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The Need for Objective Physical Activity Measurements in Routine Bariatric Care. Obes Surg 2022; 32:2975-2986. [PMID: 35739414 PMCID: PMC9392711 DOI: 10.1007/s11695-022-06165-y] [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: 03/21/2022] [Revised: 06/12/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022]
Abstract
Purpose This study aims to (1) quantify physical behavior through self-reports and sensor-based measures, (2) examine the correlation between self-reported and sensor-based physical activity (PA) and (3) assess whether bariatric patients adhere to PA guidelines. Methods A Fitbit accelerometer was used to collect minute-to-minute step count and heart rate data for 14 consecutive days. Total physical activity levels (PAL), moderate-to-vigorous intensity physical activity (MVPA) and sedentary behavior (SB) were used to quantify physical behavior. Self-reported PA was assessed with the International Physical Activity Questionnaire (IPAQ). To analyze the association between sensor-based and self-reported PA, Spearman’s correlation was used. A minimum of 150 MVPA minutes per week was considered as compliance with the PA guidelines. Results Fitbit data of 37 pre- and 18 post-surgery patients was analyzed. Participants averaged 7403 ± 3243 steps/day and spent most of their time sedentary (832 min, IQR: 749 – 879), especially in prolonged periods of ≥ 30 min (525, IQR: 419 – 641). Median MVPA time was 5.6 min/day (IQR: 1.7 – 10.6). Correlations between self-reported and sensor-based MVPA and SB were respectively 0.072 and 0.455. Only 17.1% was objectively adherent to MVPA guidelines ≥ 150 min/week, while 94.3% met the guidelines in case of self-reports. Conclusion PA quantification confirmed that bariatric patients are highly sedentary and rarely engage in MVPA, despite a relatively high daily step count. Moreover, bariatric patients are not able to assess MVPA and moderately their SB by self-reports. Our results indicate the need for sensor-based PA monitoring in routine bariatric care. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s11695-022-06165-y.
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Gil S, Kirwan JP, Murai IH, Dantas WS, Merege-Filho CAA, Ghosh S, Shinjo SK, Pereira RMR, Teodoro WR, Felau SM, Benatti FB, de Sá-Pinto AL, Lima F, de Cleva R, Santo MA, Gualano B, Roschel H. A randomized clinical trial on the effects of exercise on muscle remodelling following bariatric surgery. J Cachexia Sarcopenia Muscle 2021; 12:1440-1455. [PMID: 34666419 PMCID: PMC8718087 DOI: 10.1002/jcsm.12815] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/27/2021] [Accepted: 09/07/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Muscle atrophy and strength loss are common adverse outcomes following bariatric surgery. This randomized, controlled trial investigated the effects of exercise training on bariatric surgery-induced loss of muscle mass and function. Additionally, we investigated the effects of the intervention on molecular and histological mediators of muscle remodelling. METHODS Eighty women with obesity were randomly assigned to a Roux-en-Y gastric bypass (RYGB: n = 40, age = 42 ± 8 years) or RYGB plus exercise training group (RYGB + ET: n = 40, age = 38 ± 7 years). Clinical and laboratory parameters were assessed at baseline, and 3 (POST3) and 9 months (POST9) after surgery. The 6 month, three-times-a-week, exercise intervention (resistance plus aerobic exercise) was initiated 3 months post-surgery (for RYGB + ET). A healthy, lean, age-matched control group was recruited to provide reference values for selected variables. RESULTS Surgery resulted in a similar (P = 0.66) reduction in lower-limb muscle strength in RYGB and RYGB+ET (-26% vs. -31%), which was rescued to baseline values in RYGB + ET (P = 0.21 vs. baseline) but not in RYGB (P < 0.01 vs. baseline). Patients in RYGB+ET had greater absolute (214 vs. 120 kg, P < 0.01) and relative (2.4 vs. 1.4 kg/body mass, P < 0.01) muscle strength compared with RYGB alone at POST9. Exercise resulted in better performance in timed-up-and-go (6.3 vs. 7.1 s, P = 0.05) and timed-stand-test (18 vs. 14 repetitions, P < 0.01) compared with RYGB. Fat-free mass was lower (POST9-PRE) after RYBG than RYGB + ET (total: -7.9 vs. -4.9 kg, P < 0.01; lower-limb: -3.8 vs. -2.7 kg, P = 0.02). Surgery reduced Types I (~ - 21%; P = 0.99 between-group comparison) and II fibre cross-sectional areas (~ - 27%; P = 0.88 between-group comparison), which were rescued to baseline values in RYGB+ET (P > 0.05 vs. baseline) but not RYGB (P > 0.01 vs. baseline). RYGB + ET showed greater Type I (5187 vs. 3898 μm2 , P < 0.01) and Type II (5165 vs. 3565 μm2 , P < 0.01) fCSA than RYGB at POST9. RYGB + ET also resulted in increased capillarization (P < 0.01) and satellite cell content (P < 0.01) than RYGB at POST9. Gene-set normalized enrichment scores for the muscle transcriptome revealed that the ubiquitin-mediated proteolysis pathway was suppressed in RYGB + ET at POST9 vs. PRE (NES: -1.7; P < 0.01), but not in RYGB. Atrogin-1 gene expression was lower in RYGB + ET vs. RYGB at POST9 (0.18 vs. 0.71-fold change, P < 0.01). From both genotypic and phenotypic perspectives, the muscle of exercised patients resembled that of healthy lean individuals. CONCLUSIONS This study provides compelling evidence-from gene to function-that strongly supports the incorporation of exercise into the recovery algorithm for bariatric patients so as to counteract the post-surgical loss of muscle mass and function.
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Affiliation(s)
- Saulo Gil
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Universidade de São Paulo, São Paulo, SP, Brazil.,Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - John P Kirwan
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Igor H Murai
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.,Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Wagner S Dantas
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Carlos Alberto Abujabra Merege-Filho
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Universidade de São Paulo, São Paulo, SP, Brazil.,Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Sujoy Ghosh
- Laboratory of Computational Biology, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA.,Centre for Computational Biology, Duke-NUS Medical School, Singapore
| | - Samuel K Shinjo
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Rosa M R Pereira
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Walcy R Teodoro
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Sheylla M Felau
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Fabiana B Benatti
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.,School of Applied Sciences, Universidade Estadual de Campinas, São Paulo, Brazil
| | - Ana L de Sá-Pinto
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Fernanda Lima
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Roberto de Cleva
- Gastroenterology Department, Digestive Surgery Division Department of Digestive Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marco Aurélio Santo
- Gastroenterology Department, Digestive Surgery Division Department of Digestive Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Universidade de São Paulo, São Paulo, SP, Brazil.,Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.,Laboratory of Assessment and Conditioning in Rheumatology, Universidade de São Paulo, São Paulo, SP, Brazil.,Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Ouellette KA, Mabey JG, Eisenman PA, Shaw JM, Brusseau TA, Hatfield DL, Ford CN, Davidson LE. Physical Activity Patterns Among Individuals Before and Soon After Bariatric Surgery. Obes Surg 2021; 30:416-422. [PMID: 31602627 DOI: 10.1007/s11695-019-04186-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE Post-operative changes in moderate-to-vigorous physical activity (MVPA) may contribute to improved weight loss and long-term weight maintenance of individuals after bariatric surgery. Patients experience minimal changes in MVPA > 6 months after surgery, but no studies have investigated early changes in physical activity after surgery. This study aims to assess MVPA changes during the rapid weight loss phase through self-reporting and objective measures. METHODS Physical activity patterns were assessed as minutes per day spent doing MVPA. A walking cadence of ≥ 100 steps per minute defined MVPA. Individuals completing gastric bypass (N = 7) and sleeve gastrectomy (N = 17) procedures (21 females, 3 males, age 42.2 ± 12.6 years, body mass 121.8 ± 24.8 kg, BMI 44.0 ± 6.5) completed office visits at 12 ± 6 days pre- and 35 ± 10 days post-operative. Each wore an ActiGraph GT3X tri-axial accelerometer at the hip for 7 days before and again for 7 days 30.6 ± 10 days after surgery. Assessments also included a subjective question about their anticipated and perceived post-operative MVPA (scale of - 3 to 3 with 3 being much more physically active and - 3 being much less). RESULTS Participants did not change their minutes per day of MVPA significantly (pre-operative 1.5 ± 2.1; post-operative 2.6 ± 5.6, NS). Participants predicted their post-operative physical activity level would increase (2.8 ± 0.4). The self-reported activity level on the same scale after surgery was significantly less than predicted (1.9 ± 1.0, p < 0.05) but still suggested that participants thought they were more physically active. CONCLUSION Consistent with reports > 6 months after surgery, MVPA did not increase in the early post-operative period, despite patient expectations. The early post-operative period may be a time for behavioral intervention.
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Affiliation(s)
- Kristen A Ouellette
- Department of Exercise Science and Athletic Training, Springfield College, Room 201 Athletic Training and Exercise Science Facilities, 263 Alden Street, Springfield, MA, 01109-3739, USA.
| | - Jacob G Mabey
- Department of Exercise Sciences, Brigham Young University, 271 Smith Fieldhouse, Provo, UT, 84604, USA
| | - Patricia A Eisenman
- Department of Health, Kinesiology, and Recreation, The University of Utah, 250 S. 1850 E., Hper East, Salt Lake City, UT, 84112, USA
| | - Janet M Shaw
- Department of Health, Kinesiology, and Recreation, The University of Utah, 250 S. 1850 E., Hper East, Salt Lake City, UT, 84112, USA
| | - Tim A Brusseau
- Department of Health, Kinesiology, and Recreation, The University of Utah, 250 S. 1850 E., Hper East, Salt Lake City, UT, 84112, USA
| | - Disa L Hatfield
- Department of Kinesiology, The University of Rhode Island, Independence Square, Suite P, RM 205, 25 Independence Way, Kingston, RI, 02881, USA
| | - Candus N Ford
- Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI, 96859-5000, USA
| | - Lance E Davidson
- Department of Exercise Sciences, Brigham Young University, 271 Smith Fieldhouse, Provo, UT, 84604, USA
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Zabatiero J, Smith A, Gucciardi DF, Hamdorf Am JM, Taylor SF, Hill K. Patterns of Change in Device-Based Physical Activity and Sedentary Time Following Bariatric Surgery: a Longitudinal Observational Study. Obes Surg 2021; 31:3015-3025. [PMID: 33712935 DOI: 10.1007/s11695-021-05337-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/24/2021] [Accepted: 03/04/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of this study is to investigate changes in physical activity (PA) and sedentary time (ST) over 12 months following bariatric surgery. METHODS Pre-surgery and at 3, 6, 9, and 12 months post-surgery, wearable devices were used to measure PA at different intensities, grouped according to energy expenditure and daily step count, and ST. Measures were also collected of weight and self-efficacy for exercise. Pre- and 12 months post-surgery, measures were collected of body composition and cardiovascular fitness. RESULTS Thirty adults scheduled for bariatric surgery were recruited (20 females, 44.1 [range, 22.0 to 65.0] years, body mass index 39.6 [range, 30.9 to 50.9] kg/m2). When compared to pre-surgery measures, over the 12 months post-surgery, there were no changes in the percentage of waking hours (mean [95% CI]) spent in ST (- 2% [- 6 to 3]), light intensity PA (1% [- 3 to 5]), and moderate-to-vigorous intensity PA (1% [- 1 to 3]). At all time points, participants spent most (> 70%) of their waking hours accumulating ST, with little time spent in light intensity PA (~ 21%) and almost no time in moderate-to-vigorous intensity PA (~ 5%). Step count and cardiovascular fitness were also unchanged. There were significant changes in weight, self-efficacy for exercise, and body composition. CONCLUSIONS Although bariatric surgery resulted in substantial weight loss and improved self-efficacy for exercise, it was insufficient to effect change in PA, ST or cardiovascular fitness. Complementing surgical intervention with behavioral interventions may optimize change in PA and ST.
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Affiliation(s)
- Juliana Zabatiero
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, 6845, Australia.
| | - Anne Smith
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, 6845, Australia
| | - Daniel F Gucciardi
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, 6845, Australia
| | - Jeffrey M Hamdorf Am
- Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia.,Western Surgical Health, Nedlands, WA, Australia
| | - Susan F Taylor
- Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia.,Western Surgical Health, Nedlands, WA, Australia
| | - Kylie Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, 6845, Australia.,Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, WA, Australia
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Kovacs SJ, Courcoulas AP, Rogers RJ, Davis KK, Jakicic JM. Psychosocial factors associated with physical activity in patients who have undergone bariatric surgery. Surg Obes Relat Dis 2020; 16:1994-2005. [PMID: 32919909 DOI: 10.1016/j.soard.2020.07.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/11/2020] [Accepted: 07/26/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Identifying psychosocial variables associated with physical activity may lead to the development of interventions that better address the challenges to participating in physical activity experienced by postbariatric surgery patients. OBJECTIVE To examine associations between select psychosocial variables and physical activity in patients who had undergone bariatric surgery within the past 2 years. SETTINGS Bariatric surgery candidates were recruited from the Greater Pittsburgh region. METHODS Eighty-three patients who had undergone bariatric surgery self-reported current physical activity and select psychosocial constructs. In addition, participants provided retrospective information on physical activity and psychosocial constructs before surgery. RESULTS Patients increased physical activity from baseline (median = 156.00 [25th, 75th percentiles: 53.00, 600.00] kcal/week) to post surgery (median = 976.00 [25th, 75th percentiles: 344.00, 1832.00] kcal/week) (P < .001). A number of pre- to postsurgery changes in psychosocial variables were associated with change in physical activity; however, only change in fitness orientation (P = .001), change in social support from friends (P = .005), and change in self-reported weight (P = .012) emerged as predictors of change in physical activity from pre- to postsurgery. Several postsurgery psychosocial factors were also significantly associated with postsurgery physical activity, but only postsurgery fitness orientation (P < .001), social support from co-workers (P = .002), and physical function (P = .023) emerged as predictive of the amount of postsurgical PA. CONCLUSIONS Pre- and postbariatric surgery interventions aimed at increasing physical activity participation may need to target important constructs that include the encouragement of social support and strategies to enhance the effort individuals put forward to engage in physical activity, as well as a focus on enhancing physical function and awareness of weight status.
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Affiliation(s)
- Sara J Kovacs
- Department of Kinesiology, Temple University, Philadelphia, Pennsylvania.
| | - Anita P Courcoulas
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Renee J Rogers
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania; Healthy Lifestyle Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kelliann K Davis
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - John M Jakicic
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania; Healthy Lifestyle Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
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Bonn SE, Hult M, Spetz K, Löf M, Andersson E, Wiren M, Trolle Lagerros Y. App Technology to Support Physical Activity and Intake of Vitamins and Minerals After Bariatric Surgery (the PromMera Study): Protocol of a Randomized Controlled Clinical Trial. JMIR Res Protoc 2020; 9:e19624. [PMID: 32795990 PMCID: PMC7455871 DOI: 10.2196/19624] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 01/24/2023] Open
Abstract
Background To optimize postoperative outcomes after bariatric surgery, lifestyle changes including increased physical activity are needed. Micronutrient deficiency after surgery is also common and daily supplementation is recommended. Objective The aim of the PromMera study is to evaluate the effects of a 12-week smartphone app intervention on promotion of physical activity (primary outcome) and adherence to postsurgery vitamin and mineral supplementation, as well as on other lifestyle factors and overall health in patients undergoing bariatric surgery. Methods The PromMera study is a two-arm, randomized controlled trial comprising patients undergoing bariatric surgery. Participants are randomized postsurgery 1:1 to either the intervention group (ie, use of the PromMera app for 12 weeks) or the control group receiving only standard care. Clinical and lifestyle variables are assessed pre- and postsurgery after 18 weeks (postintervention assessment), 6 months, 1 year, and 2 years. Assessments include body composition using Tanita or BOD POD analyzers, muscle function using handgrip, biomarkers in blood, and an extensive questionnaire on lifestyle factors. Physical activity is objectively measured using the ActiGraph wGT3X-BT triaxial accelerometer. Results A total of 154 participants have been enrolled in the study. The last study participant was recruited in May 2019. Data collection will be complete in May 2021. Conclusions Implementing lifestyle changes are crucial after bariatric surgery and new ways to reach patients and support such changes are needed. An app-based intervention is easily delivered at any time and can be a key factor in the adoption of healthier behavioral patterns in this rapidly growing group of patients. Trial Registration ClinicalTrials.gov NCT03480464; https://clinicaltrials.gov/ct2/show/NCT03480464 International Registered Report Identifier (IRRID) DERR1-10.2196/19624
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Affiliation(s)
- Stephanie Erika Bonn
- Clinical Epidemiology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
| | - Mari Hult
- Clinical Epidemiology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden.,Division of Upper Abdominal Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Kristina Spetz
- Department of Surgery, Linköping University, Norrköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Norrköping, Sweden
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Ellen Andersson
- Department of Surgery, Linköping University, Norrköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Norrköping, Sweden
| | - Mikael Wiren
- Department of Surgery, Ersta Hospital, Stockholm, Sweden
| | - Ylva Trolle Lagerros
- Clinical Epidemiology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden.,Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
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Schumacher LM, Thomas JG, Vithiananthan S, Webster J, Jones DB, Bond DS. Prolonged sedentary time adversely relates to physical activity and obesity among preoperative bariatric surgery patients. Surg Obes Relat Dis 2020; 16:562-567. [PMID: 32005613 DOI: 10.1016/j.soard.2019.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/13/2019] [Accepted: 12/17/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Bariatric surgery patients spend much of their waking time sedentary. Yet, little is known about their patterns of accumulation of sedentary time (ST) and whether more prolonged ST is associated with lower physical activity (PA), independent of total ST, or obesity severity. OBJECTIVES To characterize variability in prolonged ST among bariatric patients preoperatively and assess the importance of a "prolonger" pattern in relation to PA and weight status. SETTING Two university hospital clinics, United States. METHODS Adult patients (n = 76) wore a wrist-based accelerometer for 10 days preoperatively. ST and time spent in light and moderate-to-vigorous PA was determined using validated thresholds. Percent of total ST accumulated in ≥30-consecutive ST minute bouts was calculated, and participants were trichotomized into low, medium, and high "prolongers" based on this value. The associations of prolonged ST with PA and obesity were examined. RESULTS On average, participants accumulated a mean ± standard deviation of 10.5 ± 2.1 hours of ST per day, 30% of which was prolonged (prolonger groups: low = 7.2%-24.5%, medium = 24.5%-33.0%, and high = 34.0%-52.6% of ST in ≥30-min bouts). Adjusting for covariates including total ST, high prolongers had fewer light PA minutes per day (P < .01), and a greater percentage of prolonged ST related to lower likelihood of meeting the national guideline of ≥150 moderate-to-vigorous PA minutes per week (P = .012). High (versus low) prolongers had more severe obesity (P < .05). CONCLUSIONS Accumulating a greater percentage of ST in prolonged bouts appears to be adversely related to PA and obesity severity among bariatric patients. Future research should determine whether interrupting prolonged ST with brief breaks can favorably modify PA and weight in this population.
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Affiliation(s)
- Leah M Schumacher
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, Rhode Island
| | - J Graham Thomas
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, Rhode Island
| | | | - Jennifer Webster
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, Rhode Island
| | - Daniel B Jones
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Dale S Bond
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, Rhode Island.
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Abstract
PURPOSE Given the importance of physical activities for health outcomes, it is still unclear whether bariatric surgery per se and the standard care after surgery would result in an increase of physical activity level. This study aimed to determine physical activities preoperatively and at 6 and 12 months postoperatively among female patients who underwent bariatric surgery, and to investigate its relationship with body composition changes. MATERIAL AND METHODS Thirty-four women who had Roux-Y gastric bypass (RYGB) surgery completed the study. Physical activity was measured objectively for 7 consecutive days by using an ActiGraph GT3X+ accelerometer. Body composition was estimated by using multifrequency bioimpedance analysis. RESULTS The percentage of time spent in moderate-to-vigorous physical activity (MVPA) changed significantly from preoperatively to 6 months postoperatively; however, no difference was observed at 12 months. No significant changes were detected for other physical activity variables. Multivariable regression analysis suggested that the percentage of time spent in sedentary activity was associated with fat-free mass loss at 6 months (β = - 0.323; 95% CI = - 0.649 to 0.003) and 12 months (β = - 0.510; 95% CI = - 0.867 to - 0.154) postoperatively. CONCLUSION The overall MVPA increased at 6 months post-RYGB surgery; however, this change was not maintained at 12 months. Despite the considerable body mass loss postoperatively, most of the subjects were classified as being physically inactive and did not change their sedentary behavior. These findings indicate that female patients undergoing bariatric surgery should be encouraged to increase their physical activity level.
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Abstract
Although bariatric surgery is a proven means of weight loss and treatment of obesity-related comorbidities in morbidly obese patients, it is not yet clear how it affects outcomes after total joint arthroplasty in this high-risk patient population. This article explores the effects of obesity and bariatric surgery on osteoarthritis and total joint arthroplasty, and also discusses the financial and ethical implications of use of bariatric surgery for risk reduction before total joint arthroplasty.
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Abstract
BACKGROUND Most patients do not meet the recommended level of physical activity after bariatric surgery, and psychological factors underlying postoperative physical activity remain poorly understood. This study aimed at identifying self-regulatory predictors of physical activity after bariatric surgery. METHODS Questionnaire data including self-regulation variables and the short-version of the International Physical Activity Questionnaire were obtained in a prospective cohort of 230 patients 1 year after Roux-en-Y gastric bypass. The study sample consisted of participants consenting to wear an ActiGraph GT3X+ accelerometer for seven consecutive days, 18-24 months after surgery (n = 120). RESULTS A total of 112 participants with complete self-report data provided valid accelerometer data. Mean age was 46.8 years (SD = 9.3), and 81.3% was women. Preoperative and postoperative BMI was 44.8 ± 5.5 and 30.6 ± 5.0 kg/m2, respectively. Total weight loss was 28.9% (SD = 7.5). By objective measures, 17.9% of the participants met the recommended level of moderate-to-vigorous-intensity of physical activity of ≥150 min/week, whereas 80.2% met the recommended level according to self-reported measures. Being single, higher education level, and greater self-regulation predicted objective physical activity in multivariate regression analysis. Greater self-regulation also predicted self-reported physical activity. Weight loss 1 year after surgery was not associated with self-reported or objectively measured physical activity. CONCLUSIONS Despite large differences between accelerometer-based and subjective estimates of physical activity, the associations of self-regulatory factors and weight loss with postoperative physical activity did not vary depending on mode of measurement. Self-regulation predicted both objective and self-reported physical activity. Targeting patients' self-regulatory ability may enhance physical activity after gastric bypass.
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Zabatiero J, Hill K, Gucciardi DF, Hamdorf JM, Taylor SF, Hagger MS, Smith A. Beliefs, Barriers and Facilitators to Physical Activity in Bariatric Surgery Candidates. Obes Surg 2016; 26:1097-109. [PMID: 26323658 DOI: 10.1007/s11695-015-1867-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Bariatric surgery candidates engage in less physical activity (PA) and spend longer periods in sedentary behaviour (SB) when compared to the general adult population. The aim of this study was to explore the beliefs about PA and perceived barriers and facilitators to PA in obese adults scheduled for bariatric surgery. METHODS Nineteen obese adults (15 females), with a mean (SD) age of 41.6 (12.1) years, weight of 119.2 (20.5) kg and body mass index of 41.6 (6.7) kg/m(2) participated in a one-on-one in-depth qualitative interview before undergoing bariatric surgery. Data were analysed using inductive thematic analysis. RESULTS Most participants believed that engaging in regular PA confers important health benefits, however reported insufficient PA levels to obtain those benefits. The perceived barriers to PA reported by participants were both obesity related (e.g. bodily pain, physical limitation and self-presentational concerns) and non-obesity related (e.g. lack of motivation, environment and restricted resources). All participants stated weight loss to be the main perceived facilitator to PA, together with social factors, better time management and access to financial resources. CONCLUSIONS In bariatric surgery candidates, many of the perceived barriers and facilitators to PA are not obesity related and are therefore unlikely to change as a result of bariatric surgery. This may explain why earlier research shows little change in PA or SB following surgery. It is likely that an approach that aims to address the barriers and facilitators identified in this study is needed to change the inactive lifestyle adopted in this population.
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Affiliation(s)
- Juliana Zabatiero
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Western Australia, Australia
| | - Kylie Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Western Australia, Australia.,Lung Institute of Western Australia, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Daniel F Gucciardi
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Western Australia, Australia
| | - Jeffrey M Hamdorf
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Western Australia, Australia.,School of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, Western Australia, Australia.,Western Surgical Health, Hollywood Private Hospital, Perth, Western Australia, Australia
| | - Susan F Taylor
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Western Australia, Australia.,School of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, Western Australia, Australia.,Western Surgical Health, Hollywood Private Hospital, Perth, Western Australia, Australia
| | - Martin S Hagger
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Anne Smith
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Western Australia, Australia.
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12
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Wefers JF, Woodlief TL, Carnero EA, Helbling NL, Anthony SJ, Dubis GS, Jakicic JM, Houmard JA, Goodpaster BH, Coen PM. Relationship among physical activity, sedentary behaviors, and cardiometabolic risk factors during gastric bypass surgery-induced weight loss. Surg Obes Relat Dis 2016; 13:210-219. [PMID: 27789136 DOI: 10.1016/j.soard.2016.08.493] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 08/17/2016] [Accepted: 08/19/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND The impact of daily physical activity (PA) on the cardiometabolic risk of bariatric surgery patients is not known. OBJECTIVE We examined the influence of physical activity and sedentary behavior on modifying cardiometabolic risk after Roux-en-Y gastric bypass (RYGB) surgery. SETTING University of Pittsburgh Medical Center and East Carolina University bariatric surgery centers. METHODS Data from 43 women and 7 men who completed testing at 1-3 months after RYGB surgery and again at 9 months postsurgery were analyzed. Outcomes measured included PA level (min/d), steps/d, sedentary time, and body composition. Insulin sensitivity was determined with an intravenous glucose tolerance test. Weight and blood lipid profiles also were obtained. RESULTS Patients reduced body mass index by a mean of -8.0±3.4 kg/m2 (P<.001), increased moderate-to-vigorous PA by 17.0±47.0 min/d (P = .014), and decreased sedentary time (-47.9±101.0 min/d, P = .002). However, 24% of patients decreased overall PA (P<.001), and 39% increased sedentary behavior (P<.001). Changes in overall PA (rho = -.33, P = .006) and steps/d (rho = -.31, P = .0106) were related to weight loss. Insulin sensitivity was associated with light PA before (rho = .37, P<.001) and after (rho = .37, P = .015) intervention. Increasing overall PA also was related to higher levels of high-density lipoprotein cholesterol (rho = .33, P<.01). Decreasing sedentary time was related to decreased fat mass (rho = .35, P = .012) but not to other cardiometabolic risk factors. CONCLUSIONS The majority of patients increased PA (76%) and decreased sedentary time (61%) after RYGB surgery, but the amount of PA and sedentary time varied substantially. Higher PA, even at low intensity levels, was related to beneficial outcomes in body composition, insulin sensitivity, and high-density lipoprotein cholesterol.
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Affiliation(s)
- Jakob F Wefers
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL
| | - Tracey L Woodlief
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL
| | - Elvis A Carnero
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL
| | - Nicole L Helbling
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Steven J Anthony
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Gabriel S Dubis
- Department of Kinesiology, East Carolina University, Greenville, NC
| | - John M Jakicic
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
| | - Joseph A Houmard
- Department of Kinesiology, East Carolina University, Greenville, NC
| | - Bret H Goodpaster
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL; Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Paul M Coen
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL; Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA.
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13
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Strain GW, Ebel F, Honohan J, Gagner M, Dakin GF, Pomp A, Gallagher D. Fat-free mass is not lower 24 months postbariatric surgery than nonoperated matched controls. Surg Obes Relat Dis 2016; 13:65-69. [PMID: 27387700 DOI: 10.1016/j.soard.2016.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 03/02/2016] [Accepted: 03/04/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Concerns about an excessive loss of fat-free mass (FFM) after bariatric surgery prompted this comparison of operated versus matched nonoperated controls regarding FFM. SETTING University Hospital and University Research Unit in an urban medical center. METHODS Body composition with bioelectric impedance (Tanita 310, Tanita Corp, Arlington Heights, IL) was measured approximately 2 years after bariatric surgery in weight stable patients and nonoperated weight stable controls matched for body mass index (BMI), gender, and age. t tests provided comparisons. Analysis of variance was used to compare FFM changes for 4 procedures. Levene's test evaluated variance. RESULTS Patients (n = 252; 24.7±15 mo after surgery) and nonoperated controls (n = 252) were matched for gender (71.8% female), age (44.5±11.0 yr), and BMI (32.8±7.0 kg/m2). Patients had different surgical procedures: 107 gastric bypasses (RYGBs), 62 biliopancreatic diversions with duodenal switch (BPD/DSs), 40 adjustable gastric bands (AGBs), and 43 sleeve gastrectomies (LSGs). FFM percentage was significantly higher in the operated patients than controls, 66% versus 62%, P<.0001. For 3 procedures, the FFM was significantly higher; however, AGBs changed only 7.3 BMI units and FFM was not significantly different from their matched controls, 59.8% versus 58.2%. Across surgical groups, FFM percentage differed, P<.0001 (RYGB 66.5±9.2%, BPD/DS 74.0±9.3%, AGB 59.8±7.0%, LSG 59.6±9.3%). Variance was not different (P = .17). CONCLUSION Weight-reduced bariatric surgery patients have greater FFM compared with nonoperated matched controls. These findings support surgically assisted weight loss as a physiologic process and in general patients do not suffer from excessive FFM depletion after bariatric procedures.
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Affiliation(s)
- Gladys Witt Strain
- Weill Cornell College of Medicine, Department of Surgery, New York, New York.
| | - Faith Ebel
- Weill Cornell College of Medicine, Department of Surgery, New York, New York
| | - Jamie Honohan
- Weill Cornell College of Medicine, Department of Surgery, New York, New York
| | - Michel Gagner
- Hopital du Sacre Coeur, Department of Surgery, Montreal, Canada
| | - Gregory F Dakin
- Weill Cornell College of Medicine, Department of Surgery, New York, New York
| | - Alfons Pomp
- Weill Cornell College of Medicine, Department of Surgery, New York, New York
| | - Dympna Gallagher
- Columbia University, Obesity Research Center, New York, New York
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14
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McVeigh JA, Winkler EAH, Howie EK, Tremblay MS, Smith A, Abbott RA, Eastwood PR, Healy GN, Straker LM. Objectively measured patterns of sedentary time and physical activity in young adults of the Raine study cohort. Int J Behav Nutr Phys Act 2016; 13:41. [PMID: 27009327 PMCID: PMC4806520 DOI: 10.1186/s12966-016-0363-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 03/16/2016] [Indexed: 01/08/2023] Open
Abstract
Background To provide a detailed description of young adults’ sedentary time and physical activity. Methods 384 young women and 389 young men aged 22.1 ± 0.6 years, all participants in the 22 year old follow-up of the Raine Study pregnancy cohort, wore Actigraph GT3X+ monitors on the hip for 24 h/day over a one-week period for at least one ‘valid’ day (≥10 h of waking wear time). Each minute epoch was classified as sedentary, light, moderate or vigorous intensity using 100 count and Freedson cut-points. Mixed models assessed hourly and daily variation; t-tests assessed gender differences. Results The average (mean ± SD) waking wear time was 15.0 ± 1.6 h/day, of which 61.4 ± 10.1 % was spent sedentary, 34.6 ± 9.1 % in light-, 3.7 ± 5.3 % in moderate- and, 0.3 ± 0.6 % in vigorous-intensity activity. Average time spent in moderate to vigorous activity (MVPA) was 36.2 ± 27.5 min/day. Relative to men, women had higher sedentary time, but also higher vigorous activity time. The ‘usual’ bout duration of sedentary time was 11.8 ± 4.5 min in women and 11.7 ± 5.2 min in men. By contrast, other activities were accumulated in shorter bout durations. There was large variation by hour of the day and by day of the week in both sedentary time and MVPA. Evenings and Sundays through Wednesdays tended to be particularly sedentary and/or inactive. Conclusion For these young adults, much of the waking day was spent sedentary and many participants were physically inactive (low levels of MVPA). We provide novel evidence on the time for which activities were performed and on the time periods when young adults were more sedentary and/or less active. With high sedentary time and low MVPA, young adults may be at risk for the life-course sequelae of these behaviours. Electronic supplementary material The online version of this article (doi:10.1186/s12966-016-0363-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joanne A McVeigh
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia.
| | | | - Erin K Howie
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Anne Smith
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Rebecca A Abbott
- ESMI, University of Exeter Medical School, St.Luke's Campus, Exeter, UK
| | - Peter R Eastwood
- Centre for Sleep Science, School of Anatomy, Physiology & Human Biology, University of Western Australia, Perth, Western Australia, Australia
| | - Genevieve N Healy
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia.,The University of Queensland, School of Public Health, Brisbane, Australia.,Baker IDI Heart & Diabetes Institute Melbourne, Victoria, Australia
| | - Leon M Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
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15
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Coen PM, Goodpaster BH. A role for exercise after bariatric surgery? Diabetes Obes Metab 2016; 18:16-23. [PMID: 26228356 PMCID: PMC5642115 DOI: 10.1111/dom.12545] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 07/15/2015] [Accepted: 07/28/2015] [Indexed: 12/21/2022]
Abstract
Obesity predisposes an individual to develop numerous comorbidities, including type 2 diabetes, and represents a major healthcare issue in many countries worldwide. Bariatric surgery can be an effective treatment option, resulting in profound weight loss and improvements in metabolic health; however, not all patients achieve similar weight loss or metabolic improvements. Exercise is an excellent way to improve health, with well-characterized physiological and psychological benefits. In the present paper we review the evidence to determine whether there may be a role for exercise as a complementary adjunct therapy to bariatric surgery. Objectively measured physical activity data indicate that most patients who undergo bariatric surgery do not exercise enough to reap the health benefits of exercise. While there is a dearth of data on the effects of exercise on weight loss and weight loss maintenance after surgery, evidence from studies of caloric restriction and exercise suggest that similar adjunctive benefits may be extended to patients who perform exercise after bariatric surgery. Recent evidence from exercise interventions after bariatric surgery suggests that exercise may provide further improvements in metabolic health compared with surgery-induced weight loss alone. Additional randomized controlled exercise trials are now needed as the next step to more clearly define the potential for exercise to provide additional health benefits after bariatric surgery. This valuable evidence will inform clinical practice regarding much-needed guidelines for exercise after bariatric surgery.
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Affiliation(s)
- Paul M. Coen
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL 32804, USA
| | - Bret H. Goodpaster
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL 32804, USA
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16
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Bond DS, Thomas JG. Measurement and Intervention on Physical Activity and Sedentary Behaviours in Bariatric Surgery Patients: Emphasis on Mobile Technology. EUROPEAN EATING DISORDERS REVIEW 2015; 23:470-8. [PMID: 26331982 DOI: 10.1002/erv.2394] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 04/02/2015] [Accepted: 07/30/2015] [Indexed: 12/27/2022]
Abstract
Physical activity (PA) and sedentary behaviours (SB-i.e. activities involving low-energy expenditure and a sitting/reclining posture) may each have significant implications for weight loss and other bariatric surgery outcomes. While early studies suggested that patients typically comply with clinical recommendations to adopt habitual PA, these data were based on retrospective questionnaires. Conversely, recent studies incorporating mobile health (mHealth) technologies (e.g. objective monitors), which assess PA and SB in real time and in the natural environment, show that most patients are inactive and highly sedentary pre-operatively and only make modest changes in these behaviours postoperatively. In addition to using mHealth technologies for obtaining accurate and detailed information on PA and SB, they are increasingly being employed to intervene on patients' PA and SB and/or evaluate intervention outcomes. Researchers and clinicians are encouraged to consider the benefits of using mHealth technology when studying and treating PA and SB in bariatric surgery patients.
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Affiliation(s)
- Dale S Bond
- Weight Control and Diabetes Research Center, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI, USA
| | - J Graham Thomas
- Weight Control and Diabetes Research Center, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI, USA
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17
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King WC, Chen JY, Bond DS, Belle SH, Courcoulas AP, Patterson EJ, Mitchell JE, Inabnet WB, Dakin GF, Flum DR, Cook B, Wolfe BM. Objective assessment of changes in physical activity and sedentary behavior: Pre- through 3 years post-bariatric surgery. Obesity (Silver Spring) 2015; 23:1143-50. [PMID: 26010326 PMCID: PMC4445467 DOI: 10.1002/oby.21106] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/09/2015] [Accepted: 03/09/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate change in sedentary behavior (SB) and physical activity (PA) over 3 years following bariatric surgery. METHODS A subset of participants in an observational study (n = 473 of 2,458; 79% female, median body mass index 45 kg m(-2) ) wore an activity monitor presurgery and at 1-3 annual postsurgery assessments. RESULTS Over the first year, on average, sedentary time decreased from 573 (95% CI: 563-582) to 545 (95% CI: 534-555) min days(-1) and moderate- to vigorous-intensity PA (MVPA) increased from 77 (95% CI: 71-84) to 106 (95% CI: 98-116) min week(-1) , or 7 (95% CI: 5-10) to 24 (95% CI: 18-29) min week(-1) in MVPA bouts ≥10 min. There were no changes in these parameters from years 1 to 3 (P for all > 0.05). The percentage of participants achieving ≥150 min week(-1) of bout-related MVPA was not different at year 3 [6.5% (95% CI: 3.1-12.7)] vs. presurgery [3.4% (95% CI: 1.8-5.0); P = 0.45]. Most participants followed SB and PA trajectories that paralleled mean change and were consistent with their presurgery position in relation to the group. CONCLUSIONS On average, bariatric surgical patients make small reductions in SB and increases in PA during the first postsurgery year, which are maintained through 3 years. Still, postsurgery PA levels fall short of PA guidelines for general health or weight control.
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Affiliation(s)
- Wendy C King
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Jia-Yuh Chen
- Department of Biostatistics, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Dale S Bond
- Department of Psychiatry and Behavioral Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Steven H Belle
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Anita P Courcoulas
- Department of Minimally Invasive General and Bariatric Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Emma J Patterson
- Department of Surgery, Legacy Good Samaritan Weight Management Institute, Portland, Oregon, USA
| | - James E Mitchell
- Neuropsychiatric Research Institute and the Department of Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - William B Inabnet
- Department of Surgery, Mount Sinai Hospital, New York, New York, USA
| | - George F Dakin
- Department of Surgery, Weill Cornell Medical Center, New York, New York, USA
| | - David R Flum
- School of Medicine, Department of General Surgery, University of Washington, Seattle, Washington, USA
| | - Brian Cook
- Neuropsychiatric Research Institute and the Department of Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Bruce M Wolfe
- Department of General Surgery, Oregon Health and Science University, Portland, Oregon, USA
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18
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Bond DS, Thomas JG, King WC, Vithiananthan S, Trautvetter J, Unick JL, Ryder BA, Pohl D, Roye GD, Sax HC, Wing RR. Exercise improves quality of life in bariatric surgery candidates: results from the Bari-Active trial. Obesity (Silver Spring) 2015; 23:536-42. [PMID: 25611582 PMCID: PMC4339393 DOI: 10.1002/oby.20988] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 11/13/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To examine the impact of a pre-bariatric surgery physical activity intervention (PAI), designed to increase bout-related (≥10 min) moderate to vigorous PA (MVPA), on health-related quality of life (HRQoL). METHODS Analyses included 75 adult participants (86.7% female; BMI = 45.0 ± 6.5 kg m(-2)) who were randomly assigned to 6 weeks of PAI (n = 40) or standard pre-surgical care (SC; n = 35). PAI received 6 individual weekly counseling sessions to increase walking exercise. Participants wore an objective PA monitor for 7 days and completed the SF-36 Health Survey at baseline and post-intervention to evaluate bout-related MVPA and HRQoL changes, respectively. RESULTS PAI increased bout-related MVPA from baseline to post-intervention (4.4 ± 5.5 to 21.0 ± 21.4 min day(-1)) versus no change (7.9 ± 16.6 to 7.6 ± 11.5 min day(-1)) for SC (P = 0.001). PAI reported greater improvements than SC on all SF-36 physical and mental scales (P < 0.05), except role-emotional. In PAI, better baseline scores on the physical function and general health scales predicted greater bout-related MVPA increases (P < 0.05), and greater bout-related MVPA increases were associated with greater post-intervention improvements on the physical function, bodily pain, and general health scales (P < 0.05). CONCLUSIONS Increasing PA preoperatively improves physical and mental HRQoL in bariatric surgery candidates. Future studies should examine whether this effect improves surgical safety, weight loss outcomes, and postoperative HRQoL.
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Affiliation(s)
- Dale S. Bond
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
- Corresponding author: Dale S. Bond, Ph.D., Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, 196 Richmond Street, Providence RI, USA 02903; Telephone: 401-793-8970; Fax: 401-793-8944;
| | - J. Graham Thomas
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Wendy C. King
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sivamainthan Vithiananthan
- Department of Surgery, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - Jennifer Trautvetter
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Jessica L. Unick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Beth A. Ryder
- Department of Surgery, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - Dieter Pohl
- Department of Surgery, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
- Department of Surgery, Roger Williams Hospital, Providence, RI, USA
| | - G. Dean Roye
- Department of Surgery, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - Harry C. Sax
- Department of Surgery, Cedars-Sinai Medicine, Los Angeles, CA, USA
| | - Rena R. Wing
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
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19
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Bond DS. Comment on: Patterns of physical activity and sedentary behavior after bariatric surgery: an observational study. Surg Obes Relat Dis 2014; 10:530-2. [PMID: 24704125 DOI: 10.1016/j.soard.2013.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 10/25/2013] [Indexed: 11/22/2022]
Affiliation(s)
- Dale S Bond
- Department of Psychiatry and Human Behavior Brown Alpert Medical School The Miriam Hospital/Weight Control and Diabetes Research Center Providence, Rhode Island
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