Zusammenfassung Der Artikel gibt einen Überblick über Methoden zur Energieverbrauchsmessung als Basis für eine personalisierte Adipositastherapie, da pauschale Empfehlungen aufgrund der hohen individuellen Stoffwechselvariabilität oft scheitern. Es werden die Komponenten des Energieverbrauchs (Ruheenergieverbrauch (REE), nahrungsinduzierte Thermogenese (DIT), Aktivitätsenergieverbrauch (AEE)) sowie verschiedene Messmethoden kritisch verglichen: von Forschungs-Goldstandards (Stoffwechselkammer, doppeltmarkiertes Wasser (DLW)) bis hin zu klinischen Verfahren (Haubenkalorimetrie, Formeln, Bioelektrische Impedanzanalyse (BIA)). Zudem wird die Identifizierung von Stoffwechseltypen („sparsam“ vs. „verschwenderisch“) mittels funktioneller Tests erläutert. Die indirekte Haubenkalorimetrie ist der klinische Goldstandard zur REE-Messung und Schätzformeln oder BIA weit überlegen. Die Existenz „sparsamer“ Stoffwechseltypen mit starker metabolischer Anpassung ist klinisch relevant und kann durch funktionelle Tests prädiktiv für den Abnehmerfolg identifiziert werden. Aktuelle Wearables sind für den klinischen Einsatz noch zu ungenau. Die präzise Messung des Ruheenergieverbrauchs ist der Schätzung durch Formeln oder Wearables noch fundamental überlegen. Die Anerkennung individueller metabolischer Unterschiede ist entscheidend, um Therapieziele zu personalisieren und den Weg zu einer wirksamen, datengestützten Adipositasbehandlung zu ebnen.
Background: Recent research has highlighted the potential of postbiotics for addressing obesity and associated metabolic disorders. In this randomized, double-blind clinical trial, the efficacy of a postbiotic product in managing overweight and associated parameters was assessed. Methods: Sixty individuals were randomized into two groups: one group (n = 30) received the Postbiotic (heat-killed L. fermentum strain K8-Lb1) and the other (n = 30) a Placebo control. Body weight, waist circumference, body composition, vital signs, blood biomarkers and questionnaires for quality of life, eating behavior, eating control and gastrointestinal symptoms were assessed. Results: After a 12-week intervention, body fat mass (primary parameter) was significantly (p = 0.016) reduced in the Postbiotic group (98.15 ± 3.32% of baseline) compared to the Placebo group (100.41 ± 3.39%). In line with this, body weight (p = 0.047) and waist circumference (p = 0.034) were significantly reduced and visceral fat tended to be reduced (p = 0.053). Accordingly, the Postbiotic group tended (p = 0.066) to feel more in control of their body weight. Despite weight loss, muscle mass tended (p = 0.062) to increase. ALT, AST and GGT tended to be reduced, which may indicate an improvement in liver steatosis. Estimated average glucose (eAG) differed significantly between the groups in individuals with normal fasting glucose levels. The ability to concentrate significantly (p = 0.014) improved. Conclusions: Under an ad libitum diet, the postbiotic L. fermentum strain K8-Lb1 reduced body fat mass, body weight, and waist circumference, improved the ability to concentrate, and showed a trend towards an increase in muscle mass. The results of this pilot trial need confirmation by a pivotal trial.
Background Patients with depression often report recurring memories of stressful events from the past (e.g. experiences of rejection, emotional or physical abuse). These distressing memories, commonly dating back to childhood, can contribute to the development and maintenance of depression through their impact on cognitive schemas. The method of imagery rescripting (ImRs) addresses distressing memories and the associated emotions directly: With therapeutic support, patients recall the respective memory and modify the memory during imagination in such a way that the emotional quality and meaning of the memory changes. In this randomized trial, we will assess the impact of a three-session ImRs intervention within standard cognitive behaviour therapy (CBT) for depression, comparing it to an active control intervention (imagery relaxation). Method Sixty-six patients with MDD who are currently receiving treatment (CBT) will be randomized to either (1) the experimental condition (ImRs) or (2) the control condition (imagery relaxation). Reduction of depressive symptoms, measured by the Beck Depression Inventory (BDI-II) is the primary outcome. The BDI-II will be assessed at baseline, post-intervention, and at 4-week and 8-week follow-ups. Discussion This study will help to clarify whether adding three ImRs sessions improves the effectiveness of CBT for depression. We outline the next steps for future research and highlight the potential of this novel intervention for depression.
