New Weight Loss Device Makes You Feel Full

People who are obese have a new tool in their arsenal for fighting excess weight.

The U.S. Food and Drug Administration approved a medical device called the Maestro Rechargeable System that is implanted in the stomach and, through an external, adjustable controller, helps obese people lose weight. It is approved for patients 18 and older who have a body mass index of 35 to 45, have a condition related to being obese such as type 2 diabetes, and have not been able to lose weight through traditional means. 

The Maestro Rechargeable System targets nerve pathways between the brain and the stomach that are responsible for making a person feel full. In a clinical trial, patients using the device lost 8.5% more weight than people who received an inactive version of it. About 53% of the patients with the device lost at least 20% of their excess weight, and 38% lost at least 25%.

But compared with bariatric surgery, the trial’s results are not as impressive. Eric T. Volckmann, M.D., who specializes in bariatric surgery at University of Utah Health Care, says that after gastric bypass surgery, patients can expect to lose 60% to 80% of their excess body weight.

Bariatric surgery is a highly invasive procedure. But so is implantation of the Maestro Rechargeable System. 

“Any procedure, no matter how small, is still risky,” Volckmann says.

Furthermore, Volckmann says the long-term effects of the device are not as well understood as those of bariatric surgery. He says more research is needed before he would recommend the Maestro Rechargeable System for a severely obese patient.

In the future, the device may make sense for a patient with a BMI between 30 and 35 who is not responding to medical weight loss measures such as lifestyle modifications.

Source: University of Utah

Virtual reality speeds up rehabilitation: Integrating force feedback into therapies

A child is receiving virtual door opening training under the guidance of a therapist. Credit: Copyright The Hong Kong Polytechnic University

The Hong Kong Polytechnic University has successfully developed a novel training programme using haptic technology for impaired hands that cannot function normally. This programme is unique as it provides force feedback, which creates a true sense of weight to the user through the control device.

Our hands are essential to our lives; we need them in all daily tasks including eating, bathing and getting dressed. However, even the simplest tasks are challenging for people with impaired hands due to various conditions such as cerebral palsy, stroke and ageing. Fortunately, they will soon benefit from a new training technology which may greatly improve their conditions.

In response to therapeutic needs, a computerized training programme against impaired hands has been developed at the School of Nursing of The Hong Kong Polytechnic University. Patients being trained are supposed to exercise their hands through playing a series of well-designed computer games that simulate everyday tasks, such as opening a locked door with a key or pouring tea into a cup. While playing, their hand movements are monitored and recorded by a haptic device, which is connected to the control unit held by the patient at one end, and a computer at the other. The haptic device then feeds the data into the computer, resulting in the instant reflection of the patient's actions in the animation on screen.

In addition, the haptic technology which the programme employs is more true-to-life than similar programmes, as feedback is provided through the force created by the control unit to players. For example, they can literally feel the weight of a simulated bottle diminishing as the water is being poured out. Such kind of precision will greatly enhance training effectiveness and improve the patient's coordination.

Game-based therapies are highly motivating. Firstly, playing 3D games in colourful animation is more interesting than monotonous physical exercises. Secondly, a reward system incorporated in the programme is sure to fuel a sense of competition and accomplishment. "Our games are designed to be engaging. When players make successful attempts, they get bonus points. And as they win, they move on to the next level, where more attractive rewards are waiting," said Dr Kup-sze Choi, the leader of the research team. It is satisfying for players to work their way up and keep going with the therapy, thereby improving their hand functions.

Compared to physical training, computer simulated training is a safer option when sharp or breakable objects are involved, making practices on preparing simple meals with a knife possible. It is also less likely to be interrupted by undesired circumstances. Dr Choi explained, "For instance, the hands of cerebral palsy sufferers are usually stiff, weak and prone to uncontrolled movements. If they practise pouring real tea in repeated sessions, they may make spills all over the place and end up soaking wet, requiring the healthcare workers to clean up the mess. That is not a good thing for both the trainee and the trainer." With computer simulation, there will be no such interruptions.

To cater to different degrees of disability, the programme has a built-in difficulty mode with which the level of difficulty can be adjusted with the touch of a button. Therapists can also monitor their patients' progress easily, as the system keeps track of their movements and performance.

The effectiveness of this training programme was preliminarily confirmed, as a similar tool aimed to improve hand-writing was tested on the children at the Hong Kong Red Cross Princess Alexandra School. The results have shown a marked improvement in the time they needed to complete the task after two weeks of training. More tests and trials are on the way, and the team expect that a longer period of computer-assisted training will yield greater benefits. The training system has already won a Silver Medal at the 42nd International Exhibition of Inventions of Geneva in Switzerland.

According to Dr Choi, computer simulated training using haptic technology will widen the access to rehabilitation and help more patients with impaired hands . In the future, the team will work on combining this computer-aided rehabilitation programme with traditional therapy in order to optimize the training system and benefit more patients. The prototype of the haptic platform customized for self-care training Copyright : The Hong Kong Polytechnic University The haptic platform technology developed by Dr Kup-sze Choi and his team has won a Silver Medal at the 42nd International Exhibition of Inventions of Geneva. 

Copyright : The Hong Kong Polytechnic University

Source: The Hong Kong Polytechnic University

Tailored 'activity coaching' by smartphone

Tailored activity monitoring. Credit: Image courtesy of University of Twente

Today's smartphone user can obtain a lot of data about his or her health, thanks to built-in or separate sensors. Researcher Harm op den Akker of the University of Twente (CTIT Institute) now takes this health monitoring to a higher level. Using the system he developed, the smartphone also acts as an 'activity coach': it advices the user to walk or take a rest. In what way the user wants to be addressed, is typically something the system learns by itself. Op den Akker conducted his research at Roessingh Research and Development in Enschede. October 17, he defends his PhD-thesis.

The new telemedicine system was tested for three months, among a group of COPD patients -- a chronic lung disease. For these patients, physical activity is very important but it can also lead to an oppressed feeling and thus, to over-cautiousness. Using the coaching system of Van den Akker, the patients carry a small movement sensor and a smartphone. The system calculates if it is advisable to take a rest or, on the other hand, have a walk. The system is 'context aware': it looks at the time of day, the weather, the surroundings of the patient and determines if the time is right for taking some exercise.

Tone of voice

In addition, the system knows how the patient wants to be addressed. Some people don't mind an imperative tone of voice 'go for a 10 minutes' walk', others prefer a more friendly advice: 'what if you would take a walk in the park?' Op den Akker designed learning algorithms for this: the system learns the preferences of the user by itself. Future versions of the system may not use text messages anymore, but an 'avatar' on the screen, enabling interaction with the user as well. For this, Op den Akker has started starting cooperation with the Human Media Interaction group of the University of Twente.

Roessingh Research & Development (RRD) is the research department of Roessingh rehabilitation centre in Enschede, The Netherlands. RRD closely cooperates with the University of Twente in many projects. Op den Akker conducted his research at RRD and UT's CTIT Institute, under supervision of Hermie Hermens, Professor in Neuromuscular Control and Telemedicine. A spin-off company of the university, Inertia Technology, developed the movement sensor used in this project.

Op den Akker's PhD-thesis is titled 'Smart tailoring of real-time physical activity coaching systems'.

Source: University of Twente

Intelligent training with a fitness shirt and an e-bike

The FitnessSHIRT reads out physiological signals like pulse and breath continuously when worn. The interpreted data can be viewed on a smartphone or tablet PC, for example. Credit: © Fraunhofer IIS

Fabric manufacturers are experiencing a revolution at present: if clothing previously offered protection against the cold, rain, and snow, the trend now is toward intelligent, proactive, high-tech textiles like self-cleaning jackets, gloves that recognize toxins, and ski anoraks with integrated navigational devices to make life easier for those wearing them.

Most clever clothing is only at the prototype stage. It is by no means off-the-rack yet. Soon the FitnessSHIRT from the Fraunhofer Institute for Integrated Circuits IIS in Erlangen, Germany, will be ready for the mass market. It continuously measures physiological signals such as breathing, pulse, and changes in heart rate -- metrics of adaptability and stress load. The intelligent sports shirt is expected to be available sometime in the next year, as an investor is already on-board.

Smart electronics are hidden in the material

Conductive textile electrodes integrated into the shirt's material capture the wearer's cardio activity. In addition, an elastic band around the upper body senses the motion of the chest during breathing. A removable electronic unit attached with snaps digitizes the raw data and calculates additional parameters like pulse rate or breath rate with the help of algorithms. The data are transmitted via radio link to a smartphone or optionally to a PC, where they are evaluated further and can be stored. These parameters form the basis for judging vital functions like stress, performance, exertion, or relaxation.

"The FitnessSHIRT can be employed a number of ways. It offers completely new options for the pursuit of sports, leisure activities, and wellness, as well as options for the medical branch," says Christian Hofmann, an engineer at IIS. For example, it could act as a training partner to provide seniors or rehabilitation patients with feedback on their vital signs during exercises or bicycling, and protect them from overexertion. Athletes will also benefit: for one thing, the SHIRT is more comfortable to wear than a chest strap. For another, the integrated sensors deliver more detailed information. Besides pulse and respiration, accelerometers sense the movement of the user and carry out an analysis. "If the pulse rate is high, for example, while the breath rate and the exercise activity is low, it could be a sign of possible heart problems," according to Hofmann.

The developers of the MENTORbike are also persuaded by the high degree of comfort when worn and the possibilities for performance diagnostics. MENTORbike is a new type of training device consisting of a pedelec, a smartphone, and an intelligent user service site on the internet. The project partners, led by BitifEye Digital Test Solutions, want to use the pedelec in combination with the FitnessSHIRT from IIS in future. The SHIRT will have a wireless connection via smartphone to the pedelec and the user service site on the internet, where the data can be viewed, analyzed, and documented. The smartphone mounted on the bicycle handlebars collects the vital parameters it receives like pulse and breath rate as well as the physical data, for instance the energy expended and the speed, analyzes them, and cuts in the electric motor as needed.

"If the pulse rate exceeds a maximum value of 150, for example, the rider is supported by the motor taking some of the load. If the pulse rate falls below a value of 80 beats per minute, the electric motor is throttled back and the pedal loading increased again. The motor output adapts automatically to the fitness of the cyclist," explains Markus Gratzfeld, an engineer with BitifEye. In this way, users are assured of an optimal level of training at all times, with neither over- nor under-exertion. Rehabilitation patients, especially persons with cardiovascular disease, could monitor their performance limits better, exercise more confidently, and increase their range of movement.

Source: Fraunhofer-Gesellschaft

Body weight heavily influenced by gut microbes: Genes shape body weight by affecting gut microbes

Body sizes (stock image). New research shows that our genetic makeup influences whether we are fat or thin by shaping which types of microbes thrive in our body. Credit: © olly / Fotolia

Our genetic makeup influences whether we are fat or thin by shaping which types of microbes thrive in our body, according to a study by researchers at King's College London and Cornell University.

By studying pairs of twins at King's Department of Twin Research, researchers identified a specific, little known bacterial family that is highly heritable and more common in individuals with low body weight. This microbe also protected against weight gain when transplanted into mice.

The results, published today in the journal Cell, could pave the way for personalised probiotic therapies that are optimised to reduce the risk of obesity-related diseases based on an individual's genetic make-up.

Previous research has linked both genetic variation and the composition of gut microbes to metabolic disease and obesity. Despite these shared effects, the relationship between human genetic variation and the diversity of gut microbes was presumed to be negligible.

In the study, funded by National Institutes of Health (NIH), researchers sequenced the genes of microbes found in more than 1,000 fecal samples from 416 pairs of twins. The abundances of specific types of microbes were found to be more similar in identical twins, who share 100 per cent of their genes, than in non-identical twins, who share on average only half of the genes that vary between people. These findings demonstrate that genes influence the composition of gut microbes.

The type of bacteria whose abundance was most heavily influenced by host genetics was a recently identified family called 'Christensenellaceae'. Members of this health-promoting bacterial family were more abundant in individuals with a low body weight than in obese individuals. Moreover, mice that were treated with this microbe gained less weight than untreated mice, suggesting that increasing the amounts of this microbe may help to prevent or reduce obesity.

Professor Tim Spector, Head of the Department of Twin Research and Genetic Epidemiology at King's College London, said: 'Our findings show that specific groups of microbes living in our gut could be protective against obesity -- and that their abundance is influenced by our genes. The human microbiome represents an exciting new target for dietary changes and treatments aimed at combating obesity.

'Twins have been incredibly valuable in uncovering these links -- but we now want to promote the use of microbiome testing more widely in the UK through the British Gut Project. This is a crowd-sourcing experiment that allows anyone with an interest in their diet and health to have their personal microbes tested genetically using a simple postal kit and a small donation via our website (www.britishgut.org). We want thousands to join up so we can continue to make major discoveries about the links between our gut and our health.'

Ruth Ley, Associate Professor at Cornell University in the United States, said: 'Up until now, variation in the abundances of gut microbes has been explained by diet, the environment, lifestyle, and health. This is the first study to firmly establish that certain types of gut microbes are heritable -- that their variation across a population is in part due to host genotype variation, not just environmental influences. These results will also help us find new predictors of disease and aid prevention.'

Source: King's College London

Weigh-in once a week or you'll gain weight

The researchers found that weight loss was related to how often individuals weighed themselves. Credit: Image courtesy of Cornell Food & Brand Lab

Stepping on the scale is common among dieters but how does the frequency of weigh-ins impact weight? A new study in PLOS ONE showed that the more frequently dieters weighed themselves the more weight they lost, and if participants went more than a week without weighing themselves, they gained weight.

The researchers analyzed 2,838 weight measurements (up to a years' worth of weigh-ins) from 40 overweight individuals (with a body mass index of 25 and over) who indicated that weight loss was a personal goal or concern. The researchers found that weight loss was related to how often individuals weighed themselves. "The more often you weigh yourself the more weight you lose," says to lead author Elina Helander from Tempere Univeristy of Technology in Finland. This observational study cannot prove causation -- it may be that less serious dieters weight themselves less or that dieters who stop losing weight stop weighting themselves. The average time that participants could go between weighting without gaining weight was 5.8 days or about a weekly weigh-in.

Previous Findings by the Research Team

Weigh yourself at least once a week if you wish to lose weight, and weighing yourself everyday may help you stay on track. A previous study by the same research team found that your weight naturally fluctuates throughout the week and that most people weigh the least on Wednesday. To summarize both studies Brian Wansink, PhD, Director of the Cornell Food and Brand Lab and author of Slim by Design: Mind Eating Solutions for Everyday Life advises, "The bottom line is: If you want to lose weight, it's best to weigh yourself every day. But if you weigh yourself only once a week, do it on Wednesday because that will give you the most accurate reading."

Source: Cornell Food & Brand Lab

When you lose weight, where does the fat go? Most of the mass is breathed out as carbon dioxide, study shows

Despite a worldwide obsession with diets and fitness regimes, many health professionals cannot correctly answer the question of where body fat goes when people lose weight.
Credit: © Lovrencg / Fotolia

Despite a worldwide obsession with diets and fitness regimes, many health professionals cannot correctly answer the question of where body fat goes when people lose weight, a UNSW Australia study shows.

The most common misconception among doctors, dieticians and personal trainers is that the missing mass has been converted into energy or heat.

"There is surprising ignorance and confusion about the metabolic process of weight loss," says Professor Andrew Brown, head of the UNSW School of Biotechnology and Biomolecular Sciences.

"The correct answer is that most of the mass is breathed out as carbon dioxide. It goes into thin air," says the study's lead author, Ruben Meerman, a physicist and Australian TV science presenter.

In their paper, published in the British Medical Journal today, the authors show that losing 10 kilograms of fat requires 29 kilograms of oxygen to be inhaled and that this metabolic process produces 28 kilograms of carbon dioxide and 11 kilograms of water.

Mr Meerman became interested in the biochemistry of weight loss through personal experience.

"I lost 15 kilograms in 2013 and simply wanted to know where those kilograms were going. After a self-directed, crash course in biochemistry, I stumbled onto this amazing result," he says.

"With a worldwide obesity crisis occurring, we should all know the answer to the simple question of where the fat goes. The fact that almost nobody could answer it took me by surprise, but it was only when I showed Andrew my calculations that we both realised how poorly this topic is being taught."

The authors met when Mr Meerman interviewed Professor Brown in a story about the science of weight loss for the Catalyst science program on ABC TV in March this year.

"Ruben's novel approach to the biochemistry of weight loss was to trace every atom in the fat being lost and, as far as I am aware, his results are completely new to the field," says Professor Brown.

"He has also exposed a completely unexpected black hole in the understanding of weight loss amongst the general public and health professionals alike."

If you follow the atoms in 10 kilograms of fat as they are 'lost', 8.4 of those kilograms are exhaled as carbon dioxide through the lungs. The remaining 1.6 kilograms becomes water, which may be excreted in urine, faeces, sweat, breath, tears and other bodily fluids, the authors report.

"None of this is obvious to people because the carbon dioxide gas we exhale is invisible," says Mr Meerman.

More than 50 per cent of the 150 doctors, dieticians and personal trainers who were surveyed thought the fat was converted to energy or heat.

"This violates the Law of Conservation of Mass. We suspect this misconception is caused by the energy in/energy out mantra surrounding weight loss," says Mr Meerman.

Some respondents thought the metabolites of fat were excreted in faeces or converted to muscle.

"The misconceptions we have encountered reveal surprising unfamiliarity about basic aspects of how the human body works," the authors say.

One of the most frequently asked questions the authors have encountered is whether simply breathing more can cause weight loss. The answer is no. Breathing more than required by a person's metabolic rate leads to hyperventilation, which can result in dizziness, palpitations and loss of consciousness.

The second most frequently asked question is whether weight loss can cause global warming.

"This reveals troubling misconceptions about global warming which is caused by unlocking the ancient carbon atoms trapped underground in fossilised organisms. The carbon atoms human beings exhale are returning to the atmosphere after just a few months or years trapped in food that was made by a plant," says Mr Meerman, who also presents the science of climate change in high schools around Australia.

Mr Meerman and Professor Brown recommend that these basic concepts be included in secondary school curricula and university biochemistry courses to correct widespread misconceptions about weight loss among lay people and health professionals.

Source: University of New South Wales

Moderate consumption of sugary drinks has little impact on adolescents' metabolic health

Sugar-sweetened beverages, such as soft drinks, are the largest source of added sugar in the diets of adolescents in the United States. Credit: Image courtesy of University of Missouri-Columbia

Sugar-sweetened beverages are the largest source of added sugar in the diets of adolescents in the United States, and young adults ages 15-20 consume more of these drinks than any other age group, according to the Centers for Disease Control and Prevention. Adolescent obesity rates, which have quadrupled over the past thirty years, led to widespread scrutiny of added dietary sugars, especially those found in carbonated beverages. Now, MU researchers have found that short-term, moderate consumption of high-fructose and high-glucose beverages has little impact on the metabolic health of weight-stable, physically active adolescents.

"These beverages may not be as unhealthy for adolescents as previously thought, provided that kids stay active," said Jill Kanaley, professor and associate chair in the MU Department of Nutrition and Exercise Physiology. "That physical activity component is really critical in protecting against some of the negative effects of drinking large amounts of sugar-sweetened drinks demonstrated in previous studies."

Kanaley's study measured several aspects of metabolic health, including insulin sensitivity and cholesterol levels, after participants had consumed moderate amounts of either high-glucose or high-fructose beverages every day for two weeks. The high-glucose drink contained 50 grams of glucose and 15 grams of fructose; the high-fructose drink contained 50 grams of fructose and 15 grams of glucose. In comparison, two 12-ounce cans of white soda contain about 50 grams of fructose, although the amount of sugar found in soft drinks varies by brand and type. The researchers used armbands with electronic sensors to monitor physical activity of the participants, all of whom were healthy male and female adolescents ages 15-20.

Although some research has shown that consuming sugary drinks can have detrimental metabolic effects, Kanaley said that the results of these studies have been inconsistent. Previous research often has excluded adolescents and did not measure participants' levels of physical activity. In one of her previous studies, which recently was published in Medicine in Science and Sports, Kanaley found that increased physical activity diminished negative effects associated with high-fructose diets.

"Many parents of adolescents worry about their children's consumption of sweetened beverages," Kanaley said. "I certainly would recommend that they work to reduce their children's intake of sugary drinks, but it also is important for kids to remain active, especially if they are drinking a lot of sugary beverages. In our study, the female adolescents averaged around 8,000 steps per day, and the males averaged about 10,000 steps per day. 

These children weren't athletes, but they had active lifestyles."

Kanaley's article was published in the American Journal of Clinical Nutrition.

Source: University of Missouri-Columbia