Biography:

Marton Dvorak has his expertise in exercise therapy for elderly and patients with chronic diseases. He is working in University of Physical Education in Hungary as PhD student and also in Yourpower Health Center as exercise physiologist. Part of a lifestyle medicine team with doctors and nutritionists he is leading exercise therapy department for patients with diabetes, obesity, cardiovascular diseases.

Abstract:

Obesity and Adiposity-Based Chronic Disease (ABCD) are one of the most common health risk factors nowadays but regular exercise – part of complex lifestyle medicine program – is effective treatment for obesity if it is individualized and followed by an exercise professional. For better results the accurate dose-effect is needed to be defined. Materials and Methods: The 30 weeks lifestyle change program of a 65-year-old male patient (Body Mass Index (BMI) 43.8 kg/m²) was followed by medical doctor, exercise physiologist and nutritionist. Over regular controls and blood tests every training was measured with a heart rate monitor watch and diet diary was written. Results: Bodyweight decreased by 24.1 kg (18,4%) and BMI to 35.8 kg/m². Decreased resting heart rate (from 72 bpm to 63 bpm), diastolic blood pressure (from 72 mmHg to 67 mmHg) and increased systolic blood pressure (from 126 mmHg to 135 mmHg) were reported beside the reduce of antihypertensive and antidiabetic medicines. Blood test results and fitness level improved, daily steps and time spent with trainings increased. Conclusions: Lifestyle medicine with professional support is an effective and long-term treatment for ABCD. Individualized exercise and nutritional therapy are essential and the wearable technology with telemedicine consultation has also important role.

Biography:

Lena Sagi-Dain, M.D, Genetics Institute, Department of Obstetrics and Gynecology, Carmel Medical Center, 7 Michal St·, Haifa, Israel.

Abstract:

Introduction: Given the negative health consequences of excess weight, healthcare providers have been encouraged to discuss the issue of weight during medical appointments. However, since obesity is a highly stigmatized condition, and since many obese patients have a history of numerous failed dietary and physical activity attempts, bringing up the issue of excess weight can aggravate feelings of stress and frustration. The objective of this study was to evaluate the preferences of overweight and obese individuals regarding the optimal approach for bringing up the subject of weight by health practitioners.

Methods: The cross-sectional study was conducted by distribution of an open anonymous questionnaire in social media platforms during September 2020, aimed for respondents with body mass index (BMI) over 25 kg/m². The questionnaire was comprised of Likert-scale based and open-ended questions, evaluating respondents' experiences and preferences in the context of bringing up the topic of overweight by the medical personnel.

Results: The questionnaire was completed by 1,697 respondents. Only 14.5% agreed that the weight issue should be brought up at medical appointments, and 69.3% preferred health practitioners to ask in advance whether the patient agrees to talk about the excess weight. The participants noted that they were frequently advised to lose weight during medical appointments, without them wanting to talk about this at all (65.0%), when the reason for their appointment was irrelevant to being overweight (60.4%), and without receiving any effective and practical tools on losing weight (60.1%).

Discussion: Health practitioners should acknowledge that most obese patients are aware of the excess weight, many of them have tried to lose weight for decades, and that bringing about the weight issue during medical appointments might cause considerable frustration. Prior to discussing the issue of excess weight, health practitioners should ask patients' permission, and a refuse should be respected and followed. Health practitioners should learn more about the numerous reasons for obesity, appreciate the adverse effects of weight stigmatization, and be able to offer the patients practical tools to lose weight.

Biography:

Abstract:

Obesity has recently been defined as a chronic low-grade inflammatory disease. Obesity-induced inflammation of adipose tissue (AT) is an essential trigger for insulin resistance (IR) and related metabolic diseases. Although the underlying molecular basis of this inflammation has not been fully identified, there is consensus that the recruited and activated macrophages in AT are the most important culprits of AT chronic inflammation. Adipose tissue macrophages (ATMs) are highly plastic and could be polarized from an anti-inflammatory M2 to pro-inflammatory M1 phenotypes upon stimulation by micro-environmental signals from obese AT. Many efforts have been made to elucidate the molecular signaling pathways of macrophage polarization, however, the upstream drivers governing and activating macrophage polarization have rarely been summarized, particularly regulatory messages from the AT micro-environment. In addition to adipocytes, the AT bed also contains a variety of immune cells, stem cells, as well as vascular, neural and lymphatic tissues throughout, which together orchestrate the AT micro-environment. Here, we summarized how the aforesaid neighbors of ATMs in the AT micro-environment send messages to ATMs and thus regulate its phenotype during obesity. Deciphering the biology and polarization of ATMs in the obese environment is expected to provide a precise immunotherapy for adipose inflammation and obesity-related metabolic diseases.

Biography:

Zurong Liang is currently a PhD candidate in the Department of Social Work and Social Administration, the University of Hong Kong. He earned his MSW from Nanjing University and BSW from Guangzhou University. His research focuses on gender and sexuality issues, as well as obesity and mental health problems of Chinese adolescents.

Abstract:

Previous research has indicated the association of perceived stress with mental health problems. In China, Confucian collectivism and an exam-centered culture encourage parents to have high educational ex- pectations that impose great pressure on their children’s learning. However, limited research has focused on adolescents’ perceptions of the negative consequences of academic stress stemming from their parents’ educational expectations. This study addressed this research gap by examining the direct effect of adolescents’ perceptions of academic stress on their depressive symptoms and the indirect effects of both parent-child communication and interaction. We further explored the pathway differences between overweight and non-overweight adolescents. By using a sample (n = 6,566) from the first two waves of the China Education Panel Survey, moderated mediation analysis was performed to simultaneously analyze the mediating roles of parent-children communication and parent-children interaction and the moderating role of adolescent overweight status. The results showed that adolescents’ perceived academic stress (W1) was positively associated with their depressive symptoms (W2). This association was partially mediated by both parent-child communication (W1) and parent-child interaction (W1). Moreover, adolescent overweight status significantly moderated the paths between the adolescents’ perceived academic stress and their depressive symptoms, between their perceived academic stress and parent-child interaction, and the indirect relationship via parent-child interaction. The study’s findings identify the significant roles of parent-child communication and parent-children interaction in contemporary China and indicate overweight adolescents’ susceptibility to stress.

Biography:

Mary-Ann Mbong is a Senior lecturer in the Department of Biochemistry of the University of Yaounde I, Cameroon where she got her Ph.D in 2014 at the age of 34. She is a member of the Cameroon Nutrition Society as well as the African Society of Nutrition. She has published 14 research articles in in the field of Nutritional Biochemistry. She is a Fulbright Scholar alumni who visited Yale School of Medicine, Yale University, Connecticut.

Abstract:

The high prevalence of non-communicable diseases is a challenging problem in the Cameroonian population and women are the most affected. The aim of the present study was to determine and compare the prevalence of metabolic abnormalities and metabolic syndrome (MetS) among pre- and post-menopausal women living in urban areas in Cameroon. A total of 499 women were recruited during a mass health campaign. Metabolic abnormalities were diagnosed using the International Diabetes Federation (IDF) criteria. MetS was defined using IDF criteria with slight modification (total cholesterol used instead of HDL cholesterol). Logistic regression was used to estimate the association between menopausal status and metabolic abnormalities and MetS in age control and non-control models. The prevalence of high waist-to-hip ratio (56.8% vs 36.3%, p < 0.001), elevated fasting blood glucose (glycemia ≥ 100 mg/dL) (38.7% vs 26.9%, p = 0.006); diabetes (14.6% vs 5.7%, p = 0.001); high triglycerides level (29.7% vs 17.1%, p = 0.002); hyperlipidemia (high total cholesterol and or triglycerides levels) (45.0% vs 30.8%, p = 0.002); and elevated blood pressure (67.9% vs 56.1%, p = 0.007) were higher among post-menopausal than pre-menopausal women. The overall prevalence of MetS was 30.1% and post-menopausal women were more affected (33.8% vs 25.0%; p = 0.034). The odds ratio of MetS was 1.888 (95% CI: 1.016 - 3.507) when age was covariate, but was slightly reduced without age control (OR = 1.532; 95% CI: 1.031 - 2.275). Metabolic abnormalities seem to be a major health problem among Cameroonian women and menopausal status increased the risk of developing a cardiovascular event.

Biography:

Milton Chiang currently is a Ph.D. candidate in the department of the International Master/Ph.D. program in Medicine, Taipei Medical University, Taiwan. He got his specialty in Internal Medicine at Francisco Marroquin University, Guatemala, and Medical Degree in Rafael Landivar University, Guatemala. His research focuses on obesity, inflammation, and its therapeutic.

Abstract:

Obesity is a global public health concern that has been related to an increased risk of several chronic diseases, such as cardiovascular diseases, type II diabetes mellitus, obstructive sleep apnea. As overweight has become more prevalent, the effect of obesity on acute lung injury incidence and outcome has gained more attention in recent years. Despite this negative correlation, some investigations have revealed a controversial correlation, termed “obesity paradox” in which overweight with established cardiovascular disease have a better prognosis.

To elucidate further on this issue, we conducted this study with a diet-induced obesity murine model. Obese mice, adult C57BL/6J mice fed a high-fat diet for 12 weeks, received normal saline or endotoxin (lipopolysaccharide, 10 mg/kg, intraperitoneally administered) (denoted as the Obese and LPS group, respectively). After 48 hours of administration of normal saline or endotoxin, mice were euthanized. The level of lung injury (injury score, tissue water content, and leukocyte infiltration in lung tissues) in the LPS group was significantly higher than in the Obese group (p=0.0002; =0.02; and =0.0001, respectively; Figure 1). The levels of pulmonary cytokines (tumor necrosis factor-α [TNF-α], interleukin-6 [IL-6], and interleukin-1β [IL-1 β]) in the LPS group were also significantly higher than in the Obese group (p=0.03; =0.0003; =0.0007; respectively; Figure 1D-F). Moreover, the level of pulmonary inducible nitric oxide synthase (iNOS, indicator of proinflammatory M1 phase macrophage polarization) in the LPS group was significantly higher than in the Obese group (p=0.0087; Figure 1G). The expression levels of nuclear factor-κB (NF-κB) and hypoxia-inducible factor-1α(HIF-1α) in lung tissues in the LPS group were significantly higher than in the Obese group (p=0.003 and <0.0001, respectively; Figure 2A), too. Similar pictures were observed in the levels of oxidation and apoptosis in lung tissues, as the levels of malondialdehyde (MDA) and DNA fragmentation (assayed using the terminal deoxynucleotidyl transferase dUTP nick end labeling [TUNEL] method and the count of TUNEL-positive cells) in the LPS group were significantly higher than in the Obese group (p<0.0001 and =0.001, respectively; Figure 2B-C).

In conclusion, data from this study collectively demonstrate that endotoxin induces significant inflammation in obesity mice.

Biography:

Katarina T. Borer, School of Kinesiology, The University of Michigan, United States

Abstract:

In the USA, obesity has tripled since 1970’s and is associated with a number of pathologies ranging from insulin resistance and type 2 diabetes to cardiovascular disease. Reducing obesity has been difficult whether by caloric restriction, pharmacological approaches, or bariatric surgery. Difficulties in preventing, ameliorating , and reducing obesity stem from our general lack of understanding the limitations of human physiology and psychology and challenges of societal obstacles. Five poorly understood human physiological limitations that increase the risk of gaining, and difficulty of losing, weight are : 1. Human genetic burden of almost limitless capacity to increase fat mass; 2. Absence of a mechanism that restrains overeating and increases energy expenditure to maintain healthy weight; 3. Capacity to increase stomach size with binging and weight gain; 4. Hormonal changes that promote fat gain after weight loss; and 5. Reductions in metabolic rate and physical activity that limit energy expenditure during negative energy balance. Psychological limitations include: 1. Capacity to register hunger mostly to volume, rather than energy content, of food, and fullness or satiation registering only meals eaten by mouth and processed through the gastrointestinal tract; 2. Social facilitation of overeating; 3. Trigger to overeat by the size or availability of food, and 4. Chaotic snacking causing protracted postingestive effects that may extend to 19 hours. Societal barriers include 1. Mechanisation of transportation and household chores; 2. Convenient availability of relatively inexpensive food; 3. Promotion of energy dense palatable foods by food and restaurant industries; and 4. Urban planning limiting the opportunities for walking. Solutions include 1. Deliberate restricting of eating to an 8 to 10 hour window within waking hours; 2. Using gastrointestinal signals of hunger and fullness to eat appropriate volumes of moderate-to low-caloric density healthy foods ; 3. Using activity tracking devices to sustain motivation for higher activity levels; 4. Daily weight monitoring to provide necessary bodyweight feedback in the absence of a physiological feedback counterpart.

Biography:

Dr. Xinhua Xiao is affiliated to Department of Endocrinology, Peking Union Medical College. Dr. Xinhua Xiao is currently providing services as Professor. Dr. Xinhua Xiao has authored and co-authored multiple peer-reviewed scientific papers and presented works at many national and International conferences. Dr. Xinhua Xiao contributions have acclaimed recognition from honourable subject experts around the world. Dr. Xinhua Xiao is actively associated with different societies and academies. 

Abstract:

Obesity plays a crucial role in the development of non-alcoholic fatty liver disease (NAFLD). However, the underlying mechanism for the pathogenesis of obesity-driven NAFLD remains largely obscure. Although the “multiple hit” theory provides a more accurate explanation of NAFLD pathogenesis, it still cannot fully explain precisely how obesity causes NAFLD. The liver is the key integrator of the body’s energy needs, receiving input from multiple metabolically active organs. Thus, recent studies have advocated the “multiple crosstalk” hypothesis, highlighting that obesity-related hepatic steatosis may be the result of dysregulated “crosstalk” among multiple extra-hepatic organs and the liver in obesity. A wide variety of circulating endocrine hormones work together to orchestrate this “crosstalk”. Of note, with deepening understanding of the endocrine system, the perception of hormones has gradually risen from the narrow sense (i.e. traditional hormones) to the broad sense of hormones as organokines and exosomes. In this review, we focus on the perspective of classic endocrine hormones (traditional hormones), organic endocrine hormones (organokines), and molecular endocrine hormones (exosomes), summarizing systematically how the three types of hormones mediate the dialogue between extra-hepatic organs and liver in the pathogenesis of obesity-related NAFLD.

Biography:

Dr. Camillo Buratto, graduated in orthoprosthetics in 1986 and 1989, has experience in the field of biomechanics of at-risk patients (diabetic and rheumatics). He participated as speaker in numerous conferences in Europe (Milan, Madrid, Paris) and outside Europe (Sydney, Tokyo, Dubai).

Abstract:

Walking remains a highly recommended form of exercise for the management of obesity. Thus, comfortable and adequate shoes represent, together with the prescription of a safe adapted physical activity, an important means to achieve the recommended physical activity target volume. However, the literature on shoes specific for obese individuals is inadequate. The aim of the present study was to compare the performance of shoes specifically designed for subjects with obesity with everyday sneakers during instrumented 6-min walking test and outdoor 30-min ambulation in a group of subjects with obesity using a single wearable device. Twenty-three obese individuals (mean age 58.96 years) were recruited and classified into two groups: deconditioned (n = 13) and nondeconditioned patients (n = 10). Each participant was evaluated with his/her daily sneakers and the day after with shoes specifically designed for people with obesity by means of a questionnaire related to the comfort related to each model of shoes and instrumentally during the i6MWT and an outdoor walking test. The results showed that the specifically designed shoes displayed the higher score as for comfort, in particular in the deconditioned group. During the i6MWT, the distance walked, and step length significantly increased in the deconditioned group when specifically designed shoes were worn; no significant changes were observed in the nondeconditioned individuals. The deconditioned group displayed longer step length during the outdoor 30-min ambulation test. In the non-deconditioned group, the use of specific shoes correlated to better performance in terms of gait speed and cadence. These data, although preliminary, seem to support the hypothesis that shoes specifically conceived and designed for counteracting some of the known functional limitations in subjects with obesity allow for a smoother, more stable and possibly less fatiguing gait schema over time.