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Bhatia U, Bond D, Gunstad J, Carroll I, Crosby R, Mitchell JE, Peat CM, Steffen K, Heinberg L. Examining sex differences in the association between sedentary behavior and cognitive function in bariatric surgery patients. Surg Obes Relat Dis 2023; 19:1368-1374. [PMID: 37482449 PMCID: PMC10753032 DOI: 10.1016/j.soard.2023.06.004] [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: 03/23/2023] [Revised: 06/15/2023] [Accepted: 06/17/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Obesity is associated with cognitive impairment. A potential contributor to these deficits is sedentary behavior (SB), which is linked to poorer cognitive functioning in other populations. Little is known about the association between SB and cognitive function in bariatric surgery populations. OBJECTIVES This cross-sectional study examined the association between SB and cognitive function in preoperative bariatric surgery patients, as well as possible sex differences in this relationship. SETTING Data were collected at 2 health centers in the United States. METHODS A total of 121 participants (43.2 ± 10.3 yr of age) scheduled for Roux-en-Y gastric bypass or sleeve gastrectomy completed the National Institute of Health (NIH) Toolbox for the Assessment of Neurological and Behavioral Function Cognition Domain, a computerized neuropsychological assessment battery. Participants wore a waist-mounted accelerometer for 7 consecutive days to measure SB and light-intensity physical activity (LPA). RESULTS Pearson and partial correlations found no significant relationships between cognitive function and SB or LPA in the full sample. However, partial correlations controlling for LPA found that greater SB was associated with poorer performance on List Sorting Working Memory Test in women (r = -.28; P = .006), whereas there was a positive relationship between SB and Dimensional Change Card Sort for men (r = .51; P = .015; 95% CI [.25, .73]). CONCLUSIONS These results showed that greater SB, independent of LPA, is associated with poorer working memory in women and better set shifting ability in men. Future studies should examine the possibility of domain-specific cognitive effects associated with SB in bariatric surgery samples and clarify possible sex differences.
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Affiliation(s)
- Urja Bhatia
- Department of Psychological Sciences, Kent State University, Kent, Ohio.
| | - Dale Bond
- Departments of Surgery and Research, Hartford Hospital/Hartford HealthCare, Hartford, Connecticut
| | - John Gunstad
- Department of Psychological Sciences, Kent State University, Kent, Ohio
| | - Ian Carroll
- Department of Nutrition, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Ross Crosby
- Sanford Research, Sanford Health, Sioux Falls, South Dakota; Department of Psychiatry and Behavioral Science, University of North Dakota, Fargo, North Dakota
| | - James E Mitchell
- Department of Psychiatry and Behavioral Science, University of North Dakota, Fargo, North Dakota
| | - Christine M Peat
- Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kristine Steffen
- School of Pharmacy, North Dakota State University, Fargo, North Dakota
| | - Leslie Heinberg
- Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio
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Paccou J, Genser L, Lespessailles É, Bertin É, Javier RM, Duclos M, Joly AS, Boirie Y, Pattou F, Delarue J, Cortet B. French recommendations on the prevention and treatment of osteoporosis secondary to bariatric surgery. Joint Bone Spine 2022; 89:105443. [PMID: 35908644 DOI: 10.1016/j.jbspin.2022.105443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/27/2022] [Accepted: 07/12/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION This article presents the initial recommendations of the Groupe de Recherche et d'Information sur les Ostéoporoses (Osteoporosis Research and Information Group [GRIO]) and the Société Française de Rhumatologie (French Rheumatology Society [SFR]) on the prevention and treatment of osteoporosis secondary to bariatric surgery. METHODS The recommendations were produced by a working group comprising 4 expert rheumatologists, 3 medically qualified nutritionists, 2 obesity surgeons, 1 physical activity specialist, and 1 patient-association representative. RESULTS The following generally recommended measures apply to all patients with an indication for bariatric surgery or who have already undergone bariatric surgery: normalize calcium and protein intake, attain a 25(OH) vitamin D concentration of between 30 and 60ng/mL; prevent the risk of falls, and introduce a suitable regimen of physical activity. An initial assessment of fracture risk should be routinely performed - ideally before the first bariatric surgery procedure - (i) in the case of RYGB and biliopancreatic diversion, regardless of age, (ii) in patients at high risk of fracture, regardless of age, and (iii) in all menopausal women and all men ≥ 50 years old, regardless of the type of bariatric surgical procedure. The fracture risk assessment is based on a determination of osteoporosis risk factors and bone mineral density measurements. Anti-osteoporosis treatment - zoledronic acid as the first line of treatment - is indicated for menopausal women and men ≥ 50 years old with (i) a history of severe fracture, regardless of T-score, (ii) a history of non-severe fracture and a T-score ≤ -1, and (iii) no history of fracture and a T-score ≤ -2. CONCLUSIONS There is an increased risk of fracture after bariatric surgery. Clinicians should focus their attention on patients at high fracture risk such as postmenopausal women and men older than 50 years. More research is necessary to direct and support guidelines.
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Affiliation(s)
- Julien Paccou
- University Lille, CHU Lille, MABlab ULR 4490, Department of Rheumatology, 59000 Lille, France.
| | - Laurent Genser
- Sorbonne Université, Department of Digestive and Hepato-Pancreato-Biliary Surgery, Liver Transplantation, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Institut Hospitalo-Universitaire ICAN, Paris, France
| | - Éric Lespessailles
- Department of Rheumatology, Translational Medicine Research Platform, PRIMMO, Regional Hospital of Orleans, 45067 Orléans, France
| | - Éric Bertin
- Clinical Nutrition Transversal Unit (UTNC) of Reims University Hospital and Performance, Health, Metrology, Society Laboratory (PSMS, EA 7507) of Reims Champagne-Ardenne University, Reims, France
| | - Rose-Marie Javier
- Department of Rheumatology, Strasbourg University Hospital, Strasbourg, France
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, University Hospital of Clermont-Ferrand, University Clermont Auvergne, INRAE, Human Nutrition Unit, CRNH Auvergne, Clermont-Ferrand, France
| | - Anne-Sophie Joly
- Collectif National des Associations d'Obeses (CNAO), 92800 Puteaux, France
| | - Yves Boirie
- Clinical Nutrition Department, University Hospital of Clermont-Ferrand, University Clermont Auvergne, INRAE, Human Nutrition Unit, CRNH Auvergne, Clermont-Ferrand, France
| | - François Pattou
- Department of Metabolic and Endocrine Surgery, CHRU Lille, Lille, France
| | - Jacques Delarue
- Department of Nutritional Sciences and Laboratory of Human Nutrition, University Hospital, Faculty of Medicine, University of Brest, Brest, France
| | - Bernard Cortet
- University Lille, CHU Lille, MABlab ULR 4490, Department of Rheumatology, 59000 Lille, France
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Hardy K, Kwok K, Bouchard DR, Bharti N, Gamey D, Vergis A. Impact of a Preoperative Exercise Program on General Fitness in Patients Awaiting Bariatric Surgery: A Pilot Randomized Trial. Cureus 2022; 14:e22566. [PMID: 35355537 PMCID: PMC8957355 DOI: 10.7759/cureus.22566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 11/29/2022] Open
Abstract
Background Evidence supports the association between exercise and outcomes following bariatric surgery. However, there is a lack of knowledge regarding the short-term benefits of preoperative exercise. Objectives The objective of this pilot study was to evaluate the feasibility and functional benefits of a 12-week preoperative exercise program in patients awaiting bariatric surgery. The primary aim was the six-minute walk test (6MWT). The secondary aim of this study included anthropometric measures, strength, and quality of life. Methods A total of 54 patients were enrolled in this pilot randomized controlled study. Of them, 29 patients received standard multidisciplinary preoperative care, while 25 patients participated in a 12-week supervised exercise program in addition to standard preoperative care consisting of strength and aerobic exercises three times per week in a fitness facility. The primary outcome was improvement in 6MWT. Secondary outcomes included other functional outcomes, quality of life, and anthropometric measures. Results Average attendance for the intervention group was 27.2 (75.6%) of 36 sessions. There was a mean improvement of 27 ± 10 meters in the intervention group compared with a reduction of 5 ± 10 meters in the control group (p = 0.003). Patients in the intervention group had significant improvement in all self-reported quality-of-life domains, particularly in the variables related to symptoms, hygiene, and emotions. Conclusions A 12-week preoperative exercise intervention was feasible and showed association with a statistically significant improvement in 6MWT and quality-of-life measures in patients awaiting bariatric surgery. The results of this study will inform sample size calculations and recruitment planning for a future study that will assess the longer-term benefits of a pre-surgical fitness intervention.
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Smith KE, Mason TB, Schumacher LM, Pellegrini CA, Goldschmidt AB, Unick JL. Momentary affective response to bouts of moderate-to-vigorous physical activity predicts changes in physical activity and sedentary behavior during behavioral weight loss. PSYCHOLOGY OF SPORT AND EXERCISE 2021; 57:102056. [PMID: 34737670 PMCID: PMC8562688 DOI: 10.1016/j.psychsport.2021.102056] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Affective responses are posited to be key predictors of the uptake and maintenance of health behaviors. However, few studies have examined how individuals' affective response to physical activity, as well as the degree to which their affect response changes, may predict changes in physical activity and sedentary time during behavioral weight loss treatment. PURPOSE The current study examined how baseline momentary affective response (i.e., stress and anxiety) to moderate-to-vigorous physical activity (MVPA) and the degree of pre--post intervention change in this response predicted change in daily sedentary, light, and MVPA time during a three-month internet-based weight loss program. METHODS Women with overweight/obesity (final N=37) completed 14-day ecological momentary assessment (EMA) protocols with objective measurement of physical activity (i.e., bout-related MVPA time) before and after the intervention. RESULTS Women who had more reinforcing responses to MVPA (i.e., greater reductions in anxiety and stress response following MVPA bouts) at baseline had greater increases in overall MVPA at the end of the intervention. Those who had greater anxiety reductions after MVPA bouts at baseline also evidenced less sedentary time at the end of the intervention. Changes in affective responses across the intervention were not related to changes in physical activity levels. CONCLUSIONS Findings suggest initial levels of affective reinforcement from MVPA bouts predict future change in MVPA and sedentary time during behavioral weight loss. Future work is needed to examine the utility of more precisely targeting affective responses to physical activity to optimize intervention approaches.
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Affiliation(s)
- Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Leah M Schumacher
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Christine A Pellegrini
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Andrea B Goldschmidt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Jessica L Unick
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI, USA
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Ouellette KA, Mabey JG, Eisenman PA, Shaw JM, Brusseau TA, Hatfield DL, Ford CN, Davidson LE. Physical Activity Patterns Among Individuals Before and Soon After Bariatric Surgery. Obes Surg 2021; 30:416-422. [PMID: 31602627 DOI: 10.1007/s11695-019-04186-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE Post-operative changes in moderate-to-vigorous physical activity (MVPA) may contribute to improved weight loss and long-term weight maintenance of individuals after bariatric surgery. Patients experience minimal changes in MVPA > 6 months after surgery, but no studies have investigated early changes in physical activity after surgery. This study aims to assess MVPA changes during the rapid weight loss phase through self-reporting and objective measures. METHODS Physical activity patterns were assessed as minutes per day spent doing MVPA. A walking cadence of ≥ 100 steps per minute defined MVPA. Individuals completing gastric bypass (N = 7) and sleeve gastrectomy (N = 17) procedures (21 females, 3 males, age 42.2 ± 12.6 years, body mass 121.8 ± 24.8 kg, BMI 44.0 ± 6.5) completed office visits at 12 ± 6 days pre- and 35 ± 10 days post-operative. Each wore an ActiGraph GT3X tri-axial accelerometer at the hip for 7 days before and again for 7 days 30.6 ± 10 days after surgery. Assessments also included a subjective question about their anticipated and perceived post-operative MVPA (scale of - 3 to 3 with 3 being much more physically active and - 3 being much less). RESULTS Participants did not change their minutes per day of MVPA significantly (pre-operative 1.5 ± 2.1; post-operative 2.6 ± 5.6, NS). Participants predicted their post-operative physical activity level would increase (2.8 ± 0.4). The self-reported activity level on the same scale after surgery was significantly less than predicted (1.9 ± 1.0, p < 0.05) but still suggested that participants thought they were more physically active. CONCLUSION Consistent with reports > 6 months after surgery, MVPA did not increase in the early post-operative period, despite patient expectations. The early post-operative period may be a time for behavioral intervention.
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Affiliation(s)
- Kristen A Ouellette
- Department of Exercise Science and Athletic Training, Springfield College, Room 201 Athletic Training and Exercise Science Facilities, 263 Alden Street, Springfield, MA, 01109-3739, USA.
| | - Jacob G Mabey
- Department of Exercise Sciences, Brigham Young University, 271 Smith Fieldhouse, Provo, UT, 84604, USA
| | - Patricia A Eisenman
- Department of Health, Kinesiology, and Recreation, The University of Utah, 250 S. 1850 E., Hper East, Salt Lake City, UT, 84112, USA
| | - Janet M Shaw
- Department of Health, Kinesiology, and Recreation, The University of Utah, 250 S. 1850 E., Hper East, Salt Lake City, UT, 84112, USA
| | - Tim A Brusseau
- Department of Health, Kinesiology, and Recreation, The University of Utah, 250 S. 1850 E., Hper East, Salt Lake City, UT, 84112, USA
| | - Disa L Hatfield
- Department of Kinesiology, The University of Rhode Island, Independence Square, Suite P, RM 205, 25 Independence Way, Kingston, RI, 02881, USA
| | - Candus N Ford
- Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI, 96859-5000, USA
| | - Lance E Davidson
- Department of Exercise Sciences, Brigham Young University, 271 Smith Fieldhouse, Provo, UT, 84604, USA
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Zabatiero J, Smith A, Gucciardi DF, Hamdorf Am JM, Taylor SF, Hill K. Patterns of Change in Device-Based Physical Activity and Sedentary Time Following Bariatric Surgery: a Longitudinal Observational Study. Obes Surg 2021; 31:3015-3025. [PMID: 33712935 DOI: 10.1007/s11695-021-05337-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/24/2021] [Accepted: 03/04/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of this study is to investigate changes in physical activity (PA) and sedentary time (ST) over 12 months following bariatric surgery. METHODS Pre-surgery and at 3, 6, 9, and 12 months post-surgery, wearable devices were used to measure PA at different intensities, grouped according to energy expenditure and daily step count, and ST. Measures were also collected of weight and self-efficacy for exercise. Pre- and 12 months post-surgery, measures were collected of body composition and cardiovascular fitness. RESULTS Thirty adults scheduled for bariatric surgery were recruited (20 females, 44.1 [range, 22.0 to 65.0] years, body mass index 39.6 [range, 30.9 to 50.9] kg/m2). When compared to pre-surgery measures, over the 12 months post-surgery, there were no changes in the percentage of waking hours (mean [95% CI]) spent in ST (- 2% [- 6 to 3]), light intensity PA (1% [- 3 to 5]), and moderate-to-vigorous intensity PA (1% [- 1 to 3]). At all time points, participants spent most (> 70%) of their waking hours accumulating ST, with little time spent in light intensity PA (~ 21%) and almost no time in moderate-to-vigorous intensity PA (~ 5%). Step count and cardiovascular fitness were also unchanged. There were significant changes in weight, self-efficacy for exercise, and body composition. CONCLUSIONS Although bariatric surgery resulted in substantial weight loss and improved self-efficacy for exercise, it was insufficient to effect change in PA, ST or cardiovascular fitness. Complementing surgical intervention with behavioral interventions may optimize change in PA and ST.
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Affiliation(s)
- Juliana Zabatiero
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, 6845, Australia.
| | - Anne Smith
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, 6845, Australia
| | - Daniel F Gucciardi
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, 6845, Australia
| | - Jeffrey M Hamdorf Am
- Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia.,Western Surgical Health, Nedlands, WA, Australia
| | - Susan F Taylor
- Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia.,Western Surgical Health, Nedlands, WA, Australia
| | - Kylie Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, 6845, Australia.,Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, WA, Australia
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Kovacs SJ, Courcoulas AP, Rogers RJ, Davis KK, Jakicic JM. Psychosocial factors associated with physical activity in patients who have undergone bariatric surgery. Surg Obes Relat Dis 2020; 16:1994-2005. [PMID: 32919909 DOI: 10.1016/j.soard.2020.07.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/11/2020] [Accepted: 07/26/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Identifying psychosocial variables associated with physical activity may lead to the development of interventions that better address the challenges to participating in physical activity experienced by postbariatric surgery patients. OBJECTIVE To examine associations between select psychosocial variables and physical activity in patients who had undergone bariatric surgery within the past 2 years. SETTINGS Bariatric surgery candidates were recruited from the Greater Pittsburgh region. METHODS Eighty-three patients who had undergone bariatric surgery self-reported current physical activity and select psychosocial constructs. In addition, participants provided retrospective information on physical activity and psychosocial constructs before surgery. RESULTS Patients increased physical activity from baseline (median = 156.00 [25th, 75th percentiles: 53.00, 600.00] kcal/week) to post surgery (median = 976.00 [25th, 75th percentiles: 344.00, 1832.00] kcal/week) (P < .001). A number of pre- to postsurgery changes in psychosocial variables were associated with change in physical activity; however, only change in fitness orientation (P = .001), change in social support from friends (P = .005), and change in self-reported weight (P = .012) emerged as predictors of change in physical activity from pre- to postsurgery. Several postsurgery psychosocial factors were also significantly associated with postsurgery physical activity, but only postsurgery fitness orientation (P < .001), social support from co-workers (P = .002), and physical function (P = .023) emerged as predictive of the amount of postsurgical PA. CONCLUSIONS Pre- and postbariatric surgery interventions aimed at increasing physical activity participation may need to target important constructs that include the encouragement of social support and strategies to enhance the effort individuals put forward to engage in physical activity, as well as a focus on enhancing physical function and awareness of weight status.
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Affiliation(s)
- Sara J Kovacs
- Department of Kinesiology, Temple University, Philadelphia, Pennsylvania.
| | - Anita P Courcoulas
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Renee J Rogers
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania; Healthy Lifestyle Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kelliann K Davis
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - John M Jakicic
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania; Healthy Lifestyle Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
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Salwen-Deremer JK, Schreyer C, Hymowitz GF, Montanari A, Smith MT, Coughlin JW. Sleep disturbance and insomnia in individuals seeking bariatric surgery. Surg Obes Relat Dis 2020; 16:940-947. [PMID: 32331997 DOI: 10.1016/j.soard.2020.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 02/20/2020] [Accepted: 03/03/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Sleep disturbance is well established in individuals with obesity, and the relationship between poor sleep and obesity is supported by population, longitudinal, experimental, and intervention studies. However, the prevalence and characteristics of poor sleep in individuals seeking bariatric surgery have thus far been poorly examined. OBJECTIVES We sought to characterize self-reported sleep parameters in individuals seeking bariatric surgery and to compare these data with controls. SETTING Two Academic Medical Centers, United States, and an online survey of healthy controls. METHOD Individuals seeking bariatric surgery (n = 427) completed presurgical psychological evaluations at 2 comprehensive bariatric surgery programs. Data on medical co-morbidities and from self-report questionnaires on sleep quality, insomnia, anxiety, and depression were abstracted from charts. Data from controls (n = 180) were collected using an online survey tool and compared with bariatric cases. RESULTS Across study sites, 40.4% of bariatric cases took at least 30 minutes to fall asleep, 46.7% had insufficient total sleep time (<6.5 hr), 65.1% reported general poor sleep quality, and 30.8% reported clinically significant insomnia symptoms. Approximately 20% of the variance in poor sleep quality and insomnia was explained by body mass index, obstructive sleep apnea, anxiety, and depression. Cases and controls were similar, although bariatric cases reported significantly poorer sleep efficiency. CONCLUSIONS Our results suggest that similar to a control population, the majority of patients seeking bariatric surgery are experiencing sleep difficulties. Presurgical assessment and treatment of sleep problems may be beneficial to patients and may help improve weight loss treatment outcomes. Optimally, assessment would include 1 of the 2 self-report questionnaires used herein, and treatment would involve Cognitive Behavioral Therapy for Insomnia. Future research assessing sleep patterns with objective measurement tools and evaluating the impact of sleep on postsurgical outcomes is warranted.
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Affiliation(s)
- Jessica K Salwen-Deremer
- Department of Psychiatry & Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
| | - Colleen Schreyer
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Genna F Hymowitz
- Departments of Psychiatry & Surgery, Stony Brook University, Stony Brook, New York
| | - Amanda Montanari
- Department of Psychiatry & Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Michael T Smith
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Janelle W Coughlin
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
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Schumacher LM, Thomas JG, Vithiananthan S, Webster J, Jones DB, Bond DS. Prolonged sedentary time adversely relates to physical activity and obesity among preoperative bariatric surgery patients. Surg Obes Relat Dis 2020; 16:562-567. [PMID: 32005613 DOI: 10.1016/j.soard.2019.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/13/2019] [Accepted: 12/17/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Bariatric surgery patients spend much of their waking time sedentary. Yet, little is known about their patterns of accumulation of sedentary time (ST) and whether more prolonged ST is associated with lower physical activity (PA), independent of total ST, or obesity severity. OBJECTIVES To characterize variability in prolonged ST among bariatric patients preoperatively and assess the importance of a "prolonger" pattern in relation to PA and weight status. SETTING Two university hospital clinics, United States. METHODS Adult patients (n = 76) wore a wrist-based accelerometer for 10 days preoperatively. ST and time spent in light and moderate-to-vigorous PA was determined using validated thresholds. Percent of total ST accumulated in ≥30-consecutive ST minute bouts was calculated, and participants were trichotomized into low, medium, and high "prolongers" based on this value. The associations of prolonged ST with PA and obesity were examined. RESULTS On average, participants accumulated a mean ± standard deviation of 10.5 ± 2.1 hours of ST per day, 30% of which was prolonged (prolonger groups: low = 7.2%-24.5%, medium = 24.5%-33.0%, and high = 34.0%-52.6% of ST in ≥30-min bouts). Adjusting for covariates including total ST, high prolongers had fewer light PA minutes per day (P < .01), and a greater percentage of prolonged ST related to lower likelihood of meeting the national guideline of ≥150 moderate-to-vigorous PA minutes per week (P = .012). High (versus low) prolongers had more severe obesity (P < .05). CONCLUSIONS Accumulating a greater percentage of ST in prolonged bouts appears to be adversely related to PA and obesity severity among bariatric patients. Future research should determine whether interrupting prolonged ST with brief breaks can favorably modify PA and weight in this population.
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Affiliation(s)
- Leah M Schumacher
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, Rhode Island
| | - J Graham Thomas
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, Rhode Island
| | | | - Jennifer Webster
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, Rhode Island
| | - Daniel B Jones
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Dale S Bond
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, Rhode Island.
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Abstract
Obesity can negatively influence walking cadence, reducing the overall intensity of daily activities and increasing the risk of weight gain. PURPOSE Objectively describe the walking cadence of individuals' long-term post-bariatric surgery. METHODS Fifty-eight participants, 51.2 ± 8.9 years old, with a BMI of 34.6 ± 10.1 kg/m2, 10.0 ± 3.1 years post-surgery wore an activPAL accelerometer for 7 consecutive days. Data was analyzed using participants' current BMI, dichotomized by obesity status, < or ≥ 30 kg/m2. RESULTS On average, participants walked 5124 ± 2549 steps/day on weekdays and 6097 ± 2786 steps/day on weekend days (p = .003). Participants spent the majority (75%) of their daily steps at a slow-walking average cadence (non-obese: week = 65.3 ± 5.0 steps/min and weekend = 63.8 ± 6.7 steps/min; obese: week = 67.8 ± 8.2 steps/min and weekend = 63.3 ± 6.9 steps/min), with no difference between groups for week or weekend days (p = .153 and .774). The cadence of participants with obesity was significantly lower on weekends compared to weekdays for walking events > 30 s (p = .002) and > 60 s (p = .008) in duration. Weekday cadence of participants without obesity was similar to weekend day cadence across all walking event durations. The majority of walking events occurred below 30 s in duration for all participants. CONCLUSIONS Long-term post-bariatric surgery, movement occurs in short duration bouts at a slow-walking cadence for the majority of movement. Individuals without obesity had similar movement patterns from week to weekend days while participants with obesity significantly lowered their cadence on weekend days.
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Bueno-Antequera J, Oviedo-Caro MÁ, Munguía-Izquierdo D. Relationship between objectively measured sedentary behavior and health outcomes in schizophrenia patients: The PsychiActive project. Schizophr Res 2018; 197:87-92. [PMID: 29174336 DOI: 10.1016/j.schres.2017.11.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 11/14/2017] [Accepted: 11/18/2017] [Indexed: 12/21/2022]
Abstract
This study aimed to investigate possible relationships between sedentary behavior and body mass index (BMI), cardiorespiratory fitness (CRF), and health-related quality of life (HRQoL) in schizophrenia patients. Variables contributing to the variability in sedentary behavior were identified. Eighty-two schizophrenia outpatients (mean age±SD: 41.0±8.7years, 87% men, mean illness duration±SD: 17.1±8.9years) wore a multisensor armband for 7 consecutive full days to objectively measure sedentary behavior. BMI, walking capacity (6-minute walking test) as a proxy for CRF estimation and HRQoL (Short Form 36-Item Health Survey questionnaire version 2) were also assessed. Correlation (Pearson or Spearman coefficients) and multiple regression analysis were used. Sedentary behavior was significantly associated with BMI, CRF, and the physical component summary score of HRQoL (r values, -0.34-0.41; all P<0.001) and remained significant after adjustments for age, illness duration, symptom severity, adherence to Mediterranean diet, smoking, and antipsychotic medication (all P<0.05). BMI, CRF and vitality were identified as determinants of sedentary behavior. Consistent relationships between sedentary behavior and BMI, CRF, and the physical component summary score of HRQoL were found in schizophrenia patients. All the identified determinants of sedentary behavior are modifiable and may be important areas for future interventions in this population.
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Affiliation(s)
- Javier Bueno-Antequera
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain.
| | - Miguel Ángel Oviedo-Caro
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain.
| | - Diego Munguía-Izquierdo
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain.
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12
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Shukla AP, He D, Saunders KH, Andrew C, Aronne LJ. Current concepts in management of weight regain following bariatric surgery. Expert Rev Endocrinol Metab 2018; 13:67-76. [PMID: 30058859 DOI: 10.1080/17446651.2018.1447922] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Although bariatric surgery is the most effective and durable treatment for obesity, weight regain is common. AREAS COVERED In this article, we have critically reviewed data from retrospective and prospective studies pertaining to prevalence and predictors of weight regain following bariatric surgery, as well as the utility of behavioral and pharmacotherapeutic interventions to address post-surgical weight regain. EXPERT COMMENTARY The initial step in management of post-surgical weight regain is a comprehensive evaluation of the patient including a thorough assessment of contributing factors. While lifestyle interventions including diet, exercise and behavior modification are fundamental, they have limited efficacy which can be enhanced by pharmacotherapy. The optimal time to commence pharmacotherapy may be at weight plateau to maximize weight loss outcomes after bariatric surgery. Further prospective studies are needed to determine the best combination of behavioral and pharmacological therapies, and also the timing of pharmacotherapeutic intervention.
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Affiliation(s)
- Alpana P Shukla
- a Comprehensive Weight Control Center, Division of Endocrinology, Diabetes & Metabolism , Weill Cornell Medical College , New York , USA
| | - Diana He
- a Comprehensive Weight Control Center, Division of Endocrinology, Diabetes & Metabolism , Weill Cornell Medical College , New York , USA
| | - Katherine H Saunders
- a Comprehensive Weight Control Center, Division of Endocrinology, Diabetes & Metabolism , Weill Cornell Medical College , New York , USA
| | - Caroline Andrew
- a Comprehensive Weight Control Center, Division of Endocrinology, Diabetes & Metabolism , Weill Cornell Medical College , New York , USA
| | - Louis J Aronne
- a Comprehensive Weight Control Center, Division of Endocrinology, Diabetes & Metabolism , Weill Cornell Medical College , New York , USA
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Amundsen T, Strømmen M, Martins C. Suboptimal Weight Loss and Weight Regain after Gastric Bypass Surgery-Postoperative Status of Energy Intake, Eating Behavior, Physical Activity, and Psychometrics. Obes Surg 2017; 27:1316-1323. [PMID: 27914028 PMCID: PMC5403843 DOI: 10.1007/s11695-016-2475-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Suboptimal weight loss (SWL) and weight regain (WR) after gastric bypass surgery (GB) remains poorly understood. OBJECTIVES This study aims to compare GB patients experiencing SWL or significant WR (SigWR) with successful controls, regarding postoperative food intake, eating behavior, physical activity (PA), and psychometrics. METHODS Forty-nine patients with >1 year post-surgery were classified as either experiencing SWL (excess body weight loss, EWL, <50%, n = 22) or SigWR (total weight regain ≥15%, n = 38), with respective control groups. Energy intake (EI) was measured with a Food Frequency Questionnaire, eating behavior using the Dutch Eating Behavior Questionnaire and the Three-Factor Eating Questionnaire, and PA using both SenseWear Armbands and the International Physical Activity Questionnaire. Eating disorders, depression, and quality of life (QoL) were measured using the Eating Disorder Examination Questionnaire, Beck Depression Inventory II, and Impact of Weight on Quality of Life, respectively. RESULTS EI, macronutrient distribution, and meal frequency were similar among groups. However, disinhibited eating behavior score was higher, while most subcategories from IWQOL were significantly lower in both SWL and SigWR groups compared with their respective controls. PA was significantly lower in the SWL and SigWR groups compared with the respective controls. There were no differences between groups regarding depression. CONCLUSIONS Lower PA levels, disordered eating behavior and lower QoL are associated with unsuccessful weigh loss outcome after GB surgery. Longitudinal studies are needed to clarify the potential causal relationship between the previously described variables and SWL/SigWR after GB.
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Affiliation(s)
- Tina Amundsen
- Centre for Obesity Research (ObeCe), Department of Surgery, St. Olavs Hospital-Trondheim University Hospital, Prinsesse Kristinas gate 3, 7030, Trondheim, Norway
| | - Magnus Strømmen
- Centre for Obesity Research (ObeCe), Department of Surgery, St. Olavs Hospital-Trondheim University Hospital, Prinsesse Kristinas gate 3, 7030, Trondheim, Norway.,Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Catia Martins
- Centre for Obesity Research (ObeCe), Department of Surgery, St. Olavs Hospital-Trondheim University Hospital, Prinsesse Kristinas gate 3, 7030, Trondheim, Norway. .,Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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14
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Physical Activity, Decision-Making Abilities, and Eating Disturbances in Pre- and Postbariatric Surgery Patients. Obes Surg 2017; 26:2913-2922. [PMID: 27143094 DOI: 10.1007/s11695-016-2208-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Physical activity (PA) is considered to have a beneficial influence on executive functioning, including decision-making. Enhanced decision-making after bariatric surgery may strengthen patients' ability to delay gratification, helping to establish appropriate eating behavior. The objectives of this study were to (1) compare a preoperative group with a postoperative group with regard to daily PA, decision-making, and eating disturbances; and (2) investigate the relationship between these variables. METHODS The study included 71 bariatric surgery candidates (78 % women, BMI [kg/m2] M = 46.9, SD = 6.0) and 73 postoperative patients (78 % women, BMI M = 32.0, SD = 4.1; 89 % Roux-en-Y gastric bypass, 11 % sleeve gastrectomy; months postoperative M = 8.2, SD = 3.5; total weight loss [%] M = 33.2, SD = 8.9) who completed SenseWear Pro2 activity monitoring. Decision-making was assessed using a computerized version of the Iowa Gambling Task and eating disorder psychopathology using the Eating Disorder Examination-Questionnaire. RESULTS The number of patients who were classified as physically inactive was similarly high in the pre- and postoperative groups. No group differences emerged with regard to decision-making, but the postoperative group exhibited less eating disturbances than the preoperative group. No significant associations were found between PA, decision-making, and eating behavior. CONCLUSIONS Patients after bariatric surgery were not more physically active than bariatric surgery candidates, which should be considered in care programs. Additionally, future research is needed to explore the possible link between PA, patients' decision-making abilities, and eating disturbances concerning dose-response questions.
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15
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Exercise Testing Reveals Everyday Physical Challenges of Bariatric Surgery Candidates. J Phys Act Health 2017; 14:913-918. [PMID: 28682736 DOI: 10.1123/jpah.2017-0128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Few studies have quantified cardiorespiratory fitness among individuals seeking bariatric surgery. Treadmill testing allows researchers to determine exercise capacity through metabolic equivalents. These findings can assist clinicians in understanding patients' capabilities to carry out various activities of daily living. The purpose of this study was to determine exercise tolerance and the variables associated with fitness, among individuals seeking bariatric surgery. METHODS Bariatric surgery candidates completed submaximal treadmill testing and provided ratings of perceived exertion. Each participant also completed questionnaires related to history of exercise, mood, and perceived barriers/benefits of exercise. RESULTS Over half of participants reported that exercise was "hard to very hard" before reaching 70% of heart rate reserve, and one-third of participants reported that exercise was "moderately hard" at less than 3 metabolic equivalents (light activity). Body mass index and age accounted for the majority of the variance in exercise tolerance, but athletic history, employment status, and perceived health benefits also contributed. Perceived benefit scores were higher than barrier scores. CONCLUSION Categories commonly used to describe moderate-intensity exercise (3-6 metabolic equivalents) do not coincide with perceptions of intensity among many bariatric surgery candidates, especially those with a body mass index of 50 or more.
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16
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Stenmark Tullberg H, Fagevik Olsén M, Shams K, Wiklund M. “Stepping with ease towards a new way of living” – experiences of physical activity 5 years after bariatric surgery. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2017. [DOI: 10.1080/21679169.2017.1326527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Helene Stenmark Tullberg
- Department of Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation/Physical Therapy, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Monika Fagevik Olsén
- Department of Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation/Physical Therapy, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Clinical Sciences, Department of Gastrosurgical Research and Education, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kima Shams
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Malin Wiklund
- Institute of Clinical Sciences, Department of Gastrosurgical Research and Education, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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17
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Monteiro F, Ponce DAN, Silva H, Pitta F, Carrilho AJF. Physical Function, Quality of Life, and Energy Expenditure During Activities of Daily Living in Obese, Post-Bariatric Surgery, and Healthy Subjects. Obes Surg 2017; 27:2138-2144. [DOI: 10.1007/s11695-017-2619-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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18
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Zabatiero J, Hill K, Gucciardi DF, Hamdorf JM, Taylor SF, Hagger MS, Smith A. Beliefs, Barriers and Facilitators to Physical Activity in Bariatric Surgery Candidates. Obes Surg 2016; 26:1097-109. [PMID: 26323658 DOI: 10.1007/s11695-015-1867-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Bariatric surgery candidates engage in less physical activity (PA) and spend longer periods in sedentary behaviour (SB) when compared to the general adult population. The aim of this study was to explore the beliefs about PA and perceived barriers and facilitators to PA in obese adults scheduled for bariatric surgery. METHODS Nineteen obese adults (15 females), with a mean (SD) age of 41.6 (12.1) years, weight of 119.2 (20.5) kg and body mass index of 41.6 (6.7) kg/m(2) participated in a one-on-one in-depth qualitative interview before undergoing bariatric surgery. Data were analysed using inductive thematic analysis. RESULTS Most participants believed that engaging in regular PA confers important health benefits, however reported insufficient PA levels to obtain those benefits. The perceived barriers to PA reported by participants were both obesity related (e.g. bodily pain, physical limitation and self-presentational concerns) and non-obesity related (e.g. lack of motivation, environment and restricted resources). All participants stated weight loss to be the main perceived facilitator to PA, together with social factors, better time management and access to financial resources. CONCLUSIONS In bariatric surgery candidates, many of the perceived barriers and facilitators to PA are not obesity related and are therefore unlikely to change as a result of bariatric surgery. This may explain why earlier research shows little change in PA or SB following surgery. It is likely that an approach that aims to address the barriers and facilitators identified in this study is needed to change the inactive lifestyle adopted in this population.
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Affiliation(s)
- Juliana Zabatiero
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Western Australia, Australia
| | - Kylie Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Western Australia, Australia.,Lung Institute of Western Australia, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Daniel F Gucciardi
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Western Australia, Australia
| | - Jeffrey M Hamdorf
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Western Australia, Australia.,School of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, Western Australia, Australia.,Western Surgical Health, Hollywood Private Hospital, Perth, Western Australia, Australia
| | - Susan F Taylor
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Western Australia, Australia.,School of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, Western Australia, Australia.,Western Surgical Health, Hollywood Private Hospital, Perth, Western Australia, Australia
| | - Martin S Hagger
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Anne Smith
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Western Australia, Australia.
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19
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Rioux BV, Sénéchal M, Kwok K, Fox J, Gamey D, Bharti N, Vergis A, Hardy K, Bouchard DR. Association Between Physical Activity Intensity and Physical Capacity Among Individuals Awaiting Bariatric Surgery. Obes Surg 2016; 27:1277-1283. [PMID: 27815861 DOI: 10.1007/s11695-016-2448-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Physical activity is a routine component of the lifestyle modification program implemented prior to bariatric surgery, and one of the goals is to improve patients' physical capacity. However, the physical activity intensity recommended to meet that goal is unknown. OBJECTIVE This study aimed to assess the association between time spent at different physical activity intensities and physical capacity in patients awaiting bariatric surgery. MATERIALS AND METHODS A total of 39 women and 13 men were recruited. The primary outcome was physical capacity measured using six objective tests: 6-min walk, chair stand, sit and reach, unipodal balance (eyes open and eyes closed), and hand grip strength tests. The primary exposure variable was physical activity intensity (i.e., sedentary, light, moderate, and vigorous) measured by accelerometers. RESULTS The average body mass index was 46.3 ± 5.4 kg/m2. Only 6% of total time was spent at moderate to vigorous intensity, while 71% of the time was spent sedentary. When adjusted for body mass index, age, and sex, four of the six physical capacity tests were significantly associated with moderate intensity physical activity β(SE): 6-min walk 9.7 (2.7), chair stand 0.3 (0.1), balance (eyes open) 1.8 (0.7), and hand grip strength 1.2 (0.4), and only the 6-min walk was associated with sedentary activity 1.7 (0.7). CONCLUSION These results suggest that physical capacity is associated with time spent at moderate intensity in individuals awaiting bariatric surgery. The next step is to study if an increase in time spent at moderate intensity will translate to improvements in physical capacity.
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Affiliation(s)
- Brittany V Rioux
- Faculty of Kinesiology, University of New Brunswick, Fredericton 2 Peter Kelly Drive, P.O. Box 4400, Fredericton, NB, E3B 5A3, Canada
| | - Martin Sénéchal
- Faculty of Kinesiology, University of New Brunswick, Fredericton 2 Peter Kelly Drive, P.O. Box 4400, Fredericton, NB, E3B 5A3, Canada
| | - Karen Kwok
- Faculty of Health Sciences, University of Manitoba, S013-750 Bannatyne Avenue, Winnipeg, MB, R3E 0W2, Canada
| | - Jill Fox
- Faculty of Kinesiology, University of New Brunswick, Fredericton 2 Peter Kelly Drive, P.O. Box 4400, Fredericton, NB, E3B 5A3, Canada
| | - Dean Gamey
- Faculty of Kinesiology and Recreation Management, University of Manitoba, 66 Chancellors Cir, Winnipeg, MB, R3T 2N2, Canada
| | - Neha Bharti
- Faculty of Kinesiology and Recreation Management, University of Manitoba, 66 Chancellors Cir, Winnipeg, MB, R3T 2N2, Canada
| | - Ashley Vergis
- Faculty of Health Sciences, University of Manitoba, S013-750 Bannatyne Avenue, Winnipeg, MB, R3E 0W2, Canada
| | - Krista Hardy
- Faculty of Health Sciences, University of Manitoba, S013-750 Bannatyne Avenue, Winnipeg, MB, R3E 0W2, Canada
| | - Danielle R Bouchard
- Faculty of Kinesiology, University of New Brunswick, Fredericton 2 Peter Kelly Drive, P.O. Box 4400, Fredericton, NB, E3B 5A3, Canada.
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20
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Sogg S, Lauretti J, West-Smith L. Recommendations for the presurgical psychosocial evaluation of bariatric surgery patients. Surg Obes Relat Dis 2016; 12:731-749. [DOI: 10.1016/j.soard.2016.02.008] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 02/05/2016] [Indexed: 12/20/2022]
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21
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Reid RER, Carver TE, Andersen KM, Court O, Andersen RE. Physical activity and sedentary behavior in bariatric patients long-term post-surgery. Obes Surg 2015; 25:1073-7. [PMID: 25702142 DOI: 10.1007/s11695-015-1624-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND To measure sedentary behaviors and physical activity using accelerometry in participants who have undergone bariatric surgery 8.87 ± 3.78 years earlier and to compare these results with established guidelines. METHODS Participants' weight and height were measured, an ActivPAL™3 accelerometer and sleeping journal were used to determine day sedentary time, transitions from sitting to standing, as well as steps/day, and participants were asked to indicate if they felt that they were currently less, the same, or more active than before surgery. RESULTS Participants averaged 48 ± 15 transitions/day, 6375 ± 2690 steps/day, and 9.7 ± 2.3 h/day in sedentary positions. There was a negative correlation between steps/day and sedentary time (r = -.466, p ≤ .001), 11.27 % of participants achieved 10,000 steps/day. Participants who reported being more active prior to surgery averaged 6323.4 ± 2634.79 steps/day, which was not different from the other two groups of self-perceived change in level of physical activity (F (2, 68) = .941, p ≤ .05) from pre- to post-surgery. CONCLUSIONS Participants were inadequately active and overly sedentary compared to established guidelines and norms. Healthcare workers should be taking physical activity and sedentary time into account when creating post-surgical guidelines for this population to ensure the best long-term weight loss maintenance and health outcomes.
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Affiliation(s)
- Ryan E R Reid
- Department of Kinesiology and Physical Education, McGill University, 475 avenue des Pins Ouest, Montreal, QC, H2W 1S4, Canada,
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22
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Lier HØ, Aastrom S, Rørtveit K. Patients’ daily life experiences five years after gastric bypass surgery - a qualitative study. J Clin Nurs 2015; 25:322-31. [PMID: 26621613 DOI: 10.1111/jocn.13049] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2015] [Indexed: 01/24/2023]
Affiliation(s)
- Haldis Økland Lier
- Section of Mental Health Research; Haugesund Hospital; Helse Fonna HF; Haugesund Norway
| | - Sture Aastrom
- Department of Nursing; Umeå University; Umeå Sweden
- Department of Nursing Health and Culture; University West; Trollhättan Sweden
| | - Kristine Rørtveit
- Psychiatric Nursing; Stavanger District Psychiatric Centre; Stavanger University Hospital; Stavanger Norway
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23
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Waldburger R, Schultes B, Zazai R, Ernst B, Thurnheer M, Spengler CM, Wilms B. Comprehensive assessment of physical functioning in bariatric surgery candidates compared with subjects without obesity. Surg Obes Relat Dis 2015; 12:642-650. [PMID: 26826915 DOI: 10.1016/j.soard.2015.09.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 09/20/2015] [Accepted: 09/26/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Obesity appears to be associated with reduced physical performance, but comprehensive assessments of physical functioning are lacking in subjects with severe obesity, in particular in comparison with subjects without obesity. This precludes an objective assessment of the degree of impairment. OBJECTIVE To compare motor skills and cardiopulmonary fitness between subjects with severe obesity (OB) (i.e., candidates for bariatric surgery) and control subjects without obesity (non-OB). SETTING Cantonal Hospital, Switzerland. METHODS Flexibility, movement speed, balance, maximal isometric strength, and cardiopulmonary fitness were tested in 45 OB (body mass index: 42.6±.9 kg/m(2); age: 35±1.7 years; 33 women) and 32 non-OB (body mass index: 23±.4 kg/m(2); age: 38.5±2.1 years; 25 women) subjects. RESULTS In comparison with the non-OB group, the OB group showed reduced shoulder flexibility (P<.001) but comparable hamstrings flexibility (P = .3). Speed-related tasks (i.e., timed up-and-go test and timed lying-to-standing test) indicated that the OB group was slower than the non-OB group (all P<.007). Strength-related tasks indicated a greater absolute back muscle and knee-extensor strength (all P<.002) in the OB group with no difference in knee-flexor strength (both P>.8). However, when related to weight, the OB group showed reduced maximal strength (all P<.002). Bicycle spiroergometry indicated that absolute oxygen consumption at peak exercise and at the anaerobic threshold did not differ between groups (both P>.06). Related to weight, however, values were lower in the OB than in the non-OB group (both P< .001). CONCLUSION Data indicate a differential pattern of functional impairment in bariatric surgery candidates compared with subjects without obesity. These findings might help to establish tailored intervention protocols to improve physical performance in such subjects.
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Affiliation(s)
- Rahel Waldburger
- Department of Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Bernd Schultes
- eSwiss Medical and Surgical Center, Interdisciplinary Obesity Center, St. Gallen, Switzerland
| | - Runa Zazai
- Department of Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Barbara Ernst
- eSwiss Medical and Surgical Center, Interdisciplinary Obesity Center, St. Gallen, Switzerland
| | - Martin Thurnheer
- eSwiss Medical and Surgical Center, Interdisciplinary Obesity Center, St. Gallen, Switzerland
| | - Christina M Spengler
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Britta Wilms
- Department of Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland; Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, Zurich, Switzerland.
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Berglind D, Willmer M, Eriksson U, Thorell A, Sundbom M, Uddén J, Raoof M, Hedberg J, Tynelius P, Näslund E, Rasmussen F. Longitudinal assessment of physical activity in women undergoing Roux-en-Y gastric bypass. Obes Surg 2015; 25:119-25. [PMID: 24934315 DOI: 10.1007/s11695-014-1331-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Patients undergoing bariatric surgery do not seem to increase objectively measured physical activity (PA) after surgery, despite substantial weight loss. The aims of the present study were (i) to objectively characterize 3 months pre-surgery to 9 months postsurgery PA and sedentary behavior changes in women undergoing Roux-en-Y gastric bypass (RYGB) using tri-axial accelerometers and (ii) to examine associations between pre-surgery versus postsurgery PA and sedentary behavior with anthropometric measures taken in home environment. METHODS Fifty-six women, with an average pre-surgery body mass index (BMI) of 37.6 (SD 2.6) and of age 39.5 years (SD 5.7), were recruited at five Swedish hospitals. PA was measured for 1 week by the Actigraph GT3X+ accelerometer, and anthropometric measures were taken at home visits 3 months pre-surgery and 9 months postsurgery, thus limiting seasonal effects. RESULTS Average BMI loss, 9 months postsurgery, was 11.7 (SD 2.7) BMI units. There were no significant pre- to postsurgery differences in PA or sedentary behavior. However, pre-surgery PA showed negative association with PA change and positive association with postsurgery PA. Adjustments for pre-surgery BMI had no impact on these associations. CONCLUSIONS No significant differences were observed in objectively measured changes in PA or time spent sedentary from 3 months pre-surgery to 9 months postsurgery among women undergoing RYGB. However, women with higher pre-surgery PA decreased their PA postsurgery while women with lower pre-surgery PA increased their PA.
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Affiliation(s)
- Daniel Berglind
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, Widerströmska Huset, 171 77, Stockholm, Sweden
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25
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Bond DS, Thomas JG. Measurement and Intervention on Physical Activity and Sedentary Behaviours in Bariatric Surgery Patients: Emphasis on Mobile Technology. EUROPEAN EATING DISORDERS REVIEW 2015; 23:470-8. [PMID: 26331982 DOI: 10.1002/erv.2394] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 04/02/2015] [Accepted: 07/30/2015] [Indexed: 12/27/2022]
Abstract
Physical activity (PA) and sedentary behaviours (SB-i.e. activities involving low-energy expenditure and a sitting/reclining posture) may each have significant implications for weight loss and other bariatric surgery outcomes. While early studies suggested that patients typically comply with clinical recommendations to adopt habitual PA, these data were based on retrospective questionnaires. Conversely, recent studies incorporating mobile health (mHealth) technologies (e.g. objective monitors), which assess PA and SB in real time and in the natural environment, show that most patients are inactive and highly sedentary pre-operatively and only make modest changes in these behaviours postoperatively. In addition to using mHealth technologies for obtaining accurate and detailed information on PA and SB, they are increasingly being employed to intervene on patients' PA and SB and/or evaluate intervention outcomes. Researchers and clinicians are encouraged to consider the benefits of using mHealth technology when studying and treating PA and SB in bariatric surgery patients.
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Affiliation(s)
- Dale S Bond
- Weight Control and Diabetes Research Center, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI, USA
| | - J Graham Thomas
- Weight Control and Diabetes Research Center, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI, USA
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Physical activity is unrelated to cognitive performance in pre-bariatric surgery patients. J Psychosom Res 2015; 79:165-70. [PMID: 25818838 DOI: 10.1016/j.jpsychores.2015.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 03/09/2015] [Accepted: 03/11/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the relationship between physical activity (PA) and cognitive performance in extreme obesity. METHODS Seventy-one bariatric surgery candidates (77.5% women) with a mean body mass index (BMI) of 46.9 kg/m2 (SD=6.0) and a mean age of 41.4 (SD=11.9) years completed SenseWear Pro2 activity monitoring for seven days. Cognitive functioning was assessed by a computerized test battery including tasks of executive function (Iowa Gambling Task), visuospatial short-term memory (Corsi Block Tapping Test) and verbal short-term memory (Auditory-Verbal Learning Test). Questionnaires assessing eating disturbances and depressive symptoms were administered. Somatic comorbidities were assessed by medical chart review. RESULTS The level of PA was low with mean steps per day within wear time being 7140 (SD=3422). Most patients were categorized as sedentary (31.0%) or low active (26.8%). No significant association between PA estimates and cognitive performance was found. Lower PA was modestly correlated with higher BMI but not with age, somatic comorbidity or depressive symptoms. Moderated regression analyses suggested a significant interaction effect between depression and PA in predicting performance on the Corsi Block Tapping Test. Patients with (29.6%) and without (70.4%) regular binge eating did not differ with respect to PA or cognitive function. CONCLUSION The findings indicate no association between daily PA and cognitive performance in morbidly obese patients. Future studies should explore the relationship between the variables with regard to dose-response-questions, a broader BMI range and with respect to potential changes after substantial weight loss due to bariatric surgery.
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Abstract
Bariatric surgery is an effective treatment for patients with severe or moderate obesity; however, long-term studies have identified that weight regain occurs post-operatively among a portion of patients. The underlying factors that influence weight regain following bariatric surgery are multifactorial and include endocrine/metabolic alterations, anatomic surgical failure, nutritional indiscretion, mental health issues, and physical inactivity. The extent and significance of these factors is currently uncertain and likely varies between individuals and the operative procedure performed. Multiple observational and non-randomized studies and a few randomized controlled trials have been reported that focus on improving post-operative weight loss. Across all of the behavioral and group support studies, patients in the treatment groups showed either no benefit or modestly greater weight loss than patients in the control groups. There are no randomized controlled trials that have specifically targeted weight regain. Additional clinical research is needed to identify etiological factors and interventional strategies.
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Affiliation(s)
- Robert F Kushner
- Division of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, 750 North Lake Shore Drive, Rubloff 9-976, Chicago, IL, 60611, USA.
| | - Kirsten Webb Sorensen
- Center for Lifestyle Medicine, Northwestern Medicine, 675 N. St. Clair St. Galter Pavilion, Suite 17-250, Chicago, IL, 60611, USA.
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Herman KM, Carver TE, Christou NV, Andersen RE. Keeping the weight off: physical activity, sitting time, and weight loss maintenance in bariatric surgery patients 2 to 16 years postsurgery. Obes Surg 2015; 24:1064-72. [PMID: 24682779 DOI: 10.1007/s11695-014-1212-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Bariatric surgery patients often exhibit low levels of physical activity (PA), despite the presumed importance of PA as an adjunct to surgery for successful weight loss. Little is known regarding the associations of PA and sedentary behaviors to weight loss outcomes in the long term following surgery. The objective of the study was to assess the associations of PA and sitting time with weight status, weight loss, and weight maintenance outcomes in bariatric patients 2-16 years postsurgery. METHODS A total of 303 Roux-en-Y Gastric Bypass patients (73% female; mean age 47 ± 10 years, mean 7 ± 4 years since surgery) completed a telephone questionnaire. Patients reported moderate-to-vigorous PA (MVPA: # sessions/week ≥30 min) and average daily sitting time (h/day). Associations with various weight outcomes were assessed. RESULTS Only 48% of patients reported ≥1 session/week MVPA, and mean reported sitting time was 7 ± 4 h/day. Neither MVPA nor sitting time was associated with weight loss outcomes at patients' lowest weight postsurgery. However, both MVPA and sitting time were independently positively and inversely, respectively, associated with total (kg) weight loss, % weight loss, and % excess weight loss at current weight, as well as weight loss maintained vs. regained, controlling for age, sex, surgery type, presurgery BMI, total initial weight loss, and time since surgery. CONCLUSIONS Results demonstrate associations between MVPA and high sitting time and weight loss outcomes among bariatric patients in the long term. The implications for long-term weight management and concomitant health outcomes highlight the need for appropriate follow-up and interventions in this unique high-risk patient population.
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Affiliation(s)
- Katya M Herman
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Ave W, Montreal, QC, H2W 1S4, Canada,
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King WC. Comment on: Bari-Active: a randomized controlled trial of a preoperative intervention to increase physical activity in bariatric surgery patients. Surg Obes Relat Dis 2015; 11:177-80. [DOI: 10.1016/j.soard.2014.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 08/21/2014] [Indexed: 11/29/2022]
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Physical activity after surgically obtained weight loss: study with a SenseWear armband in subjects undergoing biliopancreatic diversion. Obes Surg 2014; 24:260-5. [PMID: 24048884 DOI: 10.1007/s11695-013-1078-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND This study aimed to understand the role of the extra load of body mass in limiting physical activity and in preventing an active lifestyle in severely obese patients. MATERIALS AND METHODS The study was carried out in a University Hospital setting, and investigates severely obese patients, having undergone biliopancreatic diversion (BPD) for obesity and control subjects with a body weight closely similar to that of the BPD subjects; energy intake was evaluated by alimentary interview and energy expenditure was assessed with the Body Media SenseWear® Pro armband (SWA). RESULTS SWA metabolic efficiency (MET) was negatively associated with body mass index values (ρ = -0.464, p < 0.01), and the SWA overall energy expenditure was very similar to the energy alimentary intake in the obese patients and in the control subjects. Among the controls, the MET mean value was higher (p < 0.05) than that observed both in obese and in BPD subjects (1.392 ± 0.211 vs. 1.149 ± 0.181 and 1.252 ± 0.284, respectively); furthermore, in comparison with the obese and the BPD groups, among the control individuals a greater number of active persons (27% vs. 0 and 7%, respectively) and a lower number of sedentary persons (27% vs. 70 and 43%, respectively) was found (p < 0.01). CONCLUSIONS These preliminary results suggest the reliability of SWA data in assessing energy expenditure and tend to rule out the hypothesis that in severely obese patients the extra load of body mass by itself is a main factor limiting physical activity and leading to a sedentary lifestyle.
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Herman KM, Carver TE, Christou NV, Andersen RE. Physical activity and sitting time in bariatric surgery patients 1-16 years post-surgery. Clin Obes 2014; 4:267-76. [PMID: 25825859 DOI: 10.1111/cob.12069] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 05/29/2014] [Accepted: 06/11/2014] [Indexed: 02/02/2023]
Abstract
Physical activity (PA) is an important adjunct to bariatric surgery in the treatment of severe obesity; however, patient PA levels prior to and in the short-term following surgery are usually low. Scarce data exist describing PA and sedentary behaviours in the long term following surgery. The objectives were to describe PA and sitting time in bariatric patients 1-16 years post-surgery and assess their associations with patient, surgery and weight-loss characteristics. A total of 398 bariatric patients (73% female; mean age 47 ± 11 years, mean 6 ± 4 years since surgery) completed a telephone questionnaire. Patients reported moderate-to-vigorous PA (MVPA: # sessions week(-1) ≥30 min), sitting time (h d(-1)) and change in PA and sitting time vs. pre-surgery (more/same/less). Associations with patient, surgery and weight-loss characteristics were assessed. Only 53% of patients reported ≥1 session week(-1) MVPA, mean sitting time was 7 ± 4 h d(-1), 74% of patients reported more PA and 53% reported less sitting, now vs. pre-surgery. Age, sex, smoking status, pre-surgery body mass index, time-since-surgery and percent excess weight lost were significantly associated with PA and/or sitting outcomes. Patients currently experiencing ≥50% excess weight loss had over three times the odds of reporting ≥1 session week(-1) MVPA (odds ratio [95% confidence interval] 3.28 [1.57, 6.89]) and almost four times greater odds of reporting 'more' PA vs. pre-surgery (3.78 [2.15, 6.62]) compared with their less successful counterparts. Results point to low PA and high sedentariness among bariatric patients in the long-term following surgery, associated with several characteristics. Associations with long-term weight management highlight the need for tailored interventions to promote active living in this patient population.
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Affiliation(s)
- K M Herman
- Department of Kinesiology & Physical Education, McGill University, Montreal, QC, Canada
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Physical activity monitoring in extremely obese adolescents from the Teen-LABORATORIES study. J Phys Act Health 2014; 12:132-8. [PMID: 25205688 DOI: 10.1123/jpah.2013-0006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The accuracy of physical activity (PA) monitors to discriminate between PA, sedentary behavior, and nonwear in extremely obese (EO) adolescents is unknown. METHODS Twenty-five subjects (9 male/16 female; age = 16.5 ± 2.0 y; BMI = 51 ± 8 kg/m2) wore 3 activity monitors (StepWatch [SAM], Actical [AC], Actiheart [AH]) during a 400-m walk test (400MWT), 2 standardized PA bouts of varying duration, and 1 sedentary bout. RESULTS For the 400MWT, percent error between observed and monitor-recorded steps was 5.5 ± 7.1% and 82.1 ± 38.6% for the SAM and AC steps, respectively (observed vs. SAM steps: -17.2 ± 22.2 steps; observed vs. AC steps: -264.5 ± 124.8 steps). All activity monitors were able to differentiate between PA and sedentary bouts, but only SAM steps and AH heart rate were significantly different between sedentary behavior and nonwear (P < .001). For all monitors, sedentary behavior was characterized by bouts of zero steps/counts punctuated by intermittent activity steps/counts; nonwear was represented almost exclusively by zero steps/counts. CONCLUSION Of all monitors tested, the SAM was most accurate in terms of counting steps and differentiating levels of PA and thus, most appropriate for EO adolescents. The ability to accurately characterize PA intensity in EO adolescents critically depends on activity monitor selection.
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Bond DS. Comment on: Patterns of physical activity and sedentary behavior after bariatric surgery: an observational study. Surg Obes Relat Dis 2014; 10:530-2. [PMID: 24704125 DOI: 10.1016/j.soard.2013.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 10/25/2013] [Indexed: 11/22/2022]
Affiliation(s)
- Dale S Bond
- Department of Psychiatry and Human Behavior Brown Alpert Medical School The Miriam Hospital/Weight Control and Diabetes Research Center Providence, Rhode Island
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Galioto R, King WC, Bond DS, Spitznagel MB, Strain G, Devlin M, Cohen R, Crosby RD, Mitchell JE, Gunstad J. Physical activity and cognitive function in bariatric surgery candidates. Int J Neurosci 2014; 124:912-8. [DOI: 10.3109/00207454.2014.895344] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Chapman N, Hill K, Taylor S, Hassanali M, Straker L, Hamdorf J. Patterns of physical activity and sedentary behavior after bariatric surgery: an observational study. Surg Obes Relat Dis 2013; 10:524-30. [PMID: 24462340 DOI: 10.1016/j.soard.2013.10.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 10/09/2013] [Accepted: 10/13/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Engaging in low levels of physical activity (PA) and accumulating prolonged periods of sedentary behavior (SB) during daily life have been associated with deleterious health outcomes. The objective of this study was to undertake an analysis of the way in which PA and SB were accumulated after bariatric surgery. METHODS Adults 12 to 18 months after laparoscopic adjustable gastric banding or 6 to 18 months after laparoscopic sleeve gastrectomy wore 2 activity monitors during the waking hours for 7 days. Anthropometric and demographic data were recorded. RESULTS Data were available on 40 participants (30 females; median ± interquartile range: age 46 ± 16 years, time since surgery 14 ± 8 months, body mass index 36 ± 9 kg/m(2)). The proportion of waking hours spent in SB, light PA, moderate PA, and vigorous PA was 72% ± 12%, 22% ± 9%, 5% ± 3% and 0% ± 0%, respectively. Half of the time in SB was accumulated in uninterrupted bouts ≥ 30 minutes. Almost all PA was accumulated in bouts<10 minutes in duration. The median daily step count was 9108 ± 4360. The proportion of people who completed an average of ≥ 10,000 steps/d was similar to that reported in Western Australian adults (39% versus 32%; P = .35). CONCLUSION Our sample spent>70% of time in SB, half of which was accumulated in uninterrupted bouts ≥ 30 minutes. Very little time was spent in moderate or vigorous PA (5%), and this was accumulated in short bouts (<10 minutes). Healthcare professionals should target not just overall time in SB and PA, but also aim to reduce prolonged periods of SB and increase sustained periods of PA.
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Affiliation(s)
- Naomi Chapman
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia
| | - Kylie Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia; Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, The University of Western Australia, Perth, Western Australia.
| | - Sue Taylor
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia; School of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, Western Australia; Western Surgical Health, Hollywood Private Hospital, Perth, Western Australia
| | - Munira Hassanali
- School of Occupational Therapy, Faculty of Health Sciences, Curtin University, Perth, Western Australia
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia
| | - Jeffrey Hamdorf
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia; School of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, Western Australia; Western Surgical Health, Hollywood Private Hospital, Perth, Western Australia; Clinical Training and Evaluation Centre (CTEC), The University of Western Australia, Perth, Western Australia
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King WC, Bond DS. The importance of preoperative and postoperative physical activity counseling in bariatric surgery. Exerc Sport Sci Rev 2013; 41:26-35. [PMID: 22710705 PMCID: PMC3529741 DOI: 10.1097/jes.0b013e31826444e0] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
There is increasing evidence that physical activity (PA) can enhance weight loss and other outcomes after bariatric surgery. However, most preoperative patients are insufficiently active and, without support, fail to make substantial increases in their PA postoperatively. This review provides the rationale for PA counseling in bariatric surgery and describes how to appropriately tailor strategies to preoperative and postoperative patients.
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Affiliation(s)
- Wendy C King
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA.
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Bond DS, Thomas JG, Unick JL, Raynor HA, Vithiananthan S, Wing RR. Self-reported and objectively measured sedentary behavior in bariatric surgery candidates. Surg Obes Relat Dis 2012; 9:123-8. [PMID: 23265767 DOI: 10.1016/j.soard.2012.09.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 09/19/2012] [Accepted: 09/26/2012] [Indexed: 12/01/2022]
Abstract
BACKGROUND Sedentary behavior (SB), independent of physical activity, represents a significant health risk. We previously used objective measures to demonstrate that bariatric surgery candidates engage in high levels of SB overall, but supplementing these measures with subjective reports would provide information about time allocated to different forms of SB. The aim of this study was to examine self-reported time spent performing specific types of SB and discrepancy between self-reported and objectively measured estimates of total sedentary time in bariatric surgery candidates. METHODS A total of 52 bariatric surgery candidates (87% female; age = 46.2 ± 9.1 years; body mass index [BMI] = 45.3 ± 6.7) completed the 9-item Sedentary Behavior Questionnaire (SBQ) as a subjective measure of SB and wore the SenseWear Armband (SWA; SenseWear, Pittsburgh, PA) as an objective measure. Paired samples t tests and the intraclass correlation coefficient (ICC) assessed measurement discrepancy. RESULTS Television-viewing was the most frequently performed type of SB (2.7 ± 1.6 hours per day), followed by paper/computer work (1.9 ± 1.8 hours per day), driving/riding in automobile (1.2 ± 1.1 hours per day), and sitting/talking on telephone (1.1 ± 1.2 hours per day). On average, the SBQ and SWA produced similar estimates of daily sedentary time (hours per day) at the group level (9.6 ± 4.8 versus 9.3 ± 1.9; mean difference = -.34 ± 4.6; P = .59), although agreement between the measures at the individual level was poor (mean absolute value of difference = 3.8 ± 2.8 hours per day; ICC = .22; P = .06). CONCLUSION Television-viewing was the single SB in which participants most frequently engaged and thus may be an important modifiable target for reducing total sedentary time in bariatric surgery candidates. The SBQ and SWA can be used similarly to describe SB levels in this patient population at the group level; however, ability of these measures to produce comparable estimates of sedentary time for any individual patient is limited.
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Affiliation(s)
- Dale S Bond
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island 02903, USA.
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Bond DS, Unick JL, Jakicic JM, Vithiananthan S, Trautvetter J, O'Leary KC, Wing RR. Physical activity and quality of life in severely obese individuals seeking bariatric surgery or lifestyle intervention. Health Qual Life Outcomes 2012; 10:86. [PMID: 22838650 PMCID: PMC3463462 DOI: 10.1186/1477-7525-10-86] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 07/16/2012] [Indexed: 01/22/2023] Open
Abstract
Background Given that bariatric surgery (BS) and lifestyle intervention (LI) represent two vastly different approaches to treating severe obesity, there is growing interest in whether individuals who seek BS versus LI also differ on weight-related behaviors. In the present study, we compared BS- and LI-seekers on physical activity (PA) and sedentary behaviors (SB), and examined between-group differences in health-related quality of life (HRQoL), while controlling for PA. Findings A sample of 34 LI-seekers were matched with 34 BS-seekers on gender, age, BMI, and PA monitor-daily wear time (age: 42.1±10.0 years; BMI: 45.6±6.5 kg/m2). PA and SB were assessed over a 7-day period via the SenseWear Armband (SWA). HRQoL was measured using the SF-36, with scores standardized to a population normal distribution (M=50, SD=10). Participants wore the SWA for 13.7±1.6 h/day. BS-seekers did not differ from LI-seekers on average min/d over the wear period spent in SB (641±117.1 vs. 638.4±133.4, p=0.62) or light (136.4±76.1 vs. 145.5±72.5, p=0.59) and moderate-to-vigorous (>1-min bouts=36.4±26.2 vs. 40.2±31.3, p=0.59; ≥10-min bouts=5.7±8.3 vs. 10.2±17.0, p=0.17) PA. BS-seekers reported significantly lower SF-36 physical functioning (42.4±10.9 vs. 49.0±6.8, p=0.004) and physical component summary (43.9±10.1 vs. 48.9±7.0) scores versus LI-seekers. BS-seeker group status was related to lower physical functioning (β=0.30, p=0.009), independent of gender, age, BMI, and daily PA. Conclusions Findings suggest that seeking BS versus LI is not related to patterns of PA or SB, and that lower subjective physical functioning is not associated with lower overall PA levels in BS-seekers.
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Affiliation(s)
- Dale S Bond
- Department of Psychiatry and Human Behavior, The Miriam Hospital/Weight Control and Diabetes Research Center, Warren Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI, 02903, USA.
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Comparison of two objective monitors for assessing physical activity and sedentary behaviors in bariatric surgery patients. Obes Surg 2012; 22:347-52. [PMID: 21814865 DOI: 10.1007/s11695-011-0491-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Objective quantification of physical activity (PA) is needed to understand PA and sedentary behaviors in bariatric surgery patients, yet it is unclear whether PA estimates produced by different monitors are comparable and can be interpreted similarly across studies. METHODS We compared PA estimates from the Stayhealthy RT3 triaxial accelerometer (RT3) and the Sensewear Pro(2) Armband (SWA) at both the group and individual participant level. Bariatric surgery candidates were instructed to wear the RT3 and SWA during waking hours for 7 days. Participants meeting valid wear time requirements (≥4 days of ≥8 h/day) for both monitors were included in the analyses. Time spent in sedentary (<1.5 METs), light (1.5-2.9 METs), moderate-to-vigorous (MVPA; ≥3.0 METs), and total PA (TPA; ≥1.5 METs) according to each monitor was compared. RESULTS Fifty-five participants (BMI 48.4 ± 8.2 kg/m(2)) met wear time requirements. Daily time spent in sedentary (RT3 582.9 ± 94.3; SWA 602.3 ± 128.6 min), light (RT3 131.9 ± 60.0; SWA 120.6 ± 65.7 min), MVPA (RT3 25.9 ± 20.9; SWA 29.9 ± 19.5 min), and TPA (RT3 157.8 ± 74.5; SWA 150.6 ± 80.7 min) was similar between monitors (p > 0.05). While the average difference in TPA between the two monitors at the group level was 7.2 ± 64.2 min; the average difference between the two monitors for each participant was 45.6 ± 45.4 min. At the group level, the RT3 and SWA provide similar estimates of PA and sedentary behaviors; however, concordance between monitors may be compromised at the individual level. CONCLUSIONS Findings related to PA and sedentary behaviors at the group level can be interpreted similarly across studies when either monitor is used.
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Dynamic Relations Between Sedentary Behavior, Physical Activity, and Body Composition After Bariatric Surgery. Obes Surg 2012; 22:1251-6. [DOI: 10.1007/s11695-012-0619-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Comment on: Walking capacity of bariatric surgery candidates. Surg Obes Relat Dis 2011; 8:59-61. [PMID: 21924687 DOI: 10.1016/j.soard.2011.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 07/12/2011] [Indexed: 11/21/2022]
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Thomas JG, Bond DS, Sarwer DB, Wing RR. Technology for behavioral assessment and intervention in bariatric surgery. Surg Obes Relat Dis 2011; 7:548-57. [PMID: 21514246 PMCID: PMC3422738 DOI: 10.1016/j.soard.2011.02.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Revised: 02/24/2011] [Accepted: 02/28/2011] [Indexed: 10/18/2022]
Abstract
Patients' behaviors have a substantial effect on postoperative outcomes after bariatric surgery. Thus, studying patients' behaviors is essential to learning how to optimize postoperative outcomes. To be most effective, this research should use the best tools available for assessing patient behavior. However, the traditional methods of behavioral assessment (e.g., questionnaires and clinical interviews) rely primarily on patients' retrospective self-report, which is often inaccurate. Despite their significant shortcomings, these types of assessments continue to predominate. However, technological advances now allow for much greater accuracy in the assessment of patient behaviors by way of devices, such as accelerometers and palmtop computers. Accelerometers allow for patients' physical activity to be measured objectively in great detail, in real-time, in the patients' natural environment. Ecologic momentary assessment using a palmtop computer or mobile telephone allows the assessment of important behaviors, such as eating and activity behaviors, to be measured, with many of the same advantages. Furthermore, new computer-assisted technologies are in development that will further facilitate behavioral assessment. Technology also has the potential to play an important role in the delivery of behavioral interventions aimed at bariatric surgery patients, given that Internet-based treatments have already proved effective for nonoperative weight loss and are often highly cost-effective and easily disseminable. Future research should evaluate the efficacy of these programs for bariatric patients.
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Affiliation(s)
- J Graham Thomas
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, Rhode Island, USA.
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