Context: Young women are at high risk of weight gain but there has been limited knowledge on weight management in this group. Hyperandrogenemia and menstrual abnormalities are common co-morbidities of obesity in young women but their associations with food cravings are not known. Metformin has been shown to reduce body weight and improve metabolic outcomes in older adults but its effects on healthy overweight and obese young women have not been investigated. Quantitative lifestyle advice has been shown to be effective in inducing weight loss but its psychological effects on young women have not been extensively studied. The overall objective of this study was to investigate the effectiveness of metformin, quantitative lifestyle advice and internet-based intervention on weight management in young. Methods: In the first 12-weeks, 203 overweight and obese young women (BMI 33.3±0.3 kg/m² , age 28±0.3 years; age range:17-37) were randomized to one of three treatment arms to receive metformin (Diabex XR 1500mg a day) plus qualitative lifestyle advice (M-QL), placebo plus qualitative lifestyle advice (P-QL) or a structured lifestyle program (L-QT). L-QT consisted of an energy restricted diet with quantitative lifestyle advice (6000KJ; 40% protein, 40% carbohydrate, 30% fat), structured exercise program, and behavioural therapy. From weeks 13 to 48, all participants were placed on the structured lifestyle program conducted through a website. Outcome measures include body weight, fasting lipids, insulin, glucose, psychological distress, self-esteem, food cravings, energy intake and physical activity. Primary analyses were conducted using linear mixed models. Results: At baseline, psychological distress and hyperandrogenemia were associated with increased food cravings (P<0.01). At 12-weeks, L-QT group had greater weight loss (-4.2±0.4 kg) compared to M-QL (-1.0±0.4 kg) and P-QL groups (-0.2±0.3 kg) (P<0.001). Attrition at week 12 was high particularly in L-QT group, ie 48% (28/59) for L-QT group, 34% (22/65) for M-QL group and 29% (23/79) for P-QL group (P=0.08). Baseline psychological distress and food cravings predicted attrition at week 12. At week 12, L-QT group had significantly greater improvements in psychological distress (-3.0+0.9 vs -0.84+0.52, P=0.013) and self-esteem (3.2±0.8 vs -0.04±0.4, P<0.001) compared to the M-QL and P-QL groups. At 48 weeks, both QT and QL groups maintained significant weight loss (-4.8±0.1 kg vs -1.3±0.4 kg respectively, P=0.0005). Weight changes from week 13 to 48 were similar between the groups (P>0.05). Attrition was similarly high in both groups by week 48 (78%; 159/203) (P=0.003). Being married or having children predicted attrition at week 48. Conclusions: A structured lifestyle intervention program was more effective than metformin in achieving weight loss in young women. Quantitative lifestyle advice produced greater improvements in psychological outcomes compared to qualitative lifestyle advice. Internet-based weight loss program was effective in maintaining weight loss in young women independent of initial weight loss. High attrition rates were seen throughout the study, particularly among those who had greater psychological distress or food cravings, and those who were married or had children. Strategies on managing issues relating to psychological distress, food cravings and family responsibilities may allow better tailoring of weight management programs for this group. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1523605 / Thesis (Ph.D.) -- University of Adelaide, School of Molecular and Biomedical Science, 2009

Context: Young women are at high risk of weight gain but there has been limited knowledge on weight management in this group. Hyperandrogenemia and menstrual abnormalities are common co-morbidities of obesity in young women but their associations with food cravings are not known. Metformin has been shown to reduce body weight and improve metabolic outcomes in older adults but its effects on healthy overweight and obese young women have not been investigated. Quantitative lifestyle advice has been shown to be effective in inducing weight loss but its psychological effects on young women have not been extensively studied. The overall objective of this study was to investigate the effectiveness of metformin, quantitative lifestyle advice and internet-based intervention on weight management in young. Methods: In the first 12-weeks, 203 overweight and obese young women (BMI 33.3±0.3 kg/m² , age 28±0.3 years; age range:17-37) were randomized to one of three treatment arms to receive metformin (Diabex XR 1500mg a day) plus qualitative lifestyle advice (M-QL), placebo plus qualitative lifestyle advice (P-QL) or a structured lifestyle program (L-QT). L-QT consisted of an energy restricted diet with quantitative lifestyle advice (6000KJ; 40% protein, 40% carbohydrate, 30% fat), structured exercise program, and behavioural therapy. From weeks 13 to 48, all participants were placed on the structured lifestyle program conducted through a website. Outcome measures include body weight, fasting lipids, insulin, glucose, psychological distress, self-esteem, food cravings, energy intake and physical activity. Primary analyses were conducted using linear mixed models. Results: At baseline, psychological distress and hyperandrogenemia were associated with increased food cravings (P<0.01). At 12-weeks, L-QT group had greater weight loss (-4.2±0.4 kg) compared to M-QL (-1.0±0.4 kg) and P-QL groups (-0.2±0.3 kg) (P<0.001). Attrition at week 12 was high particularly in L-QT group, ie 48% (28/59) for L-QT group, 34% (22/65) for M-QL group and 29% (23/79) for P-QL group (P=0.08). Baseline psychological distress and food cravings predicted attrition at week 12. At week 12, L-QT group had significantly greater improvements in psychological distress (-3.0+0.9 vs -0.84+0.52, P=0.013) and self-esteem (3.2±0.8 vs -0.04±0.4, P<0.001) compared to the M-QL and P-QL groups. At 48 weeks, both QT and QL groups maintained significant weight loss (-4.8±0.1 kg vs -1.3±0.4 kg respectively, P=0.0005). Weight changes from week 13 to 48 were similar between the groups (P>0.05). Attrition was similarly high in both groups by week 48 (78%; 159/203) (P=0.003). Being married or having children predicted attrition at week 48. Conclusions: A structured lifestyle intervention program was more effective than metformin in achieving weight loss in young women. Quantitative lifestyle advice produced greater improvements in psychological outcomes compared to qualitative lifestyle advice. Internet-based weight loss program was effective in maintaining weight loss in young women independent of initial weight loss. High attrition rates were seen throughout the study, particularly among those who had greater psychological distress or food cravings, and those who were married or had children. Strategies on managing issues relating to psychological distress, food cravings and family responsibilities may allow better tailoring of weight management programs for this group. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1523605 / Thesis (Ph.D.) -- University of Adelaide, School of Molecular and Biomedical Science, 2009

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Bakgrund: År 2040 beräknas det finnas 642 miljoner diabetespatienter i världen. Sjukdomen leder till många komplikationer som kan bli allvarliga och har en negativ effekt på livskvalitén hos diabetespatienterna. Den mest förekommande av alla diabetesformer är diabetes typ 2. Diabetes typ 2 är en sjukdomstillstånd där kroppen inte producerar tillräckligt med insulin eller reagerar inte kroppens vävnader på insulinet (insulinresistens), vilket medför till att det blir en förhöjd glukoshalt i blodet. Insulin är ett peptidhormon som gör att glukos kan transporteras in i en cell och ifall inte insulinet fungerar kommer ingen glukos in i cellen och kroppen får då ingen energi. Symtom som kan uppstå är trötthet, urinering och dimsyn. Riskfaktorer som kan leda till diabetes typ 2 är stillasittande livsstil, högt blodtryck och fetma. En av metoderna som används vid diagnos av diabetes är kontroll av HbA1c-värdet. HbA1c är en mätmetod som kontrollerar blodsockervärdet under längre tid. Det är andelen glukos som fastnar på hemoglobinet som HbA1c mäter. Skulle HbA1c-värdet vara ≥ 48mmol/mol har patienten diabetes. Eftersom detta är en allt vanligare sjukdom och det inte finns något läkemedel som botar diabetes finns det ett stort behov för nya effektivare läkemedel och det är ett stort forskningsområde. ”Dualpeptider” har visat positiva resultat i djurstudier, både vad gäller glykemisk kontroll samt viktminskning hos möss. Dualpeptiderna är en kombination av två inkretinhormoner: GLP-1R (glukagonliknande peptid-1-receptor) och GIP (glukosberoende insulinotrop peptid) agonister. De nya dualpeptiderna som undersöks kallas för: ‘’LY3298176’’ och ‘’RG7697’’. Syftet med litteraturstudien var att undersöka framtida behandlingsalternativ för patienter med diabetes typ 2. Metod: I denna litteraturstudie användes PubMed för att söka efter publicerade studier. Fyra studier uppfyllde de uppställda kriterierna och undersökte effekten av nya kombinationspeptider vid behandling av diabetes typ 2. Resultat: Dualpeptiderna RG7697 och LY3298176 visade kroppsviktreducering och minskade även HbA1c-värdet. Trots den korta studietiden och en liten studiepopulation sågs signifikanta skillnader. Den glykemiska kontrollen ökade vid behandling med dualpeptiderna jämfört med placebo. Slutsats: Båda dualpeptiderna visade på glykemisk kontroll och viktminskning för patienter med diabetes typ 2 och var effektiva i fas 2 studier. Inga allvarliga biverkningar förekom i någon av studierna. Dualpeptiderna anses kunna vara mer effektiva än metformin och GLP-1 agonisterna dulaglutid (Trulicity®) och liraglutid (Victoza®). / Background: By 2040, it is estimated that there will be 642 million diabetic patients worldwide. The disease leads to many complications that may have negative effects on the quality of life of patients with diabetes. The most common of all forms of diabetes is diabetes type 2. Diabetes type 2 is a disease state where the body doesn’t produce enough insulin or the body’s tissues don’t react to the insulin (insulinresistance), this leads to an elevated level of glucose in blood. Insulin is a peptide hormone that allows glucose to be transported into a cell. If this process does not work, glucose does not enter the cell and the cell will lack a source of energy. Symptoms that may occur are fatigue, urination and blurred vision. Risk factors that can lead to type 2 diabetes are sedentary lifestyle, high blood pressure and obesity. Measuring the HbA1c is one of the methods used in diagnosing diabetes. HbA1c is a measurement method that controlls the blood sugar level for a longer period of time. It is the percentage of glucose that sticks to the hemoglobin that HbA1c measures. The patient has diabetes type 2 if the HbA1c value is ≥ 48 mmol/mol. Since there is still no treatment that can cure diabetes and the number of patients increase, there is on-going research to discover new drugs to treat diabetes in the future. ‘’Dualpeptides’’ have shown positive results in animal studies. Dualpeptides increase glycemic control and weight loss in mice. The dualpeptides are a combination of two incretin hormones: GLP-1R (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic peptide). Both are receptor agonists. The new dual peptides being studied are called: ‘’LY3298176’’ and ‘’RG7697’’. Objective: The purpose of this literature study was to investigate the future treatment alternatives for patients with diabetes type 2. Method: In this literature study PubMed was used to search for published studies. Four studies met the set criteria and were examined. The effect of new dualpeptides in the treatment of type 2 diabetes was assessed. Results: The dual peptides RG7697 and LY3298176 showed a reduction in body weight and also reduced the HbA1c value. Despite the short study-time and a small study populations, significant differences were reported. Glycemic control increased during treatment with dualpeptides compared with placebo. Conclusion: Based on the results the following can be concluded, both dualpeptides showed glycemic control and weight loss in patients with type 2 diabetes, and were effective in phase 2 studies. No serious side effects were observed in any of the studies. The dualpeptides are considered to be more effective than metformin and the GLP-1 agonists dulaglutide (Trulicity®) and liraglutide (Victoza®).

Studien har utgått från fyra olika reklamfilmer från företaget Kellogg’s. Uppsatsen är en fallstudie som syftar till att undersöka hur företaget Kellogg's använder retoriska strategier i samband med hur kvinnan i reklamfilmerna framställs. Undersökningen kommer att utföras genom att analysera fyra utvalda reklamfilmer med hjälp av olika teorier, begrepp och tidigare forskning. Det utvalda materialet studeras med hjälp av retoriska övertalningsstrategier som ethos, pathos, logos, argumentation, metonymi och doxa. I syfte att studera hur Kellogg’s framställer kvinnan i de utvalda reklamfilmerna kommer reklamfilmerna att analyseras utifrån begreppet stereotyp samt utifrån studiens utvalda diskurs Love your body-diskursen. För att presentera studiens analys är avsnittet uppdelat i gemensamma teman utifrån de fyra utvalda reklamfilmerna, samt ett avsnitt om hur Kellogg’s framställer kvinnan. Analysen visar vidare på att Kellogg’s väljer att presentera kvinnorna utifrån ett stereotypiskt perspektiv och ett icke-stereotypiskt perspektiv beroende på vilket årtal reklamfilmen är producerad, i förhållande till samhällets värderingar. / This study contains four chosen commercials from the company Kellogg’s. The thesis is a case that will aim to study how Kellogg’s use rhetorical strategies and to analyze how women is presented in their commercials. The case study will analyze the four chosen commercials from Special K, by applying chosen theories, concept and previous research. The case study will use rhetorical persuasion strategies as ethos, pathos, logos, argumentation, metonymy and doxa. The study has used persuasion strategies that showed criterias on how women often represents in commercials, to be able to understand if Kellogg’s is presenting the women as stereotypical or not. The study will also use a discourse called the “love your body”-discourse, to be able to watch the commercials from a different perspective than how women are presented stereotypical. The study analyze is divided into different mutual themes from the four chosen commercials. Further, the analyze shows that Kellogg’s has chosen to present women as stereotypical and non-stereotypical, depending on what year the commercial is produced in relation to the values of society.