Effect of Alternate-Day #Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy #Obese Adults
A Randomized Clinical Trial
http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2623528
The primary outcome was change in body weight. Secondary outcomes were adherence to the dietary intervention and risk indicators for cardiovascular disease. There were no significant differences between the intervention groups in blood pressure, heart rate, triglycerides, fasting glucose, fasting insulin, insulin resistance, C-reactive protein, or homocysteine concentrations at month 6 or 12. Mean high-density lipoprotein cholesterol levels at month 6 significantly increased among the participants in the alternate-day fasting group (6.2 mg/dL 95% CI, 0.1-12.4 mg/dL), but not at month 12 (1.0 mg/dL 95% CI, –5.9 to 7.8 mg/dL), relative to those in the daily calorie restriction group. Mean low-density lipoprotein cholesterol levels were significantly elevated by month 12 among the participants in the alternate-day fasting group (11.5 mg/dL 95% CI, 1.9-21.1 mg/dL) compared with those in the daily calorie restriction group.
Conclusions and Relevance Alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or cardioprotection vs daily calorie restriction.
A Randomized Clinical Trial
http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2623528
The primary outcome was change in body weight. Secondary outcomes were adherence to the dietary intervention and risk indicators for cardiovascular disease. There were no significant differences between the intervention groups in blood pressure, heart rate, triglycerides, fasting glucose, fasting insulin, insulin resistance, C-reactive protein, or homocysteine concentrations at month 6 or 12. Mean high-density lipoprotein cholesterol levels at month 6 significantly increased among the participants in the alternate-day fasting group (6.2 mg/dL 95% CI, 0.1-12.4 mg/dL), but not at month 12 (1.0 mg/dL 95% CI, –5.9 to 7.8 mg/dL), relative to those in the daily calorie restriction group. Mean low-density lipoprotein cholesterol levels were significantly elevated by month 12 among the participants in the alternate-day fasting group (11.5 mg/dL 95% CI, 1.9-21.1 mg/dL) compared with those in the daily calorie restriction group.
Conclusions and Relevance Alternate-day fasting did not produce superior adherence, weight loss, weight maintenance, or cardioprotection vs daily calorie restriction.
Jamanetwork
Effect of Alternate-Day Fasting Among Metabolically Healthy Obese Adults
This randomized clinical trial compares the effects of alternate-day fasting vs daily calorie restriction on weight loss, weight maintenance, and risk indicators for cardiovascular disease.
Effect of Post– #Cesarean Delivery Oral Cephalexin and Metronidazole on Surgical Site Infection Among #Obese Women
A Randomized Clinical Trial
http://jamanetwork.com/journals/jama/article-abstract/2654382
The rate of obesity among US women has been increasing, and obesity is associated with increased risk of surgical site infection (SSI) following cesarean delivery. The optimal perioperative antibiotic prophylactic regimen in this high-risk population undergoing cesarean delivery is unknown
Participants were randomly assigned to receive oral cephalexin, 500 mg, and metronidazole, 500 mg (n = 202 participants), vs identical-appearing placebo (n = 201 participants) every 8 hours for a total of 48 hours following cesarean delivery Among 403 randomized participants who were included (mean age, 28 SD, 6 years; mean BMI, 39.7 SD, 7.8), 382 (94.6%) completed the trial. The overall rate of SSI was 10.9% (95% CI, 7.9%-14.0%). Surgical site infection was diagnosed in 13 women (6.4%) in the cephalexin-metronidazole group vs 31 women (15.4%) in the placebo group (difference, 9.0% 95% CI, 2.9%-15.0%; relative risk, 0.41 95% CI, 0.22-0.77; P = .01). There were no serious adverse events, including allergic reaction, reported in either the antibiotic group or the placebo group.
Conclusions and Relevance Among obese women undergoing cesarean delivery who received the standard preoperative cephalosporin prophylaxis, a postoperative 48-hour course of oral cephalexin and metronidazole, compared with placebo, reduced the rate of SSI within 30 days after delivery. For prevention of SSI among obese women after cesarean delivery, prophylactic oral cephalexin and metronidazole may be warranted
A Randomized Clinical Trial
http://jamanetwork.com/journals/jama/article-abstract/2654382
The rate of obesity among US women has been increasing, and obesity is associated with increased risk of surgical site infection (SSI) following cesarean delivery. The optimal perioperative antibiotic prophylactic regimen in this high-risk population undergoing cesarean delivery is unknown
Participants were randomly assigned to receive oral cephalexin, 500 mg, and metronidazole, 500 mg (n = 202 participants), vs identical-appearing placebo (n = 201 participants) every 8 hours for a total of 48 hours following cesarean delivery Among 403 randomized participants who were included (mean age, 28 SD, 6 years; mean BMI, 39.7 SD, 7.8), 382 (94.6%) completed the trial. The overall rate of SSI was 10.9% (95% CI, 7.9%-14.0%). Surgical site infection was diagnosed in 13 women (6.4%) in the cephalexin-metronidazole group vs 31 women (15.4%) in the placebo group (difference, 9.0% 95% CI, 2.9%-15.0%; relative risk, 0.41 95% CI, 0.22-0.77; P = .01). There were no serious adverse events, including allergic reaction, reported in either the antibiotic group or the placebo group.
Conclusions and Relevance Among obese women undergoing cesarean delivery who received the standard preoperative cephalosporin prophylaxis, a postoperative 48-hour course of oral cephalexin and metronidazole, compared with placebo, reduced the rate of SSI within 30 days after delivery. For prevention of SSI among obese women after cesarean delivery, prophylactic oral cephalexin and metronidazole may be warranted
Jamanetwork
Effect of Postcesarean Cephalexin-Metronidazole on SSI in Obese Women
This randomized trial compares the effects of postoperative oral cephalexin-metronidazole vs placebo on frequency of surgical site infection (SSI) in obese women undergoing cesarean delivery.
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Lipid metabolism links nutrient-exercise timing to insulin sensitivity in men classified as overweight or #obese
Pre-exercise nutrient availability alters acute metabolic responses to exercise, which could modulate training responsiveness
..exercise before versus after breakfast consumption increased net intramuscular lipid utilization in type I (net change: -3.44±2.63% versus 1.44±4.18% area lipid staining, p < 0.01) and type II fibres (-1.89±2.48% versus 1.83±1.92% area lipid staining, p < 0.05). Training Study - postprandial glycemia was not differentially affected by 6-weeks of exercise training performed before versus after carbohydrate intake (p>0.05). However, postprandial insulinemia was reduced with exercise training performed before, but not after carbohydrate ingestion (p=0.03). This resulted in increased oral glucose insulin sensitivity (25±38 vs -21±32 mL.min-1.m-2; p=0.01), associated with increased lipid utilization during exercise (r=0.50, p=0.02). Regular exercise before nutrient provision also augmented remodelling of skeletal muscle phospholipids and protein content of the glucose transport protein GLUT4 (p<0.05).
Conclusions
Experiments investigating exercise training and metabolic health should consider nutrient-exercise timing, and exercise performed before versus after nutrient intake (i.e., in the fasted state) may exert beneficial effects on lipid utilisation and reduce postprandial insulinemia.
https://academic.oup.com/jcem/advance-article/doi/10.1210/clinem/dgz104/5599745
Lipid metabolism links nutrient-exercise timing to insulin sensitivity in men classified as overweight or #obese
Pre-exercise nutrient availability alters acute metabolic responses to exercise, which could modulate training responsiveness
..exercise before versus after breakfast consumption increased net intramuscular lipid utilization in type I (net change: -3.44±2.63% versus 1.44±4.18% area lipid staining, p < 0.01) and type II fibres (-1.89±2.48% versus 1.83±1.92% area lipid staining, p < 0.05). Training Study - postprandial glycemia was not differentially affected by 6-weeks of exercise training performed before versus after carbohydrate intake (p>0.05). However, postprandial insulinemia was reduced with exercise training performed before, but not after carbohydrate ingestion (p=0.03). This resulted in increased oral glucose insulin sensitivity (25±38 vs -21±32 mL.min-1.m-2; p=0.01), associated with increased lipid utilization during exercise (r=0.50, p=0.02). Regular exercise before nutrient provision also augmented remodelling of skeletal muscle phospholipids and protein content of the glucose transport protein GLUT4 (p<0.05).
Conclusions
Experiments investigating exercise training and metabolic health should consider nutrient-exercise timing, and exercise performed before versus after nutrient intake (i.e., in the fasted state) may exert beneficial effects on lipid utilisation and reduce postprandial insulinemia.
https://academic.oup.com/jcem/advance-article/doi/10.1210/clinem/dgz104/5599745
OUP Academic
Lipid Metabolism Links Nutrient-Exercise Timing to Insulin Sensitivity in Men Classified as Overweight or Obese
AbstractContext. Pre-exercise nutrient availability alters acute metabolic responses to exercise, which could modulate training responsiveness.Objective. To ass