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Guide A, Sulieman L, Garbett S, Cronin RM, Spotnitz M, Natarajan K, Carroll RJ, Harris P, Chen Q. Identifying erroneous height and weight values from adult electronic health records in the All of Us research program. J Biomed Inform 2024; 155:104660. [PMID: 38788889 DOI: 10.1016/j.jbi.2024.104660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 04/29/2024] [Accepted: 05/21/2024] [Indexed: 05/26/2024]
Abstract
INTRODUCTION Electronic Health Records (EHR) are a useful data source for research, but their usability is hindered by measurement errors. This study investigated an automatic error detection algorithm for adult height and weight measurements in EHR for the All of Us Research Program (All of Us). METHODS We developed reference charts for adult heights and weights that were stratified on participant sex. Our analysis included 4,076,534 height and 5,207,328 wt measurements from ∼ 150,000 participants. Errors were identified using modified standard deviation scores, differences from their expected values, and significant changes between consecutive measurements. We evaluated our method with chart-reviewed heights (8,092) and weights (9,039) from 250 randomly selected participants and compared it with the current cleaning algorithm in All of Us. RESULTS The proposed algorithm classified 1.4 % of height and 1.5 % of weight errors in the full cohort. Sensitivity was 90.4 % (95 % CI: 79.0-96.8 %) for heights and 65.9 % (95 % CI: 56.9-74.1 %) for weights. Precision was 73.4 % (95 % CI: 60.9-83.7 %) for heights and 62.9 (95 % CI: 54.0-71.1 %) for weights. In comparison, the current cleaning algorithm has inferior performance in sensitivity (55.8 %) and precision (16.5 %) for height errors while having higher precision (94.0 %) and lower sensitivity (61.9 %) for weight errors. DISCUSSION Our proposed algorithm outperformed in detecting height errors compared to weights. It can serve as a valuable addition to the current All of Us cleaning algorithm for identifying erroneous height values.
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Affiliation(s)
- Andrew Guide
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Lina Sulieman
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Shawn Garbett
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Robert M Cronin
- Department of Internal Medicine, The Ohio State University, Columbus, OH, United States
| | - Matthew Spotnitz
- Department of Biomedical Informatics, Columbia University, New York, NY, United States
| | - Karthik Natarajan
- Department of Biomedical Informatics, Columbia University, New York, NY, United States
| | - Robert J Carroll
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Paul Harris
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Qingxia Chen
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States.
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Garner NJ, Smith JR, Sampson MJ, Greaves CJ. Quantity and specificity of action-plans as predictors of weight loss: analysis of data from the Norfolk Diabetes Prevention Study (NDPS). Psychol Health 2024; 39:42-67. [PMID: 35333685 DOI: 10.1080/08870446.2022.2055026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/11/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Investigate associations between quantity, content and specificity of action-plans and weight loss in a diabetes prevention study. DESIGN Prospective cohort study nested within a randomised controlled trial. Participants completed action-planning worksheets during intervention sessions. MAIN OUTCOME MEASURES Action-plans were coded in terms of: number of plans set, their content, and specificity. Multivariate regression analyses assessed associations with weight loss at four-months. RESULTS 890 planning-worksheets from 106 participants were analysed. Participants wrote a mean of 2.12 (SD = 1.20) action-plans per worksheet, using a mean of 2.20 (SD = 0.68) specificity components per action-plan. Quantity of action-plans per worksheet decreased over time (r = -0.137, p < 0.001) and increased quantity was associated with reduced specificity [r = -.215, p < 0.001]. Walking (34.9% of action-plans) and reducing high fat/sugar snacks (26.1%) were the most commonly planned lifestyle actions. In multivariate modelling, increased quantity of action-plans was associated with greater weight loss (R2 = 0.135, Unstandardised Beta = 0.144, p = 0.002). Specificity was not significantly associated with weight-loss (p = 0.096). CONCLUSION Producing more action-plans was associated with greater weight loss. Further research should directly compare more versus less specific action-plans and explore ways to sustain engagement in action-planning. Our findings imply that participants should freely set numerous action-plans, rather than being encouraged to focus on specificity. Supplemental data for this article is available online at https://doi.org/10.1080/08870446.2022.2055026 .
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Affiliation(s)
- Nikki J Garner
- Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
- University of Exeter Medical School, College of Medicine & Health, University of Exeter, Exeter, UK
| | - Jane R Smith
- University of Exeter Medical School, College of Medicine & Health, University of Exeter, Exeter, UK
| | - Mike J Sampson
- Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Colin J Greaves
- School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Pigsborg K, Kalea AZ, De Dominicis S, Magkos F. Behavioral and Psychological Factors Affecting Weight Loss Success. Curr Obes Rep 2023; 12:223-230. [PMID: 37335395 DOI: 10.1007/s13679-023-00511-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE OF REVIEW There is a large variability between individuals in the weight loss response to any given diet treatment, which fuels interest into personalized or precision nutrition. Although most efforts are directed toward identifying biological or metabolic factors, several behavioral and psychological factors can also be responsible for some of this interindividual variability. RECENT FINDINGS There are many factors that can influence the response to dietary weight loss interventions, including factors related to eating behavior (emotional eating, disinhibition, restraint, perceived stress), behaviors and societal norms related to age and sex, psychological and personal factors (motivation, self-efficacy, locus of control, self-concept), and major life events. The success of a weight loss intervention can be influenced by many psychological and behavioral constructs and not merely by physiological factors such as biology and genetics. These factors are difficult to capture accurately and are often overlooked. Future weight loss studies should consider assessing such factors to better understand the underlying reasons for the large interindividual variability to weight loss therapy.
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Affiliation(s)
- Kristina Pigsborg
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg, Denmark.
| | - Anastasia Z Kalea
- Division of Medicine, University College London, London, UK
- Institute of Cardiovascular Science, University College London, London, UK
| | - Stefano De Dominicis
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg, Denmark
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg, Denmark.
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Recchia F, Leung CK, Yu AP, Leung W, Yu DJ, Fong DY, Montero D, Lee CH, Wong SHS, Siu PM. Dose-response effects of exercise and caloric restriction on visceral adiposity in overweight and obese adults: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med 2023; 57:1035-1041. [PMID: 36669870 PMCID: PMC10423480 DOI: 10.1136/bjsports-2022-106304] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To determine and compare the dose-response effects of exercise and caloric restriction on visceral adipose tissue in overweight and obese adults, while controlling for the weekly energy deficit induced by the interventions. METHODS PubMed, Embase, CINAHL and Web of Science were searched for randomised controlled trials comparing exercise or caloric restriction against eucaloric controls in overweight or obese adults. The primary outcome was the change in visceral fat measured by CT or MRI. Meta-analyses and meta-regressions were performed to determine the overall effect size (ES) and the dose-dependent relationship of exercise and caloric restriction on visceral fat. Heterogeneity, risk of bias and the certainty of evidence were also assessed. RESULTS Forty randomised controlled trials involving 2190 participants were included. Overall, exercise (ES -0.28 (-0.37 to -0.19); p<0.001; I2=25%) and caloric restriction (ES -0.53 (-0.71 to -0.35); p<0.001; I2=33%) reduced visceral fat compared with the controls. Exercise demonstrated a dose-response effect of -0.15 ((-0.23 to -0.07); p<0.001) per 1000 calories deficit per week, whereas the effect of caloric restriction was not dose-dependent (ES 0.03 (-0.12 to 0.18); p=0.64). Most of the studies showed a moderate risk of bias. CONCLUSIONS These findings support the dose-dependent effects of exercise to reduce visceral fat in overweight and obese adults. Caloric restriction did not demonstrate a dose-response relationship, although this may be attributed to the smaller number of studies available for analysis, compared with exercise studies. PROSPERO REGISTRATION NUMBER CRD42020210096.
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Affiliation(s)
- Francesco Recchia
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Chit K Leung
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Angus P Yu
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Welton Leung
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Danny J Yu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Daniel Y Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - David Montero
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Chi-Ho Lee
- Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Stephen H S Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Parco M Siu
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
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Pigsborg K, Stentoft-Larsen V, Demharter S, Aldubayan MA, Trimigno A, Khakimov B, Engelsen SB, Astrup A, Hjorth MF, Dragsted LO, Magkos F. Predicting weight loss success on a new Nordic diet: an untargeted multi-platform metabolomics and machine learning approach. Front Nutr 2023; 10:1191944. [PMID: 37599689 PMCID: PMC10434509 DOI: 10.3389/fnut.2023.1191944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023] Open
Abstract
Background and aim Results from randomized controlled trials indicate that no single diet performs better than other for all people living with obesity. Regardless of the diet plan, there is always large inter-individual variability in weight changes, with some individuals losing weight and some not losing or even gaining weight. This raises the possibility that, for different individuals, the optimal diet for successful weight loss may differ. The current study utilized machine learning to build a predictive model for successful weight loss in subjects with overweight or obesity on a New Nordic Diet (NND). Methods Ninety-one subjects consumed an NND ad libitum for 26 weeks. Based on their weight loss, individuals were classified as responders (weight loss ≥5%, n = 46) or non-responders (weight loss <2%, n = 24). We used clinical baseline data combined with baseline urine and plasma untargeted metabolomics data from two different analytical platforms, resulting in a data set including 2,766 features, and employed symbolic regression (QLattice) to develop a predictive model for weight loss success. Results There were no differences in clinical parameters at baseline between responders and non-responders, except age (47 ± 13 vs. 39 ± 11 years, respectively, p = 0.009). The final predictive model for weight loss contained adipic acid and argininic acid from urine (both metabolites were found at lower levels in responders) and generalized from the training (AUC 0.88) to the test set (AUC 0.81). Responders were also able to maintain a weight loss of 4.3% in a 12 month follow-up period. Conclusion We identified a model containing two metabolites that were able to predict the likelihood of achieving a clinically significant weight loss on an ad libitum NND. This work demonstrates that models based on an untargeted multi-platform metabolomics approach can be used to optimize precision dietary treatment for obesity.
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Affiliation(s)
- Kristina Pigsborg
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | | | | | - Mona Adnan Aldubayan
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
- King Saud bin Abdulaziz University for Health Sciences, College of Applied Medical Sciences, Riyadh, Saudi Arabia
| | - Alessia Trimigno
- Department of Food Science, University of Copenhagen, Frederiksberg, Denmark
| | - Bekzod Khakimov
- Department of Food Science, University of Copenhagen, Frederiksberg, Denmark
| | | | - Arne Astrup
- Obesity and Nutritional Sciences, Novo Nordisk Foundation, Hellerup, Denmark
| | - Mads Fiil Hjorth
- Obesity and Nutritional Sciences, Novo Nordisk Foundation, Hellerup, Denmark
| | - Lars Ove Dragsted
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
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Monsalves-Álvarez M, Jiménez T, Bunout D, Barrera G, Hirsch S, Sepúlveda-Guzman C, Silva C, Rodriguez JM, Troncoso R, de la Maza MP. High-intensity interval training prevents muscle mass loss in overweight Chilean young adults during a hypocaloric-Mediterranean diet: a randomized trial. Front Nutr 2023; 10:1181436. [PMID: 37360303 PMCID: PMC10287981 DOI: 10.3389/fnut.2023.1181436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/21/2023] [Indexed: 06/28/2023] Open
Abstract
The hypocaloric Mediterranean diet (MD) mainly reduces fat mass but inevitably causes a loss of skeletal muscle mass. High-intensity interval training (HIIT) seems to have advantages in preserving muscle mass during a hypocaloric regime. Our study compares body composition and metabolic changes in overweight and obese Chilean women and men after 3 months of weight loss treatment with a Mediterranean-type hypocaloric diet, HIIT, or a combination of both. The study included 83 overweight or obese women and men between the ages of 25 and 50. The subjects were randomly assigned to one of the three intervention groups: (1) MD, (2) EX, and (3) MD + EX. Baseline and post-intervention measurements included: (a) body composition by dual-beam densitometry, muscle, and fat measurements by thigh ultrasound and computed tomography; (b) handgrip and quadriceps muscle strength; (c) exercise performance by peak oxygen consumption, peak load, work efficiency, and exercise energy expenditure; and (d) metabolic parameters. Out of 83 participants, the retention rate was 49% due to low compliance with the interventions. As expected, the MD group resulted in significantly greater weight loss (MD -7%, EX -0.6% and MD + EX -5.3%) and appendicular fat mass loss (MD -11.1%, EX -2.9, MD + EX -10.2%) but was associated with significant lean tissue loss (2.8%), which was prevented by HIIT (EX -0.1 and MD + EX -0.6%). Metabolic and glycoxidative parameters remained unchanged, irrespective of changes in body composition. Hypocaloric diets remain the most effective means to lose weight and body fat. However, it induces a loss of lean body mass when not accompanied by exercise training. This study shows that HIIT prevents the loss of muscle mass caused by a hypocaloric Mediterranean diet.
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Affiliation(s)
| | - Teresa Jiménez
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
| | - Daniel Bunout
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
| | - Gladys Barrera
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
| | - Sandra Hirsch
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
| | - Carlos Sepúlveda-Guzman
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
- Laboratorio de Ciencias del Ejercicio, Clínica MEDS, Santiago, Chile
| | | | - Juan M. Rodriguez
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
| | - Rodrigo Troncoso
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases, Universidad de Chile, Santiago, Chile
| | - María Pía de la Maza
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
- Clínica Alemana, Santiago, Chile
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Abdi F, Zuberi S, Blom JJ, Armstrong D, Pinto-Sanchez MI. Nutritional Considerations in Celiac Disease and Non-Celiac Gluten/Wheat Sensitivity. Nutrients 2023; 15:nu15061475. [PMID: 36986205 PMCID: PMC10058476 DOI: 10.3390/nu15061475] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/12/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
A gluten-free diet (GFD) is the only available treatment for celiac disease (CeD), and it may also improve symptoms in non-celiac gluten/wheat sensitivity (NCGWS). In CeD, gluten triggers an immune reaction leading to enteropathy, malabsorption, and symptoms; in NCGWS, the mechanism leading to symptoms is unknown, and neither wheat nor gluten triggers enteropathy or malabsorption. A strict GFD is, therefore, necessary for CeD, but a gluten-restricted diet (GRD) may suffice to achieve symptom control for NCGWS. Regardless of this distinction, the risk of malnutrition and macro- and micronutrient deficiencies is increased by the adoption of a GFD or GRD. Thus, patients with CeD or NCGWS should undergo nutritional assessment and subsequent monitoring, based on evidence-based tools, under the care of a multidisciplinary team involving physicians and dietitians, for the long-term management of their nutrition. This review gives an overview of available nutrition assessment tools and considerations for the nutritional management of CeD and NCGWS populations.
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Affiliation(s)
- Fardowsa Abdi
- Department of Medicine, Faculty of Health Sciences, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Saania Zuberi
- Department of Medicine, Faculty of Health Sciences, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Jedid-Jah Blom
- Department of Medicine, Faculty of Health Sciences, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - David Armstrong
- Department of Medicine, Faculty of Health Sciences, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Maria Ines Pinto-Sanchez
- Department of Medicine, Faculty of Health Sciences, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON L8S 4K1, Canada
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Oghabian A, van der Kolk BW, Marttinen P, Valsesia A, Langin D, Saris WH, Astrup A, Blaak EE, Pietiläinen KH. Baseline gene expression in subcutaneous adipose tissue predicts diet-induced weight loss in individuals with obesity. PeerJ 2023; 11:e15100. [PMID: 36992941 PMCID: PMC10042157 DOI: 10.7717/peerj.15100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/28/2023] [Indexed: 03/31/2023] Open
Abstract
Background Weight loss effectively reduces cardiometabolic health risks among people with overweight and obesity, but inter-individual variability in weight loss maintenance is large. Here we studied whether baseline gene expression in subcutaneous adipose tissue predicts diet-induced weight loss success. Methods Within the 8-month multicenter dietary intervention study DiOGenes, we classified a low weight-losers (low-WL) group and a high-WL group based on median weight loss percentage (9.9%) from 281 individuals. Using RNA sequencing, we identified the significantly differentially expressed genes between high-WL and low-WL at baseline and their enriched pathways. We used this information together with support vector machines with linear kernel to build classifier models that predict the weight loss classes. Results Prediction models based on a selection of genes that are associated with the discovered pathways 'lipid metabolism' (max AUC = 0.74, 95% CI [0.62-0.86]) and 'response to virus' (max AUC = 0.72, 95% CI [0.61-0.83]) predicted the weight-loss classes high-WL/low-WL significantly better than models based on randomly selected genes (P < 0.01). The performance of the models based on 'response to virus' genes is highly dependent on those genes that are also associated with lipid metabolism. Incorporation of baseline clinical factors into these models did not noticeably enhance the model performance in most of the runs. This study demonstrates that baseline adipose tissue gene expression data, together with supervised machine learning, facilitates the characterization of the determinants of successful weight loss.
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Affiliation(s)
- Ali Oghabian
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Birgitta W. van der Kolk
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Pekka Marttinen
- Helsinki Institute for Information Technology HIIT, Department of Computer Science, Aalto University, Espoo, Finland
| | | | - Dominique Langin
- Department of Biochemistry, Toulouse University Hospitals, Toulouse, France
- Institut des Maladies Métaboliques et Cardiovasculaires, I2MC, Université de Toulouse, Inserm, Université Toulouse III—Paul Sabatier (UPS), Toulouse, France
| | - W. H. Saris
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Arne Astrup
- Healthy Weight Center, Novo Nordisk Fonden, Copenhagen, Denmark
| | - Ellen E. Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Kirsi H. Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Healthy Weight Hub, Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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The Effects of Intermittent Fasting and Continuous Energy Restriction with Exercise on Cardiometabolic Biomarkers, Dietary Compliance, and Perceived Hunger and Mood: Secondary Outcomes of a Randomised, Controlled Trial. Nutrients 2022; 14:nu14153071. [PMID: 35893925 PMCID: PMC9370806 DOI: 10.3390/nu14153071] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 02/07/2023] Open
Abstract
(1) Background: Excess weight in the form of adiposity plays a key role in the pathogenesis of cardiometabolic diseases. Lifestyle modifications that incorporate continuous energy restriction (CER) are effective at inducing weight loss and reductions in adiposity; however, prescribing daily CER results in poor long-term adherence. Over the past decade, intermittent fasting (IF) has emerged as a promising alternative to CER that may promote increased compliance and/or improvements in cardiometabolic health parameters independent of weight loss. (2) Methods: This paper presents a secondary analysis of data from a 12-week intervention investigating the effects of a twice-weekly fast (5:2 IF; IFT group) and CER (CERT group) when combined with resistance exercise in 34 healthy participants (17 males and 17 females, mean BMI: 27.0 kg/m2, mean age: 23.9 years). Specifically, changes in cardiometabolic blood markers and ratings of hunger, mood, energy and compliance within and between groups were analysed. Dietary prescriptions were hypoenergetic and matched for energy and protein intake. (3) Results: Both dietary groups experienced reductions in total cholesterol (TC; mean reduction, 7.8%; p < 0.001), low-density lipoprotein cholesterol (LDL-C; mean reduction, 11.1%; p < 0.001) and high-density lipoprotein cholesterol (mean reduction 2.6%, p = 0.049) over the 12 weeks. Reductions in TC and LDL-C were greater in the IFT group after adjustment for baseline levels and change in weight. No significant changes in markers of glucose regulation were observed. Both groups maintained high levels of dietary compliance (~80%) and reported low levels of hunger over the course of the intervention period. (4) Conclusions: Secondary data analysis revealed that when combined with resistance training, both dietary patterns improved blood lipids, with greater reductions observed in the IFT group. High levels of compliance and low reported levels of hunger throughout the intervention period suggest both diets are well tolerated in the short-to-medium term.
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Casanova N, Beaulieu K, Oustric P, O'Connor D, Gibbons C, Blundell J, Finlayson G, Hopkins M. Increases in physical activity are associated with a faster rate of weight loss during dietary energy restriction in women with overweight and obesity. Br J Nutr 2022; 129:1-28. [PMID: 35249565 DOI: 10.1017/s000711452200023x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This secondary analysis examined the influence of changes in physical activity (PA), sedentary time and energy expenditure (EE) during dietary energy restriction on the rate of weight loss (WL) and 1-year follow-up weight change in women with overweight/obesity.Measurements of body weight and composition (air-displacement plethysmography), resting metabolic rate (indirect calorimetry), total daily (TDEE) and activity EE (AEE), minutes of PA and sedentary time (PA monitor) were taken at baseline, after 2 weeks, after ≥5% WL or 12 weeks of continuous (25% daily energy deficit) or intermittent (75% daily energy deficit alternated with ad libitum day) energy restriction, and at 1-year post-WL. The rate of WL was calculated as total %WL/number of dieting weeks. Data from both groups were combined for analyses.Thirty-seven participants (age=35±10y; BMI=29.1±2.3kg/m2) completed the intervention (WL=-5.9±1.6%) and 18 returned at 1-year post-WL (weight change=+4.5±5.2%). Changes in sedentary time at 2 weeks were associated with the rate of WL during energy restriction (r=-0.38; p=0.03). Changes in total (r=0.54; p<0.01), light (r=0.43; p=0.01) and moderate-to-vigorous PA (r=0.55; p<0.01), sedentary time (r=-0.52; p<0.01), steps per day (r=0.39; p=0.02), TDEE (r=0.46; p<0.01) and AEE (r=0.51; p<0.01) during energy restriction were associated with the rate of WL. Changes in total (r=-0.50; p=0.04) and moderate-to-vigorous PA (r=-0.61; p=0.01) between post-WL and follow-up were associated with 1-year weight change (r=-0.51; p=0.04).These findings highlight that PA and sedentary time could act as modifiable behavioural targets to promote better weight outcomes during dietary energy restriction and/or weight maintenance.
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Affiliation(s)
- Nuno Casanova
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK
- KinesioLab, Research Unit in Human Movement Analysis, Piaget Institute, Av. Jorge Peixinho 30 Quinta da Arreinela, 2805-059 Almada, Portugal
| | - Kristine Beaulieu
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Pauline Oustric
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Dominic O'Connor
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Catherine Gibbons
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - John Blundell
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Graham Finlayson
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Mark Hopkins
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK
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11
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Kodsi R, Chimoriya R, Medveczky D, Grudzinskas K, Atlantis E, Tahrani AA, Kormas N, Piya MK. Clinical Use of the Edmonton Obesity Staging System for the Assessment of Weight Management Outcomes in People with Class 3 Obesity. Nutrients 2022; 14:967. [PMID: 35267942 PMCID: PMC8912843 DOI: 10.3390/nu14050967] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 11/17/2022] Open
Abstract
We aimed to assess weight loss and metabolic outcomes by severity of weight-related complications following an intensive non-surgical weight management program (WMP) in an Australian public hospital. A retrospective cohort study of all patients aged ≥18 years with body mass index (BMI) ≥ 40 enrolled in the WMP during March 2018−March 2019 with 12-month follow-up information were stratified using the Edmonton Obesity Staging System (EOSS). Of 178 patients enrolled in the WMP, 112 (62.9%) completed at least 12 months’ treatment. Most patients (96.6%) met EOSS-2 (56.7%) or EOSS-3 (39.9%) criteria for analysis. Both groups lost significant weight from baseline to 12 months; EOSS-2: 139.4 ± 31.8 kg vs. 131.8 ± 31.8 kg (p < 0.001) and EOSS-3: 141.4 ± 24.2 kg vs. 129.8 ± 24.3 kg (p < 0.001). After adjusting for baseline age, sex and employment status, mean weight loss was similar but a greater proportion of EOSS-3 achieved >10% weight loss compared to EOSS-2, (40% vs. 15.9%, p = 0.024). Changes in metabolic parameters including HbA1c, BP and lipids did not differ between EOSS-2 and 3. Despite increased clinical severity, adult patients with class 3 obesity achieved clinically meaningful weight loss and similar improvements in metabolic parameters compared to patients with less severe complications after 12 months in an intensive non-surgical WMP.
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Affiliation(s)
- Raymond Kodsi
- South Western Sydney Metabolic Rehabilitation and Bariatric Program (SWS MRBP), Camden and Campbelltown Hospitals, Camden, NSW 2570, Australia; (R.K.); (K.G.); (N.K.)
| | - Ritesh Chimoriya
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; (R.C.); (D.M.)
| | - David Medveczky
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; (R.C.); (D.M.)
| | - Kathy Grudzinskas
- South Western Sydney Metabolic Rehabilitation and Bariatric Program (SWS MRBP), Camden and Campbelltown Hospitals, Camden, NSW 2570, Australia; (R.K.); (K.G.); (N.K.)
| | - Evan Atlantis
- School of Health Sciences, Western Sydney University, Campbelltown, NSW 2560, Australia;
- Discipline of Medicine, Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Nepean, NSW 2747, Australia
| | - Abd A. Tahrani
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK;
- Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham B15 2TT, UK
- Department of Diabetes and Endocrinology, University Hospitals Birmingham NHS Trust, Birmingham B15 2TT, UK
| | - Nic Kormas
- South Western Sydney Metabolic Rehabilitation and Bariatric Program (SWS MRBP), Camden and Campbelltown Hospitals, Camden, NSW 2570, Australia; (R.K.); (K.G.); (N.K.)
| | - Milan K. Piya
- South Western Sydney Metabolic Rehabilitation and Bariatric Program (SWS MRBP), Camden and Campbelltown Hospitals, Camden, NSW 2570, Australia; (R.K.); (K.G.); (N.K.)
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; (R.C.); (D.M.)
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12
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The efficacy and safety of auriculotherapy for weight loss: A systematic review and meta-analysis. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2021.101402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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13
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Ruiz-Castellano C, Espinar S, Contreras C, Mata F, Aragon AA, Martínez-Sanz JM. Achieving an Optimal Fat Loss Phase in Resistance-Trained Athletes: A Narrative Review. Nutrients 2021; 13:nu13093255. [PMID: 34579132 PMCID: PMC8471721 DOI: 10.3390/nu13093255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 12/14/2022] Open
Abstract
Managing the body composition of athletes is a common practice in the field of sports nutrition. The loss of body weight (BW) in resistance-trained athletes is mainly conducted for aesthetic reasons (bodybuilding) or performance (powerlifting or weightlifting). The aim of this review is to provide dietary–nutritional strategies for the loss of fat mass in resistance-trained athletes. During the weight loss phase, the goal is to reduce the fat mass by maximizing the retention of fat-free mass. In this narrative review, the scientific literature is evaluated, and dietary–nutritional and supplementation recommendations for the weight loss phase of resistance-trained athletes are provided. Caloric intake should be set based on a target BW loss of 0.5–1.0%/week to maximize fat-free mass retention. Protein intake (2.2–3.0 g/kgBW/day) should be distributed throughout the day (3–6 meals), ensuring in each meal an adequate amount of protein (0.40–0.55 g/kgBW/meal) and including a meal within 2–3 h before and after training. Carbohydrate intake should be adapted to the level of activity of the athlete in order to training performance (2–5 g/kgBW/day). Caffeine (3–6 mg/kgBW/day) and creatine monohydrate (3–5 g/day) could be incorporated into the athlete’s diet due to their ergogenic effects in relation to resistance training. The intake of micronutrients complexes should be limited to special situations in which there is a real deficiency, and the athlete cannot consume through their diet.
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Affiliation(s)
| | - Sergio Espinar
- Faculty of Health Sciences, UCAM Universidad Católica de Murcia, 30107 Murcia, Spain;
- Correspondence:
| | - Carlos Contreras
- Faculty of Health Sciences, UCAM Universidad Católica de Murcia, 30107 Murcia, Spain;
| | - Fernando Mata
- Centro de Estudios Avanzados en Nutrición (CEAN), 14010 Córdoba, Spain;
| | - Alan A. Aragon
- Department of Family and Consumer Sciences, California State University, Northridge, CA 91330, USA;
| | - José Miguel Martínez-Sanz
- Research Group on Food and Nutrition (ALINUT), Nursing Department, Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain;
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14
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Nielsen RL, Helenius M, Garcia SL, Roager HM, Aytan-Aktug D, Hansen LBS, Lind MV, Vogt JK, Dalgaard MD, Bahl MI, Jensen CB, Muktupavela R, Warinner C, Aaskov V, Gøbel R, Kristensen M, Frøkiær H, Sparholt MH, Christensen AF, Vestergaard H, Hansen T, Kristiansen K, Brix S, Petersen TN, Lauritzen L, Licht TR, Pedersen O, Gupta R. Data integration for prediction of weight loss in randomized controlled dietary trials. Sci Rep 2020; 10:20103. [PMID: 33208769 PMCID: PMC7674420 DOI: 10.1038/s41598-020-76097-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 10/22/2020] [Indexed: 12/11/2022] Open
Abstract
Diet is an important component in weight management strategies, but heterogeneous responses to the same diet make it difficult to foresee individual weight-loss outcomes. Omics-based technologies now allow for analysis of multiple factors for weight loss prediction at the individual level. Here, we classify weight loss responders (N = 106) and non-responders (N = 97) of overweight non-diabetic middle-aged Danes to two earlier reported dietary trials over 8 weeks. Random forest models integrated gut microbiome, host genetics, urine metabolome, measures of physiology and anthropometrics measured prior to any dietary intervention to identify individual predisposing features of weight loss in combination with diet. The most predictive models for weight loss included features of diet, gut bacterial species and urine metabolites (ROC-AUC: 0.84-0.88) compared to a diet-only model (ROC-AUC: 0.62). A model ensemble integrating multi-omics identified 64% of the non-responders with 80% confidence. Such models will be useful to assist in selecting appropriate weight management strategies, as individual predisposition to diet response varies.
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Affiliation(s)
- Rikke Linnemann Nielsen
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, 2800, Denmark
- Sino-Danish Center for Education and Research, University of Chinese Academy of Sciences, Beijing, China
| | - Marianne Helenius
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, 2800, Denmark
| | - Sara L Garcia
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, 2800, Denmark
| | - Henrik M Roager
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Derya Aytan-Aktug
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, 2800, Denmark
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | | | - Mads Vendelbo Lind
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Josef K Vogt
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
| | - Marlene Danner Dalgaard
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, 2800, Denmark
| | - Martin I Bahl
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Cecilia Bang Jensen
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, 2800, Denmark
| | - Rasa Muktupavela
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, 2800, Denmark
| | | | - Vincent Aaskov
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
| | - Rikke Gøbel
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
| | - Mette Kristensen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Hanne Frøkiær
- Institute for Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | | | | | - Henrik Vestergaard
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
- Department of Medicine, Bornholms Hospital, Rønne, Denmark
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
| | - Karsten Kristiansen
- Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, 2100, Copenhagen, Denmark
| | - Susanne Brix
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
| | | | - Lotte Lauritzen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
| | - Tine Rask Licht
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark.
| | - Oluf Pedersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark.
| | - Ramneek Gupta
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, 2800, Denmark.
- Novo Nordisk Research Centre Oxford, Oxford, OX3 7FZ, UK.
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15
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Verberne LDM, Leemrijse CJ, Nielen MMJ, Friele RD. Intermediate weight changes and follow-up of dietetic treatment in primary health care: an observational study. BMC Nutr 2020; 6:62. [PMID: 33292684 PMCID: PMC7667732 DOI: 10.1186/s40795-020-00377-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 09/01/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary health care data have shown that most patients who were treated for overweight or obesity by a dietitian did not accomplish the recommended treatment period. It is hypothesised that a slow rate of weight loss might discourage patients from continuing dietetic treatment. This study evaluated intermediate weight changes during regular dietetic treatment in Dutch primary health care, and examined whether weight losses at previous consultations were associated with attendance at follow-up consultations. METHODS This observational study was based on real life practice data of overweight and obese patients during the period 2013-2017, derived from Dutch dietetic practices that participated in the Nivel Primary Care Database. Multilevel regression analyses were conducted to estimate the mean changes in body mass index (BMI) during six consecutive consultations and to calculate odds ratios for the association of weight change at previous consultations with attendance at follow-up consultations. RESULTS The total study population consisted of 25,588 overweight or obese patients, with a mean initial BMI of 32.7 kg/m2. The BMI decreased between consecutive consultations, with the highest weight losses between the first and second consultation. After six consultations, a mean weight loss of - 1.5 kg/m2 was estimated. Patients who lost weight between the two previous consultations were more likely to attend the next consultation than patients who did not lose weight or gained weight. CONCLUSIONS Body mass index decreased during consecutive consultations, and intermediate weight losses were associated with a higher attendance at follow-up consultations during dietetic treatment in overweight patients. Dietitians should therefore focus on discussing intermediate weight loss expectations with their patients.
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Affiliation(s)
- Lisa D M Verberne
- Nivel, Netherlands Institute for Health Services Research, P.O. Box 1568, Utrecht, 3500 BN, The Netherlands.
| | - Chantal J Leemrijse
- Nivel, Netherlands Institute for Health Services Research, P.O. Box 1568, Utrecht, 3500 BN, The Netherlands
| | - Markus M J Nielen
- Nivel, Netherlands Institute for Health Services Research, P.O. Box 1568, Utrecht, 3500 BN, The Netherlands
| | - Roland D Friele
- Nivel, Netherlands Institute for Health Services Research, P.O. Box 1568, Utrecht, 3500 BN, The Netherlands.,Tilburg School of Social and Behavioral Sciences, Tilburg University, Tranzo, P.O. Box 90153, Tilburg, 5000 LE, The Netherlands
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16
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De Pergola G, Zupo R, Lampignano L, Bonfiglio C, Giannelli G, Osella AR, Triggiani V. Higher Body Mass Index, Uric Acid Levels, and Lower Cholesterol Levels are Associated with Greater Weight Loss. Endocr Metab Immune Disord Drug Targets 2020; 20:1268-1281. [DOI: 10.2174/1871530320666200429235830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/30/2019] [Accepted: 01/17/2020] [Indexed: 01/02/2023]
Abstract
Background:
Identifying predictive factors that contribute to changes in body weight may
well be an interesting approach to the management of obesity.
Objective:
This study was firstly aimed at examining the effect of a one-year lifestyle program based
on improvements in the habitual diet and increased levels of physical activity on weight loss. Secondly,
it was focused on identifying anthropometric, and serum hormonal, metabolic and haematochemical
factors which can be associated with the degree of weight loss in Kg.
Methods:
488 overweight or obese subjects, 383 women and 105 men, aged 18-67 years, were enrolled
in the study. Body mass index, waist circumference, serum blood glucose, lipids, uric acid, creatinine,
insulin, TSH, FT3, FT4, and 24-h urine catecholamines were measured.
Results:
Weight loss was positively associated with BMI (P < 0.01), waist circumference (P < 0.01),
uric acid (P < 0.01), creatinine (P < 0.05), smoking (P < 0.01), and negatively correlated with age (P <
0.01), total cholesterol (P < 0.05), LDL-cholesterol (P < 0.01), HDL cholesterol (P < 0.05). In a multiple
regression model considering weight loss as a dependent variable, and smoking, age, BMI, uric
acid, creatinine, total cholesterol, LDL-cholesterol and HDL cholesterol as independent variables,
weight loss maintained a direct independent relationship with BMI (P < 0.001), uric acid (P < 0.05),
LDL-cholesterol (P < 0.05), and HDL-cholesterol (P < 0.05), and an inverse independent association
with cholesterol (P < 0.01).
Conclusions:
This study suggests that higher BMI and uric acid levels, and lower total cholesterol concentrations
are associated with a greater potential to lose weight.
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Affiliation(s)
- Giovanni De Pergola
- Clinical Nutrition Unit, Medical Oncology, Department of Biomedical Science and Human Oncology, University of Bari, School of Medicine, Policlinic, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Roberta Zupo
- National Institute of Gastroenterology "S. de Bellis," Research Hospital, 70013, Castellana Grotte, Italy
| | - Luisa Lampignano
- National Institute of Gastroenterology "S. de Bellis," Research Hospital, 70013, Castellana Grotte, Italy
| | - Caterina Bonfiglio
- National Institute of Gastroenterology "S. de Bellis," Research Hospital, 70013, Castellana Grotte, Italy
| | - Gianluigi Giannelli
- National Institute of Gastroenterology "S. de Bellis," Research Hospital, 70013, Castellana Grotte, Italy
| | - Alberto R. Osella
- National Institute of Gastroenterology "S. de Bellis," Research Hospital, 70013, Castellana Grotte, Italy
| | - Vincenzo Triggiani
- Endocrinology and Metabolic Diseases, Interdisciplinary Department of Medicine, University of Bari “A. Moro” Bari, Italy
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17
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Ballin M, Hult A, Björk S, Lundberg E, Nordström P, Nordström A. Web-based exercise versus supervised exercise for decreasing visceral adipose tissue in older adults with central obesity: a randomized controlled trial. BMC Geriatr 2020; 20:173. [PMID: 32398024 PMCID: PMC7216357 DOI: 10.1186/s12877-020-01577-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 05/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Visceral adipose tissue (VAT) is a strong risk factor for cardiovascular disease and increases with age. While supervised exercise (SE) may be an effective approach, web-based exercise (WE) have other advantages such as being more readily accessible. Therefore, we evaluated the effects of WE on VAT, body composition and cardiometabolic risk markers in centrally obese older adults and compared the effects of WE to SE. We also explored the feasibility of WE. METHODS In a randomized controlled trial conducted in Umeå, Sweden during January 2018 - November 2018, N = 77, 70-year-old men and women with central obesity (> 1 kg VAT for women, > 2 kg for men) were randomized to an intervention group (n = 38) and a wait-list control group (n = 39). The intervention group received 10 weeks of SE while the wait-list control group lived as usual. Following a 10-week wash-out-period, the wait-list control group received 10 weeks of WE. The primary outcome was changes in VAT. Secondary outcomes included changes in fat mass (FM), lean body mass (LBM), blood lipids, fasting blood glucose. Additionally, we explored the feasibility of WE defined as adherence and participant experiences. RESULTS WE had no significant effect on VAT (P = 0.5), although it decreased FM by 450 g (95% confidence interval [CI], 37 to 836, P < 0.05). The adherence to WE was 85% and 87-97% of the participants rated aspects of the WE intervention > 4 on a scale of 1-5. Comparing SE to WE, there was no significant difference in decrease of VAT (Cohen's δ effect size [ES], 0.5, 95% CI, - 24 to 223, P = 0.11), although SE decreased FM by 619 g (ES, 0.5, 95% CI, 22 to 1215, P < 0.05) compared to WE. CONCLUSIONS Ten weeks of vigorous WE is insufficient to decrease VAT in centrally obese older adults, but sufficient to decrease FM while preserving LBM. The high adherence and positive experiences of the WE intervention implies that it could serve as an alternative exercise strategy for older adults with central obesity, with increased availability for a larger population. TRIAL REGISTRATION ClinicalTrials.gov (NCT03450655), retrospectively registered February 28, 2018.
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Affiliation(s)
- Marcel Ballin
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, 901 87, Umeå, Sweden. .,Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
| | - Andreas Hult
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.,Department of Community Medicine and Rehabilitation, Section of Sports Medicine, Umeå University, Umeå, Sweden
| | - Sabine Björk
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.,Umeå School of Sport Sciences, Umeå University, Umeå, Sweden
| | - Emmy Lundberg
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, 901 87, Umeå, Sweden
| | - Anna Nordström
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.,School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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18
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Verberne LDM, Leemrijse CJ, Nielen MMJ, Friele RD. Achievement of weight loss in patients with overweight during dietetic treatment in primary health care. PLoS One 2019; 14:e0225065. [PMID: 31774845 PMCID: PMC6880966 DOI: 10.1371/journal.pone.0225065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/28/2019] [Indexed: 02/05/2023] Open
Abstract
Introduction Dietitians are the preferred primary health care professionals for nutritional care in overweight patients. Guidelines for dietitians recommend a weight reduction of ≥ 5% of initial body weight after one year of treatment. The purpose of this study was to evaluate weight change in patients with overweight who were treated by dietitians in Dutch primary health care, and to identify patient characteristics that were associated with it. Materials and methods This observational study data was based on real life practice data of patients with overweight during the period 2013–2017, derived from dietetic practices that participated in the Nivel Primary Care Database. Multilevel linear regression analyses were performed to investigate weight change after dietetic treatment and to explore associations with patient characteristics. Results In total, data were evaluated from 56 dietetic practices and 4722 patients with a body mass index (BMI) ≥ 25 kg/m2. The mean treatment time was 3 hours within an average timeframe of 5 months. Overall, patients had a mean weight change of -3.5% (95% CI: -3.8; -3.1) of their initial body weight, and a quarter of the patients reached a weight loss of 5% or more, despite the fact that most patients did not meet the recommended treatment duration of at least one year. The mean BMI change was -1.1 kg/m2 (95% CI: -1.2; -1.0). Higher weight reductions were shown for patients with a higher initial BMI and for patients with a longer treatment time. Sex and age were not associated with weight change, and patients with other dietetic diagnoses, such as diabetes, hypertension, and hypercholesterolemia, had lower weight reductions. Conclusions This study showed that dietetic treatment in primary health care coincided with modest weight reduction in patients with overweight. The weight loss goals were not reached for most patients, which was possibly due to a low treatment adherence.
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Affiliation(s)
- Lisa D. M. Verberne
- Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
- * E-mail:
| | - Chantal J. Leemrijse
- Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Markus M. J. Nielen
- Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Roland D. Friele
- Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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Chmurzynska A, Muzsik A, Krzyżanowska-Jankowska P, Mądry E, Walkowiak J, Bajerska J. PPARG and FTO polymorphism can modulate the outcomes of a central European diet and a Mediterranean diet in centrally obese postmenopausal women. Nutr Res 2019; 69:94-100. [PMID: 31675538 DOI: 10.1016/j.nutres.2019.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/27/2019] [Accepted: 08/06/2019] [Indexed: 01/15/2023]
Abstract
The aim of this study was to test the hypothesis that polymorphism of genes with the biggest effects on body mass (FTO and PPARG) can affect the results of dieting in centrally obese postmenopausal women. A total of 144 volunteers were randomized to a 16-week intervention with two hypocaloric diets: either a Mediterranean diet (MED) moderate in fat (37% total energy as fat) or the Central European diet (CED) moderate in carbohydrates (55% total energy as carbohydrates). The associations between FTO and PPARG polymorphism on the baseline body mass, body composition, blood pressure, lipid and non-lipid parameters, and their changes after the trial were analyzed. None of the examined baseline outcomes differed in the rs9939609 FTO subgroups; abdominal fat was higher in the minor (G) allele carriers of the PPARG rs1801282. After the intervention, in the CED group, the PPARG G allele carriers showed greater reductions in weight (-6.58 ± 0.61 vs -9.58 ± 0.83; P < .01), lean mass (-0.38 ± 0.29 vs -1.79 ± 0.38; P < .05) and high-density lipoprotein (HDL) cholesterol (-0.46 ± 0.77 vs -5.25 ± 1.49; P < .01) than the CC homozygotes, and the TT individuals of the rs9939609 FTO had greater reductions in diastolic blood pressure (-9.03 ± 1.78 vs. -7.58 ± 1.50; P < .05). In the MED group, greater reductions in abdominal fat were observed in the G allele carriers than in the CC homozygotes (-3.31 ± 0.26 vs. -4.23 ± 0.41; P < .05). PPARG and FTO polymorphism may affect the outcomes of the diets aimed at weight reduction in postmenopausal women.
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Affiliation(s)
- Agata Chmurzynska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Wojska Polskiego 31, 60-624 Poznan, Poland
| | - Agata Muzsik
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Wojska Polskiego 31, 60-624 Poznan, Poland
| | - Patrycja Krzyżanowska-Jankowska
- First Subdepartment of Pediatrics, Department of Pediatric Gastroenterology and Metabolism, Poznan University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland
| | - Edyta Mądry
- First Subdepartment of Pediatrics, Department of Pediatric Gastroenterology and Metabolism, Poznan University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland
| | - Jarosław Walkowiak
- First Subdepartment of Pediatrics, Department of Pediatric Gastroenterology and Metabolism, Poznan University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland
| | - Joanna Bajerska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Wojska Polskiego 31, 60-624 Poznan, Poland.
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20
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Comparing the effectiveness of general dietary advice versus a very low energy diet in an obese outpatient population in Australia. Eat Weight Disord 2019; 24:739-747. [PMID: 29022288 DOI: 10.1007/s40519-017-0443-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 09/13/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE Obesity is a major public health burden. Outpatient clinics are an essential resource for individuals with obesity to access advice for weight loss management. The aim of this study was to compare anthropometric and weight loss outcomes between participants receiving general dietary (GD) advice, and those on a very low energy diet (VLED) under non-trial conditions. METHODS Data from 276 adults with obesity attending a multidisciplinary weight management clinic were analysed. Changes in anthropometry, body composition, and blood pressure (BP) over 12 months were analysed using linear mixed-effects models. RESULTS Males on the GD demonstrated statistically greater reductions in body weight (BW), BMI, percent fat mass (FM), systolic BP, waist and hip circumference (p < 0.01). Changes in males on a VLED did not reach significance. Females showed statistically significant reductions in BW, BMI, waist and hip circumference regardless of dietary intervention (p < 0.01); those on the GD significantly reduced percent FM (p < 0.001). Females on a VLED had statistically greater reductions in BW, BMI and systolic BP compared to those on the GD. No effect of exercise physiologist was observed in this study. Participants prescribed a GD attended for significantly longer than those on a VLED (p < 0.05), irrespective of gender. At 12 months, 14.3 and 4.5% of males and females on a VLED were still attending, compared to 10.6 and 4.5% on the GD. CONCLUSIONS In this retrospective study, females in both dietary intervention groups achieved significant changes across multiple measures. Only men receiving GD advice demonstrated significant changes. LEVEL OF EVIDENCE Level II-2.
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21
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Ramos-Lopez O, Riezu-Boj JI, Milagro FI, Cuervo M, Goni L, Martinez JA. Models Integrating Genetic and Lifestyle Interactions on Two Adiposity Phenotypes for Personalized Prescription of Energy-Restricted Diets With Different Macronutrient Distribution. Front Genet 2019; 10:686. [PMID: 31417605 PMCID: PMC6683656 DOI: 10.3389/fgene.2019.00686] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 07/01/2019] [Indexed: 12/13/2022] Open
Abstract
Aim: To analyze the influence of genetics and interactions with environmental factors on adiposity outcomes [waist circumference reduction (WCR) and total body fat loss (TFATL)] in response to energy-restricted diets in subjects with excessive body weight. Materials and Methods: Two hypocaloric diets (30% energy restriction) were prescribed to overweight/obese subjects during 16 weeks, which had different targeted macronutrient distribution: a low-fat (LF) diet (22% energy from lipids) and a moderately high-protein (MHP) diet (30% energy from proteins). At the end of the trial, a total of 201 participants (LF diet = 105; MHP diet = 96) who presented good/regular dietary adherence were genotyped for 95 single nucleotide polymorphisms (SNPs) previously associated with weight loss through next-generation sequencing from oral samples. Four unweighted (uGRS) and four weighted (wGRS) genetic risk scores were computed using statistically relevant SNPs for each outcome by diet. Predictions of WCR and TFATL by diet were modeled through recognized multiple linear regression models including genetic (single SNPs, uGRS, and wGRS), phenotypic (age, sex, and WC, or TFAT at baseline), and environment variables (physical activity level and energy intake at baselines) as well as eventual interactions between genes and environmental factors. Results: Overall, 26 different SNPs were associated with differential adiposity outcomes, 9 with WCR and 17 with TFATL, most of which were specific for each dietary intervention. In addition to conventional predictors (age, sex, lifestyle, and adiposity status at baseline), the calculated uGRS/wGRS and interactions with environmental factors were major contributors of adiposity responses. Thus, variances in TFATL-LF diet, TFATL-MHP diet, WCR-LF diet, and WCR-MHP diet were predicted by approximately 38% (optimism-corrected adj. R2 = 0.3792), 32% (optimism-corrected adj. R2 = 0.3208), 22% (optimism-corrected adj. R2 = 0.2208), and 21% (optimism-corrected adj. R2 = 0.2081), respectively. Conclusions: Different genetic variants and interactions with environmental factors modulate the differential individual responses to MHP and LF dietary interventions. These insights and models may help to optimize personalized nutritional strategies for modeling the prevention and management of excessive adiposity through precision nutrition approaches taking into account not only genetic information but also the lifestyle/clinical factors that interplay in addition to age and sex.
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Affiliation(s)
- Omar Ramos-Lopez
- Department of Nutrition, Food Science and Physiology, and Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Medical and Psychology School, Autonomous University of Baja California, Tijuana, Baja California, Mexico
| | - Jose I Riezu-Boj
- Department of Nutrition, Food Science and Physiology, and Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Fermin I Milagro
- Department of Nutrition, Food Science and Physiology, and Center for Nutrition Research, University of Navarra, Pamplona, Spain.,CIBERobn, Fisiopatología de la Obesidad y la Nutrición; Carlos III Health Institute, Madrid, Spain
| | - Marta Cuervo
- Department of Nutrition, Food Science and Physiology, and Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,CIBERobn, Fisiopatología de la Obesidad y la Nutrición; Carlos III Health Institute, Madrid, Spain
| | - Leticia Goni
- Department of Nutrition, Food Science and Physiology, and Center for Nutrition Research, University of Navarra, Pamplona, Spain
| | - J Alfredo Martinez
- Department of Nutrition, Food Science and Physiology, and Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,CIBERobn, Fisiopatología de la Obesidad y la Nutrición; Carlos III Health Institute, Madrid, Spain.,Madrid Institute of Advanced Studies (IMDEA Food), Madrid, Spain
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22
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Heideman WH, Rongen FC, Bolleurs C, Govers E, Kroeze W, Steenhuis IHM. Facilitators and barriers to a dietitian-implemented blended care weight-loss intervention (SMARTsize): a qualitative study. J Hum Nutr Diet 2019; 32:338-348. [PMID: 30891851 PMCID: PMC6593710 DOI: 10.1111/jhn.12641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Dietitians play an important role in the intervention and prevention of being overweight and obesity. More and more blended care interventions are being implemented. The present study aimed to evaluate the delivery by Dutch dietitians of a multicomponent, evidence-based weight-loss programme (SMARTsize), including counselling for relapse prevention. The aim of this qualitative study was to identify facilitators and barriers to the delivery of SMARTsize. METHODS Nine semi-structured interviews were conducted with 10 dietitians who participated in a larger implementation study. Each interview was recorded and transcribed verbatim. Determinants of theory of implementation, including characteristics of the user, the innovation, organisational context and setting, and innovation strategy guided interviews and analysis. Data were coded and analysed using the framework approach. RESULTS According to dietitians, the SMARTsize intervention had a positive influence on patients. The main implementation facilitators were the availability of implementation materials, such as a manual, training in relapse prevention and social support from other dietitians. The main barriers to implementation were organisation and financial reimbursement of cooking classes, the belief that patients need more individual counselling in the starting phase, and the unsuitability for people with low levels of health literacy. CONCLUSIONS Most dietitians considered that implementation of the SMARTsize intervention consisting of e-health, written information and cooking classes and face-to-face counselling is challenging but feasible. Further development of the SMARTsize intervention and implementation tools is needed to lower experienced barriers. It is also recommended that a version of the intervention to be developed that is suitable for patients with lower levels of health literacy.
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Affiliation(s)
- W H Heideman
- Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - F C Rongen
- Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - C Bolleurs
- Dutch Association of Dietitians, Houten, The Netherlands
| | - E Govers
- Amstelring and Dutch Knowledge Centre of Dietitians on Obesity (KDOO), Amsterdam, The Netherlands
| | - W Kroeze
- Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - I H M Steenhuis
- Department of Health Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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23
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Kim SY, Shin IS, Park YJ. Effect of acupuncture and intervention types on weight loss: a systematic review and meta-analysis. Obes Rev 2018; 19:1585-1596. [PMID: 30180304 DOI: 10.1111/obr.12747] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 01/29/2023]
Abstract
This study aimed to evaluate the effect of acupuncture and intervention types on weight loss. We searched electronic databases, including Embase, PubMed, CENTRAL, RISS, KISS and CNKI, for randomized controlled trials that used acupuncture to treat obesity before June 2017. We found 27 trials involving 32 intervention arms and 2,219 patients. Acupuncture plus lifestyle modification (LM) was more effective than LM alone (Hedges' g = 1.104, 95% CI = 0.531-1.678) and sham acupuncture plus LM (Hedges' g = 0.324, 95% CI = 0.177-0.471), whereas acupuncture alone was not more effective than sham acupuncture alone and no treatment. Auricular acupuncture (Hedges' g = 0.522, 95% CI = 0.152-0.893), manual acupuncture (Hedges' g = 0445, 95% CI = 0.044-0.846) and pharmacopuncture (Hedges' g = 0.411, 95% CI = 0.026-0.796) favoured weight loss. Finally, acupuncture treatment was effective only in subjects with overweight (25 ≤ body mass index < 30, Hedges' g = 0.528, 95% CI = 0.279-0.776), not in subjects with obesity (body mass index ≥30). Our study suggests that the effect of acupuncture on weight loss may be maximized when auricular and manual acupuncture or pharmacopuncture treatment is combined with LM in patients with overweight.
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Affiliation(s)
- S-Y Kim
- Department of Biofunctional Medicine & Diagnostics, College of Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - I-S Shin
- Department of Education, College of Education, Jeonju University, Jeonju, South Korea
| | - Y-J Park
- Department of Biofunctional Medicine & Diagnostics, College of Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea.,Department of Diagnosis and Biofunctional Medicine, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
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24
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McLoughlin RF, McDonald VM, Gibson PG, Scott HA, Hensley MJ, MacDonald-Wicks L, Wood LG. The Impact of a Weight Loss Intervention on Diet Quality and Eating Behaviours in People with Obesity and COPD. Nutrients 2017; 9:nu9101147. [PMID: 29053575 PMCID: PMC5691763 DOI: 10.3390/nu9101147] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 11/16/2022] Open
Abstract
There is a paucity of evidence to guide clinicians about appropriate management strategies for people with obesity and Chronic Obstructive Pulmonary Disease (COPD). We have recently published results from the first weight loss intervention in adults (>18 years) with obesity (body mass index; BMI ≥ 30 kg/m2) and COPD, using a low-calorie diet coupled with a partial meal replacement plan and resistance exercise training, which resulted in a 6.4% reduction in weight while maintaining skeletal muscle mass and improving health status. This sub-study aims to evaluate the intervention by (a) examining changes in dietary intake and nutritional biomarkers and (b) examining predictors of weight loss. Dietary intake was evaluated using four-day food diaries, and analysis of plasma fatty acids and plasma carotenoids as biomarkers of dietary fat intake and fruit and vegetable intake, respectively. Twenty-eight obese COPD subjects (n = 17 males, n = 11 females) with a mean (standard deviation; SD) age of 67.6 (6.3) years completed the 12-week weight loss intervention. Pre-intervention, mean (SD) BMI was 36.3 (4.6) kg/m2. Micronutrient intake improved from pre- to post-intervention, with the percentage of subjects meeting the Nutrient Reference Values increased for all micronutrients. Post-intervention, significant decreases in total (p = 0.009) and saturated fat intake (p = 0.037), and corresponding decreases in total (p = 0.007) and saturated plasma fatty acids (p = 0.003) were observed. There was a trend towards higher total carotenoids post-intervention (p = 0.078). Older age (p = 0.025), higher pre-intervention uncontrolled eating (p < 0.001) and plasma carotenoids (p = 0.009) predicted weight loss. This demonstrates the efficacy of a weight loss intervention in improving diet quality of obese COPD adults.
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Affiliation(s)
- Rebecca F McLoughlin
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2305, Australia.
| | - Vanessa M McDonald
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2305, Australia.
| | - Peter G Gibson
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2305, Australia.
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton, NSW 2305, Australia.
| | - Hayley A Scott
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2305, Australia.
| | - Michael J Hensley
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2305, Australia.
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton, NSW 2305, Australia.
| | - Lesley MacDonald-Wicks
- Discipline of Nutrition and Dietetics, School of Health Sciences, University of Newcastle, Newcastle, NSW 2308, Australia.
| | - Lisa G Wood
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2305, Australia.
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25
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Tremellen K, Wilkinson D, Savulescu J. Should obese women's access to assisted fertility treatment be limited? A scientific and ethical analysis. Aust N Z J Obstet Gynaecol 2017; 57:569-574. [PMID: 28299785 DOI: 10.1111/ajo.12600] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 12/15/2016] [Indexed: 12/12/2022]
Abstract
Obesity is associated with a reduction in fertility treatment success and increased risks to mother and child. Therefore guidelines of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) suggest that a body mass index exceeding 35 kg/m2 should be an absolute contraindication to assisted fertility treatment such as in vitro fertilisation IVF. In this paper we challenge the ethical and scientific basis for such a ban. Livebirth rates for severely obese women are reduced by up to 30%, but this result is still far better than that observed for many older women who are allowed access to IVF. This prohibition is particularly unjust when IVF is the only treatment capable of producing a pregnancy, such as bilateral tubal blockage or severe male factor infertility. Furthermore, the absolute magnitude of risks to mother or child is relatively small, and while a woman has a right to be educated about these risks, she alone should be allowed to make a decision on proceeding with treatment. We do not prohibit adults from engaging in dangerous sports, nor do we force parents to vaccinate their children, despite the risks. Similarly, we should not prohibit obese women from becoming parents because of increased risk to themselves or their child. Finally, prohibiting obese women's access to IVF to prevent potential harms such as 'fetal programing' is questionable, especially when compared to that child never being born at all. As such, we believe the RANZCOG ban on severely obese women's access to assisted reproductive treatment is unwarranted and should be revised.
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Affiliation(s)
- Kelton Tremellen
- Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia, Australia
| | - Dominic Wilkinson
- Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, UK.,Department of Neonatology, John Radcliffe Hospital, Oxford, UK
| | - Julian Savulescu
- Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, UK
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26
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Runhaar J, de Vos BC, van Middelkoop M, Vroegindeweij D, Oei EHG, Bierma-Zeinstra SMA. Prevention of Incident Knee Osteoarthritis by Moderate Weight Loss in Overweight and Obese Females. Arthritis Care Res (Hoboken) 2016; 68:1428-33. [PMID: 26866630 DOI: 10.1002/acr.22854] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 01/12/2016] [Accepted: 01/26/2016] [Indexed: 01/05/2023]
Abstract
OBJECTIVE This study evaluated the effect of moderate weight loss on the incidence of knee osteoarthritis (OA) in middle-aged overweight and obese women, without clinical and radiologic knee OA at baseline. METHODS A total of 353 women (87%) with followup data available were selected from the Prevention of Knee Osteoarthritis in Overweight Females study, which evaluated the preventive effect of a diet and exercise intervention and of oral glucosamine sulfate on the incidence of knee OA. This was an exploratory proof-of-concept analysis, which compared the incidence of knee OA between women who reached the clinically relevant weight loss target of 5 kg or 5% of body weight after 30 months and those who did not reach this target. RESULTS The weight loss group showed a significantly lower incidence of knee OA according to the primary outcome measure, which was composed of the American College of Rheumatology criteria (clinical and radiographic), Kellgren/Lawrence grade ≥2, and joint space narrowing ≥1.0 mm (15% versus 20%; odds ratio 0.5, 95% confidence interval 0.3-0.9). Moreover, the weight loss also positively affected several health measures, such as blood glucose level, body fat percentage, and blood pressure. CONCLUSION A reduction of ≥5 kg or 5% of body weight over a 30-month period reduces the risk for the onset of radiographic knee OA in middle-aged overweight and obese women. Because of the slow progression of the disease, a longer followup period will be necessary before the number of prevented cases of knee OA by moderate weight loss becomes clinically more relevant.
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Affiliation(s)
- Jos Runhaar
- Erasmus Medical Center, Rotterdam, The Netherlands.
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27
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Cadzow RB, Chambers MK, Sandell AMD. School-Based Obesity Intervention Associated with Three Year Decrease in Student Weight Status in a Low-Income School District. J Community Health 2016; 40:709-13. [PMID: 25582637 DOI: 10.1007/s10900-015-9989-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
School-based interventions may be a way to address increasing rates of childhood obesity. Following an obesity intervention implemented by a low-income school district we found evidence of weight status change among district students. The school district served 5,000 children in Western New York at that time and approximately 4,000 students were in the target group (grades 3-12). The district allocated federal grant funds to implement changes to physical education equipment and curriculum, health education curriculum, and school food and to offer afterschool access to equipment and activities. As part of the grant reporting requirements, school staff measured student height and weight twice yearly for three years. We were subcontracted as evaluators for this grant and district staff shared this de-identified data with us for assistance with grant reporting. We obtained IRB approval from SUNY at Buffalo for analysis and publication of the data. Data analysis involved longitudinal descriptive and inferential (paired-samples t tests, Chi square tests) statistical analyses of Body Mass Index (BMI) percentiles of students with baseline and endpoint height and weight measurements (n = 2,259). Overall the mean BMI percentile of students decreased significantly from 70.4 to 65.7% (p < 0.001). This exceeds the change in BMI percentile seen at the national level. There was a significant decrease in the proportion of students categorized as overweight or obese (p < 0.001). Conclusions are limited due to the lack of a control population however they indicate that a three year multilevel school-based intervention involving physical activity and nutritional changes was correlated with improved weight status among participating school children.
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Affiliation(s)
- Renee B Cadzow
- Department of Family Medicine, Primary Care Research Institute, State University of New York at Buffalo, Buffalo, NY, USA,
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29
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Reductions in body weight and percent fat mass increase the vitamin D status of obese subjects: a systematic review and metaregression analysis. Nutr Res 2016; 36:201-13. [DOI: 10.1016/j.nutres.2015.11.013] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 11/19/2015] [Accepted: 11/24/2015] [Indexed: 12/16/2022]
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30
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Lee A, Jeon KJ, Kim HK, Han SN. Effect of a 12-week weight management program on the clinical characteristics and dietary intake of the young obese and the contributing factors to the successful weight loss. Nutr Res Pract 2014; 8:571-9. [PMID: 25324939 PMCID: PMC4198972 DOI: 10.4162/nrp.2014.8.5.571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 04/07/2014] [Accepted: 04/07/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND/OBJECTIVES The objectives were to investigate the effect of a 12-wk intervention with behavioral modification on clinical characteristics and dietary intakes of young and otherwise healthy obese and to identify factors for successful weight loss. The goal was to lose 0.5 kg per week by reducing 300-500 kcal/day and by increasing physical activities. SUBJECTS AND METHODS Forty four obese subjects (BMI > 25) and 19 normal weight subjects (BMI 18.5-23) finished the 12-week intervention. Obese subjects participated in 5 group educations and 6 individual counseling sessions. Normal weight subjects attended 6 individual counseling sessions for evaluations of dietary intake and exercise pattern. Anthropometric and clinical characteristics and 3-day dietary records were evaluated at baseline and week12. RESULTS Weight and serum triglyceride and free fatty acid concentrations in obese group decreased significantly with intervention. Intakes of energy, fat, and cholesterol decreased significantly in the obese. Active participation, realistic weight loss goal setting, and weight gain after high school graduation not during childhood were identified as key factors for successful weight loss. CONCLUSIONS The 12-week intervention with behavioral modification resulted in reduced energy and fat intakes and led to significant weight loss and improvements of clinical characteristics in the obese. The finding that those who became obese during childhood lost less weight indicates the importance of 'early' intervention.
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Affiliation(s)
- AeJin Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul 151-742, Korea
| | - Kyeong Jin Jeon
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul 151-742, Korea
| | - Hye-Kyeong Kim
- Department of Food Science and Nutrition, The Catholic University of Korea, Gyeonggi, 420-717, Korea
| | - Sung Nim Han
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul 151-742, Korea. ; Research Institute of Human Ecology, College of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea
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31
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Julia C, Péneau S, Andreeva VA, Méjean C, Fezeu L, Galan P, Hercberg S. Weight-loss strategies used by the general population: how are they perceived? PLoS One 2014; 9:e97834. [PMID: 24852440 PMCID: PMC4031181 DOI: 10.1371/journal.pone.0097834] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 04/25/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The rising prevalence of obesity and the social pressure for thinness increase the prevalence of dieting. However, little is known about the overall perception of dieting strategies actually used by the general population. OBJECTIVES Our main objective was to investigate perceptions of weight-loss practices in an observational study in order to identify the most favourable strategy. DESIGN Adults from the ongoing Nutrinet-Santé cohort study who had reported engaging in dieting in the three previous years were included in the study. For each diet, detailed information was collected on types of diets, circumstances and perception of the diet, and outcomes. Perceptions were compared across diets using sex-specific mixed effects models. RESULT Among the 48 435 subjects who had completed the respective questionnaire, 12 673 (26.7%, 87.8% of women) had followed at least one weight-loss diet in the previous three years. Diet plans prescribed by health professionals and diets conforming to official dietary recommendations were the most favourably perceived among all assessed weight-loss strategies. Alternatively, commercial diet plans and self-imposed dietary restrictions were more negatively perceived (Odds ratios (OR) for adherence difficulty 1.30 (95% confidence interval (0.99;1.7)) in men and OR 1.92 (1.76;2.10) in women compared to official nutritional guidelines; OR 1.06 (0.82;1.38) in men and OR 1.39 (1.26;1.54) in women respectively) compared to official nutritional guidelines. CONCLUSION Official dietary recommendations could be useful tools for maintaining a dietary balance while following a weight-loss diet.
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Affiliation(s)
- Chantal Julia
- Paris 13 University, Sorbonne Paris Cité, Nutritional Epidemiology Research Team, Epidemiology and biostatistics Center, Cnam, Paris 5 University, Paris 7 University, Bobigny, France
- Department of Public Health, Avicenne Hospital, Bobigny, France
| | - Sandrine Péneau
- Paris 13 University, Sorbonne Paris Cité, Nutritional Epidemiology Research Team, Epidemiology and biostatistics Center, Cnam, Paris 5 University, Paris 7 University, Bobigny, France
| | - Valentina A. Andreeva
- Paris 13 University, Sorbonne Paris Cité, Nutritional Epidemiology Research Team, Epidemiology and biostatistics Center, Cnam, Paris 5 University, Paris 7 University, Bobigny, France
| | - Caroline Méjean
- Paris 13 University, Sorbonne Paris Cité, Nutritional Epidemiology Research Team, Epidemiology and biostatistics Center, Cnam, Paris 5 University, Paris 7 University, Bobigny, France
| | - Léopold Fezeu
- Paris 13 University, Sorbonne Paris Cité, Nutritional Epidemiology Research Team, Epidemiology and biostatistics Center, Cnam, Paris 5 University, Paris 7 University, Bobigny, France
| | - Pilar Galan
- Paris 13 University, Sorbonne Paris Cité, Nutritional Epidemiology Research Team, Epidemiology and biostatistics Center, Cnam, Paris 5 University, Paris 7 University, Bobigny, France
| | - Serge Hercberg
- Paris 13 University, Sorbonne Paris Cité, Nutritional Epidemiology Research Team, Epidemiology and biostatistics Center, Cnam, Paris 5 University, Paris 7 University, Bobigny, France
- Department of Public Health, Avicenne Hospital, Bobigny, France
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Tol J, Swinkels IC, de Bakker DH, Seidell J, Veenhof C. Dietetic treatment lowers body mass index in overweight patients: an observational study in primary health care. J Hum Nutr Diet 2013; 27:426-33. [PMID: 24205956 DOI: 10.1111/jhn.12175] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- J. Tol
- The Netherlands Institute for Health Services Research (NIVEL); Utrecht the Netherlands
| | - I. C. Swinkels
- The Netherlands Institute for Health Services Research (NIVEL); Utrecht the Netherlands
| | - D. H. de Bakker
- The Netherlands Institute for Health Services Research (NIVEL); Utrecht the Netherlands
- Tilburg University, Scientific Centre for Transformation in Care and Welfare (TRANZO); Tilburg the Netherlands
| | - J. Seidell
- VU University of Amsterdam; Amsterdam the Netherlands
| | - C. Veenhof
- The Netherlands Institute for Health Services Research (NIVEL); Utrecht the Netherlands
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de Vos BC, Runhaar J, Bierma-Zeinstra SMA. Effectiveness of a tailor-made weight loss intervention in primary care. Eur J Nutr 2013; 53:95-104. [DOI: 10.1007/s00394-013-0505-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 02/08/2013] [Indexed: 10/27/2022]
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