The impact of Emblica Officinalis (Amla) on lipid profile, glucose, and C-reactive protein: A systematic review and meta-analysis of randomized controlled trials
Diabetes & Metabolic Syndrome: Clinical Research & Reviews
It is well-established that green tea supplementation has antioxidant properties. However, whethe... more It is well-established that green tea supplementation has antioxidant properties. However, whether green tea supplementation leads to oxidative stress reduction remains unclear, as clinical investigations on this subject have yielded inconsistent outcomes. Consequently, we aimed to determine the effects of green tea supplementation on oxidative stress in adults. A systematic search of English language publications up to 21 August 2021 was carried out in PubMed, Scopus, Embase, and ISI Web of Science, utilizing pertinent keywords. These searches included randomized controlled trials (RCTs) evaluating the relationship between green tea supplementation, malondialdehyde (MDA), and total antioxidant capacity (TAC) in adults. A random-effects model was used to estimate the weighted mean difference (WMD) and 95% confidence intervals (95% CI). Meta-regression and non-linear dose-response analyses were performed to investigate the association between the dosage of green tea (mg/day) and the ...
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Objective This study aimed to compare attendance of nutritional counseling, dietary composition, ... more Objective This study aimed to compare attendance of nutritional counseling, dietary composition, exercise patterns, and socioeconomic factors among obese women with inappropriate gestational weight gain (iGWG) versus appropriate GWG (aGWG). Study Design Medicaid-eligible women receiving prenatal care at a tertiary care center from January 2013 to December 2015 were offered individualized nutritional counseling by a registered dietitian encouraging well-balanced meals and 150 min/wk of exercise. We conducted a prospective case–control study of obese women (body mass index or BMI ≥30) with a singleton gestation with iGWG (<11 or >20 pounds) versus aGWG (11–20 pounds). Dietary intake, activity level, and socioeconomic factors were compared with Chi-square, Fisher's exact, Student's t-test, and Wilcoxon Rank Sum tests as indicated, and odds ratios with 95% confidence intervals were calculated. Multivariate regression analysis for significant variables was performed. A subg...
Metabolomics, a systems biology discipline representing analysis of known and unknown pathways of... more Metabolomics, a systems biology discipline representing analysis of known and unknown pathways of metabolism, has grown tremendously over the past 20 years. Because of its comprehensive nature, metabolomics requires careful consideration of the question(s) being asked, the scale needed to answer the question(s), collection and storage of the sample specimens, methods for extraction of the metabolites from biological matrices, the analytical method(s) to be employed and the quality control of the analyses, how collected data are correlated, the statistical methods to determine metabolites undergoing significant change, putative identification of metabolites, and the use of stable isotopes to aid in verifying metabolite identity and establishing *
The study of metabolism has had a long history. Metabolomics, a systems biology discipline repres... more The study of metabolism has had a long history. Metabolomics, a systems biology discipline representing analysis of known and unknown pathways of metabolism, has grown tremendously over the past 20 years. Because of its comprehensive nature, metabolomics requires careful consideration of the question(s) being asked, the scale needed to answer the question(s), collection and storage of the sample specimens, methods for extraction of the metabolites from biological matrices, the analytical method(s) to be employed and the quality control of the analyses, how collected data are correlated, the statistical methods to determine metabolites undergoing significant change, putative identification of metabolites and the use of stable isotopes to aid in verifying metabolite identity and establishing pathway connections and fluxes. The National Institutes of Health Common Fund Metabolomics Program was established in 2012 to stimulate interest in the approaches and technologies of metabolomics....
BACKGROUND: A unique biological shift in sleep cycles occurs during adolescence causing later sle... more BACKGROUND: A unique biological shift in sleep cycles occurs during adolescence causing later sleep and wake times. This shift is not matched by a concurrent modification in school start times, resulting in sleep curtailment for a large majority of adolescents. Chronic inadequate sleep is associated with poor academic performance including executive function impairments, mood, and behavioral issues, as well as adverse health outcomes such as an increased risk of obesity, hypertension, and cardiovascular disease. In order to address sleep deficits and the potential negative outcomes associated with chronic sleep deprivation, the American Academy of Pediatrics (AAP) and US Centers for Disease Control and Prevention (CDC) support delaying school start times for middle and high school students. METHODS: We summarize current evidence, explicate the need for policy change, and urge school districts to put adolescent students' health as top priority and implement school start times consistent with their developmental needs. RESULTS: Whereas substantial evidence illustrating adverse consequences of inadequate sleep on psychological and physical health, and recommendations exist to adapt daytime school schedules to match sleep needs have been released, actual implementation of these recommendations have been limited. CONCLUSIONS: This is a call to action for the implementation of AAP/CDC recommendations across the state and nation.
Given the crucial role of exercise in the enhancement of cancer survivors' long-term health and w... more Given the crucial role of exercise in the enhancement of cancer survivors' long-term health and wellbeing, the aim of the current paper is to review what is known regarding the physiological mechanisms underlying treatment for cancer in adolescent and young adults (AYAs), summarize the interventions that have been implemented to date to increase AYA survivor exercise, and provide recommendations for specific strategies to promote exercise engagement with consideration of developmental issues relevant to AYA survivors. As musculoskeletal function is among the greatest determinants of morbidity and mortality across the life course, and the strength-structural properties of the musculoskeletal system are largely established in adolescence and young adulthood, perturbations during this time may have profound implications as AYA survivors age. While evidence exists supporting interventions delivered at any time point in the cancer journey, the most effective interventions may be those implemented prior to the onset of late effects or noted declines in key health behaviors. Targeting adolescents is of vital importance as physical activity in AYAs continues to decline with age and onset of chronic conditions. As an endocrine organ, contractions of skeletal muscle via resistance exercise exert indirect effects on overall metabolic pathways via the paracrine and endocrine effects of skeletal muscle and direct effects via muscle hypertrophy. By intervening at an earlier stage of survivorship, prior to the onset of many late effects, and by providing supervised strength training with immediate feedback to survivors, interventions may be associated with increased efficacy in the mitigation of long-term health risks.
AIM: Cardiovascular risk factors and compromised bone phenotype are apparent in obese children. I... more AIM: Cardiovascular risk factors and compromised bone phenotype are apparent in obese children. Identification of cardiovascularbone linking factors is warranted. The objective is to determine the association between circulating factors of lipid metabolism and bone parameters in obese early-pubertal females. MATERIALS AND METHODS: 43 peri-pubertal obese girls aged 7-11 years who underwent dual-energy x-ray absorptiometry (DXA) to measure whole body bone mineral content (BMC) and peripheral quantitative computed tomography (pQCT) to measure bone parameters were included. Lipids (total cholesterol, TC; high-density lipoprotein cholesterol, HDL; low-density lipoprotein cholesterol, LDL; triglyceride, TG), bone turnover markers (carboxy-terminal collagen crosslinks, CTX; type 1 procollagen N-terminal propeptide, P1NP), and inflammatory cytokines (tumor necrosis factor alpha, TNFα; interleukin-6, IL-6) were obtained from venipuncture. RESULTS: HDL was positively associated with P1NP (p<0.01) and total bone area at 66% radial length, yet negatively associated with total bone density (p≤0.05). Stratification by HDL level revealed significant differences in total bone area at 66% radial length between normal-and low-HDL groups. TNFα and IL-6 contributed to the observed differences (p≤0.05). CONCLUSION: The findings herein indicate a link between lipid and inflammatory markers and bone parameters in overweight/obese girls, which may partially explain the increased risk of fracture in this population.
Background: African American women are one of the least active demographic groups in the US, with... more Background: African American women are one of the least active demographic groups in the US, with only 36% meeting the national physical activity recommendations in comparison to 46% of White women. Physical activity begins to decline in African American women in adolescence and continues to decline into young adulthood. Yet, few interventions have been developed to promote physical activity in African American women during this critical period of life. The purpose of this article was to evaluate the acceptability and feasibility of a culturally-relevant Internet-enhanced physical activity pilot intervention for overweight/obese African American college females and to examine psychosocial and behavioral characteristics associated with intervention adherence and completion. Methods: A 6-month single group pre-posttest design was used. Participants (n = 27) accessed a culturally-relevant Social Cognitive Theory-based physical activity promotion website while engaging in a minimum of four moderateintensity physical activity sessions each week. Acceptability and feasibility of the intervention was assessed by participant retention and a consumer satisfaction survey completed by participants. Results: Fifty-six percent of participants (n = 15) completed the intervention. Study completers were more physically active at baseline (P = 0.05) and had greater social support for exercise from family members (P = 0.04). Sixty percent of study completers (n = 9) reported the website as "enjoyable" or "very enjoyable" to use and 60% (n = 9) reported increased motivation from participation in the physical activity program. Moreover, 87% (n = 13) reported they would recommend the website to a friend. Conclusions: Results provide some preliminary support for the acceptability and feasibility of an Internet-enhanced physical activity program for overweight/obese African American women, while highlighting important limitations of the approach. Successful promotion of physical activity in college aged African American women as they emerge into
Getting to the height of the matter: the relationship between stature and adiposity in pre-pubertal children
Ethnicity & disease, 2013
Height has been inversely associated with cardiometabolic disease, with adiposity as the proposed... more Height has been inversely associated with cardiometabolic disease, with adiposity as the proposed contributor. Childhood represents a time when underlying metabolic pathways converge to determine growth. Although the extent to which influence is relevant, insulin, as a key growth signaling factor, likely provides key insight into mechanisms linking height and adiposity. Insulin concentration displays well-established sex and racial differences, with hyperinsulinemia more common among African Americans (AA) females relative to European Americans (EA). The objective of our study was to evaluate the relationship between height and adiposity in children. In addition, a secondary objective was to evaluate potential moderation by insulin concentration. Seventy-two pre-pubertal children aged 4-10 years (mu = 6.6 +/- .2) participated. Percent fat was assessed by DXA and fasting insulin by serum assay. Height was positively associated with percent fat in the overall sample (P = .04). When ev...
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2014
This study evaluated body composition outcomes following a 3-month exercise program for overweigh... more This study evaluated body composition outcomes following a 3-month exercise program for overweight/obese Black women. BMI decreased over the 3-month study despite an observed increase in body fat. Enhancements in bone marrow density and muscle density were also observed. Results show promising yet hypothesis-generating findings to explore in future research. Few studies have evaluated the relationship between aerobic physical activity (PA) and body composition among young adult overweight/obese African American (AA) women. The current study evaluated the effect of a 3-month moderate-intensity aerobic physical activity intervention for overweight and obese young adult women on bone, lean, and fat mass. Participants (n = 15) were a randomly selected subset of AA female college students (M age = 21.7 years; M BMI = 33.3) enrolled in a larger PA promotion pilot study (n = 31). Study protocol required participants to engage in four 30-60-min moderate-intensity aerobic PA sessions each we...
Mechanical stimulation is necessary for maximization of geometrical properties of bone mineraliza... more Mechanical stimulation is necessary for maximization of geometrical properties of bone mineralization contributing to long-term strength. The amount of mineralization in bones has been reciprocally related to volume of bone marrow adipose tissue and this relationship is suggested to be an independent predictor of fracture. Physical activity represents an extrinsic factor that impacts both mineralization and marrow volume exerting permissive capacity of the growing skeleton to achieve its full genetic potential. Because geometry-and shape-determining processes primarily manifest during the linear growth period, the accelerated structural changes accompanying early childhood (ages 3 to 6 y) may have profound impact on lifelong bone health. The objective of this pilot study was to determine if a short-term physical activity intervention in young children would result in augmentation of geometric properties of bone. Three days per week the intervention group (n=10) participated in 30 minutes of moderate intensity physical activity, such as jumping, hopping and running, and stretching activities, whereas controls (n=10) underwent usual activities during the 10-week intervention period. Femoral bone marrow adipose tissue volume and total body composition were assessed by magnetic resonance imaging and dual-energy X-ray absorptiometry, respectively, at baseline and after ten weeks. Although after 10-weeks, intergroup differences were not observed, a significant decrease in femoral marrow adipose tissue volume was observed in those participating in physical activity intervention. Our findings suggest physical activity may improve bone quality via antagonistic effects on femoral bone marrow adipose tissue and possibly long-term agonistic effects on bone mineralization.
The classic silhouette of the typical adolescent with an eating disorder (ED) is a white female w... more The classic silhouette of the typical adolescent with an eating disorder (ED) is a white female with extremely low body weight; this has begun to take a new shape. The most apparent shift in the classic views are sex and weight. A trend toward a progressively decreasing age of onset in ED has also emerged. The objective of this paper is to describe the ED patients presenting to Children's of Alabama's Adolescent Eating Disorders Clinic, encompassing their age, sex, BMI percentile and muscle function. The data was examined from all first presentations to the clinic from 2013 to 2016. Between May 2013 and March 2016, 102 new patient appointments were scheduled. 88 patient's charts were reviewed from the time of each initial appointment in the Adolescent Eating Disorders Clinic to obtain the sex, age, race, height, weight, reason for referral/active problems and ED diagnosis for each patient. BMI percentile was calculated according to reference ranges for sex and age. Handgrip strength was measured by dynamometer. As is consistent with previously published data, there were significantly more females than males seen in our population. There were more females than males across all categories of ED diagnoses. The highest number of diagnoses occurred between the ages of 13-16. A positive correlation between BMI percentile and measured handgrip strength was observed. Measured handgrip strength in females was lower in ages 13-18 than expected grip strength for age. When males were grouped by "Males 14 and under" and "Males 15 and over," a lower measured grip strength compared to the expected grip strength for age was demonstrated. The impact of ED on morbidity and mortality has been well recognized; however the most often reported association was mainly based on changes in body weight. The adverse metabolic consequences perturb nutrient sensing and ultimately delivery and utilization. A shift in the focus of energy balanced towards systemic malnourishment may allow healthy and sustained metabolic improvements.
The objectives of this study were to identify the independent effect of physical activity and fit... more The objectives of this study were to identify the independent effect of physical activity and fitness on insulin dynamics in a cohort of European-, African-, and Hispanic-American children (n = 215) age 7–12 years and to determine if racial/ethnic differences in insulin dynamics could be statistically explained by racial/ethnic differences in physical activity or fitness. An intravenous glucose tolerance test and minimal modeling were used to derive the insulin sensitivity index (SI) and acute insulin response to glucose (AIRg). Fitness was assessed as VO2-170 and physical activity by accelerometer. Multiple regression models were tested for contributions of fitness and physical activity to SI and AIRg. Fitness was a stronger predictor of SI and AIRg than physical activity regardless of ethnicity; racial/ethnic differences in insulin dynamics were not accounted for by differences in fitness and/or physical activity.
Aim-Diabetes-associated glucoregulatory derangements may precipitate atherogenesis in childhood a... more Aim-Diabetes-associated glucoregulatory derangements may precipitate atherogenesis in childhood and CVD risk, particularly with obesity. We aimed to delineate lipoprotein profile differences between children with type 1 and 2 diabetes who are overweight/obese. Methods-Data were obtained from electronic medical records of patients ≥85 th BMI percentile with type 1 (n=159) and type 2 (n=77) diabetes, ages 12-19y. Group differences were evaluated by correlations and general linear modeling analysis, adjusting for BMI, HbA1c, and diabetes duration. Results-There were no group differences in TC, LDL, or non-HDL. Fewer subjects with type 1 diabetes had low HDL (17 vs. 30%; P<0.05). While no difference in HbA1c level was observed between groups, HbA1c was positively correlated with TC (P≤0.0001), LDL (P≤0.0001), non-HDL (P≤0.0001), ApoB100 (P≤0.0001), and LDL pattern B (P≤0.0001). In adjusted models, apoB100 (85.4 vs. 91.3mg/dl; P<0.05) and incidence of LDL pattern B (21 vs. 42%; P<0.01) were lower in subjects with type 1 diabetes. BMI was inversely correlated with HDL, HDL-2 and HDL-3 (all P≤0.0001). The correlation of BMI with HDL-2 and HDL-3 were attenuated when evaluating subjects by diabetes type. Conclusions-Despite having no difference in absolute LDL levels, children with type 2 diabetes were more likely to have small, dense LDL particle pattern, higher apo B100 and lower total HDL, HDL-2, and HDL-3 fractions. Furthermore, poor glycemic control was associated with abnormal lipoprotein profiles in patients with both type 1 and 2 diabetes.
Current pediatric obesity interventions have collectively yielded relatively unsuccessful results... more Current pediatric obesity interventions have collectively yielded relatively unsuccessful results. In this Field of Vision, we present plausible physiologic underpinnings fostering ineffectiveness of conventional strategies grounded in requisite induction of negative energy imbalance. Moreover, such recommendations exacerbate the underlying metabolic dysfunction by further limiting metabolic fuel availability, lowering energy expenditure, and increasing hunger (recapitulating the starvation response amid apparent nutritional adequacy) which precede and promote obesity during growth and development. The qualitative aspects of musculoskeletal system (i.e. , endocrine response, muscle functional capacity) are likely to improve metabolic function and increase nutrient delivery and utilization. An intricate and complex system including multiple feedback mechanisms operates to homeostatically regulate energy balance and support optimal body composition trajectories and metabolic health, during growth and development. Thus, ignoring the interdependencies of regulatory growth processes initiates a nuanced understanding of energy regulation and thus misguided attempts at preventive strategies. Importantly, these gains are not dependent upon weight-loss, rather we suggest can be achieved through resistance training. Collectively, optimizing musculoskeletal health via resistance training elicits augmentation of competitive capacity across systems. Further, substantial gains can be achieved in skeletal muscle mass, strength, and functional capacity through resistance training in a relatively short period of time.
Standard obesity cut points based on BMI percentiles do not equally correspond to body fat percentage across racial/ethnic groups in a representative sample of children and adolescents
International journal of body composition research
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