Spotlight on body weight: Studies target postmenopausal women, bariatric surgery and menstrual disorders

01 Apr 2020 --- Nutritional research in the obesity space is booming, with American River Nutrition set to examine the effects of its annatto-derived tocotrienol DeltaGold on lipid-related parameters in 60 obese postmenopausal women. Meanwhile, Brazialian researchers are re-educating superobese patients who have undergone bariatric surgery to prefer healthier foods in a bid to combat unconscious food impulses. On the other end of the body weight spectrum, people with menstrual disorders related to heavy exercise should consume more calories, according to another study.

Set to be conducted at Texas Tech University Health Sciences Center, US, the tocotrienol clinical trial is the first-ever to be conducted on an obese population, addressing the gap in this scientific field. “We have previously shown that tocotrienol from annatto improves bone turnover in postmenopausal osteopenic women. If results of this study are positive, we will have yet another reason to recommend tocotrienols as an important supplement for postmenopausal women,” Dr. Barrie Tan, President of American River Nutrition, tells NutritionInsight.

Annatto is natural source of tocotrienols, which are found in vitamin E.At a 300 mg daily dosage, the test subjects will be tested for fat mass and visceral adipose tissue, with secondary outcomes measuring changes in the lipid profile, metabolism-related gene expression, fatty acid metabolites and the gut microbiome.

Previous in vitro and in vivo studies have also shown that annatto tocotrienols have beneficial effects in adipocytes, specifically by reducing inflammation and hepatic steatosis. “In clinical trials of patients with non-alcoholic fatty liver disease, tocotrienols also helped reduce weight and Fatty Liver Index,” Dr. Tan further explains.

The mechanism for annatto-derived tocotrienol fighting obesity is yet to be determined, but evidence points to anti-inflammatory, he notes. Tocotrienols are derived from rice, palm and annatto.

Attention to food detail
Superobese patients, whose body mass index reaches up to 50 kg/m2, may undergo bariatric, or weight loss, surgery as an alternative means of weight management. However, a recently published Brazilian study found that post-surgery obese patients are often susceptible to unconscious food impulses that may make it more difficult to maintain post-surgery weight loss. 

Unlearning unhealthy eating behaviors is a “psycho-educational” task.To be published in the Journal of the Endocrine Society, the Brazilian study used a computerized task to measure two types of attentional bias – preconscious and conscious – in 59 test subjects. Half of the participants were superobese. While preconscious attention is a highly automatic response to visual experiences, conscious attentional bias lasts long enough for a person to become aware of it. 

The study found that only the patients that were classified as superobese also had a preconscious attentional bias – the image caught their attention before they even realized it, which may be a predisposing factor to weight regain.

Given its association with binging and emotional eating, attentional bias greatly contributes to obesity. As the longstanding societal taboo on mental health continues to crumble, this research highlights that behavioral and cognitive factors can be as defining as the physical aspects of an individual’s weight loss journey.

Dr. Rogério Friedman, Professor of Internal Medicine, Universidade Federal do Rio Grande do Sul and lead author of the study, tells NutritionInsight that unlearning such unhealthy eating patterns is a “psycho-educational” task in order to ensure post-surgery patients develop and sustain safer eating strategies.

“‘Gateway’ foods have to be discussed with each individual patient. It is a question of minimizing the damage and making healthier choices. We tend to discuss food choices together with the patient and, out of these, we rank the patient’s selections from the most ‘healthy’ to the ‘least healthy.’ The patients are systematically taught to prefer more natural, less energy-dense items, such as lean meats, fruits, vegetables and low-fat dairy.” Dr. Friedman explains.

Not all increased caloric intake is harmful to the body, a US study suggests.Beneficial caloric intake?
On the other end of the obesity spectrum, another study set to be published in the Journal of the Endocrine Society found that increasing caloric intake can help women who heavily exercise suffering from menstrual disorders to stabilize their menstrual cycles. By consuming an additional 300 to 400 calories per day, the target group may avoid complications associated with the Female Athlete Triad, a medical condition that leads to menstrual disorders and poor bone health due to inadequate food intake.

The study included 62 young, exercising women with infrequent menstrual periods. Compared to the control group, the 32 women who increased their calorie intake for the 12-month study were twice as likely to have their menstrual period. “This strategy is easy to implement with the help of a nutritionist. It does not require a prescription and avoids complications from drug therapy,” says lead researcher Dr. Mary Jane De Souza of Penn State University.

The study affirms its findings can encourage healthcare providers to try to help exercising women with menstrual disorders who consume too few calories to eat more, which may also help them to improve athletic performance and avoid bone complications.

By Anni Schleicher, with additional reporting from Katherine Durrell