Susan Franks

Influence of BMI and gender on postprandial hormone responses.

Objective: Influences of gender and body weight on the hormonal response to eating are not well understood. This study was conducted to determine a convenient time‐point to evaluate peak postprandial hormone responses and to test the hypothesis that gender and BMI interact to produce differences in postprandial secretion of selected humoral markers implicated in hunger and satiety.

Positive relationship between support group attendance and one-year postoperative weight loss in gastric banding patients

BACKGROUND Few empirical reports of studies examining the association between bariatric after care support group attendance and weight loss outcomes have been published. The present study investigated the association between the number of support group meetings attended and percentage of excess weight loss at 12 months after gastric banding surgery. The setting was a private practice at which no-cost, professionally led support group meetings were held weekly. METHODS The medical records and support group attendance logs were examined for the dates of attendance, frequency of attendance (or no attendance) in relation to the percentage of excess weight loss (n = 102; 88.2% women; mean age 45.6 ± 11.3 years; mean baseline body mass index 46.4 ± 8.8 kg/m(2)). Linear regression models were used to assess the relationship between the number of group meetings attended and the percentage of excess weight of loss with age and baseline body mass index used as optional independent variables. RESULTS A significant linear relationship was found between support group meeting attendance and the percentage of excess weight loss with simple regression analysis (adjusted R(2) = .061, P = .007), with age (adjusted R(2) = .100, P = .002) and the baseline body mass index added to the model (adjusted R(2) = .072, P = .011). CONCLUSION The results of the present study add to the growing evidence of the positive relationship between the frequency of support group attendance and the percentage of excess weight loss. Future studies should examine patient motivational characteristics in relation to support group participation and other aspects of compliance with aftercare recommendations to investigate unique effects of each part of the treatment program on weight loss outcomes.

Direction of post-prandial ghrelin response associated with cortisol response, perceived stress and anxiety, and self-reported coping and hunger in obese women

The neurobiological mechanisms modulating stress may share common pathways with appetite regulation and consequent obesity. The orexigenic hormone, ghrelin may moderate anxiety and stress-related eating behavior. This study was designed to investigate humoral (ghrelin, cortisol) and psychological/behavioral characteristics (subjective hunger, anxiety, and stress; eating behavior; coping ability) among obese subjects in a fasting state and after eating a standard meal. Subjects included 18 obese but otherwise healthy adult women. Subjects were divided into two groups based on the relative direction of ghrelin response to a standard meal. A meal mediated suppression in serum ghrelin (post/pre<.94) was defined as a normal ghrelin response (NG) (n=9) and failure to suppress (post/pre>1.0) was designated as faulty ghrelin response (FG) (n=9). Ghrelin and cortisol responses were correlated, r(18)=0.558, p=.016. FG subjects had lower ratings of coping ability [t(2,16)=2.437, p=.027 and higher ratings of hunger cues in the expected direction [t(2,16)=-2.061, p=.056] compared to NG subjects. Meal mediated declines in subjective hunger were observed for both NG [t(1,8)=4.141, p=.003] and FG [t(1,8)=2.718, p=.026]. NG also showed declines in subjective anxiety [t(1,8)=2.977, p=.018], subjective stress [t(1,8)=2.321, p=.049], and cortisol [t(1,8)=4.214, p=.003]. In conclusion, changes in ghrelin, cortisol and selected psychological and behavioral indices are closely associated with one another suggesting that ghrelin may influence stress related eating and thus, the consequent observed relationship among stress, mood and obesity.

Curcumin Mimics the Neurocognitive and Anti-Inflammatory Effects of Caloric Restriction in a Mouse Model of Midlife Obesity.

Dietary curcumin was studied for its potential to decrease adiposity and reverse obesity- associated cognitive impairment in a mouse model of midlife sedentary obesity. We hypothesized that curcumin intake, by decreasing adiposity, would improve cognitive function in a manner comparable to caloric restriction (CR), a weight loss regimen. 15-month-old male C57BL/6 mice were assigned in groups to receive the following dietary regimens for 12 weeks: (i) a base diet (Ain93M) fed ad libitum (AL), (ii) the base diet restricted to 70% of ad libitum (CR) or (iii) the base diet containing curcumin fed AL (1000 mg/kg diet, CURAL). Blood markers of inflammation, interleukin 6 (IL-6) and C-reactive protein (CRP), as well as an indicator of redox stress (GSH: GSSG ratio), were determined at different time points during the treatments, and visceral and subcutaneous adipose tissue were measured upon completion of the experiment. After 8 weeks of dietary treatment, the mice were tested for spatial cognition (Morris water maze) and cognitive flexibility (discriminated active avoidance). The CR group showed significant weight loss and reduced adiposity, whereas CURAL mice had stable weight throughout the experiment, consumed more food than the AL group, with no reduction of adiposity. However, both CR and CURAL groups took fewer trials than AL to reach criterion during the reversal sessions of the active avoidance task, suggesting an improvement in cognitive flexibility. The AL mice had higher levels of CRP compared to CURAL and CR, and GSH as well as the GSH: GSSG ratio were increased during curcumin intake, suggesting a reducing shift in the redox state. The results suggest that, independent of their effects on adiposity; dietary curcumin and caloric restriction have positive effects on frontal cortical functions that could be linked to anti-inflammatory or antioxidant actions.

Work site, physician's office, or medical university clinic: The effect of setting on success in a multidisciplinary weight-loss program

The effect of treatment setting on success in a 16-week multidisciplinary cognitive-behavioral weight-management program was examined. Twenty-seven women and six men with an average initial weight of 198.13 lb (+/-39.10) participated in the program at a medical university (MU), their primary care physicians office (PCP), or their work site (WS). The average amount of weight lost, body mass index (BMI) decrement, and number of sessions attended were compared as measures of success between programs. Results supported the hypothesis that treatment setting affects program success [F(6,40)=0.54, P<.05]. WS was more effective than PCP [Wilks lambda=0.59, P<.05] in promoting weight loss [F(1,2)=5.22, P<.05]. Results indicate that the ongoing contingencies in the WS environment promote weight loss through more consistent adherence to suggested weight-loss strategies.

Postinjury personality and outcome in acquired brain injury: the Millon Behavioral Medicine Diagnostic.

To examine the relationship between postinjury personality and outcome in individuals with acquired brain injury. It was hypothesized that patients with differing levels of Introversive, Dejected, and Oppositional coping styles as described by Millons Theory of Personality would show different outcomes after completion of a rehabilitation program.

Efficacy of curcumin for age-associated cognitive decline: a narrative review of preclinical and clinical studies

Processes such as aberrant redox signaling and chronic low-grade systemic inflammation have been reported to modulate age-associated pathologies such as cognitive impairment. Curcumin, the primary therapeutic component of the Indian spice, Turmeric (Curcuma longa), has long been known for its strong anti-inflammatory and antioxidant activity attributable to its unique molecular structure. Recently, an interest in this polyphenol as a cognitive therapeutic for the elderly has emerged. The purpose of this paper is to critically review preclinical and clinical studies that have evaluated the efficacy of curcumin in ameliorating and preventing age-associated cognitive decline and address the translational progress of preclinical to clinical efficacy. PubMed, semantic scholar, and Google scholar searches were used for preclinical studies; and clinicaltrials.gov, the Australian and New Zealand clinical trials registry, and PubMed search were used to select relevant completed clinical studies. Results from preclinical studies consistently demonstrate curcumin and its analogues to be efficacious for various aspects of cognitive impairment and processes that contribute to age-associated cognitive impairment. Results of published clinical studies, while mixed, continue to show promise for curcumin’s use as a therapeutic for cognitive decline but overall remain inconclusive at this time. Both in vitro and in vivo studies have found that curcumin can significantly decrease oxidative stress, systemic inflammation, and obstruct pathways that activate transcription factors that augment these processes. Future clinical studies would benefit from including evaluation of peripheral and cerebrospinal fluid biomarkers of dementia and behavioral markers of cognitive decline, as well as targeting the appropriate population.

Liver Biomarkers and Lipid Profiles in Mexican and Mexican-American 10- to 14-Year-Old Adolescents at Risk for Type 2 Diabetes.

Liver enzymes alanine aminotransferase (ALT) and gamma glutamyl transferase (GGT) are markers for type 2 diabetes mellitus (T2DM); alkaline phosphatase is a marker of liver disease. Mexican-American adolescents are disproportionately affected by T2DM, while in Mexico its prevalence is emerging. We assessed liver biomarkers and lipid profiles among Mexican and Mexican-American adolescents 10–14 years old with high/low risk of T2DM through a cross-sectional, descriptive study (Texas n = 144; Mexico n = 149). We included family medical histories, anthropometry, and blood pressure. Obesity was present in one-third of subjects in both sites. ALT (UL) was higher (p < 0.001) in high-risk adolescents (23.5 ± 19.5 versus 17.2 ± 13.4 for males, 19.7 ± 11.6 versus 15.1 ± 5.5 for females), in Toluca and in Texas (26.0 ± 14.7 versus 20.0 ± 13.2 for males, 18.2 ± 13.4 versus 14.6 ± 10.1 for females), as well as GGT (UL) (p < 0.001) (18.7 ± 11.1 versus 12.4 ± 2.3 for males, 13.6 ± 5.8 versus 11.5 ± 3.9 for Mexican females; 21.0 ± 6.8 versus 15.4 ± 5.5 for males, 14.3 ± 5.0 versus 13.8 ± 5.3 for females in Texas). We found no differences by sex or BMI. Total cholesterol and HDL were higher among Mexican-Americans (p < 0.001). In conclusion, multiple risk factors were present in the sample. We found differences by gender and between high and low risk for T2DM adolescents in all liver enzymes in both sites.

Correlation of Lipid Profile and Risk of Developing Type 2 Diabetes Mellitus in 10-14 Year Old Children.

Background/Aims: The role of lipid profile in predicting the risk of Type 2 diabetes mellitus (T2DM) in children is not clearly established. Our aim is to screen non-diabetic children aged 10-14 years for risk of developing T2DM and evaluate the association of abnormal lipids and socioeconomic status (SES). Methods: Data on race/ethnicity, family history, body mass index percentile, blood pressure and presence of neck pigmentation (acanthosis nigricans) were collected from 149 non-diabetic children. Using these factors, children were classified into low risk (<3 risk factors) and high risk (>3 risk factors) groups. Logistic regression model and chi-square tests were used to evaluate the association of blood lipid profile and demographic variables. Independent t-test was used to compare the ratio of Total Cholesterol (TC) and High Density Lipids (HDL) with T2DM risk. Results: 60% of children were at high risk for developing T2DM. HDL (p<0.001), triglycerides (p=0.02) and TC/HDL ratio (p<.001) were significantly abnormal in high risk group. Low SES showed a marginal association with high risk group. There were no gender or age differences between high and low risk groups. Conclusions: The significant determinants associated with high risk group were modifiable factors providing an opportunity for early intervention and prevention.