Active clinical trials for "Obesity"

Vitamin D deficiency is common in the general population in the United States, but is more common in overweight and obese children. Additionally, vitamin D levels are inversely correlated with body mass index, hypertension, inflammatory markers and insulin resistance. There are currently no clear guidelines regarding vitamin D replacement in obese but otherwise healthy children. The Endocrine Society recommends that children with vitamin D deficiency should take 2000 IU once a day for at least 6 weeks; however, they state that obese children may need 2-3 times this dose in order to reach sufficient levels. The goals of this study are: To determine the prevalence of vitamin D sufficiency (>30 ng/mL), insufficiency (21-29 ng/mL); deficiency (10-19 ng/mL) and severe vitamin D deficiency (<10 ng/dL) in an obese pediatric population (2-11 years) as measured by 25-hydroxyvitamin D. To determine if vitamin D level correlates with percentage body fat by bioelectrical impedance analysis and/or visceral fat by waist circumference in children ages 5 - 11 years. To observe the effect of vitamin D replacement in obese children with vitamin D deficiency using two different replacement dosage levels recommended by the Endocrine Society over three months: 2000 IU once a day (general pediatric dose) vs 6000 IU once a day (suggested obesity dose) in children between the ages of 5 - 11 years. To measure vitamin D levels, bone markers, inflammatory markers and vitamin D binding protein before and after vitamin D supplementation in children between the ages of 5 - 11 years. Analysis will be stratified by degree of obesity (Class I, Class II, Class III) and season.

Obesity, defined as BMI> 30kg / m2, is a major public health problem, with devastating medical and psychological consequences. 30% of obese suffer from BED type of eating disorders. The optimal treatment of obesity remains bariatric surgery, failed in 20% of cases. Many arguments are in favor of the involvement of the reward circuitry, with the central role of NAc in the pathophysiology of BED and obesity. The recent application and effectiveness of DBS (Deep Brain Stimulation) in refractory psychiatric disorders suggest that DBS may be of interest in treating obesity and BED with potential target for the NAc. This project propose to study fMRI activation of the reward system in response to food stimuli to better direct the DBS targets. This is a pilot study to define indication criteria based on fMRI to obese BED patients are potential candidates for treatment with DBS.

Aim: Exercise training improves the risk of cardiometabolic diseases; yet the underlying mechanisms are unclear. Exercise induces release of IL-6 from skeletal muscle. Acute elevations in IL-6 improve lipid and glucose metabolism, the latter partly through a delayed gastric emptying. Physical inactivity causes accumulation of visceral fat (VAT). Visceral and epicardial adipose tissue (EAT) is more inflamed than subcutaneous adipose tissue. Thus, the investigators hypothesize that exercise-induced IL-6 mediates the exercise-induced reduction in EAT and VAT. Secondly, the investigators hypothesize that exercise-induced adaptations in glucose metabolism and gastric motility are dependent on IL-6. Finally the investigators hypothesise that both endurance and resistance exercise training reduce VAT and EAT. Primary aim: To investigate the effects of exercise training on VAT and to determine to what extend IL-6 mediates this effect. Secondary aims: 1) To determine whether 12 weeks of endurance and strength training can reduce the amount of EAT. 2) To study whether the effects of exercise on glucose metabolism and gastric emptying are dependent on IL-6. Methods: Inclusion: 70 inactive men and women, >18 years, waist to height ratio > 0.5 and/or waist circumference ≥ 88 cm (women); waist circumference ≥ 102 cm (men) Design: A 12-week, double-blinded randomised, placebo-controlled exercise intervention study. Intervention: Subjects will be randomised to one of five groups: i) Tocilizumab (IL-6 receptor antibody) and endurance training, ii) Placebo to Tocilizumab and endurance training, iii) Tocilizumab, no exercise iv) Placebo to Tocilizumab and no training, and v) Placebo to Tocilizumab, and resistance training. Tocilizumab/placebo dose will be administered (according to standard recommendations) before the first training session, and maintained during the 12-week training program. Training will be supervised to ensure intensity and compliance. Subjects will be instructed not to change eating habits and informed that this study does not aim for a weight loss. Statistical considerations: Study investigators are blinded to treatment allocation. Dropouts will be replaced. A sample size of 70 subjects is needed to detect a 10% change in visceral adipose, with a power of 80% and a significance level of 0.05.

Weight gain occurs because of imbalances in energy balance favouring energy intake. Whilst over 50% of a person's energy requirement goes towards the maintenance of physiological functions, around 40% is used for physical activity. In addition to this, around 10-15% of energy is spent on what is termed as Diet Induced Thermogenesis (DIT). Diet Induced Thermogenesis is the increase in energy expenditure following a meal, and represents the energy utilised for the digestion and metabolism of food. Some nutrients such as proteins require more energy to digest and therefore produce a greater DIT than others. In addition to this, some food components are able to independently stimulate calorie burning. For example caffeine, chilli, ginger and green tea have been shown to induce calorie burning through DIT. Therefore the inclusion of such foods in the diet could increase energy expenditure and thereby help in weight control. The objective of this study is to determine the DIT effects of some plant foods that are native to Scotland (blackberries, blueberries, red raspberries, wild garlic and sea buckthorn). These foods have been shown to contain compounds that stimulate DIT. If found to be effective, these foods could then be used to develop dietary strategies for weight control in Scotland.

This research study is being done to determine whether taking a dietary supplement called capsinoids, derived from sweet peppers, can activate brown fat that is already present or even generate new brown fat in individuals with excess weight. Previous studies have suggested that chronic consumption of capsinoids may be able to generate new brown fat in thin individuals. Capsinoids may also have a small positive effect on metabolism (increased calorie-burning) and fat loss. The knowledge gained in this study may eventually lead to more treatment options for people with excess weight.

In this study the investigators will investigate the effect of dopamine (bromocriptine) on Brown Adipose Tissue in lean, young, healthy males. The investigators will also examine energy expenditure, body temperature and insulin sensitivity as measurements of Brown Adipose Tissue activity.

BASIC fMRI is a prospective single center intervention trial using fMRI imaging in 9-11 year old obese male and females pre and post family-based behavioral treatment of 24 weeks duration to determine the relationship between impulsivity and central satiety responses.

The main objective of the study is to evaluate the protein requirement associated with postoperative weight loss caused by by-pass (shunt which leads to a certain degree of malabsorption) or sleeve gastrectomy (more technically conservative with less malabsorption), through the study of nitrogen balance. The benefit of protein supply easily absorbed and with high essential amino acids content (proteins "fast" soluble milk) on protein metabolism and muscle function will also be studied. Endotoxemia and intestinal flora variations were measured before and after bariatric surgery.

Obesity is an important public health problem that is taking epidemic proportions worldwide. Indeed, nearly 50% of Canadians are obese and their number has increased dramatically in the last 20 years. Direct costs of obesity added to those of sedentary represent nearly 5% of the health system's budget. Also, obesity is linked with multiple co-morbidities; furthermore, modest weight loss has significant impact on type 2 diabetes, blood pressure and even reduces mortality. The investigators group has implemented an interdisciplinary team that has demonstrated its effectiveness for obesity management. However, the majority of obese subjects should be treated by primary care physicians (PCPs) that often feel uncomfortable when faced with the management of obesity. The investigators have therefore developed a clinical preceptorship for PCPs; this continuing medical education (CME) activity aims at engaging PCPs in obesity/overweight management. The current research proposal is aimed at the development and implementation of an innovative, integrated, interdisciplinary obesity care management system involving both primary and secondary health care professionals. The investigators hypothesize that CME based on preceptorships in combination with electronic tools (web site and virtual community), networking primary care (FMGs) and secondary care health professionals, will increase the knowledge, modify attitudes and perceptions of health care professionals and increase their sense of self-efficacy. Furthermore, this intervention should modify health care organization regarding obesity management and eventually improve accessibility to optimal obesity care. The investigators will use both action (objectives 1-2) and evaluative (objectives 3-5) research in order to attain specific objectives: 1) Develop and implement a preceptorship-based CME complemented by a web site for physicians and nurses working in Family Medicine Groups (FMGs). This CME will be based on needs assessment and will be validated by one FMG using questionnaires and semi structured interviews. Also, references and teaching tools will be available for participants on the web site. 2) Establish a collaborative intra/inter-regional interdisciplinary network to enable on-going expertise update and networking for FMG teams. This tool consists of a discussion forum including exchanges about difficult "cases" and a monthly virtual meeting of all participants. 3) Evaluate the implementation of this integrated system at the level of the ability to form a number of 8 FMGs/year, access and utilization of the electronic tools and participants' satisfaction (physicians, nurses and experts). This will be measured with the help of questionnaires and web logging tools. Questionnaires and group interviews will also be performed in order to evaluate participants' satisfaction. 4) Determine the impact for the participants at the level of knowledge and expertise, attitudes and perceptions, and self-efficacy regarding the management of obesity. Questionnaires and interviews will be used to this purpose. 5) Deliver transferable knowledge for health professionals and decision-makers. Strategies and pitfalls of setting up this program will be identified, performance indicators series will be developed and accessibility to care will be evaluated for each FMG and the 2nd line team. A knowledge transfer plan will be elaborated and applied.

The overall goal of this proposal is to determine the autonomic and nitric oxide contribution in the pathogenesis of hypertension and insulin resistance in obese African American women. For this purpose we will use two non-FDA approved drugs: Trimethaphan IND# 63826 Approval date 12/20/2001 L-NMMA IND# 41735 Approval date 09/1993