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Pramono A, Fitranti DY, Nugroho KH, Sobirin MA, Syauqy A. The Association between Unhealthy Food Consumption and Impaired Glucose Metabolism among Adults with Overweight or Obesity: A Cross-Sectional Analysis of the Indonesian Population. J Obes 2023; 2023:2885769. [PMID: 37006782 PMCID: PMC10060072 DOI: 10.1155/2023/2885769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND It has been shown that dietary patterns are associated with glucose control. However, the association between the types of food consumed and blood glucose in overweight or obese individuals is still unclear. The present study aimed to determine the association between unhealthy food consumption and impaired glucose metabolism in adults with overweight or obesity. METHODS The analysis presented in this study was based on the data from a population-based, cross-sectional, nationally representative survey (Indonesian Basic Health Research 2018/RISKESDAS 2018). The body mass index (BMI) was calculated as weight (kg)/height squared (m2) and was determined based on the World Health Organization (WHO) criteria for the Asian population. A validated questionnaire and food card were used to assess the diet. Fasting plasma glucose and 2-hpost-prandial glucose were employed to determine blood glucose markers. RESULTS In total, 8752 adults with overweight or obesity were included in this analysis. We found that consumption of sweet, grilled, and processed foods was associated with impaired fasting plasma glucose (IFG) before and after adjustment (p < 0.05). Consumption of high-fat foods was also associated with impaired glucose tolerance (IGT) for all models tested (p < 0.05). Furthermore, all models showed a link between processed food consumption and combined glucose intolerance (CGI) (p ≤ 0.001). CONCLUSIONS Differential food group consumption was associated with IFG, IGT, and CGI in Indonesian adults who were overweight or obese.
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Affiliation(s)
- Adriyan Pramono
- Department of Nutrition, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
- Center of Nutrition Research (Cenure), Diponegoro University, Tembalang, Semarang 50275, Indonesia
| | - Deny Y. Fitranti
- Department of Nutrition, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
- Center of Nutrition Research (Cenure), Diponegoro University, Tembalang, Semarang 50275, Indonesia
| | - K. Heri Nugroho
- Department of Internal Medicine, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
| | - M. Ali Sobirin
- Department of Pharmacology and Therapeutics, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
| | - Ahmad Syauqy
- Department of Nutrition, Faculty of Medicine, Diponegoro University, Tembalang, Semarang 50275, Indonesia
- Center of Nutrition Research (Cenure), Diponegoro University, Tembalang, Semarang 50275, Indonesia
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2
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McDonald MD, Hunt K, Sivaramakrishnan H, Moullin J, Avenell A, Kerr DA, Birch JM, Ntoumanis N, Quested E. A systematic review examining socioeconomic factors in trials of interventions for men that report weight as an outcome. Obes Rev 2022; 23:e13436. [PMID: 35187778 PMCID: PMC9285916 DOI: 10.1111/obr.13436] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 12/19/2022]
Abstract
Weight management interventions designed specifically for men have become more common, but the extent to which socioeconomic factors are considered in trials of these interventions is unclear. We synthesized study characteristics, methods, and reporting of interventions with a behavioral component for men that report weight as an outcome, to establish the extent to which socioeconomic factors are considered during intervention design, conduct, and reporting. A comprehensive search was conducted on Medline, Embase, PsycINFO, and CENTRAL for studies published from January 2000 to July 2021. Thirty-six trials were included. Educational attainment (n = 24) was the most frequently reported socioeconomic characteristic, followed by working status (n = 14) and area level deprivation (n = 12). Seven studies did not report any socioeconomic characteristics. Most studies (n = 20) did not mention the socioeconomic profile of their samples in relation to study strengths or limitations. Few (n = 4) consulted with men from lower socioeconomic groups during intervention design. One study examined potential differential intervention effects across socioeconomic groups, with most not powered to do so. Recent feasibility trials (n = 3) targeting specific socioeconomic groups suggest a potential nascent towards a greater consideration of factors related to equity. To best inform public health policy related to health inequalities, greater consideration of socioeconomic factors is required in trials of men's weight management interventions.
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Affiliation(s)
- Matthew D McDonald
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia.,Physical Activity and Well-Being Research Group, enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Kate Hunt
- Physical Activity and Well-Being Research Group, enAble Institute, Curtin University, Perth, Western Australia, Australia.,Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Hamsini Sivaramakrishnan
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia.,Physical Activity and Well-Being Research Group, enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Joanna Moullin
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Alison Avenell
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Deborah A Kerr
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia.,Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Jack M Birch
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Nikos Ntoumanis
- Physical Activity and Well-Being Research Group, enAble Institute, Curtin University, Perth, Western Australia, Australia.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Eleanor Quested
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia.,Physical Activity and Well-Being Research Group, enAble Institute, Curtin University, Perth, Western Australia, Australia
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Weight Management Interventions for Adults With Overweight or Obesity: An Evidence Analysis Center Scoping Review. J Acad Nutr Diet 2020; 121:1855-1865. [PMID: 33069660 DOI: 10.1016/j.jand.2020.07.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/30/2020] [Accepted: 07/21/2020] [Indexed: 12/26/2022]
Abstract
The objectives of this evidence scoping review were to identify and characterize studies investigating weight management interventions provided by a registered dietitian nutritionist or international equivalent (RDN) among adults with overweight or obesity. A medical librarian conducted an electronic literature search in 6 databases-MEDLINE (Ovid), Embase (Ovid), PyscINFO (Ovid), Cochrane CENTRAL (Ovid), Cochrane Database of Systematic Reviews (Ovid), and CINAHL (Ebsco). Except for narrative review, gray literature, and case study or report, all types of peer-reviewed articles published between January 2008 and April 26, 2019 were eligible. Two content advisors, who are experts in adult weight management, guided the process and reviewed the search plan and findings. The literature search resulted in 30,551 records with 16 additional records identified through other sources. A total of 29,756 records were excluded during the first round of screening due to duplication or irrelevancy. Of the 811 full-text articles that were screened, 139 met the criteria and were included. Approximately 51% and 43% of the studies were conducted in the community setting and in the United States or Canada, respectively. Over 97% of the studies were clinical or quasi-experimental trials. A total of 6 different intervention delivery modes were reported, which resulted in 22 combinations of the modes of delivery. RDNs delivered the weight management intervention (especially the nutrition component) in all studies, but some (61%) also involved an interdisciplinary team to deliver other components of the intervention. The average length of the intervention was about 10 months with a follow-up that ranged from 0 to 9 years. The commonly reported outcomes were anthropometrics, endocrine, and cardiovascular measures; dietary intake; and physical activity. Based on the scoping review, there were systematic reviews and evidence-based practice guidelines on weight management interventions but none of them met the a priori inclusion or exclusion criteria. Therefore, it would be beneficial to conduct a systematic review and develop an evidence-based practice guideline on adult weight management interventions provided by an RDN to guide practitioners and to evaluate their effects on health and nutrition-related outcomes.
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4
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Lisón JF, Palomar G, Mensorio MS, Baños RM, Cebolla-Martí A, Botella C, Benavent-Caballer V, Rodilla E. Impact of a Web-Based Exercise and Nutritional Education Intervention in Patients Who Are Obese With Hypertension: Randomized Wait-List Controlled Trial. J Med Internet Res 2020; 22:e14196. [PMID: 32286232 PMCID: PMC7189251 DOI: 10.2196/14196] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 10/31/2019] [Accepted: 02/09/2020] [Indexed: 12/24/2022] Open
Abstract
Background Internet-based interventions are a promising strategy for promoting healthy lifestyle behaviors. These have a tremendous potential for delivering electronic health interventions in scalable and cost-effective ways. There is strong evidence that the use of these programs can lead to weight loss and can lower patients’ average blood pressure (BP) levels. So far, few studies have investigated the effects of internet-based programs on patients who are obese with hypertension (HTN). Objective The aim of this study is to investigate the short- and long-term efficacy, in terms of body composition and BP parameters, of a self-administered internet-based intervention involving different modules and learning techniques aimed at promoting lifestyle changes (both physical activity and healthy eating) in patients who are obese with HTN. Methods A randomized wait-list controlled trial design was used. We recruited 105 adults with HTN who were overweight or obese and randomly assigned them to either a 3-month internet-based intervention group (n=55) or the wait-list control group (n=50). We assessed BMI (primary outcome), body fat mass (BFM), systolic (S)BP and diastolic (D)BP, blood glucose and insulin levels, physical activity levels, and functional capacity for aerobic exercise at Time 0 (preintervention) and Time 1 (postintervention). All the patients in the wait-list control group subsequently received the intervention, and a secondary within-group analysis, which also included these participants, was conducted at Time 2 (12-month follow-up). Results A 2-way mixed analysis of covariance showed a significant decrease in BMI, BFM, and blood glucose at 3 months in the internet-based intervention group; the effect size for the BMI and BFM parameters was moderate to large, and there was also a borderline significant trend for DBP and insulin. These results were either maintained or improved upon at Time 2 and showed significant changes for BMI (mean difference −0.4, 95% CI −0.1 to −0.6; P=.005), BFM (mean difference −2.4, 95% CI −1.1 to −3.6; P<.001), DBP (mean difference −1.8, 95% CI −0.2 to −3.3; P=.03), and blood glucose (mean difference −2, 95% CI 0 to −4; P=.04). Conclusions Implementation of our self-administered internet-based intervention, which involved different learning techniques aimed to promote lifestyle changes, resulted in positive short- and long-term health benefits in patients who are obese with HTN. Trial Registration ClinicalTrials.gov NCT03396302; https://clinicaltrials.gov/ct2/show/NCT03396302
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Affiliation(s)
- Juan Francisco Lisón
- Department of Medicine, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain.,Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición, Instituto Carlos III, Madrid, Spain
| | | | - Marinna S Mensorio
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior Foundation, Brasilia, Brazil.,Department of Personality, Assessment and Psychological Treatment, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Rosa M Baños
- Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición, Instituto Carlos III, Madrid, Spain.,Department of Personality, Assessment and Psychological Treatment, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Ausiàs Cebolla-Martí
- Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición, Instituto Carlos III, Madrid, Spain.,Department of Personality, Assessment and Psychological Treatment, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Cristina Botella
- Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición, Instituto Carlos III, Madrid, Spain.,Universitat Jaume I, Castellón, Spain
| | - Vicent Benavent-Caballer
- Department of Physiotherapy, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
| | - Enrique Rodilla
- Department of Medicine, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain.,Hypertension and Vascular Risk Unit, Hospital de Sagunto, Sagunto, Spain
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5
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Hwang WJ, Kang SJ. Interventions to Reduce the Risk of Cardiovascular Disease among Workers: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2267. [PMID: 32230939 PMCID: PMC7177901 DOI: 10.3390/ijerph17072267] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 11/17/2022]
Abstract
This study examined the effect of lifestyle interventions on cardiovascular disease risk factors among workers. The study comprised a systematic review and meta-analysis of controlled trials. Relevant controlled trials were searched, with selections based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed using the Scottish Intercollegiate Guidelines Network (SIGN). Of 1174 identified publications, one low-quality study was excluded. Finally, 10 were analyzed. The effect sizes were analyzed for heterogeneity, and random effect models (Hedge's g) were used. A subgroup analysis was performed on the follow-up point of intervention (≤ 12 months vs. > 12 months). Publication bias was also analyzed. Interventions were effective for systolic (g = 0.66, 95% CI: 0.27-1.60) and diastolic blood pressure (g = 0.63, 95% CI: 0.21-1.06), and BMI (g = 0.71, 95% CI: 0.15-1.11). Interventions were ineffective for weight (g = 0.18, 95% CI: -0.04, 0.40) and LDL-cholesterol (g = 0.46, 95% CI: -0.02, 0.93). There was high heterogeneity between studies (I2 =78.45 to I2 = 94.61). There was no statistically significant publication bias, except for systolic blood pressure. Interventions to reduce risk of cardiovascular disease risk might be effective in improving physical outcomes, but additional high-quality trials are needed in the future.
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Affiliation(s)
- Won Ju Hwang
- College of Nursing Science, Kyung Hee University, 26 Kyunghee-daero, Dongaemun-gu, Seoul 02247, Korea;
| | - Soo Jin Kang
- Department of Nursing, Daegu University, 33 Seongdang-ro 50-gil, Nam-gu, Daegu 42400, Korea
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Das S, Rouseff M, Guzman HE, Osondu CU, Brown D, Betancourt B, Ochoa T, Mora J, Lehn V, Sherriff SB, Rubens MB, Saxena A, Nasir K, Veledar E. The Impact of Lifestyle Modification on Cardiometabolic Risk Factors in Health-Care Employees With Type 2 Diabetes. Am J Health Promot 2019; 33:745-748. [PMID: 30651005 DOI: 10.1177/0890117118823164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE Diabetes imposes a significant economic burden on employers, particularly when including productivity costs. Given the great interest on multicomponent lifestyle interventions in these individuals, we assessed the short-term and long-term efficacy of a structured lifestyle modification program, My Unlimited Potential, among employees with diabetes of Baptist Health South Florida (BHSF), a large non-for profit health-care system. DESIGN This is a pre- and post-effectiveness of a workplace health promotion program. SETTING Worksite intervention at BHSF. PARTICIPANTS The study analyzed the data of 93 employees with diabetes involved in a worksite wellness program after completion of a year long program. INTERVENTION The intervention was an intense lifestyle modification program that was targeted to the individual needs of the participants. MEASURES Cardimetabolic risk factors such as body mass index (BMI), weight, systolic blood pressure, diastolic blood pressure, glycated hemoglobin, total cholesterol, triglycerides, high-sensitivity C-reactive protein, low-density lipoprotein, high-density lipoprotein, and maximal oxygen consumption. ANALYSIS Paired 2-sample t tests for means and descriptive statistics were used. RESULTS A mean decrease of 0.6 percentage points was observed in HbA1c values from baseline to 12 months. Weight, BMI, blood pressure, and lipid profile improved significantly after 12 months. CONCLUSION This study suggests worksites with existing health promotion programs, and health-care staff can effectively deliver a diabetes prevention program that appears to have a long-term impact on employee health.
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Affiliation(s)
- Sankalp Das
- 1 Wellness Advantage, Baptist Health South Florida, Miami, FL, USA
| | - Maribeth Rouseff
- 1 Wellness Advantage, Baptist Health South Florida, Miami, FL, USA
| | - Henry E Guzman
- 1 Wellness Advantage, Baptist Health South Florida, Miami, FL, USA
| | - Chukwuemeka U Osondu
- 2 Center for Prevention and Wellness, Baptist Health Medical Group, Miami, FL, USA
| | - Doris Brown
- 1 Wellness Advantage, Baptist Health South Florida, Miami, FL, USA
| | - Brian Betancourt
- 1 Wellness Advantage, Baptist Health South Florida, Miami, FL, USA
| | - Teresa Ochoa
- 1 Wellness Advantage, Baptist Health South Florida, Miami, FL, USA
| | - Joseph Mora
- 1 Wellness Advantage, Baptist Health South Florida, Miami, FL, USA
| | - Virginia Lehn
- 1 Wellness Advantage, Baptist Health South Florida, Miami, FL, USA
| | | | - Muni B Rubens
- 3 Clinical Trials-Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Anshul Saxena
- 4 Corporate Clinical Administration, Baptist Health South Florida, Miami, FL, USA.,5 Robert Stempel College of Public Health and Social Work, Miami, FL, USA
| | - Khurram Nasir
- 2 Center for Prevention and Wellness, Baptist Health Medical Group, Miami, FL, USA.,6 Center for Outcomes Research & Evaluation, Yale School of Medicine, New Haven, CT, USA
| | - Emir Veledar
- 4 Corporate Clinical Administration, Baptist Health South Florida, Miami, FL, USA.,5 Robert Stempel College of Public Health and Social Work, Miami, FL, USA
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7
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Zhao Q, Zhen Q, Li Y, Lv R, Zhang K, Qiao Y, Kou C, Li B, Tao Y, Yu Y, Liu Y, Cheng Y, Liu Y. PREVALENCE AND RISK FACTORS OF IMPAIRED FASTING GLUCOSE AMONG ADULTS IN NORTHEAST CHINA: A CROSS-SECTIONAL STUDY. Endocr Pract 2018; 24:677-683. [PMID: 30048165 DOI: 10.4158/ep-2018-0046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate the prevalence and risk factors of impaired fasting glucose (IFG) among adults in northeast China. METHODS A cross-sectional study was conducted in Jilin Province in 2012. Questionnaires were used to collect information about demographic characteristics, lifestyle factors, and health status from 15,540 residents. Fasting blood glucose (FBG) was measured in the morning after at least 12 hours of fasting, and χ2 tests were performed to compare differences between subjects with and without IFG. Logistic regression was carried out to identify factors influencing IFG occurrence. RESULTS There were significant differences in demographic characteristics (age, sex, education, and marriage status), lifestyle factors (smoking, drinking, physical activity, and average sleep duration), and health status (hyperlipidemia, hypertension, and BMI category) between subjects with IFG and without IFG ( P<.05). IFG risk was significantly associated with sex, age, education (senior high school and college), marriage status (single), drinking, hyperlipidemia, hypertension, and BMI category (all P<.05). CONCLUSION In adults in northeast China, risk factors of IFG are sex, age, education (senior high school and college), drinking, hyperlipidemia, hypertension, and BMI category; however, the protective factor of IFG is marriage status (single). ABBREVIATIONS BMI = body mass index; CI = confidence interval; FBG = fasting blood glucose; IFG = impaired fasting glucose; OR = odds ratio; T2DM = type 2 diabetes.
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Galaviz KI, Narayan KMV, Lobelo F, Weber MB. Lifestyle and the Prevention of Type 2 Diabetes: A Status Report. Am J Lifestyle Med 2018; 12:4-20. [PMID: 30202378 PMCID: PMC6125024 DOI: 10.1177/1559827615619159] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 11/03/2015] [Accepted: 11/04/2015] [Indexed: 12/11/2022] Open
Abstract
Diabetes is a costly disease affecting 387 million individuals globally and 28 million in the United States. Its precursor, prediabetes, affects 316 and 86 million individuals globally and in the United States, respectively. People living with elevated blood glucose levels are at high risk for all-cause mortality and numerous cardiometabolic ailments. Fortunately, diabetes can be prevented or delayed by maintaining a healthy lifestyle and a healthy body weight. In this review, we summarize the literature around lifestyle diabetes prevention programs and provide recommendations for introducing prevention strategies in clinical practice. Overall, evidence supports the efficacy and effectiveness of lifestyle diabetes prevention interventions across clinical and community settings, delivery formats (eg, individual-, group-, or technology-based), and implementers (eg, clinicians, community members). Evidence-based diabetes prevention strategies that can be implemented in clinical practice include brief behavior change counseling, group-based education, community referrals, and health information technologies. These strategies represent opportunities where practitioners, communities, and health care systems can work together to provide individuals with education, support and opportunities to maintain healthy, diabetes-free lifestyles.
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Affiliation(s)
- Karla I. Galaviz
- Karla I. Galaviz, MSc, PhD, Emory Global Diabetes Research Center, Hubert Department of Global Health, Emory University, No. 1518 Clifton Rd, Atlanta, GA 30322; e-mail:
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9
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Haw JS, Galaviz KI, Straus AN, Kowalski AJ, Magee MJ, Weber MB, Wei J, Narayan KMV, Ali MK. Long-term Sustainability of Diabetes Prevention Approaches: A Systematic Review and Meta-analysis of Randomized Clinical Trials. JAMA Intern Med 2017; 177:1808-1817. [PMID: 29114778 PMCID: PMC5820728 DOI: 10.1001/jamainternmed.2017.6040] [Citation(s) in RCA: 209] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 08/31/2017] [Indexed: 01/01/2023]
Abstract
Importance Diabetes prevention is imperative to slow worldwide growth of diabetes-related morbidity and mortality. Yet the long-term efficacy of prevention strategies remains unknown. Objective To estimate aggregate long-term effects of different diabetes prevention strategies on diabetes incidence. Data Sources Systematic searches of MEDLINE, EMBASE, Cochrane Library, and Web of Science databases. The initial search was conducted on January 14, 2014, and was updated on February 20, 2015. Search terms included prediabetes, primary prevention, and risk reduction. Study Selection Eligible randomized clinical trials evaluated lifestyle modification (LSM) and medication interventions (>6 months) for diabetes prevention in adults (age ≥18 years) at risk for diabetes, reporting between-group differences in diabetes incidence, published between January 1, 1990, and January 1, 2015. Studies testing alternative therapies and bariatric surgery, as well as those involving participants with gestational diabetes, type 1 or 2 diabetes, and metabolic syndrome, were excluded. Data Extraction and Synthesis Reviewers extracted the number of diabetes cases at the end of active intervention in treatment and control groups. Random-effects meta-analyses were used to obtain pooled relative risks (RRs), and reported incidence rates were used to compute pooled risk differences (RDs). Main Outcomes and Measures The main outcome was aggregate RRs of diabetes in treatment vs control participants. Treatment subtypes (ie, LSM components, medication classes) were stratified. To estimate sustainability, post-washout and follow-up RRs for medications and LSM interventions, respectively, were examined. Results Forty-three studies were included and pooled in meta-analysis (49 029 participants; mean [SD] age, 57.3 [8.7] years; 48.0% [n = 23 549] men): 19 tested medications; 19 evaluated LSM, and 5 tested combined medications and LSM. At the end of the active intervention (range, 0.5-6.3 years), LSM was associated with an RR reduction of 39% (RR, 0.61; 95% CI, 0.54-0.68), and medications were associated with an RR reduction of 36% (RR, 0.64; 95% CI, 0.54-0.76). The observed RD for LSM and medication studies was 4.0 (95% CI, 1.8-6.3) cases per 100 person-years or a number-needed-to-treat of 25. At the end of the washout or follow-up periods, LSM studies (mean follow-up, 7.2 years; range, 5.7-9.4 years) achieved an RR reduction of 28% (RR, 0.72; 95% CI, 0.60-0.86); medication studies (mean follow-up, 17 weeks; range, 2-52 weeks) showed no sustained RR reduction (RR, 0.95; 95% CI, 0.79-1.14). Conclusions and Relevance In adults at risk for diabetes, LSM and medications (weight loss and insulin-sensitizing agents) successfully reduced diabetes incidence. Medication effects were short lived. The LSM interventions were sustained for several years; however, their effects declined with time, suggesting that interventions to preserve effects are needed.
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Affiliation(s)
- J. Sonya Haw
- Division of Endocrinology, Metabolism and Lipids, School of Medicine, Emory University, Atlanta, Georgia
| | - Karla I. Galaviz
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Alysse J. Kowalski
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Matthew J. Magee
- Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta
| | - Mary Beth Weber
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jingkai Wei
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - K. M. Venkat Narayan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Mohammed K. Ali
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
- Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia
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10
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Khodaveisi M, Ashtarani F, Beikmoradi A, Mohammadi N, Mahjub H, Mazdeh M, Ashtarani E. The Effect of Continuous Care on the Lifestyle of Patients with Multiple Sclerosis: A Randomized Clinical Trial. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2017; 22:225-231. [PMID: 28706548 PMCID: PMC5494953 DOI: 10.4103/1735-9066.208170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Multiple sclerosis is a common debilitating chronic disease of the central nervous system with a progressive and prolonged nature. Patients need an adjusted lifestyle and continuous care in order to prevent its recurrence and progressive disabilities. This study aimed to assess the effect of continuous care on lifestyle in patients suffering from multiple sclerosis. MATERIALS AND METHODS A randomized clinical trial was conducted among 72 patients with multiple sclerosis who referred to the Farshchian Educational Hospital in Hamadan, Iran in 2013. The patients were allocated to intervention and control groups using balanced block randomization with blocks of four. The steps of continuous care (orientation, sensitization, control, and evaluation) were implemented in the case group for 2 months. The patients' lifestyle was assessed before and 1 and 2 months after continuous care using the researcher-developed Lifestyle Questionnaire. The data were analyzed using the Chi-square test, t-test, and repeated-measures analysis of variance. RESULTS The mean score of lifestyle and its dimensions were significantly higher in the intervention group 1 and 2 months after the intervention compared to the baseline (P = 0.001). In contrast, the mean score of lifestyle and its dimensions had no significant difference in the control group 1 and 2 months after routine care compared to the baseline. CONCLUSIONS Continuous care improved the patients' lifestyle. It could be designed as an appropriate care system into the hospitals or other health care centers. This care system could be used widely in order to improve adherence to suitable lifestyle in patients with chronic diseases.
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Affiliation(s)
- Masoud Khodaveisi
- Chronic Diseases (Home Care) Research Center, and Community Health Nursing Department, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemah Ashtarani
- Clinical Research Development Unit of Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Beikmoradi
- Medical-Surgical Nursing Department, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nahid Mohammadi
- Chronic Diseases (Home Care) Research Center, and Community Health Nursing Department, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hossein Mahjub
- Biostatistics and Epidemiology Department, Faculty of Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mehrdokht Mazdeh
- Neurology Department, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Elham Ashtarani
- School of Psychology and Education, Kharazmi University, Tehran, Iran
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11
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Sun Y, You W, Almeida F, Estabrooks P, Davy B. The Effectiveness and Cost of Lifestyle Interventions Including Nutrition Education for Diabetes Prevention: A Systematic Review and Meta-Analysis. J Acad Nutr Diet 2017; 117:404-421.e36. [PMID: 28236962 PMCID: PMC5330213 DOI: 10.1016/j.jand.2016.11.016] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 11/28/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Type 2 diabetes is a significant public health concern. With the completion of the Diabetes Prevention Program, there has been a proliferation of studies attempting to translate this evidence base into practice. However, the cost, effectiveness, and cost-effectiveness of these adapted interventions is unknown. OBJECTIVE The purpose of this systematic review was to conduct a comprehensive meta-analysis to synthesize the effectiveness, cost, and cost-effectiveness of lifestyle diabetes prevention interventions and compare effects by intervention delivery agent (dietitian vs non-dietitian) and channel (in-person vs technology-delivered). METHODS English and full-text research articles published up to July 2015 were identified using the Cochrane Library, PubMed, Education Resources Information Center, CAB Direct, Science Direct, and Google Scholar. Sixty-nine studies met inclusion criteria. Most employed both dietary and physical activity intervention components (four of 69 were diet-only interventions). Changes in weight, fasting and 2-hour blood glucose concentration, and hemoglobin A1c were extracted from each article. Heterogeneity was measured by the I2 index, and study-specific effect sizes or mean differences were pooled using a random effects model when heterogeneity was confirmed. RESULTS Participants receiving intervention with nutrition education experienced a reduction of 2.07 kg (95% CI 1.52 to 2.62; P<0.001; I2=90.99%, 95% CI 88.61% to 92.87%) in weight at 12 months with effect sizes over time ranging from small (0.17, 95% CI 0.04 to 0.30; P=0.012; I2= 86.83%, 95% CI 80.42% to 91.14%) to medium (0.65, 95% CI 0.49 to 0.82; P<0.001; I2=98.75%, 95% CI 98.52% to 98.94). Effect sizes for 2-hour blood glucose and hemoglobin A1c level changes ranged from small to medium. The meta-regression analysis revealed a larger relative weight loss in dietitian-delivered interventions than in those delivered by nondietitians (full sample: -1.0 kg; US subsample: -2.4 kg), and did not find statistical evidence that the delivery channel was an important predictor of weight loss. The average cost per kilogram weight loss ranged from $34.06 over 6 months to $1,005.36 over 12 months. The cost of intervention per participant delivered by dietitians was lower than interventions delivered by non-dietitians, although few studies reported costs. CONCLUSIONS Lifestyle interventions are effective in reducing body weight and glucose-related outcomes. Dietitian-delivered interventions, compared with those delivered by other personnel, achieved greater weight reduction. No consistent trend was identified across different delivery channels.
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Yang XJ, Zou SF, Xu Y, Li Y, Yang SS. The influence of intensive lifestyle intervention on patients with isolated impaired fasting glucose: a meta-analysis. J Adv Nurs 2016; 72:2587-2597. [PMID: 27237703 DOI: 10.1111/jan.13015] [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] [Accepted: 04/22/2016] [Indexed: 12/31/2022]
Abstract
AIM To evaluate the effect of intensive lifestyle intervention on patients with isolated impaired fasting glucose. BACKGROUND The application of lifestyle intervention to clinical nursing can help improve outcomes of patients with impaired fasting glucose. DESIGN We performed a meta-analysis of randomized controlled trials using methods outlined in the Cochrane Handbook. METHODS We performed keyword searches of the literature databases up to September 2014 and performed manual searches of selected article reference lists. Data were extracted by the lead reviewer, cross-checked by the second reviewer, entered into RevMan5·3, and pooled and analysed using the fixed effect inverse-variance model or random effects model to determine the mean difference and calculate the weighted mean difference. The heterogeneity statistic (I2 ), overall effect (Z) and P-value were calculated. RESULTS A total of five studies were included in our analysis. Following the heterogeneity test statistic, overall effect Z score with P-value was calculated. The targets of fasting plasma glucose, weight, body mass index, triglycerides, high-density lipoprotein cholesterol and total cholesterol all showed significant differences between the intervention and control groups. CONCLUSION Lifestyle intervention can improve glycaemic control in patients with isolated impaired fasting glucose. It also reduces blood-lipid levels and promotes weight loss. Larger patient cohorts and adequate follow-up should be included in future trials.
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Affiliation(s)
- Xiu-Juan Yang
- Southwest Medical University School of Nursing, Luzhou, China
| | - Shu-Fang Zou
- The Affiliated Hospital of Southwest Medical University, Luzhou, China.
| | - Yong Xu
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yi Li
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Shan-Shan Yang
- Southwest Medical University School of Nursing, Luzhou, China
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13
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Rouseff M, Aneni EC, Guzman H, Das S, Brown D, Osondu CU, Spatz E, Shaffer B, Santiago-Charles J, Ochoa T, Mora J, Gilliam C, Lehn V, Sherriff S, Tran TH, Post J, Veledar E, Feldman T, Agatston AS, Nasir K. One-year outcomes of an intense workplace cardio-metabolic risk reduction program among high-risk employees: The My Unlimited Potential. Obesity (Silver Spring) 2016; 24:71-8. [PMID: 26637983 DOI: 10.1002/oby.21324] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 07/27/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study details 6- and 12-month cardio-metabolic outcomes of an intense 12-week workplace lifestyle intervention program, the My Unlimited Potential (MyUP), conducted in a large healthcare organization. METHODS This study was conducted among 230 employees of Baptist Health South Florida with high cardiovascular disease (CVD) risk. Employees were considered at high risk and eligible for the study if they had two or more of the following cardio-metabolic risk factors: total cholesterol ≥ 200 mg/dl, systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg, hemoglobin A1C (HbA1c) ≥ 6.5%, body mass index (BMI) ≥ 30 kg/m(2) . RESULTS At the end of 12 weeks, there was significant reduction in the mean BMI, SBP and DBP, serum lipids, and HbA1c among persons with diabetes. At 1 year, there was significant decline in the mean BMI, SBP and DBP, HbA1c, and high-sensitivity C-reactive protein, and in the prevalence of poor BP control, BMI ≥ 35 kg/m(2) , and abnormal HbA1c among all persons and those with diabetes. CONCLUSIONS This intensive 12-week lifestyle change program was successful at improving cardio-metabolic risk factors at 1 year. This study provides a template for other workplace programs aimed at improving CVD risk in high-risk employees.
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Affiliation(s)
- Maribeth Rouseff
- Wellness Advantage Administration, Baptist Health South Florida, Miami, Florida, USA
| | - Ehimen C Aneni
- Department of Internal Medicine, Mount Sinai Medical Center, Miami, Florida, USA
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, Florida, USA
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Henry Guzman
- Employee Health Management, Baptist Health South Florida, Miami, Florida, USA
| | - Sankalp Das
- Wellness Advantage Administration, Baptist Health South Florida, Miami, Florida, USA
| | - Doris Brown
- Employee Health Management, Baptist Health South Florida, Miami, Florida, USA
| | - Chukwuemeka U Osondu
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, Florida, USA
| | - Erica Spatz
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, USA
| | - Brandon Shaffer
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, Florida, USA
| | | | - Teresa Ochoa
- Employee Health Management, Baptist Health South Florida, Miami, Florida, USA
| | - Joseph Mora
- Baptist Hospital, Baptist Health South Florida, Miami, Florida, USA
| | - Cynthia Gilliam
- Employee Health Management, Baptist Health South Florida, Miami, Florida, USA
| | - Virginia Lehn
- Employee Health Management, Baptist Health South Florida, Miami, Florida, USA
| | - Shoshana Sherriff
- Employee Health Management, Baptist Health South Florida, Miami, Florida, USA
| | - Thinh H Tran
- Center for Performance Excellence, Baptist Health South Florida, Miami, Florida, USA
| | - Janisse Post
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, Florida, USA
| | - Emir Veledar
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, Florida, USA
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Theodore Feldman
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, Florida, USA
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Arthur S Agatston
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, Florida, USA
| | - Khurram Nasir
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, Florida, USA
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
- The Ciccarone Center for Preventive Cardiology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
- Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, Florida, USA
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14
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Burke LE, Ma J, Azar KMJ, Bennett GG, Peterson ED, Zheng Y, Riley W, Stephens J, Shah SH, Suffoletto B, Turan TN, Spring B, Steinberger J, Quinn CC. Current Science on Consumer Use of Mobile Health for Cardiovascular Disease Prevention: A Scientific Statement From the American Heart Association. Circulation 2015; 132:1157-213. [PMID: 26271892 PMCID: PMC7313380 DOI: 10.1161/cir.0000000000000232] [Citation(s) in RCA: 366] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Seo DC, Niu J. Evaluation of Internet-Based Interventions on Waist Circumference Reduction: A Meta-Analysis. J Med Internet Res 2015. [PMID: 26199208 PMCID: PMC4527011 DOI: 10.2196/jmir.3921] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background Internet-based interventions are more cost-effective than conventional interventions and can provide immediate, easy-to-access, and individually tailored support for behavior change. Waist circumference is a strong predictor of an increased risk for a host of diseases, such as hypertension, diabetes, and dyslipidemia, independent of body mass index. To date, no study has examined the effect of Internet-based lifestyle interventions on waist circumference change. Objective This study aimed to systematically review the effect of Internet-based interventions on waist circumference change among adults. Methods This meta-analysis reviewed randomized controlled trials (N=31 trials and 8442 participants) that used the Internet as a main intervention approach and reported changes in waist circumference. Results Internet-based interventions showed a significant reduction in waist circumference (mean change –2.99 cm, 95% CI −3.68 to −2.30, I2=93.3%) and significantly better effects on waist circumference loss (mean loss 2.38 cm, 95% CI 1.61-3.25, I2=97.2%) than minimal interventions such as information-only groups. Meta-regression results showed that baseline waist circumference, gender, and the presence of social support in the intervention were significantly associated with waist circumference reduction. Conclusions Internet-based interventions have a significant and promising effect on waist circumference change. Incorporating social support into an Internet-based intervention appears to be useful in reducing waist circumference. Considerable heterogeneity exists among the effects of Internet-based interventions. The design of an intervention may have a significant impact on the effectiveness of the intervention.
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Affiliation(s)
- Dong-Chul Seo
- College of Health Sciences, Department of Health Education and Management, Ewha Womans University, Seoul, Republic Of Korea.
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16
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Kim CJ, Kang HS, Schlenk EA, Chae SM. Assessment of Cardiovascular Risk in Adults With Type 2 Diabetes and Metabolic Syndrome. DIABETES EDUCATOR 2015; 41:203-13. [DOI: 10.1177/0145721715572154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Purpose The purpose of this study was to assess risk of cardiovascular disease (CVD) by comparing the Framingham and United Kingdom Prospective Diabetes Study (UKPDS) risk equations in Korean adults with type 2 diabetes (T2DM) and metabolic syndrome. Methods The study was a cross-sectional survey enrolling a convenience sample of 110 Korean adults with T2DM and metabolic syndrome. The 10-year CVD risk scores were calculated using the Framingham risk equation and UKPDS risk engines. Results Overall participants had a moderate prevalence (average, 64.3%) of metabolic syndrome factors, with the most prevalent being abdominal obesity (86.4%) and elevated blood pressure (78.2%). A lower percentage of women were current smokers and consumed alcohol than men, whereas a higher percentage of men had their weight and stress controlled than women. The mean scores of 10-year CVD risk using the Framingham and UKPDS equations were 14.55% and 15.99%, respectively. However, there were no significant differences between results of the 2 equations. Regarding level of CVD risk, the percentage of high risk (>20%) was about 24% using both equations. Also, the area under the receiver operating characteristic curves using Framingham and UKPDS equations was similar: 0.707 and 0.696, respectively, which indicated moderate accuracy. Conclusions About one-fourth of adults with T2DM and metabolic syndrome had high level of CVD risk (>20%). In practice, people with diabetes and metabolic syndrome could be managed earlier and more intensively based on their risk estimated by the Framingham or UKPDS equations.
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Affiliation(s)
- Chun-Ja Kim
- Ajou University College of Nursing, Korea (Dr Kim)
- Red Cross College of Nursing, Chung-Ang University, Korea (Dr Kang)
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA (Dr Schlenk)
- Seoul National University College of Nursing, Korea (Dr Chae)
| | - Hee Sun Kang
- Ajou University College of Nursing, Korea (Dr Kim)
- Red Cross College of Nursing, Chung-Ang University, Korea (Dr Kang)
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA (Dr Schlenk)
- Seoul National University College of Nursing, Korea (Dr Chae)
| | - Elizabeth A. Schlenk
- Ajou University College of Nursing, Korea (Dr Kim)
- Red Cross College of Nursing, Chung-Ang University, Korea (Dr Kang)
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA (Dr Schlenk)
- Seoul National University College of Nursing, Korea (Dr Chae)
| | - Sun-Mi Chae
- Ajou University College of Nursing, Korea (Dr Kim)
- Red Cross College of Nursing, Chung-Ang University, Korea (Dr Kang)
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA (Dr Schlenk)
- Seoul National University College of Nursing, Korea (Dr Chae)
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Kang JY, Sung SH, Lee YJ, Choi TI, Choi SJ. Impact of ENPP1 K121Q on change of insulin resistance after web-based intervention in Korean men with diabetes and impaired fasting glucose. J Korean Med Sci 2014; 29:1353-9. [PMID: 25368487 PMCID: PMC4214934 DOI: 10.3346/jkms.2014.29.10.1353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 07/05/2014] [Indexed: 11/20/2022] Open
Abstract
Ectoenzyme nucleotide pyrophosphate phosphodiesterase 1 (ENPP1) gene has been studied in relation to type 2 diabetes mellitus (T2DM) and insulin resistance (IR). We hypothesized that the difference in genotype may be one of the factors that affect the outcome of intervention. We genotyped 448 men with fasting glucose≥5.6 mM/L, including 371 in subjects with K allele (KK) (69 control group [CG]; and 302 intervention group [IG]) and 77 in subjects with Q allele (KQ+QQ) (13 CG and 64 IG). The web-based intervention based on a lifestyle modification was delivered by e-mail once a month for 10 months. In the KK, IG demonstrated significantly decreased levels of fasting serum insulin (FSI) as compared to CG and homeostasis model of assessment of insulin resistance (HOMA-IR). In the KQ+QQ IG group, hemoglobin A1c (HbA1c), FSI and HOMA-IR were significantly decreased, and showed further reduction in the HOMA-IR than KQ+QQ CG. After analysis of covariance, K121Q did significantly influence the change of HbA1c in CG after appropriate adjustment. In a multivariate model, BMI change predicted HOMA-IR change (adjusted β=0.801; P=0.022) in KK IG subjects with T2DM. ENPP1 K121Q did not influence the change in IR. However, individuals with T2DM carrying the K121 variant are very responsive to the effect of BMI reduction on HOMA-IR.
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Affiliation(s)
- Ji Yeon Kang
- Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd., Seoul, Korea
| | - Sook Hee Sung
- Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd., Seoul, Korea
| | - Yeon Ju Lee
- Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd., Seoul, Korea
| | - Tae In Choi
- Central Research Institute, Korea Hydro & Nuclear Power Co., Ltd., Daejeon, Korea
| | - Seung Jin Choi
- Radiation Health Research Institute, Korea Hydro & Nuclear Power Co., Ltd., Seoul, Korea
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Aneni EC, Roberson LL, Maziak W, Agatston AS, Feldman T, Rouseff M, Tran TH, Blumenthal RS, Blaha MJ, Blankstein R, Al-Mallah MH, Budoff MJ, Nasir K. A systematic review of internet-based worksite wellness approaches for cardiovascular disease risk management: outcomes, challenges & opportunities. PLoS One 2014; 9:e83594. [PMID: 24421894 PMCID: PMC3885454 DOI: 10.1371/journal.pone.0083594] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 11/14/2013] [Indexed: 11/18/2022] Open
Abstract
Context The internet is gaining popularity as a means of delivering employee-based cardiovascular (CV) wellness interventions though little is known about the cardiovascular health outcomes of these programs. In this review, we examined the effectiveness of internet-based employee cardiovascular wellness and prevention programs. Evidence Acquisition We conducted a systematic review by searching PubMed, Web of Science and Cochrane library for all published studies on internet-based programs aimed at improving CV health among employees up to November 2012. We grouped the outcomes according to the American Heart Association (AHA) indicators of cardiovascular wellbeing – weight, BP, lipids, smoking, physical activity, diet, and blood glucose. Evidence Synthesis A total of 18 randomized trials and 11 follow-up studies met our inclusion/exclusion criteria. Follow-up duration ranged from 6 – 24 months. There were significant differences in intervention types and number of components in each intervention. Modest improvements were observed in more than half of the studies with weight related outcomes while no improvement was seen in virtually all the studies with physical activity outcome. In general, internet-based programs were more successful if the interventions also included some physical contact and environmental modification, and if they were targeted at specific disease entities such as hypertension. Only a few of the studies were conducted in persons at-risk for CVD, none in blue-collar workers or low-income earners. Conclusion Internet based programs hold promise for improving the cardiovascular wellness among employees however much work is required to fully understand its utility and long term impact especially in special/at-risk populations.
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Affiliation(s)
- Ehimen C. Aneni
- Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida, United States of America
| | - Lara L. Roberson
- Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida, United States of America
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida, United States of America
| | - Arthur S. Agatston
- Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida, United States of America
| | - Theodore Feldman
- Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida, United States of America
| | - Maribeth Rouseff
- Baptist Health South Florida, Miami, Florida, United States of America
| | - Thinh H. Tran
- Baptist Health South Florida, Miami, Florida, United States of America
| | - Roger S. Blumenthal
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland, United States of America
| | - Michael J. Blaha
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland, United States of America
| | - Ron Blankstein
- Brigham and Women's Hospital, Harvard School of Medicine, Boston, Massachusetts, United States of America
| | | | - Matthew J. Budoff
- Los Angeles Biomedical Research Institute, Torrance, California, United States of America
| | - Khurram Nasir
- Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida, United States of America
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida, United States of America
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland, United States of America
- Department of Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
- * E-mail:
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Ahn HJ, Han KA, Jang JY, Lee JH, Park KS, Min KW. Small rice bowl-based meal plan for energy and marcronutrient intake in korean men with type 2 diabetes: a pilot study. Diabetes Metab J 2011; 35:273-81. [PMID: 21785748 PMCID: PMC3138099 DOI: 10.4093/dmj.2011.35.3.273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Accepted: 12/08/2010] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Koreans eat rice, which is usually served in a rice bowl. We investigated the effect of a meal plan using small rice bowls on the total energy intake (TEI) and the marcronutrient intake in Korean men with type 2 diabetes. METHODS A total of 62 men with type 2 diabetes were divided by body mass index (BMI) (normal weight [NW], BMI<23 kg/m(2); overweight [OW], 23≤BMI<25 kg/m(2); obese [OB], BMI≥25 kg/m(2)) and proportions of carbohydrate intake to TEI (PCI) (low carbohydrate intake [LC], <55%; recommended carbohydrate intake [RC], ≥55% and ≤60%; high carbohydrate intake [HC], >60%). The 3-day dietary records were analyzed for TEI and proportions of macronutrients, before and 2 weeks after a small-sized (300 mL) rice bowl based education was given. RESULTS There were no significant differences in the age and BMI within the sub-groups by BMI and PCI groups. In baseline, the ratio of TEI to recommended total energy intake (RTR) of OW and OB were higher than that of NW. The PCI of HC was higher than that of LC and alcohol intake of HC was lower than that of LC. After education, the reduction of RTREI in OB was higher than that in OW and NW. The reduction of PCI in HC was higher than that of LC. CONCLUSION A small rice bowl based meal plan was effective for the reduction of energy intake and control of marcronutrient intake in Korean obese men with type 2 diabetes consuming a high carbohydrate diet.
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Affiliation(s)
- Hee Jung Ahn
- Diabetes Center, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Kyung Ah Han
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Jin Young Jang
- Diabetes Center, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Jae Hyuk Lee
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Kang Seo Park
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Kyung Wan Min
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea
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