Mediterranean Diet Linked to Liver Fat Reduction

The main finding from this study is that the green Mediterranean diet, the enhanced version of the Mediterranean diet, rich in walnuts, green tea, and Mankai aquatic plant and low in red/processed meat, was the most successful in liver fat reduction.

WeightControl.com Interview with:
Anat Yaskolka Meir RD Ph.D.
Post-doctoral fellow
Department of Epidemiology
Faculty of Health Sciences
Ben-Gurion University, Beer-Sheva, Israel

WeightControl.com:  What is the background for this study?  What are the main findings?

Response: In the past 15 years, Prof. Shai’s group at the Ben Gurion University of the Negev has conducted several large-scale, long-term clinical trials among over 1000 participants. Results from our previous DIRECT, CASCADE, and CENTRAL trials indicated that the Mediterranean diet is superior to other diets in terms of reducing cardiometabolic risk (e.g., by achieving lower blood lipids levels). Moreover, specific plant components named “polyphenols” (secondary metabolites of plants with antioxidant properties) might associate with this beneficial effect observed. Following the conclusions from these trials, we designed the DIRECT PLUS trial, aimed to examine whether we can enhance the observed and known effect of the Mediterranean diet by adding specific polyphenol-rich food items. Specifically, we enriched the Mediterranean diet, naturally rich in polyphenols, by adding specific components: Mankai aquatic plant (as green shake), walnuts, and green tea, which provided additional 1240 mg polyphenols a day. We also instructed the participants to avoid red and processed meat. 

The main finding from this study is that the green Mediterranean diet, the enhanced version of the Mediterranean diet, rich in walnuts, green tea, and Mankai aquatic plant and low in red/processed meat, was the most successful in liver fat reduction. This group showed the greatest reduction of hepatic fat (-39%), as compared to the traditional Mediterranean diet (-20%) and the healthy dietary guidelines (-12%). The results were significant after adjusting for weight loss (currently, the primary treatment for fatty liver). Moreover, the prevalence of non-alcoholic fatty liver diseases was reduced in the green group by 50%.

Fried Foods Linked to Cardiovascular Disease

WeightControl.com Interview with:

Fulan Hu
School of Public Health
Shenzhen University Health Science Center
Shenzhen, Guangdong
People’s Republic of China

WeightControl.com:  What is the background for this study?  What are the main findings?

Response: Increasing number of studies has explored the association of fried food consumption and risk of cardiovascular events and all-cause mortality. However, the association remains contradictory and dose–response association is unknown.

In this meta-analysis, we found that total fried food consumption was significantly associated with increased risk of major cardiovascular events, coronary heart disease, and heart failure. A linear association was observed for the relation of fried food consumption and major cardiovascular events, coronary heart disease, and heart failure.

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Intellihealth: Population Health Guidelines + Online Support Improves Weight Loss

Even small amounts of weight loss, even 3%-5% of body weight, can provide significant health benefits to individuals with overweight and obesity.

WeightControl.com Interview with:
Dr. Louis Aronne, MD, FACP
Chief Medical Officer, Intellihealth
Medical Director, Comprehensive Weight Control Center,
Weill Cornell Medicine

Dr. Louis Aronne

WeightControl.com:  What is the background for the study “Effect of an Online Weight Management Program Integrated With Population Health Management on Weight Change: A Randomized Clinical Trial”?

Response: More than 70% of U.S. adults have overweight or obesity. Online programs promoting lifestyle change have had some success in helping people achieve and maintain weight loss, but study results have been variable, and these programs have not been widely implemented in primary care. We studied the effectiveness of an online program we have developed (Intellihealth, formerly known as BMIQ) in routine primary care practices, both alone and integrated with population health management (with participants receiving additional support and outreach from nonclinical staff). The study’s objective was to determine whether a combined intervention integrating online weight management with population health management would increase weight loss at 12 months among primary care patients compared with the online program only and usual care.

The study, funded through an award from the Patient-Centered Outcomes Research Institute (PCORI), was carried out as a cluster randomized trial with 840 patients within the Brigham and Women’s Hospital Primary Care Center of Excellence, a group of 15 primary care practices, between 2016 and 2019. Eligible participants had a scheduled primary care visit and were aged 20 to 70 years, had a body mass index between 27 and less than 40, and had a diagnosis of hypertension or type 2 diabetes.

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Experimental Antibiotic May Boost Metabolism and Mitigate Obesity

No clinical trial has been conducted to prove this concept in humans just yet, current fluoroquinolones are not to be used for weight control at this point.

WeightControl.com Interview with:
Dr. Marcelo Alves da Silva Mori PhD
Professor,University of Campinas 

WeightControl.com: What is the background for this study? What are the main findings?

Response: microRNAs are small non-coding RNAs that play important roles in gene expression regulation. Aging and obesity leads to dysfunction of microRNA processing in adipose tissue, which in turn impairs the thermogenic capacity of brown fat and results in insulin resistance. Enoxacin is a small molecule fluoroquinolone that promotes microRNA biogenesis.

In our most recent paper, we used enoxacin as proof of principle to demonstrate in mice and human cells that drugs targeting the microRNA processing pathway can be used to enhance oxidative metabolism and promote thermogenesis, thus mitigating obesity.  

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Older Patients Are Able to Lose Weight As Well as Younger Patients

Weight gain and obesity can affect anyone, regardless of age. There may be barriers that exist for older people with obesity.

Weightcontrol.com Interview with:
Dr. Thomas M Barber MRCP, PhD
Associate Professor
Honorary Consultant Endocrinologist
University of Warwick and UHCW NHS Trust

Dr. Barber

Weightcontrol.com: What is the background for this study? What are the main findings?

Response: Obesity management within the UK is structured into a 4-tiered system. Tier 3 refers to hospital-based management that usually consists of medical input combined with focused dietary and psychological support where required. Typically within hospital-based tier 3 obesity services, certain subgroups of the population are under-represented, including men and older people. There are likely multiple reasons for this. However, obesity can affect anyone regardless of sex, age or any other classification.

To improve the health and wellbeing of the nation, it is important that we facilitate effective weight management for as many people with obesity as possible. Much of the chronic effects of weight gain and obesity are similar to those that occur with ageing (including, for example increased cardiovascular risk). Therefore, older people with obesity can experience a type of ‘accelerated ageing’ with increased risk for co-morbidities and premature mortality.

The effective management of obesity is therefore particularly important for older people. Unfortunately, we live in an ageist society, which perhaps explains, at least in part, why older people are currently under-represented in obesity services provided by the NHS. The aim of our study was to explore the effects of older age on ability to lose weight within the context of a hospital-based tier 3 obesity service.

Efficacy and Safety of Setmelanotide For Patients with a Rare form of Genetic Obesity

The severe hyperphagia and the feeling of permanent failure due to the situation of being unable to reduce body weight with conservative treatment options (increase exercise, reduce caloric intake) may affect the relationship within the family

WeightControl.com Interview with:
Prof. Dr. Peter Kühnen
Institute for Experimental Pediatric Endocrinology
Charité Universitätsmedizin Berlin
Berlin, Germany

Prof. Dr. Peter Kühnen

WeightControl.com:  What is the background for this study?  What are the main findings?

Response: The leptin melanocortin signaling pathway plays a pivotal role for central appetite regulation. Gene mutations in this pathway are leading to severe hyperphagia and early onset obesity. We present the data of two phase 3 trials, in which patients with POMC/PCSK1 or LEPR deficiency received treatment with the MC4R agonist setmelanotide. In the past, there were centrally acting obesity drugs, like the cannabinoid receptor inhibitor rimonabant, whose use was associated with depression. Therefore, here we present the data about suicidality and depression of the participants during the treatment with the MC4R agonist setmelanotide.

The main finding was that there was no consistent increase in depression or suicidal ideation / behavior of the treated patients. However, in all cases depressive episode or increase in suicidal ideation was related to the medical history of the participants.

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Weight Loss in Low Income Patients in Primary Care Settings

Clinically significant weight loss is possible in underserved, low-income patients in primary care settings.

WeightControl.com Interview with:
Peter Katzmarzyk, Ph.D., FACSM, FAHA, FTOS
Professor and Marie Edana Corcoran Endowed Chair
Pediatric Obesity and Diabetes
Assoc Exec Dir for Population and Public Health Sciences
Pennington Biomedical Research Center
Baton Rouge, LA

WeightControl.com:  What is the background for this study?

Response: Obesity remains one of the greatest public health threats, and there is good evidence that intensive lifestyle interventions should be a primary approach to obesity management and treatment. However, there has been minimal uptake of obesity treatment approaches in primary care, which is the cornerstone of medicine in the US.

WeightControl.com: What are the main findings?

Response: We developed an intervention to reduce calorie intake and increase physical activity that was delivered by health coaches embedded in primary care clinics. The sample was diverse with a large percentage of low-income and African American patients. The results demonstrated that patients in the intensive lifestyle intervention lost approximately 5% of their initial body weight, compared to patients in usual care who lost about 0.5% of their body weight. These weight loss differences between the two groups were maintained out to 2 years, which demonstrates the durability of the intervention.    

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COVID-19 Linked to Difficulty with Weight Control

With the current concerns that the pandemic may lead to increases in obesity rates, it’s important to develop appropriate and large-scale support options for those aiming to manage their weight.

WeightControl.com Interview with:

Dr Sarah-Elizabeth Bennett
Senior Research Associate
Slimming World, UK

WeightControl.com:  What is the background for this study?

Response: This research is part of a larger Health and Wellbeing study, investigating the behaviour changes made by members of Slimming World, the UK’s largest group-based weight management organisation. New members were surveyed regularly over the course of one year and a representative sample of non-members were also surveyed at similar timepoints for comparison. The survey at the six-month point coincided with lockdown, so questions were added to learn more about how lockdown measures had impacted the nation’s health, wellbeing, and lifestyle behaviours. The following findings were based on the responses of 222 members who had completed all 3 surveys to-date and 637 non-members.

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Weight Control: Better to Eat a Big Breakfast than Big Dinner

The importance of the time of day and our internal clock for food intake and energy metabolism is a very exciting research field. Future studies should investigate why we spend so much more energy after breakfast than after dinner

WeightControl.com Interview with:
M. Sc. Juliane Richter
University of Lübeck
Center of Brain, Behavior and Metabolism
Section of Psychoneurobiology

WeightControl.com:  What is the background for this study?  What are the main findings?

Response: The background for this study is that there is still the misbelief that it does not matter when we eat and that the only thing that counts is the energy balance of the whole day. However, since our body has an internal clock and many processes in the body, for example glucose metabolism, are subject to diurnal variations, we investigated whether diet-induced thermogenesis also varies during the course of the day.

Diet-induced thermogenesis is the energy our body spends for the digestion, absorption and transport of nutrients. We found that diet-induced thermogenesis after breakfast is more than twice as high as after dinner. We also investigated whether this difference in time of day depends on the amount of calories consumed. In both cases, high- and low-calorie meals, the body spends more energy after breakfast than after dinner.

breakfast-timing of meals for weight control
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Obesity Prevented and Reversed in Mice By Blocking Cellular Receptor

We are beginning to understand how the blockage of the AHR prevents and reverses obesity, which may lead to a therapeutic treatment of obesity in humans.

WeightControl.com Interview with:
Craig R. Tomlinson, Ph.D.
Director of Genomics & Molecular Biology Shared Resource
Norris Cotton Cancer Center
Geisel School of Medicine at Dartmouth
Dartmouth Hitchcock Medical Center
Lebanon, NH 03756

WeightControl.com:  What is the background for this study?

Response: Obesity, a global epidemic, is a known contributor to numerous diseases, including diabetes, heart disease, and cancer. Preventing and reversing the obesity epidemic would be a critical aid in preventing and treating these diseases.

Our laboratory had discovered that a drug called NF, which was known to block the activity of a cellular receptor called the AHR, prevented obesity in mice fed a high-fat diet. We undertook studies to determine how the AHR, when inhibited by NF, exerted its effects on obesity.

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