Publications
174 results found
Miras AD, Seyfried F, Phinikaridou A, et al., 2014, Rats fed diets with different energy contribution from fat do not differ in adiposity, Obesity Facts, Vol: 7, Pages: 302-310, ISSN: 1662-4025
Objective: To determine whether rats reaching the same body mass, having been fed either a low-fat (LFD) or a high-fat diet (HFD), differ in white adipose tissue (WAT) deposition. Methods: In experiment 1, 22 Sprague-Dawley rats of the same age were divided into 11 rats with body mass below the batch median and fed a HFD, and 11 above the median and fed a LFD. In experiment 2, 20 Sprague-Dawley rats of the same age and starting body mass were randomised to either a HFD or LFD. When all groups reached similar final body mass, WAT was quantified using magnetic resonance imaging (MRI), dissection, and plasma leptin. Results: In experiment 1, both groups reached similar final body mass at the same age; in experiment 2 the HFD group reached similar final body mass earlier than the LFD group. There were no significant differences in WAT as assessed by MRI or leptin between the HFD and LFD groups in both experiments. Dissection revealed a trend for higher retroperitoneal and epididymal adiposity in the HFD groups in both experiments. Conclusions: We conclude that at similar body mass, adiposity is independent of the macronutrient composition of the feeding regimen used to achieve it.
Perry LM, Towey DJ, Chuah L, et al., 2014, Validation of Glomerular Filtration Rate Calculation Using Cr-51 EDTA in the Obese Population, Annual Congress of the European-Association-of-Nuclear-Medicine (EANM), Publisher: SPRINGER, Pages: S577-S577, ISSN: 1619-7070
Behary P, Miras AD, 2014, Brain responses to food and weight loss, EXPERIMENTAL PHYSIOLOGY, Vol: 99, Pages: 1121-1127, ISSN: 0958-0670
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- Citations: 18
Miras AD, Al-Najim W, Jackson SN, et al., 2014, Psychological characteristics, eating behavior, and quality of life assessment of obese patients undergoing weight loss interventions., Scand J Surg, ISSN: 1457-4969
Bariatric surgery is the most effective treatment for obesity. However, not all patients have similar weight loss following surgery and many researchers have attributed this to different pre-operative psychological, eating behavior, or quality-of-life factors. The aim of this study was to determine whether there are any differences in these factors between patients electing to have bariatric surgery compared to less invasive non-surgical weight loss treatments, between patients choosing a particular bariatric surgery procedure, and to identify whether these factors predict weight loss after bariatric surgery.
Angelopoulos T, Kokkinos A, Liaskos C, et al., 2014, The effect of slow spaced eating on hunger and satiety in overweight and obese patients with type 2 diabetes mellitus., BMJ Open Diabetes Research and Care, Vol: 2, ISSN: 2052-4897
BACKGROUND: Slow spaced eating is associated with improved satiety and gut hormone responses in normal-weight participants. This crossover study compared the effect of slow and rapid eating patterns on hunger, fullness, glucose, insulin, and the appetite-related gut hormones peptide YY (PYY), glucagon-like peptide-1 (GLP-1), and ghrelin in overweight and obese participants with type 2 diabetes mellitus (T2DM). METHODS: 20 overweight and obese participants with T2DM on metformin were recruited. A test meal of 300 mL ice-cream was consumed in random order in two different sessions by each participant; meal duration was 5 or 30 min. Fullness and hunger as assessed by visual analog scales (VAS), and glucose, insulin, PYY, GLP-1, and ghrelin were measured at baseline and at 30 min intervals after meal termination for 3 h. RESULTS: Fullness VAS ratings were significantly higher at the 90', 120', 150', and 180' time points and hunger ratings were lower at 90', 150', and 180' for the 30 min meal. The area under the curve (AUC) for fullness was higher after the 30 min meal than after the 5 min meal (11 943.7±541.2 vs 10 901.0±568.8 mm min, p=0.003) whereas the hunger AUC was lower (4442.9±328 vs 4966.7±347.5 mm min, p=0.012). There were no differences in glucose, insulin, PYY, GLP-1, and ghrelin responses. CONCLUSIONS: Slow spaced eating increased fullness and decreased hunger ratings in overweight and obese participants with T2DM, without the improvement in gut hormone responses found in normal-weight participants. Slow spaced eating may be a useful prevention strategy, but might also help curb food intake in those already suffering from obesity and diabetes.
Scholtz S, Miras AD, Chhina N, et al., 2014, Obese patients after gastric bypass surgery have lower brain-hedonic responses to food than after gastric banding, GUT, Vol: 63, Pages: 891-902, ISSN: 0017-5749
Scholtz S, Miras AD, Chhina N, et al., 2014, Obese patients after gastric bypass surgery have lower brain-hedonic responses to food than after gastric banding, Gut, Vol: 63, Pages: 891-902, ISSN: 0017-5749
Objectives Roux-en-Y gastric bypass (RYGB) has greater efficacy for weight loss in obese patients than gastric banding (BAND) surgery. We hypothesise that this may result from different effects on food hedonics via physiological changes secondary to distinct gut anatomy manipulations.Design We used functional MRI, eating behaviour and hormonal phenotyping to compare body mass index (BMI)-matched unoperated controls and patients after RYGB and BAND surgery for obesity.Results Obese patients after RYGB had lower brain-hedonic responses to food than patients after BAND surgery. RYGB patients had lower activation than BAND patients in brain reward systems, particularly to high-calorie foods, including the orbitofrontal cortex, amygdala, caudate nucleus, nucleus accumbens and hippocampus. This was associated with lower palatability and appeal of high-calorie foods and healthier eating behaviour, including less fat intake, in RYGB compared with BAND patients and/or BMI-matched unoperated controls. These differences were not explicable by differences in hunger or psychological traits between the surgical groups, but anorexigenic plasma gut hormones (GLP-1 and PYY), plasma bile acids and symptoms of dumping syndrome were increased in RYGB patients.Conclusions The identification of these differences in food hedonic responses as a result of altered gut anatomy/physiology provides a novel explanation for the more favourable long-term weight loss seen after RYGB than after BAND surgery, highlighting the importance of the gut–brain axis in the control of reward-based eating behaviour.
Goldstone AP, Prechtl CG, Scholtz S, et al., 2014, Ghrelin mimics fasting to enhance human hedonic, orbitofrontal cortex, and hippocampal responses to food, AMERICAN JOURNAL OF CLINICAL NUTRITION, Vol: 99, Pages: 1319-1330, ISSN: 0002-9165
Chuah LL, Miras AD, Papamargaritis D, et al., 2014, Effect of Roux-en-Y Gastric Bypass Surgery on Microvascular Complications of Type 2 Diabetes Mellitus, Publisher: AMER DIABETES ASSOC, Pages: A525-A525, ISSN: 0012-1797
Miras AD, Scholtz S, Chhina N, et al., 2014, Role for Increased Plasma PYY and GLP-1 in Reducing Anticipatory Food Reward after Gastric Bypass Surgery, ENDOCRINE REVIEWS, Vol: 35, ISSN: 0163-769X
Chakravartty S, Sarma D, Miras A, et al., 2014, ENDOBARRIER: A BRIDGE TO SURGERY IN MORBIDLY OBESE PATIENTS?, GUT, Vol: 63, Pages: A6-A6, ISSN: 0017-5749
Miras AD, Le Roux CW, 2014, Mechanisms of bariatric surgery, Treatment of the Obese Patient, Pages: 137-148, ISBN: 9781493912025
Bariatric surgery has been shown to be the most effective treatment for obesity and T2DM, both in large well-matched clinical studies and randomised controlled trials. In this chapter, we have discussed the clinical efficacy of bariatric surgery and the physiological mechanisms through which it causes weight loss and improved metabolic control. We have limited our focus to the Roux-en-Y gastric bypass, the adjustable gastric band and the vertical sleeve gastrectomy, the procedures that have stood the test of time and are most commonly performed around the world.
Tako AA, Kotiadis K, Vasilakis C, et al., 2014, Improving patient waiting times: a simulation study of an obesity care service, BMJ Quality & Safety, Vol: 23, Pages: 373-381, ISSN: 2044-5415
Background Obesity care services are often faced with the need to adapt their resources to rising levels of demand. The main focus of this study was to help prioritise planned investments in new capacity allowing the service to improve patient experience and meet future anticipated demand.Methods We developed computer models of patient flows in an obesity service in an Academic Health Science Centre that provides lifestyle, pharmacotherapy and surgery treatment options for the UK's National Health Service. Using these models we experiment with different scenarios to investigate the likely impact of alternative resource configurations on patient waiting times.Results Simulation results show that the timing and combination of adding extra resources (eg, surgeons and physicians) to the service are important. For example, increasing the capacity of the pharmacotherapy clinics equivalent to adding one physician reduced the relevant waiting list size and waiting times, but it then led to increased waiting times for surgical patients. Better service levels were achieved when the service operates with the resource capacity of two physicians and three surgeons. The results obtained from this study had an impact on the planning and organisation of the obesity service.Conclusions Resource configuration combined with demand management (reduction in referral rates) along the care service can help improve patient waiting time targets for obesity services, such as the 18 week target of UK's National Health Service. The use of simulation models can help stakeholders understand the interconnectedness of the multiple microsystems (eg, clinics) comprising a complex clinical service for the same patient population, therefore, making stakeholders aware of the likely impact of resourcing decisions on the different microsystems.
Neff KJ, Chuah LL, Aasheim ET, et al., 2014, Beyond Weight Loss: Evaluating the Multiple Benefits of Bariatric Surgery After Roux-en-Y Gastric Bypass and Adjustable Gastric Band, OBESITY SURGERY, Vol: 24, Pages: 684-691, ISSN: 0960-8923
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- Citations: 17
Sarma D, Chakravartty S, Murgatroyd B, et al., 2014, Risk reducing strategy in super obese patients: the potential role for the Endobarrier, 5th Annual Scientific Meeting of the British-Obesity-and-Metabolic-Surgery-Society (BOMSS), Publisher: WILEY-BLACKWELL, Pages: 8-9, ISSN: 0007-1323
Miras AD, le Roux CW, 2014, Can medical therapy mimic the clinical efficacy or physiological effects of bariatric surgery?, INTERNATIONAL JOURNAL OF OBESITY, Vol: 38, Pages: 325-333, ISSN: 0307-0565
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- Citations: 45
Chuah LL, Miras A, Olbers T, et al., 2014, Effect of intensive preoperative and postoperative glucose management on glycaemic outcome after Roux-en-Y gastric bypass surgery, DIABETIC MEDICINE, Vol: 31, Pages: 94-95, ISSN: 0742-3071
Jurowich CF, Seyfried F, Miras AD, et al., 2014, Does bariatric surgery change olfactory perception? Results of the early postoperative course, INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, Vol: 29, Pages: 253-260, ISSN: 0179-1958
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- Citations: 19
Miras AD, le Roux CW, 2014, Metabolic surgery: shifting the focus from glycaemia and weight to end-organ health, LANCET DIABETES & ENDOCRINOLOGY, Vol: 2, Pages: 141-151, ISSN: 2213-8587
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- Citations: 24
Neff KJ, Prener C, Chuah LL, et al., 2014, A holistic assessment of bariatric surgical outcomes in a Northern Irish cohort., Ir Med J, Vol: 107, Pages: 24-26, ISSN: 0332-3102
The King's Obesity Staging system was developed to evaluate the effect of obesity treatments in multiple physical, psychological and functional domains. In this prospective cohort study, a Northern Irish cohort was scored using the King's Obesity Staging system before and 1 year after bariatric surgery. 71 individuals underwent surgery and 31 (44%) had type 2 diabetes. Bariatric surgery improved each health domain (p < 0.05). A subgroup with type 2 diabetes showed a significantly greater improvement in gonadal disease (polycystic ovarian syndrome and sub-fertility) (p = 0.02), and a trend towards greater improvement in cardiovascular disease (p = 0.07) compared with the non-diabetic subgroup. Half of those with pre-diabetes were normoglycaemic postoperatively (p < 0.05). The King's Obesity Staging system can be used to holistically evaluate the outcomes of bariatric surgery. Patients benefit from bariatric surgery in many ways, but those with diabetes may benefit more.
Miras AD, Risstad H, Baqai N, et al., 2014, Application of the International Diabetes Federation and American Diabetes Association criteria in the assessment of metabolic control after bariatric surgery, DIABETES OBESITY & METABOLISM, Vol: 16, Pages: 86-89, ISSN: 1462-8902
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- Citations: 15
Le Roux C, Miras A, Risstad H, et al., 2013, Application of the International Diabetes Federation and American Diabetes Association Criteria in the Assessment of Metabolic Control After Bariatric Surgery, OBESITY SURGERY, Vol: 23, Pages: 1147-1147, ISSN: 0960-8923
Seyfried F, Reimer S, Miras AD, et al., 2013, Successful treatment of a gastric leak after bariatric surgery using endoluminal vacuum therapy, ENDOSCOPY, Vol: 45, Pages: E267-E268, ISSN: 0013-726X
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- Citations: 20
Seyfried F, Miras AD, Bueter M, et al., 2013, Effects of preoperative exposure to a high-fat versus a low-fat diet on ingestive behavior after gastric bypass surgery in rats, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 27, Pages: 4192-4201, ISSN: 0930-2794
Neff KJ, Miras AD, le Roux C, 2013, Duodenal-jejunal bypass liners: outcomes in glycaemic control and weight loss, CURRENT OPINION IN ENDOCRINOLOGY DIABETES AND OBESITY, Vol: 20, Pages: 420-428, ISSN: 1752-296X
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- Citations: 3
Miras AD, le Roux CW, 2013, Mechanisms underlying weight loss after bariatric surgery, NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY, Vol: 10, Pages: 575-584, ISSN: 1759-5045
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- Citations: 219
Le Roux C, Chuah L, Baqai N, et al., 2013, Effect of Roux-en-Y Gastric Bypass Surgery on Diabetes Neuropathy, 18th World Congress of the International-Federation-for-the-Surgery-of-Obesity-and-Metabolic-Disorders (IFSO), Publisher: SPRINGER, Pages: 1115-1116, ISSN: 0960-8923
Meillon S, Jackson S, Miras A, et al., 2013, Are Gut Hormones Responsible for the Decrease of Appetitive Behaviour for Sweet and Fatty Foods After Gastric Bypass Surgery?, 18th World Congress of the International-Federation-for-the-Surgery-of-Obesity-and-Metabolic-Disorders (IFSO), Publisher: SPRINGER, Pages: 1076-1076, ISSN: 0960-8923
Jackson S, Shah P, Mohite A, et al., 2013, Investigation of the Effects of RYGB Surgery on the Intensity and Consummatory Reward Value of Combined Fat and Sweet Taste, 18th World Congress of the International-Federation-for-the-Surgery-of-Obesity-and-Metabolic-Disorders (IFSO), Publisher: SPRINGER, Pages: 1125-1125, ISSN: 0960-8923
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- Citations: 1
Meillon S, Miras AD, Le Roux CW, 2013, Gastric bypass surgery alters food preferences through changes in the perception of taste, Clinical Practice, Vol: 10, Pages: 471-479, ISSN: 2044-9038
Roux-en-Y gastric bypass is one of the most effective treatments for morbid obesity as it results in long-term weight loss and significant remission of obesity-related comorbidities. Although it is successful in causing weight loss, the underlying mechanisms are not completely understood. A significant decrease in calorie intake related to a shift in food preferences towards lower-calorie-dense foods has been observed after the surgery. This modification in ingestive behavior occurs through changes in the sensory and reward domain of taste. Potential mediators of these taste modifications are the exaggerated levels of gut hormones or altered gut nutrient sensing. Understanding the molecular mechanisms involved in the Roux-en-Y gastric bypass-induced taste/food preference modifications would be crucial for the development of 'knifeless' treatments. © 2013 Future Medicine Ltd.
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