The latest medical research on Bariatric Surgery

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about bariatric surgery gathered by our medical AI research bot.

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The effect of pharmacological treatment and lifestyle modification in patients with nonalcoholic fatty liver disease: An umbrella review of meta-analyses of randomized controlled trials.

Obesity Reviews

Nonalcoholic fatty liver disease (NAFLD) is a liver disease that affects approximately 25% of the world's population, and various treatments have b...

A Classification System for Defining and Estimating Dietary Intake of Live Microbes in US Adults and Children.

Journal of Nutrition

Consuming live microbes in foods may benefit human health. Live microbe estimates have not previously been associated with individual foods in dietary databases.

We aimed to estimate intake of live microbes in US children (aged 2-18 y) and adults (≥19 y) (n = 74,466; 51.2% female).

Using cross-sectional data from the NHANES (2001-2018), experts assigned foods an estimated level of live microbes per gram [low (Lo), <104 CFU/g; medium (Med), 104-107 CFU/g; or high (Hi), >107 CFU/g]. Probiotic dietary supplements were also assessed. The mean intake of each live microbe category and the percentages of subjects who ate from each live microbe category were determined. Nutrients from foods with live microbes were also determined using the population ratio method. Because the Hi category comprised primarily fermented dairy foods, we also looked at aggregated data for Med or Hi (MedHi), which included an expanded range of live microbe-containing foods, including fruits and vegetables.

Our analysis showed that 52%, 20%, and 59% of children/adolescents, and 61%, 26%, and 67% of adults, consumed Med, Hi, or MedHi foods, respectively. Per capita intake of Med, Hi, and MedHi foods was 69, 16, and 85 g/d for children/adolescents, and 106, 21, and 127 g/d for adults, respectively. The proportion of subjects who consumed live microbes and overall per capita intake increased significantly over the 9 cycles/18-y study period (0.9-3.1 g/d per cycle in children across categories and 1.4 g/d per cycle in adults for the Med category).

This study indicated that children, adolescents, and adults in the United States steadily increased their consumption of foods with live microbes between the earliest (2001-2002) and latest (2017-2018) survey cycles. Additional research is needed to determine the relations between exposure to live microbes in foods and specific health outcomes or biomarkers.

Serum Omega-3 Fatty Acids and Cognitive Domains in Community-Dwelling Older Adults From the Nuage Study: Exploring the Associations with Other Fatty Acids and Sex.

Journal of Nutrition

Omega-3 (n-3) polyunsaturated fatty acids (PUFAs) are suggested to play a role in the prevention of cognitive decline. The evidence may be inconsistent due to methodological issues including interrelations with other long-chain (14 or more carbons) fatty acids (LCFAs) and use of sex as a confounding factor rather than an effect modifier.

This study evaluated the association between serum n-3 PUFAs and performance across four cognitive domains, overall and by sex, while controlling for other LCFAs.

386 healthy older adults (77.4 ± 3.8 years; 53% females) from the Québec Longitudinal Study on Nutrition and Successful Aging underwent a cognitive evaluation and blood sampling. Verbal and non-verbal episodic memory, executive functioning, and processing speed were evaluated. Serum LCFA concentrations were measured by gas chromatography. LCFAs were grouped according to standard fatty acid classes and according to a factor analysis using principal component analysis (FA-PCA). Multivariate linear regression models were performed, including unadjusted and adjusted models for other LCFAs.

Higher n-3 PUFA concentrations were associated with better non-verbal memory and processing speed in fully adjusted models not including other LCFAs (betas of 0.21 and 0.19, respectively). The magnitude of these associations varied when other LCFAs were entered in the model (betas of 0.27 and 0.32, respectively) or when FA-PCA factors were considered (betas of 0.27 and 0.21, respectively). Associations with verbal episodic memory were limited to higher concentrations of eicosapentaenoic acid whereas there was no association between n-3 PUFAs and executive functioning. Higher n-3 PUFAs were associated with better verbal and non-verbal episodic memory in females, and with better executive functioning and processing speed in males.

These results suggest that other LCFAs should be considered when evaluating the association between n-3 PUFAs and cognitive performance in healthy older adults. Sex differences across cognitive domains warrant further investigation.

Glycemic Index, Glycemic Load, Fiber, and Gluten Intake and Risk of Laparoscopically-Confirmed Endometriosis in Premenopausal Women.

Journal of Nutrition

The etiology of endometriosis is not well understood. Limited evidence suggests that dietary factors influence risk, but prospective data related to carbohydrate, fiber, and gluten consumption are scarce. Despite this, recommendations concerning fiber, gluten intake and endometriosis are pervasive in the lay literature.

To investigate the association between carbohydrate quality (glycemic index [GI] and glycemic load [GL]), fiber intake (total, legume, vegetable, cruciferous vegetable, fruit, cereal), and gluten intake and incident laparoscopically-confirmed endometriosis.

A prospective cohort study using data collected from 81,961 premenopausal women in the Nurses' Health Study II (mean age = 36 in 1991). Diet was assessed with a validated food frequency questionnaire every four years. Cox proportional hazards models were used to calculate rate ratios (RR) and 95% confidence intervals (CI).

3,810 incident cases of laparoscopically-confirmed endometriosis were reported over 24 years of follow-up. Women in the highest quintile of GI had 12% (95% CI = 1.01-1.23, ptrend = 0.03) higher risk of endometriosis diagnosis than those in the lowest quintile. Total vegetable and cruciferous vegetable fiber intake were also associated with higher risk (highest vs lowest quintile RR = 1.13, 95% CI = 1.02-1.24, ptrend = 0.004; RR = 1.17, 95% CI = 1.06-1.29, ptrend = 0.02; respectively). Higher intake of fruit fiber was associated with lower risk of endometriosis but the association was not significant after adjusting for AHEI. Gluten intake was also associated with lower risk (highest vs lowest quintile = 0.91, 95% CI = 0.80-1.02, ptrend = 0.01), but these results were not consistent in direction nor statistical significance across sensitivity analyses. No association was observed for GL, total, legume, or cereal fiber intake.

Our findings suggest that carbohydrate quality and specific types of fiber - total vegetable and cruciferous vegetable fiber - are associated with endometriosis diagnosis in premenopausal women. These results also indicate it is unlikely that gluten intake is a strong factor in the etiology or symptomatology of endometriosis.

Associations Between Adherence to a Dietary Index Based on the EAT-Lancet Reference Diet with Nutritional, Anthropometric and Ecological Sustainability Parameters: Results From the German DONALD Cohort Study.

Journal of Nutrition

Validation of the EAT-Lancet reference (ELR) diet, recently proposed by the EAT-Lancet Commission, within the context of real-life studies is necessary to elucidate its feasibility, nutritional value, sustainability, and health effects.

To develop a dietary index (DI score) to measure adherence to the ELR-diet. To study the association between the DI score and a) nutritional characteristics, b) indicators of ecological sustainability, and c) anthropometric and biomarkers for cardio-metabolic health.

A DI score was constructed by comparing the categories defined by the ELR-diet to the dietary data of 2-5 sets of three-day weighed dietary records from DONALD study participants (n = 298; ≥ 15 years of age). Prospective associations between the DI score and risk markers (anthropometric and cardio-metabolic) in young adulthood (≥18 years) were investigated using multivariate linear regression.

Adherence to the DI score components was considerable (majority > 50%), but varied within the population (2%-100%). The highest tertile of the DI score was inversely associated with the intake of protein (13.5 vs. 14.5 energy%), added sugars (10.5 vs. 12.4 energy%), and cholesterol (100 vs. 116 mg/1000 kcal), but positively associated with fiber intake (10.0 vs. 8.82 g/1000 kcal) (all P < 0.05). The DI score was inversely associated with greenhouse-gas emissions (6.48 vs. 5.85 kgCO2eq/2500 kcal; P < 0.001), and land use (8.24 vs. 7.16 m2 × year/2500 kcal; P < 0.001). Inverse associations between the DI score and anthropometric markers during young adulthood were observed with BMI (22.9 vs. 21.9 kg/m2; P = 0.03) (all P < 0.05). No associations between the DI score and cardio-metabolic risk markers were found (all P ≥ 0.05).

Adherence to the ELR-diet was associated with favorable nutritional characteristics and reduced environmental impact. Adherence to the DI score in adolescence was also beneficial with respect to anthropometric markers in early adulthood, though not for further cardio-metabolic risk markers.

Perceived Availability of Healthy and Unhealthy Foods in the Community, Work, and Higher Education Settings across Five Countries: Findings from the International Food Policy Study 2018.

Journal of Nutrition

Food environments play a key role in dietary behavior and vary due to different contexts, regulations, and policies.

This study aimed to characterize the perceived availability of healthy and unhealthy foods in three different settings in 5 countries.

We analyzed data from the 2018 International Food Policy Study, a cross-sectional survey of adults (18-100 years, n = 22,824) from Australia, Canada, Mexico, the United Kingdom (UK), and the United States (US). Perceived availability of unhealthy (junk food and sugary drinks) and healthy foods (fruit or vegetables, healthy snacks, and water) in the community, workplace, and university settings were measured (i.e., not available, available for purchase, or available for free). Differences in perceived availability across countries were tested using adjusted multinomial logistic regression models.

Across countries, unhealthy foods were perceived as highly available in all settings; in university and work settings unhealthy foods were perceived as more available than healthy foods. Australia and Canada had the highest perceived availability of unhealthy foods (range 87.5-90.6% between categories), while the UK had the highest perceived availability of fruits and vegetables for purchase (89.3%) in the community. In university and work settings, Mexico had the highest perceived availability for purchase of unhealthy foods (range 69.9-84.9%). The US and the UK had the highest perceived availability of fruits and vegetables for purchase (65.3-66.3%) or for free (21.2-22.8%) in the university. In the workplace, the UK had high perceived availability of fruits and vegetables for purchase (40.2%) or for free (18.5%), while the US had the highest perceived availability of junk food for free (17.3%).

Across countries, unhealthy foods were perceived as highly available in all settings. Variability between countries may reflect differences in policies and regulations. Results underscore the need for the continuation and improvement of policy efforts to generate healthier food environments.

Investigating the Intersections of Racial Identity and Perceived Income Adequacy in Relation to Dietary Quality Among Adults in Canada.

Journal of Nutrition

Structural racism and economic marginalization shape dietary patterns in complex ways. Most research examining race and income inequities discount their interactions in shaping dietary intakes. An intersectional approach is needed to identify interconnected sources of social inequities and to more precisely locate dietary inequities.

We examined whether racial identity and perceived income adequacy independently and jointly shape dietary quality, defined using the Healthy Eating Index (HEI) 2015, among a large sample of adults in Canada.

Cross-sectional data from 2540 adults (≥18 years of age) in Canada who participated in the 2019 International Food Policy Study were analyzed. Multivariable linear regression models were executed to test the independent associations and interactions between racial identity and perceived income adequacy with HEI-2015 scores. Models were constructed to examine HEI-2015 total and component scores, adjusting for age, gender, and education.

Perceived income adequacy, but not racial identity, was independently associated with HEI-2015 total scores. The interaction between racial identity and perceived income adequacy was significantly associated with HEI-2015 scores. Compared to the reference group (individuals identifying as White and reporting income adequacy), those identifying as Black and reporting income adequacy were associated with lower HEI-2015 scores (β, -7.30; 95% CI, -13.07 to -1.54) and those identifying as Black and reporting income inadequacy were associated with lower HEI-2015 scores (β, -6.37; 95% CI, -12.13 to -0.60). Individuals who identified as indigenous and reported neither income adequacy nor inadequacy had lower HEI-2015 scores (β, -8.50; 95% CI, -13.82 to -3.18) compared to the reference group.

Findings suggest that racial identity and perceived income adequacy jointly shape dietary quality. Inequities in dietary quality may be missed when intersecting racial identities and socioeconomic positions are not explicitly investigated. To support healthier dietary patterns, strategies must reduce socioeconomic barriers that impose dietary constraints on some racialized groups.

Meat-reduced Dietary Practices and Efforts in Five Countries: Analysis of Cross-sectional Surveys in 2018 and 2019.

Journal of Nutrition

Diets that reduce reliance on animal-source foods are recommended in some contexts.

This study aimed to compare proportions of respondents who reported following meat-reduced dietary practices (i.e., vegetarian, vegan or pescatarian diets) and/or making efforts to reduce animal-source foods, and to examine sociodemographic correlates across five countries.

Online surveys were conducted in November/December 2018 and 2019 with 41,607 adults from Australia (n = 7926), Canada (n = 8031), Mexico (n = 8110), the United Kingdom (UK; n = 9129) and the United States (US; n = 8411) as part of the International Food Policy Study. Respondents were asked if they would describe themselves as vegetarian, vegan or pescatarian, and if they had made efforts to consume less red meat, all meats, and dairy products in the past year. Logistic regressions examined differences in the likelihood of each behaviour between countries and sociodemographic subgroups.

Approximately 1 in 10 respondents reported following a vegetarian, vegan or pescatarian diet, ranging from 8.6% (Canada) to 11.7% (UK). In the past 12 months, the proportions of respondents who reported efforts to consume less red meat ranged from 34.5% (Australia) to 44.4% (Mexico); efforts to consume less of all meats ranged from 27.9% (US) to 35.2% (Mexico), and efforts to consume less dairy were reported by 20.6% (UK) to 41.3% (Mexico). Respondents were more likely to report efforts to consume less animal-source products in 2019 compared to 2018 in most countries. Sociodemographic patterns varied by country; in general, women, those with higher education, and those in minority ethnic groups were more likely to report following meat-reduced dietary practices or efforts to consume fewer animal-source products.

Nearly half of respondents reported following a meat-reduced diet or efforts to reduce animal-source products, with differences between countries and population subgroups. Population-level approaches and policies that support meat-reduction may further reduce consumption of animal-source products.

Adults' Exposure to Unhealthy Food and Beverage Marketing: A Multi-country Study in Australia, Canada, Mexico, United Kingdom, and United States.

Journal of Nutrition

Food marketing increases product appeal, purchasing and consumption, using diverse strategies and locations to reach consumers.

The aim of this study was to examine differences in adults' self-reported exposure to various marketing strategies (brand and licensed characters, celebrities, sponsorship of sports and cultural events) and locations (television, radio, digital media) across five countries: Australia, Canada, Mexico, the United Kingdom (UK), and the United States (US).

We analyzed cross-sectional survey data on self-reported exposure to food marketing strategies and locations collected in 2018 by the International Food Policy Study (IFPS). Participants (n = 21,678) aged ≥ 18 years completed an online survey. Exposure to unhealthy food marketing strategies and locations in the last 30 days were self-reported. Regression models examined differences in marketing exposure and locations across countries.

The average number of unhealthy food marketing strategies to which participants reported being exposed ranged from 0.5 in the UK to 2.3 in Mexico. Self-reported exposure to strategies across all countries was highest for brand characters (32%), followed by licensed characters (22%). In total, the reported mean exposure of marketing locations was 1.6 in the last month. Television was the most prevalent location (44%), followed by digital marketing (32%). Adjusted models indicated that the odds of reporting exposure to marketing strategies and marketing locations was higher for Mexico compared to the rest of the countries.

Adults report a variety of exposures to unhealthy food marketing in all countries, but exposure was highest in Mexico. Special attention should be paid to regulating marketing strategies such as brand characters, licensed characters, and locations such as television, and digital marketing.

High-intensity interval exercise versus moderate-intensity continuous exercise on postprandial glucose and insulin responses: A systematic review and meta-analysis.

Obesity Reviews

We performed a meta-analysis to investigate the effects of high-intensity interval exercise (HIIE) as compared to moderate-intensity exercise (MIE)...

Brussels chicory stabilizes unstable atherosclerotic plaques and reshapes the gut microbiota in Apoe-/- mice.

Journal of Nutrition

Adherence to a Mediterranean dietary pattern may protect against atherosclerosis in part by reducing intestinal permeability and gut microbial lipopolysaccharide (LPS) production. Brussels chicory, a typical Mediterranean vegetable, has been shown to inhibit the formation of early-stage atherosclerosis in mice.

We evaluated whether Brussels chicory affects advanced atherosclerosis progression, intestinal permeability, and gut microbial LPS production.

Thirty-wk-old male apolipoprotein E-deficient mice with unstable atherosclerotic plaques in the brachiocephalic artery were fed the AIN-93G diet alone (control) or supplemented with 0.5% freeze-dried Brussels chicory for 20 wk. Plaque volume and features of plaque stability, plaque macrophage polarization, fecal and serum LPS concentrations, serum lipid profiles and inflammation-related cytokines, and gut microbial profiles were measured.

Compared with the control treatment, Brussels chicory consumption did not significantly change plaque volume and serum lipid profiles. However, it increased plaque stability (P < 0.05), as evidenced by reduced necrotic core size (42.3%), and increased fibrous cap thickness (55.0%) and collagen content (68.4%). Moreover, Brussels chicory consumption reduced intestinal permeability (56.3%), fecal and serum LPS concentrations (52.2% and 39.4%), serum IL1B and TNFA (52.0% and 33.8%), promoted plaque macrophage polarization towards the M2-like phenotype, and altered gut microbial compositions, the latter indicated by increasing the relative abundance of certain genus members of the Ruminococcaceae family, such as Ruminiclostridium_9, Ruminiclostridium_5 and Intestinimonas (P < 0.05). Spearman's correlation analyses further showed that these genus bacteria were significantly correlated with intestinal permeability, fecal and serum LPS, serum pro-inflammatory cytokines and several features of plaque stability.

Brussels chicory may help stabilize atherosclerotic plaques in mice by reducing intestinal permeability and gut microbial LPS production. This study provides a promising approach to slow down the progression of atherosclerosis.

Association of Egg Consumption with Risk of All-Cause and Cardiovascular Disease Mortality: A Systematic Review and Dose-Response Meta-analysis of Observational Studies.

Journal of Nutrition

Recent studies have reported conflicting associations between egg consumption and the risk of all-cause or cardiovascular disease (CVD) mortality, including ischemic heart disease (IHD) mortality and stroke mortality. With accumulating evidence, up-to-date evidence about the association should be synthesized.

To assess the association of the risk of all-cause and CVD mortality with egg consumption.

We searched PubMed, EMBASE, and Web of Science databases through November 3, 2021 for observational studies conducted in participants ≥18 y of age and provided ORs or RRs or HRs and 95% CIs for ≥3 egg consumption categories or for increased intake of egg with the associations of interest. Random-effects model was used to pool the reported risk estimates. Restricted cubic splines were used to examine the dose-response association.

Twenty-four articles with 48 reports (25 for all-cause mortality, 11 for CVD mortality, 6 for IHD mortality, and 6 for stroke mortality) involving 11,890,695 participants were included. Intake of each 1 egg/day increment was associated with increased risk of all-cause mortality (RR 1.06; 95% CI 1.02, 1.10; P = 0.008), but the association was restricted to women, Americans, and studies with adjustments for hyperlipidemia. Egg consumption was linearly associated with CVD mortality only in participants >60 y of age, Americans, studies with follow-up duration≥15 years, and adjustments for hyperlipidemia (P ≤0.018). No significant association was found between egg consumption and IHD or stroke mortality (P ≥0.080).

Egg consumption was linearly associated with a modestly risk of all-cause mortality and, in older participants, Americans, studies with longer follow-up or adjustments for hyperlipidemia, CVD mortality. These findings suggest that it may be prudent to avoid high egg consumption.