Official Organ of EASO Editorial Representatives Ellen Blaak, Maastricht Hermann Toplak, Graz ...

272 Pages·2015·6.99 MB·English

Vol. 8, Supplement 1, May 2015
Official Organ of Editor-in-Chief Editorial Board
Hans Hauner, München Hans-Rudolf Berthoud, Baton Rouge, LA
EASO
European Association Ellen Blaak, Maastricht
for the Study of Obesity Assistant Editor Karine Clément, Paris
Nora Klöting, Leipzig Stefan Engeli, Hannover
Editorial Representatives
I. Sadaf Farooqi, Cambridge
Ellen Blaak, Maastricht
Associate Editor Gema Frühbeck, Pamplona
Hermann Toplak, Graz
Jennifer Lyn Baker, Frederiksberg Susanna Hofmann, Neuherberg
Matthias Blüher, Leipzig Martin Klingenspor, Freising
John E. Blundell, Leeds Max Lafontan, Toulouse
DAG
Deutsche Adipositas-Gesellschaft Ulrich Cuntz, Prien Julian G. Mercer, Aberdeen
Carl-Erik Flodmark, Malmö Vidya Mohamed-Ali, London
Editorial Representative Martin Fried, Prague Dénes Molnár, Pécs
Martin Wabitsch, Ulm Vojtech Hainer, Prague Ruben Nogueiras, Santiago de Compostela
Berit L. Heitmann, Copenhagen Jean-Michel Oppert, Paris
Anja Hilbert, Leipzig Andreas F. Pfeiffer, Potsdam
Affiliated with
Anke Hinney, Essen Paul T. Pfluger, Neuherberg
IFSO-EC Christina Holzapfel, Munich Stephan Rössner, Bromma
International Federation Jan Kopecký, Prague Jacob C. Seidell, Amsterdam
for the Surgery of Obesity
John Kral, Brooklyn, NY Antonio J. Torres, Madrid
and Metabolic Disorders –
European Chapter Bernhard Ludvik, Vienna Christian Vaisse, San Francisco, CA
Dragan Micic, Belgrade
Editorial Representative Founding Editor
Manfred J. Müller, Kiel
Martin Fried, Prague
Annette Schürmann, Potsdam Johannes Hebebrand, Essen
Yves Schutz. Lausanne
Pedro Teixeira, Lisbon
Hermann Toplak, Graz
Matthias Tschöp, Neuherberg
Haijun Wang, Beijing
Jane Wardle, London
Kurt Widhalm, Vienna
Tommy Visscher, Zwolle
S. Karger GmbH
P.O. Box
D-79095 Freiburg
Editorial Office
Attn. Dr. Sven Riestenpatt
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Imprint
Obesity Facts 2015;8(suppl 1):II
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Vol. 8, Supplement 1,
May 2015
22nd European Congress on
Obesity (ECO2015)
Prague, Czech Republic, May 6–9, 2015
ABSTRACTS
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Committee
Obesity Facts 2015;8(suppl 1):IV
INTERNATIONAL SCIENTIFIC COMMITTEE
Chair
Martin Fried (Czech Republic)
Members
Gijs Goossens (Netherlands)
Vojtech Hainer (Czech Republic)
Martin Haluzik (Czech Republic)
Teodora Handjieva-Darlenska (Bulgaria)
Jøran Hjelmesæth (Norway)
Patricia Iozzo (Italy)
Jan Kopecky (Czech Republic)
Marie Kunesova (Czech Republic)
Lauren Lissner (Sweden)
Dana Mullerova (Czech Republic)
Grace O’Malley (Ireland)
Terezie Pelikanova (Czech Republic)
Christine Poitou (France)
Amaia Rodriguez (Spain)
Harry Rutter (UK)
Stepan Svacina (Czech Republic)
John Wilding (UK)
Volkan Yumuk (Turkey)
FIwnawfxow +r.m4k9aa rt7gio6e1nr. @c4o K5m2a r0g7e r1.4com ©Awwc 2cw0e1s.ks5ia bSrl.ge Ke ora.ncrlgoinemre / Gaotfm:a bH, Freiburg Downloaded by: ETH-Bibliothek Zürich 198.143.58.65 - 10/8/2015 4:37:10 PM
Contents
Obesity Facts 2015;8(suppl 1):V
PLENARY SESSIONS
Thursday, 7 May, 2015
T1:PL - Track 1 Plenary Lecture 1
T3:PL - Track 3 Plenary Lecture 1
Friday, 8 May, 2015
T2:PL - Track 2 Plenary Lecture 1
T5/T6:PL - Track 5 Plenary Debate 1
Saturday, 9 May, 2015
T6/T7:PL – Track T6/T7 Plenary Lecture 2
T8:PL – Track T8 Plenary Debate 2
REVIEW SESSIONS / WORKSHOP
Wednesday, 6 May, 2015
T1:RS1 – Secretory Factors in Non-Adipose Tissues 3
T3:RS1 – Changing Behaviors 3
T5:RS1 – Screening and Intervening Early for Healthy Growth 4
T8:RS1 – Ethics of Medico-Surgical Management 6
Thursday, 7 May, 2015
T2:RS1 – Remodelling, Fibrosis and Inflammation 7
T3:RS2 – Physical Fitness 8
T7:RS2 – Lifecourse Perspective 8
T4:RS1 – Addiction 10
Friday, 8 May, 2015
T1:RS2 – Lipid Metabolism 10
T3:RS3 – Nutrients and Diet Patterns 11
T4:RS2 – Extreme Weight Loss and Psychological Support 12
T5:RS2 – Genetics. Epigenetics and Early Feeding Practices 12
T2:RS2 – Adipose Tissue Oxygen Tension and Angiogenesis 13
T8:RS2 – Multidisciplinary Clinical Management 14
Saturday, 9 May, 2015
T6:RS1 – Societal and health economics (taxation) 15
T8:WS1 – Multidisciplinary Treatment in Children and Adults 16
SPECIAL SESSIONS
Wednesday, 6 May, 2015
EASO OMTF Teaching Course: Multidisciplinary Treatment in Adults 17
EASO PPHTF and WHO Europe Join Workshop:
Primary Prevention of Overweight and Obesity 17
WHO Session: Population Trends 17
Thursday, 7 May, 2015
T8: CS1 – Should Children, Elderly and Adults who are Moderately Obese
be Offered Surgery? 18
T1/T2:CS1 – Central or Peripheral Regulation in Obesity and Insulin Sensitivity? 19
Controversy Session: Should Weight/Adipose Tissue Loss or General Health
be the Treatment Goal? 19
EASO/IFSO-EC Young Investigators United (YIU) Scientific and Awards Session 20
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Contents
Obesity Facts 2015;8(suppl 1):VI
Friday, 8 May, 2015
Special Session: Stigma, Discrimination and Health Related QoL 20
Saturday, 9 May, 2015
T2:CS2 – Lipotoxicity and Skeletal Muscle: Are Ceramides to Blame? 21
Special Session: EASO/EFAD Roundtable, Dietary guidelines for the
prevention and treatment of Obesity in Europe – What do the dietitians use? 22
ORAL SESSONS
Wednesday, 6 May, 2015
T1/T2:OS1 – Organ Cross Talk 23
T3:OS1 – Eating Behaviour and Patterns 25
T6/T7:OS1 – Working with Perception and Stigma 26
Thursday, 7 May, 2015
T1/T2:OS2 – Adipose Tissue Plasticity and Oxidative Phenotype 28
T8:OS1 – Co-Morbidities 31
T5:OS1 – Childhood Growth 33
Friday, 8 May, 2015
T6/T7:OS2 – Drivers of Difference 35
T3:OS2 – Macro and Micro Nutrients 37
T5:OS2 – Childhood Obesity 39
T8:OS2 – Multidisciplinary Treatment 41
Saturday, 9 May, 2015
T1/T2:OS3 – Adipose Tissue Mass and Function 44
T6/T7:OS3 – Actions for Change 46
T3:OS3 – Genes and Metabolic Function 48
T8:OS3 – Bariatric and Metabolic Surgery 50
POSTER SESSIONS
Thursday, 7 May, 2015
T1 – Organ cross-talk 53
T1 – Genetics, epigenetics and omics 57
T1 – Lipid Metabolism 60
T1 – Myokines 64
T1 – Gut microbiota 64
T1 – Gut hormones/incretins 65
T1 – Bone & Muscle 67
T1 – Imaging 68
T1 – Immunometabolism 69
T3 – Nutrients and diet patterns 70
T3 – Changing behaviors 82
T3 – Physical fitness 91
T3 – Food reformulation 95
T3 – Genetic susceptibility 95
T3 – Taste, hedonics and appetite 97
T3 – Protective foods 102
T3 – Energy balance 103
T3 – Popular diets 106
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Contents
Obesity Facts 2015;8(suppl 1):VII
T3 – Sleep 112
T3 – Sugar and artificial sweeteners 114
T6 – Environmental/ecological drivers 115
T6 – The role of industry (inc reformulation) 116
T6 – Stigma, bias and discrimination 116
T6 – Inequalities/Cultural variation 119
T6 – Consumer perspectives 120
T6 – Media 120
T7 – Lifecourse perspective 120
T7 – Population trends (European comparison) 122
T7 – Health promotion policies 125
T7 – Community based interventions 125
T7 – Success and failure of interventions 128
T7 – Obesity and disease in populations 133
T7 – Primary/secondary prevention 145
T7 – Policy 149
T7 – New analytical approaches in epidemiology 149
T7 – Optimising monitoring and technology with technology 150
Friday, 8 May, 2015
T2 – De novo lipogenesis 151
T2 – Mitochondrial functions 151
T2 – Remodeling, fibrosis and inflammation 152
T2 – Oxygen tension 157
T2 – Ectopic fat 157
T2 – Lipotoxicity 159
T2 – Lipid Metabolism 160
T2 – Adipokines 163
T2 – Recruitment of adipocytes 168
T2 – White, beige and brown Adipocytes 168
T2 – Angiogenesis 173
T2 – Systemic consequences of adipose tissue metabolism 173
T4 – Addiction/Addiction after Bariatric Surgery 178
T4 – Brain imaging and phenotyping 180
T4 – Eating Disorders 181
T4 – Psychological support and Patient Support 182
T4 – Quality of life 185
T4 – Anxiety and depression 188
T4 – Disability/intellectual deficiency 189
T5 – Pregnancy 190
T5 – Fetal programming/epigenetics 193
T5 – Early feeding practices and nutrition 195
T5 – Healthy development 197
T5 – Education/Schools 198
T5 – Childhood and adolescence 199
T5 – Screening and early interventions 202
T5 – Child protection and welfare 203
T8 – Comorbidities (inc diabetes, hypertension, lipids, sleep apnea,
sexual dysfunction) 203
T8 – Metabolic outcomes (diabetes, lipids, hypertension) 208
T8 – Long term outcomes 214
T8 – Bariatric and metabolic surgery 218
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Contents
Obesity Facts 2015;8(suppl 1):VIII
T8 – Drugs (approval, regulation) 235
T8 – Medico-Surgical approaches 237
T8 – Ethics and guidelines 238
T8 – Emerging treatments 238
T8 – Diagnostics 242
T8 – Geriatric obesity, treatment 245
T8 – Complications 245
T8 – Alternative treatments 245
Author Index 249
Imprint II
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Abstracts
Obesity Facts 2015;8(suppl 1):1–247
DOI: 10.1159/000382140
PLENARY SESSIONS
Thursday, 7 May, 2015 fatty acid arachidonic acid; increased production of anti-inflammatory and
inflammation resolving mediators (resolvins, protectins and maresins); al-
tered activity of several transcription factors (NFkB, AP-1, PPARa, PPARg)
T1:PL so acting to reduce production of pro-inflammatory chemicals and to pro-
Mammalian circadian clock and metabolism: The epigenetic link mote fatty acid b-oxidation, insulin sensitivity and reduction in circulating
and hepatic triglycerides; and signalling through GPR120 in inflammatory
Sassone-Corsi P.1
cells and adipocytes. Through these molecular and cellular actions, O3FA
1Center for Epigenetics and Metabolism, University of California, Irvine counter several effects of saturated and omega-6 polyunsaturated fatty ac-
Circadian rhythms govern a number of fundamental physiological functions ids. The resulting improvements in cell and tissue function are associated
in almost all organisms, from prokaryotes to humans. The circadian clocks with improved health and well-being.
are intrinsic time-tracking systems with which organisms can anticipate en-
vironmental changes and adapt to the appropriate time of day. Disruption of
Friday, 8 May, 2015
these rhythms can have a profound influence on human health and has been
linked to depression, insomnia, coronary heart disease, metabolic disorders
and cancer. At the heart of circadian regulatory pathways is the clock machin-
T2:PL
ery, a remarkably coordinated transcription-translation system that utilizes Molecular mechanisms linking inflammation and adipocyte
dynamic changes in chromatin transitions and epigenetic control. Recent
de novo lipogenesis to insulin resistance in obesity
findings show that regulation goes also the other way: specific elements of the
clock are able to sense changes in cellular metabolism. Importantly, dynamic Czech M.P.1, Aouadi M.1, Tencerova M.1, Cohen J.L.1, Shen Y.1,
transitions in the epigenome have been associated with regulated patterns of Pedersen D.J.1, Danai L.V.1, Guilherme A.1
nuclear organization. The accumulating evidence that chromatin remodeling 1Program in Molecular Medicine, University of Massachusetts Medical School,
is implicated in circadian function prompted us to explore whether the clock Worcester, MA, USA
may control nuclear architecture. We applied the 3C-derived 4C technology
Regulatory mechanisms that control fatty acid synthesis and oxidization
(Chromosome Conformation Capture on Chip) to demonstrate the presence
under various physiological conditions contribute to overall body weight
of circadian long-range interactions using the clock-controlled dbp gene as
changes during nutrient overload. Insulin stimulates synthesis of fatty acids
bait. The circadian genomic interactions with dbp are highly specific and are
(de novo lipogenesis) and their esterification into triglycerides in liver and
absent in cells whose clock is disrupted by ablation of the Bmal1 gene. We
white adipocytes, which can secondarily modulate systemic glucose toler-
establish that the dbp circadian interactome contains a wide variety of genes
ance. Paradoxically, hepatic de novo lipogenesis is greatly increased in obe-
and clock-related DNA elements. While revealing a previously unappreciated
sity while in white adipocytes it is markedly decreased, even though both
role of the circadian clock, these findings pave the way towards the elucida-
tissues exhibit insulin resistance. Parallel to these effects of obesity on lipo-
tion of how nutrition may impact the shaping of the nuclear landscape.
genesis and insulin resistance, expansion of immune cells and inflammation
of these tissues occurs. Although it is clear that inflammation contributes to
insulin resistance, it has not however been technically possible to determine
T3:PL
whether immune cells within a given tissue cause insulin resistance within
Modulation of inflammation and metabolism by dietary fatty acids
that specific tissue. Using newly developed siRNA gene silencing technology
Calder P.C.1 selectively directed to either resident liver macrophages, denoted as Kupffer
cells, or selectively to adipose tissue macrophages, we show these tissue im-
1Faculty of Medicine, University of Southampton, Southampton SO16 6YD,
United Kingdom and NIHR Southampton Biomedical Research Centre, University mune cells do directly and locally contribute to the insulin resistance in both
Hospital Southampton NHS Foundation Trust and University of Southampton, hepatocytes and adipocytes, respectively, in obese mice. The downregulation
Southampton General Hospital, Southampton SO16 6YD, United Kingdom of lipogenic genes in adipocytes caused by obesity is also mediated in part by
adipose macrophage cytokines. New data on questions that remain open will
Both inflammation and dysmetabolism contribute to a range of human dis-
be presented: Do the cytokines that adipocytes release contribute to meta-
eases. These two processes are linked since inflammation alters metabolism,
bolic regulation in vivo, as do macrophage-derived cytokines? How do rates
while metabolism can produce compounds that induce or modulate inflam-
of adipocyte lipogenesis appatently modulate whole body glucose tolerance?
matory processes. Lipids and their fatty acid components play key roles in
regulation of inflammatory and metabolic processes. Different fatty acid Acknowledgement: We gratefully acknowledge funding for our studies from NIH
classes, and within the classes, different individual fatty acids have different grant DK030898 and from the International Research Alliance at Novo Nordisk
Foundation Center for Metabolic Research.
effects. This is because they act through both general and specific molecular
and cellular mechanisms. Consequently one fatty acid, or class of fatty ac-
ids, may oppose the action(s) of another. Within metabolism, saturated and
T5:PL
polyunsaturated fatty acids often oppose one another’s actions, while within
It is a Parental Responsibility
inflammation omega-3 fatty acids (O3FA) often oppose different actions of
saturated and omega-6 polyunsaturated fatty acids. Among the O3FA, the Marcus C.1
most biologically active are eicosapentaenoic acid (EPA) and docosahexae-
1Karolinska Institutet, Division of Pediatrics, Department of Clinical Science,
noic acid (DHA). EPA and DHA are found in oily fish, fish oil supplements
Intervention and Technology, Stockholm, Sweden
and a small number of pharmaceutical grade preparations. They are able to
reduce inflammatory responses and modify metabolism. Key effects of EPA Although changes in society are important for the obesity epidemic, pa-
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– especially for younger children. Before 10 years of age parents decide attention given to the importance of economic factors in driving health
almost everything regarding their children’s type of food, meal patterns improvement. In the 1960s, the epidemiologist Thomas McKeown contro-
physical activity and snacking. Already during pregnancy parental behav- versially claimed that rising living standards and nutritional improvement
ior is of importance. Maternal weight gain is associated with children’s mattered far more than medicine as an explanation for rising health trends,
long-term weight development at least until 6–12 years of age. Genetic an assessment extended by Nobel Laureate Robert Fogel in his proposi-
factors are of importance for obesity development but obesity genes do tion of ‘techno-physio’ evolution. Rather than improving health, aspects of
not make anyone obese without overeating. The temporal pattern for how technological and economic advance in the 21st century – the revolution
and when parental obesity affects childhood obesity is not the same as in farming production and food systems, private motor transport and a
that for the obesity genes. Parental education is associated with children’s burgeoning culture industry – seem only to have confounded it, contrib-
weight already at one year of age. Taken together, all these facts clearly uting to population weight gain and also, via links to climate change and
indicate that the mechanisms behind the strong association between pa- biodiversity loss, threatening the ecological platform of human existence.
rental and offspring obesity primarily is of social and/or epigenetic ori- In an age of complex and increasingly conjoint public health and envi-
gin, i.e., factors parents should have the capacity to modify in an obesi- ronmental dilemmas once successful models of public health no appear
ty-preventive direction. Thus, the most important measures to be taken either adequate or able to command public support. Our proposition of
are to increase the awareness of the parents regarding their importance Ecological Public Health is hardly new. Its past supporters ranged from
and support the parents as role-models and decision-makers for their French biologist Rene Dubos to US public health official John Hanlon.
children. If the parents shoulder these responsibilities, their children will In my presentation I will argue that in the 21st century public health ad-
have optimal chances to handle both a potential genetic vulnerability and vocates must embrace the Ecological Public Health perspective. I further
the obesogenic society! demonstrate how such thinking might contribute to the establishment of
a ‘healthy weight’ society.
Acknowledgement: Swedish Research Council
Acknowledgement: The presentation is drawn from the book, Ecological Public
Health: Reshaping the Conditions for Good Health, Routledge 2012, with Tim Lang.
T5:PL
Obesity: A societal responsibility
T8:PL
Perry Ivan J.1 Long term outcomes of bariatric and metabolic surgery.
1Department of Epidemiology & Public Health, University College Cork, Ireland, What can bariatric / metabolic surgery offer ?
2HRB Centre for Health & Diet Research
Suter M.1
The debate on the relative importance of genes and environment in obe-
1Department of Surgery, Hôpital Riviera-Chablais, Aigle-Monthey, Switzerland,
sity is now largely redundant. It is accepted that obesity like all conditions Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois
reflects a complex interplay of both genetic and environmental factors (CHUV), Lausanne, Switzerland
and that efforts to partition the origins of this condition between genes
and environment are futile. This issue will be briefly reviewed. The relative Bariatric / Metabolic surgery (BMS) is the only form of treatment for se-
contributions of personal agency versus societal conditioning will also be vere obesity that provides significant long-term weight loss and mainte-
addressed. It will be argued that although efforts to empower individuals nance. With current technology and a laparoscopic approach, BMS can be
and families are not futile they are likely to play a relatively small part in performed safely with low early morbidity and very low mortality. BMS
tacking the epidemic of overweigh and obesity in children and adults. Ru- results in significant long-term weight loss of between 10 and 30% of total
dolf Virchow in his Report on the 1848 typhus epidemic in Upper Silesia body weight. Results depend on the procedure, and generally are superior
stated “If disease is an expression of individual life under favorable con- with procedures that alter the enteral route and/or result in malabsorp-
ditions, then epidemics must be indicative of mass disturbances of mass tion. Along with weight loss, BMS induces remission/improvement of
life.” The global epidemic of overweight and obesity is undoubtedly “in- many obesity-related comorbidities, improves quality of life, and prevents
dicative of mass disturbances of mass life” – a societal issue that requires the development of obesity-related complications. These effects result in
a societal level response. All of us who work in the area of overweight improved survival, especially in relation to a reduction in cardiovascular
and obesity face difficult challenges in addressing societal level issues, risk factors and in the incidence of malignant tumors. Whatever the sur-
in particular the need to confront powerful commercial interests on the gical option, but depending on the patients’ discipline, some weight regain
over-supply of cheap calories and inappropriate/unethical marketing of occurs over time. According to its magnitude, and together with aging, it
processed, calorie dense foods. can result in progressive recurrence of comorbidities. Due to its remark-
able effects on Type 2 diabetes (T2D) in the severely obese patients, BMS
Acknowledgement: Irish Health Research Board (HRB)
is also considered for the treatment of poorly controlled T2D in less obese
patients who would not qualify for surgery based on their weight, with
promising early and mid-term results. The main long-term side effects of
Saturday, 9 May, 2015
BMS are nutritional deficiencies requiring mineral/vitamin supplementa-
tions. Depending on the procedure, other long-term complications, usu-
ally benign but occasionally severe, may develop. While absolutely nec-
T6:PL essary, BMS is only part of the treatment for severe obesity. Long-lasting
Ecological Public Health: A new approach to 21st century dietary and behavioral modifications are essential, usually facilitated by
public health dilemmas the surgical procedure. A specialized multidisciplinary approach is key to
success, and long-term patient follow-up by the bariatric team is essential,
Rayner G.C.1
not only to help achieving good results, but also to prevent and treat com-
1City University London
plications in a timely manner.
The main lines of the modern public health approach were established in
Europe’s major cities from the mid-19th century. Sanitary measures fo-
cused on unhealthy urban environments, health education applied new
behavioural rules to personal hygiene, and mass immunisation spread the
first of many bio-medical measures, with bio-medicine later coming to
2dominate the public healtOh bfieesiltdy. FOacntlsy 2 0fr1o5m;8( stuhpep ml 1i)d:1- –2204t7h century was Abstracts Downloaded by: ETH-Bibliothek Zürich 198.143.58.65 - 10/8/2015 4:37:10 PM