocardial infarction, left ventricular ejection fraction <40% and previous cancer. Linear regression models, adjusted for age, sex, current smoking and lean-mass, were used to assess the relation between CPET and inflammatory parameters. Results A 14 ml/min (95%-confidence interval [CI] −23 to −6, p=0.004) lower VO2peak was associated with a one mg/L higher hs-CRP. A lower VO2peak was also related with a one Gpt/L greater WBC (β: −42. 95% CI: −55 to −27 ml/min, p<0.001) as well as neutrophil (β: −57, 95% CI: −77 to −36 ml/min, p<0.001), lymphocyte (β: −63, 95% CI: −107 to 19 ml/min, p=0.005) and monocyte count (β: −204, 95% CI: −360 to −47 ml/min, p=0.011). No significant associations were found for eosinophil and basophil count. Similar results were found for VO2@AT, O2HRmax and max. Watt. Conclusion Results suggest an inverse association between CRF and resting inflammatory status. Our non-significant findings with regards to eosinophils and basophils may be expected since these cell types are generally involved in type 2 immune responses related to allergic skin and airway inflammation as well as immunity against parasites. Overall, our results imply that potential biological mechanisms underlying the athero- and cardioprotective effects of high CRF may be related to lower chronic inflammation in fitter individuals.

scholarly journals Prevalence of nonalcoholic fatty liver disease (NAFLD) in patients of cardiovascular diseases and its association with hs-CRP and TNF-α

2014 ◽  
Vol 66 (6) ◽  
pp. 574-579 ◽  
Author(s):  
Masihur Rehman Ajmal ◽  
Monika Yaccha ◽  
Mohammed Azharuddin Malik ◽  
M.U. Rabbani ◽  
Ibne Ahmad ◽  
...  
Keyword(s):  
Liver Disease ◽  
Cardiovascular Diseases ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Nonalcoholic Fatty Liver ◽  
Tnf Α ◽  
Hs Crp

scholarly journals Mobile Delivery of the Diabetes Prevention Program in People With Prediabetes: Randomized Controlled Trial

10.2196/17842 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e17842
Author(s):  
Tatiana Toro-Ramos ◽  
Andreas Michaelides ◽  
Maria Anton ◽  
Zulekha Karim ◽  
Leah Kang-Oh ◽  
...  
Keyword(s):  
Weight Loss ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Controlled Trial ◽  
Intervention Group ◽  
Diabetes Prevention Program ◽  
Control Group ◽  
Significant Weight Loss ◽  
Randomized Controlled ◽  
Hba1c Levels

Background The Centers for Disease Control and Prevention (CDC) diabetes prevention program (DPP) has formed the foundation for Type 2 Diabetes Mellitus (T2DM) prevention efforts and lifestyle change modifications in multiple care settings. To our knowledge, no randomized controlled trial has verified the efficacy of a fully mobile version of CDC’s diabetes prevention program (DPP). Objective This study aimed to investigate the long-term weight loss and glycemic efficacy of a mobile-delivered DPP compared with a control group receiving usual medical care. Methods Adults with prediabetes (N=202) were recruited from a clinic and randomized to either a mobile-delivered, coach-guided DPP (Noom) or a control group that received regular medical care including a paper-based DPP curriculum and no formal intervention. The intervention group learned how to use the Noom program, how to interact with their coach, and the importance of maintaining motivation. They had access to an interactive coach-to-participant interface and group messaging, daily challenges for behavior change, DPP-based education articles, food logging, and automated feedback. Primary outcomes included changes in weight and hemoglobin A1c (HbA1c) levels at 6 and 12 months, respectively. Exploratory secondary outcomes included program engagement as a predictor of changes in weight and HbA1c levels. Results A total of 202 participants were recruited and randomized into the intervention (n=101) or control group (n=99). In the intention-to-treat (ITT) analyses, changes in the participants’ weight and BMI were significantly different at 6 months between the intervention and control groups, but there was no difference in HbA1c levels (mean difference 0.004%, SE 0.05; P=.94). Weight and BMI were lower in the intervention group by −2.64 kg (SE 0.71; P<.001) and −0.99 kg/m2 (SE 0.29; P=.001), respectively. These differences persisted at 12 months. However, in the analyses that did not involve ITT, program completers achieved a significant weight loss of 5.6% (SE 0.81; P<.001) at 6 months, maintaining 4.7% (SE 0.88; P<.001) of their weight loss at 12 months. The control group lost −0.15% at 6 months (SE 0.64; P=.85) and gained 0.33% (SE 0.70; P=.63) at 12 months. Those randomized to the intervention group who did not start the program had no meaningful weight or HbA1c level change, similar to the control group. At 1 year, the intervention group showed a 0.23% reduction in HbA1c levels; those who completed the intervention showed a 0.28% reduction. Those assigned to the control group had a 0.16% reduction in HbA1c levels. Conclusions This novel mobile-delivered DPP achieved significant weight loss reductions for up to 1 year compared with usual care. This type of intervention reduces the risk of overt diabetes without the added barriers of in-person interventions. Trial Registration ClinicalTrials.gov NCT03865342; https://clinicaltrials.gov/ct2/show/NCT03865342

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