MATERIALS AND METHODS
obesity, obese, Anxiety, anxiety, osteoarthritis, hernia, HAD, daytime sleepiness, NASH, depressive, Sarcopenia, depression, Depression, weight loss, diabetes
OBESITY, SLEEP APNOEA SYNDROME, OBESE, OSTEOARTHRITIS, SARCOPENIA, BLOOD, COMPLICATIONS, DIABETES
We conducted a prospective interventional study at the obesity unit at the Zouhair El Kallel National Institute of Nutrition and Food Technology of Tunis, from March 2022 to August 2022.We included in our study obese patients (BMI ≥30 kg/mForty‐five patients were recruited on their first visit to the obesity unit (T0) and were randomly assigned to three groups matched for age, sex and BMI. All participants were enrolled in the weight loss program at the beginning of the study and followed a low‐carbohydrate, reduced‐energy intake eating plan provided by the same dietician.
First group called “diet only”: on low‐calorie diet alone without any intervention (15 patients).Second group: 15 patients on the same diet plan but additionally received prebiotic supplementation (2 carob beans/day about 30 g) called “prebiotic group”.Third group: same diet with probiotic supplementation (Patients were reassessed after 1 month (T1) and we track adherence by regular phone calls.All subjects gave their informed consent for participating in the study. The study was approved by the ethical committee of the national institute of nutrition of Tunis and the clinical trial was registered under number PACTR202210705998795 in the Pan African Clinical Trial Registry.Body mass index (BMI) was calculated using body weight and height measured with bare feet and in minimal clothing according to the World Health Organization definition and classification.We took the waist circumference of the patients. Muscle strength was measured by the handgrip. Sarcopenia was defined by muscle strength lower than 27 kg for men and 16 for women.A biological assessment was carried out at T0 and T1 including: fasting glycaemia, HbA1C, Cholesterol, triglycerides, HDL, calculated LDL Friedwald formula,Blood glucose results were interpreted according to American diabetes association guidelines.We looked at the physical examination for blood pressure and other complications of obesity such as hernia, sleep apnoea syndrome, osteoarthritis and NASH and if necessary we completed with the necessary radiological examinations.All patients benefited from an interview including food survey, stress questionnaire (Cunji), sleep questionnaire (Epworth), symptoms of depression and anxiety (HADS).For the evaluation of stress, we used the brief stress evaluation scale, this is the scale of Cungi 1997.The evaluation of the quality of sleep was carried out using the Epworth Sleepiness Scale,A total of less than 10 suggests that there is no excessive daytime sleepiness.A total of 10 and above suggests excessive daytime sleepiness.To assess the depressive state of the patients, we used the “HAD” scale (Hospital Anxiety and Depression Scale).Less than 7 points: no symptoms of depression.Eight to 10 points: doubtful symptomatology.Eleven and over: certain symptomatology.