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Adam TC, Drummen M, Macdonald I, Jalo E, Siig-Vestentoft P, Martinez JA, Handjiev-Darlenska T, Brand-Miller J, Poppitt S, Stratton G, Fogelholm M, Pietiläinen KH, Taylor M, Navas-Carretero S, Winkens B, Handjiev S, Muirhead R, Silvestre M, Swindell N, Huttunen-Lenz M, Schlicht W, Lam T, Sundvall J, Råman L, Feskens E, Larssen TM, Tremblay A, Raben A, Westerterp-Plantenga M. Association of Psychobehavioral Variables With HOMA-IR and BMI Differs for Men and Women With Prediabetes in the PREVIEW Lifestyle Intervention. Diabetes Care 2021; 44:1491-1498. [PMID: 34088702 DOI: 10.2337/dc21-0059] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/22/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Stress, sleep, eating behavior, and physical activity are associated with weight change and insulin resistance (IR). The aim of this analysis was the assessment of the overall and sex-specific associations of psychobehavioral variables throughout the 3-year PREVIEW intervention using the homeostatic model assessment of IR (HOMA-IR), BMI, and length of time in the study. RESEARCH DESIGN AND METHODS Associations of psychobehavioral variables, including stress, mood, eating behavior, physical activity (PA), and sleep, with BMI, HOMA-IR, and time spent in the study were assessed in 2,184 participants with prediabetes and overweight/obesity (n = 706 men; n = 1,478 women) during a 3-year lifestyle intervention using linear mixed modeling and general linear modeling. The study was a randomized multicenter trial using a 2 × 2 diet-by-PA design. RESULTS Overall, cognitive restraint and PA increased during the intervention compared with baseline, whereas BMI, HOMA-IR, disinhibition, hunger, and sleepiness decreased (all P < 0.05). Cognitive restraint and PA were negatively, whereas disinhibition, hunger, stress, and total mood disturbance were positively, associated with both BMI and HOMA-IR. Sleep duration, low sleep quality, total mood disturbance, disinhibition, and hunger scores were positively associated with HOMA-IR for men only. Participants who dropped out at 6 months had higher stress and total mood disturbance scores at baseline and throughout their time spent in the study compared with study completers. CONCLUSIONS Eating behavior and PA, control of stress, mood disturbance, and sleep characteristics were associated with BMI, HOMA-IR, and time spent in the study, with different effects in men and women during the PREVIEW lifestyle intervention study.
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Affiliation(s)
- Tanja C Adam
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Mathijs Drummen
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Ian Macdonald
- Medical Research Council/Arthritis Research UK (ARUK) Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, University of Nottingham, Nottingham, U.K.,National Institute for Health Research Nottingham Biomedical Research Centre, Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, Nottingham, U.K
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Pia Siig-Vestentoft
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - J Alfredo Martinez
- Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion, Madrid, Spain.,IdisNA Instituto for Health Research, Pamplona, Spain.,Precision Nutrition and Cardiometabolic Health Program, IMDEA Food Institute, Madrid Institute for Advanced Studies, Campus of International Excellence Universidad Autonoma de Madrid and Spanish National Research Council, Madrid, Spain
| | | | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Sally Poppitt
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Gareth Stratton
- Applied Sports Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Swansea, U.K
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Obesity Center, Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Moira Taylor
- Medical Research Council/Arthritis Research UK (ARUK) Centre for Musculoskeletal Ageing Research, ARUK Centre for Sport, Exercise and Osteoarthritis, University of Nottingham, Nottingham, U.K.,National Institute for Health Research Nottingham Biomedical Research Centre, Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, Queen's Medical Centre, Nottingham, U.K
| | - Santiago Navas-Carretero
- Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion, Madrid, Spain.,IdisNA Instituto for Health Research, Pamplona, Spain
| | - Bjorn Winkens
- Department of Methodology and Statistics, Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Marta Silvestre
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand.,Centro de Investigação em Tecnologias e Serviços de Saúde, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Nils Swindell
- Applied Sports Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Swansea, U.K
| | - Maija Huttunen-Lenz
- Exercise and Health Sciences, University of Stuttgart, Stuttgart, Germany.,Institute of Nursing Science, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Wolfgang Schlicht
- Exercise and Health Sciences, University of Stuttgart, Stuttgart, Germany
| | | | - Jouko Sundvall
- Biochemistry Laboratory, Forensic Toxicology Unit, Department of Government Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Laura Råman
- Biochemistry Laboratory, Forensic Toxicology Unit, Department of Government Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Edith Feskens
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Thomas-Meinert Larssen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Angelo Tremblay
- Department of Kinesiology, Laval University, Quebec City, Canada
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Margriet Westerterp-Plantenga
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
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Mohd-Sidik S, Lekhraj R, Foo CN. Prevalence, Associated Factors and Psychological Determinants of Obesity among Adults in Selangor, Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:868. [PMID: 33498401 PMCID: PMC7908089 DOI: 10.3390/ijerph18030868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/07/2021] [Accepted: 01/12/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The pervasiveness of obesity is a growing concern in the world. This study aims to determine the prevalence of obesity among a segment of the Malaysian population, as well as investigate associated factors and psychological determinants of obesity. METHODS A cross-sectional study design was carried out in Selangor, Malaysia. A total of 1380 Malaysian adults (≥18 years old) participated in a structured and validated questionnaire survey. TANITA body scale and SECA 206 body meter were used to measure the respondents' weight and height, from which measurements of their body mass index (BMI) were calculated. RESULTS The overall prevalence of obesity (BMI ≥ 30 kg/m2) among adults in Selangor, Malaysia, was 18.6%. Factors significantly associated with increased risk of obesity were: being female (OR = 1.61, 95% CI [1.20-2.17]), aged between 30 to 39 years old (OR = 1.40, 95% CI [1.04-1.88]), being Indian (OR = 1.55, 95% CI [1.13-2.12]), married (OR = 1.37, 95% CI [1.03-1.83]), and having only primary school education (OR = 1.80, 95% CI [1.17-2.78] or secondary school education (OR = 1.37, 95% CI [1.04-1.81]). In the multiple linear regression analysis (stepwise method), perceived stress (B = -0.107, p = 0.041), suicidal ideation (B = -2.423, p = 0.003), and quality of life in the physical health domain (B = -0.350, p = 0.003) inversely and significantly contributed to BMI among males. Among females, stressful life events contributed positively to BMI (B = 0.711, p < 0.001, whereas quality of life in the psychological domain had a negative effect (B = -0.478, p < 0.001) in this respect. CONCLUSION There is an urgent need to integrate psychological approaches to enhance the effectiveness of obesity prevention strategies and weight-loss programs.
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Affiliation(s)
- Sherina Mohd-Sidik
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Rampal Lekhraj
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
| | - Chai Nien Foo
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang 43000, Malaysia
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5
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Oumohand SE, Ward DD, Boenniger MM, Merten N, Kirschbaum C, Breteler MMB. Perceived stress but not hair cortisol concentration is related to adult cognitive performance. Psychoneuroendocrinology 2020; 121:104810. [PMID: 32739745 DOI: 10.1016/j.psyneuen.2020.104810] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 07/12/2020] [Accepted: 07/20/2020] [Indexed: 11/26/2022]
Abstract
Chronic stress detrimentally affects cognition but evidence from population-based studies is scarce and largely based on one-dimensional stress assessments. In this study, we aimed to investigate associations of subjective and psychological chronic stress measures with cognition in a population-based sample of adults aged 30-95 years from the Rhineland Study. Participants completed the Perceived Stress Scale (subjective measure) and a cognitive test battery (N = 1766). Hair cortisol concentration (physiological measure) was assessed by liquid chromatography tandem mass spectrometry in 1098 participants. Cross-sectional associations between the two measures of chronic stress and cognition were investigated using multivariable linear regression models. Subjective and physiological measures of chronic stress were not associated with each other (B = 0.005 [95 %CI = -0.005 - 0.015]). Participants with higher perceived stress and specifically lower perceived self-efficacy performed worse in all cognitive domains (effect sizes ranged from β = -0.129 [95 %CI = -0.177 - -0.080] to -0.054 [95 %CI = -0.099 - -0.009]; and from β = 0.052 [95 %CI = 0.005 - 0.098] to 0.120 [95 %CI = 0.072 - 0.167], respectively). Relationships between subjective chronic stress measures and executive functioning were stronger in men compared to women (interaction β = -0.144 [95 %CI = -0.221 - -0.067]). Relationships between perceived stress and working memory, and between perceived self-efficacy and executive functioning, processing speed, verbal episodic and working memory, increased with older age. Hair cortisol concentration was not associated with performance in any cognitive domain. Our results suggest that subjective and physiological measures capture different aspects of chronic stress in the general population.
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Affiliation(s)
- Sadia E Oumohand
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, Building 99, 53127 Bonn, Germany
| | - David D Ward
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, Building 99, 53127 Bonn, Germany
| | - Meta M Boenniger
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, Building 99, 53127 Bonn, Germany
| | - Natascha Merten
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, Building 99, 53127 Bonn, Germany
| | - Clemens Kirschbaum
- Faculty of Psychology, Technische Universität Dresden, 01062 Dresden, Germany
| | - Monique M B Breteler
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, Building 99, 53127 Bonn, Germany; Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Venusberg-Campus 1, Building 11, 53127 Bonn, Germany.
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6
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Partridge SR, Raeside R, Latham Z, Singleton AC, Hyun K, Grunseit A, Steinbeck K, Redfern J. 'Not to Be Harsh but Try Less to Relate to 'the Teens' and You'll Relate to Them More': Co-Designing Obesity Prevention Text Messages with Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4887. [PMID: 31817167 PMCID: PMC6950483 DOI: 10.3390/ijerph16244887] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/03/2019] [Accepted: 12/03/2019] [Indexed: 02/07/2023]
Abstract
Text messages remain a preferred way for adolescents to communicate, and recent evidence suggests adolescents would like access to digital healthcare options. However, there is limited evidence for text messages to engage adolescent populations in obesity prevention behaviors. We aimed to co-design a bank of text messages that are evidence-based, acceptable, and engaging for adolescents. An established iterative mixed methods process, consisting of three phases, was used to develop the text message program. The first bank of 145 text messages was drafted based on current evidence, behavior change techniques, and input from researchers and health professionals. A survey was then administered to adolescents and professionals for review of text message content, usefulness, understanding, and age-appropriateness. An adolescent research assistant collaborated with the research team on all three phases. Forty participants (25 adolescents and 15 professionals) reviewed the initial bank of 145 text messages. On average, all reviewers agreed the text messages were easy to understand (13.6/15) and useful (13.1/15). In total, 107 text messages were included in the final text message bank to support behavior change and prevent obesity. This study may guide other researchers or health professionals who are seeking to engage adolescents in the co-design of health promotion or intervention content. Effectiveness of the text message program will be tested in a randomized controlled trial.
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Affiliation(s)
- Stephanie R. Partridge
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; (R.R.); (Z.L.); (A.C.S.); (K.H.); (J.R.)
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Rebecca Raeside
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; (R.R.); (Z.L.); (A.C.S.); (K.H.); (J.R.)
| | - Zoe Latham
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; (R.R.); (Z.L.); (A.C.S.); (K.H.); (J.R.)
| | - Anna C. Singleton
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; (R.R.); (Z.L.); (A.C.S.); (K.H.); (J.R.)
| | - Karice Hyun
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; (R.R.); (Z.L.); (A.C.S.); (K.H.); (J.R.)
| | - Alicia Grunseit
- Department of Weight Management, The Children’s Hospital Westmead, Westmead, NSW 2145, Australia;
| | - Katharine Steinbeck
- Discipline of Child and Adolescent Health, Faculty of Medicine, University of Sydney, Westmead, NSW 2145, Australia;
| | - Julie Redfern
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; (R.R.); (Z.L.); (A.C.S.); (K.H.); (J.R.)
- The George Institute for Global Health, The University of New South Wales, Camperdown, NSW 2006, Australia
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