Search

Abstract: The prevalence of obesity has steadily increased over the past three decades both in the United States and worldwide. Recent studies have shown the role of dietary polyphenols in the prevention of obesity and obesity-related chronic diseases. Here, we evaluated the impact of commonly consumed polyphenols, including green tea catechins, especially epigallocatechin gallates, resveratrol and curcumin, on obesity and obesity-related inflammation. Cellular studies demonstrated that these dietary polyphenols reduce viability of adipocytes and proliferation of preadipocytes, suppress adipocyte differentiation and triglyceride accumulation, stimulate lipolysis and fatty acid β-oxidation, and reduce inflammation. Concomitantly, the polyphenols modulate signaling pathways including the adenosine-monophosphate-activated protein kinase, peroxisome proliferator activated receptor γ, CCAAT/enhancer binding protein α, peroxisome proliferator activator receptor gamma activator 1-alpha, sirtuin 1, sterol regulatory element binding protein-1c, uncoupling proteins 1 and 2, and nuclear factor-κB that regulate adipogenesis, antioxidant and anti-inflammatory responses. Animal studies strongly suggest that commonly consumed polyphenols described in this review have a pronounced effect on obesity as shown by lower body weight, fat mass and triglycerides through enhancing energy expenditure and fat utilization, and modulating glucose hemostasis. Limited human studies have been conducted in this area and are inconsistent about the antiobesity impact of dietary polyphenols probably due to the various study designs and lengths, variation among subjects (age, gender, ethnicity), chemical forms of the dietary polyphenols used and confounding factors such as other weight-reducing agents. Future randomized controlled trials are warranted to reconcile the discrepancies between preclinical efficacies and inconclusive clinic outcomes of these polyphenols. [Copyright &y& Elsevier]

: PurposeThis report: 1) examines the importance of long-term follow-up (25 years) in BMI–cardiovascular mortality associations in eight age-gender subcohorts from the Chicago Heart Association Detection Project in Industry; and 2) addresses the impact of previously identified methodologic problems in studies on weight–mortality associations, which include no adjustment for cigarette smoking, adjustment for physiological effects of obesity, and no exclusion of early deaths.: MethodsAssociations were adjusted for age and ethnicity only, then for cigarettes/day, and for systolic blood pressure, serum cholesterol, and diabetes, for three periods of follow-up, 0 to 15, 6 to 15, and 16 to 25 years.: ResultsIn 25-year follow-up with exclusion of deaths for 0 to 15 years, there was a positive association in all subcohorts, with seven significant, both with and without adjustment for smoking or obesity-related risk factors. In contrast, with adjustment for obesity-related risk factors and no exclusion of early deaths in shorter-term (15-year) follow-up, there were two non-significant positive, three non-significant inverse, one significant positive, and one significant quadratic association.: ConclusionFailure to address potential methodologic problems can substantially alter associations in BMI–mortality studies and may contribute to observed differences among studies. The long-term outlook with overweight or obesity is adverse and deserves concerted efforts in prevention and treatment. [Copyright &y& Elsevier]

Background: Treating to a lower blood pressure (BP) may increase acute kidney injury (AKI) events., Study Design: Data for AKI resulting in or during hospitalization or emergency department visits were collected as part of the serious adverse events reporting process of the Systolic Blood Pressure Intervention Trial (SPRINT)., Setting & Participants: 9,361 participants 50 years or older with 1 or more risk factors for cardiovascular disease., Interventions: Participants were randomly assigned to a systolic BP target of <120 (intensive arm) or <140mmHg (standard arm)., Outcomes & Measurements: Primary outcome was the number of adjudicated AKI events. Secondary outcomes included severity of AKI and degree of recovery of kidney function after an AKI event. Baseline creatinine concentration was defined as the most recent SPRINT outpatient creatinine value before the date of the AKI event., Results: There were 179 participants with AKI events in the intensive arm and 109 in the standard arm (3.8% vs 2.3%; HR, 1.64; 95% CI, 1.30-2.10; P<0.001). Of 288 participants with an AKI event, 248 (86.1%) had a single AKI event during the trial. Based on modified KDIGO (Kidney Disease: Improving Global Outcomes) criteria for severity of AKI, the number of AKI events in the intensive versus standard arm by KDIGO stage was 128 (58.5%) versus 81 (62.8%) for AKI stage 1, 42 (19.2%) versus 18 (14.0%) for AKI stage 2, and 42 (19.2%) versus 25 (19.4%) for AKI stage 3 (P=0.5). For participants with sufficient data, complete or partial resolution of AKI was seen for 169 (90.4%) and 9 (4.8%) of 187 AKI events in the intensive arm and 86 (86.9%) and 4 (4.0%) of 99 AKI events in the standard arm, respectively., Limitations: Trial results are not generalizable to patients with diabetes mellitus or without risk factors for cardiovascular disease., Conclusions: More intensive BP lowering resulted in more frequent episodes of AKI. Most cases were mild and most participants had complete recovery of kidney function., Trial Registration: Registered at ClinicalTrials.gov with study number NCT01206062., (Copyright © 2017 National Kidney Foundation, Inc. All rights reserved.)