scholarly journals Diet prescription in obese patients

2005 ◽  
Vol 64 (1) ◽  
Author(s):  
Carlo Lesi ◽  
Ester Giaquinto ◽  
Luca Valeriani ◽  
Luisa Zoni
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Weight Loss ◽  
Patient Characteristics ◽  
The Body ◽  
Obese Patients ◽  
Metabolic Complications ◽  
Unbalanced Diet ◽  
Lipid Abnormalities

Diet is a cornerstone in the treatment of obese patients with or without metabolic complications. To optimize outcome, diet treatment should always take into account factors such as the Body Mass Index, the timeframe for reaching the recommended weight loss, comorbidities (e.g. arterial hypertension, diabetes mellitus, renal disease, lipid abnormalities, hyperuricemia) and, finally, individual patient characteristics (e.g. habits, preferences, adherence capacity). Hypocaloric diets need to be adequately balanced in terms of glucides, lipids and proteins, vitamins and minerals. For these reasons the diet prescription for obese patients, particularly those with comorbidities or cardiovascular disease, should be under the guidance of expert nutrition professionals who are aware of the risks of an unbalanced diet.

scholarly journals The effects of three-week fasting diet on blood pressure, lipid profile and glucoregulation in extremely obese patients

2007 ◽  
Vol 135 (7-8) ◽  
pp. 440-446 ◽  
Author(s):  
Biljana Beleslin ◽  
Jasmina Ciric ◽  
Milos Zarkovic ◽  
Zorana Penezic ◽  
Svetlana Vujovic ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Body Weight ◽  
Insulin Sensitivity ◽  
Lipid Profile ◽  
Body Mass ◽  
Glucose Intolerance ◽  
The Body ◽  
Obese Patients

Introduction Obesity is often accompanied by a number of complications including diabetes mellitus and cardiovascular diseases. Elevated blood pressure and lipids, as well as deterioration of glucoregulation are attributed, as the most significant factors, to development of diabetes mellitus and cardiovascular complications in obese patients. Objective The aim of our study was to evaluate the effects of a fasting diet on blood pressure, lipid profile and glucoregulatory parameters. Method We included 110 patients (33 male and 77 female; mean age 35?1 years, body weight 131.7?2.6 kg, body mass index 45.4?0.8 kg/m2) who were hospitalized for three weeks for the treatment of extreme obesity with the fasting diet. At the beginning, during, and at the end of this period, we evaluated changes in blood pressure, lipid profile, as well as parameters of glucoregulation including glycaemia, insulinaemia, and insulin sensitivity by HOMA. Oral glucose tolerance test (OGTT) was performed in all patients at the beginning and at the end of the fasting diet. Results During the fasting diet, the body weight decreased from 131.7?2.6 kg to 117.7?2.4 kg (p<0.001), the body mass index decreased from 45.4?0.8 kg/m2 to 40.8?0.8 kg/m2 (p<0.001), and both systolic and diastolic blood pressure significantly declined (143?2 vs. 132?2 mm Hg, p<0.001; 92?2 vs. 85?2 mm Hg, p<0.001). In addition, the fasting diet produced a significant decrease in total cholesterol, LDL cholesterol, triglycerides, as well as basal glycaemia and insulinaemia (p<0.001) Before the fasting diet, OGTT was normal in 76% of patients, whereas 21% of patients showed glucose intolerance, and 4% of patients diabetes mellitus. After the fasting diet, OGTT was normal in 88% of patients, whereas 12% of patients still had signs of glucose intolerance (p<0.05). In addition, insulin resistance significantly (p<0.05) increased from 54?6% to 89?13% after the fasting diet. Conclusion The three-week fasting diet in extremely obese patients produced a significant decrease and normalization of blood pressure, decrease in lipids, and improvement in glucoregulation including the increase in insulin sensitivity.

scholarly journals Effect of weight loss on early left atrial myopathy in obese patients without known cardiovascular disease

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
O Deal ◽  
J Rayner ◽  
A Stracquadanio ◽  
R Wijesurendra ◽  
S Neubauer ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Weight Loss ◽  
Body Mass ◽  
Left Atrial ◽  
Normal Weight ◽  
Obese Patients ◽  
Weight Loss Intervention ◽  
Reservoir Function ◽  
Lv Mass

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): BHF & NIHR BRC Introduction Obesity is strongly associated with increased risk of heart failure and ischaemic stroke independently of associated co-morbidities. Left atrial (LA) reservoir dysfunction, a marker of atrial distensibility and compliance, is an early pathophysiological change which precedes the onset of cardiovascular disease in patients with obesity. It is unclear whether a weight loss intervention may be sufficient to reverse LA reservoir dysfunction. Purpose To longitudinally assess whether a weight loss intervention normalizes LA reservoir function by cardiac magnetic resonance (CMR) feature-tracking in patients with obesity and only subclinical cardiovascular disease and compared this age and sex matched non-obese normal weight controls. Methods A total of 45 patients with severe obese (age = 45 ± 11 years, body mass index = 39.1 ± 6.7 kg/m2, 51 ± 18 kg of excess body weight [EBW], 67% female) underwent CMR for quantification of LA and left ventricular (LV) size and function before and a median of 373 days following weight loss intervention. Weight loss was achieved by means of a very-low calorie diet (N = 28; 800 kcal/day) or by bariatric surgery (N = 17). A total of N = 27 non-obese healthy controls (age = 41 ± 12 years, body mass index = 22.3 ± 2.4 kg/m2, 75% female) underwent the same CMR protocol once. Results At baseline, patients with obesity displayed signs of atrial myopathy with increased LA volume and reduced LA reservoir function as compared to normal-weight controls (both P &lt; 0.05, Figure 1) alongside increased LV mass and hyper-normal LV ejection fraction [LVEF] (both p &lt; 0.01). As expected, weight loss led to a significant reduction of LA volume and LV mass with normalization of LVEF regardless of the degree of weight loss achieved (all P &lt; 0.05, Figure 2). By contrast, only a large weight loss (&gt;46.6% EBW, in red in Figure 2) was sufficient to improve and normalize the LA reservoir function (P &lt; 0.05, Figure 2).  On the other hand, moderate or milder weight loss (in orange and red) had no significant effect on LA reservoir function (both P &gt; 0.05). Conclusion Successful weight loss can completely revert early LA myopathic phenotype in obese patients without known cardiovascular disease although this can be achieved only with larger weight loss targets.

scholarly journals Update on the Mechanisms Facilitating Weight Loss and Resolution of Type 2 Diabetes Following Bariatric Surgery

2012 ◽  
Vol 19 (4) ◽  
pp. 425-432
Author(s):  
Cornelia Zetu ◽  
Rubin Munteanu ◽  
Anca Frunză ◽  
Constantin Ionescu-Tîrgovişte
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Body Mass Index ◽  
Weight Loss ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Glucose Profiles ◽  
Obese Subjects

AbstractThe prevalence of type 2 diabetes mellitus (T2DM) and obesity is steadily increasingworldwide. To fight the twin pandemics of obesity and T2DM, clinicians need everytool they can get. Major, durable weight loss is uncommon with medical andbehavioral approaches; many diabetes drugs promote weight gain, while using themto obtain better blood glucose profiles increases the risk of hypoglycemia. Bariatricsurgery seems to be the most effective method for promoting major and durableweight loss in obese subjects, leading also to ameliorations of obesity-associated comorbidities,especially T2DM. Currently, indications for bariatric surgery includemorbidly obese patients or patients with a body mass index (BMI) >35 withsignificant co-morbidities. Currently, bariatric surgery (also referred to as“metabolic surgery”) is advocated for the treatment of T2DM even in overweightsubjects who do not meet the current BMI criteria. This review examines the currentevidence regarding the mechanisms of T2DM resolution following bariatric surgery.

Use of Metformin for Weight Management in Children and Adolescents With Obesity in the Clinical Setting

2018 ◽  
Vol 57 (14) ◽  
pp. 1677-1685 ◽  
Author(s):  
Kathryn E. Kyler ◽  
Rachel B. Kadakia ◽  
Hannah L. Palac ◽  
Soyang Kwon ◽  
Adolfo J. Ariza ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Linear Regression ◽  
Weight Management ◽  
Clinical Setting ◽  
Regression Models ◽  
Obese Patients ◽  
Z Score ◽  
Linear Regression Models ◽  
Anthropometric Measures

Use of metformin for weight loss for children in a clinical setting has not been well described; therefore, we aimed to identify characteristics of obese patients prescribed metformin in a clinical setting and evaluate changes in anthropometric measures. Records of obese patients aged 10 to 18 years without diabetes attending an academic endocrinology practice from 2009 to 2013 were reviewed. Analyses assessed changes in anthropometric measures (weight, body mass index [BMI], and BMI z-score) over 12 months between those prescribed metformin (n = 49) and those not prescribed metformin (n = 142). Outcomes were standardized before using multivariable linear regression models. Patients prescribed metformin were significantly older, more often female, and had larger baseline anthropometric measures (all P < .05). In the models, subjects prescribed metformin had significantly less gain in standardized weight, BMI, and BMI z-score over 6 and 12 months (all P < .05). Metformin may be a useful weight management aid in children in a clinical setting.

scholarly journals Frequency of Genital Infections According to Body Mass Index in Dapagliflozin-treated Patients with Type 2 Diabetes Mellitus

2017 ◽  
Vol 04 (01) ◽  
pp. e1-e4
Author(s):  
Gottfried Rudofsky ◽  
Tanja Haenni ◽  
John Xu ◽  
Eva Johnsson
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Body Mass ◽  
The Body ◽  
Baseline Body Mass Index ◽  
Obese Patients ◽  
Genital Infections ◽  
Increased Risk ◽  
Three Body

Abstract Genital infections are associated with sodium glucose co-transporter 2 inhibitors such as dapagliflozin. Since patients with Type 2 diabetes are at increased risk of genital infections, and obesity is a risk factor for infections, obese patients with Type 2 diabetes could be more susceptible to genital infections when treated with sodium glucose co-transporter 2 inhibitors. This pooled dataset assessed the frequency of genital infections according to baseline body mass index in patients treated with dapagliflozin 10 mg. Data were pooled from 13 studies of up to 24 weeks’ duration (dapagliflozin N=2 360; placebo N=2 295). Frequency of genital infections was compared between three body mass index subgroups (<30, ≥30−< 35 and ≥35 kg/m2). Genital infections were reported in 130 (5.5%) patients receiving dapagliflozin and 14 (0.6%) patients receiving placebo; none of which were serious. Genital infections were more common in women (84/130 [64.6%]) than in men (46/130 [35.4%]) treated with dapagliflozin. In the body mass index < 30, ≥ 30−< 35 and ≥ 35 kg/m2 dapagliflozin-treated subgroups, 38/882 (4.3%), 47/796 (5.9%) and 45/682 (6.6%) patients presented with genital infections, respectively. Although the frequency was low overall and relatively similar between subgroups, there was a trend towards an increase in genital infections in patients with a higher body mass index. This trend is unlikely to be clinically relevant or to affect suitability of dapagliflozin as a treatment option for obese patients with Type 2 diabetes, but rather should influence advice and counselling of overweight patients on prevention and treatment of genital infections.

The Impact of the Body Mass Index on Outcome After Subarachnoid Hemorrhage

Neurosurgery ◽  
2013 ◽  
Vol 73 (2) ◽  
pp. 201-208 ◽  
Author(s):  
Johannes Platz ◽  
Erdem Güresir ◽  
Patrick Schuss ◽  
Jürgen Konczalla ◽  
Volker Seifert ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Subarachnoid Hemorrhage ◽  
Body Mass ◽  
Glasgow Outcome Scale ◽  
The Body ◽  
Favorable Outcome ◽  
World Federation ◽  
Obese Patients ◽  
Aneurysm Size ◽  
The Impact

Abstract BACKGROUND: Obesity is a risk factor for cardiovascular disease and associated with a poor outcome, especially for intensive care patients. However, recent studies have described favorable outcomes of obese patients after stroke, a phenomenon called the “obesity paradox.” OBJECTIVE: To assess the impact of the body mass index (BMI) on outcome after subarachnoid hemorrhage (SAH). METHODS: We analyzed the data for 741 SAH patients. A BMI greater than 25 kg/m2 was considered overweight and greater than 30 kg/m2 obese. The outcome according to the Glasgow Outcome Scale at discharge and after 6 months was assessed using logistic regression analysis. RESULTS: According to the BMI, 268 patients (36.2%) were overweight and 113 (15.2%) were obese. A favorable outcome (Glasgow Outcome Scale score &gt;3) was achieved in 53.0% of overweight patients. In contrast, 61.4% of the 360 patients with a normal BMI had a favorable outcome (P = .021). However, in the multivariate analysis, only age (odds ratio [OR]: 1.051, 95% confidence interval [CI]: 1.04-1.07, P &lt; .001), World Federation of Neurological Surgeons grade (OR: 2.095, 95% CI: 1.87-2.35, P &lt; .001), occurrence of vasospasm (OR: 2.90, 95% CI: 1.94-4.34, P &lt; .001), and aneurysm size larger than 12 mm (OR: 2.215, 95% CI: 1.20-4.10, P = .011) were independent predictors of outcome after 6 months. Of the 321 poor grade patients (World Federation of Neurological Surgeons score &gt;3), 171 (53.3%) were overweight. Of these, 21.6% attained a favorable outcome compared with 35.3% of normal-weight patients (P = .006). CONCLUSION: Although many physicians anticipate a worse outcome for obese patients, in our study, the BMI was not an independent predictor of outcome. Based on the BMI, obesity seems to be negligible for outcome after SAH compared with the impact of SAH itself, the patient's age, occurrence of vasospasm, or aneurysm size.

scholarly journals Cardiac Changes in Overweight and Obese Patients

2016 ◽  
Vol 54 (3) ◽  
pp. 161-172 ◽  
Author(s):  
Teodora Gabriela Alexescu ◽  
Angela Cozma ◽  
Adela Sitar-Tăut ◽  
V. Negrean ◽  
M.I. Handru ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Body Mass ◽  
Body Surface ◽  
Interventricular Septum ◽  
Normal Weight ◽  
The Body ◽  
Obese Patients ◽  
Left Ventricle Mass

Abstract Background. Obesity and overweight are two pathologies that are more and more frequent in the XXIst century diagnosis and are causing high morbidity and mortality rates in the general population, especially through cardiovascular complications.Aims. Identification and early diagnosis of cardiac changes in overweight and obese patients. Material and method. We carried out a sectional, analytical and observational study on 111 subjects: 27 normal weight subjects and 84 overweight and obese patients, which were submitted to a clinical exam, biochemical exams and 2D ultrasound.Results. The presence of diastolic dysfunction is twice more frequent in overweight patients in comparison to normal weight ones (30% vs 15%) and 5 times more frequent in obese patients than normal weight ones (75% vs 15%). The size increase of the interventricular septum is correlated with the body mass index, there being statistically significant differences between normal weight vs overweight vs obese patients, as well as between overweight and obese ones. Within the whole group and within the groups, both the left ventricle mass (g) as well as the left ventricle mass to body surface ratio (g/m²) are statistically significantly higher in patients with present diastolic dysfunction (E/A < 1). This indicates a relation between the presence of diastolic dysfunction, increased left ventricle mass and body mass index (p < 0.05).Conclusions. Overweight and obese patients, unlike normal weight ones, present early cardiac changes, such as: a decrease of left ventricle ejection fraction, diastolic dysfunction, thickening of the interventricular septum, increase of the left ventricle mass both per se as well as in ratio to body surface.

Weight loss as a result of religious zeal in young Orthodox Jewish males

2013 ◽  
Vol 25 (2) ◽  
pp. 181-183
Author(s):  
Martin Fisher
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Anorexia Nervosa ◽  
The Body ◽  
Orthodox Jewish ◽  
Judaic Studies ◽  
History Of ◽  
Religious Concept ◽  
Religious Zeal ◽  
Religious Reasons

Abstract This paper presents three cases involving young Orthodox Jewish males, each of whom lost 15–25 pounds over a course of time ranging between a few months and up to 2 years, as the result of decreased food intake because of misinterpretation of a religious concept learned in their Judaic studies. Although each had a body mass index between 15.8 and 16.1, they did not display the body image concerns necessary for the diagnosis of anorexia nervosa. The discussion covers the distinction between anorexia nervosa and the newly described diagnosis in these young men, i.e., weight loss as a result of religious zeal, along with a brief history of fasting for religious reasons as described in previous centuries.

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