Vicky Drapeau

The effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies

Sedentary lifestyles and increased pollution brought about by industrialization pose major challenges to the prevention of both obesity and chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD), asthma, obstructive sleep apnea and obesity hypoventilation syndrome. Obesity has emerged as an important risk factor for these respiratory diseases, and in many instances weight loss is associated with important symptomatic improvement. Moreover, obesity may influence the development and presentation of these diseases. In this article, we review the current understanding of the influence of obesity on chronic respiratory diseases and the clinical management of obesity concurrent with asthma, COPD, obstructive sleep apnea or obesity hypoventilation syndrome.

Effects of red pepper on appetite and energy intake

Two studies were conducted to investigate the effects of red pepper (capsaicin) on feeding behaviour and energy intake. In the first study, the effects of dietary red pepper added to high-fat (HF) and high-carbohydrate (HC) meals on subsequent energy and macronutrient intakes were examined in thirteen Japanese female subjects. After the ingestion of a standardized dinner on the previous evening, the subjects ate an experimental breakfast (1883 kJ) of one of the following four types: (1) HF; (2) HF and red pepper (10 g); (3) HC; (4) HC and red pepper. Ad libitum energy and macronutrient intakes were measured at lunch-time. The HC breakfast significantly reduced the desire to eat and hunger after breakfast. The addition of red pepper to the HC breakfast also significantly decreased the desire to eat and hunger before lunch. Differences in diet composition at breakfast time did not affect energy and macronutrient intakes at lunch-time. However, the addition of red pepper to the breakfast significantly decreased protein and fat intakes at lunch-time. In Study 2, the effects of a red-pepper appetizer on subsequent energy and macronutrient intakes were examined in ten Caucasian male subjects. After ingesting a standardized breakfast, the subjects took an experimental appetizer (644 kJ) at lunch-time of one of the following two types: (1) mixed diet and appetizer; (2) mixed diet and red-pepper (6 g) appetizer. The addition of red pepper to the appetizer significantly reduced the cumulative ad libitum energy and carbohydrate intakes during the rest of the lunch and in the snack served several hours later. Moreover, the power spectral analysis of heart rate revealed that this effect of red pepper was associated with an increase in the ratio sympathetic: parasympathetic nervous system activity. These results indicate that the ingestion of red pepper decreases appetite and subsequent protein and fat intakes in Japanese females and energy intake in Caucasian males. Moreover, this effect might be related to an increase in sympathetic nervous system activity in Caucasian males.

Appetite sensations and satiety quotient: predictors of energy intake and weight loss.

PURPOSE The aim of this study was to further evaluate the validity and clinical meaningfulness of appetite sensations to predict overall energy intake as well as body weight loss. METHODS Men (n = 176) and women (n = 139) involved in six weight loss studies were selected to participate in this study. Visual analogue scales were used to measure appetite sensations before and after a fixed test meal. Fasting appetite sensations, 1 h post-prandial area under the curve (AUC) and the satiety quotient (SQ) were used as predictors of energy intake and body weight loss. Two separate measures of energy intake were used: a buffet style ad libitum test lunch and a three-day self-report dietary record. RESULTS One-hour post-prandial AUC for all appetite sensations represented the strongest predictors of ad libitum test lunch energy intake (p < or = 0.001). These associations were more consistent and pronounced for women than men. Only SQ for fullness was associated with ad libitum test lunch energy intake in women. Similar but weaker relationships were found between appetite sensations and the 3-day self-reported energy intake. Weight loss was associated with changes in appetite sensations (p < or = 0.01) and the best predictors of body weight loss were fasting desire to eat; hunger; and PFC (p < or = 0.01). CONCLUSIONS These results demonstrate that appetite sensations are relatively useful predictors of spontaneous energy intake, free-living total energy intake and body weight loss. They also confirm that SQ for fullness predicts energy intake, at least in women.

Do 6-y changes in eating behaviors predict changes in body weight? Results from the Québec Family Study

OBJECTIVE: This study was performed to examine changes in eating behaviors as assessed by the three-factor eating questionnaire (TFEQ) and to quantify the potential associations between these eating behaviors and body weight changes in a 6-follow-up study.DESIGN AND SUBJECTS: Prospective study performed in men and women who were tested twice (Visit 1=1989–1995 and Visit 2=6 y later) in the Québec Family Study (QFS).RESULTS: Women were more restrained and less hungry than men. To reduce food intake, women relied more on strategic dieting behavior and avoided more fattening food. However, they had higher emotional and situational susceptibility to eat than men. Significant decreases in the disinhibition score were noted over time in women (P<0.01), which resulted from a decrease in habitual susceptibility behavior to increase food intake. In men, we observed an increase in the avoidance of fattening food (P<0.05). In both genders, we found that the 6-y change in restraint behavior was negatively correlated with body weight changes (P<0.05). In women, a high restraint behavior seems to promote weight gain, whereas in men, it is associated with the opposite trend.CONCLUSION: These results suggest that variables reflecting some eating behaviors are associated with body weight changes in a free-living context. However, these behaviors are expressed differently between men and women. These behaviors should be considered in clinical interventions for individuals seeking a better body weight control.

Combined effects of red pepper and caffeine consumption on 24 h energy balance in subjects given free access to foods

The effects of red pepper and caffeine ingestion on energy and macronutrient balances were examined in eight Caucasian male subjects. All subjects participated in two randomly assigned conditions: control and experimental (red pepper and caffeine). After ingesting a standardized breakfast, subjects ate three meals ad libitum (lunch, dinner and breakfast) and snacks which were served approximately 2 h after the lunch and dinner over a 24 h period. Two appetizers with or without 3 g red pepper) were given before lunch and dinner, and a drink (decaffeinated coffee with or without 200 mg caffeine) was served at all meals and snacks except for the after-dinner snack. It is also important to note that on the experimental day, 8.6 and 7.2 g red pepper were also added to lunch and dinner respectively. Red pepper and caffeine consumption significantly reduced the cumulative ad libitum energy intake and increased energy expenditure. The mean difference in energy balance between both conditions was 4000 kJ/d. Moreover, the power spectral analysis of heart rate suggested that this effect of red pepper was associated with an increase in sympathetic:parasympathetic nervous system activity ratio. These results indicate that the consumption of red pepper and caffeine can induce a considerable change in energy balance when individuals are given free access to foods.

Effect of Lactobacillus rhamnosus CGMCC1.3724 supplementation on weight loss and maintenance in obese men and women.

The present study investigated the impact of a Lactobacillus rhamnosus CGMCC1.3724 (LPR) supplementation on weight loss and maintenance in obese men and women over 24 weeks. In a double-blind, placebo-controlled, randomised trial, each subject consumed two capsules per d of either a placebo or a LPR formulation (1.6 × 10(8) colony-forming units of LPR/capsule with oligofructose and inulin). Each group was submitted to moderate energy restriction for the first 12 weeks followed by 12 weeks of weight maintenance. Body weight and composition were measured at baseline, at week 12 and at week 24. The intention-to-treat analysis showed that after the first 12 weeks and after 24 weeks, mean weight loss was not significantly different between the LPR and placebo groups when all the subjects were considered. However, a significant treatment × sex interaction was observed. The mean weight loss in women in the LPR group was significantly higher than that in women in the placebo group (P = 0.02) after the first 12 weeks, whereas it was similar in men in the two groups (P= 0.53). Women in the LPR group continued to lose body weight and fat mass during the weight-maintenance period, whereas opposite changes were observed in the placebo group. Changes in body weight and fat mass during the weight-maintenance period were similar in men in both the groups. LPR-induced weight loss in women was associated not only with significant reductions in fat mass and circulating leptin concentrations but also with the relative abundance of bacteria of the Lachnospiraceae family in faeces. The present study shows that the Lactobacillus rhamnosus CGMCC1.3724 formulation helps obese women to achieve sustainable weight loss.

The night-eating syndrome and obesity

The rising prevalence of obesity is a global concern. Eating behaviour and circadian rhythm are proving to be important factors in the aetiology of obesity. The night‐eating syndrome (NES) is characterized by increased late‐night eating, insomnia, a depressed mood and distress. It is evident that prevalence is higher among weight‐related populations than the general community. The exact relationship between this syndrome and obesity remains unclear. The reasons for the discrepancies found in the literature likely include varying diagnostic criteria and a wide range of study population characteristics. NES does not always lead to weight gain in thus certain individuals may be susceptible to night‐eating‐related weight gain. Weight loss through surgical and behavioural treatments has shown success in diminishing symptoms. The increasing literature associating obesity with circadian imbalances strengthens the link between the NES and obesity. Circadian genes may play a role in this syndrome. This review will examine different aspects of obesity in the context of the NES.

Metabolic and inflammatory profile in obese patients with chronic obstructive pulmonary disease

Background: Overweight and obesity have been associated with better survival in patients with chronic obstructive pulmonary disease (COPD). On the other hand, excess body weight is associated with abnormal metabolic and inflammatory profiles that define the metabolic syndrome and predispose to cardiovascular diseases. This study was undertaken to evaluate the impact of overweight and obesity on the prevalence of the metabolic syndrome and on the metabolic and inflammatory profiles in patients with COPD. Methods: Twenty-eight male patients with COPD were divided into an overweight/obese group [ n = 16, body mass index (BMI) = 33.5 ± 4.2 kg/m2] and normal weight group (n = 12, BMI = 21.1 ± 2.6kg/m2). Anthropometry, pulmonary function and body composition were assessed. The metabolic syndrome was diagnosed according to waist circumference, circulating levels of triglyceride and high-density lipoprotein cholesterol levels, fasting glycemia and blood pressure. C-reactive protein, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), leptin and adiponectin plasma levels were measured. Results: Airflow obstruction was less severe in overweight/obese compared with normal weight patients (forced expiratory volume1: 51 ± 19% versus 31 ± 12% predicted, respectively, P < 0.01). The metabolic syndrome was diagnosed in 50% of overweight/obese patients and in none of the normal weight patients. TNF-α, IL-6 and leptin were significantly higher in overweight/obese patients whereas the adiponectin levels were reduced in the presence of excess weight. Conclusions: The metabolic syndrome was frequent in overweight/obese patients with COPD. Obesity in COPD was associated with a spectrum of metabolic and inflammatory abnormalities. Chronic Respiratory Disease 2008; 5: 35—41

Glycemic Instability and Spontaneous Energy Intake : Association With Knowledge-Based Work

Objective: To further document the impact of knowledge-based work (KBW) on spontaneous energy intake and glucose homeostasis. Methods: We used a within-subjects experimental design, in which each participant was engaged in each of the three 45-minute conditions followed by an ad libitum buffet, 1) resting in a sitting position; 2) reading a document and writing a summary; or 3) performing a battery of computerized tests. Fourteen female students (mean age: 22.8 ± 2.3 years, mean body mass index: 22.4 ± 2.5 kg/m2) were recruited to participate. Plasma glucose, insulin, and cortisol levels at seven time-points, and appetite sensation markers were measured at each experimental condition. Results: The mean ad libitum energy intake after the reading-writing and the automated test-battery conditions exceeded that measured after rest by 848 kJ and 1057 kJ, respectively (p < .05). No specific dietary preference was detected, as reflected by the comparable percent of energy from each macronutrient in the three conditions. No significant difference in appetite sensation markers was observed among the three conditions. Mean cortisol level over 45 minutes in the two KBW conditions was significantly higher (p < .05) compared with the control condition. Finally, a significant increase in variations in plasma glucose and insulin levels was observed as compared with the control condition (p < .01). Conclusions: This study showed that KBW acutely induces an increase in spontaneous energy intake, and promotes an increased fluctuation in plasma glucose and insulin levels. This study contributes to the documentation of a new risk factor for a positive energy balance, with the potential to lead to overweight in the long-term. KBW = knowledge-based work; BMI = body mass index; HRV = heart rate variability; TFEQ = Three-Factor Eating Questionnaire; STAI = State-Trait Anxiety Inventory; SDNN = standard deviation of R-R interval; SDANN = standard deviation of the mean R-R calculated over a 5-min period; rMSSD = square root of the mean squared difference of successive R-R intervals; NN50 = number of adjacent N-N differing by more than 50 msec; pNN50 = NN50 divided by total number of N-N intervals; LF = low frequency; HF = high frequency; VAS = visual analogue scale; ANOVA = analysis of variance; SD = standard deviation; SEM = standard error of the mean; HPA = hypothalamo-pituitary-adrenal; WHR = waist-to-hip ratio.

Awakening Cortisol Response in Lean, Obese, and Reduced Obese Individuals: Effect of Gender and Fat Distribution

Objective: Our goal was to assess the awakening cortisol response (ACR) in obese and reduced obese men and women.