Weight loss
Murine models of chronic Pseudomonas aeruginosa lung infection.

van Heeckeren AM, Schluchter MD.

Department of Pediatrics, Rainbow Babies and Childrens Hospital, Case Western Reserve University School of Medicine, 2109 Adelbert Road, Cleveland, OH 44106-4948, USA. amv2 po.cwru.edu

The animal model of chronic bronchopulmonary infection using agarose beads laden with Pseudomonas aeruginosa is frequently utilized in cystic fibrosis research, though it is challenging to perform it in mice. This paper reports the most successful methods for the creation of this model. Transtracheal insertion of a 22 G 1" over-the-needle intravenous catheter to preferentially inoculate the right mainstem bronchus using tribromoethanol anaesthesia administered i.p. was better for a successful surgical outcome compared, respectively, to the use of a 27 G (1/2)" needle, bilateral inoculation or an anaesthetic cocktail of xylazine, acepromazine and ketamine administered i.p. Bilateral infection was associated with higher mortality, greater weight loss and higher levels of bronchoalveolar cytokine concentration, compared to mice infected primarily in the right lung. Mucoid clinical strain PA M57-15 was preferred since mucoid clinical strain PA 2192 led to comparatively more severe lesions and higher mortality. Using the same operator for a given task reduced the variability inherent in this model, illustrated using outcome measures such as gross lung pathology. The response of mice inoculated with P. aeruginosa-laden agarose beads was characterized by bronchopulmonary inflammation, high production of cytokines, and significant weight loss; whereas the response to infection with free-living bacteria was characterized by pneumonia, lower production of cytokines and weight loss. The use of free P. aeruginosa pre-mixed with sterile agarose beads may be considered as an alternative to the use of P. aeruginosa-laden agarose beads, since the histopathological features were similar, though further characterization is needed to evaluate its utility as an adequate model of cystic fibrosis.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12144741&dopt=Abstract weight loss



Weight loss
Decreased mitochondrial proton leak and reduced expression of uncoupling protein 3 in skeletal muscle of obese diet-resistant women.

Harper ME, Dent R, Monemdjou S, Bezaire V, Van Wyck L, Wells G, Kavaslar GN, Gauthier A, Tesson F, McPherson R.

Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Faculty of Medicine, Ottawa, Ontarion, Canada. mharper uottawa.ca

Weight loss in response to caloric restriction is variable. Because skeletal muscle mitochondrial proton leak may account for a large proportion of resting metabolic rate, we compared proton leak in diet-resistant and diet-responsive overweight women and compared the expression and gene characteristics of uncoupling protein (UCP)2 and UCP3. Of 1,129 overweight women who completed the University of Ottawa Weight Management Clinic program, 353 met compliance criteria and were free of medical conditions that could affect weight loss. Subjects were ranked according to percent body weight loss during the first 6 weeks of a 900-kcal meal replacement protocol. The highest and lowest quintiles of weight loss were defined as diet responsive and diet resistant, respectively. After body weight had been stable for at least 10 weeks, 12 of 70 subjects from each group consented to muscle biopsy and blood sampling for determinations of proton leak, UCP mRNA expression, and genetic studies. Despite similar baseline weight and age, weight loss was 43% greater, mitochondrial proton leak-dependent (state 4) respiration was 51% higher (P = 0.0062), and expression of UCP3 mRNA abundance was 25% greater (P < 0.001) in diet-responsive than in diet-resistant subjects. There were no differences in UCP2 mRNA abundance. None of the known polymorphisms in UCP3 or its 5' flanking sequence were associated with weight loss or UCP3 mRNA abundance. Thus, proton leak and the expression of UCP3 correlate with weight loss success and may be candidates for pharmacological regulation of fat oxidation in obese diet-resistant subjects.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12145158&dopt=Abstract weight loss



Weight loss
[Ephedrine and ephedra in weight loss products and other preparations]

[Article in Dutch]

van der Hooft CS, Stricker BH.

Inspectie voor de Gezondheidszorg, sectie Geneesmiddelenbewaking, Postbus 16.119, 2500 BC Den Haag.

Ephedrine is a sympathicomimetic agent that stimulates the central nervous and cardiovascular systems and causes bronchodilatation. It is one of the alkaloids in the herb Ephedra which is the basis of several over-the-counter herbal products, among which a number of popular weight-loss products. The Dutch Inspectorate for Health Care has received reports of adverse reactions presumably associated with Ephedra-containing weight-loss products. These adverse reactions comprised mainly palpitations, stress, headache and insomnia. The Ministry of Health in Canada has recently requested a market recall of some ephedrine-containing herbal products in response to a large number of adverse reactions reported in association with these products. The adverse reactions included stroke, heart attacks, cardiac arrhythmias, seizures and psychotic disorders. The voluntary recall concerns especially products that were marketed without approval and contain Ephedra in combination with caffeine or other stimulants. In the Netherlands, the status of Ephedra-containing products is currently reconsidered.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12148223&dopt=Abstract weight loss



Weight loss
Steps to soulful living (steps): a weight loss program for African-American women.

Karanja N, Stevens VJ, Hollis JF, Kumanyika SK.

Kaiser Permanente Center for Health Research, Portland, Oregon 97227-1098, USA. njeri.karanja kpchr.org

BACKGROUND: The disproportionate disease burden experienced by African-American women can be explained partially by the higher rates of obesity in this population. African-American women who can benefit from weight loss may be less likely to attempt it and may have relatively less success in using traditional weight loss programs compared to White women. Steps to Soulful Living (Steps) was a pilot study to test the effects of a culturally adapted weight loss program on weight loss in African-American women. METHODS: Sixty-six African-American women participated in a 6-month weight loss program that included weekly group meetings and supervised exercise sessions. Mean baseline body mass index was 39 kg/m2, and mean baseline weight was 107 kg. Cultural adaptations, defined as program adjustments, made in response to women's preferences as expressed in focus group interviews included changes in intervention format, the content of the group meetings, and the location and format of the exercise sessions. RESULTS: Seventy-six percent of the participants attended at least 50% of the 26 weekly sessions, and 56% attended at least 75% of the sessions. Average hours of exercise per week approximately doubled during the program in comparison to baseline levels. Mean weight loss at 26 weeks was 3.7 kg, categorizing those who were lost to follow-up as having zero weight loss. Participants who attended at least 75% of the group meetings lost a mean of 6.2 kg at six months. Those who attended fewer meetings lost a mean of 0.9 kg. CONCLUSIONS: This 6-month program was associated with relatively larger weight losses, particularly among participants with high attendance, than have usually been observed in culturally adapted programs for African-American women.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12148707&dopt=Abstract weight loss



Weight loss
Greater than predicted decrease in energy expenditure during exercise after body weight loss in obese men.

Doucet E, Imbeault P, St-Pierre S, Almeras N, Mauriege P, Despres JP, Bouchard C, Tremblay A.

School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada K1N 6N5.

This study was performed retrospectively to investigate whether exercise energy expenditure (EE) measured during a standardized treadmill protocol (4.5 km/h at 0% grade) falls below predicted values after body weight loss in obese men. A reference equation was established to predict net exercise EE in a control sample of 83 obese individuals (27 kg/m(2)< or = body mass index <45 kg/m(2)), using age, fat mass and fat-free mass as independent variables. This equation was then used to predict net exercise EE in another group of 11 obese men before and after a 15-week drug-based weight loss programme that was coupled with energy restriction [-2929 kJ/day (-700 kcal/day)]. Body weight and body composition were determined by hydrodensitometry. Net exercise EE, insulin, leptin, 3,3',5-tri-iodothyronine and free thyroxine were measured after an overnight fast at baseline and 2-4 weeks after the end of the programme, when subjects were weight stable. Body weight was significantly reduced (-11%; P <0.01) at the end of the weight loss programme. At baseline, measured net exercise EE was similar to that predicted from the regression equation [19.6 and 19.8 kJ/min (4.69 and 4.74 kcal/min) respectively; not significant]. However, after the end of the intervention, measured net exercise EE was significantly below the predicted value [15.5 and 17.3 kJ/min (3.71 and 4.14 kcal/min) respectively; P <0.01]. The difference between the predicted and the measured fall in net exercise EE was significantly associated with changes in leptin concentration ( r =0.79, P <0.01), even after correction for changes in fat mass and insulin. These observations suggest that net exercise EE falls below predicted values after body weight loss. In addition, this greater than predicted decrease in net exercise EE was associated with changes in leptin.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12617720&dopt=Abstract weight loss



Weight loss
Laparoscopic biliopancreatic diversion with duodenal switch.

Feng JJ, Gagner M.

Department of Surgery, Mount Sinai School of Medicine, New York, NY 10029, USA.

The biliopancreatic diversion with duodenal switch combines a sleeve gastrectomy with a duodenoileal switch to achieve maximum weight loss. Consistent excess weight loss between 70% to 80% is achieved with acceptable decreased long-term nutritional complications. With a higher entry weight, the super obese patient (body mass index [BMI] >50 kg/m(2)) benefits the greatest from a procedure that produces a higher mean excess weight loss. The laparoscopic approach to this procedure has successfully created a surgical technique with optimum benefit and minimal morbidity, especially in the super obese patient. Copyright 2002, Elsevier Science (USA). All rights reserved.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12152155&dopt=Abstract weight loss



Weight loss
Weight loss and weight loss maintenance in African-American women.

Walcott-McQuigg JA, Chen SP, Davis K, Stevenson E, Choi A, Wangsrikhun S.

Purdue University, School of Nursing, West Lafayette, IN 47907-1337, USA. jmcquigg nursing.purdue.edu

The purpose of this study was to identify factors associated with weight loss and weight loss maintenance in 23 African American women participating in a 32-week lifestyle enhancement awareness program (LEAP), 16 weekly sessions on weight loss and 16 weekly sessions on weight loss maintenance. A pre-test, post-test one group design was used. Measures included dietary readiness to lose weight, bioelectrical impedance analysis, lipid levels, blood pressure, waist/hip ratio, weight, height, and activity level. Women who completed the weight loss phase of the program showed a reduction in weight; body mass index; percentage body fat; and waist/hip ratio; and an increase in physical activity and dietary readiness to control over-eating. Weight loss was significantly correlated with attendance and dietary readiness to decrease emotional eating. Women who continued on to complete the weight loss maintenance classes maintained a significant loss in body mass index, and increased their high-density lipoproteins and dietary readiness to monitor hunger and eating cues. African-American women who sustain weight loss and weight loss maintenance regimens reduce their risks for developing chronic diseases.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12152924&dopt=Abstract weight loss



Weight loss
Intensive lifestyle intervention combined with the choice of pharmacotherapy improves weight loss and cardiac risk factors in the obese.

Frost G, Lyons F, Bovill-Taylor C, Carter L, Stuttard J, Dornhorst A.

Department of Nutrition and Dietetics, Hammersmith Hospital, Du Cane Road, London, UK. g.frost ic.ac.uk

BACKGROUND: Obesity is on the increase yet within the National Health Service (NHS) treatment approaches differ greatly and service is patchy. Our aim was to compare current practice within a general dietetic clinic with a new clinic developed specifically for patients of higher morbidity risk. METHODS: Locally referred patients to the dietitians from within or without Hammersmith Hospitals NHS Trust of higher morbidity risk were invited to attend a new Lifestyle Clinic. Treatment was of a contractual nature and included more time with the dietitian, the offer of pharmacotherapy if appropriate and an emphasis on achieving a realistic weight loss of 10% within a 6-month period. Cognitive behavioural strategies were utilized focusing on achieving changes in dietary intake and physical activity levels. RESULTS: A total of 103 patients have been enrolled of whom 34 have been discharged before completion of the clinic programme. Twenty-six patients have completed (18 started pharmocotherapy with Orlistat and eight remained on lifestyle advice only), with the remainder still attending the Lifestyle Clinic. The results for these 26 patients demonstrate clinically significant benefits with regard to exercise tolerance 390.8 +/- 37.5 m vs. 473 +/- 46.6 m (P < 0.001), waist measurement 121.5 +/- 4.4 cm vs. 110.9 +/- 3.6 cm (P < 0.001), and total cholesterol : HDL ratio 1.17 +/- 0.05 mmol L-1 vs. 1.27 +/- 0.07 mmol L-1 (P < 0.05). A weight loss comparison with historical data collected in the general dietetic clinic achieves a 7.8 +/- 0.7 kg reduction in weight (with pharmocotherapy 8.96 +/- 0.98 kg, with lifestyle only 5.23 +/- 0.657) vs. 1.7 +/- 0.4 kg (P < 0.05). CONCLUSION: Lifestyle clinics facilitate beneficial lifestyle changes which impact positively on morbidity risk factors demonstrating an improvement on current service offered within the NHS. There is an obvious resource implication of offering an intensive management package. There is need for a randomized control trial with analysis to evaluate whether there is cost benefit from this type of intervention.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12153502&dopt=Abstract weight loss



Weight loss
Weight loss reduces interleukin-18 levels in obese women.

Esposito K, Pontillo A, Ciotola M, Di Palo C, Grella E, Nicoletti G, Giugliano D.

Center for Obesity Management, Department of Geriatrics and Metabolic Diseases, Chair of Plastic and Reconstructive Surgery, Second University of Naples, 80138 Naples, Italy. katerine.esposito unina2.it

Obesity is associated with an increased risk of developing atherosclerosis, which may be mediated, at least in part, by increased secretion of proinflammatory cytokines by adipose tissue. We examined the hypothesis that circulating levels of IL-18 were elevated in obese women and would be reduced by weight loss. In a sample of 40 obese (body mass index, 36.4 +/- 3.1 kg/m(2)) women we found that plasma IL-18 levels were higher than in 40 normal weight control women (P < 0.01) and were positively associated with body weight (r = 0.46; P < 0.01) and visceral fat (waist to hip ratio; r = 0.39; P < 0.01). Caloric restriction-induced weight loss (> or = 10% of original weight) over 1 yr reduced IL-18 levels from 247 (204/309) to 147 (111/210) pg/ml (medians and 25%/75%; P < 0.01), positively associated with changes in body mass index and waist to hip ratio. In obese women, IL-18 levels are associated with body weight and abdominal fat deposition; weight loss is an important intervention to reduce IL-18 levels. IL-18 may be a novel cytokine operating in human obesity.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12161523&dopt=Abstract weight loss