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Jo S. Motivational Interviewing to Increase Physical Activity: A Teaching Activity for Exercise Psychology Students. JOURNAL OF SPORT PSYCHOLOGY IN ACTION 2021. [DOI: 10.1080/21520704.2021.1900478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sabrena Jo
- University of Kansas, Lawrence, Kansas, USA
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Lanca M, Abrams DN, Crittenden P, Jones KM. Cognitive Stabilization Intervention during the Era of COVID-19. Dev Neuropsychol 2021; 46:298-313. [PMID: 34225510 DOI: 10.1080/87565641.2021.1943398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
As COVID-19 halted traditional neuropsychological assessment due to infection risk, neuropsychologists considered alternative practice models. Cognitive stabilization intervention (CSI) via telehealth, was developed to stabilize cognition in advance of neuropsychological assessment. It incorporates elements of evidence-based treatments, including cognitive training, sleep training, and medication adherence training within a motivational interview framework. Two case vignettes are described. One vignette describes an elder man who received CSI to manage sleep difficulties, forgetfulness, and mood symptoms. Another vignette describes a woman who completed CSI following an autoimmune disorder episode to improve sleep, organization, and attention. The benefits and limitations of CSI are discussed.
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Affiliation(s)
- Margaret Lanca
- Department of Psychiatry, Harvard Medical School/Cambridge Health Alliance, Cambridge, USA
| | - Danielle N Abrams
- Department of Psychiatry, Harvard Medical School/Cambridge Health Alliance, Cambridge, USA
| | - Persephone Crittenden
- Department of Psychiatry, Harvard Medical School/Cambridge Health Alliance, Cambridge, USA
| | - Kelly M Jones
- Private Practice, Boston & Woburn, Massachusetts, USA
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53
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Ghorayeb JH, Theriault MD. Biopsychosocial Exercise Prescription for Weight Control: A Frontline Perspective. South Med J 2021; 114:438-441. [PMID: 34215898 DOI: 10.14423/smj.0000000000001270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Joe H Ghorayeb
- From the University of Medicine and Health Sciences, New York, New York and the Department of Family Medicine, Beaumont Hospital, Grosse Pointe, Michigan
| | - Martin D Theriault
- From the University of Medicine and Health Sciences, New York, New York and the Department of Family Medicine, Beaumont Hospital, Grosse Pointe, Michigan
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Varela C, Oda-Montecinos C, Andrés A, Saldaña C. Effectiveness of web-based feedback interventions for people with overweight and obesity: systematic review and network meta-analysis of randomized controlled trials. J Eat Disord 2021; 9:75. [PMID: 34174949 PMCID: PMC8234624 DOI: 10.1186/s40337-021-00432-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Web-based delivered interventions have become an innovative option to treat health problems, like obesity. The aim of this systematic review and network meta-analysis was to analyze the effectiveness of web-based behavioral treatments for adults with overweight and obesity. Web-based interventions and comparison interventions (traditional weight control programs) were classified according to the following feedback characteristics: frequency, personalization, and provider (human versus machine). METHOD From the initial 1789 studies, 15 were included in this review. A network meta-analysis was conducted to analyze the efficacy of web-based programs with traditional interventions, considering direct and indirect comparisons. The main outcome was the weight loss mean difference (kg) between baseline and post-treatment. Heterogeneity and consistency assumptions were validated to conduct the network meta-analysis. RESULTS Network meta-analysis showed comparisons between different treatment options. The main results were that Intensive Contact Web-based programs were more effective than wait-list (Mean Difference - 1.86 kg; 95% Confidence Interval: - 3.61, - 0.12). Moreover, Intensive Contact Web-based programs were more effective than the other web-based options and self-help traditional interventions. However, the only significant comparison was Intensive Contact Web-based programs versus Guided Self-Help Web-based programs (Mean Difference - 4.31 kg; 95% Confidence Interval: - 5,22, - 3,41). Intensive Contact Web-based programs were the most effective treatment option according the obtained results, achieving the first place in the ranking provided by the network meta-analysis with 98.5% of probabilities. CONCLUSIONS Intensive Contact Web-based interventions have obtained the first position in the ranking, proving the relevance of frequent, personalized, and professional feedback and their association with a better prognosis for people with overweight and obesity. These results provide relevant information to design more effective treatments for people with overweight and obesity, in a new format especially appropriate for the current situation.
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Affiliation(s)
- Carmen Varela
- Department of Clinical Psychology and Psychobiology, Section of Personality, Assessment and Treatment, Faculty of Psychology, University of Barcelona, Passeig Vall d'Hebrón, 171, P.C. 08035, Barcelona, Cataluña, Spain
| | | | - Ana Andrés
- Faculty of Psychology, Education and Sport Sciences, Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Carmina Saldaña
- Department of Clinical Psychology and Psychobiology, Section of Personality, Assessment and Treatment, Faculty of Psychology, University of Barcelona, Passeig Vall d'Hebrón, 171, P.C. 08035, Barcelona, Cataluña, Spain.
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain.
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Vallis M, Macklin D. When behaviour meets biology: if obesity is a chronic medical disease what is obesity management? Clin Obes 2021; 11:e12443. [PMID: 33590712 DOI: 10.1111/cob.12443] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/07/2020] [Accepted: 01/12/2021] [Indexed: 12/15/2022]
Affiliation(s)
- M Vallis
- Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - D Macklin
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Medcan Clinic, Toronto, Ontario, Canada
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A Novel Personalized Systems Nutrition Program Improves Dietary Patterns, Lifestyle Behaviors and Health-Related Outcomes: Results from the Habit Study. Nutrients 2021; 13:nu13061763. [PMID: 34067248 PMCID: PMC8224682 DOI: 10.3390/nu13061763] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 12/21/2022] Open
Abstract
Personalized nutrition may be more effective in changing lifestyle behaviors compared to population-based guidelines. This single-arm exploratory study evaluated the impact of a 10-week personalized systems nutrition (PSN) program on lifestyle behavior and health outcomes. Healthy men and women (n = 82) completed the trial. Individuals were grouped into seven diet types, for which phenotypic, genotypic and behavioral data were used to generate personalized recommendations. Behavior change guidance was also provided. The intervention reduced the intake of calories (−256.2 kcal; p < 0.0001), carbohydrates (−22.1 g; p < 0.0039), sugar (−13.0 g; p < 0.0001), total fat (−17.3 g; p < 0.0001), saturated fat (−5.9 g; p = 0.0003) and PUFA (−2.5 g; p = 0.0065). Additionally, BMI (−0.6 kg/m2; p < 0.0001), body fat (−1.2%; p = 0.0192) and hip circumference (−5.8 cm; p < 0.0001) were decreased after the intervention. In the subgroup with the lowest phenotypic flexibility, a measure of the body’s ability to adapt to environmental stressors, LDL (−0.44 mmol/L; p = 0.002) and total cholesterol (−0.49 mmol/L; p < 0.0001) were reduced after the intervention. This study shows that a PSN program in a workforce improves lifestyle habits and reduces body weight, BMI and other health-related outcomes. Health improvement was most pronounced in the compromised phenotypic flexibility subgroup, which indicates that a PSN program may be effective in targeting behavior change in health-compromised target groups.
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Khadoura KJ, Shakibazadeh E, Mansournia MA, Aljeesh Y, Fotouhi A. Effectiveness of motivational interviewing on medication adherence among Palestinian hypertensive patients: a clustered randomized controlled trial. Eur J Cardiovasc Nurs 2021; 20:411-420. [PMID: 34009313 DOI: 10.1093/eurjcn/zvaa015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 07/16/2020] [Accepted: 10/23/2020] [Indexed: 11/14/2022]
Abstract
BACKGROUND This trial aimed to evaluate the effectiveness of motivational interviewing (MINT) among medication non-adherent hypertensive patients attending primary healthcare centres in Gaza Strip. METHODS AND RESULTS A clustered randomized controlled trial was run among 355 hypertensive participants; who were identified as non-adherent by a self-reported adherent scale and were recruited from 10 centres by two stages cluster random sampling approach (five centres were randomly allocated to each group). Standard of hypertension care was provided to 173 participants, parallel to 182 one who received their standard of care including non-blinded MINT sessions for 3 months. The change in medication adherence status was the primary outcome and within-patient changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), self-efficacy and intrinsic motivation were the secondary outcomes. Data were collected via an interview-based structured questionnaire and were analysed by generalizing equation estimation model adjusting for covariates. The results showed a significant improvement in medication adherence status among participants in the intervention group (n = 159) [OR= 6.28; 95% confidence interval (CI): 3.20, 12.33; P < 0.001] compared with those in the control group (n = 151). Moreover, there were significant drops in both SBP (OR = 0.18; 95% CI: 0.06, 0.55; P = 0.002) and DBP (OR = 0.26; 95% CI: 0.09, 0.76; P = 0.013) and significant positive changes in both within-patient's self-efficacy (OR = 15.4; 95% CI: 3.9, 60.6; P < 0.001) and intrinsic motivation (OR = 31.7; 95% CI: 13.9, 71.9; P < 0.001). CONCLUSION Standard of care including MINT is an effective client-centred approach which promoted medication adherence, decreased mean blood pressure, and improved self-efficacy and intrinsic motivations among hypertensive patients.
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Affiliation(s)
- Khalid Jamal Khadoura
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences-International Campus, Tehran, Iran.,Department of Nursing, Faculty of Medical Sciences, Israa University-Gaza, Palestine
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Aljeesh
- Faculty of Nursing, Islamic University of Gaza, Gaza, Palestine
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Andrade L, Chiote I, Santos-Cruz A, Brito-Costa A, Mendes L, Silva-Nunes J, Pereira J. Protein Intake, Adherence to Vitamin-Mineral Supplementation, and Dumping Syndrome in Patients Undergoing One Anastomosis Gastric Bypass. Obes Surg 2021; 31:3557-3564. [PMID: 33880746 DOI: 10.1007/s11695-021-05428-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/08/2021] [Accepted: 04/13/2021] [Indexed: 01/22/2023]
Abstract
INTRODUCTION One anastomosis gastric bypass (OAGB) is an effective bariatric procedure. However, nutritional deficiencies or dumping syndrome (DS) may occur. The aim of this study was to assess adherence to nutritional recommendations and development of DS in a 3-year OAGB patient follow-up. METHODS For 150 OAGB patients, in our center, data were collected through the electronic platform and by an individual telephone interview. The inclusion criterion is OAGB as a primary bariatric procedure, no revisional surgery, or no pregnancy. The adequacy of daily protein intake cutoff was defined as 60 g. Adherence to micronutrient supplementation protocol was considered if a minimum of 5 takes/week were reported. To evaluate the occurrence of DS, the Sigstad score questionnaire was used. For statistical analysis, a significance level less than 5% (p < 0.05) was considered. RESULTS A total of 150 patients (80% females), BMI 44.3 ± 21.3 kg/m2, were subjected to the OAGB procedure. Of those, 128 fulfilled the study inclusion criteria. After 3 years, the mean %EBMIL was 78.4 ± 14.4. During the 3-year follow-up, the average protein intake was 60 g/day, and 48% reported an adequate daily protein intake. Adherence to the micronutrient supplementation protocol was reported by 70%. According to the Sigstad score questionnaire, DS was present in 24% of patients. CONCLUSION A significant part of OAGB patients does not comply with the nutrition prescription assessed, emphasizing the need to improve team/patient communication strategies. Long-term studies are needed to characterize and assess the health impact of protein, vitamin, and mineral malnutrition in patients undergoing OAGB.
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Affiliation(s)
- Léneo Andrade
- Department of Nutrition, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal. .,Multidisciplinary Department of Bariatric and Metabolic Surgery, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
| | - Inês Chiote
- Escola Superior de Tecnologia da Saúde de Lisboa, Lisbon, Portugal
| | - Ana Santos-Cruz
- Department of Nutrition, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.,Multidisciplinary Department of Bariatric and Metabolic Surgery, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Ana Brito-Costa
- Department of Nutrition, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.,Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Lisbon, Portugal
| | - Lino Mendes
- Escola Superior de Tecnologia da Saúde de Lisboa, Lisbon, Portugal
| | - José Silva-Nunes
- Multidisciplinary Department of Bariatric and Metabolic Surgery, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.,Escola Superior de Tecnologia da Saúde de Lisboa, Lisbon, Portugal.,Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.,NOVA Medical School/Faculdade de Ciências Médicas, New University of Lisbon, Lisbon, Portugal
| | - João Pereira
- Multidisciplinary Department of Bariatric and Metabolic Surgery, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
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Gamification for Family Engagement in Lifestyle Interventions: A Systematic Review. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:831-844. [PMID: 33786746 DOI: 10.1007/s11121-021-01214-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 10/21/2022]
Abstract
The majority of chronic conditions that plague the USA are modifiable by lifestyle change. Lifestyle interventions that incorporate family members for social support and that use game design elements to engage family members have the potential to improve upon traditional interventions, which have largely been unsustainable. Determining the populations where family member support in a lifestyle intervention are present and the extent of gamification of lifestyle intervention components that engage these family members is an important and underexplored area of work. A systematic review of lifestyle interventions involving family members were reviewed for game design elements using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Game design elements related to engaged learning and motivational affordances from previous literature were included. Sixty-one studies met inclusion criteria. These studies reported on 50 independent interventions that were reviewed. Thirty-one of these interventions addressed lifestyle in those with a chronic condition, and 19 addressed lifestyle in those at high risk for chronic conditions. The majority of the lifestyle interventions included at least one game design element, yet overall there were limited elements utilized together. Compared with successful gamified programs that have greatly impacted a population's health behaviors, there were relatively a limited number of elements reported, particularly those that support social relatedness, such as meaningful storylines. Meaningfulness of the game design elements chosen and their arrangement was not apparent. Technology was under-utilized as a potential modality for intervention component delivery. Developing products to train researchers to properly apply game design elements to intervention components, as well as test their effectiveness, are areas for future research.
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60
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Wang Y, Chen Z, Wu Z, Ye X, Xu X. Pilates for Overweight or Obesity: A Meta-Analysis. Front Physiol 2021; 12:643455. [PMID: 33776797 PMCID: PMC7992419 DOI: 10.3389/fphys.2021.643455] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/08/2021] [Indexed: 01/02/2023] Open
Abstract
Background: Evidence for the efficacy of Pilates for the modulation of body weight and body composition is unclear. Objective: This meta-analysis aimed to evaluate the effects of Pilates on body weight and body composition in adults with overweight or obesity. Data Sources: The PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and EMBASE databases were systematically searched from the inception dates to 12 November 2020 for relevant randomized controlled trials (RCTs). Study Selection: Randomized controlled trials comparing Pilates with other physical exercises or without any intervention were included. Data Extraction and Synthesis: Three reviewers independently performed the data extraction and assessed study quality. The mean differences (MDs) and 95% confidence intervals (CIs) for pooled data were calculated. Main Outcomes and Measures: Outcome measures were body weight, body mass index (BMI), body fat percentage, lean body mass, and waist circumference. Results: Eleven RCTs with 393 subjects were included. This study revealed that Pilates dramatically reduces body weight (MD = -2.40, 95% CI: [-4.04, -0.77], P = 0.004, I 2 = 51%), BMI (MD = -1.17, 95% CI: [-1.85, -0.50], P = 0.0006, I 2 = 61%), and body fat percentage (MD = -4.22, 95% CI: [-6.44, -2.01], P = 0.0002, I 2 = 88%) in adults with overweight or obesity. The reduction in body weight and body fat percentage appears to be more pronounced in studies including participants with obesity only, and the efficacy of Pilates for the improvement of body weight and BMI appears to be more evident in longer intervention duration. However, Pilates has no significant effect on waist circumference (MD = -2.65, 95% CI: [-6.84, 1.55], P = 0.22, I 2 = 0%) and lean body mass (MD = -0.00, 95% CI: [-1.40, 1.40], P = 1.00, I 2 = 23%). Conclusions: Pilates dramatically reduces body weight, BMI, and body fat percentage in adults with overweight or obesity. Large-scale and well-designed RCTs with improved methodology and reporting are urgently needed to further confirm these results.
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Affiliation(s)
- Yi Wang
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zehua Chen
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zugui Wu
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiangling Ye
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xuemeng Xu
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
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Armitage NH, Kramer MK, Nelson MS, Hopkins D, Langeslay R, Thornton JA. Effectiveness of Lifestyle Interventions in an Active Duty Air Force Population. Am J Health Promot 2021; 35:784-793. [PMID: 33657870 DOI: 10.1177/0890117121997308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE To examine the effectiveness of 3 lifestyle intervention programs in an active duty military population. DESIGN Experimental design with stratified random assignment to 1 of 3 intervention groups. Measures were taken at baseline, 3 months and 6 months. SETTING A Military Treatment Facility in the western U.S. SUBJECTS/INTERVENTION 122 active duty service members were enrolled and randomly assigned to 1 of 3 lifestyle intervention programs: the Diabetes Prevention Program-Group Lifestyle Balance (DPP-GLB), the Better Body Better Life (BBBL) program or the Fitness Improvement Program (FIP). MEASURES weight, abdominal circumference, lipid and HbA1c levels, physical activity, and well-being as measured by the RAND SF-36 questionnaire. ANALYSIS Statistical analyses were performed to assess changes over time. RESULTS 83 participants completed the study (BBBL N = 23, FIP N = 30, DPP-GLB N = 30). The DPP-GLB participants had statistically significant decreases in weight (-3.1 pounds, p = .01) and abdominal circumference (-0.9 inches; p = .01) over time. HbA1c was also significantly lower in this group at 6 months compared to baseline (p = .036). There were no statistically significant changes in weight, abdominal circumference, or HbA1c in the FIP or BBBL groups. No significant changes were observed in lipids in any of the groups. CONCLUSION Results from this study indicate that the DPP-GLB program may be effective in reducing weight, abdominal circumference, and HbA1c in an active duty U.S. military population.
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Affiliation(s)
| | | | | | | | - Ruby Langeslay
- 22494Virginia Commonwealth University Richmond School of Medicine, VA, USA
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Renton MC, McGee SL, Howlett KF. The role of protein kinase D (PKD) in intracellular nutrient sensing and regulation of adaptive responses to the obese environment. Obes Rev 2021; 22:e13145. [PMID: 32929844 DOI: 10.1111/obr.13145] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/19/2020] [Accepted: 09/01/2020] [Indexed: 12/16/2022]
Abstract
Obesity is associated with ectopic accumulation of lipids, which is implicated in the development of insulin resistance, type 2 diabetes mellitus and cardiovascular disease. As the global prevalence of obesity continues to rise, it is becoming increasingly important to understand the underlying cellular mechanisms of this disease. Protein kinase D (PKD) is an intracellular signalling kinase with well characterized roles in intracellular vesicle transport and secretion, cancer cell proliferation and cardiac hypertrophy. However, emerging evidence also highlights PKD as a novel nutrient sensor. PKD activation is mediated by the accumulation of the lipid intermediate diacylglycerol, and PKD activity in the liver, heart and adipose tissue increases upon feeding. In obesity, PKD signalling is linked to reduced insulin signalling and dysfunction in adipose tissue, liver and heart, whilst in the pancreas, PKD is essential for the compensatory increase in glucose-stimulated insulin secretion from β-cells during obesity. Collectively, these studies reveal aspects of PKD signalling that are involved in the tissue-specific responses to obesity. This review summarizes the emerging evidence suggesting that PKD plays an important role in regulating the adaptive response to the obese environment.
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Affiliation(s)
- Mark C Renton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - Sean L McGee
- Institute for Mental and Physical Health and Clinical Translation, Metabolic Research Unit, School of Medicine, Deakin University, Geelong, Australia
| | - Kirsten F Howlett
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
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Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042023. [PMID: 33669679 PMCID: PMC7922504 DOI: 10.3390/ijerph18042023] [Citation(s) in RCA: 162] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 12/18/2022]
Abstract
Physical inactivity is a major concern and poor adherence to exercise programs is often reported. The aim of this paper was to systematically review published reviews on the study of adherence to physical exercise in chronic patients and older adults and to identify those adherence-related key factors more frequently suggested by reviews for that population. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Results were classified considering the target population and participants’ characteristics to identify the most repeated factors obtained for each condition. Fifty-five articles were finally included. Fourteen key factors were identified as relevant to increase adherence to physical exercise by at least ten reviews: (a) characteristics of the exercise program, (b) involvement of professionals from different disciplines, (c) supervision, (d) technology, (e) initial exploration of participant’s characteristics, barriers, and facilitators, (f) participants education, adequate expectations and knowledge about risks and benefits, (g) enjoyment and absence of unpleasant experiences, (h) integration in daily living, (i) social support and relatedness, (j) communication and feedback, (k) available progress information and monitoring, (l) self-efficacy and competence, (m) participant’s active role and (n) goal setting. Therefore, adherence to physical exercise is affected by several variables that can be controlled and modified by researchers and professionals.
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Jessen-Winge C, Ilvig PM, Fritz H, Brandt CJ, Lee K, Christensen JR. What a weight loss programme should contain if people with obesity were asked - a qualitative analysis within the DO:IT study. BMC Public Health 2021; 21:28. [PMID: 33407271 PMCID: PMC7789717 DOI: 10.1186/s12889-020-09850-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 11/05/2020] [Indexed: 12/31/2022] Open
Abstract
Background Currently 1.9 billion adults worldwide are estimated to be overweight or obese. In Denmark the municipalities hold the responsibility to deliver weight loss programmes to overweight and obese citizens. There is a tendency to assume that weight loss programmes that show positive effects in specialized hospital settings are directly transferrable to municipal settings. However, municipality-based weight loss programmes have not produced clinically significant reductions in body weight. One reason for this may be that much research evidence regarding obesity programming neglects the perspectives of people with obesity. The first step in developing a weight loss programme designed for municipal settings is to understand what people with obesity want and need from a programme. The aim of this study was to examine what people with obesity find important in a weight loss programme for weight loss and weight maintenance. Methods We used a qualitative, explorative, descriptive design with individual interviews. We included men and women age 17 and older with a BMI ≥ 25 kg/m2. Participants were recruited from the wait lists of 13 municipality programmes and through Facebook posts. Data were analyzed using content analysis. Results Thirty-four participants with overweight or obesity were individually interviewed (ages between 19 and 74). Findings suggest that weight loss programmes should; a) support participants in structuring days; b) consider the use of replacement activities to reduce cognitive and emotional burden; c) aide individuals to increase self-efficacy and; d) include family and friends as well as health professionals and peers in the weight loss process. Diet and exercise, while important, should be balanced with other meaningful activities in everyday life. Conclusion Participants in this study wished to balance weight loss related activities with overall everyday life as well as finding the believe in their ability to lose weight in social relations.
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Affiliation(s)
- Christina Jessen-Winge
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psycomotore therapy, University College Copenhagen, Sigurdsgade 26, 2200, Copenhagen, Denmark. .,Department of Public Health, University of Southern Denmark, JB Winsløwsvej 9A, 5000, Odense C, Denmark.
| | - Pia Maria Ilvig
- Department of Public Health, University of Southern Denmark, JB Winsløwsvej 9A, 5000, Odense C, Denmark
| | - Heather Fritz
- Department of Health Care sciences, Occupational Therapy Program, Wayne State University, 259 Mack Ave, Detroit, MI, 48201, USA
| | - Carl J Brandt
- Department of Public Health, University of Southern Denmark, JB Winsløwsvej 9A, 5000, Odense C, Denmark
| | - Kim Lee
- Department of Public Health, University of Southern Denmark, JB Winsløwsvej 9A, 5000, Odense C, Denmark.,Department of Occupational Therapy, University College South, Degnevej 16, 6705, Esbjerg, Denmark
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65
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Pfoh ER, Flench R, Varghai NH, King M, Heinberg LJ. Patients Desire Personalized, Specific, and Continuous Advice on Weight Management. South Med J 2021; 114:41-45. [PMID: 33398360 DOI: 10.14423/smj.0000000000001196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To deliver effective care, healthcare systems should understand patients' preferences for weight management across a spectrum of needs. Our objective was to describe patients' perceptions of what helps or hinders weight loss and maintenance. METHODS Semistructured interviews were conducted with patients who accessed weight management services at a large integrated health system in 2018. The interview guide was developed and iteratively refined through a literature search and by consulting experts. Questions included the respondent's weight history, interactions with the health system, and current health status. The analysis used a grounded theory approach, and each transcript was double-coded in 2019. Codes were sorted into themes. All discrepancies were resolved through team discussion. RESULTS Fifteen patients were interviewed. The majority of respondents (87%) reported multiple weight loss attempts. Three themes were identified. First, advice should be matched to a patient's knowledge and prior experience (eg, using bariatric deck cards). As patients progressed, clinician advice also needed to advance (eg, explaining how to expand food options instead of defining a healthy diet). Second, respondents had a variety of motivating factors, and understanding where motivation is generated from can inform how to design a weight management approach. Third, patients need continual and long-term advice. Some respondents feared becoming ineligible for services if their weight dropped too much. CONCLUSIONS Health systems can support patients by developing processes for identifying the extent of a patient's knowledge and giving personalized advice based on the patient's preferences and experiences. Reassessing needs at defined intervals may help patients attain and sustain their goals.
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Affiliation(s)
- Elizabeth R Pfoh
- From the Center for Value-Based Care Research and the Department of Family Medicine, Cleveland Clinic Community Care, the Strategy Office, Cleveland Clinic, and the Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| | - Russell Flench
- From the Center for Value-Based Care Research and the Department of Family Medicine, Cleveland Clinic Community Care, the Strategy Office, Cleveland Clinic, and the Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| | - N Homa Varghai
- From the Center for Value-Based Care Research and the Department of Family Medicine, Cleveland Clinic Community Care, the Strategy Office, Cleveland Clinic, and the Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| | - Michelle King
- From the Center for Value-Based Care Research and the Department of Family Medicine, Cleveland Clinic Community Care, the Strategy Office, Cleveland Clinic, and the Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| | - Leslie J Heinberg
- From the Center for Value-Based Care Research and the Department of Family Medicine, Cleveland Clinic Community Care, the Strategy Office, Cleveland Clinic, and the Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
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66
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Jessen-Winge C, Ilvig PM, Thilsing T, Lee K, Fritz H, Christensen JR. Health professionals' perceptions of weight loss programmes and recommendations for future implementation: a qualitative study. BMJ Open 2020; 10:e039667. [PMID: 33208329 PMCID: PMC7677371 DOI: 10.1136/bmjopen-2020-039667] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Obesity is an increasing public health challenge and most weight loss programmes are still inadequate to support sustainable weight loss. One reason for the continued lack of success might be the dominant biomedical, individualised approach to weight loss. Holistic approaches that focus on overall health and well-being in addition to weight loss are increasingly recommended. In Denmark, health professionals in the municipalities are responsible for developing and conducting weight loss programmes. The objective of this study was to explore what health professional's perceived as an ideal, holistic weight loss programme that could be feasibly implemented in the municipalities. DESIGN A phenomenological-hermeneutical qualitative study was performed using semistructured interviews. SETTING Thirty-two Danish municipalities were weight loss programmes are developed and conducted. PARTICIPANTS Thirty-five health professionals with experience conducting weight loss programmes. RESULTS Three themes emerged from the analysis: Support from the social network are important both during and after a weight loss, Changing the self-belief by positive discussions and doing activities, Maintaining changes through daily life. CONCLUSION Future municipal weight loss programmes should emphasise overall health and well-being instead of weight loss and adopt a holistic approach including a focus on social relationships, meaningful activities and successes as part of a balanced daily life.
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Affiliation(s)
- Christina Jessen-Winge
- Department of Public Health, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
- Department of Health, University College Copenhagen, Kobenhavn, Denmark
| | - Pia Marie Ilvig
- Department of Public Health, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Trine Thilsing
- Department of Public Health, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Kim Lee
- Department of Public Health, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Heather Fritz
- Department of occupational therapy, Wayne State University, Detroit, Michigan, USA
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67
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Vedrine B, Fernandes D, Gérard F, Fribourg-Blanc LA. Use of an intragastric balloon for management of obesity in a dog. J Small Anim Pract 2020; 62:816-821. [PMID: 33058157 DOI: 10.1111/jsap.13247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 09/11/2020] [Accepted: 09/17/2020] [Indexed: 11/30/2022]
Abstract
While various bariatric surgeries are commonplace in obesity medicine for humans, these techniques have not been commonly used in veterinary medicine. A technique used in humans consists in endoscopically placing an intragastric balloon. The intragastric balloon takes volume in the stomach causing a feeling of satiety and reducing food intake. A 57.6 kg, 9-year-old neutered female Labrador dog with chronic hypothyroidism was presented for overweight management. Combined levothyroxine treatment and dietary management with specific alimentation for obesity had failed to control overweight. An intragastric balloon was placed endoscopically in the stomach to allow the reduction of the gastric capacity and resulted in effective weight loss. The dog weight decreased to 40.9 kg at the time of intragastric balloon removal 198 days after placement. Further research including a larger sample size and long term follow-up is required to establish safety and effectiveness of this procedure.
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Affiliation(s)
- B Vedrine
- Clinique Vétérinaire SeineVet, 26 rue de la République 76520, Boos, France
| | - D Fernandes
- Clinique Vétérinaire SeineVet, 26 rue de la République 76520, Boos, France
| | - F Gérard
- Clinique Vétérinaire SeineVet, 26 rue de la République 76520, Boos, France
| | - L-A Fribourg-Blanc
- Clinique Vétérinaire SeineVet, 26 rue de la République 76520, Boos, France
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Batrakoulis A, Tsimeas P, Deli CK, Vlachopoulos D, Ubago-Guisado E, Poulios A, Chatzinikolaou A, Draganidis D, Papanikolaou K, Georgakouli K, Batsilas D, Gracia-Marco L, Jamurtas AZ, Fatouros I. Hybrid neuromuscular training promotes musculoskeletal adaptations in inactive overweight and obese women: A training-detraining randomized controlled trial. J Sports Sci 2020; 39:503-512. [PMID: 33054601 DOI: 10.1080/02640414.2020.1830543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This study investigated the effects of a 10-month high-intensity interval-type neuromuscular training programme on musculoskeletal fitness in overweight and obese women. Forty-nine inactive females (36.4 ± 4.4 yrs) were randomly assigned to either a control (N = 21), a training (N = 14, 10 months) or a training-detraining group (N = 14, 5 months training followed by 5 months detraining). Training used progressive loaded fundamental movement patterns with prescribed work-to-rest intervals (1:2, 1:1, 2:1) in a circuit fashion (2-3 rounds). Muscular strength and endurance, flexibility, passive range of motion (PRoM), static balance, functional movement screen (FMS) and bone mass density (BMD) and content (BMC) were measured at pre-, mid-, and post-intervention. Ten months of training induced greater changes than the controls in (i) BMD (+1.9%, p < 0.001) and BMC (+1.5%, p = 0.023) ii) muscular strength (25%-53%, p = 0.001-0.005); iii) muscular endurance (103%-195%, p < 0.001); and iv) mobility (flexibility: 40%, p < 0.001; PRoM [24%-53%, p = 0.001-0.05;]; balance: 175%, p = 0.058; FMS: +58%, p < 0.001). The response rate to training was exceptionally high (86-100%). Five months of detraining reduced but not abolished training-induced adaptations. These results suggest that a hybrid-type exercise approach integrating endurance-based bodyweight drills with resistance-based alternative modes into a real-world gym setting may promote musculoskeletal fitness in overweight and obese women.
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Affiliation(s)
- Alexios Batrakoulis
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Panagiotis Tsimeas
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Chariklia K Deli
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Dimitrios Vlachopoulos
- College of Life and Environmental Sciences, Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Esther Ubago-Guisado
- Health and Social Research Center, Universidad De Castilla-La Mancha, Cuenca, Spain
| | - Athanasios Poulios
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | | | - Dimitrios Draganidis
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | | | - Kalliopi Georgakouli
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Dimitrios Batsilas
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Luis Gracia-Marco
- Faculty of Sport Sciences, Department of Physical Education and Sports, University of Granada, Granada, Spain
| | - Athanasios Z Jamurtas
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Ioannis Fatouros
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
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van Belle E, Huisman‐De Waal G, Vermeulen H, Heinen M. Feasibility and early effectiveness of the Tell-us Card communication tool to increase in-hospital patient participation: a cluster randomised controlled pilot study. Scand J Caring Sci 2020; 35:911-922. [PMID: 32964468 PMCID: PMC8451905 DOI: 10.1111/scs.12909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 05/04/2020] [Accepted: 08/12/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Patient participation is fundamental to nursing care and has beneficial effects on patient outcomes. However, it is not well embedded yet and little is known on how nurses could effectively stimulate patient participation in hospital care. The Tell-us Card is a communication tool for inviting patients to talk about their preferences and needs, and to increase patient participation in daily care. OBJECTIVES To assess feasibility and early effectiveness of the Tell-us Card communication tool for enhanced patient participation during hospitalisation. DESIGN AND METHOD A pilot cluster randomised controlled study design was used including four nursing wards. Effectiveness was measured with the Individualized Care Scale (ICS) and the Quality from the Patients' Perspective (QPP) questionnaire. Linear mixed model analysis was used for analysis. Feasibility was assessed with an evaluative questionnaire for patients and nurses and by reviewing the content of Tell-us Cards using the Fundamentals of Care Framework (FOCF) for analysis. Ethical approval was attained. RESULTS Data of 265 patients showed a significant increase at one intervention ward on the ICS (effect size 0.61, p = 0.02) and most ICS subscales. No effect was visible on the QPP. The majority of patients regarded the intervention as beneficial; nurses however experienced barriers with incorporating the Tell-us Card into daily care. Analysis of the Tell-us Card content showed many elements of the FOCF being mentioned, with most patients indicating psychosocial needs like being involved and informed. CONCLUSIONS This pilot study showed a positive early effect of the Tell-us Card communication tool on patient participation, although integration in daily nursing care appeared to be complex and an optimal fit has not yet been reached. Patients were positive about the intervention and wrote meaningful issues on the Tell-us Cards. More research is needed on how to incorporate patient participation effectively in complex hospital care.
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Affiliation(s)
- Elise van Belle
- Radboud Institute for Health SciencesIQ HealthcareRadboud University Medical CenterNijmegenThe Netherlands
- Department of CardiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Getty Huisman‐De Waal
- Radboud Institute for Health SciencesIQ HealthcareRadboud University Medical CenterNijmegenThe Netherlands
| | - Hester Vermeulen
- Radboud Institute for Health SciencesIQ HealthcareRadboud University Medical CenterNijmegenThe Netherlands
- Faculty of Health and Social StudiesHAN University of Applied SciencesNijmegenThe Netherlands
| | - Maud Heinen
- Radboud Institute for Health SciencesIQ HealthcareRadboud University Medical CenterNijmegenThe Netherlands
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Speyer H, Jakobsen AS, Westergaard C, Nørgaard HCB, Jørgensen KB, Pisinger C, Krogh J, Hjorthøj C, Nordentoft M, Gluud C, Correll CU. Lifestyle Interventions for Weight Management in People with Serious Mental Illness: A Systematic Review with Meta-Analysis, Trial Sequential Analysis, and Meta-Regression Analysis Exploring the Mediators and Moderators of Treatment Effects. PSYCHOTHERAPY AND PSYCHOSOMATICS 2020; 88:350-362. [PMID: 31522170 DOI: 10.1159/000502293] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/19/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Serious mental illness (SMI) reduces life expectancy, primarily due to somatic comorbidity linked to obesity. Meta-analyses have found beneficial effects of lifestyle interventions in people with SMI and recommended their implementation to manage obesity. OBJECTIVE The objective of this systematic review was to assess the benefits and harms of individualized lifestyle interventions for weight in people diagnosed with SMI and to explore potential mediators and moderators of the effect. METHODS The protocol was registered at PROSPERO (CRD42016049093). Randomized clinical trials (RCTs) assessing the effect of individualized lifestyle interventions on weight management in people with SMI were included. Primary outcomes were differences in endpoint body mass index (BMI) and the proportion achieving clinically relevant weight loss (≥5%). Secondary outcomes included quality of life, cardiometabolic risk factors, and adverse effects. RESULTS We included 41 RCTs (n = 4,267). All trials were at high risk of bias according to the Cochrane Handbook for Systematic Reviews of Interventions. The experimental interventions reduced the mean difference in BMI by -0.63 kg/m2 (95% confidence interval [CI] = -1.02 to -0.23; p = 0.002; I2 = 70.7%) compared to the control groups. At postintervention follow-up (17 RCTs), the effect size remained similar but was no longer significant (BMI = -0.63 kg/m2; 95% CI = -1.30 to 0.04; p = 0.07; I2 = 48.8%). The risk ratio for losing ≥5% of baseline weight was 1.51 (95% CI = 1.07-2.13; p = 0.02) compared to the control groups. GRADE showed very low or low quality of evidence. CONCLUSION There is a statistically significant, but clinically insignificant, mean effect of individualized lifestyle interventions for weight reduction in people with SMI.
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Affiliation(s)
- Helene Speyer
- Mental Health Center Copenhagen, Copenhagen University Hospital, Hellerup, Denmark,
| | - Ane Storch Jakobsen
- Mental Health Center Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
| | - Casper Westergaard
- Mental Health Center Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
| | | | | | - Charlotta Pisinger
- Research Center for Prevention and Health, Department 84-85, Glostrup University Hospital, Glostrup, Denmark
| | - Jesper Krogh
- Mental Health Center Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
| | - Carsten Hjorthøj
- Mental Health Center Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
| | - Merete Nordentoft
- Mental Health Center Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
| | - Christian Gluud
- The Copenhagen Trial Unit, Center for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christoph U Correll
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York, USA.,Department of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, New York, USA.,Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
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71
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Begum S, Povey R, Ellis N, Gidlow C. A systematic review of recruitment strategies and behaviour change techniques in group-based diabetes prevention programmes focusing on uptake and retention. Diabetes Res Clin Pract 2020; 166:108273. [PMID: 32590009 DOI: 10.1016/j.diabres.2020.108273] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/26/2020] [Accepted: 06/14/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Many countries worldwide have developed diabetes prevention programmes (DPPs) that involve lifestyle modification. Research has shown that uptake and retention of DPPs are important and by exploring recruitment strategies and behaviour change techniques (BCTs) used, factors that are most effective in promoting uptake and retention can be identified. OBJECTIVES This review aims to identify recruitment strategies of group-based DPPs that are associated with high uptake and common BCTs associated with high retention. METHODS Papers were identified with a systematic literature search. Programmes that were predominantly group-based and involved lifestyle modification and in which uptake and/or retention could be determined, were included. Intervention details were extracted, recruitment strategies and BCTs identified, and response, uptake and retention rates were calculated. RESULTS A range of recruitment strategies were used making it difficult to discern associations with uptake rates. For BCTs, all programmes used a credible source, 81% used instruction on how to perform a behaviour and 71% used goal setting (behaviour). BCTs more commonly found in high retention programmes included problem-solving, demonstrating the behaviour, using behavioural practice and reducing negative emotions. CONCLUSIONS Recommendations include that DPPs incorporate BCTs like problem-solving and demonstrating the behaviour to maximise retention.
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Affiliation(s)
- Sonia Begum
- School of Life Sciences and Education, Science Centre, Staffordshire University, Stoke-on-Trent ST4 2DF, UK.
| | - Rachel Povey
- School of Life Sciences and Education, Science Centre, Staffordshire University, Stoke-on-Trent ST4 2DF, UK
| | - Naomi Ellis
- School of Life Sciences and Education, Science Centre, Staffordshire University, Stoke-on-Trent ST4 2DF, UK
| | - Christopher Gidlow
- School of Life Sciences and Education, Science Centre, Staffordshire University, Stoke-on-Trent ST4 2DF, UK
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72
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Ramos-Barrera GE, DeLucia CM, Bailey EF. Inspiratory muscle strength training lowers blood pressure and sympathetic activity in older adults with OSA: a randomized controlled pilot trial. J Appl Physiol (1985) 2020; 129:449-458. [PMID: 32730174 DOI: 10.1152/japplphysiol.00024.2020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Previous work has shown lowered casual blood pressure after just 6 wk of inspiratory muscle strength training (IMST), suggesting IMST as a potential therapeutic in the prevention/treatment of hypertension. In this study, we assessed the effects of IMST on cardiovascular parameters in older, overweight adults diagnosed with moderate and severe obstructive sleep apnea (OSA). Subjects were randomly assigned to one of two interventions 1) high-intensity IMST (n = 15, 75% maximal inspiratory pressure), or 2) a control intervention (n = 10, 15% maximum inspiratory pressure). Subjects in both groups trained at home completing 30 training breaths/day, 5 days/wk for 6 wk. Pre- and posttraining measures included maximal inspiratory pressure, casual and ambulatory blood pressures, spontaneous cardiac baroreflex sensitivity, and muscle sympathetic nerve activity. Men and women in the high-intensity IMST group exhibited reductions in casual systolic (SBP), diastolic (DBP), and mean arterial blood pressures (MAP) [SBP: -8.82 ± 4.98 mmHg; DBP: -4.69 ± 2.81 mmHg; and MAP: -6.06 ± 1.03 mmHg; P < 0.002] and nighttime SBP (pre: -12.00 ± 8.20 mmHg; P < 0.01). Muscle sympathetic nerve activities also were lower (-6.97 ± 2.29 bursts/min-1; P = 0.01 and -9.55 ± 2.42 bursts/100 heartbeats; P = 0.002) by week 6. Conversely, subjects allocated to the control group showed no change in casual blood pressure or muscle sympathetic nerve activity and a trend toward higher overnight blood pressures. A short course of high-intensity IMST may offer significant respiratory and cardiovascular benefits for older, overweight adults with OSA. For Clinical Trial Registration, see https://www.clinicaltrials.gov (Identifier: NCT02709941).NEW & NOTEWORTHY Older, obese adults with moderate-severe obstructive sleep apnea who perform 5 min/day high-intensity inspiratory muscle strength training (IMST) exhibit lowered casual and nighttime systolic blood pressure and sympathetic nervous outflow. In contrast, adults assigned to a control (low-intensity) intervention exhibit no change in casual blood pressure or muscle sympathetic nerve activity and a trend toward increased overnight blood pressure. Remarkably, adherence to IMST even among sleep-deprived and exercise-intolerant adults is high (96%).
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Affiliation(s)
| | - Claire M DeLucia
- Department of Physiology, University of Arizona College of Medicine, Tucson, Arizona
| | - E Fiona Bailey
- Department of Physiology, University of Arizona College of Medicine, Tucson, Arizona
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Nijs J, Wijma AJ, Willaert W, Huysmans E, Mintken P, Smeets R, Goossens M, van Wilgen CP, Van Bogaert W, Louw A, Cleland J, Donaldson M. Integrating Motivational Interviewing in Pain Neuroscience Education for People With Chronic Pain: A Practical Guide for Clinicians. Phys Ther 2020; 100:846-859. [PMID: 31995191 DOI: 10.1093/ptj/pzaa021] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 07/07/2019] [Accepted: 10/06/2019] [Indexed: 12/28/2022]
Abstract
Pain neuroscience education (PNE) and motivational interviewing (MI) have been widely implemented and tested in the field of chronic pain management, and both strategies have been shown to be effective in the short term (small effect sizes) for the management of chronic pain. PNE uses contemporary pain science to educate patients about the biopsychosocial nature of the chronicity of their pain experience. The goal of PNE is to optimize patients' pain beliefs/perceptions to facilitate the acquisition of adaptive pain-coping strategies. MI, on the other hand, is a patient-centered communication style for eliciting and enhancing motivation for behavior change by shifting the patient away from a state of indecision or uncertainty. Conceptually, PNE and MI appear to be complementary interventions, with complementary rather than overlapping effects; MI primarily improves cognitive and behavioral awareness and, potentially, adherence to treatment principles, whereas PNE potentially increases pain knowledge/beliefs, awareness, and willingness to explore psychological factors that are potentially associated with pain. Therefore, combining PNE with MI might lead to improved outcomes with larger and longer-lasting effect sizes. The combined use of PNE and MI in patients having chronic pain is introduced here, along with a description of how clinicians might be able to integrate PNE and MI in the treatment of patients experiencing chronic pain. Clinical trials are needed to examine whether combining PNE with MI is superior to PNE or MI alone for improving pain and quality of life in patients having chronic pain.
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Affiliation(s)
- Jo Nijs
- Department of Physiotherapy, Faculty of Physical Education and Physiotherapy, Pain in Motion International Research Group, Vrije Universiteit Brussel, Building F-KIMA, Laarbeeklaan 103, BE-1090 Brussels, Belgium; and Department of Physical Medicine and Physiotherapy, Chronic Pain Rehabilitation, University Hospital Brussels, Brussels, Belgium
| | - Amarins J Wijma
- Department of Physiotherapy, Faculty of Physical Education and Physiotherapy, Pain in Motion International Research Group, Vrije Universiteit Brussel; Department of Physical Medicine and Physiotherapy, Chronic Pain Rehabilitation, University Hospital Brussels; and Transcare Pain, Transdisciplinary Treatment Center, Groningen, the Netherlands
| | - Ward Willaert
- Department of Physiotherapy, Faculty of Physical Education and Physiotherapy, Pain in Motion International Research Group,Vrije Universiteit Brussel; Department of Physical Medicine and Physiotherapy, Chronic Pain Rehabilitation, University Hospital Brussels; and Research Foundation-Flanders (FWO), Brussels, Belgium
| | - Eva Huysmans
- Department of Physiotherapy, Faculty of Physical Education and Physiotherapy, Pain in Motion International Research Group, Vrije Universiteit Brussel; Department of Physical Medicine and Physiotherapy, Chronic Pain Rehabilitation, University Hospital Brussels; Research Foundation-Flanders (FWO); and Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel
| | - Paul Mintken
- Department of Physical Therapy, School of Medicine, University of Colorado, Aurora, Colorado, and Wardenburg Health Center, University of Colorado, Boulder, Colorado
| | - Rob Smeets
- Research School CAPHRI, Maastricht University, Maastricht, the Netherlands, and CIR Revalidatie Eindhoven/Zwolle, Eindhoven/Zwolle, the Netherlands
| | - Mariëlle Goossens
- Research School CAPHRI, Maastricht University, and CIR Revalidatie Eindhoven/Zwolle
| | - C Paul van Wilgen
- Department of Physiotherapy, Faculty of Physical Education and Physiotherapy, Pain in Motion International Research Group, Vrije Universiteit Brussel; and Transcare Pain, Transdisciplinary Treatment Center
| | - Wouter Van Bogaert
- Department of Physiotherapy, Faculty of Physical Education and Physiotherapy, Pain in Motion International Research Group, Vrije Universiteit Brussel
| | - Adriaan Louw
- Department of Physical Therapy, International Spine and Pain Institute, Louisville, Kentucky
| | - Josh Cleland
- Department of Physical Therapy, Franklin Pierce University, Manchester, New Hampshire
| | - Megan Donaldson
- Physical Therapy Program, School of Medicine, Tufts University, Boston, Massachusetts
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Individual differences in processes of lifestyle changes among people with obesity: an acceptance and commitment therapy (ACT) intervention in a primary health care setting. Prim Health Care Res Dev 2020; 21:e12. [PMID: 32419684 PMCID: PMC7264856 DOI: 10.1017/s146342362000016x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIM To explore what thoughts, feelings, and learning processes were involved in obese participants' lifestyle change during an acceptance and commitment therapy (ACT) lifestyle intervention delivered in primary health care. BACKGROUND Previous studies have revealed that lifestyle interventions are effective at promoting initial weight loss, but reduced weight is often difficult to sustain because of the failure to maintain healthy lifestyle changes. Achieving and maintaining lifestyle changes requires to learn self-regulation skills. ACT-based lifestyle interventions combine many self-regulatory skill factors, and the results from previous studies are promising. Research on the individual learning processes of lifestyle change is still needed. METHODS This study investigated a subset of data from a larger web-based lifestyle intervention. This subset consisted of online logbooks written by 17 obese participants (n = 17, body mass index mean 41.26 kg/m2) during the six-week online module. The logbooks were analyzed via data-driven content analysis. FINDINGS Four groups were identified based on the participants being at different phases in their lifestyle changes: stuck with barriers, slowly forward, reflective and hardworking, and convincingly forward with the help of concrete goals. Differences between the groups were manifested in personal barriers, goal setting, training of mindfulness and acceptance, and achieving healthy actions. The ACT-based lifestyle intervention offered participants an opportunity to reflect on how their thoughts and feelings may hinder healthy lifestyle changes and provided tools for learning psychological flexibility.
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Odukoya OO, Manortey S, Takemoto M, Alder S, Okuyemi KS. Body, Soul and Spirit, an adaptation of two evidence-based interventions to promote physical activity and healthy eating among adults in churches in Lagos Nigeria: a three-arm cluster randomized controlled pilot trial. Pilot Feasibility Stud 2020; 6:59. [PMID: 32391167 PMCID: PMC7203804 DOI: 10.1186/s40814-020-00600-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 04/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical inactivity and unhealthy eating are two leading behavioral risk factors contributing to preventable non-communicable diseases (NCDs). Evidence-based interventions (EBI) using community-engaged approaches to address these risks abound in high-income countries. Comparatively, evidence of such interventions is sparse in low- and middle-income countries, where NCD mortality is greater. This paper describes the protocol for the development of the cultural adaptation and pilot testing of a combination of two EBI (i.e., Body and Soul and the Healthy Body Healthy Spirit), in church-based settings in Lagos, Nigeria. In addition, we describe the development of the inclusion of an additional component, i.e., faith-based text messages, into one of the treatment arms. Our objective is to assess the feasibility of developing and implementing the adapted interventions with the ultimate aim of developing a fully powered trial. METHODS This pilot study will assess the design and implementation of a three-arm cluster-randomized pilot trial in 12 randomly selected Anglican churches (4 in each arm). First, we will design a cultural adaptation of the two EBI's to form a multifaceted combined intervention known as the Body Soul and Spirit. The second treatment arm, i.e., Body Soul and Spirit Plus, will retain all the components of Body Soul and Spirit with the inclusion of faith-based text messages using mobile phones. Participants in the control arm will receive information leaflets designed to increase physical activity and healthy food consumption. The outcome measures include participant recruitment and retention, program participation and satisfaction, and data collection completion rates. The outcomes for the proposed definitive trial will be the number of servings of fruit and vegetables and minutes of moderate to vigorous physical activity per day will be assessed at baseline, 3 and 6-month follow-up. Implementation outcomes will be assessed using qualitative and quantitative methods. DISCUSSION The study will enhance the understanding of how best to design and implement behavioral interventions in church-based settings using community-based participatory approaches. It will also inform the development of a definitive randomized controlled trial. TRIAL REGISTRATION Pan African Clinical Trials Registry on 12th July 2018. PACTR201807136835945. Available at https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3481.
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Affiliation(s)
- Oluwakemi Ololade Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, State, Lagos, Nigeria
- Non-Communicable Disease Research Group, University of Lagos, State, Lagos, Nigeria
- Department of Family Medicine and Public Health, School of Medicine, UC San Diego, San Diego, CA USA
| | | | - Michelle Takemoto
- Department of Family Medicine and Public Health, School of Medicine, UC San Diego, San Diego, CA USA
| | - Steve Alder
- ENSIGN School of Public Health, Kpong, Ghana
- Department of Family and Preventive Medicine, University of Utah School Of Medicine, Salt Lake City, UT USA
| | - Kolawole S. Okuyemi
- Department of Family and Preventive Medicine, University of Utah School Of Medicine, Salt Lake City, UT USA
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76
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Summers C, Curtis K. Novel Digital Architecture of a "Low Carb Program" for Initiating and Maintaining Long-Term Sustainable Health-Promoting Behavior Change in Patients with Type 2 Diabetes. JMIR Diabetes 2020; 5:e15030. [PMID: 32130113 PMCID: PMC7081139 DOI: 10.2196/15030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/29/2019] [Accepted: 09/29/2019] [Indexed: 12/11/2022] Open
Abstract
Globally, the burden of noncommunicable diseases such as type 2 diabetes is crippling health care systems. Type 2 diabetes, a disease linked with obesity, affects 1 in every 30 people today and is expected to affect 1 in 10 people by 2030. Current provisions are struggling to manage the trajectory of type 2 diabetes prevalence. Offline, face-to-face education for patients with type 2 diabetes has shown to lack long-term impact or the capacity for widespread democratized adoption. Digitally delivered interventions have been developed for patients with type 2 diabetes, and the evidence shows that some interventions provide the capacity to support hyperpersonalization and real-time continuous support to patients, which can result in significant engagement and health outcomes. However, digital health app engagement is notoriously difficult to achieve. This paper reviews the digital behavior change architecture of the Low Carb Program and the application of health behavioral theory underpinning its development and use in scaling novel methods of engaging the population with type 2 diabetes and supporting long-term behavior change.
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Affiliation(s)
| | - Kristina Curtis
- Faculty Research Centre for Advances in Behavioural Science, University of Coventry, Coventry, United Kingdom
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Adding Telephone and Text Support to an Obesity Management Program Improves Behavioral Adherence and Clinical Outcomes. A Randomized Controlled Crossover Trial. Int J Behav Med 2020; 26:580-590. [PMID: 31512155 DOI: 10.1007/s12529-019-09815-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Behavioral treatment strategies improve adherence to lifestyle intervention for adults with obesity, but can be time and resource intensive when delivered via traditional face-to-face care. This study aimed to investigate the efficacy and optimal timing of using telephone calls and text message as adjunctive tools to support a community-based obesity management program. METHOD This 8-month randomized controlled crossover trial recruited 61 adults with class III obesity (BMI > 40 kg/m2) enrolled in a publicly funded obesity management service (OMS). Participants were randomly assigned to receive telephone and text message support in addition to standard OMS care, or standard OMS care alone. After 4 months, participants crossed over to the alternative sequence. The technological support was based on self-determination theory. Outcome measures included diet, physical activity, anthropometry, self-efficacy, and treatment self-regulation. RESULTS Telephone and text message support improved lifestyle intervention adherence and clinical outcomes when compared with standard care. Participants who received the intervention in the first 4-month period lost 4.87 kg, compared with no weight loss (+ 0.38 kg) in the standard care only group. There was no evidence to indicate an optimal timing of the intervention, with both groups achieving significant results by the end of the intervention. CONCLUSION These results suggest a high degree of promise for the incorporation of telephone and text message support into community-based obesity management services. The findings have the potential to improve existing practices and reduce the burden on the health care system by demonstrating a resource-effective improvement to obesity management service delivery.
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78
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Surrow S, Jessen-Winge C, Ilvig PM, Christensen JR. The motivation and opportunities for weight loss related to the everyday life of people with obesity: A qualitative analysis within the DO:IT study. Scand J Occup Ther 2020; 28:479-487. [PMID: 32065553 DOI: 10.1080/11038128.2020.1726451] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Unsuccessful weight loss or weight loss maintenance is due to different barriers and physical limitations related to participation in everyday life. It will, therefore, be relevant to investigate the field from an occupational therapy perspective, since occupational therapists are uniquely trained in focussing on people's resources, meaningfulness and participation in everyday life. AIM The aim was to explore what motivates people to lose weight from an OT perspective and which opportunities people with obesity experience in their everyday lives to achieve and maintain lost weight. MATERIAL AND METHODS A descriptive phenomenological study including 21 semi-structured individual interviews was conducted as part of the DO:IT study. RESULTS The data analysis led to the identification of three main themes: The influence of external circumstances on the desire for weight loss; use of time in everyday life; and changes in habits, routines and structure. CONCLUSION People who are overweight or obese are motivated to lose weight because of health issues and feeling more comfortable with their body. The opportunities for weight loss lie in creating habits, routines and structuring everyday life activities to facilitate a healthier lifestyle. SIGNIFICANCE The findings indicate that an occupational therapist should be part of weight-loss interventions.
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Affiliation(s)
- Signe Surrow
- Department of Public Health, The Research Initiative for Occupational Science and Occupational Therapy, University of Southern Denmark, Odense C, Denmark
| | - Christina Jessen-Winge
- Department of Public Health, The Research Initiative for Occupational Science and Occupational Therapy, University of Southern Denmark, Odense C, Denmark.,Department of Midwifery, Physiotherapy, Occupational therapy, University College Copenhagen, Copenhagen, Denmark
| | - Pia Maria Ilvig
- Department of Public Health, The Research Initiative for Occupational Science and Occupational Therapy, University of Southern Denmark, Odense C, Denmark
| | - Jeanette Reffstrup Christensen
- Department of Public Health, The Research Initiative for Occupational Science and Occupational Therapy, University of Southern Denmark, Odense C, Denmark
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79
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Cole T, Robinson L, Romero L, O'Brien L. Effectiveness of interventions to improve therapy adherence in people with upper limb conditions: A systematic review. J Hand Ther 2020; 32:175-183.e2. [PMID: 29292028 DOI: 10.1016/j.jht.2017.11.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 11/23/2017] [Accepted: 11/25/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Systematic review. INTRODUCTION Patient adherence to orthosis wear and/or prescribed exercises improves functional outcome after acute injury and can prevent deformities, contractures, and reinjury of tissues. This is the first systematic review to review the evidence of the effectiveness of interventions to improve treatment adherence in children and adults with acute or chronic upper limb injuries or conditions. PURPOSE OF THE STUDY The purpose of this study is to establish the effectiveness of interventions to improve hand therapy adherence in people with upper limb conditions and to report on outcome measures used when reporting adherence. METHODS A literature search of MEDLINE (OVID), Embase (OVID), CENTRAL (OVID), CINAHL (EBSCO), and EmCare (OVID) (from inception to March 2017) was undertaken. Studies were selected if they met the following inclusion criteria: clinical trials; in adults or children with any injury or condition affecting the upper limb including acute trauma and injury; chronic and acquired musculoskeletal conditions; and neurological conditions. Two independent assessors rated the study quality and risk of bias using the Cochrane Collaboration tool for assessing the risk of bias. RESULTS Eight studies met the inclusion criteria. Study quality ranged from 3 to 6 out of 7 points on the Cochrane risk of bias tool. There were 4 categories of intervention for improving adherence: orthosis/cast material/design; orthosis wear schedule; patient education mode for home exercise programs; and behavioral approaches. Due to heterogeneity of condition acuity, interventions, and outcomes reported, it was not possible to pool the results from all studies. Therefore, a narrative best evidence synthesis was undertaken. There is weak evidence from a very small number of trials that orthosis/cast material has no influence on treatment adherence in acute or chronic conditions and mode of patient education (audio-visual vs written) has no effect in acute conditions. There is low-to-moderate quality of evidence in support of behavioral interventions for achieving treatment adherence in chronic rheumatoid arthritis. CONCLUSION Behavioral approaches that encourage self-efficacy are likely to be useful in achieving treatment adherence in populations with chronic upper limb conditions. There is insufficient evidence for other interventions aimed at improving adherence in acute upper limb injuries and conditions.
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80
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Essential Amino Acid Supplement Lowers Intrahepatic Lipid despite Excess Alcohol Consumption. Nutrients 2020; 12:nu12010254. [PMID: 31963802 PMCID: PMC7019240 DOI: 10.3390/nu12010254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 12/18/2022] Open
Abstract
Excess alcohol consumption is a top risk factor for death and disability. Fatty liver will likely develop and the risk of liver disease increases. We have previously demonstrated that an essential amino acid supplement (EAAS) improved protein synthesis and reduced intrahepatic lipid in the elderly. The purpose of this exploratory pilot study was to initiate the evaluation of EAAS on intrahepatic lipid (IHL), body composition, and blood lipids in individuals with mild to moderate alcohol use disorder (AUD). Following consent, determination of eligibility, and medical screening, 25 participants (18 males at 38 ± 15 years/age and 7 females at 34 ± 18 years/age) were enrolled and randomly assigned to one of two dosages: a low dose (LD: 8 g of EAAS twice/day (BID)) or high dose (HD: 13 g of EAAS BID). Five of the twenty-five enrolled participants dropped out of the intervention. Both groups consumed the supplement BID for 4 weeks. Pre- and post-EAAS administration, IHL was determined using magnetic resonance imaging/spectroscopy, body composition was analyzed using dual-energy X-ray absorptiometry, and blood parameters were measured by LabCorp. T-tests were used for statistical analysis and considered significant at p < 0.05. While there was no significant change in IHL in the LD group, there was a significant 23% reduction in IHL in the HD group (p = 0.02). Fat mass, lean tissue mass, bone mineral content, and blood lipids were not altered. Post-EAAS phosphatidylethanol was elevated and remained unchanged in LD at 407 ± 141 ng/mL and HD at 429 ± 196 ng/mL, indicating chronic and excess alcohol consumption. The HD of the proprietary EAAS formulation consumed BID seemed to lower IHL in individuals with mild to moderate AUD. We suggest that further studies in a larger cohort be conducted to more completely address this important area of investigation.
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81
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Valero-Elizondo J, Aneni EC, Osondu CU, Grandhi GR, Virani SS, Nasir K. Gaps in provider lifestyle counseling and its adherence among obese adults with prediabetes and diabetes in the United States. Prev Med 2019; 129:105815. [PMID: 31454663 DOI: 10.1016/j.ypmed.2019.105815] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/18/2019] [Accepted: 08/20/2019] [Indexed: 11/16/2022]
Abstract
Obesity is an epidemic affecting about 40% of the US adult population. Tracking with the obesity epidemic is an increase in the prevalence of diabetes and pre-diabetes. Both pre-diabetes and diabetes are often coexistent with obesity and contribute to an increased total and cardiovascular disease related morbidity and mortality. Lifestyle modification is usually the first step in management among individuals with obesity and/or pre-diabetes or diabetes, but remains an unfulfilled potential by healthcare providers to promote healthier lifestyles in obese patients. We aimed to describe the current patterns of lifestyle counseling (diet, physical activity, and weight loss) and their adherence by patients with obesity in the US using the National Health Interview Survey, 2016-2017. We analyzed these patterns among individuals with pre-diabetes and diabetes. We found that, regardless of pre-diabetes or diabetes status, almost 1 in 3 individuals with mild obesity (BMI ≥ 30 & < 35) and 1 in 4 with severe obesity (BMI ≥ 35) reported lack of lifestyle counseling from healthcare providers regarding diet or physical activity, and 2 in 3 individuals with any level of obesity reported lack of referral/counsel concerning weight loss programs. Lifestyle counseling and its compliance among obese adults from a contemporary dataset in the US is still suboptimal. This study highlights the gaps in the implementation of the AHA/ACC 2013 guidelines on management of obesity among adults particularly among those with metabolic disease, who would derive the greatest benefit.
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Affiliation(s)
- Javier Valero-Elizondo
- Center for Outcomes Research and Evaluation, Yale New Haven Health, New Haven, CT, United States of America. https://twitter.com/jvaleromd
| | - Ehimen C Aneni
- Yale University School of Medicine, Division of Cardiovascular Medicine, New Haven, CT, United States of America.
| | - Chukwuemeka U Osondu
- Baptist Health South Florida, Miami, FL, United States of America. https://twitter.com/droz09
| | - Gowtham R Grandhi
- Center for Outcomes Research and Evaluation, Yale New Haven Health, New Haven, CT, United States of America. https://twitter.com/gowthyharsha
| | - Salim S Virani
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States of America; Baylor College of Medicine, Houston, TX, United States of America. https://twitter.com/virani_md
| | - Khurram Nasir
- Center for Outcomes Research and Evaluation, Yale New Haven Health, New Haven, CT, United States of America; Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven, CT, United States of America; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, United States of America. https://twitter.com/khurramn1
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82
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Impact of a Tailored Nutrition and Lifestyle Intervention for Overweight Cancer Survivors on Dietary Patterns, Physical Activity, Quality of Life, and Cardiometabolic Profiles. JOURNAL OF ONCOLOGY 2019; 2019:1503195. [PMID: 31871455 PMCID: PMC6906801 DOI: 10.1155/2019/1503195] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/09/2019] [Accepted: 10/05/2019] [Indexed: 02/06/2023]
Abstract
Survivors of cancer often experience treatment-related toxicity in addition to being at risk of cancer recurrence, second primary cancers, and greater all-cause mortality. The objective of this study was to test the safety and efficacy of an intensive evidence-based garden intervention to improve outcomes for cancer survivors after curative therapy. To do so, a clinical trial of adult overweight and obese cancer survivors within 2 years of completing curative therapy was completed. The 6-month intervention, delivered within the context of harvesting at an urban garden, combined group education with cooking demonstrations, remote motivational interviewing, and online digital resources. Data on dietary patterns, program satisfaction, and quality of life were collected via questionnaires; anthropometrics, physical activity, and clinical biomarkers were measured objectively. Of the 29 participants, 86% were white, 83% were female, and the mean age was 58 years. Compared to baseline, participants had significant improvements in Healthy Eating Index (HEI) scores (+5.2 points, p = 0.006), physical activity (+1,208 steps, p = 0.033), and quality of life (+16.07 points, p = 0.004). Significant improvements were also documented in weight (−3.9 kg), waist circumference (−5.5 cm), BMI (−1.5 kg/m2), systolic BP (−9.5 mmHg), plasma carotenoids (+35%), total cholesterol (−6%), triglycerides (−14%), hs-CRP (−28%), and IGFBP-3 (−5%) (all p < 0.010). These findings demonstrate a tailored multifaceted garden-based biobehavioral intervention for overweight and obese cancer survivors after curative therapy is safe and highly effective, warranting larger randomized controlled trials to identify program benefits, optimal maintenance strategies, program value relative to cost, and approaches for integration into a survivor's oncology management program. This trial is registered on ClinicalTrials.gov NCT02268188.
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83
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Brodie ZP, Wilson C, Scott GG. Sextual Intercourse: Considering Social-Cognitive Predictors and Subsequent Outcomes of Sexting Behavior in Adulthood. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:2367-2379. [PMID: 31502070 PMCID: PMC6757024 DOI: 10.1007/s10508-019-01497-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/12/2019] [Accepted: 06/12/2019] [Indexed: 05/16/2023]
Abstract
The purpose of this study was to identify specific social-cognitive factors that may influence the likelihood of engaging in sexting, and potential positive and negative outcomes of such behaviors, in adults. We asked 244 adult participants (64.5% women) to complete a set of online measures reflecting sexting engagement, social-cognitive factors (definitions, differential association, differential reinforcement, and imitation), and outcomes of sexting behavior (risky sexual behavior appraisal, sexual satisfaction, and relationship satisfaction). Results showed that 77.6% of our sample had sexted. Sexting in the context of a romantic relationship was predicted by differential reinforcement and friend imitation, while positive definitions of sexting alone predicted sexting someone outside the context of a romantic relationship. This indicates that motivations for sexting engagement may be context specific in adulthood. Those who had sexted demonstrated significantly higher sexual satisfaction than those who had never sexted. However, sexting outside of a romantic relationship predicted reduced perceived risk and heightened perceived benefit of engaging in real-life risky sexual behaviors. This suggests there may be both positive and negative implications of sexting engagement in adulthood.
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Affiliation(s)
- Zara P Brodie
- School of Media, Culture, & Society, University of the West of Scotland, Room L248, Elles Building East, Glasgow, Scotland, PA1 2BE, UK.
| | - Claire Wilson
- School of Media, Culture, & Society, University of the West of Scotland, Room L248, Elles Building East, Glasgow, Scotland, PA1 2BE, UK
| | - Graham G Scott
- School of Media, Culture, & Society, University of the West of Scotland, Room L248, Elles Building East, Glasgow, Scotland, PA1 2BE, UK
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84
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Nijs J, D'Hondt E, Clarys P, Deliens T, Polli A, Malfliet A, Coppieters I, Willaert W, Tumkaya Yilmaz S, Elma Ö, Ickmans K. Lifestyle and Chronic Pain across the Lifespan: An Inconvenient Truth? PM R 2019; 12:410-419. [PMID: 31437355 DOI: 10.1002/pmrj.12244] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 07/19/2019] [Indexed: 12/31/2022]
Abstract
Chronic pain has a tremendous personal and socioeconomic impact and remains difficult to treat. Therefore, it is important to provide an update on the current understanding regarding lifestyle factors in people with chronic pain across the lifespan. Lifestyle factors such as physical (in)activity, sedentary behavior, stress, poor sleep, unhealthy diet, and smoking are associated with chronic pain severity and sustainment. This applies to all age categories, that is, chronic pain across the lifespan. Yet current treatment options often do not or only partly address the many lifestyle factors associated with chronic pain or attempt to address them in a standard format rather than providing an individually tailored multimodal lifestyle intervention. The evidence regarding lifestyle factors is available in adults, but limited in children and older adults having chronic pain, providing important avenues for future research. In conclusion, it is proposed that treatment approaches for people with chronic pain should address all relevant lifestyle factors concomitantly in an individually-tailored multimodal intervention. Ultimately, this should lead to improved outcomes and decrease the psychological and socioeconomic burden of chronic pain. Level of Evidence: IV.
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Affiliation(s)
- Jo Nijs
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Eva D'Hondt
- Motor Skills and Didactics Research group, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Peter Clarys
- Physical Activity, Nutrition and Health Research group, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Tom Deliens
- Physical Activity, Nutrition and Health Research group, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Andrea Polli
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Research Foundation - Flanders (FWO), Brussels, Belgium
| | - Anneleen Malfliet
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.,Research Foundation - Flanders (FWO), Brussels, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Iris Coppieters
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Ward Willaert
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Sevilay Tumkaya Yilmaz
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Physical Activity, Nutrition and Health Research group, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ömer Elma
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Physical Activity, Nutrition and Health Research group, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kelly Ickmans
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.,Research Foundation - Flanders (FWO), Brussels, Belgium
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85
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Batrakoulis A, Loules G, Georgakouli K, Tsimeas P, Draganidis D, Chatzinikolaou A, Papanikolaou K, Deli CK, Syrou N, Comoutos N, Theodorakis Y, Jamurtas AZ, Fatouros IG. High-intensity interval neuromuscular training promotes exercise behavioral regulation, adherence and weight loss in inactive obese women. Eur J Sport Sci 2019; 20:783-792. [DOI: 10.1080/17461391.2019.1663270] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Alexios Batrakoulis
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Georgios Loules
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Kalliopi Georgakouli
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Panagiotis Tsimeas
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Dimitrios Draganidis
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | | | | | - Chariklia K. Deli
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Niki Syrou
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Nikolaos Comoutos
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Yiannis Theodorakis
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Athanasios Z. Jamurtas
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Ioannis G. Fatouros
- School of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
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Interdisciplinary Weight Loss and Lifestyle Intervention for Obstructive Sleep Apnoea in Adults: Rationale, Design and Methodology of the INTERAPNEA Study. Nutrients 2019; 11:nu11092227. [PMID: 31540168 PMCID: PMC6770131 DOI: 10.3390/nu11092227] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 12/12/2022] Open
Abstract
Obesity is a major risk factor for obstructive sleep apnoea (OSA), the most common sleep-disordered breathing related to neurocognitive and metabolic syndromes, type II diabetes, and cardiovascular diseases. Although strongly recommended for this condition, there are no studies on the effectiveness of an interdisciplinary weight loss and lifestyle intervention including nutrition, exercise, sleep hygiene, and smoking and alcohol cessation. INTERAPNEA is a randomised controlled trial with a two-arm parallel design aimed at determining the effects of an interdisciplinary tailored weight loss and lifestyle intervention on OSA outcomes. The study will include 84 males aged 18–65 with a body mass index of ≥25 kg/m2 and severe to moderate OSA randomly assigned to usual care (i.e., continuous positive airway pressure), or interdisciplinary weight loss and lifestyle intervention combined with usual care. Outcomes will be measured at baseline, intervention end-point, and six-month post-intervention, including apnoea-hypopnoea index (primary outcome), other neurophysical and cardiorespiratory polysomnographic outcomes, sleep quality, daily functioning and mood, body weight and composition, physical fitness, blood biomarkers, health-related quality of life, and cost-effectiveness. INTERAPNEA may serve to establish a cost-effective treatment not only for the improvement of OSA and its vast and severe comorbidities, but also for a potential remission of this condition.
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87
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Brindal E, Hendrie GA, Freyne J, Noakes M. A Mobile Phone App Designed to Support Weight Loss Maintenance and Well-Being (MotiMate): Randomized Controlled Trial. JMIR Mhealth Uhealth 2019; 7:e12882. [PMID: 31486407 PMCID: PMC6834303 DOI: 10.2196/12882] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 04/29/2019] [Accepted: 06/05/2019] [Indexed: 01/07/2023] Open
Abstract
Background Few people successfully maintain lost weight over the longer term. Mobile phones have the potential to deliver weight loss management programs that can encourage self-monitoring while also providing some behavioral therapy to assist users in developing personal skills that may be necessary for improved longer term weight loss maintenance. Objective The aim of this study was to evaluate a program supporting weight maintenance, which uses a behaviorally based mobile phone app to manage weight, food, exercise, mood, and stress. Methods In a randomized controlled trial over 24 weeks, the full version of the app (MotiMate) was compared with a control app (monitoring only; excluding mood and stress) for its effect on weight, diet, and psychological well-being. Both apps had the same visual appearance and were designed to deliver all intervention content without face-to-face contact. The control version included features to track weight, food intake, and exercise with limited feedback and no encouraging/persuasive features. The intervention app included more persuasive and interactive features to help users track their weight, food intake, and physical activity and prompted users to enter data each day through notifications and included a mood and stress workshopping tool. Participants were recruited through advertising and existing databases. Clinic visits occurred at baseline, 4 weeks, 8 weeks, 12 weeks, and 24 weeks. At all visits, the clinical trial manager recorded body weight, and participants then completed a computer-delivered survey, which measured psychological and lifestyle outcomes. Objective app usage data were recorded throughout the trial. Results A total of 88 adults who had lost and maintained at least 5% of their body weight within the last 2 years were randomized (45 MotiMate and 43 control). Overall, 75% (66/88) were female, and 69% (61/88) completed week 24 with no differences in dropout by condition (χ21,87=0.7, P=.49). Mixed models suggested no significant changes in weight or psychological outcomes over 24 weeks regardless of condition. Of 61 completers, 53% (32/61) remained within 2% of their starting weight. Significant increases occurred over 24 weeks for satisfaction with life and weight loss self-efficacy regardless of app condition. Diet and physical activity behaviors did not vary by app or week. Negative binomial models indicated that those receiving the full app remained active users of the app for 46 days longer than controls (P=.02). Users of the full version of the app also reported that they felt more supported than those with the control app (P=.01). Conclusions Although some aspects of the intervention app such as usage and user feedback showed promise, there were few observable effects on behavioral and psychological outcomes. Future evaluation of the app should implement alternative research methods or target more specific populations to better understand the utility of the coping interface. Trial Registration Australia New Zealand Clinical Trials Registry ACTRN12614000474651; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366120
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Affiliation(s)
- Emily Brindal
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Adelaide, Australia
| | - Gilly A Hendrie
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Adelaide, Australia
| | - Jill Freyne
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Epping, Australia
| | - Manny Noakes
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Adelaide, Australia
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88
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Dolezal BA, Boland DM, Neufeld EV, Martin JL, Cooper CB. Behavioral Modification Enhances the Benefits from Structured Aerobic and Resistance Training. Sports Med Int Open 2019; 3:E48-E57. [PMID: 31312715 PMCID: PMC6629998 DOI: 10.1055/a-0900-7501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 03/14/2019] [Accepted: 04/25/2019] [Indexed: 10/29/2022] Open
Abstract
Behavioral modification (BM) is a strategy designed to sustain or restore well-being through effects such as enhanced relaxation, reduced stress, and improved sleep. Few studies have explored the role of BM delivered in the context of fitness programs for healthy adults. Thus, the purpose of this investigation was to examine whether BM combined with aerobic and resistance training programs would improve health and fitness measures more than the exercise training alone. Thirty-two healthy fitness club members (19 men) were randomized to receive a BM program (n=15) or an equal-attention (EA) control (n=17). BM consisted of twelve, 10-min education sessions between a trained fitness professional and the participant, coupled with weekly, individualized relaxation, stress reduction, and sleep improvement assignments. All participants engaged in 1 h of coached resistance training and remotely guided aerobic exercise thrice weekly for 12 weeks. Fitness measures (aerobic performance, body composition, muscle strength and endurance, lower-body power), sleep characteristics, and heart rate variability (HRV) were obtained at baseline and after the 12-week program. BM resulted in greater improvements in aerobic performance (increased maximum oxygen uptake, metabolic (lactate) threshold, and percent of maximum oxygen uptake at which metabolic threshold occurred), peak and average lower-body power, and body composition (decreased body fat percentage and fat mass) compared to EA. BM also positively influenced parasympathetic tone through increased High-frequency HRV. BM resulted in greater improvements in fitness measures, body composition, and heart rate variability compared with EA. These findings have intriguing implications regarding the role of BM in augmenting health and physical performance.
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Affiliation(s)
- Brett A Dolezal
- David Geffen School of Medicine at UCLA, Medicine, Physiology, Los Angeles, United States
| | - David M Boland
- David Geffen School of Medicine at UCLA, Medicine, Physiology, Los Angeles, United States.,Army-Baylor University Doctoral Program, Physical Therapy, San Antonio, United States
| | - Eric V Neufeld
- David Geffen School of Medicine at UCLA, Medicine, Physiology, Los Angeles, United States
| | - Jennifer L Martin
- David Geffen School of Medicine at UCLA, Medicine, Los Angeles, United States.,VA Greater Los Angeles Healthcare System, Geriatric Research, Education and Clinical Center, Los Angeles, United States
| | - Christopher B Cooper
- David Geffen School of Medicine at UCLA, Medicine, Physiology, Los Angeles, United States
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89
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Contribution of brown adipose tissue to human energy metabolism. Mol Aspects Med 2019; 68:82-89. [PMID: 31306668 DOI: 10.1016/j.mam.2019.07.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/09/2019] [Accepted: 07/11/2019] [Indexed: 12/24/2022]
Abstract
The present "obesogenic' environment has favored excessive energy intake resulting in the current obesity epidemic and its associated diseases. The epidemic has incentivized scientists to develop novel behavioral and pharmacological strategies that enhance energy expenditure to compensate for excessive energy intake. Although physical activity is effective to increase total energy expenditure, it is insufficient to induce negative energy balance and weight loss. With the discovery of brown adipose tissue (BAT) in adult humans, BAT activation soon emerged as a potential strategy for elevating energy expenditure. BAT is the only tissue that expresses uncoupling protein 1, conferring on this tissue high thermogenic capacity due to a low efficiency for mitochondrial ATP generation. Potential manipulation of BAT mass and activity has fueled the interest in altering whole-body energy balance through increased energy expenditure. Remarkable advances have been made in quantifying the amount and activity of BAT in humans. Many studies have concluded that the amount of active BAT appears insufficient to induce meaningful increases in energy expenditure. Thus, the majority of studies report that BAT activation does not influence body weight and metabolic control in humans. Strategies to increase BAT mass and/or to potentiate BAT activity seem necessary.
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90
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Ely BR, Clayton ZS, McCurdy CE, Pfeiffer J, Needham KW, Comrada LN, Minson CT. Heat therapy improves glucose tolerance and adipose tissue insulin signaling in polycystic ovary syndrome. Am J Physiol Endocrinol Metab 2019; 317:E172-E182. [PMID: 31136202 PMCID: PMC7199222 DOI: 10.1152/ajpendo.00549.2018] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Polycystic ovary syndrome (PCOS) is associated with high rates of obesity and metabolic dysfunction. Repeated passive heat exposure (termed heat therapy) is a novel lifestyle intervention for improving health in obese women with PCOS. The purpose of this study was to examine changes in metabolic function in obese women with PCOS following heat therapy. Eighteen age- and BMI-matched obese women with PCOS (age: 27 ± 1 yr, BMI: 41.3 ± 1.1 kg/m-2) were assigned to heat therapy (HT) or time control (CON). HT participants underwent 30 one-hour hot tub sessions over 8-10 wk, while CON participants completed all testing but did not undergo heat therapy. Before (Pre), at the mid-point (Mid), and following (Post) 8-10 wk of heat therapy, metabolic health was assessed using a 2-h oral glucose tolerance test, a subcutaneous abdominal fat biopsy (Pre-Post only), and other blood markers relating to metabolic function. HT participants exhibited improved fasting glucose (Pre: 105 ± 3, Post: 89 ± 5mg/dl; P = 0.001), glucose area under the curve (AUC) (Pre: 18,698 ± 1,045, Post: 16,987 ± 1,017 mg·dl-1·min-1; P = 0.028) and insulin AUC (Pre: 126,924 ± 11,730, Post: 91,233 ± 14,429 IU l-1·min-1; P = 0.012). Adipocyte insulin signaling (p-AKT at Ser-473 with 1.2 nM insulin) increased in HT (Pre: 0.29 ± 0.14, Post: 0.93 ± 0.29 AU; P = 0.021). Additionally, serum testosterone declined in HT participants (Pre: 51 ± 7, Post: 34 ± 4 ng/dl; P = 0.033). No parameters changed over time in CON, and no change in BMI was observed in either group. HT substantially improved metabolic risk profile in obese women with PCOS. HT also reduced androgen excess and may improve PCOS symptomology.
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Affiliation(s)
- Brett R Ely
- Department of Human Physiology, University of Oregon , Eugene, Oregon
| | - Zachary S Clayton
- Department of Human Physiology, University of Oregon , Eugene, Oregon
| | - Carrie E McCurdy
- Department of Human Physiology, University of Oregon , Eugene, Oregon
| | - Joshua Pfeiffer
- PeaceHealth Medical Group, Oregon Bariatric Center , Springfield, Oregon
| | | | - Lindan N Comrada
- Department of Human Physiology, University of Oregon , Eugene, Oregon
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91
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Hovhannisyan K, Günther M, Raffing R, Wikström M, Adami J, Tønnesen H. Compliance with the Very Integrated Program (VIP) for Smoking Cessation, Nutrition, Physical Activity and Comorbidity Education Among Patients in Treatment for Alcohol and Drug Addiction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2285. [PMID: 31261620 PMCID: PMC6650928 DOI: 10.3390/ijerph16132285] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/21/2019] [Accepted: 06/23/2019] [Indexed: 12/20/2022]
Abstract
Meeting adherence is an important element of compliance in treatment programmes. It is influenced by several factors one being self-efficacy. We aimed to investigate the association between self-efficacy and meeting adherence and other factors of importance for adherence among patients with alcohol and drug addiction who were undergoing an intensive lifestyle intervention. The intervention consisted of a 6-week Very Integrated Programme. High meeting adherence was defined as >75% participation. The association between self-efficacy and meeting adherence were analysed. The qualitative analyses identified themes important for the patients and were performed as text condensation. High self-efficacy was associated with high meeting adherence (ρ = 0.24, p = 0.03). In the multivariate analyses two variables were significant: avoid complications (OR: 0.51, 95% CI: 0.29-0.90) and self-efficacy (OR: 1.28, 95% CI: 1.00-1.63). Reflections on lifestyle change resulted in the themes of Health and Wellbeing, Personal Economy, Acceptance of Change, and Emotions Related to Lifestyle Change. A higher level of self-efficacy was positively associated with meeting adherence. Patients score high on avoiding complications but then adherence to the intervention drops. There was no difference in the reflections on lifestyle change between the group with high adherence and the group with low adherence.
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Affiliation(s)
- Karen Hovhannisyan
- Clinical Health Promotion Centre, WHO Collaborating Centre for Implementation of Evidence-based Clinical Health Promotion, Faculty of Medicine, Lund University and Addiction Centre Malmö, Region Skåne, Södra Förstadsgatan 35, 4th floor, SE 205 02 Malmö, Sweden.
| | - Michelle Günther
- Skånevård Kryh, Medicon Village, Region Skåne, 223 81 Lund, Sweden
| | - Rie Raffing
- Clinical Health Promotion Centre, WHO Collaborating Centre for Implementation of Evidence-based Clinical Health Promotion, Faculty of Medicine, Lund University and Addiction Centre Malmö, Region Skåne, Södra Förstadsgatan 35, 4th floor, SE 205 02 Malmö, Sweden.
- Clinical Health Promotion Centre, WHO Collaborating Centre for Evidence-based Health promotion in Hospitals and Health Services, The Parker Institute, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, Nordre Fasanvej 57-59, Entr. 5, 2000 Frederiksberg, Denmark.
| | - Maria Wikström
- Student Health, Malmö University, Neptuniplan 7, 21118 Malmö, Sweden
| | - Johanna Adami
- President Office, Sophiahemmet University, Box 5605, 114 86 Stockholm, Sweden
| | - Hanne Tønnesen
- Clinical Health Promotion Centre, WHO Collaborating Centre for Implementation of Evidence-based Clinical Health Promotion, Faculty of Medicine, Lund University and Addiction Centre Malmö, Region Skåne, Södra Förstadsgatan 35, 4th floor, SE 205 02 Malmö, Sweden
- Clinical Health Promotion Centre, WHO Collaborating Centre for Evidence-based Health promotion in Hospitals and Health Services, The Parker Institute, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, Nordre Fasanvej 57-59, Entr. 5, 2000 Frederiksberg, Denmark
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92
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Batrakoulis A, Fatouros IG, Chatzinikolaou A, Draganidis D, Georgakouli K, Papanikolaou K, Deli CK, Tsimeas P, Avloniti A, Syrou N, Jamurtas AZ. Dose-response effects of high-intensity interval neuromuscular exercise training on weight loss, performance, health and quality of life in inactive obese adults: Study rationale, design and methods of the DoIT trial. Contemp Clin Trials Commun 2019; 15:100386. [PMID: 31193901 PMCID: PMC6543184 DOI: 10.1016/j.conctc.2019.100386] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 05/01/2019] [Accepted: 05/22/2019] [Indexed: 01/10/2023] Open
Abstract
Obesity is associated with high mortality and morbidity rates and low levels of quality of life among adults globally. It is critical to examine evidence-based practices for developing lifestyle behavioral changes such as physical movement and structured exercise training. The DoIT protocol, a high-intensity interval exercise training (HIIT) program, effectively reduces body mass, alters energy balance, and improves performance of obese adults with a high adherence rate. This study aims to determine the dose-response effects of the DoIT protocol on body composition, health, performance and quality of life in sedentary obese adults. This study will recruit 88 sedentary, obese males and females (BMI 25.0–34.9; 30–50 years) who will be randomly assigned to one of four groups: (i) control (n = 22), (ii) one session/week (n = 22), (iii) two sessions/week (n = 22) or (iv) three sessions/week (n = 22). DoIT will use a supervised, circuit-type (1–3 rounds), functional/neuromotor and progressive exercise program for 12 months. DoIT incorporates 8–12 multi-planar, fundamental and complex, whole body movements and uses bodyweight and alternative exercise modes as a resistance. DoIT utilizes prescribed work-to-rest ratios which will be varied every four weeks. Each session will last less than 30 min. DoIT will be implemented for a year and its effects on body mass and body composition, physical fitness, functional capacity, bone health, leptin, adiponectin, blood lipids, glycemic control, inflammation, oxidative stress and quality of life will be assessed. The outcomes of the proposed study will provide insight on optimal exercise prescription guidelines for such HIIT-type exercise protocols for overweight or obese individuals.
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Affiliation(s)
- Alexios Batrakoulis
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, 42100, Greece
| | - Ioannis G Fatouros
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, 42100, Greece
| | - Athanasios Chatzinikolaou
- School of Physical Education and Sport Sciences, Democritus University of Thrace, Komotini, 69100, Greece
| | - Dimitrios Draganidis
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, 42100, Greece
| | - Kalliopi Georgakouli
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, 42100, Greece
| | - Konstantinos Papanikolaou
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, 42100, Greece
| | - Charikleia K Deli
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, 42100, Greece
| | - Panagiotis Tsimeas
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, 42100, Greece
| | - Alexandra Avloniti
- School of Physical Education and Sport Sciences, Democritus University of Thrace, Komotini, 69100, Greece
| | - Niki Syrou
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, 42100, Greece
| | - Athanasios Z Jamurtas
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, 42100, Greece
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93
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Carneiro-Barrera A, Díaz-Román A, Guillén-Riquelme A, Buela-Casal G. Weight loss and lifestyle interventions for obstructive sleep apnoea in adults: Systematic review and meta-analysis. Obes Rev 2019; 20:750-762. [PMID: 30609450 DOI: 10.1111/obr.12824] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 11/27/2018] [Accepted: 11/28/2018] [Indexed: 12/17/2022]
Abstract
Lifestyle interventions addressing diet, exercise-training, sleep hygiene, and/or tobacco/alcohol cessation are recommended in the management of obstructive sleep apnoea (OSA). Yet their effectiveness on this condition still requires further research. This systematic review and meta-analysis was aimed at establishing (a) the effectiveness of lifestyle interventions on apnoea-hypopnoea index (AHI), oxygen desaturation index (ODI), excessive daytime sleepiness (EDS), and secondary OSA measures among adults, and (b) which intervention characteristics may drive the greatest improvements. A systematic search of studies was conducted using CINAHL, ProQuest, Psicodoc, Scopus, and Web of Science, from inception to April 2018. Standardized mean differences were calculated using the inverse variance method and random-effects models. The meta-analyses of 13 randomized controlled trials and 22 uncontrolled before-and-after studies (1420 participants) revealed significant reductions on AHI (d = -0.61 and -0.46, respectively), ODI (d = -0.61 and -0.46) and EDS (d = -0.41 and -0.49). Secondary OSA outcomes were also improved after interventions. However, effectiveness of interventions differed depending on their components, OSA severity, and gender. Thus, until future research further supports the differential effectiveness among lifestyle interventions on OSA, those addressing weight loss through diet and exercise-training may be the most effective treatments for male patients with moderate-severe OSA.
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Affiliation(s)
| | - Amparo Díaz-Román
- Mind, Brain, and Behaviour Research Centre, CIMCYC, University of Granada, Granada, Spain
| | | | - Gualberto Buela-Casal
- Mind, Brain, and Behaviour Research Centre, CIMCYC, University of Granada, Granada, Spain
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94
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Rayes ABR, de Lira CAB, Viana RB, Benedito-Silva AA, Vancini RL, Mascarin N, Andrade MS. The effects of Pilates vs. aerobic training on cardiorespiratory fitness, isokinetic muscular strength, body composition, and functional tasks outcomes for individuals who are overweight/obese: a clinical trial. PeerJ 2019; 7:e6022. [PMID: 30842893 PMCID: PMC6397755 DOI: 10.7717/peerj.6022] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/29/2018] [Indexed: 11/20/2022] Open
Abstract
Background Some studies have been conducted to verify the effects of Pilates for individuals who are obese, but conclusive results are not yet available due to methodological concerns. The present study aims to verify and compare the effects of Pilates and aerobic training on cardiorespiratory fitness, isokinetic muscular strength, body composition, and functional task outcomes for individuals who are overweight/obese. Methods Of the sixty participants, seventeen were allocated to the control group, since the intervention protocol (Pilates or walking sessions) was during their working hours. The remaining 44 participants were randomly allocated to one of two experimental groups (Pilates (n = 22)) or aerobic groups (n = 21).The Pilates and aerobic groups attended 60-min exercise sessions, three times per week for 8 weeks. The aerobic group performed walking training at a heart rate corresponding to the ventilatory threshold. The Pilates group performed exercises on the floor, resistance apparatus, and 1-kg dumbbells. The control group received no intervention. All volunteers were evaluated at the beginning and end of the intervention. The following assessments were conducted: food intake, cardiorespiratory maximal treadmill test, isokinetic strength testing, body composition and anthropometry, abdominal endurance test, trunk extensor endurance test, flexibility test and functional (stair and chair) tests. Results There was no significant difference pre- and post-intervention in calorie intake [F(2, 57) = 0.02744, p = 0.97)]. A significant improvement in oxygen uptake at ventilatory threshold (p = 0.001; d = 0.60), respiratory compensation point (p = 0.01; d = 0.48), and maximum effort (p = 0.01; d = 0.33) was observed only in the Pilates group. Isokinetic peak torque for knee flexor and extensor muscles did not change for any groups. Lean mass (p = 0.0005; d = 0.19) and fat mass (p = 0.0001; d = 0.19) improved only in the Pilates group. Waist and hip circumference measurements decreased similarly in both experimental groups. Abdominal test performance improved more in the Pilates group (p = 0.0001; d = 1.69) than in the aerobic group (p = 0.003; d = 0.95). Trunk extensor endurance and flexibility improved only in the Pilates group (p = 0.0003; d = 0.80 and p = 0.0001; d = 0.41, respectively). The Pilates group showed greater improvement on the chair and stair tests (p = 0.0001; d = 1.48 and p = 0.003; d = 0.78, respectively) than the aerobic group (p = 0.005; d = 0.75 and p = 0.05; d = 0.41, respectively). Conclusion Pilates can be used as an alternative physical training method for individuals who are overweight or obese since it promotes significant effects in cardiorespiratory fitness, body composition, and performance on functional tests.
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Affiliation(s)
| | | | - Ricardo B Viana
- Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Ana A Benedito-Silva
- Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, Brazil
| | - Rodrigo L Vancini
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Naryana Mascarin
- Departamento de Fisiologia, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Marilia S Andrade
- Departamento de Fisiologia, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
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95
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Tomar M, Rao RP, Dorairaj P, Koshta A, Suresh S, Rafiq M, Kumawat R, Paramesh R, V BU, Venkatesh K. A clinical and computational study on anti-obesity effects of hydroxycitric acid. RSC Adv 2019; 9:18578-18588. [PMID: 35547650 PMCID: PMC9087877 DOI: 10.1039/c9ra01345h] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 07/18/2019] [Accepted: 06/06/2019] [Indexed: 12/03/2022] Open
Abstract
Hydroxycitric acid (HCA), a major active ingredient of Garcinia cambogia extracts, is known to suppress body weight gain and fat synthesis in animals and humans. But the underlying mechanism of HCA action is not fully understood. Clinical study on 100 obese individuals for a period of 3 months was performed followed by a computational study aimed to investigate the effects of HCA treatment on human subjects at anthropometric and plasma lipid profile levels. A detailed hepatic metabolic model was used to incorporate the effect of HCA at the metabolic pathway level. Perturbation analysis of ATP citrate lyase activity in the metabolic pathway was performed to simulate the net effect of HCA. Significant reductions in body weight, triceps, subscapular, and mid axillary measurements as well as in serum triglyceride, cholesterol, HDL and LDL levels were observed following HCA dosage. During the study, half of the subjects experienced a decline in body weight and the remainder experienced an increase in body weight. However, analysis of fat mass with the help of empirical correlations clearly showed significant reduction in the mean values due to HCA dosage in both cases. An extra increase in fat free mass was responsible for offsetting the decrease in fat mass for the subjects who experienced an increase in body weight during the trials. Perturbation analysis showed a net reduction in fatty acid, triglyceride and cholesterol synthesis along with urea cycle fluxes under lipogenetic conditions. Moreover, protein synthesis fluxes increased under these conditions. These results indicate that HCA treatment can reduce body weight gain and fat accumulation in obese subjects along with improving their anthropometric parameters and metabolic state. Hydroxycitric acid (HCA), a major active ingredient of Garcinia cambogia extracts, is known to suppress body weight gain and fat synthesis in animals and humans.![]()
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Affiliation(s)
- Manu Tomar
- Department of Chemical Engineering
- Indian Institute of Technology, Bombay
- Mumbai – 400076
- India
| | | | | | - Abhishek Koshta
- Department of Chemical Engineering
- Indian Institute of Technology, Bombay
- Mumbai – 400076
- India
| | - Sowbhagya Suresh
- Department of Chemical Engineering
- Indian Institute of Technology, Bombay
- Mumbai – 400076
- India
| | | | | | | | - Babu U. V
- The Himalaya Drug Company
- Bengaluru
- India
| | - K. V. Venkatesh
- Department of Chemical Engineering
- Indian Institute of Technology, Bombay
- Mumbai – 400076
- India
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96
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Ghanemi A, Yoshioka M, St-Amand J. Broken Energy Homeostasis and Obesity Pathogenesis: The Surrounding Concepts. J Clin Med 2018; 7:E453. [PMID: 30463389 PMCID: PMC6262529 DOI: 10.3390/jcm7110453] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 11/15/2018] [Accepted: 11/19/2018] [Indexed: 11/16/2022] Open
Abstract
Obesity represents an abnormal fat accumulation resulting from energy imbalances. It represents a disease with heavy consequences on population health and society economy due to its related morbidities and epidemic proportion. Defining and classifying obesity and its related parameters of evaluation is the first challenge toward understanding this multifactorial health problem. Therefore, within this review we report selected illustrative examples of the underlying mechanisms beyond the obesity pathogenesis which is systemic rather than limited to fat accumulation. We also discuss the gut-brain axis and hormones as the controllers of energy homeostasis and report selected impacts of obesity on the key metabolic tissues. The concepts of "broken energy balance" is detailed as the obesity starting key step. Sleep shortage and psychological factors are also reported with influences on obesity development. Importantly, describing such mechanistic pathways would allow clinicians, biologists and researchers to develop and optimize approaches and methods in terms of diagnosis, classification, clinical evaluation, treatment and prognosis of obesity.
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Affiliation(s)
- Abdelaziz Ghanemi
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec G1V 0A6, Canada.
- Functional Genomics Laboratory, CREMI, Québec Genome Center, CHUL-CHU de Québec Research Center, Québec, Québec G1V 4G2, Canada.
| | - Mayumi Yoshioka
- Functional Genomics Laboratory, CREMI, Québec Genome Center, CHUL-CHU de Québec Research Center, Québec, Québec G1V 4G2, Canada.
| | - Jonny St-Amand
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec G1V 0A6, Canada.
- Functional Genomics Laboratory, CREMI, Québec Genome Center, CHUL-CHU de Québec Research Center, Québec, Québec G1V 4G2, Canada.
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Amiri P, Kazemian E, Mansouri-Tehrani MM, Khalili A, Amouzegar A. Does motivational interviewing improve the weight management process in adolescents? Protocol for a systematic review and meta-analysis. Syst Rev 2018; 7:178. [PMID: 30376888 PMCID: PMC6208103 DOI: 10.1186/s13643-018-0814-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 09/11/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Data on the effects of motivational interviewing (MI) on modifying unhealthy lifestyles and promoting weight status during childhood is controversial. Adolescents are more prone to assume higher personal responsibilities for behavioral changes. This study aims to investigate whether MI will improve weight management process in adolescents. METHODS/DESIGN A systematic review will be conducted on clinical trials, assessing the effect of MI on weight management processes in adolescents, aged 10 to 19 years. The primary objective is to assess the efficacy of MI in controlling weight-related measures in overweight and obese adolescents. Secondary objectives are assessing the efficacy of MI on obesity-related behaviors and cognitive abilities considering heterogeneity in outcomes of primary studies in different MI settings. Main data sources include MEDLINE/PubMed, Scopus, Embase, Web of Science, Cochrane, and PsycINFO from 1980 to May, 2018, with no language restrictions. Study selection, data extraction, and risk of bias assessment will be performed by two independent reviewers. A meta-analysis will be conducted on relevant outcomes. Data will be analyzed for outcome of interest using the 95% confidence interval (CI) of an estimate for dichotomous outcomes and mean differences (MDs) for continious outcomes. Cochrane's Q statistic and the I2 statistic will be performed to evaluate the heterogeneity. Subgroup analysis and suitable analytical strategies will be conducted to identify the potential sources of heterogeneity. As we expect a high heterogeneity in our included studies, pooled risk ratios (RRs) and 95% CI will be calculated to estimate the overall effect sizes, using meta-regression models or finite mixture modeling through conducting random effect methods. GRADE system will be used to evaluate the certainty of evidence. We will also use subgroup analysis and the GRADE system to investigate the effect of methodological quality of primary studies on results of meta-analysis. Funnel plots and egger and beggs test and plot will be implemented to assess publication bias. DISCUSSION The results of this systematic review will provide more insights regarding the effect of MI on weight management in adolescents and will be useful for future research and health promotion programs in this age group. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2017:CRD42017069813.
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Affiliation(s)
- Parisa Amiri
- Research Center of Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Kazemian
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
- Department of Basic Sciences and Cellular and Molecular Nutrition, Faculty of Nutrition Sciences and Food Technology and National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Masih Mansouri-Tehrani
- Research Center of Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Khalili
- Research Center of Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atieh Amouzegar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
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Barrett S, Begg S, O’Halloran P, Kingsley M. Integrated motivational interviewing and cognitive behaviour therapy for lifestyle mediators of overweight and obesity in community-dwelling adults: a systematic review and meta-analyses. BMC Public Health 2018; 18:1160. [PMID: 30290793 PMCID: PMC6173936 DOI: 10.1186/s12889-018-6062-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 09/24/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate whether integrated motivational interviewing and cognitive behaviour therapy leads to changes in lifestyle mediators of overweight and obesity in community-dwelling adults. METHOD Six electronic databases were systematically searched up to 04 October, 2017. Analyses were restricted to randomised controlled trials that examined the effect of integrated motivational interviewing and cognitive behaviour therapy on lifestyle mediators of overweight and obesity (physical activity, diet, body composition) in community-dwelling adults. Meta-analyses were conducted using change scores from baseline in outcome measures specific to the lifestyle mediators of overweight and obesity to determine standardized mean differences (SMD) and 95% confidence intervals (95% CI). The Grades of Recommendation, Assessment, Development and Evaluation approach was used to evaluate the quality of the evidence. RESULTS Ten randomised controlled trials involving 1949 participants were included. Results revealed moderate quality evidence that integrated motivational interviewing and cognitive behaviour therapy had a significant effect in increasing physical activity levels in community-dwelling adults (SMD: 0.18, 95% CI: 0.06 to 0.31, p < 0.05). The combined intervention resulted in a small, non-significant effect in body composition changes (SMD: -0.12, 95% CI: -0.24 to 0.01, p = 0.07). Insufficient evidence existed for outcome measures relating to dietary change. DISCUSSION The addition of integrated motivational interviewing and cognitive behaviour therapy to usual care can lead to modest improvements in physical activity and body composition for community-dwelling adults. The available evidence demonstrates that it is feasible to integrate MI with CBT and that this combined intervention has the potential to improve health-related outcomes. CONCLUSION This review details recommendations for future research including the adoption of uniform objective outcome measures and well-defined interventions with sufficient follow-up durations and assessments of treatment fidelity.
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Affiliation(s)
- Stephen Barrett
- La Trobe University, La Trobe Rural Health School, PO Box 199, Bendigo, VIC 3552 Australia
| | - Stephen Begg
- La Trobe University, La Trobe Rural Health School, PO Box 199, Bendigo, VIC 3552 Australia
| | - Paul O’Halloran
- La Trobe University, School of Psychology and Public Health, Bundoora, VIC 3068 Australia
| | - Michael Kingsley
- La Trobe University, La Trobe Rural Health School, PO Box 199, Bendigo, VIC 3552 Australia
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Batrakoulis A, Jamurtas AZ, Georgakouli K, Draganidis D, Deli CK, Papanikolaou K, Avloniti A, Chatzinikolaou A, Leontsini D, Tsimeas P, Comoutos N, Bouglas V, Michalopoulou M, Fatouros IG. High intensity, circuit-type integrated neuromuscular training alters energy balance and reduces body mass and fat in obese women: A 10-month training-detraining randomized controlled trial. PLoS One 2018; 13:e0202390. [PMID: 30138475 PMCID: PMC6107179 DOI: 10.1371/journal.pone.0202390] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 08/02/2018] [Indexed: 01/06/2023] Open
Abstract
This randomized controlled trial examined body mass, body composition, energy balance and performance responses of previously sedentary overweight/obese women to a circuit-type integrated neuromuscular training program with alternative modalities. Forty-nine healthy overweight or class I obese females (36.4±4.4 yrs) were randomly assigned to either a control (N = 21), training (N = 14) or training-detraining (N = 14) group. In weeks 1-20, the training groups trained three times/week using 10-12 whole-body exercises of progressively increased intensity/volume, organized in timed interval circuit form. In weeks 21-40, the training group continued training whereas the training-detraining group not. Heart rate, perceived exertion, blood lactate, exertion, oxygen consumption and excess post-exercise oxygen consumption were measured for one session/phase/person and exercise energy expenditure was calculated. Energy intake, habitual physical activity, resting metabolic rate, body composition, body mass, strength and maximal oxygen consumption were measured at baseline, mid-intervention and post-intervention. A two-way repeated measures ANOVA was used to determine differences between three time points and three groups. In C, VO2max declined (p<0.013) and body fat (p<0.008), waist (p<0.059) and hip (p<0.012) circumferences increased after 40 weeks compared to baseline. Training reduced body mass (6%, p<0.001), body fat (~5.5%, p<0.001) and increased fat-free mass (1.2-3.4%, p<0.05), strength (27.2%, p<0.001) and endurance (26.8%, p<0.001) after a 10-month implementation period using a metabolic overload of only 5-12 metabolic equivalents of task-hours per week. Training induced a long-term negative energy balance during an exercise and a non-exercise day due to an elevation of resting metabolic rate (6%-10%, p<0.05) and exercise-related energy expenditure. Training had an 8% and 94% attrition and attendance rates, respectively. Training-induced gains were attenuated but not lost following a 5-month detraining. A 10-month implementation of a high-intensity interval type training program elicited both endurance and musculoskeletal gains and resulted in a long-term negative energy balance that induced a progressive and sustained reduction of body and fat mass. TRIAL REGISTRATION ClinicalTrials.gov NCT03134781.
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Affiliation(s)
- Alexios Batrakoulis
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, Greece
| | - Athanasios Z. Jamurtas
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, Greece
| | - Kalliopi Georgakouli
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, Greece
| | - Dimitrios Draganidis
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, Greece
| | - Chariklia K. Deli
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, Greece
| | | | - Alexandra Avloniti
- School of Physical Education and Sport Sciences, Democritus University of Thrace, Komotini, Greece
| | | | - Diamanda Leontsini
- School of Physical Education and Sport Sciences, Democritus University of Thrace, Komotini, Greece
| | - Panagiotis Tsimeas
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, Greece
| | - Nikolaos Comoutos
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, Greece
| | - Vassilios Bouglas
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, Greece
| | - Maria Michalopoulou
- School of Physical Education and Sport Sciences, Democritus University of Thrace, Komotini, Greece
| | - Ioannis G. Fatouros
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala, Greece
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Saslow LR, Summers C, Aikens JE, Unwin DJ. Outcomes of a Digitally Delivered Low-Carbohydrate Type 2 Diabetes Self-Management Program: 1-Year Results of a Single-Arm Longitudinal Study. JMIR Diabetes 2018; 3:e12. [PMID: 30291081 PMCID: PMC6238840 DOI: 10.2196/diabetes.9333] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 02/22/2018] [Accepted: 03/25/2018] [Indexed: 02/01/2023] Open
Abstract
Background Type 2 diabetes mellitus has serious health consequences, including blindness, amputation, stroke, and dementia, and its annual global costs are more than US $800 billion. Although typically considered a progressive, nonreversible disease, some researchers and clinicians now argue that type 2 diabetes may be effectively treated with a carbohydrate-reduced diet. Objective Our objective was to evaluate the 1-year outcomes of the digitally delivered Low-Carb Program, a nutritionally focused, 10-session educational intervention for glycemic control and weight loss for adults with type 2 diabetes. The program reinforces carbohydrate restriction using behavioral techniques including goal setting, peer support, and behavioral self-monitoring. Methods The study used a quasi-experimental research design comprised of an open-label, single-arm, pre-post intervention using a sample of convenience. From adults with type 2 diabetes who had joined the program and had a complete baseline dataset, we randomly selected participants to be followed for 1 year (N=1000; mean age 56.1, SD 15.7 years; 59.30% (593/1000) women; mean glycated hemoglobin A1c (HbA1c) 7.8%, SD 2.1%; mean body weight 89.6 kg, SD 23.1 kg; taking mean 1.2, SD 1.01 diabetes medications). Results Of the 1000 study participants, 708 (70.80%) individuals reported outcomes at 12 months, 672 (67.20%) completed at least 40% of the lessons, and 528 (52.80%) completed all lessons of the program. Of the 743 participants with a starting HbA1c at or above the type 2 diabetes threshold of 6.5%, 195 (26.2%) reduced their HbA1c to below the threshold while taking no glucose-lowering medications or just metformin. Of the participants who were taking at least one hypoglycemic medication at baseline, 40.4% (289/714) reduced one or more of these medications. Almost half (46.40%, 464/1000) of all participants lost at least 5% of their body weight. Overall, glycemic control and weight loss improved, especially for participants who completed all 10 modules of the program. For example, participants with elevated baseline HbA1c (≥7.5%) who engaged with all 10 weekly modules reduced their HbA1c from 9.2% to 7.1% (P<.001) and lost an average of 6.9% of their body weight (P<.001). Conclusions Especially for participants who fully engage, an online program that teaches a carbohydrate-reduced diet to adults with type 2 diabetes can be effective for glycemic control, weight loss, and reducing hypoglycemic medications.
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Affiliation(s)
- Laura R Saslow
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | | | - James E Aikens
- Department of Family Medicine, University of Michigan Medical School, University of Michigan, Ann Arbor, MI, United States
| | - David J Unwin
- Principal in General Practice, The Norwood Surgery, Southport, United Kingdom
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