Role of Meal Timing in Efficacy of Bariatric Surgery in Obese Individuals

进餐时间对肥胖个体减肥手术疗效的影响

基本信息

批准号：
10469973
负责人：
FRANK A SCHEER
金额：
$ 63.52万
依托单位：
BRIGHAM AND WOMEN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-15 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10469973
关键词：
Affect Ambulatory Monitoring Animal Experiments Autonomic nervous system Bariatrics Blood Pressure Body Weight Body Weight decreased Body mass index Caloric Restriction Calories Carbohydrates Cardiovascular Physiology Clinical Consumption Cross-Over Trials Data Desire for food Development Dietary Intervention Drops Eating Economic Burden Effectiveness Energy Intake Energy Metabolism Etiology Fasting Food Patterns Gastrectomy Glucose Intolerance Goals Health Health Benefit High Fat Diet Home Homeostasis Hormones Human Hunger Individual Individual Differences Intake Intervention Laboratories Leptin Measures Mechanics Mediating Metabolic Obesity Obesity Epidemic Operative Surgical Procedures Outcome Overweight Participant Pathway interactions Patients Pattern Peptides Phase Physiological Procedures Prospective Studies Protocols documentation Public Health Publishing Randomized Randomized, Controlled Trials Research Research Design Rest Risk Marker Rodent Role Satiation Stomach Testing Time Variant Weight Work bariatric surgery blood glucose regulation cardiometabolism cardiovascular risk factor design diet-induced obesity dietary control energy balance evidence base experience feeding follow-up food restriction ghrelin glucagon-like peptide 1 glucose metabolism glucose tolerance healthy weight high body mass index improved inflammatory marker insight interest novel novel therapeutic intervention obese person obesity treatment oxidation post intervention prevent response success weight loss intervention

项目摘要

Abstract The broad goal of this project is to determine whether improvements in the daily pattern of food intake can enhance the beneficial effects of bariatric surgery. Bariatric surgery is currently the most effective and durable weight loss treatment for obese individuals, with clear long-term benefit for cardiometabolic health. Though bariatric surgery was original designed to cause mechanical and consequently caloric restriction, this seems not to be the primary mechanism for weight loss. This is because, first, patients who lose a substantial amount of body weight do not experience excessive hunger which normally follows caloric restriction and, second, the amount of weight loss varies widely between individuals and is not correlated with post-surgical gastric pouch size. Indeed, the interindividual difference in post-surgical weight loss is large and approximately 25% of patients can be considered poor weight-loss responders who either do not lose a substantial amount of weight (i.e., BMI loss < 7 kg/m2) or regain the lost weight afterwards. Of interest, altered daily patterns of food intake, such as skipping breakfast and night snacking, is experienced by over half of the bariatric surgery candidates, raising the question whether interindividual differences in meal timing contribute to interindividual differences in weight loss success. Indeed, there is accumulating animal experimental and human evidence that such altered daily patterns of food intake actually contribute to obesity (detailed in the Background). However, none of the published human bariatric surgery studies have tested the causality between meal timing and the beneficial effects of bariatric surgery on measures of energy balance, glucose control, and cardiovascular risk factors. In this proposal, we aim to test the hypotheses that: 1) Early Eaters have a higher BMI loss 1 year after SG as compared to Late Eaters; 2) patients with poor post-surgical weight loss, as compared to those who respond successfully, have higher hunger-related measures late in the day; and 3) experimentally restricting food intake to the daytime in bariatric surgery patients with poor weight loss improves measures of energy balance, glucose tolerance and cardiovascular function. The first hypothesis will be tested in an observational prospective study (baseline plus after 1 year follow up), monitoring ambulatory meal patterns and BMI loss in the field. The second hypothesis will assess 24-h profiles of hunger and appetite-regulatory peptides in the laboratory. The third hypothesis will be tested in a parallel, randomized controlled trial in which patients with poor weight loss response will undergo a 12-week meal timing intervention or a control dietary intervention, and their baseline and post-intervention 24-h physiological outcomes will be measured under the in-laboratory conditions. This research will provide mechanistic insight into the interindividual differences in the effectiveness of bariatric surgery and may help in designing evidence-based dietary interventions incorporating meal timing to optimize post-surgical outcomes.

抽象的该项目的总体目标是确定改善日常食物摄入模式是否可以增强减肥手术的有益效果。减肥手术是目前最有效、最持久的方法针对肥胖者的减肥治疗，对心脏代谢健康具有明显的长期益处。尽管减肥手术最初的目的是引起机械限制，从而限制热量，这似乎不是减肥的主要机制。这是因为，首先，患者失去大量体重的人不会经历过度饥饿，这通常遵循热量限制，其次，体重减轻量因人而异，与术后胃袋无关尺寸。事实上，手术后体重减轻的个体差异很大，约 25% 患者可以被认为是减肥反应不佳的人，他们要么没有减轻大量体重（即 BMI 减轻 < 7 kg/m2）或之后恢复减轻的体重。有趣的是，日常食物摄入模式的改变，超过一半的减肥手术候选人都经历过不吃早餐和夜宵等情况，提出这样一个问题：进餐时间的个体差异是否会导致个体差异减肥成功。事实上，越来越多的动物实验和人类证据表明，这种改变日常食物摄入模式实际上会导致肥胖（背景中详述）。然而，没有一个已发表的人类减肥手术研究测试了进餐时间与有益效果之间的因果关系减肥手术对能量平衡、血糖控制和心血管危险因素的影响。在在此提议中，我们旨在检验以下假设：1) 早食者在 SG 后 1 年后体重指数下降更高，如下所示：与晚食者相比； 2) 与有反应的患者相比，术后体重减轻不佳的患者成功地，在当天晚些时候采取更高的饥饿相关措施； 3）通过实验限制食物摄入量白天减肥手术中体重减轻不佳的患者改善能量平衡指标，葡萄糖耐量和心血管功能。第一个假设将通过观察进行检验前瞻性研究（基线加上 1 年随访后），监测动态膳食模式和 BMI 损失领域。第二个假设将评估饥饿和食欲调节肽的 24 小时概况。实验室。第三个假设将在一项平行、随机对照试验中进行检验，其中患有以下疾病的患者减肥反应不佳将接受12周的进餐时间干预或控制饮食干预，他们的基线和干预后24小时生理结果将在实验室内测量状况。这项研究将从机制上洞察个体间有效性差异减肥手术，可能有助于设计基于证据的饮食干预措施，包括进餐时间以优化术后效果。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Heart rate response and recovery during exercise predict future delirium risk-A prospective cohort study in middle- to older-aged adults.

DOI：
10.1016/j.jshs.2021.12.002
发表时间：
2023-05
期刊：
JOURNAL OF SPORT AND HEALTH SCIENCE
影响因子：
11.7
作者：
Gao, Lei;Gaba, Arlen;Li, Peng;Saxena, Richa;Scheer, Frank A. J. L.;Akeju, Oluwaseun;Rutter, Martin K.;Hu, Kun
通讯作者：
Hu, Kun