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Featured Articles on Nutrition and Obesity Management (2nd Edition)

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Obesity".

Deadline for manuscript submissions: closed (5 February 2025) | Viewed by 13850

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Dr. Javier Gómez-Ambrosi

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Clínica Universidad de Navarra, Metabolic Research Lab, Irunlarrea 1, 31008 Pamplona, Spain
Interests: obesity; dietary treatment; adipose tissue dysfunction; inflammation; adipokines; metabolic surgery; cardiometabolic risk improvement; body composition changes
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Dear Colleagues,

Obesity has become one of the most prevalent metabolic disorders. Excess adiposity favors the development of cardiometabolic alterations such as type 2 diabetes (T2D), cardiovascular disease, dyslipidemia, fatty liver and cancer. In recent years, our understanding of the pathophysiology of obesity has greatly improved, and novel approaches for its treatment have emerged. However, the obesity pandemic continues without signs of abatement.

In this Special Issue, “Featured Articles on Nutrition and Obesity Management (2nd Edition)”, we welcome reviews and original articles related to any aspect of obesity management, from the traditional dietary approach (with different types of diets) to bariatric surgery, including pharmacologic treatments, with particular emphasis on recent successful combinations of drugs. We will also consider manuscripts regarding lifestyle modifications in relation to physical activity and sleep hygiene. Novel approaches such as the different modalities of intermittent fasting, including aspects relative to their effectiveness or the different physiological mechanisms involved, or the use of innovative technologies such as mobile apps or wearable devices, are very welcome. We aim to provide readers with a clear view of the pathophysiological relevance of weight loss and the improvements in cardiometabolic risk factors that occur with different therapeutic approaches, as well as the changes in body physiology and energy expenditure that drive weight regain. Original articles and reviews analyzing the clinical usefulness of predictors of treatment success and the importance of monitoring body composition in the management of patients living with obesity are also welcome.

Dr. Javier Gómez-Ambrosi
Guest Editor

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Keywords

obesity
dietary treatment
lifestyle intervention
pharmacological treatment
metabolic surgery
intermittent fasting
cardiometabolic risk improvement
body composition changes
weight regain
predictors of treatment success
use of wearable devices and apps for weight loss and weight maintenance
novel targets
treatment of children and adolescents

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10 pages, 1092 KiB

Open AccessArticle

Positive Changes in Body Composition and Profiles of Individuals with Diabetes 3 Years Following Laparoscopic Sleeve Gastrectomy in Japanese Patients with Obesity

by Yoshinori Ozeki, Takayuki Masaki, Shotaro Miyamoto, Yuichi Yoshida, Mitsuhiro Okamoto, Koro Gotoh, Yuichi Endo, Masafumi Inomata and Hirotaka Shibata

Nutrients 2024, 16(22), 3926; https://doi.org/10.3390/nu16223926 - 18 Nov 2024

Viewed by 853

Abstract

Background and Objectives: We analyzed the changes in obesity, glucose metabolism, and body composition over a 3-year period in Japanese patients with obesity following laparoscopic sleeve gastrectomy (LSG). Methods: Body weight, parameters related to diabetes such as glycated hemoglobin (HbA1c), and electrical impedance analysis were used to assess body composition in forty-eight Japanese patients with obesity before surgery and 6 months, 1 year, 2 years, and 3 years after LSG. Results: At 6 months, 1, 2, and 3 years post-LSG, there were significant reductions in body weight, body mass index, blood pressure, fasting plasma glucose, triglyceride, and HbA1c levels. Six months after LSG, fat mass (FM), muscle mass (MM), and %FM all showed a decrease compared to pre-treatment values (all p < 0.05). FM and %FM remained in a decreased state until 3 years had passed. In contrast, %MM increased at 6 months post-LSG and was maintained up to 3 years post-LSG (all p < 0.05). Furthermore, changes in FM and %FM were associated with changes in body weight and A1C. In contrast, change in %MM exhibited a negative correlation with body weight and A1C following LSG. Finally, multivariate regression analyses demonstrated that alterations in FM were independent factors affecting body weight in patients with obesity 3 years after LSG. Conclusions: We observed improvements in FM, fasting plasma glucose, and HbA1c levels over a 3-year period in Japanese patients after LSG. The reduction in FM and maintenance of %MM after LSG were suggested as possible links between the effects of LSG on obesity and diabetes over 3 years. Full article

(This article belongs to the Special Issue Featured Articles on Nutrition and Obesity Management (2nd Edition))

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11 pages, 282 KiB

Open AccessArticle

Weight Loss After Sleeve Gastrectomy According to Metabolic Dysfunction-Associated Steatotic Liver Disease Stage in Patients with Obesity: A Liver Biopsy-Based Prospective Study

by José Ignacio Martínez-Montoro, Isabel Arranz-Salas, Carolina Gutiérrez-Repiso, Ana Sánchez-García, Luis Ocaña-Wilhelmi, José M. Pinazo-Bandera, Diego Fernández-García, Araceli Muñoz-Garach, Dieter Morales-García, Miren García-Cortés, Eduardo García-Fuentes, Francisco J. Tinahones and Lourdes Garrido-Sánchez

Nutrients 2024, 16(22), 3857; https://doi.org/10.3390/nu16223857 - 12 Nov 2024

Viewed by 1086

Abstract

Background: The role of metabolic dysfunction-associated steatotic liver disease (MASLD) in sleeve gastrectomy (SG)-related outcomes remains uncertain. In this study, we aimed to assess the influence of preoperative biopsy-proven MASLD and its stages on weight loss after SG. Methods: One hundred sixty-three patients with obesity undergoing SG with concomitant intraoperative liver biopsy were followed up for 1 year. Fifty-eight participants were categorized as no MASLD, thirty-eight as metabolic dysfunction-associated steatotic liver (MASL), and sixty-seven as metabolic dysfunction-associated steatohepatitis (MASH). Percentage total weight loss (%TWL) and percentage excess weight loss (%EWL) 1 year after SG were calculated for the different groups. We also evaluated the association between preoperative MASLD (and its stages) and weight loss, after adjusting for potential confounders. Results: Significant differences among groups were detected in %EWL (p = 0.004, ANOVA test), but not in %TWL (p = 0.079). However, significant differences in %TWL were found when MASH and no MASH (i.e., participants with MASL and participants without MASLD) groups were compared (27.3 ± 9.9 vs. 30.7 ± 9, respectively, p = 0.025). In the linear regression model for predicting %EWL 1 year after SG, the presence of MASH was independently associated with a lower %EWL, after adjusting for age, sex, baseline body mass index (BMI), and baseline glycated hemoglobin (HbA1c) (Beta −7.1; 95% CI −13.6, −0.5; p = 0.035). The presence of MASLD, liver fibrosis, or advanced liver fibrosis (≥F2) was also associated with lower %EWL after SG in crude models, although they did not remain significant after adjusting for these confounders. The presence of MASH was inversely related to %TWL, although the association did not remain significant after adjustment (Beta −2.7; 95% CI −5.7, 0.2; p = 0.069). Conclusions: MASH may be independently associated with lower %EWL 1 year after SG in patients with obesity. Full article

(This article belongs to the Special Issue Featured Articles on Nutrition and Obesity Management (2nd Edition))

14 pages, 422 KiB

Open AccessArticle

Continuous Glucose Monitor Metrics That Predict Neonatal Adiposity in Early and Later Pregnancy Are Higher in Obesity Despite Macronutrient-Controlled Eucaloric Diets

by Teri L. Hernandez, Sarah S. Farabi, Rachael E. Van Pelt, Nicole Hirsch, Emily Z. Dunn, Elizabeth A. Haugen, Melanie S. Reece, Jacob E. Friedman and Linda A. Barbour

Nutrients 2024, 16(20), 3489; https://doi.org/10.3390/nu16203489 - 15 Oct 2024

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Abstract

Background: Fasting glucose is higher in pregnancies with obesity (OB); less is known about postprandial (PP) and nocturnal patterns when the diet is eucaloric and fixed or about the continuous-glucose-monitor (CGM) metrics that predict neonatal adiposity (NB%fat). We hypothesized that continuous glucose monitors (CGMs) would reveal higher glycemia in OB vs. normal weight (NW) during Early (14–16 weeks) and Later (26–28 weeks) gestation despite macronutrient-controlled eucaloric diets and elucidate unique predictors of NB%fat. Methods: In a prospective, parallel-group comparative study, a eucaloric diet (NW: 25 kcal/kg; OB: 30 kcal/kg) was provided (50% carbohydrate [20% simple/30% complex; of total calories], 35% fat, 15% protein) to Early and Later gestation groups wearing a blinded CGM for three days. CGM metrics (mean fasting; 1 h and 2 h PP; daytime and nocturnal glucose; percent time-in-range (%TIR: 63–140 mg/dL); PP excursions; and area-under-the-curve [AUC]) were interrogated between groups and as predictors of NB%fat by dual X-ray absorptiometry(DXA). Results: Fifty-four women with NW (BMI: 23 kg/m²; n = 27) and OB (BMI: 32; n = 27) provided their informed consent to participate. Early, the daytime glucose was higher in OB vs. NW (mean ± SEM) (91 ± 2 vs. 85 ± 2 mg/dL, p = 0.017), driven by 2 h PP glucose (95 ± 2 vs. 88 ± 2, p = 0.004). Later, those with OB exhibited higher nocturnal (89 ± 2 vs. 81 ± 2), daytime (95 ± 2 vs. 87 ± 2), 1 h (109 ± 3 vs. 98 ± 2), and 2 h PP (101 ± 3 vs. 92 ± 2) glucose (all p < 0.05) but no difference in %TIR (95–99%). Postprandial peak excursions for all meals were markedly blunted in both the Early (9–19 mg/dL) and Later (15–26 mg/dL). In OB, the Later group’s 24 h AUC was correlated with NB%fat (r = 0.534, p = 0.02). Despite similar weight gain, infants of OB had higher birthweight (3528 ± 107 vs. 3258 ± 74 g, p = 0.037); differences in NB%fat did not reach statistical significance (11.0 vs. 8.9%; p > 0.05). Conclusions: Despite macronutrient-controlled eucaloric diets, pregnancies with OB had higher glycemia Early and Later in gestation; the Later 24 h glucose AUC correlated with NB%fat. However, glycemic patterns were strikingly lower than current management targets. Full article

(This article belongs to the Special Issue Featured Articles on Nutrition and Obesity Management (2nd Edition))

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22 pages, 1964 KiB

Open AccessArticle

A Pilot Randomized Control Trial Testing a Smartphone-Delivered Food Attention Retraining Program in Adolescent Girls with Overweight or Obesity

by Megan N. Parker, Bess F. Bloomer, Jeffrey D. Stout, Meghan E. Byrne, Natasha A. Schvey, Sheila M. Brady, Kong Y. Chen, Allison C. Nugent, Sara A. Turner, Shanna B. Yang, Monika M. Stojek, Andrew J. Waters, Marian Tanofsky-Kraff and Jack A. Yanovski

Nutrients 2024, 16(20), 3456; https://doi.org/10.3390/nu16203456 - 12 Oct 2024

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Abstract

Background/Objectives: Attention bias (AB) toward food is associated with obesity, but it is unclear if programs designed to reduce AB can impact adolescents’ eating behavior. We investigated whether a two-week, smartphone-delivered attention retraining (AR) program (vs a control program) altered food AB in adolescent girls with overweight. Methods: Participants completed three food-cue visual-probe trainings/day. The AR and control programs directed attention away from food stimuli during 100% and 50% of trainings, respectively. Before and after completion of the programs, girls completed a food-cue visual-probe task while undergoing magnetoencephalography (MEG), and then a laboratory test meal. Results: Sixty-eight adolescents were randomized; 58 completed post-program visits. There was minimal effect of condition on AB scores (β [95%CI] = −1.9 [−20.8, 16.9]; d = −0.06). There was a small effect of condition on energy intake (EMM_control = 1017 kcal, EMM_AR = 1088 kcal, d = 0.29). Within the AR group, there was slightly blunted initial engagement in brain areas associated with reward response and subsequent increased goal-directed attention and action control. Conclusions: We found preliminary support for efficacy of an intensive smartphone-delivered AR program to alter neural correlates of attention processing in adolescent girls with overweight or obesity. Studies with larger sample sizes are needed to elucidate if AR trainings disrupt the link between food AB and eating behavior. Full article

(This article belongs to the Special Issue Featured Articles on Nutrition and Obesity Management (2nd Edition))

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14 pages, 289 KiB

Open AccessArticle

Disparities in the Cardiometabolic Impact of Adiposity among African American and Hispanic Adolescents

by Pedro A. Velásquez-Mieyer, Ramfis Nieto-Martinez, Andres E. Velasquez, Xichen Mou, Stephanie Young-Moss, Jeffrey I. Mechanick, Cori Cohen Grant and Claudia P. Neira

Nutrients 2024, 16(18), 3143; https://doi.org/10.3390/nu16183143 - 18 Sep 2024

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Abstract

As adiposity increases in youth, so does the prevalence of cardiometabolic risk factors (CMRFs). The etiology of adiposity-based chronic disease and CMRFs includes ethnoracial disparities that are rarely considered in current treatment approaches. Precision interventions require further characterization of these disparities among high-risk youth. The objective of this study was to characterize differences in CMRF among African American (AA) and Hispanic (H) adolescents with varying levels of adiposity. A cross-sectional analysis of 2284 adolescents aged 12–17 was conducted using 3-year clinical data from Lifedoc Health. CMRF prevalence were compared using χ², with logistic regression models (LRM) applied to explore the relationships between exposures (age, sex, ethnoracial group, adiposity) and CMRF outcomes. Prevalence of CMRF rose with increasing adiposity, which was the strongest determinant of risk overall. However, individual risk profiles differed between the two groups, with H having higher prevalence of metabolic syndrome (MetS), higher triglycerides and liver enzymes, and low high-density lipoprotein cholesterol (HDL-c). Meanwhile, AA had higher prevalence of elevated blood pressure (BP) in the overweight category, prediabetes in overweight to severe obesity, and type 2 diabetes in obesity. LRM showed 3.0-fold greater chance of impaired glucose metabolism in AA than H, who were 1.7, 5.9, and 8.3 times more likely to have low HDL-c, high liver enzymes, and high triglycerides, respectively. Overweight/obesity prevalence was very high among AA and H adolescents. Excess adiposity was associated with an increased prevalence of CMRF, with individual risk factors differing between groups as adiposity increased. Research within routine clinical settings is required to better characterize these discrepancies and ameliorate their adverse impact on health in the transition to adulthood. Full article

(This article belongs to the Special Issue Featured Articles on Nutrition and Obesity Management (2nd Edition))

20 pages, 24854 KiB

Open AccessArticle

Both Maternal High-Fat and Post-Weaning High-Carbohydrate Diets Increase Rates of Spontaneous Hepatocellular Carcinoma in Aged-Mouse Offspring

by Daniel Holt, Laura Contu, Alice Wood, Hannah Chadwick, Ilaria Alborelli, Andrea Cacciato Insilla, Francesco Crea and Cheryl A. Hawkes

Nutrients 2024, 16(16), 2805; https://doi.org/10.3390/nu16162805 - 22 Aug 2024

Viewed by 1403

Abstract

Both maternal obesity and postnatal consumption of obesogenic diets contribute to the development of metabolic dysfunction-associated steatotic liver disease (MASLD) and hepatocellular carcinoma (HCC). However, there is no consensus as to whether diets that are high in fat or carbohydrates/sugars differentially influence the development of HCC. Moreover, the long-term effects of prenatal HF exposure on HCC and whether this is influenced by postnatal diet has not yet been evaluated. C57BL/6 dams were fed either a low-fat, high-carbohydrate control (C) or low-carbohydrate, high-fat (HF) diet. At weaning, male and female offspring were fed the C or HF diet, generating four diet groups: C/C, C/HF, HF/C and HF/HF. Tissues were collected at 16 months of age and livers were assessed for MASLD and HCC. Glucose regulation and pancreatic morphology were also evaluated. Liver tissues were assessed for markers of glycolysis and fatty acid metabolism and validated using a human HCC bioinformatic database. Both C/HF and HF/HF mice developed obesity, hyperinsulinemia and a greater degree of MASLD than C/C and HF/C offspring. However, despite significant liver and pancreas pathology, C/HF mice had the lowest incidence of HCC while tumour burden was highest in HF/C male offspring. The molecular profile of HCC mouse samples suggested an upregulation of the pentose phosphate pathway and a downregulation of fatty acid synthesis and oxidation, which was largely validated in the human dataset. Both pre-weaning HF diet exposure and post-weaning consumption of a high-carbohydrate diet increased the risk of developing spontaneous HCC in aged mice. However, the influence of pre-weaning HF feeding on HCC development appeared to be stronger in the context of post-weaning obesity. As rates of maternal obesity continue to rise, this has implications for the future incidence of HCC and possible dietary manipulation of offspring carbohydrate intake to counteract this risk. Full article

(This article belongs to the Special Issue Featured Articles on Nutrition and Obesity Management (2nd Edition))

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21 pages, 1762 KiB

Open AccessArticle

Predictive Roles of Basal Metabolic Rate and Muscle Mass in Lung Function among Patients with Obese Asthma: A Prospective Cohort Study

by Xin Zhang, Li Zhang, Ying Liu, Lei Liu, Ji Wang, Changyong Wang, Shuwen Zhang, Gaiping Cheng and Lei Wang

Nutrients 2024, 16(12), 1809; https://doi.org/10.3390/nu16121809 - 8 Jun 2024

Viewed by 1374

Abstract

Background: The metabolic-status-related mechanisms underlying the deterioration of the lung function in obese asthma have not been completely elucidated. Objective: This study aimed to investigate the basal metabolic rate (BMR) in patients with obese asthma, its association with the lung function, and its mediating role in the impact of obesity on the lung function. Methods: A 12-month prospective cohort study (n = 598) was conducted in a real-world setting, comparing clinical, body composition, BMR, and lung function data between patients with obese (n = 282) and non-obese (n = 316) asthma. Path model mediation analyses for the BMR and skeletal muscle mass (SMM) were conducted. We also explored the effects of the BMR on the long-term lung function in patients with asthma. Results: Patients with obese asthma exhibited greater airway obstruction, with lower FEV₁ (1.99 vs. 2.29 L), FVC (3.02 vs. 3.33 L), and FEV₁/FVC (65.5 vs. 68.2%) values compared to patients with non-obese asthma. The patients with obese asthma also had higher BMRs (1284.27 vs. 1210.08 kcal/d) and SMM (23.53 vs. 22.10 kg). Both the BMR and SMM mediated the relationship between obesity and the lung function spirometers (FEV₁, %FEV₁, FVC, %FVC, and FEV₁/FVC). A higher BMR or SMM was associated with better long-term lung function. Conclusions: Our study highlights the significance of the BMR and SMM in mediating the relationship between obesity and spirometry in patients with asthma, and in determining the long-term lung function. Interventions for obese asthma should focus not only on reducing adiposity but also on maintaining a high BMR. Full article

(This article belongs to the Special Issue Featured Articles on Nutrition and Obesity Management (2nd Edition))

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13 pages, 3130 KiB

Open AccessArticle

A Combination of a Dopamine Receptor 2 Agonist and a Kappa Opioid Receptor Antagonist Synergistically Reduces Weight in Diet-Induced Obese Rodents

by Beatriz Cicuéndez, Javier Pérez-García and Cintia Folgueira

Nutrients 2024, 16(3), 424; https://doi.org/10.3390/nu16030424 - 31 Jan 2024

Cited by 2 | Viewed by 1877

Abstract

As the global obesity rate increases, so does the urgency to find effective anti-obesity drugs. In the search for therapeutic targets, central nervous system (CNS) mechanisms engaged in the regulation of energy expenditure and food intake, such as the opioid and dopamine systems, are crucial. In this study, we examined the effect on body weight of two drugs: bromocriptine (BC), a D2R receptor agonist, and PF-04455242, a selective κ opioid receptor (KOR) antagonist. Using diet-induced obese (DIO) rats, we aimed to ascertain whether the administration of BC and PF-04455242, independently or in combination, could enhance body weight loss. Furthermore, the present work demonstrates that the peripheral coadministration of BC and PF-04455242 enhances the reduction of weight in DIO rats and leads to a decrease in adiposity in a food-intake-independent manner. These effects were based on heightened energy expenditure, particularly through the activation of brown adipose tissue (BAT) thermogenesis. Overall, our findings indicate that the combination of BC and PF-04455242 effectively induces body weight loss through increased energy expenditure by increasing thermogenic activity and highlight the importance of the combined use of drugs to combat obesity. Full article

(This article belongs to the Special Issue Featured Articles on Nutrition and Obesity Management (2nd Edition))

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Review

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19 pages, 328 KiB

Open AccessReview

Current Perspectives for Treating Adolescents with Obesity and Type 2 Diabetes: A Review

by Elżbieta Niechciał, Paulina Wais, Jan Bajtek and Andrzej Kędzia

Nutrients 2024, 16(23), 4084; https://doi.org/10.3390/nu16234084 - 27 Nov 2024

Viewed by 1259

Abstract

Background: Childhood obesity is an epidemic and a significant health concern all over the world. Several factors can influence excess weight gain, including eating behaviors, physical inactivity, and genetics. Children and adolescents with obesity have a four-times greater risk of developing type 2 diabetes (T2D) compared with their normal-weight peers. The management of obesity before the development of its comorbidities may prevent its escalation into significant medical and psychosocial problems. However, treatment options for obesity and T2D in youth remained limited for many years, and moreover, available drugs were characterized by low efficacy. The Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study showed that metformin in monotherapy failed in almost 52% of children with T2D, while adjuncts to rosiglitazone and lifestyle intervention failed in 38.6% and 46.6%, respectively. Recently approved antiobesity medications and/or bariatric surgery are revolutionizing the management of adolescents with obesity and T2D. This work aims to provide a comprehensive overview of the current treatment possibilities for childhood obesity and T2D. Methods: An in-depth review of articles with evidence-based research from different countries discussing novel management options for adolescents with obesity and/or T2D was conducted in this review paper. Results: The new medications, such as SGLT2 receptor agonists and GLP-1 agonists, are highly effective in treating T2D in adolescents with obesity. Conclusions: Based on the performed literature review, the recent approval of a novel generation of drugs seems to be the dawn of a new era in childhood obesity and T2D treatment. Full article

(This article belongs to the Special Issue Featured Articles on Nutrition and Obesity Management (2nd Edition))

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16 pages, 1059 KiB

Open AccessSystematic Review

Effects of Chewing Gum on Satiety, Appetite Regulation, Energy Intake, and Weight Loss: A Systematic Review

by Claudia Jiménez-ten Hoevel, Elisabet Llauradó, Rosa M. Valls, Maria Besora-Moreno, Judit Queral, Rosa Solà and Anna Pedret

Nutrients 2025, 17(3), 435; https://doi.org/10.3390/nu17030435 - 25 Jan 2025

Viewed by 1098

Abstract

Background: New approaches for the management of obesity, a worldwide problem and a major determinant of disability and mortality, are needed. Mastication influences appetite and satiety mechanisms via actual food or sham feeding. However, the effect of mastication of chewing gum, a type of sham feeding, on appetite regulation has not yet been elucidated. Objectives: Our aim was to evaluate the influence of chewing gum on appetite regulation, satiety, energy intake, and weight loss via randomized controlled Trials. Methods: This study was conducted in accordance with the 2020 PRISMA guidelines, and the protocol was registered in PROSPERO (CRD42023432699). Electronic databases MEDLINE^®/PubMed, Scopus, and Cochrane Central Register of Controlled Trials were searched from July 2023 to September 2024. The quality of each included study was assessed using the Cochrane risk of bias tool, RoB 2. Results: A total of eight articles with nine RCTs were included in this systematic review. Seven out of nine RCTs evaluated appetite regulation. Five out of seven RCTs reported a significant suppressing effect of hunger, three out of five RCTs reported a significant reduction in desire to eat, and three out of four reported a significant reduction in the desire to eat a sweet snack, all of them compared to the control group. However, the effects on satiety, energy intake, and weight loss are not conclusive. Conclusions: Chewing gum could be a promising non-pharmacological tool for obesity management through appetite regulation; however, further research, with sustained RCTs evaluating the sustained effects of gum chewing on appetite and weight management, is needed. Full article

(This article belongs to the Special Issue Featured Articles on Nutrition and Obesity Management (2nd Edition))

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