Browsing by Subject "Obesity"

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Consumption of antioxidant-rich “Cerrado” cashew pseudofruit affects hepatic gene expression in obese C57BL/6J high fat-fed mice
(2022) Egea, Mariana Buranelo; Pierce, Gavin; Park, Si-Hong; Lee, Sang-In; Heger, Fabienne; Shay, Neil
The pseudofruit of A. othonianum Rizzini, “Cerrado” cashew pulp, has been described as rich in flavonoids, phenolic compounds, and vitamin C. The objective of this work was to evaluate the beneficial health effects seen with the addition of “Cerrado” cashew pulp (CP) to an obesogenic high fat diet provided to C57BL/6J male mice. In week 9, the HF-fed group had a significantly higher baseline glucose concentration than the LF- or HF+CP-fed groups. In RNAseq analysis, 4669 of 5520 genes were found to be differentially expressed. Among the genes most upregulated with the ingestion of the CP compared to HF were Ph1da1, SLc6a9, Clec4f, and Ica1 which are related to glucose homeostasis; Mt2 that may be involved steroid biosynthetic process; and Ciart which has a role in the regulation of circadian rhythm. Although “Cerrado” CP intake did not cause changes in the food intake or body weight of fed mice with HF diet, carbohydrate metabolism appeared to be improved based on the observed changes in gene expression.
Essays in health economics
(2023) Meng, Fan; Sousa-Poza, Alfonso
As the global economy and healthcare evolve, subjective well-being is increasingly becoming a topic of interest in the field of health economics. In this dissertation, we try to investigate subjective well-being from two related aspects: obesity and marriage. Obesity is a global health crisis that has reached alarming proportions in recent years. Defined as an excessive accumulation of body fat, obesity has far-reaching implications for both individ- ual health and society as a whole. Its prevalence has steadily risen, with over 650 million adults worldwide classified as obese, according to data from the World Health Organization (WHO). This epidemic has led to a surge in obesity-related health problems, including diabetes, cardio- vascular disease, and certain types of cancer, making it a pressing concern for healthcare systems and policymakers. Estimates of the cost of obesity are an important basis for the development and evaluation of obesity-related policies. Previous studies have estimated the direct and indirect costs of obesity, but in addition to these, the intangible costs of obesity are also noteworthy. The intangi- ble costs of obesity are associated with a loss of well-being. In addition, obesity-related inequality may also combine with peer effects to lead to lower well-being in obese individuals. So, ignoring the intangible costs of obesity may lead to underestimating the benefits of obesity control policies. Marriage, without a doubt, is a major event in life. People from almost any socio-cultural back- ground consider marriage-related decisions such as whether to get married, when to get married, and with whom to get married. But nowadays, in increasingly countries around the world, mar- riage rates continue to decline and the age of first marriage continues to be delayed, so we sought to analyze whether these trends are related to marriage-related well-being. The contributions of each chapter are shown below: Chapter 2 uses SOEP 2002-2018 data and a life satisfaction-based compensation approach to quantify the intangible costs of overweight and obesity. Previous literature documents the direct and indirect economic costs of obesity, yet none has attempted to quantify the intangible costs of obesity. This study focuses on quantifying the intangible costs of one unit body mass index (BMI) increase and being overweight and obese in Germany. Our results underscore how existing research into obesity’s economic toll may underestimate its true costs, and they strongly imply that if obesity interventions took the intangible costs of obesity into account, the economic benefits would be considerably larger. Chapter 3 uses data from the German Socio-Economic Panel (GSOEP), investigates the changes in the BMI distribution and obesity inequality among German adults aged 18+ between 2002-2018 and estimates the relationship between obesity inequality and subjective well-being. The results show that the rise in obesity prevalence is mainly due to an overall rightward shift of the BMI distribution, accompanied by an increase in left skewness. Over the entire 16-year period, obe- sity inequality increased significantly, especially among females, those with low education levels, and low-income groups. The results also document a significant association between different measures of obesity inequality and subjective well-being, especially among women. Chapter 4 explores the trends in the subjective well-being (SWB) of never-married people (referenced with the married) and the factors that account for the gaps in SWB between never- married and married people. By employing a harmonized data from surveys conducted in six distinct countries, namely Australia (HILDA), South Korea (KLIPS), Russia (RLMS), Switzerland (SHP), Germany (SOEP), and the United Kingdom (BHPS and UKHLS), our analysis discerns a consistent and statistically significant association between never-married status and lower levels of life satisfaction, a relationship that has exhibited no substantial alteration over time. Particularly noteworthy is the discernible reduction in life satisfaction among never-married individuals in South Korea in comparison to their married counterparts. The thesis concludes with a short summary in chapter five.
Gut microbiota patterns predicting long-term weight loss success in individuals with obesity undergoing nonsurgical therapy
(2022) Bischoff, Stephan C.; Nguyen, Nguyen K.; Seethaler, Benjamin; Beisner, Julia; Kügler, Philipp; Stefan, Thorsten
The long-term success of nonsurgical weight reduction programs is variable; thus, predictors of outcome are of major interest. We hypothesized that the intestinal microbiota known to be linked with diet and obesity contain such predictive elements. Methods: Metagenome analysis by shotgun sequencing of stool DNA was performed in a cohort of 15 adults with obesity (mean body mass index 43.1 kg/m2) who underwent a one-year multidisciplinary weight loss program and another year of follow-up. Eight individuals were persistently successful (mean relative weight loss 18.2%), and seven individuals were not successful (0.2%). The relationship between relative abundancies of bacterial genera/species and changes in relative weight loss or body mass index was studied using three different statistical modeling methods. Results: When combining the predictor variables selected by the applied statistical modeling, we identified seven bacterial genera and eight bacterial species as candidates for predicting success of weight loss. By classification of relative weight-loss predictions for each patient using 2–5 term models, 13 or 14 out of 15 individuals were predicted correctly. Conclusions: Our data strongly suggest that gut microbiota patterns allow individual prediction of long-term weight loss success. Prediction accuracy seems to be high but needs confirmation by larger prospective trials.
Maternal employment and childhood obesity : a European perspective
(2013) Bammann, Karin; Williams, Garrath; Veidebaum, Toomas; Lauria, Fabio; Kovacs, Eva; Hadjigeorgiou, Charalampos; Fernandez-Alvira, Juan M.; Eiben, Gabriele; de Henauw, Stefaan; Ahrens, Wolfgang; Reisch, Lucia A.; Sousa-Poza, Alfonso; Gwozdz, Wencke
The substantial increase in female employment rates in Europe over the past two decades has often been linked in political and public rhetoric to negative effects on child development, including obesity. We analyse this association between maternal employment and childhood obesity using rich objective reports of various anthropometric and other measures of fatness from the IDEFICS study of children aged 2-9 in 16 regions of eight European countries. Based on such data as accelerometer measures and information from nutritional diaries, we also investigate the effects of maternal employment on obesity's main drivers: calorie intake and physical activity. Our analysis provides little evidence for any association between maternal employment and childhood obesity, diet or physical activity.
Nutritional and hemoglobin status in relation to dietary micronutrient intake: studies in female and male small-scale farmers from Lindi region, Tanzania, and Gurué district, Mozambique
(2024) Eleraky, Laila; Frank, Jan
Inadequate consumption of micronutrient-dense and protein-rich foods, such as vegetables, legumes and meat, are important contributing causes for malnutrition, anemia and micronutrient deficiencies in rural communities of Tanzania and Mozambique. The increasing public health concern of the malnutrition form of overweight has repeatedly been reported in urban as well as rural areas of Sub-Sahara Africa and may have already reached farmers in Tanzania and Mozambique. Nutritional status is assessed by anthropometry, dietary intake and hemoglobin. Compared to the often-used body mass index (BMI) and traditional 24-hour recall, the mid-upper-arm-circumference (MUAC), as well as a food group-based algorithm (CIMI) can be suitable additional assessment tools, especially in resource poor environments. Cross-sectional studies within the framework of the Vegi-Leg project were conducted to assess the nutritional status (anthropometrics and hemoglobin measurements), and the dietary behaviours (Household Dietary Diversity Scores (HDDS), Food Frequency Questionnaires (FFQ) and 24-hour recalls) of female and male farmers from rural areas of Tanzania and Mozambique. Data were analysed by region, sex, age, partly season (Tanzania)and correlates. Additional data from similar projects, namely Scale-N and Trans-SEC in rural villages of Tanzania were included in MUAC and CIMI analysis. MUAC as an additional and easy-to-handle anthropometric marker for underweight, as well as overweight was evaluated using data from Vegi-Leg and Scale-N surveys. MUAC cut-offs, calculated via BMI cut-offs and multiple linear regression (MLR), compared to those selected by highest Youden’s index (YI) value, were assessed. The CIMI algorithm included 23 food groups and was tested in comparison to NutriSurvey (detailed quantitative 24 hour recalls) with data from Scale-N and Trans-SEC.A total of 1526 farmers from the Vegi-Leg project (669 from Tanzania, 857 from Mozambique) were studied, of whom 19% were overweight and 35% were anemic. The study showed an overall higher prevalence of overweight (19%) than underweight (10%), mainly due to the high prevalence of overweight female farmers (up to 35%) in southern Tanzania. The highest prevalence of overweight and anemia, at 35% and 48%, was observed in Tanzanian and Mozambican women, respectively. Regarding HDDS and FFQ data, pigeon pea farmers in Lindi and Gurué reported high consumption frequencies of cereals, legumes, vegetables and oil, while meat, fish and eggs were only consumed rarely. Overall, only a small proportion of enrolled women and men reached the recommended daily dietary intake of vitamin A (10%), iron (51%) and zinc (44%) according to the 24-hour recalls. Multiple regression models revealed that dark green leafy vegetables (DGLVs) highly predicted vitamin A intake, whereas legumes in Tanzania and starchy plants in Mozambique were the dominant sources of vitamin A. Cereals contributed to over half of the iron and the zinc intake in both countries. Seasonal analysis revealed high fluctuations for the consumption frequency of food items from the food groups ‘legumes and pulses’, ‘green leafy vegetables’, ‘other vegetables’ and ‘fruits’, including tomatoes, pigeon peas, mangoes and oranges. The results from Lindi Tanzania revealed, that in seasons, when the availability of food groups like fruits, legumes or vegetables was low, the consumption frequency decreased significantly. BMI, which correlated positively and strongly with MUAC, was higher in Tanzania than in Mozambique and higher among female than male farmers, and decreased significantly from the age of 65 years. MUAC cut-offs of <24 cm and ≥30.5 cm, calculated by multiple linear regression, detected 55% of farmers being underweight and 74% being overweight, with a specificity of 96%; the higher cut-off <25 cm and lower cut-off ≥29 cm, each selected according to Youden’s Index, consequently detected more underweight (80%) and overweight farmers (91%), but on the basis of a lower specificity (87–88%). The results of the algorithm CIMI and NutriSurvey were similar with regard to the average intake and range of data distribution. The correlation coefficients of NutriSurvey and CIMI with regards to energy (0.931), protein (0.898), iron (0.775) and zinc (0.838) intake, supported the matching of both calculations. An increased consumption of micronutrient rich DGLVs and legumes, while reducing the high amounts of refined sugar, maize and polished rice, is suggested to counteract the high prevalence of anemia and overweight among smallholder farmers in rural Tanzania and Mozambique. MUAC cut-offs to detect malnutrition whether defined via linear regression or Youden’s Index, proved to be easy-to-use tools for large-scale rural screenings of both underweight and overweight. The food group based CIMI algorithm is a valid instrument that calculates energy and nutrient intake in agreement with the preferred nutrition software NutriSurvey.
Outcomes addressed in randomized controlled lifestyle intervention trials in community‐dwelling older people with (sarcopenic) obesity - an evidence map
(2022) Galicia Ernst, Isabel; Torbahn, Gabriel; Schwingshackl, Lukas; Knüttel, Helge; Kob, Robert; Kemmler, Wolfgang; Sieber, Cornel C.; Batsis, John A.; Villareal, Dennis T.; Stroebele‐Benschop, Nanette; Visser, Marjolein; Volkert, Dorothee; Kiesswetter, Eva; Schoene, Daniel
Obesity and sarcopenic obesity (SO) are characterized by excess body fat with or without low muscle mass affecting bio‐psycho‐social health, functioning, and subsequently quality of life in older adults. We mapped outcomes addressed in randomized controlled trials (RCTs) on lifestyle interventions in community‐dwelling older people with (sarcopenic) obesity. Systematic searches in Medline, Embase, Cochrane Central, CINAHL, PsycInfo, Web of Science were conducted. Two reviewers independently performed screening and extracted data on outcomes, outcome domains, assessment methods, units, and measurement time. A bubble chart and heat maps were generated to visually display results. Fifty‐four RCTs (7 in SO) reporting 464 outcomes in the outcome domains: physical function (n = 42), body composition/anthropometry (n = 120), biomarkers (n = 190), physiological (n = 30), psychological (n = 47), quality of life (n = 14), pain (n = 4), sleep (n = 2), medications (n = 3), and risk of adverse health events (n = 5) were included. Heterogeneity in terms of outcome definition, assessment methods, measurement units, and measurement times was found. Psychological and quality of life domains were investigated in a minority of studies. There is almost no information beyond 52 weeks. This evidence map is the first step of a harmonization process to improve comparability of RCTs in older people with (sarcopenic) obesity and facilitate the derivation of evidence‐based clinical decisions.
The role of NLRC5 in obesity
(2024) Bauer, Sarah Katharina; Kufer, Thomas
Obesity and its associated morbidities are major global health problems. It has become evident in the last decades that the state of obesity is intimately linked with our immune system. Pattern recognition receptors (PRRs), the main sensor molecules of the innate immune system, were shown to play an essential role in the pathology of obesity and its associated morbidities. Among others, members of the nucleotide-binding and oligomerization domain (NOD) -like receptors (NLRs), a family of cytosolic PRRs, were associated with the obesity-accompanying low-grade inflammatory response contributing to obesity-associated morbidities. NLRC5 is a NLR protein functioning as key transcriptional regulator of major histocompatibility complex (MHC) class I genes responsible for antigen presentation. Recent observations now suggest novel roles of NLRC5 in metabolic trades, but so far, no confirmation of these singular observations is available, and the underlying mechanisms remain elusive. The aim of this thesis was to characterize the role of the NLR protein NLRC5 in obesity. To this end, two Nlrc5 deficient mouse lines (Nlrc5 deltaExon4-7 and Nlrc5 deltaExon4) were subjected to high-fat diet (HFD) feeding and phenotypic, morphological, and biochemical analyses were performed. Female Nlrc5 deltaExon4-7 mice presented with higher body and adipose tissue (AT) weight gain and larger adipocytes compared to wildtype (WT) animals. This phenotype, however, could not be recapitulated in the Nlrc5 deltaExon4 mouse line. Microbiome analysis revealed subtle alterations of the faecal microbiome by diet:genotype interactions. To further characterize the effect of NLRC5 deficiency on adipocyte differentiation, the CRISPR/Cas9 gene editing system was used to modify Nlrc5 expression in the 3T3-L1 preadipocyte cell line. Using inducible HeLa cell lines with stable GFP-NLRC5 expression we showed NLRC5 to interact with the master regulator of adipogenesis peroxisome proliferator-activated receptor y (PPARy) and to enhance the expression of PPARy target genes. In addition, a contribution of NLRC5 to PPARy’s anti-inflammatory actions was revealed using NLRC5 deficient THP-1 macrophage-like cells and bone marrow-derived macrophages from Nlrc5 deltaExon4-7 mice. To elucidate the mechanism behind the synergy between NLRC5 and PPARy, reporter gene and chromatin immunoprecipitation (ChIP) assays were performed. Lastly, the expression of multiple NLR family members was correlated with body mass index (BMI) in obese human patients and investigated in the adipose tissue and liver of HFD-fed mice, the latter revealing Nlrp10 to be highly upregulated by HFD feeding. Taken together, this thesis provides a comprehensive characterization of Nlrc5 deficient mice on HFD and reveals a function of NLRC5 as transcriptional co-regulator of PPARy targets and its anti-inflammatory properties. In addition, this work provides first insights into the potential mechanism behind the synergistic transcriptional regulation by NLRC5 and PPARy and extends the knowledge on the regulation of NLR expression by HFD feeding.
Untersuchungen zur Rolle des intestinalen serotonergen Systems in der Entstehung von Adipositas und der nahrungsinduzierten nicht-alkoholbedingten Fettlebererkrankung im Mausmodell
(2011) Haub, Synia; Bischoff, Stephan C.
The worldwide prevalence of overweight and obesity has increased dramatically throughout the last decades. The causes of obesity are numerous and complex and the understanding of the mechanism(s) involved in the disease process are still limited. The same is true for the development of NAFLD, a liver disease for which a strong association with overweight and obesity has repeatedly been shown. High dietary fat intake has long been thought to be the major cause of obesity and NAFLD. However, other factors like carbohydrate intake may also contribute. Alterations at the level of the intestinal tract have also been discussed to be associated with the development of NAFLD and obesity. The enteric nervous system (ENS) might be of particular importance in this context, regulating the fundamental intestinal functions like peristalsis, secretion and permeability through its main neurotransmitter serotonin (5-HT) and different 5-HT receptors. The termination of the 5-HT action is mediated by the 5-HT selective reuptake transporter (SERT), located on epithelial cells. Based on this background the aim of the present work was to investigate the role of the intestinal serotonergic system and herein particularly of SERT and 5-HT3R in the onset of sugar-induced overweight and NAFLD as well as in the progression of NAFLD in mouse models.