Obesities, Volume 2, Issue 4 (December 2022) – 7 articles

Orange juice contains flavanones, which are associated with reducing the risk of obesity-associated diseases. We evaluated the effects of two varieties of orange juices on the oxidative stress, inflammatory response, and gut microbiota of individuals with insulin resistance and different obesity classes. In a randomized crossover study, obese patients consumed ‘Pera’ (POJ—source of flavanones) and ‘Moro’ (MOJ—source of flavanones and anthocyanins) orange juices for 15 days. Blood, urine, and fecal samples were collected before and after the intervention. Daily orange juice intake significantly reduced HDL and total cholesterol, in addition to urinary 8-OHdG and plasmatic MCP-1 levels. Multivariate analyses highlighted the beneficial effects of orange juice intake, mainly the modulation of inflammatory and oxidative stress biomarkers. Patients in different obesity classes presented a gut microbiota with obesity-associated alterations (dysbiosis), and the consumption of Pera and Moro orange juices improved this profile by modulating their gut microbiota in different ways. Although the Firmicutes/Bacteroidetes ratio changed after both interventions, MOJ provided more accentuated changes than POJ. Blautia, Bifidobacterium, and other genera had their relative abundance altered by juice consumption, which correlated with patient parameters (such as HDL-cholesterol and diastolic blood pressure) and biomarkers (such as TNF-α and 8-OHdG). In conclusion, regular orange juice intake can be associated with a reduction in oxidative stress and inflammatory response, in addition to modulating gut microbiota. Full article

(1) Background: Obesity is a global epidemic issue that has increased greatly in recent decades. Although interventions such as nutritional approaches and the practice of physical exercise are potential therapies to combat obesity, in some cases they are not sufficient. Therefore, the development of new pharmacological treatments is necessary. Combining these therapies with non-pharmacological alternatives could be an interesting strategy for treating obesity. Considered a pharmacological treatment for overactive bladder (OAB), mirabegron is also categorized as a β(3)-adrenoceptor agonist, and is used in recommended doses of 25 mg and 50 mg. Animal models have shown that the administration of 0.8 mg/kg of mirabegron leads to elevated activation of brown adipose tissue (BAT) and white adipose tissue (WAT) browning. (2) Results: Findings suggest that the pharmacological application of mirabegron has numerous beneficial effects in lipid metabolism, suggesting a potential action against obesity. In this context, physical exercise and mirabegron stimulate browning activation using different mechanisms. (3) Conclusions: According to the results of the studies presented in this review, mirabegron may be a promising pharmacological treatment for obesity due to its significant effects on estimated energy expenditure (EER) through thermogenesis elevation, BAT activation, and WAT browning seen in dosages up to 100 mg. In addition, the administration of mirabegron combined with physical exercise may be a potential alternative for increasing the body’s energy expenditure, with actions in distinct signaling pathways. Thus, physical exercise combined with mirabegron can alleviate some adverse side effects encountered with the use of the medication. Finally, although there have been advances in knowledge, more studies are needed to understand the combined effects of using mirabegron and physical exercise. Full article

Fibroblast growth factor 21 (FGF-21) is a protein that is involved in the regulation of glucose, lipids, and energy metabolism. To act on target tissues, endocrine FGF-21 binds preferably to FGF receptor 1 (FGFR1) in the presence of the coreceptor named β-klotho (KLB). Some of the effects of FGF-21 include increased fatty acid oxidation, glucose uptake, insulin sensitivity, and thermogenesis, which can regulate body weight and glycemia control. By exerting such metabolic effects, the therapeutic potential of FGF-21 for the treatment of obesity and diabetes has been investigated. Physical exercise has been widely used for the prevention and treatment of obesity. Several mechanisms mediate the effects of physical exercise, including the FGF-21 pathway. Studies have shown that physical exercise increases the concentration of circulating and tissue FGF-21 in animals, while contradictory results are still observed in humans. Considering the metabolic role of FGF-21 and the chance of physical exercise to induce FGF-21 secretion, in this review we explore the potential of physical exercise-induced FGF-21 modulation as a strategy for prevention and treatment of obesity. Full article

The triglyceride-to-high-density lipoprotein-cholesterol (TG/HDL-c) ratio is a simple but effective indicator of metabolic imbalance that characterizes metabolic syndrome (MetS) and can consequently indicate a higher cardiovascular risk. It may, therefore, be useful in identifying a high risk for cardiometabolic diseases according to the onset of obesity. The aim of this study was to evaluate the association between MetS and the stage of life at obesity onset and to establish the cutoff point for the TG/HDL-c ratio as a marker of MetS in women with severe obesity. Forty-seven women who were to undergo bariatric surgery were evaluated. Anthropometric and metabolic parameters were measured, and the TG/HDL-c ratio was calculated. The volunteers were grouped according to their stage of life at obesity onset. A receiver operating characteristic (ROC) curve was constructed to define cutoff points for the TG/HDL-c ratio as predictors of MetS. Women who developed obesity early (during infancy/adolescence) had higher weight (p = 0.008), body mass index (p = 0.031), and hip circumference (p = 0.036) than those who developed obesity later (in adulthood); however, no association was found between obesity onset and MetS. The cutoff points for the TG/HDL-c ratio that were established for those who developed early or late obesity were 2.30 and 2.19, respectively. Although the stage of life at the onset of obesity was not related to MetS, different cutoff points for the TG/HDL-c ratio were observed. Full article

Background: Obesity is a serious public health concern, challenging health professionals worldwide. Women with obesity have an increased risk of triggering psychological disorders, due to the weight stigma. Stigmatization of weight-related health correlates with behavior and contributes to a vicious cycle of obesogenic processes. Objective: Our objective is to analyze the association between the presence of mental suffering, risk of mental disorders, and eating behaviors in lean, overweight, and obese women. Methods: A total of 169 adult women aged between 20 and 39 years were included, and participants signed the informed consent, answered a questionnaire on eating habits, the Self Report Questionnaire (SRQ-20), the Scale of Depression, Anxiety and Stress (DASS-21), and the Three-Factor Eating Questionnaire—R21 (TFEQ-R21). Results: The presence of mental suffering was higher in the lean group (26.9%) compared to the overweight and obese group (57.8%). The overweight and obese group had significantly higher scores for the SRQ, DASS, and TFEQ-R21 (p = 0.001 for all analyses), except when evaluating cognitive restraint. Several correlations among scores were found and summarized. There was no significant effect of body mass index on emotional eating, albeit body mass index exerts effects on the DASS score and on binge eating behavior, both of which present mediation effects on emotional eating. Conclusions: These results support the connection between mental health status and the presence of overweight and obesity and emphasize that mental health risks also need specific targeting in public policy. Full article

(1) Background: this work reports the clinical case of a man who underwent a kidney transplant at the age of 19 for idiopathic interstitial nephritis resulting in renal failure. (2) Methods: the patient also had severe obesity and underwent four cycles of a very low-calorie ketogenic diet (VLCKD) for weight loss. (3) Results: the cycles of diet therapy carried out during a six-year period allowed a significant weight loss (from 103.2 kg in 2012 to 87.5 kg in 2018) with lean mass conservation (from 49.9 kg to 52.5 kg) and a reduction of fat mass (from 53.3 kg to 35.0 kg), as assessed with bioimpedance analysis. Throughout the diet cycles, body weight remained stable, except for a weight regain that occurred between the 2nd and 3rd cycle. Renal function was preserved despite the known mild chronic kidney disease (creatininemia ranged from 1.11 mg/dL to 1.27 mg/dL, and GRF from 91 to 71 mL/min/1.73 m²). (4) Conclusions: this report shows that a VLCKD, performed under strict medical supervision, is safe and effective even in a complex clinical picture. Full article

Family involvement is important in interventions targeting childhood obesity. However, family-based interventions have limited impact. Being labeled obese or overweight and/or perceiving oneself as overweight is associated with weight gain over time. The links between weight perception, labelling, as well as individual and familial identities need to be studied more closely. This paper examines how dynamics of identity and identification within the family impact how the intervention is implemented into daily practices. The dataset consists of 15 semi-structured family interviews with a total of 15 children and 21 parents. The study showed an intense focus on the children’s weight and weight loss. Identification as overweight or obese determined how the members of the enrolled families approached the intervention. Children and other family members who identified themselves as being overweight or obese took more responsibility for their own health behavior, but not necessarily in a positive manner. This often resulted in conflicts within the families. Healthcare professionals working with childhood obesity interventions need to consider how to deal with family identity dynamics to secure support as different identities within the family predicts whether the family members find the intervention relevant and whether the intervention was implemented positively into daily life. Full article