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Liu S, Qian F, Lu Q, Deng Y, Qu W, Lin X, Li R, Li R, Guo T, Pan A, Liu G. Association of life's essential 8 with risk of recurrent cardiovascular events among patients with coronary heart disease. Int J Cardiol 2024; 412:132318. [PMID: 38971538 DOI: 10.1016/j.ijcard.2024.132318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/17/2024] [Accepted: 07/01/2024] [Indexed: 07/08/2024]
Abstract
AIMS To examine the association of Life's Essential 8 (LE8) with the risk of recurrent cardiovascular events among patients with CHD. METHODS This prospective cohort study included 11,997 patients with CHD from the UK Biobank. The LE8 score was generated using five lifestyle factors (diet, body mass index, physical activity, smoking, and sleep) and three biological factors (blood lipids, blood glucose, and blood pressure). LE8 score ranged from 0 to 100 and was categorized into quartiles. Cox proportional hazards regression models were applied to estimate the hazard ratio (HR) and 95% CI (confidence interval). RESULTS During a median follow up of 12.5 years, we documented 3366 recurrent cardiovascular events, 1068 myocardial infarction, 1829 heart failure events, 703 strokes, and 934 cardiovascular deaths. The multivariable-adjusted HR (95% CI) for the highest versus the lowest quartile of LE8 score was 0.57 (0.50, 0.65) for recurrent cardiovascular events, 0.66 (0.52, 0.83) for myocardial infarction, 0.54 (0.45, 0.67) for heart failure, 0.50 (0.36, 0.68) for stroke, and 0.46 (0.37, 0.56) for cardiovascular death. Furthermore, the population attributable fraction of the lowest to the highest quartile of LE8 score were ranged from 16.2% to 32.5% for the various cardiovascular outcomes. In addition, biomarkers including renal function and inflammation collectively explained 47.6%-87.7% of the associations between the lifestyle factors and recurrent cardiovascular events. CONCLUSIONS Better cardiovascular health as measured by LE8 was associated with significantly lower risk of recurrent cardiovascular events among patients with CHD. Clinicians should prioritize educating patients with CHD on the importance of optimal cardiovascular health for secondary prevention. In addition, our findings indicated significant mediation effect of biomarkers involving of glycemic control, renal function, liver function, lipid profile, and systemic inflammation on the associations between overall lifestyle factors and recurrent cardiovascular events.
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Affiliation(s)
- Sen Liu
- Nanchang Center for Disease Control and Prevention, Nanchang, China; Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Frank Qian
- Section of Cardiovascular Medicine, Boston Medical Center, and Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Qi Lu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yulei Deng
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wensheng Qu
- Department of Neurology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyu Lin
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ruyi Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tianyu Guo
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Xie Y, Gu Y, Li Z, He B, Zhang L. Effects of Different Exercises Combined with Different Dietary Interventions on Body Composition: A Systematic Review and Network Meta-Analysis. Nutrients 2024; 16:3007. [PMID: 39275322 PMCID: PMC11397086 DOI: 10.3390/nu16173007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 08/28/2024] [Accepted: 09/03/2024] [Indexed: 09/16/2024] Open
Abstract
BACKGROUND Exercise and dietary interventions are essential for maintaining weight and reducing fat accumulation. With the growing popularity of various dietary strategies, evidence suggests that combining exercise with dietary interventions offers greater benefits than either approach alone. Consequently, this combined strategy has become a preferred method for many individuals aiming to maintain health. Calorie restriction, 5/2 intermittent fasting, time-restricted feeding, and the ketogenic diet are among the most popular dietary interventions today. Aerobic exercise, resistance training, and mixed exercise are the most widely practiced forms of physical activity. Exploring the best combinations of these approaches to determine which yields the most effective results is both meaningful and valuable. Despite this trend, a comparative analysis of the effects of different exercise and diet combinations is lacking. This study uses network meta-analysis to evaluate the impact of various combined interventions on body composition and to compare their efficacy. METHODS We systematically reviewed literature from database inception through May 2024, searching PubMed, Web of Science, Embase, and the Cochrane Library. The study was registered in PROSPERO under the title: "Effects of Exercise Combined with Different Dietary Interventions on Body Composition: A Systematic Review and Network Meta-Analysis" (identifier: CRD42024542184). Studies were meticulously selected based on specific inclusion and exclusion criteria (The included studies must be randomized controlled trials involving healthy adults aged 18 to 65 years. Articles were rigorously screened according to the specified inclusion and exclusion criteria.), and their risk of bias was assessed using the Cochrane risk of bias tool. Data were aggregated and analyzed using network meta-analysis, with intervention efficacy ranked by Surface Under the Cumulative Ranking (SUCRA) curves. RESULTS The network meta-analysis included 78 randomized controlled trials with 5219 participants, comparing the effects of four combined interventions: exercise with calorie restriction (CR+EX), exercise with time-restricted eating (TRF+EX), exercise with 5/2 intermittent fasting (5/2F+EX), and exercise with a ketogenic diet (KD+EX) on body composition. Intervention efficacy ranking was as follows: (1) Weight Reduction: CR+EX > KD+EX > TRF+EX > 5/2F+EX (Relative to CR+EX, the effect sizes of 5/2F+EX, TRF+EX and KD+EX are 2.94 (-3.64, 9.52); 2.37 (-0.40, 5.15); 1.80 (-1.75, 5.34)). (2) BMI: CR+EX > KD+EX > 5/2F+EX > TRF+EX (Relative to CR+EX, the effect sizes of 5/2F+EX, TRF+EX and KD+EX are 1.95 (-0.49, 4.39); 2.20 (1.08, 3.32); 1.23 (-0.26, 2.71)). (3) Body Fat Percentage: CR+EX > 5/2F+EX > TRF+EX > KD+EX (Relative to CR+EX, the effect sizes of 5/2F+EX, TRF+EX and KD+EX are 2.66 (-1.56, 6.89); 2.84 (0.56, 5.13); 3.14 (0.52, 5.75).). (4) Lean Body Mass in Male: CR+EX > TRF+EX > KD+EX (Relative to CR+EX, the effect sizes of TRF+EX and KD+EX are -1.60 (-6.98, 3.78); -2.76 (-7.93, 2.40)). (5) Lean Body Mass in Female: TRF+EX > CR+EX > 5/2F+EX > KD+EX (Relative to TRF+EX, the effect sizes of CR+EX, 5/2F+EX and KD+EX are -0.52 (-2.58, 1.55); -1.83 (-4.71, 1.04); -2.46 (-5.69,0.76).). CONCLUSION Calorie restriction combined with exercise emerged as the most effective strategy for reducing weight and fat percentage while maintaining lean body mass. For women, combining exercise with time-restricted eating proved optimal for preserving muscle mass. While combining exercise with a ketogenic diet effectively reduces weight, it is comparatively less effective at decreasing fat percentage and preserving lean body mass. Hence, the ketogenic diet combined with exercise is considered suboptimal.
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Affiliation(s)
- Yongchao Xie
- Centre for Sport Nutrition and Health, Centre for Nutritional Ecology, School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou 450001, China
| | - Yu Gu
- Henan Sports Medicine and Rehabilitation Center, Henan Sport University, Zhengzhou 450044, China
| | - Zhen Li
- Centre for Sport Nutrition and Health, Centre for Nutritional Ecology, School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou 450001, China
| | - Bingchen He
- Department of Physical Education, South China University of Technology, Guangzhou 510641, China
| | - Lei Zhang
- Centre for Sport Nutrition and Health, Centre for Nutritional Ecology, School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou 450001, China
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Khalafi M, Habibi Maleki A, Symonds ME, Rosenkranz SK, Rohani H, Ehsanifar M. The effects of intermittent fasting on body composition and cardiometabolic health in adults with prediabetes or type 2 diabetes: A systematic review and meta-analysis. Diabetes Obes Metab 2024; 26:3830-3841. [PMID: 38956175 DOI: 10.1111/dom.15730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/23/2024] [Accepted: 05/31/2024] [Indexed: 07/04/2024]
Abstract
AIM To perform a meta-analysis to investigate the effects of intermittent fasting (IF), as compared with either a control diet (CON) and/or calorie restriction (CR), on body composition and cardiometabolic health in individuals with prediabetes and type 2 diabetes (T2D). METHODS PubMed, Web of Science, and Scopus were searched from their inception to March 2024 to identify original randomized trials with parallel or crossover designs that studied the effects of IF on body composition and cardiometabolic health. Weighted mean differences (WMDs) or standardized mean differences with 95% confidence intervals (CIs) were calculated using random-effects models. RESULTS Overall, 14 studies involving 1101 adults with prediabetes or T2D were included in the meta-analysis. IF decreased body weight (WMD -4.56 kg [95% CI -6.23 to -2.83]; p = 0.001), body mass index (BMI; WMD -1.99 kg.m2 [95% CI -2.74 to -1.23]; p = 0.001), glycated haemoglobin (HbA1c; WMD -0.81% [95% CI -1.24 to -0.38]; p = 0.001), fasting glucose (WMD -0.36 mmol/L [95% CI -0.63 to -0.09]; p = 0.008), total cholesterol (WMD -0.31 mmol/L [95% CI -0.60 to -0.02]; p = 0.03) and triglycerides (WMD -0.14 mmol/L [95% CI -0.27 to -0.01]; p = 0.02), but did not significantly decrease fat mass, insulin, low-densitiy lipoprotein, high-density lipoprotein, or blood pressure as compared with CON. Furthermore, IF decreased body weight (WMD -1.14 kg [95% CI -1.69 to -0.60]; p = 0.001) and BMI (WMD -0.43 kg.m2 [95% CI -0.58 to -0.27]; p = 0.001), but did not significantly affect fat mass, lean body mass, visceral fat, insulin, HbA1c, lipid profiles or blood pressure. CONCLUSION Intermittent fasting is effective for weight loss and specific cardiometabolic health markers in individuals with prediabetes or T2D. Additionally, IF is associated with a reduction in body weight and BMI compared to CR, without effects on glycaemic markers, lipid profiles or blood pressure.
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Affiliation(s)
- Mousa Khalafi
- Department of Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran
| | - Aref Habibi Maleki
- Department of Exercise Physiology and Corrective Exercises, Faculty of Sport Sciences, Urmia University, Urmia, Iran
| | - Michael E Symonds
- Centre for Perinatal Research, Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Sara K Rosenkranz
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Hadi Rohani
- Department of Exercise Physiology, Sport Sciences Research Institute, Tehran, Iran
| | - Mahsa Ehsanifar
- Department of Exercise Physiology and Corrective Exercises, Faculty of Sport Sciences, Urmia University, Urmia, Iran
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Pandey A, Patel KV, Segar MW, Ayers C, Linge J, Leinhard OD, Anker SD, Butler J, Verma S, Joshi PH, Neeland IJ. Effect of liraglutide on thigh muscle fat and muscle composition in adults with overweight or obesity: Results from a randomized clinical trial. J Cachexia Sarcopenia Muscle 2024; 15:1072-1083. [PMID: 38561962 PMCID: PMC11154779 DOI: 10.1002/jcsm.13445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/28/2024] [Accepted: 02/11/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Excess muscle fat is observed in obesity and associated with greater burden of cardiovascular risk factors and higher risk of mortality. Liraglutide reduces total body weight and visceral fat but its effect on muscle fat and adverse muscle composition is unknown. METHODS This is a pre-specified secondary analysis of a randomized, double-blind, placebo-controlled trial that examined the effects of liraglutide plus a lifestyle intervention on visceral adipose tissue and ectopic fat among adults without diabetes with body mass index ≥30 kg/m2 or ≥27 kg/m2 and metabolic syndrome. Participants were randomly assigned to a once-daily subcutaneous injection of liraglutide (target dose 3.0 mg) or matching placebo for 40 weeks. Body fat distribution and muscle composition was assessed by magnetic resonance imaging at baseline and 40-week follow-up. Muscle composition was described by the combination of thigh muscle fat and muscle volume. Treatment difference (95% confidence intervals [CI]) was calculated by least-square means adjusted for baseline thigh muscle fat. The association between changes in thigh muscle fat and changes in body weight were assessed using Spearman correlation coefficients. The effect of liraglutide versus placebo on adverse muscle composition, denoted by high thigh muscle fat and low thigh muscle volume, was explored. RESULTS Among the 128 participants with follow-up imaging (92.2% women, 36.7% Black), median muscle fat at baseline was 7.8%. The mean percent change in thigh muscle fat over median follow-up of 36 weeks was -2.87% among participants randomized to liraglutide (n = 73) and 0.05% in the placebo group (absolute change: -0.23% vs. 0.01%). The estimated treatment difference adjusted for baseline thigh muscle fat was -0.24% (95% CI, -0.41 to -0.06, P-value 0.009). Longitudinal change in thigh muscle fat was significantly associated with change in body weight in the placebo group but not the liraglutide group. The proportion of participants with adverse muscle composition decreased from 11.0% to 8.2% over follow-up with liraglutide, but there was no change with placebo. CONCLUSIONS In a cohort of predominantly women with overweight or obesity in the absence of diabetes, once-daily subcutaneous liraglutide was associated with a reduction in thigh muscle fat and adverse muscle composition compared with placebo. The contribution of muscle fat improvement to the cardiometabolic benefits of liraglutide requires further study.
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Affiliation(s)
| | - Kershaw V. Patel
- Department of CardiologyHouston Methodist DeBakey Heart & Vascular CenterHoustonTXUSA
| | | | - Colby Ayers
- University of Texas Southwestern Medical CenterDallasTXUSA
| | - Jennifer Linge
- AMRA Medical and Linköping UniversityLinköpingSweden
- Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist MedicineLinköping UniversityLinköpingSweden
| | - Olof D. Leinhard
- AMRA Medical and Linköping UniversityLinköpingSweden
- Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist MedicineLinköping UniversityLinköpingSweden
| | - Stefan D. Anker
- Department of Cardiology (CVK), Berlin Institute of Health Center for Regenerative Therapies (BCRT), and German Centre for Cardiovascular Research (DZHK) Partner Site BerlinCharité UniversitätsmedizinBerlinGermany
| | - Javed Butler
- Baylor Heart and Vascular InstituteBaylor University Medical CenterDallasTXUSA
- Department of MedicineUniversity of Mississippi School of MedicineJacksonMSUSA
| | - Subodh Verma
- St. Michael's HospitalUniversity of TorontoTorontoONCanada
| | - Parag H. Joshi
- University of Texas Southwestern Medical CenterDallasTXUSA
| | - Ian J. Neeland
- Harrington Heart and Vascular InstituteUniversity Hospitals Cleveland Medical Center and Case Western Reserve University School of MedicineClevelandOHUSA
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Zhao K, Zhu H, Huang L, Yang N, Othman SMA, Shi W, Hua H, Liang H, Xu Q. Formation Mechanisms, Interrelationships, and Effects of Cognitive Factors on Diet and Physical Activity During the Post-Bariatric Surgery Period: A Cross-Sectional Study Based on Compensatory Carry-Over Action Model. Diabetes Metab Syndr Obes 2024; 17:1887-1901. [PMID: 38711676 PMCID: PMC11070847 DOI: 10.2147/dmso.s455913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/17/2024] [Indexed: 05/08/2024] Open
Abstract
Background Diet and physical activity (PA) are pivotal behaviors for managing energy balance post-bariatric surgery. Given the need for dual behavioral management, understanding the interplay of cognitive factors influencing these behaviors is crucial. This study applied the compensatory carry-over action model (CCAM) to explore the impact of cognitive factors on behaviors and their subsequent effects on subjective health outcomes. Methods This cross-sectional study was conducted among patients at the third month after bariatric surgery in China. Data on diet and PA status, behavioral cognitive factors (intention, self-efficacy, compensatory belief, transfer cognition), and subjective health outcomes (perceived stress, well-being, quality of life) were collected. Structural equation model (SEM) was employed to test hypotheses in CCAM and assess mediation relationships. Results Analysis of data from 239 patients revealed the following: (1) Among antecedent cognitive factors, only compensatory belief significantly influenced diet (P<0.001). (2) Intention and self-efficacy directly correlated with their respective behaviors, while compensatory belief affected intention, and transfer cognition impacted self-efficacy (P<0.05), aligning with CCAM hypotheses. (3) PA demonstrated significant influence only on perceived stress (P=0.004), whereas diet significantly affected all subjective health outcomes (P<0.05). (4) Mediation analysis indicated intention partially mediated the relationship between compensatory belief and diet and fully mediated the relationship between compensatory belief and PA. Self-efficacy completely mediated the relationship between transfer cognition and diet and PA. Conclusion Transfer cognition's carry-over effect did not directly influence behaviors among antecedent cognitions. Interventions should primarily target improving diet by mitigating compensatory belief. Moreover, diet exhibited a more pronounced impact on overall health compared to PA. Consequently, prioritizing dietary intervention over PA intervention is warranted based on the analysis of CCAM and the aim of promoting joint behaviors post-bariatric surgery.
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Affiliation(s)
- Kang Zhao
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Lidong Huang
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Ningli Yang
- Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | | | - Wenbing Shi
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Hongxia Hua
- Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Hui Liang
- Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
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Lee DC, Brellenthin AG, Lanningham-Foster LM, Kohut ML, Li Y. Aerobic, resistance, or combined exercise training and cardiovascular risk profile in overweight or obese adults: the CardioRACE trial. Eur Heart J 2024; 45:1127-1142. [PMID: 38233024 PMCID: PMC10984570 DOI: 10.1093/eurheartj/ehad827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/22/2023] [Accepted: 12/01/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND AND AIMS To determine the comparative efficacy of resistance, aerobic, and combined resistance plus aerobic exercise on cardiovascular disease (CVD) risk profile. METHODS This randomized controlled trial enrolled 406 adults aged 35-70 years with overweight or obesity and elevated blood pressure. Participants were randomly assigned to resistance (n = 102), aerobic (n = 101), combined resistance plus aerobic exercise (n = 101), or no-exercise control (n = 102). All exercise participants were prescribed 1 h of time-matched supervised exercise (the combination group with 30 min of each resistance and aerobic exercise) three times per week for 1 year. The primary outcome was the change from baseline to 1 year in the standardized composite Z-score of four well-established CVD risk factors: systolic blood pressure, low-density lipoprotein (LDL) cholesterol, fasting glucose, and per cent body fat. RESULTS Among 406 participants (53% women), 381 (94%) completed 1-year follow-up. Compared with the control group, the composite Z-score decreased at 1 year, which indicates improved CVD risk profile, in the aerobic {mean difference, -0.15 [95% confidence interval (CI): -0.27 to -0.04]; P = .01} and combination [mean difference, -0.16 (95% CI: -0.27 to -0.04); P = .009] groups, but not in the resistance [mean difference, -0.02 (95% CI: -0.14 to 0.09); P = .69] group. Both aerobic and combination groups had greater reductions in the composite Z-score compared with the resistance group (both P = .03), and there was no difference between the aerobic and combination groups (P = .96). Regarding the four individual CVD risk factors, only per cent body fat decreased in all three exercise groups at 1 year, but systolic blood pressure, LDL cholesterol, and fasting glucose did not decrease in any exercise groups, compared with the control group. CONCLUSIONS In adults with overweight or obesity, aerobic exercise alone or combined resistance plus aerobic exercise, but not resistance exercise alone, improved composite CVD risk profile compared with the control.
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Affiliation(s)
- Duck-chul Lee
- Department of Kinesiology, Iowa State University, 534 Wallace Road, Ames, IA 50011, USA
| | | | | | - Marian L Kohut
- Department of Kinesiology, Iowa State University, 534 Wallace Road, Ames, IA 50011, USA
| | - Yehua Li
- Department of Statistics, University of California-Riverside, Riverside, CA, USA
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Ng SH, Babar MG, Ahmed SI, Hasan SS, Yang WY. Measuring empathic behaviour among undergraduate dietetics students. J Eval Clin Pract 2024; 30:153-161. [PMID: 37641432 DOI: 10.1111/jep.13913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/31/2023]
Abstract
AIM Empathic behaviour has a direct link to the positive clinical outcomes. Health professionals, which include dietitians, are increasingly expected to demonstrate the impact of their care on patient outcomes. To date, there is limited research exploring the empathic behaviour of dietetics students. METHODS This cross-sectional study evaluated the psychometric properties of Jefferson Scale of Empathy-Healthcare Provider Student (JSE-HPS) and empathic behaviour of dietetics students. RESULTS Undergraduate dietetics students from one private and two public universities in Malaysia participated (n = 455). Item and scale psychometric properties were examined using principal component analysis and differences in mean empathy scores for students were assessed across years of study and types of universities. A 3-factor solution emerged in the results, accounting for 26.76%, 10.75% and 6.3% of the variance. The JSE-HPS demonstrated good internal consistency (α = 0.83). Despite students enroled at public universities scoring higher mean empathy scores than students enroled at the private university, the difference was not significant. The only significant difference was between the empathy level of first and third year students (p = 0.033). CONCLUSION As empathy underpins patient-centred management in the nutrition care process, it should be well integrated into curriculum delivery so that appropriate levels of empathy can be developed to prepare work-ready healthcare professionals.
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Affiliation(s)
- Shi Hui Ng
- School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Muneer Gohar Babar
- Clinical Oral Health Sciences Division, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Syed Imran Ahmed
- School of Pharmacy, College of Health and Science, University of Lincoln, UK
| | | | - Wai Yew Yang
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
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Bastos M, Gonsalves C, de Almeida BP, Cavazzotto TG, da Silva MP. Do patients with obesity undergoing bariatric surgery modify their objectively measured physical activity? A systematic review and meta-analysis. Int J Obes (Lond) 2024; 48:315-323. [PMID: 38151611 DOI: 10.1038/s41366-023-01452-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Obesity is a chronic disease associated with adverse outcomes and its prevalence is increasing, which makes it a concern. One of the obesity treatment options is bariatric surgery, which effectively reduces calorie absorption and total body mass, but its effects on physical activity (PA) levels need to be clarified, considering the protective effect of the PA against cardiovascular disease, independently of the weight loss alone. OBJECTIVES To carry out a systematic review and meta-analysis of observational studies that evaluated PA in pre- and post-bariatric surgery periods through objective evaluation. METHODS A systematic search was carried out following the PRISMA criteria of studies with adult individuals who underwent bariatric surgery and were objectively evaluated for PA pre- and post-surgery. Studies with interventions were excluded. RESULTS A total of 419 records were found, and after excluding duplicates and applying the eligibility criteria, 10 studies remained. This meta-analysis found a significant increase in the steps by day (MD = 1340; 95% CI = 933.90; 1745.35, p < 0.001) and the light physical activity level (MD = 16.8 min/day; 95% CI = 2.60; 30.98, p = 0.02), but not in moderate to vigorous physical activity (MD = 0.24; 95% CI = -0.08; 1.57, p = 0.92). CONCLUSIONS Patients undergoing bariatric surgery increased their steps by day and light physical activity but did not increase moderate to vigorous physical activity.
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Affiliation(s)
- Murilo Bastos
- Physical Activity and Public Health Research Group (GPASP), Rio Grande, Brazil.
- Pharmaceutical Sciences Sector - Midwestern State University (UNICENTRO), Guarapuava, Brazil.
| | - Camila Gonsalves
- Physical Education Department - Midwestern State University (UNICENTRO), Guarapuava, Brazil
| | - Bruno Pedrini de Almeida
- Physical Activity and Public Health Research Group (GPASP), Rio Grande, Brazil
- Graduate Program in Health Sciences - FAMED - FURG, Rio Grande, Brazil
| | - Timothy G Cavazzotto
- Physical Education Department - Midwestern State University (UNICENTRO), Guarapuava, Brazil
| | - Michael Pereira da Silva
- Physical Activity and Public Health Research Group (GPASP), Rio Grande, Brazil
- Graduate Program in Health Sciences - FAMED - FURG, Rio Grande, Brazil
- Graduate Program in Public Health - FAMED - FURG, Rio Grande, Brazil
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Hajializadeh Z, Khaksari M. Cardioprotective effects of calorie restriction against inflammation and apoptosis in ovariectomized obese rats: Role of classical estrogen receptors and SIRT1. Obes Res Clin Pract 2023; 17:492-498. [PMID: 38071166 DOI: 10.1016/j.orcp.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/29/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023]
Abstract
AIM Obesity is a metabolic complication linked with bad eating habits and a sedentary lifestyle, and the heart is one of the target organs damaged by it. Estrogen deficiency during menopause worsens the situation. Calorie restriction (CR) can contribute to reducing cardiovascular disease (CVD) in postmenopausal conditions. Thus, the effects of CR on inflammation and apoptosis in ovariectomized rats' hearts with obesity were studied. METHOD Female Wistar rats were categorized into Sham and OVX (ovariectomized) groups and received a standard diet (SD) or high-fat diet (60%HFD) or calorie restriction (30% CR) for 16 weeks. The real-time PCR method was used to evaluate the inflammatory markers and estrogen receptors gene expression. Western-blot and ELISA methods were respectively used for the measurement of apoptosis and SIRT1 protein expression. RESULTS HFD led to the elevation of body weight, IL-6 (interleukin-6) and TNF-α (tumor necrosis factor-α) and reduction of IL-10 (interleukin-10) gene expressions, and also an increment in protein levels of cleaved caspase-3, Bax and Bax/Bcl2 ratio and decrement in Bcl-2 in OVX rats (P < 0.001). Additionally, HFD reduced SIRT1 (sirtuin1) protein levels, ERα (estrogen receptor α), and ERβ (estrogen receptor β) gene expressions (P < 0.001). In contrast, CR declined body weight, IL-6 and TNF-α (P < 0.001), increased IL-10 expressions (P < 0.05), decreased cleaved caspase-3 (P < 0.001), Bax (P < 0.01), and Bax/Bcl2 ratio (P < 0.05), enhanced Bcl-2 (P < 0.001), increased SIRT1 (P < 0.05) and ERα (P < 0.001) and ERβ (P < 0.01) expressions. CONCLUSION CR through the SIRT1 regulation and estrogen receptors attenuate obesity-induced-cardiac inflammation and apoptosis. CR can be a cardioprotective candidate in postmenopausal conditions.
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Affiliation(s)
- Zahra Hajializadeh
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Khaksari
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
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10
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Alick CL, Braxton D, Skinner H, Alexander R, Ammerman AS, Keyserling TC, Samuel-Hodge CD. Rural African American Women With Severe Obesity: A Cross-Sectional Analysis of Lifestyle Behaviors and Psychosocial Characteristics. Am J Health Promot 2023; 37:1060-1069. [PMID: 37505193 PMCID: PMC10631280 DOI: 10.1177/08901171231190597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
PURPOSE To examine differences in lifestyle behavioral and psychosocial factors between rural African American women with Class 3 obesity and those with overweight, and Class 1-2 obesity. DESIGN Cross-sectional study. SETTING Rural Southeastern United States. SUBJECTS Participants included 289 African American women with a mean age of 56 years, 66% with a high school education or less, and a mean body mass index (BMI) of 38.6 kg/m2; 35% (n = 102) were classified with Class 3 obesity. MEASURES We objectively measured height, weight, and physical activity steps/day. Self-reported dietary and physical activity behaviors, general health-related quality of life, mental health, and social support were measured with validated surveys. ANALYSIS Chi-Square analysis for categorical variables and analysis of variance (ANOVA) - via multiple linear regression - for continuous variables. RESULTS There were no significant demographic differences between BMI groups, except for age, where women with Class 3 obesity were on average younger (51 vs 58 y, P < .001). Although dietary behaviors did not differ significantly between groups, we observed significant group differences in self-reported and objective measures of physical activity. The age-adjusted difference in means for self-reported total physical activity minutes/wk. was 91 minutes, with women categorized with Class 3 obesity reporting significantly fewer weekly minutes than those with overweight/Class 1-2 obesity (64.3 vs 156.4 min/wk. respectively, P < .01). Among psychosocial variables, only in the physical component scores of health-related quality of life did we find significant group differences - lower physical well-being among women with Class 3 obesity compared to those with overweight/Class 1-2 obesity (P = .02). CONCLUSION For African American women with Class 3 obesity living in rural setting, these findings suggest behavioral weight loss interventions may need to target physical activity strategies that address physical, psychosocial, and environmental barriers.
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Affiliation(s)
- Candice L. Alick
- Center for Health Promotion & Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
| | - Danielle Braxton
- Department of Health Promotion, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Harlyn Skinner
- Department of Biological Science, Center for Human Health and the Environment, North Carolina State University, Chapel Hill, NC, USA
| | - Ramine Alexander
- Department of Family and Consumer Sciences, Food and Nutritional Sciences, North Carolina Agricultural & Technical State University, Greensboro, NC, USA
| | - Alice S. Ammerman
- Department of Nutrition, Gillings School of Global Public Health, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas C. Keyserling
- Internal Medicine, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Carmen D. Samuel-Hodge
- Department of Nutrition, Gillings School of Global Public Health, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
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11
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Patel ML, Rodriguez Espinosa P, King AC. Moderators of a Diet and Physical Activity Intervention: who Responds Best to Sequential vs. Simultaneous Approaches. Int J Behav Med 2023:10.1007/s12529-023-10223-9. [PMID: 37816943 PMCID: PMC11004089 DOI: 10.1007/s12529-023-10223-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Given that low physical activity levels and poor dietary intake are co-occurring risk factors for chronic disease, there is a need for interventions that target both health behaviors, either sequentially or simultaneously. Little is known about participant characteristics that are associated with better or worse response to sequential and simultaneous interventions. METHOD The 12-month Counseling Advice for Lifestyle Management (CALM) randomized trial (N = 150; Mage = 55.3 years) targeted these two behaviors either via a sequential approach - dietary advice first then exercise advice added ("Diet-First") or exercise advice first then dietary advice added ("Exercise-First") - or via a simultaneous approach. The objective was to examine demographic, clinical, and psychosocial moderators of intervention effects on 12-month change in (1) moderate-to-vigorous physical activity (MVPA), (2) fruit/vegetable intake, (3) caloric intake from saturated fat, and (4) weight. Hierarchical regressions first compared Diet-First to Exercise-First, followed by comparisons of these arms combined ("sequential") to the simultaneous arm. RESULTS Older age, higher baseline BMI, and lower social support were associated with higher MVPA in Exercise-First vs. Diet-First, while lower tangible support was associated with higher fruit/vegetable intake in Exercise-First but not in Diet-First. Poor sleep was associated with higher levels of MVPA in the sequential arm than in the simultaneous arm. Lower vitality was associated with greater weight loss in the sequential arm than in the simultaneous arm, while the opposite was true for those who were not married. CONCLUSION Identifying moderators of treatment response can allow the behavioral medicine field to enhance intervention efficacy by matching participant subgroups to their best-fitting interventions. TRIAL REGISTRATION NCT00131105.
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Affiliation(s)
- Michele L Patel
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA.
| | | | - Abby C King
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
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12
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Geiseler SJ, Phan KD, Brox C, Nguyen TD, Tartanoglu C, Doosje HL, Christiansen CL, Liesz A, Morland C. Pre-stroke exercise does not reduce atrophy in healthy young adult mice. Neurosci Lett 2023; 814:137447. [PMID: 37604388 DOI: 10.1016/j.neulet.2023.137447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023]
Abstract
Stroke is the main cause of acquired disability in adults. Exercise reduces the risk for stroke and protects against functional loss after stroke. An exercise-induced reduction in key risk factors probably contributes to the protective effect, but direct effects on the brain may also contribute to stroke protection. We previously reported that exercise increases angiogenesis and neurogenesis through activation of the lactate receptor HCA1. Here we exposed young adult wild-type mice and HCA1 knockout mice to interval exercise at high or medium intensity, or to intraperitoneal injections of L-lactate or saline for seven weeks before we induced experimental stroke by permanent occlusion of the distal medial cerebral artery (dMCA). The resulting cortical atrophy measured three weeks after stroke was unaffected by exercise or L-lactate pre-treatments, and independent of HCA1 activation. Our results suggest that the beneficial effect of exercise prior to stroke where no reperfusion occurs is limited in individuals who do not carry risk factors.
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Affiliation(s)
- Samuel J Geiseler
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway.
| | - Kimberly D Phan
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Camilla Brox
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Teresa D Nguyen
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Can Tartanoglu
- Department of Biosciences, University of Oslo, Oslo, Norway
| | - Hanne-Lise Doosje
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway; Institute for Life Science and Technology, Hanzehogeschool, Groningen, the Netherlands
| | - Cathrine L Christiansen
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Artur Liesz
- Institute for Stroke and Dementia Research, Ludwig-Maximilians University Munich, Munich, Germany; Munich Cluster for Systems Neurology SyNergy, Munich, Germany
| | - Cecilie Morland
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway.
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13
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Coppock JA, McNulty AL, Porter Starr KN, Holt AG, Borack MS, Kosinski AS, Collins AT, Bales CW, DeFrate LE. The effects of a 6-month weight loss intervention on physical function and serum biomarkers in older adults with and without osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100376. [PMID: 37719442 PMCID: PMC10499923 DOI: 10.1016/j.ocarto.2023.100376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 09/19/2023] Open
Abstract
Objective To examine the effects of a 6-month weight loss intervention on physical function, inflammatory biomarkers, and metabolic biomarkers in both those with and without osteoarthritis (OA). Design 59 individuals ≥60 years old with obesity and a functional impairment were enrolled into this IRB approved clinical trial and randomized into one of two 6-month weight loss arms: a higher protein hypocaloric diet or a standard protein hypocaloric diet. All participants were prescribed individualized 500-kcal daily-deficit diets, with a goal of 10% weight loss. Additionally, participants participated in three, low-intensity, exercise sessions per week. Physical function, serum biomarkers and body composition data were assessed at the baseline and 6-month timepoints. Statistical analyses assessed the relationships between biomarkers, physical function, body composition, and OA status as a result of the intervention. Results No group effects of dietary intervention were detected on any outcome measures (multiple p > 0.05). During the 6-month trial, participants lost 6.2 ± 4.0% of their bodyweight (p < 0.0001) and experienced improved physical function on the Short-Performance-Physical-Battery (p < 0.0001), 8-foot-up-and-go (p < 0.0001), and time to complete 10-chair-stands (p < 0.0001). Adiponectin concentrations (p = 0.0480) were elevated, and cartilage oligomeric matrix protein (COMP) concentrations (p < 0.0001) were reduced; further analysis revealed that reductions in serum COMP concentrations were greater in OA-negative individuals. Conclusions These results suggest that weight loss in older adults with and without OA may provide a protective effect to cartilage and OA. In particular, OA-negative individuals may be able to mitigate changes associated with OA through weight loss.
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Affiliation(s)
- James A. Coppock
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Amy L. McNulty
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Department of Pathology, Duke University School of Medicine, Durham, NC, USA
| | - Kathryn N. Porter Starr
- Department of Medicine, Duke University School of Medicine, and Durham VA Medical Center, Durham, NC, USA
- Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
| | - Abigail G. Holt
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Michael S. Borack
- Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
| | - Andrzej S. Kosinski
- Department of Biostatistics & Bioinformatics, Duke University, Durham, NC, USA
| | - Amber T. Collins
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Connie W. Bales
- Department of Medicine, Duke University School of Medicine, and Durham VA Medical Center, Durham, NC, USA
- Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
| | - Louis E. DeFrate
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Department of Mechanical Engineering and Materials Science, Duke University, Durham NC, USA
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14
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Elias S, Dadi TK. Prevalence of Undiagnosed Hypertension and Associated Factors among Adults in Mizan-Aman Town, Bench Sheko Zone, Southwest Ethiopia: A Community-Based Cross-Sectional Study. Adv Med 2023; 2023:2746284. [PMID: 37469806 PMCID: PMC10352527 DOI: 10.1155/2023/2746284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/27/2023] [Accepted: 06/30/2023] [Indexed: 07/21/2023] Open
Abstract
Objectives This study aimed to assess the prevalence of undiagnosed hypertension and associated factors among people aged 18 years and above in Mizan-Aman town of Bench Sheko Zone in Southwest Ethiopia. Study Design. A community-based cross-sectional study design was carried out among people aged 18 years old and above from April 1 to 30, 2021, in Mizan Aman town. Methods A community-based cross-sectional study design was carried out among people aged 18 years old and above from April 1 to 30, 2021, in Mizan Aman town. Seven hundred fifty-nine subjects were selected by the multistage sampling technique. A structured pretested STEPwise questionnaire was used to interview the participants. Data entry and analysis were done using EpiData 3.1 and SPSS version 25 statistical software, respectively. Descriptive analysis was undertaken, and the results were presented using frequency tables, graphs, and statistical summaries. The dependent variable has a dichotomized response of yes and no, and hence binary logistic regression was used to predict a dependent variable based on independent variables, and predictors having p ≤ 0.25 on the bivariable analysis were considered as candidates for the multivariable analysis. Odds ratios with their 95% confidence intervals were calculated to measure the strength of association, and finally a p value <0.05 was considered statistically significant. Result The prevalence of undiagnosed hypertension was 14.8% with 95% CI [12.3-15.6]. Older age (AOR = 3.1, 95% CI [1.5-6.5]), male (AOR = 2.2, 95% CI [1.3-3.9]), low physical activity (AOR = 3.9, 95% CI [1.8-8.3]), low consumption of fruit and vegetable (AOR = 4.5, 95% CI [2.4-8.8]), and higher BMI (AOR = 2.7, 95% CI [1.6-4.6]) were significantly associated with undiagnosed hypertension. Conclusion The current study outlined that the prevalence of undiagnosed hypertension was high in the study area. In addition, most of the risk factors identified were modifiable, and hence community-based preventive approaches like lifestyle modification, increasing awareness, and strengthening routine screening at primary health service facilities resulted in a substantial change in tackling the burden effectively.
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Affiliation(s)
- Sebsibe Elias
- Public Health Department, College of Health Sciences, Mizan-Aman College of Health Science, Mizan-Aman, Ethiopia
| | - Teshome Kabeta Dadi
- Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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15
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Tsamos G, Vasdeki D, Koufakis T, Michou V, Makedou K, Tzimagiorgis G. Therapeutic Potentials of Reducing Liver Fat in Non-Alcoholic Fatty Liver Disease: Close Association with Type 2 Diabetes. Metabolites 2023; 13:metabo13040517. [PMID: 37110175 PMCID: PMC10141666 DOI: 10.3390/metabo13040517] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/21/2023] [Accepted: 03/29/2023] [Indexed: 04/29/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD), the most widespread chronic liver disease worldwide, confers a significant burden on health systems and leads to increased mortality and morbidity through several extrahepatic complications. NAFLD comprises a broad spectrum of liver-related disorders, including steatosis, cirrhosis, and hepatocellular carcinoma. It affects almost 30% of adults in the general population and up to 70% of people with type 2 diabetes (T2DM), sharing common pathogenetic pathways with the latter. In addition, NAFLD is closely related to obesity, which acts in synergy with other predisposing conditions, including alcohol consumption, provoking progressive and insidious liver damage. Among the most potent risk factors for accelerating the progression of NAFLD to fibrosis or cirrhosis, diabetes stands out. Despite the rapid rise in NAFLD rates, identifying the optimal treatment remains a challenge. Interestingly, NAFLD amelioration or remission appears to be associated with a lower risk of T2DM, indicating that liver-centric therapies could reduce the risk of developing T2DM and vice versa. Consequently, assessing NAFLD requires a multidisciplinary approach to identify and manage this multisystemic clinical entity early. With the continuously emerging new evidence, innovative therapeutic strategies are being developed for the treatment of NAFLD, prioritizing a combination of lifestyle changes and glucose-lowering medications. Based on recent evidence, this review scrutinizes all practical and sustainable interventions to achieve a resolution of NAFLD through a multimodal approach.
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Affiliation(s)
- Georgios Tsamos
- Division of Gastroenterology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK
| | - Dimitra Vasdeki
- Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Theocharis Koufakis
- Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Vassiliki Michou
- Sports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece
| | - Kali Makedou
- Laboratory of Biological Chemistry, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Georgios Tzimagiorgis
- Laboratory of Biological Chemistry, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, 54636 Thessaloniki, Greece
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16
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Wei JH, Lee WJ, Luo JL, Huang HL, Wang SC, Chou RH, Huang PH, Lin SJ. Vertical Sleeve Gastrectomy Offers Protection against Disturbed Flow-Induced Atherosclerosis in High-Fat Diet-Fed Mice. Int J Mol Sci 2023; 24:ijms24065669. [PMID: 36982743 PMCID: PMC10051344 DOI: 10.3390/ijms24065669] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023] Open
Abstract
Bariatric surgery reduces body weight, enhances metabolic and diabetic control, and improves outcomes on obesity-related comorbidities. However, the mechanisms mediating this protection against cardiovascular diseases remain unclear. We investigated the effect of sleeve gastrectomy (SG) on vascular protection in response to shear stress-induced atherosclerosis using an overweighted and carotid artery ligation mouse model. Eight-week-old male wild-type mice (C57BL/6J) were fed a high-fat diet (HFD) for two weeks to induce weight gain and dysmetabolism. SG was performed in HFD-fed mice. Two weeks after the SG procedure, partial carotid-artery ligation was performed to promote disturbed flow-induced atherosclerosis. Compared with the control mice, HFD-fed wild-type mice exhibited increased body weight, total cholesterol level, hemoglobin A1c, and enhanced insulin resistance; SG significantly reversed these adverse effects. As expected, HFD-fed mice exhibited greater neointimal hyperplasia and atherosclerotic plaques than the control group, and the SG procedure attenuated HFD-promoted ligation-induced neointimal hyperplasia and arterial elastin fragmentation. Besides, HFD promoted ligation-induced macrophage infiltration, matrix metalloproteinase-9 expression, upregulation of inflammatory cytokines, and increased vascular endothelial growth factor secretion. SG significantly reduced the above-mentioned effects. Moreover, HFD restriction partially reversed the intimal hyperplasia caused by carotid artery ligation; however, this protective effect was significantly lower than that observed in SG-operated mice. Our study demonstrated that HFD deteriorates shear stress-induced atherosclerosis and SG mitigates vascular remodeling, and this protective effect was not comparable in HFD restriction group. These findings provide a rationale for using bariatric surgery to counter atherosclerosis in morbid obesity.
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Affiliation(s)
- Jih-Hua Wei
- Division of Cardiology, Department of Internal Medicine, Min-Sheng General Hospital, Taoyuan 330, Taiwan; (J.-H.W.)
- School of Medicine, National Defense Medical Center, Taipei 114, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Wei-Jei Lee
- Department of Surgery, Min-Sheng General Hospital, Taoyuan 330, Taiwan
| | - Jing-Lin Luo
- Division of Cardiology, Department of Internal Medicine, Min-Sheng General Hospital, Taoyuan 330, Taiwan; (J.-H.W.)
| | - Hsin-Lei Huang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
| | - Shen-Chih Wang
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
| | - Ruey-Hsing Chou
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Department of Anesthesiology, Taipei Veteran General Hospital, Taipei 112, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei 112, Taiwan
| | - Po-Hsun Huang
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Department of Anesthesiology, Taipei Veteran General Hospital, Taipei 112, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei 112, Taiwan
- Correspondence: ; Tel.: +886-2-2875-7374; Fax: +886-2-2875-7375
| | - Shing-Jong Lin
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Anesthesiology, Taipei Veteran General Hospital, Taipei 112, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei 112, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei 110, Taiwan
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17
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Kaikkonen KM, Korpelainen R, Vanhala ML, Keinänen-Kiukaanniemi SM, Korpelainen JT. Long-term effects on weight loss and maintenance by intensive start with diet and exercise. Scand J Med Sci Sports 2023; 33:246-256. [PMID: 36371700 DOI: 10.1111/sms.14269] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 08/16/2022] [Accepted: 10/13/2022] [Indexed: 11/14/2022]
Abstract
This 36-month study aimed to determine whether exercise intervention added to weight loss treatment in the beginning or at 6 months is effective for weight loss and long-term weight maintenance. A total of 120 obese adults (body mass index >30) were randomly assigned to intensified behavioral modification (iBM), iBM+ additional exercise from 0 to 3 months (CWT1), iBM+ additional exercise from 6 to 9 months (CWT2), and a control group (CON). Questionnaires and measurements were collected at baseline, 3, 9, 24, and 36 months. The intervention consisted of an 12 months intensified weight-loss period followed by a 24 months weight-maintenance period. Eighty (67%) subjects (mean age 46.0 years, BMI 36.2) completed the trial. Compared with the control group, all three intervention groups had significant weight loss during the 36-month intervention period (p < 0.001). The achieved weight loss remained significant at 36 months in the iBM (-6.8%, p < 0.001), the CWT1 (-5.8%, p < 0.001), and the CWT2 group (-3.9%, p < 0.001). The CWT1 group showed significant reduction in waist circumference at 9 months (-11.3 cm, p < 0.001), at 24 months (-8.8 cm, p < 0.001), and at 36 months (-8.7 cm, p < 0.001). Intensified behavioral modification alone and with exercise resulted in clinically significant weight loss and long-term weight maintenance. The addition of exercise at the onset promoted greater reductions in waist circumference. In the treatment of obesity, including severe obesity, more intensive lifestyle interventions with exercise should be incorporated.
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Affiliation(s)
- Kaisu M Kaikkonen
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland.,Research Unit of Population Health, University of Oulu, Faculty of Medicine, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland.,Research Unit of Population Health, University of Oulu, Faculty of Medicine, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marja L Vanhala
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland
| | - Sirkka M Keinänen-Kiukaanniemi
- Research Unit of Population Health, University of Oulu, Faculty of Medicine, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
| | - Juha T Korpelainen
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
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18
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Sundgot-Borgen C, Bond DS, Sniehotta FF, Kvalem IL, Hansen BH, Bergh I, Rø Ø, Mala T. Associations of changes in physical activity and sedentary time with weight recurrence after bariatric surgery: a 5-year prospective study. Int J Obes (Lond) 2023; 47:463-470. [PMID: 36828898 PMCID: PMC9951836 DOI: 10.1038/s41366-023-01284-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Increasing physical activity and limiting sedentary time may minimize weight recurrence after bariatric surgery. However, few studies have evaluated potential associations of objectively-measured physical activity and sedentary time with post-surgical weight recurrence over time. AIMS To evaluate associations of change in physical activity and sedentary time with weight recurrence after bariatric surgery. METHODS Participants from the Oslo Bariatric Surgery Study, a prospective cohort study, wore an ActiGraph monitor for seven days at 1- and 5 years after surgery to assess daily physical activity and sedentary time. Participants' weight was measured at in-person clinic visits. Chi-square Test and Paired-samples T-test evaluated group differences and change over time, while Pearson's Correlation, multiple logistic and linear regression investigated associations between variables. RESULTS Five years after surgery 79 participants (70.5% response rate, 81% female) (mean (sd) age: 54.0 (±9.3), BMI: 32.1 (±4.7)) had valid monitor data. Participants increased their sedentary time (71.4 minutes/day (95% CI: 54.2-88.6, p = <0.001)) and reduced daily steps (-1411.1 (95% CI: 737.8-208.4), p = <0.001), light physical activity (-54.1 min/day (95% CI: 40.9-67.2, p = <0.001)), and total physical activity (-48.2 (95% CI: 34.6-63.3), p = <0.001) from 1- to 5 years after surgery. No change was found for moderate-to-vigorous intensity physical activity. No associations were found between changes in steps, physical activity or sedentary time and weight recurrence. CONCLUSION Participants increased sedentary time and decreased light- and total physical activity between 1- and 5 years post-surgery. Overall, changes in physical activity and sedentary time were not associated with weight recurrence. Interventions to help patients increase physical activity and limit sedentary time after bariatric surgery are needed.
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Affiliation(s)
- C. Sundgot-Borgen
- grid.55325.340000 0004 0389 8485Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - D. S. Bond
- grid.277313.30000 0001 0626 2712Department of Surgery and Research, Hartford Hospital, Hartford, CT USA
| | - F. F. Sniehotta
- grid.1006.70000 0001 0462 7212Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK ,grid.7700.00000 0001 2190 4373Department of Public Health, Preventive and Social Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - I. L. Kvalem
- grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, Oslo, Norway
| | - B. H. Hansen
- grid.23048.3d0000 0004 0417 6230Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | | | - Ø. Rø
- grid.55325.340000 0004 0389 8485Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - T. Mala
- grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Oslo, Norway ,grid.55325.340000 0004 0389 8485Center for Morbid Obesity and Bariatric Surgery, Oslo University Hospital, Oslo, Norway
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19
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Chen G, Banini B, Do A, Lim JK. The independent effect of exercise on biopsy-proven non-alcoholic fatty liver disease: A systematic review. Clin Mol Hepatol 2023; 29:S319-S332. [PMID: 36517000 PMCID: PMC10029942 DOI: 10.3350/cmh.2022.0366] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/12/2022] [Indexed: 03/15/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. Although previous studies have demonstrated that exercise independently reduces hepatic steatosis measured by imaging modalities in NAFLD, the effect of exercise on histological endpoints remains unclear. We aimed to conduct a systematic review of the independent effect of exercise on hepatic steatosis, steatohepatitis, and liver fibrosis as measured by histological assessment or non-invasive tests (NITs) in biopsy-proven NAFLD. A systematic literature search of PubMed, Embase, and Web of Science databases was performed using keywords related to exercise, NAFLD, and biopsy. Articles were selected based on the following inclusion criteria: (1) involved human subjects with biopsy-proven NAFLD, (2) analyzed the independent effect of exercise, (3) assessed changes in hepatic steatosis, steatohepatitis, or liver fibrosis via either histological evaluation or NITs, and (4) were original research studies. We identified a total of six studies that analyzed the independent effect of exercise on histological endpoints in biopsy-proven NAFLD. Two randomized controlled trials (RCTs) did not detect significant histological improvement following exercise interventions, while other non-randomized interventional studies showed that exercise reduces hepatocyte ballooning and liver fibrosis. In addition, five studies assessed NIT outcomes, collectively demonstrating that exercise improves hepatic steatosis measured by magnetic resonance imaging-based techniques but not serum biomarkers for steatohepatitis and liver fibrosis. Additional large RCTs and meta-analyses are warranted to investigate the independent effect of exercise on histological and clinical outcome endpoints in NAFLD.
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Affiliation(s)
- George Chen
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Bubu Banini
- Section of Digestive Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Albert Do
- Section of Digestive Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Joseph K Lim
- Section of Digestive Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
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20
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Liu G, Li Y, Pan A, Hu Y, Chen S, Qian F, Rimm EB, Manson JE, Stampfer MJ, Giatsidis G, Sun Q. Adherence to a Healthy Lifestyle in Association With Microvascular Complications Among Adults With Type 2 Diabetes. JAMA Netw Open 2023; 6:e2252239. [PMID: 36701156 PMCID: PMC9880795 DOI: 10.1001/jamanetworkopen.2022.52239] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
IMPORTANCE The association between an overall healthy lifestyle and the subsequent risk of microvascular complications among patients with diabetes remains unclear. OBJECTIVE To examine the association between adherence to a healthy lifestyle before and after diabetes diagnosis and the risk of subsequent microvascular complications among adults with diabetes. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study included incident patients with type 2 diabetes who were free of cardiovascular disease and cancer at the time of diabetes diagnosis and completed the diabetes supplementary questionnaires in the Nurses' Health Study (in 2000 and 2005) and the Health Professionals Follow-Up Study (in 2000, 2004, and 2008) in the US. Data were analyzed from April to August 2021. EXPOSURES Diet and lifestyle factors before and after diabetes diagnosis were assessed by validated questionnaires. A healthy lifestyle consisted of nonsmoking, having a healthy body weight (a body mass index of ≥18.5 or <25), engaging in moderate-to-vigorous physical activity (≥150 minutes per week), consuming a high-quality diet (top 40th percentile of the Alternative Healthy Eating Index), and moderate alcohol drinking (5-15 g/d for women and 5-30 g/d for men). MAIN OUTCOMES AND MEASURES Physician-diagnosed microvascular complications including diabetic neuropathy, retinopathy, nephropathy, and foot disorders were self-reported at questionnaire surveys. RESULTS A total of 7077 patients with type 2 diabetes were included in the cohort (4982 women in NHS and 2095 men in HPFS, mean [SD] age 61 [8.8], 94.2% White). During follow-up, 2878 patients developed microvascular complications. After multivariable adjustment, adherence to a healthy lifestyle before and after diabetes diagnosis were both associated with a lower risk of developing microvascular complications. The relative risk (RR) for participants with 4 or more low-risk lifestyle factors before diabetes diagnosis compared with zero was 0.73 (95% CI, 0.60-0.91) for any microvascular complications, 0.71 (95% CI, 0.54-0.93) for diabetic neuropathy, 0.76 (95% CI, 0.57-1.01) for diabetic retinopathy, 0.42 (95% CI, 0.23-0.79) for diabetic nephropathy, and 0.60 (95% CI, 0.35-1.00) for diabetic foot disorders. Similar results were observed for adherence to a healthy lifestyle after diabetes diagnosis, with an RR of 0.68 (95% CI, 0.55-0.83) for any microvascular complications, 0.67 (95% CI, 0.51-0.88) for diabetic neuropathy, 0.65 (95% CI, 0.48-0.86) for diabetic retinopathy, 0.57 (95% CI, 0.34-0.98) for diabetic nephropathy, and 0.62 (95% CI, 0.37-1.05) for diabetic foot disorders. In addition, greater improvement in lifestyle factors from before to after diabetes diagnosis was also significantly associated with a lower risk of neuropathy or total microvascular complications. Each increment in number of low-risk lifestyle factors was associated with a 6% (RR, 0.94; 95% CI, 0.90-0.98) lower risk for any microvascular complications and a 9% (RR, 0.91; 95% CI, 0.86-0.96) lower risk for diabetic neuropathy. Consistent results were observed when analyses were stratified by age at diabetes diagnosis, sex/cohort, or lifestyle factors before diabetes diagnosis. CONCLUSIONS AND RELEVANCE In this cohort study, adhering to an overall healthy lifestyle was associated with a significantly lower risk of microvascular complications among individuals with diabetes. These findings suggest substantial reduction in the burden of microvascular complications associated with adopting a healthy lifestyle among patients with type 2 diabetes.
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Affiliation(s)
- Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Yanping Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Siyu Chen
- Department of Endocrinology and Metabolism, Suzhou Dushu Lake Hospital (Dushu Lake Hospital Affiliated to Soochow University), Suzhou, Jiangsu, China
| | - Frank Qian
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Eric B. Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - JoAnn E. Manson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Meir J. Stampfer
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Giorgio Giatsidis
- Department of Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Qi Sun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Joslin Diabetes Center, Boston, Massachusetts
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21
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Geng T, Zhu K, Lu Q, Wan Z, Chen X, Liu L, Pan A, Liu G. Healthy lifestyle behaviors, mediating biomarkers, and risk of microvascular complications among individuals with type 2 diabetes: A cohort study. PLoS Med 2023; 20:e1004135. [PMID: 36626356 PMCID: PMC9831321 DOI: 10.1371/journal.pmed.1004135] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/26/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The influence of overall lifestyle behaviors on diabetic microvascular complications remains unknown. In addition, the potential mediating biomarkers underlying the association is unclear. This study aimed to examine the associations of the combined lifestyle factors with risks of total and individual microvascular complications among patients with type 2 diabetes (T2D) and to explore the potential mediation effects of metabolic biomarkers. METHODS AND FINDINGS This retrospective cohort study included 15,104 patients with T2D free of macro- and microvascular complications at baseline (2006 to 2010) from the UK Biobank. Healthy lifestyle behaviors included noncurrent smoking, recommended waist circumference, regular physical activity, healthy diet, and moderate alcohol drinking. Outcomes were ascertained using electronic health records. Over a median of 8.1 years of follow-up, 1,296 cases of the composite microvascular complications occurred, including 558 diabetic retinopathy, 625 diabetic kidney disease, and 315 diabetic neuropathy, with some patients having 2 or 3 microvascular complications simultaneously. After multivariable adjustment for sociodemographic characteristics, history of hypertension, glycemic control, and medication histories, the hazard ratios (95% confidence intervals (CIs)) for the participants adhering 4 to 5 low-risk lifestyle behaviors versus 0 to 1 were 0.65 (0.46, 0.91) for diabetic retinopathy, 0.43 (0.30, 0.61) for diabetic kidney disease, 0.46 (0.29, 0.74) for diabetic neuropathy, and 0.54 (0.43, 0.68) for the composite outcome (all Ps-trend ≤0.01). Further, the population-attributable fraction (95% CIs) of diabetic microvascular complications for poor adherence to the overall healthy lifestyle (<4 low-risk factors) ranged from 25.3% (10.0%, 39.4%) to 39.0% (17.7%, 56.8%). In addition, albumin, HDL-C, triglycerides, apolipoprotein A, C-reactive protein, and HbA1c collectively explained 23.20% (12.70%, 38.50%) of the associations between overall lifestyle behaviors and total diabetic microvascular complications. The key limitation of the current analysis was the potential underreporting of microvascular complications because the cases were identified via electronic health records. CONCLUSIONS Adherence to overall healthy lifestyle behaviors was associated with a significantly lower risk of microvascular complications in patients with T2D, and the favorable associations were partially mediated through improving biomarkers of glycemic control, systemic inflammation, liver function, and lipid profile.
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Affiliation(s)
- Tingting Geng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Zhu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Lu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhenzhen Wan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xue Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- * E-mail: (AP); (GL)
| | - Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- * E-mail: (AP); (GL)
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22
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Epidemiologic, Genetic, Pathogenic, Metabolic, Epigenetic Aspects Involved in NASH-HCC: Current Therapeutic Strategies. Cancers (Basel) 2022; 15:cancers15010023. [PMID: PMID: 36612019 PMCID: PMC9818030 DOI: 10.3390/cancers15010023] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and is the sixth most frequent cancer in the world, being the third cause of cancer-related deaths. Nonalcoholic steatohepatitis (NASH) is characterized by fatty infiltration, oxidative stress and necroinflammation of the liver, with or without fibrosis, which can progress to advanced liver fibrosis, cirrhosis and HCC. Obesity, metabolic syndrome, insulin resistance, and diabetes exacerbates the course of NASH, which elevate the risk of HCC. The growing prevalence of obesity are related with increasing incidence of NASH, which may play a growing role in HCC epidemiology worldwide. In addition, HCC initiation and progression is driven by reprogramming of metabolism, which indicates growing appreciation of metabolism in the pathogenesis of this disease. Although no specific preventive pharmacological treatments have recommended for NASH, dietary restriction and exercise are recommended. This review focuses on the molecular connections between HCC and NASH, including genetic and risk factors, highlighting the metabolic reprogramming and aberrant epigenetic alterations in the development of HCC in NASH. Current therapeutic aspects of NASH/HCC are also reviewed.
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23
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Braun TD, Olson K, Panza E, Lillis J, Schumacher L, Abrantes AM, Kunicki Z, Unick JL. Internalized weight stigma in women with class III obesity: A randomized controlled trial of a virtual lifestyle modification intervention followed by a mindful self-compassion intervention. Obes Sci Pract 2022; 8:816-827. [PMID: 36483124 PMCID: PMC9722463 DOI: 10.1002/osp4.616] [Citation(s) in RCA: 1] [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: 01/19/2022] [Revised: 05/11/2022] [Accepted: 05/15/2022] [Indexed: 11/11/2022] Open
Abstract
Background Internalized weight stigma (Internalized-WS) is prevalent among individuals with severe obesity, particularly women, and is associated with shame, disordered eating, and weight gain. Effective, accessible interventions that address both severe (Class-III) obesity and Internalized-WS are needed. This randomized pilot trial evaluated the feasibility, acceptability, and preliminary efficacy of a fully-remote lifestyle modification intervention (LM) followed by mindful self-compassion training (MSC) or control. Methods Twenty-eight women with Class-III obesity (46.6 ± 3.7 kg/m2) and elevated Internalized-WS were randomized to a virtually-delivered 4-month LM followed by a 2-month MSC or cooking/dietary education (CON). Psychosocial measures/weight were assessed at baseline, 4-(post-LM), 6-(post-MSC/CON), and 9-month (follow-up). Results Improvements in Internalized-WS, shame, and self-compassion were observed with LM. Mean 4-month weight loss was 6.3 ± 3.7%. MSC had lower attendance and usefulness ratings versus CON. Post-MSC/CON, MSC yielded significant and/or meaningful improvements in Internalized-WS, self-compassion, and intuitive eating relative to CON. Weight loss did not differ by group at 6-month, and at 9-month trended lower in MSC versus CON. Conclusion Virtual LM is feasible, acceptable, and leads to significant weight loss among women with severe obesity; MSC led to further improved Internalized-WS, self-compassion, and intuitive eating. Continued work is needed to elucidate effects of self-compassion training on Internalized-WS, its mechanisms, and linkages to cardiometabolic health and long-term weight loss.
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Affiliation(s)
- Tosca D. Braun
- Alpert Medical School of Brown UniversityProvidenceRIUSA
- Centers for Behavioral and Preventive MedicineThe Miriam HospitalProvidenceRIUSA
- Butler HospitalProvidenceRIUSA
| | - Kayloni Olson
- Alpert Medical School of Brown UniversityProvidenceRIUSA
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRIUSA
| | - Emily Panza
- Alpert Medical School of Brown UniversityProvidenceRIUSA
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRIUSA
| | - Jason Lillis
- Alpert Medical School of Brown UniversityProvidenceRIUSA
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRIUSA
| | - Leah Schumacher
- Alpert Medical School of Brown UniversityProvidenceRIUSA
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRIUSA
| | - Ana M. Abrantes
- Alpert Medical School of Brown UniversityProvidenceRIUSA
- Butler HospitalProvidenceRIUSA
| | - Zachary Kunicki
- Quantitative Sciences ProgramBrown UniversityProvidenceRIUSA
| | - Jessica L. Unick
- Alpert Medical School of Brown UniversityProvidenceRIUSA
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRIUSA
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24
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Hafida S, Apovian C. Physiology of the Weight-Reduced State and Its Impact on Weight Regain. Endocrinol Metab Clin North Am 2022; 51:795-815. [PMID: 36244694 DOI: 10.1016/j.ecl.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Obesity is a chronic disease characterized by long duration, slow progression, and periods of remission and relapses. Despite the development of effective medical and surgical interventions and millions of people conducting tremendous personal efforts to manage their weight every year, recidivism remains a significant barrier to attaining long-term weight maintenance. This review aimed to explain the underlying physiology of the weight-reduced state including changes in energy balance, adipose tissue, genetic, environmental, and behavioral factors that may predispose individuals to weight regain following weight loss.
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Affiliation(s)
- Samar Hafida
- Division of Endocrinology, Diabetes, Nutrition and Weight Management, 72 East, Concord Street C3 (Room 321 A), Collamore Building, Boston, MA 02118, USA.
| | - Caroline Apovian
- Division of Endocrinology, Diabetes and Hypertension, Center for Weight Management and Wellness, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Suite RFB-2, Brigham and Women's at 221 Longwood, Boston, MA 02115, USA
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25
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Handley D, Rafey MF, Almansoori S, Brazil JF, McCarthy A, Amin HA, O’Donnell M, Blakemore AI, Finucane FM. Higher Waist Hip Ratio Genetic Risk Score Is Associated with Reduced Weight Loss in Patients with Severe Obesity Completing a Meal Replacement Programme. J Pers Med 2022; 12:jpm12111881. [PMID: 36579607 PMCID: PMC9695448 DOI: 10.3390/jpm12111881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/24/2022] [Accepted: 11/03/2022] [Indexed: 11/12/2022] Open
Abstract
Background: A better understanding of the influence of genetic factors on the response to lifestyle interventions in people with obesity may allow the development of more personalised, effective and efficient therapeutic strategies. We sought to determine the influence of six obesity-related genetic risk scores on the magnitude of weight lost by patients with severe obesity who completed a dietary intervention. Methods: In this single-centre prospective cohort study, participants with severe and complicated obesity who completed a 24-week, milk-based meal replacement programme were genotyped to detect the frequency of common risk alleles for obesity and type 2 diabetes-related traits. Genetic risk scores (GRS) for six of these traits were derived. Participants with a potentially deleterious monogenic gene variant were excluded from the analysis. Results: In 93 patients completing the programme who were not carrying a known obesity-related gene mutation, 35.5% had diabetes, 53.8% were female, mean age was 51.4 ± 11 years, mean body mass index was 51.5 ± 8.7 and mean total weight loss percent at 24 weeks was 16 ± 6.3%. The waist-hip ratio (WHR) GRS was inversely associated with percentage total weight loss at 24 weeks (adjusted β for one standard deviation increase in WHR GRS -11.6 [-23.0, -0.3], p = 0.045), and patients in the lowest tertile of WHR GRS lost more weight. Conclusions: Patients with severe and complicated obesity with a genetic predisposition to central fat accumulation had less weight loss in a 24-week milk-based meal replacement programme, but there was no evidence for influence from the five other obesity-related genetic risk scores on the response to dietary restriction.
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Affiliation(s)
- Dale Handley
- College of Health, Medical and Life Sciences, Brunel University London, London UB8 3PH, UK
| | - Mohammed Faraz Rafey
- Bariatric Medicine Service, Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospitals, H91 YR71 Galway, Ireland
- HRB Clinical Research Facility, University of Galway, H91 CF50 Galway, Ireland
- Department of Medicine, University of Galway, H91 CF50 Galway, Ireland
| | - Sumaya Almansoori
- College of Health, Medical and Life Sciences, Brunel University London, London UB8 3PH, UK
- Faculty of Medicine, Imperial College London, London SW7 2BX, UK
- International Centre for Forensic Science, General Department of Forensic Science and Criminology, Dubai Police, Dubai 00000, United Arab Emirates
| | - John F. Brazil
- Bariatric Medicine Service, Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospitals, H91 YR71 Galway, Ireland
- HRB Clinical Research Facility, University of Galway, H91 CF50 Galway, Ireland
- Department of Medicine, University of Galway, H91 CF50 Galway, Ireland
| | - Aisling McCarthy
- Bariatric Medicine Service, Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospitals, H91 YR71 Galway, Ireland
| | - Hasnat A. Amin
- College of Health, Medical and Life Sciences, Brunel University London, London UB8 3PH, UK
| | - Martin O’Donnell
- HRB Clinical Research Facility, University of Galway, H91 CF50 Galway, Ireland
- Department of Medicine, University of Galway, H91 CF50 Galway, Ireland
| | - Alexandra I. Blakemore
- College of Health, Medical and Life Sciences, Brunel University London, London UB8 3PH, UK
- Department of Medicine, University of Galway, H91 CF50 Galway, Ireland
- Faculty of Medicine, Imperial College London, London SW7 2BX, UK
| | - Francis M. Finucane
- College of Health, Medical and Life Sciences, Brunel University London, London UB8 3PH, UK
- Bariatric Medicine Service, Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospitals, H91 YR71 Galway, Ireland
- HRB Clinical Research Facility, University of Galway, H91 CF50 Galway, Ireland
- Department of Medicine, University of Galway, H91 CF50 Galway, Ireland
- Correspondence: ; Tel.: +353-(39)-1893803
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Sysko R, Michaelides A, Costello K, Herron DM, Hildebrandt T. An Initial Test of the Efficacy of a Digital Health Intervention for Bariatric Surgery Candidates. Obes Surg 2022; 32:3641-3649. [PMID: 36074201 PMCID: PMC10312669 DOI: 10.1007/s11695-022-06258-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Rigorous research on smartphone apps for individuals pursuing bariatric surgery is limited. A digital health intervention was recently developed using standard behavioral weight loss programs with specific modifications for bariatric surgery. The current study evaluated this intervention for improving diet, exercise, and psychosocial health over 8 weeks prior to surgery in an academic medical center. METHODS Fifty patients were randomized to receive either the digital intervention or treatment as usual prior to a surgical procedure. Measures of anxiety, depression, stress, quality of life, physical activity, and diet were administered at baseline and at 8-week follow-up. Statistical power of 80% estimated for N = 50 to detect ES = 0.68 with alpha = 0.05. RESULTS Results of intent-to-treat (N = 50 baseline, N = 36 follow-up) analyses indicated significant moderate differences in stress and anxiety (ES = - 0.58 to - 0.62) favoring the digital intervention. Effects of the program on total daily calories consumed, body mass index, quality of life, and eating disorder symptoms were small (ES = - 0.24 to 0.33) and not significant. Given small effects for these domains, the sample size of the study likely affected the ability to detect significant differences. CONCLUSIONS The digital health intervention appears to significantly impact several measures of physical activity and emotional functioning in candidates for bariatric surgery, which could augment surgical outcomes.
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Affiliation(s)
- Robyn Sysko
- Center of Excellence for Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY, 10029, USA.
| | | | - Kayla Costello
- Center of Excellence for Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY, 10029, USA
| | - Daniel M Herron
- Garlock Division of General Surgery, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, 3rd Fl, New York, NY, 10029, USA
| | - Tom Hildebrandt
- Center of Excellence for Eating and Weight Disorders, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1230, New York, NY, 10029, USA
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Dhillon J, Jacobs AG, Ortiz S, Diaz Rios LK. A Systematic Review of Literature on the Representation of Racial and Ethnic Minority Groups in Clinical Nutrition Interventions. Adv Nutr 2022; 13:1505-1528. [PMID: 35108358 PMCID: PMC9526835 DOI: 10.1093/advances/nmac002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/29/2021] [Accepted: 01/10/2022] [Indexed: 02/04/2023] Open
Abstract
The racial and ethnic disparities in diet-related chronic diseases are major concerns. This systematic review examines the extent to which diet-induced changes in health outcomes, such as cardiometabolic, inflammation, cancer, bone health, and kidney function outcomes, etc., have been reported and discussed by race or ethnicity in randomized trials with 2 or more diet arms that recruited both minority and non-Hispanic White groups. Databases (i.e., PubMed, Cochrane Library, and Web of Science) were searched up to August 2021. Thirty-four studies that discussed effects of defined dietary interventions on health outcomes by racial or ethnic minority group compared with non-Hispanic Whites were included in the systematic review (PROSPERO registration number: CRD42021229256). Acute trials and those with 1 diet arm that accounted for race or ethnicity in their analyses and studies that focused on a single racial or ethnic group were discussed separately. Most studies were conducted in Black compared with White adults testing effects of energy restriction, macronutrient modification, sodium reduction, or variations of the Dietary Approaches to Stop Hypertension (DASH) diet on cardiometabolic outcomes. There was limited focus on other minority groups. Evidence suggests greater blood pressure reduction for Black adults compared with Whites particularly with DASH (or similar) diets. Overall, there was limited consideration for group-specific eating patterns and diet acceptability. Overall risk of bias was low. With emerging precision nutrition initiatives that aim to optimize metabolic responses in population subgroups through tailored approaches, it is imperative to ensure adequate representation of racial and ethnic subgroups for addressing health disparities. Factors that help explain variability in responses such as socioecological context should be included and adequately powered. Given the racial and ethnic disparities in chronic diseases, studying the adoption, maintenance, and effectiveness of dietary interventions on health outcomes among different groups is critical for developing approaches that can mitigate diet-related health disparities.
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Affiliation(s)
- Jaapna Dhillon
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA
- Department of Molecular & Cell Biology, School of Natural Sciences, University of California Merced, Merced, CA, USA
| | | | - Sigry Ortiz
- Department of Molecular & Cell Biology, School of Natural Sciences, University of California Merced, Merced, CA, USA
| | - L Karina Diaz Rios
- Division of Agriculture and Natural Resources, University of California Merced, Merced, CA, USA
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Pfisterer J, Rausch C, Wohlfarth D, Bachert P, Jekauc D, Wunsch K. Effectiveness of Physical-Activity-Based Interventions Targeting Overweight and Obesity among University Students—A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159427. [PMID: 35954789 PMCID: PMC9368556 DOI: 10.3390/ijerph19159427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/21/2022] [Accepted: 07/26/2022] [Indexed: 02/05/2023]
Abstract
Overweight and obesity, including their prevalence and consequences, reflect a leading public health problem. Studies have already shown that physical activity leads to a reduction in body weight in children and adults. However, the university setting has rarely been investigated. The aim of this review is, therefore, to examine and summarize the effectiveness of physical-activity-based interventions to reduce obesity and overweight in university students. Three databases (PubMed, Scopus, and Web of Science) were searched for relevant studies published in English between January 2010 and February 2022. Quantitative studies conducting a physical-activity-based intervention with overweight or obese university students and reporting changes in BMI were included. Data were described in a narrative synthesis. Out of 16 included studies, 11 reported a significant reduction in BMI. However, all studies except one were able to demonstrate some BMI improvements, whereas all studies reported significant changes in at least one health-related indicator. Aerobic exercises were able to demonstrate the greatest reductions in BMI. This review is the first systematic presentation on the effectiveness of physical-activity-based interventions in overweight and obese university students. Future work should reconsider BMI as the primary outcome if appropriate within the respective study design (i.e., to measure long-term effects). More interventions are needed to improve strategies.
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Fu CP, Oczypok EE, Ali H, DeLany JP, Reeves VL, Chang RF, Kershaw EE. Effect of physical activity in a weight loss program on circulating total ANGPTL8 concentrations in northern Americans with obesity: A prospective randomized controlled trial. Nutr Metab Cardiovasc Dis 2022; 32:1725-1733. [PMID: 35527126 PMCID: PMC9233128 DOI: 10.1016/j.numecd.2022.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/22/2022] [Accepted: 04/07/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND AIMS The primary goals of this study were to clarify 1) the effect of weight loss by lifestyle intervention on circulating total angiopoietin-like protein 8 (ANGPTL8), and 2) the role of physical activity on serum total ANGPTL8 in northern Americans with obesity but without diabetes. METHODS AND RESULTS A total of 130 subjects with body mass index (BMI) ≧ 35 kg/m2 but without diabetes were recruited, and 121 subjects completed a weight loss program for data analysis. Abdominal adipose tissue was determined by non-contrast computed tomography (CT). Serum total ANGPTL8 was higher in the group with obesity than in the lean control group. Serum total ANGPTL8 was positively correlated with waist circumference (WC), BMI, fasting insulin, HOMA-IR, HOMA-B, QUICKI, hs-CRP, IL-6, and leptin. Serum total ANGPTL8 did not significantly differ between the two intervention groups at baseline, and it was significantly lower after weight loss, with comparable changes with diet only and diet plus physical activity. CONCLUSION Among northern Americans with obesity but without diabetes, a lifestyle modification resulted in significant reduction of circulating total ANGPTL8 concentrations in a 6-month weight-loss period. Although addition of physical activity resulted in greater total and liver fat loss, it did not promote further significant decline of serum total ANGPTL8 beyond diet alone.
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Affiliation(s)
- Chia-Po Fu
- Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan; Division of Endocrinology and Metabolism, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Elizabeth E Oczypok
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Hira Ali
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - James P DeLany
- Translational Research Institute Adventhealth, Florida, USA
| | - Valerie L Reeves
- Customer Delivery, Data Science Platform, Broad Institute of MIT and Harvard, Cambridge, MA 02412, USA
| | - Ruey-Feng Chang
- Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan
| | - Erin E Kershaw
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA.
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Associations between Objectively Determined Physical Activity and Cardiometabolic Health in Adult Women: A Systematic Review and Meta-Analysis. BIOLOGY 2022; 11:biology11060925. [PMID: 35741446 PMCID: PMC9220764 DOI: 10.3390/biology11060925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this systematic review and meta-analysis was to qualitatively synthesize and quantitatively assess the evidence of the relationship between objectively determined volumes of physical activity (PA) and cardiometabolic health in women. Four databases (PubMed, Web of Science, Scopus, and the Cochrane library) were searched and, finally, 24 eligible studies were included, with a total of 2105 women from eight countries. A correlational meta-analysis shows that moderate-to-vigorous intensity physical activity (MVPA) was favorably associated with high-density lipoprotein (r = 0.16; 95% CI: 0.06, 0.25; p = 0.002); however, there was limited evidence for the effects of most of the other cardiometabolic biomarkers recorded from steps, total physical activity, light- and moderate-intensity physical activity and MVPA. It is most compelling and consistent that being more physically active is beneficial to the metabolic syndrome. Overall, PA levels are low in adult women, suggesting that increasing the total volume of PA is more important than emphasizing the intensity and duration of PA. The findings also indicate that, according to the confounding effects of body composition and cardiorespiratory fitness, meeting the minimal level of 150 min of moderate-intensity physical activity recommended is not enough to obtain a significant improvement in cardiometabolic indicators. Nonetheless, the high heterogeneity between studies inhibits robust conclusions.
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Lee J, Hale N. Evidence and Implications of the Affordable Care Act for Racial/Ethnic Disparities in Diabetes Health During and Beyond the Pandemic. Popul Health Manag 2022; 25:235-243. [PMID: 35442797 DOI: 10.1089/pop.2021.0248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Amid the global pandemic, it becomes more apparent that diabetes is a pressing health concern because racial/ethnic minorities with underlying diabetes conditions have been disproportionately affected. The study proposes a multiyear examination to document the role of the Affordable Care Act (ACA) in racial/ethnic disparities in diabetes health. Using the Behavioral Risk Factor Surveillance System from 2011 to 2019, the study with a pre-post design investigated changes in access to care and diabetes health among non-White minorities compared with Whites before and after the ACA by conducting multivariable linear regression, with state-fixed effects and robust standard errors. Compared with Whites, racial/ethnic minorities showed significant improvements in health insurance coverage, having a personal doctor, and not seeing a doctor because of cost. Blacks (3.2% points, P ≤ 0.000), Hispanics (1.6% points, P = 0.001), and "other" racial/ethnic group (1.5% points, P = 0.003) experienced a greater increase in diagnosed prediabetes than Whites, whereas no and small differences were found in diagnosed diabetes and obesity, respectively. The yearly comparisons of changes in diagnosed prediabetes showed that Blacks compared with Whites had a growing increase from 1.2% points (P = 0.001) in 2014 to 3.3% points (P = 0.001) in 2019. Insurance coverage has declined after 2016, and obesity had an increasing trend across race/ethnicity. The ACA had a positive role in improving access to care and identifying those at risk for diabetes to a larger extent among racial/ethnic minorities. However, the policy impacts have been diminishing in recent years. Continued efforts are needed for sustained policy effects.
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Affiliation(s)
- Jusung Lee
- Department of Public Health, University of Texas at San Antonio, San Antonio, Texas, USA
| | - Nathan Hale
- Department of Health Services Management and Policy, East Tennessee State University, Johnson City, Tennessee, USA
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Blackman Carr LT, Samuel-Hodge CD, Tate DF. The Multi-Caregiver Role and Its Relationship to Behavioral Adherence and Weight Among Treatment Engaged Black Women. Am J Health Promot 2022; 36:1162-1169. [PMID: 35417263 DOI: 10.1177/08901171221092389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine the relationship between the multiple caregiver role and its perceived barriers to self-care on behavioral adherence in a weight loss intervention. DESIGN A secondary analysis of data from a behavioral weight loss intervention. SETTING The study was conducted in two cohorts from March 2016 to February 2017 at the University of North Carolina at Chapel Hill. SUBJECTS Eighty-one Black women with overweight/obesity (age = 48.4 ± 10.9 years [M ± SD], BMI = 36.4 ± 4.5 kg/m2 [M ± SD]). MEASURES Identification with the multiple caregiver role and barriers was assessed with the Multiple Caregiving Measurement Instrument. Weight was measured with a digital scale and height with a stadiometer. The Block food frequency questionnaire evaluated dietary intake. Moderate-to-vigorous physical activity (MVPA) was measured objectively with an accelerometer. Study adherence was measured by session attendance, self-weighing, and self-monitoring (diet and physical activity) frequency. ANALYSIS Generalized linear models were used to examine the relationship between the multiple caregiver scales and the outcomes of interest, controlling for study arm, cohort, and income. Chi-square tests tested correlations. RESULTS Greater identification with the multiple caregiver role was associated with decreased session attendance (β = -.56 [SE = .27], P < .05) and a trend towards weight gain (β = .36, [SE = .19], P = .07). Greater multiple caregiver barriers score predicted a decrease in fruit/vegetable intake (β = -.17 [SE = .07], P < .05). All regression results are unstandardized. Negative correlations between multiple caregiver barriers and MVPA (r = -.24, P = .06) and daily self-weighing (r = -.19, P = .10) approached significance. CONCLUSIONS Participants' identification with multiple caregiving role and barriers can reduce adherence, behavior and weight change. Interventions to address Black women's multiple roles and barriers during weight loss are needed to maximize outcomes.
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Affiliation(s)
| | - Carmen D Samuel-Hodge
- Department of Nutrition, 41474University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Deborah F Tate
- Department of Nutrition, 41474University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Health Behavior, 41474University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Storman D, Świerz MJ, Storman M, Jasińska KW, Jemioło P, Bała MM. Psychological Interventions and Bariatric Surgery among People with Clinically Severe Obesity-A Systematic Review with Bayesian Meta-Analysis. Nutrients 2022; 14:1592. [PMID: 35458154 PMCID: PMC9024573 DOI: 10.3390/nu14081592] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the effectiveness of perioperative psychological interventions provided to patients with clinically severe obesity undergoing bariatric surgery regarding weight loss, BMI, quality of life, and psychosocial health using the Bayesian approach. METHODS We considered randomised trials that assessed the beneficial and harmful effects of perioperative psychological interventions in people with clinically severe obesity undergoing bariatric surgery. We searched four data sources from inception to 3 October 2021. The authors independently selected studies for inclusion, extracted data, and assessed the risk of bias. We conducted a meta-analysis using a Bayesian approach. PROSPERO CRD42017077724. RESULTS Of 13,355 identified records, we included nine studies (published in 27 papers with 1060 participants (365 males; 693 females, 2 people with missing data)). Perioperative psychological interventions may provide little or no benefit for BMI (the last reported follow-up: MD [95% credible intervals] = -0.58 [-1.32, 0.15]; BF01 = 0.65; 7 studies; very low certainty of evidence) and weight loss (the last reported follow-up: MD = -0.50 [-2.21, 0.77]; BF01 = 1.24, 9 studies, very low certainty of evidence). Regarding psychosocial outcomes, the direction of the effect was mainly inconsistent, and the certainty of the evidence was low to very low. CONCLUSIONS Evidence is anecdotal according to Bayesian factors and uncertain whether perioperative psychological interventions may affect weight-related and psychosocial outcomes in people with clinically severe obesity undergoing bariatric surgery. As the results are ambiguous, we suggest conducting more high-quality studies in the field to estimate the true effect, its direction, and improve confidence in the body of evidence.
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Affiliation(s)
- Dawid Storman
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, 31-034 Krakow, Poland; (D.S.); (M.J.Ś.)
- Systematic Reviews Unit, Jagiellonian University Medical College, 31-034 Krakow, Poland;
| | - Mateusz Jan Świerz
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, 31-034 Krakow, Poland; (D.S.); (M.J.Ś.)
- Systematic Reviews Unit, Jagiellonian University Medical College, 31-034 Krakow, Poland;
| | - Monika Storman
- Systematic Reviews Unit, Jagiellonian University Medical College, 31-034 Krakow, Poland;
- Department of Diabetology and Internal Medicine, Medical University of Warsaw, 02-091 Warszawa, Poland
| | - Katarzyna Weronika Jasińska
- Students’ Scientific Research Group, Systematic Reviews Unit, Jagiellonian University Medical College, 31-034 Krakow, Poland;
| | - Paweł Jemioło
- Faculty of Electrical Engineering, Automatics, Computer Science and Biomedical Engineering, AGH University of Science and Technology, al. Mickiewicza 30, 30-059 Krakow, Poland;
| | - Małgorzata Maria Bała
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, 31-034 Krakow, Poland; (D.S.); (M.J.Ś.)
- Systematic Reviews Unit, Jagiellonian University Medical College, 31-034 Krakow, Poland;
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Boppre G, Diniz‐Sousa F, Veras L, Oliveira J, Fonseca H. Can exercise promote additional benefits on body composition in patients with obesity after bariatric surgery? A systematic review and meta-analysis of randomized controlled trials. Obes Sci Pract 2022; 8:112-123. [PMID: 35127127 PMCID: PMC8804945 DOI: 10.1002/osp4.542] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/04/2021] [Accepted: 06/15/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Bariatric surgery is the most effective treatment for patients with severe obesity, but success rates vary substantially. Exercise is recommended after bariatric surgery to reduce weight regain but the effectiveness remains undetermined on weight loss due to conflicting results. It is also unclear what should be the optimal exercise prescription for these patients. A systematic review and meta-analysis of randomized controlled trials on the effects of exercise on body weight (BW), anthropometric measures, and body composition after bariatric surgery was performed. METHODS PubMed/MEDLINE®, EBSCO®, Web of Science® and Scopus® databases were searched to identify studies evaluating exercise effectiveness. RESULTS The analysis comprised 10 studies (n = 487 participants). Exercise favored BW (-2.51kg; p = 0.02), waist circumference (-4.14cm; p = 0.04) and body mass index (-0.84kg·m-2; p = 0.02) reduction but no improvements in body composition. Combined exercise interventions were the most effective in reducing BW (-5.50kg; p < 0.01) and body mass index (-1.86kg·m-2; p < 0.01). Interventions starting >6-months after bariatric surgery were more successful in reducing BW (-5.02kg; p < 0.01) and body mass index (-1.62kg·m-2; p < 0.01). CONCLUSION Exercise, combined exercise regimens and interventions starting >6-months after bariatric surgery were effective in promoting BW, waist circumference and body mass index reduction. Exercise following bariatric surgery does not seem to favor body composition improvements.
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Affiliation(s)
- Giorjines Boppre
- Research Center in Physical ActivityHealth and Leisure (CIAFEL)Faculty of SportUniversity of PortoPortoPortugal
- Laboratory for Integrative and Translational Research in Population Health (ITR)PortoPortugal
| | - Florêncio Diniz‐Sousa
- Research Center in Physical ActivityHealth and Leisure (CIAFEL)Faculty of SportUniversity of PortoPortoPortugal
- Laboratory for Integrative and Translational Research in Population Health (ITR)PortoPortugal
| | - Lucas Veras
- Research Center in Physical ActivityHealth and Leisure (CIAFEL)Faculty of SportUniversity of PortoPortoPortugal
- Laboratory for Integrative and Translational Research in Population Health (ITR)PortoPortugal
| | - José Oliveira
- Research Center in Physical ActivityHealth and Leisure (CIAFEL)Faculty of SportUniversity of PortoPortoPortugal
- Laboratory for Integrative and Translational Research in Population Health (ITR)PortoPortugal
| | - Hélder Fonseca
- Research Center in Physical ActivityHealth and Leisure (CIAFEL)Faculty of SportUniversity of PortoPortoPortugal
- Laboratory for Integrative and Translational Research in Population Health (ITR)PortoPortugal
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Abe T, Song JS, Bell ZW, Wong V, Spitz RW, Yamada Y, Loenneke JP. Comparisons of calorie restriction and structured exercise on reductions in visceral and abdominal subcutaneous adipose tissue: a systematic review. Eur J Clin Nutr 2022; 76:184-195. [PMID: 34040197 DOI: 10.1038/s41430-021-00942-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 05/02/2021] [Accepted: 05/12/2021] [Indexed: 01/06/2023]
Abstract
Exercise and low-calorie diets are common approaches taken to produce an energy deficit for weight loss in obesity. Changes in visceral and abdominal subcutaneous fat associated with weight loss are important questions but have not yet been concluded. We investigated the relationship between changes in visceral (VAT) and subcutaneous adipose tissue (SAT) areas obtained by abdominal imaging with the change in total body fat. The relevant databases were searched through January 2021 according to the PRISMA guidelines. Sixty-five studies were included. We found that the change in total body fat was associated with changes in both VAT and abdominal SAT areas, but the relationship between total body fat and the abdominal SAT area appeared stronger. Baseline values of VAT and abdominal SAT area were similar in the three treatment groups (calorie restriction, calorie restriction plus exercise, and exercise alone). The reduction in abdominal SAT area for a loss of 1 kg of total body fat was about 10 cm2, which was similar among all the treatments. The change in VAT area (-26.3 cm2) was a similar level as the change in abdominal SAT area (-31.5 cm2) in the exercise, whereas in the calorie restriction with and without exercise, the change in VAT area (-33.6 and -51.6 cm2, respectively) was approximately half of the reduction of SAT area (-65.1 and -87.2 cm2, respectively). Absolute changes in VAT and abdominal SAT areas might differ between interventions for the exercise and calorie restriction with and without exercise.
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Affiliation(s)
- Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA. .,Graduate School of Health and Sports Science, Juntendo University, Inzai, Chiba, Japan.
| | - Jun Seob Song
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA
| | - Zachary W Bell
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA
| | - Vickie Wong
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA
| | - Robert W Spitz
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA
| | - Yujiro Yamada
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA
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Khani Jeihooni A, Layeghiasl M, Yari A, Rakhshani T. The effect of educational intervention based on the theory of planned behavior on improving physical and nutrition status of obese and overweight women. BMC Womens Health 2022; 22:13. [PMID: 35033045 PMCID: PMC8761043 DOI: 10.1186/s12905-022-01593-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 01/04/2022] [Indexed: 11/18/2022] Open
Abstract
Background Regarding the high rate of obesity and overweight among women, develop a comprehensive and effective program it seems necessary to improve their nutritional behaviors and physical activity. This study aims to survey the effect of educational intervention based on the theory of planned behavior (TPB) on improving physical and nutritional activities of obese and overweight women. Methods This experimental study was performed on 400 obese and overweight women over the age of 20. The sampling method was A simple random sampling. The data collection was valid and reliable self-reports measure, questionnaires. This tools was including demographic information, questionnaire based on the constructs of the theory of planned behavior, physical activity performance questionnaire and nutritional performance questionnaire that individuals completed before and 6 months after the educational intervention. The training intervention for the experimental group consisted of 12 sessions of 50–55 min. Data analyzed by SPSS22 and by using chi-square test, independent t-test and paired t-test. Results Findings showed that before the educational intervention, was no significant difference between the experimental and control groups in terms of education, household monthly income, occupation, mean age, marital status, awareness, attitude, perceived behavioral control, subjective norms, physical activity and nutritional behavioral intentions, and physical activity and nutritional performance, weight and BMI. However, six months after the training intervention, there was a significant increase in each of the TPB contracts, weight and BMI in the experimental group, while no significant difference was observed in the control group. The meaningful level was considered 0.05. Conclusion Our findings partially support of applying theory of planned behavior in reducing the weight, BMI and improved nutritional performance and physical activity of the study subjects. TPB could be an important strategy for effective future educational interventions.
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Affiliation(s)
- Ali Khani Jeihooni
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Layeghiasl
- Departement of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Asiyeh Yari
- Department of Health Education and Health Promotion, School of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Tayebeh Rakhshani
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
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Ma XN, Ma CX, Hou LJ, Fu SB. The association of obesity with thyroid carcinoma risk. Cancer Med 2022; 11:1136-1144. [PMID: 35032114 PMCID: PMC8855891 DOI: 10.1002/cam4.4498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 11/10/2021] [Accepted: 11/18/2021] [Indexed: 12/24/2022] Open
Abstract
Background The prevalence of obesity and an increased incidence of thyroid carcinoma (TC) threaten public health in parallel on a global scale. Sufficient evidence supports excess body fatness in thyroid carcinogenesis, and the role and anthropometric markers of obesity have been causally associated with the rising risk of TC. Methods A literature search was conducted in PubMed. Studies focused on the effect of obesity in TC. Results This review mainly discusses the global incidence and prevalence of obesity‐related TC. We also review the role of obesity in TC and potential clinical strategies for obesity‐related TC. Conclusions Excess body fatness in early life and TC survival initiate adverse effects later in life. The incidence of thyroid cancer has been increasing in the last decades all over the world. Such a steady growth cannot be entirely attributable to more sensitive diagnostic procedures. Obesity has increased with sufficient rapidity in the same time frame and may as possible promoters and modifiable risk factors for thyroid cancer in recent years. The aim of this review was to focus on the relationship between obesity and the risk of thyroid cancer. Obesity seems to play a relevant role in thyroid cancer carcinogenesis as well as in its severity and aggressiveness. The possible underlying mechanism is involved chronic inflammation mediated by cytokines, leptin, and adiponectins.
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Affiliation(s)
- Xiao-Ni Ma
- Department of Laboratory Medicine, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.,The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China
| | - Cheng-Xu Ma
- The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China.,Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Li-Jie Hou
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Song-Bo Fu
- The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China.,Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
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The Dynamic Interplay of Healthy Lifestyle Behaviors for Cardiovascular Health. Curr Atheroscler Rep 2022; 24:969-980. [PMID: 36422788 PMCID: PMC9750923 DOI: 10.1007/s11883-022-01068-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The recent rise in cardiovascular disease (CVD) deaths in the USA has sparked interest in identifying and implementing effective strategies to reverse this trend. Healthy lifestyle behaviors (i.e., healthy diet, regular physical activity, achieve and maintain a healthy weight, avoid tobacco exposure, good quality sleep, avoiding and managing stress) are the cornerstone for CVD prevention. RECENT FINDINGS Achieving all of these behaviors significantly benefits heart health; however, even small changes lower CVD risk. Moreover, there is interplay among healthy lifestyle behaviors where changing one may result in concomitant changes in another behavior. In contrast, the presence of one or more unhealthy lifestyle behaviors may attenuate changing another lifestyle behavior(s) (poor diet, inadequate physical activity, overweight/obesity, poor sleep quality, tobacco exposure, and poor stress management). It is important to assess all of these lifestyle behaviors with patients to plan an intervention program that is best positioned for adherence.
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Anand AC, Acharya SK. Nonalcoholic Steatohepatitis, Peroxisome Proliferator-Activated Receptors and Our Good Glitazar: Proof of the Pudding is in the Eating. J Clin Exp Hepatol 2022; 12:263-267. [PMID: 35535098 PMCID: PMC9077217 DOI: 10.1016/j.jceh.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Anil C. Anand
- Address for correspondence: Anil C Anand, Professor and Head, Department of Gastroenterology & Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, 751024 Odisha, India.
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Khodaveisi M, Azizpour B, Jadidi A, Mohammadi Y. Education based on the health belief model to improve the level of physical activity. Phys Act Nutr 2021; 25:17-23. [PMID: 35152620 PMCID: PMC8843841 DOI: 10.20463/pan.2021.0022] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/05/2021] [Indexed: 11/30/2022] Open
Abstract
[Purpose] This study aimed to investigate the effect of education based on the health belief model on the physical activity of the staff of the University of Medical Sciences. [Methods] This semi-experimental study was conducted on 130 university staff aged 25-50 years from the Hamadan University of Medical Sciences. Inclusion criteria were having at least 1 year of work experience, lack of acute and chronic physical and mental illnesses, and not using drugs that affect physical activity. The samples were randomly divided into two groups. The experimental group received three training sessions based on the health belief model. Before and 2 months after training, the control and experimental groups were evaluated via the following questionnaires: (1) demographic information questionnaire, (2) Health Belief Model Questionnaire, and (3) International Physical Activity Questionnaire. Finally, data were analyzed statistically. [Results] The training process resulted in a significant increase in the mean scores of the health belief model constructs in the experimental group, but changes in the control group were not significant. Self-efficacy was the strongest predictor of physical activity. [Conclusion] The health belief model is a useful model for improving individuals' understanding of the benefits of physical activity.
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Wu N, Yuan F, Yue S, Jiang F, Ren D, Liu L, Bi Y, Guo Z, Ji L, Han K, Yang X, Feng M, Su K, Yang F, Wu X, Lu Q, Li X, Wang R, Liu B, Le S, Shi Y, He G. Effect of exercise and diet intervention in NAFLD and NASH via GAB2 methylation. Cell Biosci 2021; 11:189. [PMID: 34736535 PMCID: PMC8569968 DOI: 10.1186/s13578-021-00701-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/25/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is a disorder that extends from simple hepatic steatosis to nonalcoholic steatohepatitis (NASH), which is effectively alleviated by lifestyle intervention. Nevertheless, DNA methylation mechanism underling the effect of environmental factors on NAFLD and NASH is still obscure. The aim of this study was to investigate the effect of exercise and diet intervention in NAFLD and NASH via DNA methylation of GAB2. METHODS Methylation of genomic DNA in human NAFLD was quantified using Infinium Methylation EPIC BeadChip assay after exercise (Ex), low carbohydrate diet (LCD) and exercise plus low carbohydrate diet (ELCD) intervention. The output Idat files were processed using ChAMP package. False discovery rate on genome-wide analysis of DNA methylation (q < 0.05), and cytosine-guanine dinucleotides (CpGs) which are located in promoters were used for subsequent analysis (|Δβ|≥ 0.1). K-means clustering was used to cluster differentially methylated genes according to 3D genome information from Human embryonic stem cell. To quantify DNA methylation and mRNA expression of GRB2 associated binding protein 2 (GAB2) in NASH mice after Ex, low fat diet (LFD) and exercise plus low fat diet (ELFD), MassARRAY EpiTYPER and quantitative reverse transcription polymerase chain reaction were used. RESULTS Both LCD and ELCD intervention on human NAFLD can induce same DNA methylation alterations at critical genes in blood, e.g., GAB2, which was also validated in liver and adipose of NASH mice after LFD and ELFD intervention. Moreover, methylation of CpG units (i.e., CpG_10.11.12) inversely correlated with mRNA expression GAB2 in adipose tissue of NASH mice after ELFD intervention. CONCLUSIONS We highlighted the susceptibility of DNA methylation in GAB2 to ELFD intervention, through which exercise and diet can protect against the progression of NAFLD and NASH on the genome level, and demonstrated that the DNA methylation variation in blood could mirror epigenetic signatures in target tissues of important biological function, i.e., liver and adipose tissue. Trial registration International Standard Randomized Controlled Trial Number Register (ISRCTN 42622771).
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Affiliation(s)
- Na Wu
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Fan Yuan
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Siran Yue
- Shanghai Innovation Center of Traditional Chinese Medicine Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fengyan Jiang
- Shanghai Innovation Center of Traditional Chinese Medicine Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Decheng Ren
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Liangjie Liu
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Bi
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Zhenming Guo
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Ji
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ke Han
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao Yang
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Mofan Feng
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Kai Su
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Fengping Yang
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Xi Wu
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Qing Lu
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Xingwang Li
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ruirui Wang
- Shanghai Innovation Center of Traditional Chinese Medicine Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Baocheng Liu
- Shanghai Innovation Center of Traditional Chinese Medicine Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shenglong Le
- Exercise Translational Medicine Center, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Yi Shi
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China. .,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China.
| | - Guang He
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai, 200030, China. .,Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China.
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Djousse L, Schubert P, Ho YL, Whitbourne SB, Cho K, Gaziano JM. Leisure time physical activity, sedentary behavior, and risk of cardiovascular disease and mortality among US Veterans. JOURNAL OF NOVEL PHYSIOTHERAPY AND PHYSICAL REHABILITATION 2021; 8:33-39. [PMID: 35098260 PMCID: PMC8793724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Cardiovascular disease (CVD) remains the leading cause of death in the US. Although physical activity (PA) has been inversely associated with the risk of CVD, few studies have examined whether sedentary behaviors modify such association. Our goal was to examine associations of leisure time PA with risk of CVD and mortality and the role of sedentary behavior as potential effect modifier among US veterans. METHODS We analyzed self-reported data on leisure time PA, television watching, and time spent on the computer among 438,364 participants of the Veterans Affairs Million Veteran Program from 2011 to 2018. We calculated metabolic equivalent of task-hours per week (MET-h/week) for each person and used electronic health record data to ascertain CVD. RESULTS Mean age was 64.6 ± 12.6 years and 92% were men. During a mean follow up of 3.3 years, we observed 22,942 new cases of CVD and 48,325 deaths. There was an inverse relation of leisure time PA with CVD and total mortality [HR: 0.96 (0.95-0.97) and 0.91 (0.90-0.92) per 2 MET-h/week increment for CVD and total mortality, respectively]. The associations of PA with both incident CVD and mortality were stronger in participants who spent more time watching television or on computer (all p values for interaction < 0.01). No interaction of PA with time spent on video game was observed (p>0.05). CONCLUSIONS Leisure time PA is inversely associated with risk of CVD and mortality among US veterans and such relations were stronger in participants who spent more time watching television or on computer.
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Affiliation(s)
- Luc Djousse
- Massachussets Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA
- Harvard Medical School, Boston, MA
- Department of Medicine, Division of Aging, Brigham and Women's Hospital
| | - Petra Schubert
- Massachussets Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA
| | - Yuk-Lam Ho
- Massachussets Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA
| | - Stacey B Whitbourne
- Massachussets Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA
- Harvard Medical School, Boston, MA
- Department of Medicine, Division of Aging, Brigham and Women's Hospital
| | - Kelly Cho
- Massachussets Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA
- Harvard Medical School, Boston, MA
- Department of Medicine, Division of Aging, Brigham and Women's Hospital
| | - J Michael Gaziano
- Massachussets Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA
- Harvard Medical School, Boston, MA
- Department of Medicine, Division of Aging, Brigham and Women's Hospital
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Unsupervised Exercise Training Was Not Found to Improve the Metabolic Health or Phenotype over a 6-Month Dietary Intervention: A Randomised Controlled Trial with an Embedded Economic Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158004. [PMID: 34360293 PMCID: PMC8345544 DOI: 10.3390/ijerph18158004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/19/2021] [Accepted: 07/23/2021] [Indexed: 11/16/2022]
Abstract
Ectopic fat leads to metabolic health problems. This research aimed to assess the effectiveness of a hypocaloric diet intervention together with an unsupervised exercise training program in comparison with a hypocaloric diet alone to reduce ectopic fat deposition. Sixty-one premenopausal women with overweight or obesity participated in this controlled trial and were each randomised into either a usual care group (hypocaloric diet) or intervention group (hypocaloric diet + unsupervised exercise training). Ectopic fat deposition, metabolic parameters, incremental costs from a societal perspective and incremental quality-adjusted life years (QALYs) were assessed before, during and after the six-month intervention period. In the total sample, there was a significant decrease in visceral adipose tissue (VAT: -18.88 cm2, 95% CI -11.82 to -25.95), subcutaneous abdominal adipose tissue (SAT: -46.74 cm2, 95% CI -29.76 to -63.18), epicardial fat (ECF: -14.50 cm3, 95% CI -10.9 to -18.98) and intrahepatic lipid content (IHL: -3.53%, 95% CI -1.72 to -5.32). Consequently, an "adapted" economic analysis revealed a non-significant decrease in costs and an increase in QALYs after the intervention. No significant differences were found between groups. A multidisciplinary lifestyle approach seems successful in reducing ectopic fat deposition and improving the metabolic risk profile in women with overweight and obesity. The addition of unsupervised exercise training did not further improve the metabolic health or phenotype over the six months.
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Battista F, Ermolao A, van Baak MA, Beaulieu K, Blundell JE, Busetto L, Carraça EV, Encantado J, Dicker D, Farpour-Lambert N, Pramono A, Bellicha A, Oppert JM. Effect of exercise on cardiometabolic health of adults with overweight or obesity: Focus on blood pressure, insulin resistance, and intrahepatic fat-A systematic review and meta-analysis. Obes Rev 2021; 22 Suppl 4:e13269. [PMID: 33960110 PMCID: PMC8365642 DOI: 10.1111/obr.13269] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/06/2021] [Accepted: 04/10/2021] [Indexed: 12/17/2022]
Abstract
This systematic review examined the impact of exercise intervention programs on selected cardiometabolic health indicators in adults with overweight or obesity. Three electronic databases were explored for randomized controlled trials (RCTs) that included adults with overweight or obesity and provided exercise-training interventions. Effects on blood pressure, insulin resistance (homeostasis model of insulin resistance, HOMA-IR), and magnetic resonance measures of intrahepatic fat in exercise versus control groups were analyzed using random effects meta-analyses. Fifty-four articles matched inclusion criteria. Exercise training reduced systolic and diastolic blood pressure (mean difference, MD = -2.95 mmHg [95% CI -4.22, -1.68], p < 0.00001, I2 = 63% and MD = -1.93 mmHg [95% CI -2.73, -1.13], p < 0.00001, I2 = 54%, 60 and 58 study arms, respectively). Systolic and diastolic blood pressure decreased also when considering only subjects with hypertension. Exercise training significantly decreased HOMA-IR (standardized mean difference, SMD = -0.34 [-0.49, -0.18], p < 0.0001, I2 = 48%, 37 study arms), with higher effect size in subgroup of patients with type 2 diabetes (SMD = -0.50 [95% CI: -0.83, -0.17], p = 0.003, I2 = 39%). Intrahepatic fat decreased significantly after exercise interventions (SMD = -0.59 [95% CI: -0.78, -0.41], p < 0.00001, I2 = 0%), with a larger effect size after high-intensity interval training. In conclusion, exercise training is effective in improving cardiometabolic health in adults with overweight or obesity also when living with comorbitidies.
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Affiliation(s)
- Francesca Battista
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padua, Italy
| | - Andrea Ermolao
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padua, Italy
| | - Marleen A van Baak
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University, Maastricht, The Netherlands
| | - Kristine Beaulieu
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - John E Blundell
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Luca Busetto
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO).,Department of Medicine, University of Padova, Padua, Italy
| | - Eliana V Carraça
- Faculdade de Educação Física e Desporto, CIDEFES, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal
| | - Jorge Encantado
- APPsyCI - Applied Psychology Research Center Capabilities & Inclusion, ISPA - University Institute, Lisbon, Portugal
| | - Dror Dicker
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO).,Department of Internal Medicine D, Hasharon Hospital, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nathalie Farpour-Lambert
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO).,Obesity Prevention and Care Program Contrepoids, Service of Endocrinology, Diabetology, Nutrition and Patient Education, Department of Internal Medicine, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Adriyan Pramono
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University, Maastricht, The Netherlands
| | - Alice Bellicha
- INSERM, Nutrition and Obesities: Systemic Approaches (NutriOmics), Sorbonne University, Paris, France.,UFR SESS-STAPS, University Paris-Est Créteil, Créteil, France
| | - Jean-Michel Oppert
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière hospital, Department of Nutrition, Institute of Cardiometabolism and Nutrition, Sorbonne University, Paris, France
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Association between physical exercise and stroke recurrence among first-ever ischemic stroke survivors. Sci Rep 2021; 11:13372. [PMID: 34183726 PMCID: PMC8238988 DOI: 10.1038/s41598-021-92736-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 05/25/2021] [Indexed: 02/05/2023] Open
Abstract
The relationship between exercise and stroke recurrence is controversial. This study was designed to test whether an association exists between exercise and ischemic stroke recurrence in first-ever ischemic stroke survivors. Data were collected from January 2010 to June 2016. Baseline information was obtained during face-to-face interviews, and follow-up phone interviews were conducted every 3 months. Exercise type, frequency, intensity, and duration were recorded. Discrete-time survival analysis was used to determine the relationship between exercise and stroke recurrence. 760 first-ever ischemic stroke survivors who were able to exercise were enrolled. After adjusting for covariates, patients who exercised 3.5–7 h per week and more than 7 h per week had a lower relapse risk than patients who did not exercise (3.5–7: OR 0.415; > 7: OR 0.356). Moreover, if the fluctuation of exercise duration was over 4 h, the patients had a higher risk of stroke recurrence than those with variability of less than 2 h (OR 2.153, P = 0.013). Stroke survivors who engage in long-term regular mild exercise (more than 5 sessions per week and lasting on average 40 min per session) have a lower recurrence rate. Irregular exercise increases the risk of stroke recurrence.
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Abstract
CONTEXT Obesity is a chronic disease that is difficult to manage without holistic therapy. The therapeutic armamentarium for obesity primarily consists of 4 forms of therapy: lifestyle modification (ie, diet and exercise), cognitive behavioral therapy, pharmacotherapy, and bariatric surgery. EVIDENCE ACQUISITION Evidence was consolidated from randomized controlled trials, observational studies, and meta-analyses. EVIDENCE SYNTHESIS After 2 years, lifestyle interventions can facilitate weight loss that equates to ~5%. Even though lifestyle interventions are plagued by weight regain, they can have substantial effects on type 2 diabetes and cardiovascular disease risk. Although 10-year percentage excess weight loss can surpass 50% after bariatric surgery, weight regain is likely. To mitigate weight regain, instituting a multifactorial maintenance program is imperative. Such a program can integrate diet, exercise, and pharmacotherapy. Moreover, behavioral therapy can complement a maintenance program well. CONCLUSIONS Obesity is best managed by a multidisciplinary clinical team that integrates diet, exercise, and pharmacotherapy. Bariatric surgery is needed to manage type 2 diabetes and obesity in select patients.
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Affiliation(s)
- Karim Kheniser
- Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA
| | - David R Saxon
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine and Rocky Mountain VA Medical Center, Anschutz Medical Campus, Aurora, CO, USA
| | - Sangeeta R Kashyap
- Department of Endocrinology and Metabolism, Cleveland Clinic, Cleveland, OHUSA
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Hariharan R, Mousa A, de Courten B. Influence of AMY1A copy number variations on obesity and other cardiometabolic risk factors: A review of the evidence. Obes Rev 2021; 22:e13205. [PMID: 33432778 DOI: 10.1111/obr.13205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 12/01/2022]
Abstract
The rising incidence of obesity and type 2 diabetes is contributing to the escalating burden of disease globally. These metabolic disorders are closely linked with diet and in particular with carbohydrate consumption; hence, it is important to understand the underlying mechanisms that influence carbohydrate metabolism. Amylase, the enzyme responsible for the digestion of starch, is coded by the genes AMY1A, AMY1B, and AMY1C (salivary amylase) and AMY2A and AMY2B (pancreatic amylase). Previous studies demonstrate wide variations in AMY1A copy numbers, which can be attributed to several genetic, nutritional, and geographical diversities seen in populations globally. Current literature suggests that AMY1A copy number variations are important in obesity and other cardiometabolic disorders through their effects on glucose and lipid homeostasis, inflammatory markers, and the gut microbiome. This review synthesizes the available evidence to improve understanding of the role of AMY1A in obesity and related cardiometabolic risk factors and disorders including insulin resistance and type 2 diabetes, cardiovascular risk and inflammation, and the gut microbiome.
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Affiliation(s)
- Rohit Hariharan
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
| | - Barbora de Courten
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia
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Ren J, Wu NN, Wang S, Sowers JR, Zhang Y. Obesity cardiomyopathy: evidence, mechanisms, and therapeutic implications. Physiol Rev 2021; 101:1745-1807. [PMID: 33949876 PMCID: PMC8422427 DOI: 10.1152/physrev.00030.2020] [Citation(s) in RCA: 166] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The prevalence of heart failure is on the rise and imposes a major health threat, in part, due to the rapidly increased prevalence of overweight and obesity. To this point, epidemiological, clinical, and experimental evidence supports the existence of a unique disease entity termed “obesity cardiomyopathy,” which develops independent of hypertension, coronary heart disease, and other heart diseases. Our contemporary review evaluates the evidence for this pathological condition, examines putative responsible mechanisms, and discusses therapeutic options for this disorder. Clinical findings have consolidated the presence of left ventricular dysfunction in obesity. Experimental investigations have uncovered pathophysiological changes in myocardial structure and function in genetically predisposed and diet-induced obesity. Indeed, contemporary evidence consolidates a wide array of cellular and molecular mechanisms underlying the etiology of obesity cardiomyopathy including adipose tissue dysfunction, systemic inflammation, metabolic disturbances (insulin resistance, abnormal glucose transport, spillover of free fatty acids, lipotoxicity, and amino acid derangement), altered intracellular especially mitochondrial Ca2+ homeostasis, oxidative stress, autophagy/mitophagy defect, myocardial fibrosis, dampened coronary flow reserve, coronary microvascular disease (microangiopathy), and endothelial impairment. Given the important role of obesity in the increased risk of heart failure, especially that with preserved systolic function and the recent rises in COVID-19-associated cardiovascular mortality, this review should provide compelling evidence for the presence of obesity cardiomyopathy, independent of various comorbid conditions, underlying mechanisms, and offer new insights into potential therapeutic approaches (pharmacological and lifestyle modification) for the clinical management of obesity cardiomyopathy.
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Affiliation(s)
- Jun Ren
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital Fudan University, Shanghai, China.,Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington
| | - Ne N Wu
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital Fudan University, Shanghai, China
| | - Shuyi Wang
- School of Medicine, Shanghai University, Shanghai, China.,University of Wyoming College of Health Sciences, Laramie, Wyoming
| | - James R Sowers
- Dalton Cardiovascular Research Center, Diabetes and Cardiovascular Research Center, University of Missouri-Columbia, Columbia, Missouri
| | - Yingmei Zhang
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital Fudan University, Shanghai, China
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Cornejo-Pareja I, Molina-Vega M, Gómez-Pérez AM, Damas-Fuentes M, Tinahones FJ. Factors Related to Weight Loss Maintenance in the Medium-Long Term after Bariatric Surgery: A Review. J Clin Med 2021; 10:jcm10081739. [PMID: 33923789 PMCID: PMC8073104 DOI: 10.3390/jcm10081739] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/27/2021] [Accepted: 04/09/2021] [Indexed: 12/15/2022] Open
Abstract
Despite bariatric surgery being the most effective treatment for obesity, some individuals do not respond adequately, especially in the long term. Identifying the predictors of correct weight maintenance in the medium (from 1 to 3 years after surgery) and long term (from 3 years and above) is of vital importance to reduce failure after bariatric surgery; therefore, we summarize the evidence about certain factors, among which we highlight surgical technique, psychological factors, physical activity, adherence to diet, gastrointestinal hormones or neurological factors related to appetite control. We conducted a search in PubMed focused on the last five years (2015–2021). Main findings are as follows: despite Roux-en-Y gastric bypass being more effective in the long term, sleeve gastrectomy shows a more beneficial effectiveness–complications balance; pre-surgical psychological and behavioral evaluation along with post-surgical treatment improve long-term surgical outcomes; physical activity programs after bariatric surgery, in addition to continuous and comprehensive care interventions regarding diet habits, improve weight loss maintenance, but it is necessary to improve adherence; the impact of bariatric surgery on the gut–brain axis seems to influence weight maintenance. In conclusion, although interesting findings exist, the evidence is contradictory in some places, and long-term clinical trials are necessary to draw more robust conclusions.
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Affiliation(s)
- Isabel Cornejo-Pareja
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María Molina-Vega
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Correspondence: (M.M.-V.); (A.M.G.-P.); Tel.: +34-95-1034-044 (M.M.-V. & A.M.G.-P.)
| | - Ana María Gómez-Pérez
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Correspondence: (M.M.-V.); (A.M.G.-P.); Tel.: +34-95-1034-044 (M.M.-V. & A.M.G.-P.)
| | - Miguel Damas-Fuentes
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
| | - Francisco J. Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
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