Weight Loss

2020 ◽  
Keyword(s):  
Weight Loss ◽  
Eating Disorder ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
Caloric Intake ◽  
Ideal Body Weight ◽  
Tuberculin Test ◽  
Dietary History ◽  
Test Culture ◽  
Hiv Test

Key Points When considering weight loss, consider the possibility of an error in recorded weights.Obtain a thorough dietary history. Consider inaccuracy, especially if an eating disorder is possible.A basic workup should be performed before attributing the loss to mental health. Consider the following assessments: complete blood cell count, comprehensive metabolic panel, C-reactive protein, erythrocyte sedimentation rate, tuberculin test, rapid plasma reagin test, HIV test, tissue transglutaminase plus immunoglobulin A, thyrotropin plus free thyroxine, stool guaiac test/culture/ova/parasites, and urinalysis.Close follow-up is mandatory. Admission criteria if an eating disorder is considered can include less than 75% of the ideal body weight, a supine heart rate less than 50 beats/min, a temperature less than 35.6°C, a systolic blood pressure less than 90 mm Hg, arrhythmia, and orthostatic vital signs.If findings from the workup are negative, attempts to increase caloric intake are insufficient, and an eating disorder is not suspected, refer the patient to a registered dietitian and/or a gastroenterologist.

scholarly journals Prevalence and Predictors of Malnutrition in Nasopharyngeal Carcinoma

2015 ◽  
Vol 8 ◽  
pp. CMENT.S12119 ◽  
Author(s):  
Catherine Wanjiru irungu ◽  
Herbert O. Oburra ◽  
Betha Ochola
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Nasopharyngeal Carcinoma ◽  
Serum Albumin ◽  
Stage Iv ◽  
Ideal Body Weight ◽  
Predictive Marker ◽  
Calorie Intake ◽  
Dietary History ◽  
Ideal Body

We assessed the prevalence and predictors of malnutrition in patients with nasopharyngeal carcinoma. Sixty cases and 123 controls matched for age and gender were included. Bio-data, dietary history, height, weight, body mass index (BMI), ideal body weight, and serum albumin levels were recorded. Pretreatment weight loss of >5% was present in 35% of subjects (P < 0.0001). A BMI of < 18.5 kg/m2 was present in 13.3% (P < 0.001), percent ideal body weight of <90% was present in 30% (P < 0.001), and serum albumin levels < 30 g/dL was present in 23.3% (P < 0.001) of cases. Nasopharyngeal carcinoma increased the likelihood of having a BMI < 18.5 kg/m2 (odds ratio, 9.3 (3.4–25.3) P ≤ 0.001). Logistic regression shows that stage IV disease was associated with a decrease in all parameters except protein-calorie intake. Stage IV nasopharyngeal carcinoma is a predictive marker for weight loss and low serum albumin levels. Nutritional management is important for ensuring the patients’ ability to withstand chemoradiation and thus improve survival and quality of life.

scholarly journals Long-Term Iron and Vitamin B12 Deficiency Are Present after Bariatric Surgery, Despite the Widespread Use of Supplements

2021 ◽  
Vol 18 (9) ◽  
pp. 4541
Author(s):  
Mauro Lombardo ◽  
Arianna Franchi ◽  
Roberto Biolcati Rinaldi ◽  
Gianluca Rizzo ◽  
Monica D’Adamo ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Ideal Body Weight ◽  
Excess Weight ◽  
Nutritional Deficiencies ◽  
Average Percentage ◽  
Nutritional Studies

There are few long-term nutritional studies in subjects undergoing bariatric surgery that have assessed weight regain and nutritional deficiencies. In this study, we report data 8 years after surgery on weight loss, use of dietary supplements and deficit of micronutrients in a cohort of patients from five centres in central and northern Italy. The study group consisted of 52 subjects (age: 38.1 ± 10.6 y, 42 females): 16 patients had Roux-en-Y gastric bypass (RYGB), 25 patients had sleeve gastrectomy (SG) and 11 subjects had adjustable gastric banding (AGB). All three bariatric procedures led to sustained weight loss: the average percentage excess weight loss, defined as weight loss divided by excess weight based on ideal body weight, was 60.6% ± 32.3. Despite good adherence to prescribed supplements, 80.7% of subjects (72.7%, AGB; 76.7%, SG; 93.8 %, RYGB) reported at least one nutritional deficiency: iron (F 64.3% vs. M 30%), vitamin B12 (F 16.6% vs. M 10%), calcium (F 33.3% vs. M 0%) and vitamin D (F 38.1% vs. M 60%). Long-term nutritional deficiencies were greater than the general population among men for iron and among women for vitamin B12.

Is Endoscopic Assessment of the Esophagus and Stomach Enough to Determine the Need for Biopsy at These Sites in Pediatric Patients Undergoing Endoscopy for Elevated TTG?

2021 ◽  
pp. 109352662199148
Author(s):  
M. Cristina Pacheco ◽  
Nicole Green ◽  
Jane Dickerson ◽  
Dale Lee
Keyword(s):  
Sensitivity And Specificity ◽  
Pediatric Patients ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
High Specificity ◽  
Visual Assessment ◽  
Pathology Report ◽  
Low Sensitivity ◽  
Endoscopic Assessment

Objectives The goal of our study was to determine whether visual assessment of the esophagus and stomach could predict abnormal histology and determine the frequency of interventions based on biopsies in patients undergoing endoscopy for elevated tissue transglutaminase immunoglobulin A antibody (TTG). Methods Pathology records were searched for patients with biopsy performed for elevated TTG. Pathology report, endoscopy report, and follow-up were obtained and slides from the duodenum reviewed. Pathology was considered gold standard for sensitivity and specificity calculations. Results 240 patients were included. 215 patients had esophageal biopsies performed. Esophageal endoscopic visual assessment had sensitivity of 47% and specificity of 93% for abnormal histology. 16(7%) patients had therapy or referral related to results and, of these, 6(38%) had visually normal endoscopy. 237 biopsies were performed of stomach. Gastric endoscopic visual assessment had a sensitivity and specificity of 20% and 87%. 24(10%) patients had therapy based on findings and, of these, 12 (50%) had visually normal endoscopy. Conclusions Endoscopic assessment of esophagus and stomach has low sensitivity and high specificity for pathologic abnormalities when indication for endoscopy is elevated TTG. When endoscopy is visually normal clinical interventions based on biopsy are rare, and foregoing biopsy may be considered.

Infant Obesity, Weight Reduction with Normal Increase in Linear Growth and Fat-free Body Mass

PEDIATRICS ◽  
1992 ◽  
Vol 89 (1) ◽  
pp. 143-145
Author(s):  
JOYCE M. PEIPERT ◽  
VIRGINIA A. STALLINGS ◽  
GERARD T. BERRY ◽  
JULE ANNE D. HENSTENBURG
Keyword(s):  
Weight Loss ◽  
Body Mass ◽  
Weight Maintenance ◽  
Caloric Intake ◽  
Resting Energy Expenditure ◽  
Induce Weight Loss ◽  
Infant Obesity ◽  
Normal Increase ◽  
Free Body ◽  
Treatment Of Obesity

Dietary caloric restriction, as a means to induce weight loss, is seldom used as a treatment of obesity in infancy for fear that permanent stunting of growth may result.1-4 Thus, there is little information on controlled weight loss as the treatment for infant obesity or, more importantly, its effect on growth in length, head circumference, and fat-free body mass during weight loss.5 We present a case of an obese infant who, secondary to a metabolic disorder, required nutritional support both intravenously and by nasogastric tube. During 15 months, the patient's resting energy expenditure (REE) was measured to determine an appropriate caloric intake to promote weight loss and later weight maintenance.

THE EFFECTS OF LOW-CARBOHYDRATE VERSUS LOW-FAT DIETS IN OBESE/OVERWEIGHT ADULTS: ONE-YEAR FOLLOW-UP OF A RANDOMIZED TRIAL

2021 ◽  
pp. 27-29
Author(s):  
Maitri Hathi ◽  
Sudesh Kumar
Keyword(s):  
Weight Loss ◽  
Randomized Trial ◽  
Caloric Intake ◽  
Low Fat ◽  
Obese Adults ◽  
Low Carbohydrate Diet ◽  
Low Carbohydrate ◽  
One Year ◽  
The One

Aprevious paper reported the six month comparison of weight loss in overweight and/or obese adults randomly assigned to either a VLCK-diet or LF-diet. To review the one year outcomes between these diets 1year follow-up of a randomized trial on 113 overweight/obese adults with a BMI>25 kg/m2; with no abnormalities were randomly selected. Participants who selected VLCK diet received counseling to restrict carbohydrate intake to <30 gram per day and those who selected LF diet received counseling to restrict caloric intake by 500 calories per day with <30% of calories from fat. Changes in weight, Body Mass Index, Body Fat, and Waist Circumference were measured at intervals of rst, third, sixth and twelfth month of participants who completed the one-year follow-up. Participants on the very-low-carbohydrate diet had lost more weight loss than participants on the conventional low-fat diet at 3months, 6month and but the difference at 12months were signicant. Study conclude that participants on a VLCK-diet had more favorable overall outcomes at 1year than did those on a conventional LF-diet. Weight loss was similar between groups.

Abstract P297: Reduced Fat Mass and Improved Insulin Sensitivity in Overweight Black Women after Completion of 6-month Worksite Weight Loss Program

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Benjamin M Leon ◽  
Bernard V Miller ◽  
Gloria Zalos ◽  
Kong Y Chen ◽  
Anne E Sumner ◽  
...  
Keyword(s):  
Weight Loss ◽  
Black Women ◽  
Insulin Sensitivity ◽  
Fat Mass ◽  
Caloric Intake ◽  
Mass Gain ◽  
The United States ◽  
Sensitivity Index ◽  
Web Based ◽  
Total Fat

Background: As the epidemic of obesity in the United States steadily worsens, black women are disproportionately affected. Diminished insulin sensitivity has been linked with obesity and heightened risk of subsequent type 2 diabetes (T2D) and cardiovascular disease (CVD). Hypothesis: We propose that a decrease in fat mass achievable by weight loss intervention at the worksite improves insulin sensitivity in overweight black women. Methods: Fifty-four overweight black women [age 45±10 years (mean±SD), BMI range 25.9 to 54.7 kg/m 2 ] completed a 6-month program that included web-based nutrition information and/or dietitian counseling and access to exercise rooms near their work areas. All participants were advised to reduce daily caloric intake by 500 kcal and instructed to increase daily activity by 5,000 steps, measured by pedometer, above baseline readings. The following measurements were performed: weight, total fat mass by dual-energy X-ray absorptiometry, and insulin sensitivity index (S I ) calculated from the minimal model. Repeat of all measurements was performed at 6 months. Results: Baseline S I (median 3.0 liter/mU -1 •min -1 , range 0.74 to 7.58 liter/mU -1 •min -1 , with lower values signifying insulin resistance) was negatively associated with fat mass (r= -0.584, P<0.001) independent of age. Significant reductions in weight (92.6±18.1 to 91.1±18.9 kg, P<0.01) and fat mass (40.8±12.4 to 39.4±12.6 kg, P<0.01) were determined for subjects completing the program. Reduction in fat mass following completion of the program was associated with an increase in S I (r= -0.293, P=0.032). When analyzed by tertiles of fat mass change (Figure), compared to the tertile with net fat mass gain (far left bar), the two tertiles with net fat mass loss had significantly improved insulin sensitivity (higher S I ). Conclusions: Even modest fat mass reduction in overweight non-diabetic black women with a combination of diet and exercise can improve insulin sensitivity, which has the potential to reduce or delay the onset of T2D and CVD.

scholarly journals Prevalence of Celiac Disease in Collagenous and Lymphocytic Colitis

2000 ◽  
Vol 14 (11) ◽  
pp. 919-921 ◽  
Author(s):  
Helen Rachel Gillett ◽  
Hugh James Freeman
Keyword(s):  
Celiac Disease ◽  
Small Bowel ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
Collagenous Colitis ◽  
Lymphocytic Colitis ◽  
Small Bowel Biopsy ◽  
Major Antigen ◽  
Immunofluorescent Technique ◽  
Endomysium Antibody

Both collagenous and lymphocytic colitis have been described in patients with celiac disease, suggesting an association between the conditions. Over the past few years, the availability, sensitivity and specificity of serological markers for celiac disease have improved - the most recent advancement being the description of tissue transglutaminase as the major antigen for endomysium antibody. A quantitative ELISA was used to measure titres of immunoglobulin A (IgA) antibody to tissue transglutaminase (tTG) along with an immunofluorescent technique for IgA endomysium antibody (EmA) in 15 patients with lymphocytic colitis and eight with collagenous colitis to determine whether celiac disease latency could be detected. One patient with lymphocytic colitis demonstrated both elevated titres of tTG antibody and positive EmA, and small bowel biopsy confirmed celiac disease. One patient with collagenous colitis had a slightly elevated titre of tTG antibody with a negative EmA, and results of a small bowel biopsy were normal. Three other patients with lymphocytic colitis were already treated for previously diagnosed celiac disease. The prevalence of celiac disease occurring in lymphocytic colitis was found to be 27%, but no cases of celiac disease in association with collagenous colitis were found.

scholarly journals Relationship Between Weekly Patterns of Caloric Intake and Reported Weight Loss Outcomes: Retrospective Cohort Study (Preprint)

2017 ◽  
Author(s):  
Christine Hill ◽  
Brian W Weir ◽  
Laura W Fuentes ◽  
Alicia Garcia-Alvarez ◽  
Danya P Anouti ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Linear Regression ◽  
Mobile Phone ◽  
Body Mass ◽  
Caloric Intake ◽  
Body Mass Index Category ◽  
Obese Adults ◽  
Weight Loss Outcomes ◽  
The Relationship

BACKGROUND Although millions of overweight and obese adults use mobile phone apps for weight loss, little is known about the predictors of success. OBJECTIVE The objective of this study was to understand the relationship between weight loss outcomes and weekly patterns of caloric intake among overweight and obese adults using a mobile phone app for weight loss. METHODS We examined the relationship between weekly patterns of caloric intake and weight loss outcomes among adults who began using a weight loss app in January 2016 and continued consistent use for at least 5 months (N=7007). Unadjusted and adjusted linear regression analyses were used to evaluate the predictors of percentage of bodyweight lost for women and men separately, including age, body mass index category, weight loss plan, and difference in daily calories consumed on weekend days (Saturday and Sunday) versus Monday. RESULTS In adjusted linear regression, percentage of bodyweight lost was significantly associated with age (for women), body mass index (for men), weight loss plan, and differences in daily caloric intake on Mondays versus weekend days. Compared with women consuming at least 500 calories more on weekend days than on Mondays, those who consumed 50 to 250 calories more on weekend days or those with balanced consumption (±50 calories) lost 1.64% more and 1.82% more bodyweight, respectively. Women consuming 250 to 500 calories or more than 500 calories more on Mondays than on weekend days lost 1.35% more and 3.58% more bodyweight, respectively. Compared with men consuming at least 500 calories more on weekend days than on Mondays, those consuming 250 to 500 calories or more than 500 calories more on Mondays than on weekend days lost 2.27% and 3.42% less bodyweight, respectively. CONCLUSIONS Consistent caloric intake on weekend days and Mondays or consuming slightly fewer calories per day on Mondays versus weekend days was associated with more successful weight loss. CLINICALTRIAL ClinicalTrials.gov NCT03136692; https://clinicaltrials.gov/ct2/show/NCT03136692 (Archived by WebCite at http://www.webcitation.org/6y9JvHya4)

scholarly journals Testing for Gluten-Related Disorders in Clinical Practice: The Role of Serology in Managing the Spectrum of Gluten Sensitivity

2011 ◽  
Vol 25 (4) ◽  
pp. 193-197 ◽  
Author(s):  
David Armstrong ◽  
Andrew C Don-Wauchope ◽  
Elena F Verdu
Keyword(s):  
Celiac Disease ◽  
Serological Test ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
Intestinal Damage ◽  
Gluten Sensitivity ◽  
Serological Testing ◽  
Diet Compliance ◽  
At Risk Populations ◽  
Irritable Bowel

Immunoglobulin A tissue transglutaminase is the single most efficient serological test for the diagnosis of celiac disease. It is well known that immunoglobulin A tissue transglutaminase levels correlate with the degree of intestinal damage, and that values can fluctuate in patients over time. Serological testing can be used to identify symptomatic individuals that need a confirmatory biopsy, to screen at-risk populations or to monitor diet compliance in patients previously diagnosed with celiac disease. Thus, interpretation of serological testing requires consideration of the full clinical scenario. Antigliadin tests are no longer recommended for the diagnosis of classical celiac disease. However, our understanding of the pathogenesis and spectrum of gluten sensitivity has improved, and gluten-sensitive irritable bowel syndrome patients are increasingly being recognized. Studies are needed to determine the clinical utility of antigliadin serology in the diagnosis of gluten sensitivity.

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