Randomized clinical trial comparing standard diet with perioperative oral immunonutrition in total gastrectomy for gastric cancer
Satoshi IdaNaoki HikiH ChoKentaro SakamakiSeiji ItoKazumasa FujitaniNobuhiro TakiguchiYoshiyuki KawashimaKazuo NishikawaMitsuru SasakoToru AoyamaMichitaka HondaTsutomu SatoSouya NunobeTakaki Yoshikawa
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Abstract Background Total gastrectomy for gastric cancer is associated with excessive weight loss and decreased calorie intake. Nutritional support using eicosapentaenoic acid modulates immune function and limits catabolism in patients with advanced cancer, but its impact in the perioperative period is unclear. Methods This was a randomized phase III clinical trial of addition of eicosapentaenoic acid-rich nutrition to a standard diet in patients having total gastrectomy for gastric cancer. Patients were randomized to either a standard diet or standard diet with oral supplementation of an eicosapentaenoic acid (ProSure®), comprising 600 kcal with 2·2 g eicosapentaenoic acid, for 7 days before and 21 days after surgery. The primary endpoint was percentage bodyweight loss at 1 and 3 months after surgery. Results Of 127 eligible patients, 126 were randomized; 124 patients (61 standard diet, 63 supplemented diet) were analysed for safety and 123 (60 standard diet, 63 supplemented diet) for efficacy. Across both groups, all but three patients underwent total gastrectomy with Roux-en-Y reconstruction. Background factors were well balanced between the groups. Median compliance with the supplement in the immunonutrition group was 100 per cent before and 54 per cent after surgery. The surgical morbidity rate was 13 per cent in patients who received a standard diet and 14 per cent among those with a supplemented diet. Median bodyweight loss at 1 month after gastrectomy was 8·7 per cent without dietary supplementation and 8·5 per cent with eicosapentaenoic acid enrichment (P = 0·818, adjusted P = 1·000). Similarly, there was no difference between groups in percentage bodyweight loss at 3 months (P = 0·529, adjusted P = 1·000). Conclusion Immunonutrition based on an eicosapentaenoic acid-enriched oral diet did not reduce bodyweight loss after total gastrectomy for gastric cancer compared with a standard diet. Registration number: UMIN000006380 (http://www.umin.ac.jp/)Keywords:
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Abstract: The Journal of Nutrition and Weight loss (JNWL) was inaugurated in 2016 and has continued publishing successfully with Volume 5 in 2020. Since the journal was established, JNWL has published in excess of 14 topical broadly such as diet pills, liquid diet, Yoga for weight loss, green tea weight loss, Vitamins for weight loss, Weight management, Ideal body weight, Obesity, Weight Reduction, Weight loss surgery, Overweight and Obesity, Ornish diet, Rapid weight loss, Body mass index (BMI), Body Mass composition, Non-surgical weight loss, Weight loss supplements, Weight loss diet, Weight Loss Medical Devices, Very low Calorie diet and Weight loss management program, Monitoring and treatment protocols. This journal was also accepting articles about animal nutrition.
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CaCo-2 monolayers, cultured for 1 week after reaching confluence, were incubated with micellar solutions of fatty acids for up to 7 days. These conditioned cells were incubated acutely (5 h) with eicosapentaenoic acid and oleic acid, and the levels of cell-associated and secreted triacylglycerol were determined. With acute addition of oleic acid, both cell-associated and secreted triacylglycerol were decreased in cells chronically exposed to eicosapentaenoic acid. This effect was observed after as little as 2 days of chronic incubation with eicosapentaenoic acid. A further decrease was found when these cells were incubated acutely with eicosapentaenoic acid, regardless of which radioisotopes were used to label precursors in the incubation media. The secretion of both labelled and total triacylglycerol and apolipoprotein B was reduced approximately 50% in cells incubated chronically with eicosapentaenoic acid. The amounts of triacylglycerol and apolipoprotein B within the cells were not decreased by chronic exposure to eicosapentaenoic acid. Our data indicate that CaCo-2 cells chronically incubated with eicosapentaenoic acid secrete significantly less triacylglycerol than cells incubated chronically with oleic acid. When eicosapentaenoic acid was also included acutely, triacylglycerol secretion was reduced even more. We conclude that chronic exposure of eicosapentaenoic acid to this intestinal cell type reduces the rate of chylomicron secretion and may help explain the decreased postprandial lipaemia observed in humans taking fish oil supplements.
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Abstract Objective Individuals seeking weight loss treatment have diverse pretreatment weight trajectories, and once enrolled, individuals' response to weight loss treatments also varies greatly and may be influenced by the presence of binge‐eating disorder (BED). Reported average weight losses may obscure these considerable differences. This study examined whether BED status and different weight‐related change variables are associated with successful weight loss treatment outcomes in a controlled treatment study. Method Participants ( N = 89) with overweight/obesity, with and without BED, participated in a 3‐month weight loss trial in primary care with 3‐ and 12‐month follow‐ups. We tested the prognostic significance of four weight‐related change variables (the last supper, early weight loss, pretreatment weight trajectory, weight suppression) on outcomes (weight loss‐overall, weight loss‐“subsequent,” weight loss during second half of treatment). Results Early weight loss was positively associated with weight loss‐overall at post‐treatment, and at 3‐month and 12‐month follow‐up. Early weight loss was positively associated with weight loss‐subsequent at post‐treatment only. No other weight‐related variables were significantly associated with weight loss. Models including BED status and treatment condition were not significant. Discussion Participants with early weight loss were more likely to continue losing weight, regardless of BED status or treatment condition. The results highlight the importance of early dedication to weight loss treatment to increase the likelihood of positive outcomes.
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Abstract The changing pattern of obesity‐related disease has created a need for a greater range of weight management options for the increasing number of people for whom weight loss and maintenance cannot be addressed by conventional dietary methods. Formula diet weight loss programmes [very low‐calorie diets ( VLCD s) (400–800 kcal/day) and low‐calorie diets ( LCD s) (800–1200 kcal/day)] can deliver weight loss at rates of 1–2 kg/week. This rate of weight loss can result in 10–20 kg weight loss in 8–12 weeks. Many health benefits associated with weight reduction seem to require between 10 and 20 kg weight loss. Formula diet programmes can result in weight loss, reduction of liver volume and reduction of visceral fat before bariatric surgery; weight loss before knee joint replacement surgery has also been shown. The benefit of pre‐operative weight loss is still under investigation and such practices before bariatric surgery are variable in surgical units across the UK . Weight loss with formula diet in obesity‐associated conditions where inflammation is an important component, such as osteoarthritis and psoriasis, has been demonstrated. Maintenance of about 10% of initial bodyweight loss, with symptom improvement in elderly obese people with knee osteoarthritis, has been shown over a period of 4 years. In obese people with psoriasis, weight loss with skin improvement has been maintained for 1 year. Clinical trials are currently underway to examine the merits of an initial weight loss with formula diet in pre‐diabetes, in early type 2 diabetes and in insulin‐treated type 2 diabetes. Rapid initial weight loss can result in rapid symptom improvement, such as reduced joint pain in osteoarthritis, improved sleep quality in obstructive sleep apnoea, reduced shortness of breath on exertion, reduced peripheral oedema and rapid improvement in metabolic control in diabetes, all changes that are highly motivating and conducive towards compliance. There is also some evidence for improved vitamin D status and maintained bone health in elderly obese people with osteoarthritis but more research is needed. Rapid initial weight loss was feared to be followed by rapid weight regain. However, provided initial weight loss is delivered in parallel with an intense education programme about nutrition, cooking, shopping and lifestyle for long‐term maintenance; and where long‐term support is provided, subsequent weight maintenance after VLCDs and LCDs has been shown to be possible. A recent literature review identified high‐protein diets, obesity drugs and partial use of formula meal replacements as methods which can result in statistically significantly greater weight maintenance after initial weight loss with VLCDs or LCDs . Anxiety about serious adverse side effects seems to be unfounded although users need to be aware of both minor and more serious, though very infrequent, adverse events, such as gallstones and gallbladder disease.
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This Scientific journal covers the following topics broadly such as diet pills, liquid diet, Yoga for weight loss, green tea weight loss, Vitamins for weight loss, Weight management, Ideal body weight, Obesity, Weight Reduction, Weight loss surgery, Overweight and Obesity, Ornish diet, Rapid weight loss, Body mass index (BMI), Adipose Tissue, Lipid Metabolism, Body Mass composition, Colon cleanse weight loss, Non-surgical weight loss, Weight loss supplements, Weight loss diet, Weight Loss Medical Devices, Very low Calorie diet and Weight loss management program, Monitoring and treatment protocols. This journal was also accepting articles about animal nutrition.
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Weight loss and weight loss maintenance can be achieved through lifestyle changes such as a hypocaloric diet and increased physical activity. Hypocaloric diet alone as well as training alone can induce weight loss; however, the combination of these result in the greatest weight loss. Whereas a hypocaloric diet plays a major role in weight loss, physical activity seems to be of great importance during weight loss maintenance. In Denmark, there are private and public offers to achieve weight loss, but the focus on weight loss in the maintenance period after treatment is limited.
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This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The objective of this review will be to determine the effectiveness of fish oils, containing eicosapentaenoic acid, to decrease weight loss, increase duration of survival and improve quality of life for those patients with incurable cancer and cachexia.
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Objective Individuals with obesity are often recommended weight loss for their health; however, the amount of weight loss that is recommended varies. Lay people's beliefs about weight loss could influence the types of behaviours they view as necessary for people with obesity. The present study explored lay beliefs regarding the health benefits of varying degrees of weight loss.Design Participants (379 community members and 235 students) read information about an obese target who lost varying amounts of weight (none vs. modest vs. substantial) following behaviour changes.Main outcome Participants evaluated the target's health and recommended health-related behaviours to the target.Results The substantial weight-loss target, but not the modest weight-loss target, was perceived as being healthier than the no weight-loss target. There were no differences in behaviour recommendations made to the no weight-loss and modest weight-loss targets, with most participants recommending further weight loss to both targets.Conclusions Lay people appear to view substantial, but not modest, weight loss as beneficial to health, and they recommend further, more unrealistic amounts of weight loss to obese individuals who have already achieved modest weight loss. A failure to recognise the health benefits of modest weight loss may contribute to unrealistic weight loss goals.
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