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MacEwan JP, Chiu K, Ahmad NN, Sacks N, Shinde S, Poon JL, Kan H. Clinical, economic, and health-related quality of life outcomes in patients with overweight or obesity in the United States: 2016-2018. Obes Sci Pract 2024; 10:e726. [PMID: 38263999 PMCID: PMC10804324 DOI: 10.1002/osp4.726] [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: 03/17/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 01/25/2024] Open
Abstract
Objectives This study aimed to estimate clinical, economic (including productivity), and health-related quality of life (HRQoL) outcomes and associated individual characteristics among adults with overweight (OW) or obesity in the United States. Methods This study included adult respondents with body mass index (BMI) ≥18.5 kg/m2 in the 2017-2018 National Health and Nutrition Examination Survey (NHANES) and 2016 Medical Expenditure Panel Survey. Respondents were classified according to BMI. Individual characteristics were described by BMI categories. Multivariable regression models estimated the association between BMI categories and outcomes, adjusting for individual characteristics. Results Nearly three-quarters (73.7%) of NHANES participants were OW or obese. Relative to Normal weight (NW), respondents with Class 3 obesity had more obesity-related complications (2.07 vs. 4.62, p < 0.001). Higher BMI was associated with significantly lower HRQoL, lower productivity, and higher healthcare expenditures as well as more frequent weight loss attempts in the previous 12 months. Weight loss surgery and prescription anti-obesity medications (AOMs) were used only by a very small proportion of individuals. Despite frequent weight loss attempts, most respondents did not achieve clinically meaningful weight loss. Conclusions Adults with OW or obesity experienced worse clinical, economic and HRQoL outcomes than those with NW. Better use of evidence-based obesity treatments, including prescription AOMs, should be considered to achieve more clinically meaningful weight reduction and improved outcomes in individuals with OW or obesity.
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Affiliation(s)
| | - Kevin Chiu
- Santa Clara UniversitySanta ClaraCaliforniaUSA
| | | | | | | | | | - Hong Kan
- Eli Lilly & CompanyIndianapolisIndianaUSA
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van Loggerenberg F, Akena D, Alinaitwe R, Birabwa-Oketcho H, Méndez CAC, Gómez-Restrepo C, Kulenović AD, Selak N, Kiseljaković M, Musisi S, Nakasujja N, Sewankambo NK, Priebe S. Feasibility and outcomes of using DIALOG+ in primary care to improve quality of life and mental distress of patients with long-term physical conditions: an exploratory non-controlled study in Bosnia and Herzegovina, Colombia and Uganda. BMC PRIMARY CARE 2023; 24:241. [PMID: 37968592 PMCID: PMC10652546 DOI: 10.1186/s12875-023-02197-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 10/30/2023] [Indexed: 11/17/2023]
Abstract
INTRODUCTION The management of long-term physical conditions is a challenge worldwide, absorbing a majority resources despite the importance of acute care. The management of these conditions is done largely in primary care and so interventions to improve primary care could have an enormous impact. However, very little data exist on how to do this. Mental distress is frequently comorbid with long term physical conditions, and can impact on health behaviour and adherence, leading to poorer outcomes. DIALOG+ is a low-cost, patient-centred and solution-focused intervention, which is used in routine patient-clinician meetings and has been shown to improve outcomes in mental health care. The question arises as to whether it could also be used in primary care to improve the quality of life and mental health of patients with long-term physical conditions. This is particularly important for low- and middle-income countries with limited health care resources. METHODS An exploratory non-controlled multi-site trial was conducted in Bosnia and Herzegovina, Colombia, and Uganda. Feasibility was determined by recruitment, retention, and session completion. Patient outcomes (quality of life, anxiety and depression symptoms, objective social situation) were assessed at baseline and after three approximately monthly DIALOG+ sessions. RESULTS A total of 117 patients were enrolled in the study, 25 in Bosnia and Herzegovina, 32 in Colombia, and 60 in Uganda. In each country, more than 75% of anticipated participants were recruited, with retention rates over 90% and completion of the intervention exceeding 92%. Patients had significantly higher quality of life and fewer anxiety and depression symptoms at post-intervention follow-up, with moderate to large effect sizes. There were no significant improvements in objective social situation. CONCLUSION The findings from this exploratory trial suggest that DIALOG+ is feasible in primary care settings for patients with long-term physical conditions and may substantially improve patient outcomes. Future research may test implementation and effectiveness of DIALOG+ in randomized controlled trials in wider primary care settings in low- and middle-income countries. TRIAL REGISTRATION All studies were registered prospectively within the ISRCTN Registry. ISRCTN17003451, 02/12/2020 (Bosnia and Herzegovina), ISRCTN14018729, 01/12/2020 (Colombia) and ISRCTN50335796, 02/12/2020 (Uganda).
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Affiliation(s)
- Francois van Loggerenberg
- Youth Resilience Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
| | - Dickens Akena
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Racheal Alinaitwe
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
| | | | | | - Carlos Gómez-Restrepo
- Departments of Clinical Epidemiology and Biostatistics and Psychiatry and Mental Health, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Nejra Selak
- Primary Care Center Zenica, Zenica, Bosnia and Herzegovina
| | - Meliha Kiseljaković
- Emergency Medical Center of Canton Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Seggane Musisi
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Noeline Nakasujja
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Nelson K Sewankambo
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, East London NHS Foundation Trust, London, UK
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Goessl CL, VanWormer JJ, Pathak RD, Ellerbeck EF, Kurz DL, Befort CA. Weight change and mental health status in a behavioral weight loss trial. J Affect Disord 2023; 334:302-306. [PMID: 37156276 DOI: 10.1016/j.jad.2023.04.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 04/12/2023] [Accepted: 04/29/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Obesity, depression, and anxiety often co-occur, but research on weight change and mental health status is limited. This analysis examined how the mental component score (MCS-12) from the Short Form health survey changed over 24 months in weight loss trial participants with vs. without treatment seeking for affective symptoms (TxASx) and by weight change quintiles. METHODS Participants with complete data (n = 1163) were analyzed from enrollees in a cluster-randomized, behavioral weight loss trial in rural U.S. Midwestern primary care practices. Participants received a lifestyle intervention with different delivery models, including in-clinic individual, in-clinic group, or telephone group counseling visits. Participants were stratified by baseline TxASx status and 24-month weight change quintiles. Mixed models were used to estimate MCS-12 scores. RESULTS There was a significant group-by-time interaction at the 24-month follow-up. The largest 0-24 month increase in MCS-12 scores (+5.3 points [12 %]) was observed in participants with TxASx who lost the most weight during the trial, while the largest decrease in MCS-12 scores (-1.8 points [-3 %]) was observed in participants without TxASx who gained the most weight (p < 0.001). LIMITATIONS Notable limitations included self-reported mental health, the observational analytical design, and a largely homogenous source population, as well as the possibility of reverse causation biasing some findings. CONCLUSIONS Mental health status generally improved, particularly among participants with TxASx who experienced significant weight loss. Those without TxASx who gained weight, however, had a decline in mental health status over 24 months. Replication of these findings is warranted.
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Affiliation(s)
- Cody L Goessl
- Marshfield Clinic Research Institute, Center for Clinical Epidemiology & Population Health, Marshfield, WI, USA; Marshfield Clinic-Marshfield Medical Center, Department of Occupational Medicine, Marshfield, WI, USA
| | - Jeffrey J VanWormer
- Marshfield Clinic Research Institute, Center for Clinical Epidemiology & Population Health, Marshfield, WI, USA.
| | - Ram D Pathak
- Marshfield Clinic-Marshfield Medical Center, Department of Endocrinology, Marshfield, WI, USA
| | - Edward F Ellerbeck
- University of Kansas Medical Center, Department of Population Health, Kansas City, KS, USA
| | - Daniel L Kurz
- University of Kansas Medical Center, Department of Population Health, Kansas City, KS, USA
| | - Christie A Befort
- University of Kansas Medical Center, Department of Population Health, Kansas City, KS, USA
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Remotely delivered and clinic-delivered lifestyle interventions produced similar effects on the diet quality of participants. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01835-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Bahadori F, Jahanian Sadatmahalleh S, Montazeri A, Nasiri M. Sexuality and psychological well-being in different polycystic ovary syndrome phenotypes compared with healthy controls: a cross-sectional study. BMC Womens Health 2022; 22:390. [PMID: 36155624 PMCID: PMC9509607 DOI: 10.1186/s12905-022-01983-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 09/21/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. The present study aimed to compare the women with different PCOS phenotypes with the healty group in terms of sexual function, depression, anxiety and quality of life scale.
Materials and methods
The present cross-sectional study was carried out on 192 women with PCOS (classified on the basis of Rotterdam criteria into four categories) and 50 healthy controls. All participants were asked to fill out the valid and reliable questionnaires of FSFI (Female Sexual Function Index), HADS (Hospital Depression and Anxiety Scale) and SF-12.
Results
In the HADS questionnaire, phenotype B achieved the highest mean score in anxiety and depression domains, whereas, phenotype B had the lowest mean score in the FSFI and SF-12 quassionnaires. Furthermore, there was a significant difference between the women with PCOS phenotypes and the control grroup in arousal, lubrication, pain, and mean total score of FSFI (P < 0.05). In regression logistic analysis, age, infertility and depression were predictors of sexual dysfunction (P < 0.05).
Conclusion
The results indicated significant differences in terms of sexual dysfunction, depression, anxiety and quality of life in the women suffering from different phenotypes of PCOS compared with the healthy group. These results provide evidence that care and recommendations for improving women’s QoL and sexual function should be considered according to the relevant PCOS phenotypes.
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Conradson HE, Hayden KA, Russell‐Mayhew S, Raffin Bouchal S, King‐Shier K. Positive psychological well‐being in women with obesity: A scoping review of qualitative and quantitative primary research. Obes Sci Pract 2022; 8:691-714. [DOI: 10.1002/osp4.605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 03/30/2022] [Accepted: 04/06/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - K. Alix Hayden
- Libraries & Cultural Resources University of Calgary Calgary Alberta Canada
| | - Shelly Russell‐Mayhew
- Counselling Psychology Werklund School of Education University of Calgary Calgary Alberta Canada
| | | | - Kathryn King‐Shier
- Faculty of Nursing Department of Community Health Sciences University of Calgary Calgary Alberta Canada
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Dixon AE, Blake KV, DiMango EA, Dransfield MT, Feemster LC, Johnson O, Roy G, Hazucha H, Harvey J, McCormack MC, Wise RA, Holbrook JT. The challenge of addressing obesity in people with poorly controlled asthma. Obes Sci Pract 2021; 7:682-689. [PMID: 34877007 PMCID: PMC8633940 DOI: 10.1002/osp4.533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/07/2021] [Accepted: 05/02/2021] [Indexed: 01/10/2023] Open
Abstract
Objective There is a high prevalence of obesity in people with asthma, and obesity is associated with poorly controlled asthma. Significant weight loss might improve asthma control: the purpose of this study was to investigate patient characteristics and factors that might affect implementation of a weight loss and/or roflumilast intervention, to target both obesity and asthma. Methods A cross-sectional study of people with obesity and poorly controlled asthma performed at 13 sites across the United States. Results One hundred and two people participated in this study. Median BMI was 37 (IQR 35-42). The majority, 55%, were African American and 76% were female. Fifty two percent had very poorly controlled asthma. Most participants were quite sedentary (70% reported being inactive or participating only in light-intensity activities according to the Stanford Brief Activity Survey). Participants reported significant impairments related to physical function on the Impact of Weight on Quality of Life-Lite questionnaire (median score 67 [IQR 41-84]). Thirty-five percent of participants reported mild, and 2 % moderate, depressive symptoms as assessed by the Patient Health Questionnaire-9. Conclusions Poorly controlled asthma and obesity often affect minority populations and are associated with significant impairments in health related to physical function and low levels of physical activity that might complicate efforts to lose weight. Interventions targeted at poorly controlled asthma associated with obesity in the United States need to address factors complicating health in underserved communities, such as increasing opportunities for physical activity, while also managing activity limitations related to the combination of asthma and obesity.
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Affiliation(s)
| | | | | | | | - Laura C Feemster
- Veterans Affairs Puget Sound Health Care System Seattle Washington USA
| | | | - Gem Roy
- Center for Clinical Trials Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA
| | - Heather Hazucha
- Center for Clinical Trials Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA
| | - Jean Harvey
- University of Vermont Burlington Vermont USA
| | - Meredith C McCormack
- Center for Clinical Trials Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA
| | - Robert A Wise
- Center for Clinical Trials Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA
| | - Janet T Holbrook
- Center for Clinical Trials Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA
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Katakami N, Mita T, Yoshii H, Shiraiwa T, Yasuda T, Okada Y, Torimoto K, Umayahara Y, Kaneto H, Osonoi T, Yamamoto T, Kuribayashi N, Maeda K, Yokoyama H, Kosugi K, Ohtoshi K, Hayashi I, Sumitani S, Tsugawa M, Ryomoto K, Taki H, Nakamura T, Kawashima S, Sato Y, Watada H, Shimomura I. The Influence of Tofogliflozin on Treatment-Related Quality of Life in Patients with Type 2 Diabetes Mellitus. Diabetes Ther 2021; 12:2499-2515. [PMID: 34357559 PMCID: PMC8385006 DOI: 10.1007/s13300-021-01125-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/19/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Treatment-related quality of life (QOL) is an important aspect of diabetes management. We evaluated the influence of a sodium-glucose cotransporter 2 (SGLT2) inhibitor, tofogliflozin, on treatment-related QOL in Japanese patients with type 2 diabetes mellitus (T2DM). METHODS This is the prespecified subanalysis study of the "Using TOfogliflozin for Possible better Intervention against Atherosclerosis for type 2 diabetes patients (UTOPIA)" trial. Treatment-related QOL was evaluated at baseline, week 26, week 52, and week 104 after the initiation of the study using the Diabetes Therapy-Related QOL questionnaire (DTR-QOL). Among the 340 patients in the original UTOPIA study, a total of 252 patients (127, tofogliflozin group; 125, conventional treatment group) who completed the DTR-QOL questionnaire at baseline were the study subjects of the current subanalysis. RESULTS The tofogliflozin and conventional treatment groups exhibited almost comparable baseline clinical characteristics, while the use of antihypertensive drugs and lipid-lowering agents was significantly lower in the tofogliflozin treatment group than in the conventional treatment group. Tofogliflozin treatment increased the total score of DTR-QOL7 from baseline (P < 0.001), while conventional treatment did not change it. There were statistically significant differences in delta change in the total DTR-QOL7 score and DTR-QOL7 Q4, Q5, Q6, and Q7 scores from the baseline to week 104 between the treatment groups. Delta changes in HbA1c (Spearman's correlation coefficient, ρ = - 0.30, P < 0.001), fasting blood glucose (ρ = - 0.16, P = 0.031), BMI (ρ = - 0.19, P = 0.008), and waist circumference (ρ = - 0.17, P = 0.024) at week 104 were negatively associated with delta change in the total QOL7 score. CONCLUSIONS Our data indicated that tofogliflozin treatment improved treatment-related QOL compared to conventional treatment in Japanese patients with T2DM, in accordance with the improvement of major cardiovascular risk factors. TRIAL REGISTRATION UMIN000017607.
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Affiliation(s)
- Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
- Department of Metabolism and Atherosclerosis, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Tomoya Mita
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hidenori Yoshii
- Department of Medicine, Diabetology and Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Koto-ku, Tokyo, 136-0075, Japan
| | - Toshihiko Shiraiwa
- Shiraiwa Medical Clinic, 4-10-24 Hozenji, Kashiwara, Osaka, 582-0005, Japan
| | - Tetsuyuki Yasuda
- Department of Diabetes and Endocrinology, Osaka Police Hospital, 10-31, Kitayama-cho, Tennoji-ku, Osaka, 543-0035, Japan
| | - Yosuke Okada
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| | - Keiichi Torimoto
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| | - Yutaka Umayahara
- Department of Diabetes and Endocrinology, Osaka General Medical Center, 3-1-56, Bandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Hideaki Kaneto
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Takeshi Osonoi
- Nakakinen Clinic, 745-5, Nakadai, Naka, Ibaraki, 311-0113, Japan
| | - Tsunehiko Yamamoto
- Diabetes and Endocrinology, Kansai Rosai Hospital, 3-1-69, Inabaso, Amagasaki, Hyogo, Japan
| | | | - Kazuhisa Maeda
- Kitasenri Maeda Clinic, 4-119, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Hiroki Yokoyama
- Jiyugaoka Medical Clinic, West 6, South 6-4-3, Obihiro, Hokkaido, 080-0016, Japan
| | - Keisuke Kosugi
- Kosugi Medical Clinic, 3-9, Tamatsukurimoto-cho, Tennoji-ku, Osaka, 543-0014, Japan
| | - Kentaro Ohtoshi
- Otoshi Medical Clinic, 8-47, Kakudacho, Osaka Kita-ku, Osaka, 530-0017, Japan
| | - Isao Hayashi
- Hayashi Clinic, 3-9-23, Koshienguchi, Nishinomiya, Hyogo, 663-8113, Japan
| | - Satoru Sumitani
- Center for Diabetes and Endocrinology, Nippon Life Hospital, 2-1-54 Enokojima, Nishi-ku, Osaka, 550-0006, Japan
| | - Mamiko Tsugawa
- Department of Endocrinology and Metabolism, Ikeda Municipal Hospital, 3-1-18, Jonan, Ikeda, Osaka, 563-8510, Japan
| | - Kayoko Ryomoto
- Center for Diabetes Mellitus, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Hideki Taki
- Diabetes Center, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan
| | - Tadashi Nakamura
- Department of Internal Medicine, Kawasaki Hospital, 3-3-1, Higashiyamacho, Hyogo-ku, Kobe, Hyogo, 652-0042, Japan
| | - Satoshi Kawashima
- Kanda Naika Clinic, 5-21-3, Hannancho, Osaka Abeno-ku, Osaka, 545-0021, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, 45 Shinanomachi Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hirotaka Watada
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
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Lopes ACS, Lopes MS, Duarte CK, de Freitas PP. Longitudinal effect of nutritional intervention on body weight: A randomized controlled trial. Nutrition 2021; 93:111436. [PMID: 34479045 DOI: 10.1016/j.nut.2021.111436] [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: 12/22/2020] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES This study evaluates, in the medium and long term (12, 36, and 48 mo), the effect of an intervention to promote consumption of fruit and vegetables on the body weight of Brazilian primary health care users. METHODS A follow-up with participants (n = 3414) in a controlled randomized trial was performed in a primary health care service. Those in the control group performed the service's usual intervention (guided physical exercise 3 times/wk), and those in the intervention group additionally participated for 7 mo in collective activities to promote consumption of fruit and vegetables. Sociodemographic, health, and body weight data were collected by face-to-face interview at baseline and after 12 mo. At 36 and 48 mo, weight was obtained by telephone interview and was validated. Adherence to the intervention was assessed by the presence of the actions. Weight change (Δ) was measured by subtracting the weight at each follow-up time from the baseline measurement. RESULTS Participants in both groups had a minor weight loss of about 0.1 kg over 12, 36, and 48 mo. The addition of an intervention for consumption of fruit and vegetables did not enhance this effect. Higher weight loss was observed in individuals with obesity classes II and III with low adherence in the intervention and after 36 mo (Δ = -27.1 kg; P = 0.024). CONCLUSIONS Participating in the primary health care service contributed to a small reduction in weight, and the intervention for consumption of fruit and vegetables did not enhance this effect. However, greater weight loss was observed in participants with obesity and those who adhered to the intervention.
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Affiliation(s)
- Aline Cristine Souza Lopes
- Department of Nutrition, Universidade Federal de Minas Gerais, Research Group in Nutrition Interventions (GIN-UFMG), Santa Efigênia, Brazil.
| | - Mariana Souza Lopes
- Department of Nutrition, Universidade Federal de Minas Gerais, Research Group in Nutrition Interventions (GIN-UFMG), Santa Efigênia, Brazil
| | - Camila Kummel Duarte
- Department of Nutrition, Universidade Federal de Minas Gerais, Research Group in Nutrition Interventions (GIN-UFMG), Santa Efigênia, Brazil
| | - Patrícia Pinheiro de Freitas
- Department of Preventive and Social Medicine, Universidade Federal de Minas Gerais, Research Group in Nutrition Interventions (GIN-UFMG), Santa Efigênia, Brazil
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Semlitsch T, Krenn C, Jeitler K, Berghold A, Horvath K, Siebenhofer A. Long-term effects of weight-reducing diets in people with hypertension. Cochrane Database Syst Rev 2021; 2:CD008274. [PMID: 33555049 PMCID: PMC8093137 DOI: 10.1002/14651858.cd008274.pub4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND All major guidelines for antihypertensive therapy recommend weight loss. Dietary interventions that aim to reduce body weight might therefore be a useful intervention to reduce blood pressure and adverse cardiovascular events associated with hypertension. OBJECTIVES Primary objectives To assess the long-term effects of weight-reducing diets in people with hypertension on all-cause mortality, cardiovascular morbidity, and adverse events (including total serious adverse events, withdrawal due to adverse events, and total non-serious adverse events). Secondary objectives To assess the long-term effects of weight-reducing diets in people with hypertension on change from baseline in systolic blood pressure, change from baseline in diastolic blood pressure, and body weight reduction. SEARCH METHODS For this updated review, the Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to April 2020: the Cochrane Hypertension Specialised Register, CENTRAL (2020, Issue 3), Ovid MEDLINE, Ovid Embase, and ClinicalTrials.gov. We also contacted authors of relevant papers about further published and unpublished work. The searches had no language restrictions. SELECTION CRITERIA We included randomised controlled trials (RCTs) of at least 24 weeks' duration that compared weight-reducing dietary interventions to no dietary intervention in adults with primary hypertension. DATA COLLECTION AND ANALYSIS Two review authors independently assessed risks of bias and extracted data. Where appropriate and in the absence of significant heterogeneity between studies (P > 0.1), we pooled studies using a fixed-effect meta-analysis. In case of moderate or larger heterogeneity as measured by Higgins I2, we used a random-effects model. MAIN RESULTS This second review update did not reveal any new trials, so the number of included trials remains the same: eight RCTs involving a total of 2100 participants with high blood pressure and a mean age of 45 to 66 years. Mean treatment duration was 6 to 36 months. We judged the risks of bias as unclear or high for all but two trials. No study included mortality as a predefined outcome. One RCT evaluated the effects of dietary weight loss on a combined endpoint consisting of the necessity of reinstating antihypertensive therapy and severe cardiovascular complications. In this RCT, weight-reducing diet lowered the endpoint compared to no diet: hazard ratio 0.70 (95% confidence interval (CI) 0.57 to 0.87). None of the trials evaluated adverse events as designated in our protocol. The certainty of the evidence was low for a blood pressure reduction in participants assigned to weight-loss diets as compared to controls: systolic blood pressure: mean difference (MD) -4.5 mm Hg (95% CI -7.2 to -1.8 mm Hg) (3 studies, 731 participants), and diastolic blood pressure: MD -3.2 mm Hg (95% CI -4.8 to -1.5 mm Hg) (3 studies, 731 participants). We judged the certainty of the evidence to be high for weight reduction in dietary weight loss groups as compared to controls: MD -4.0 kg (95% CI -4.8 to -3.2) (5 trials, 880 participants). Two trials used withdrawal of antihypertensive medication as their primary outcome. Even though we did not consider this a relevant outcome for our review, the results of these RCTs strengthen the finding of a reduction of blood pressure by dietary weight-loss interventions. AUTHORS' CONCLUSIONS In this second update, the conclusions remain unchanged, as we found no new trials. In people with primary hypertension, weight-loss diets reduced body weight and blood pressure, but the magnitude of the effects are uncertain due to the small number of participants and studies included in the analyses. Whether weight loss reduces mortality and morbidity is unknown. No useful information on adverse effects was reported in the relevant trials.
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Affiliation(s)
- Thomas Semlitsch
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria
| | - Cornelia Krenn
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria
| | - Klaus Jeitler
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria
| | - Andrea Berghold
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Karl Horvath
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria
| | - Andrea Siebenhofer
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria
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The Effect of Lifestyle Intervention on Health-Related Quality of Life in Adults with Metabolic Syndrome: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030887. [PMID: 33498570 PMCID: PMC7908372 DOI: 10.3390/ijerph18030887] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 01/22/2023]
Abstract
The aim of this meta-analysis was to assess the effects of a lifestyle intervention through health education on nutrition, physical activity, and healthy habits on physical and mental health-related quality of life (HRQoL), in adults with metabolic syndrome (MetS). The databases used were PubMed, WOS, and Scopus. The inclusion criteria were: observational, longitudinal and randomized clinical trial (RCT) study designs, adults (both sexes), with at least two criteria of MetS, lifestyle intervention and comparison with a control group, and a measurement of HRQoL with a validated questionnaire. We analyzed the Hedges’ g and SF-36 score. I2 statistics were calculated and possible publication and small study biases were assessed using Egger’s test and funnel plots. Seven RCTs were selected for meta-analysis, based on 637 study participants. Significant improvements were found in the physical dimensions of the HRQoL scores for subjects in the active intervention compared to the group that received general lifestyle information (Hedges’ g 0.61, 95% confidence interval (CI) = 0.31–0.91). Mental health-related quality of life was also significantly improved in the intervention group compared with the control group (Hedges’ g 0.84, 95% CI = 0.64–1.03). In conclusion, our results suggest that, according to the RCTs selected for this meta-analysis, a lifestyle intervention significantly improves HRQoL in all its domains.
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12
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O'Connor EA, Evans CV, Rushkin MC, Redmond N, Lin JS. Behavioral Counseling to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults With Cardiovascular Risk Factors: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2020; 324:2076-2094. [PMID: 33231669 DOI: 10.1001/jama.2020.17108] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
IMPORTANCE Cardiovascular disease is the leading cause of death in the US, and poor diet and lack of physical activity are major factors contributing to cardiovascular morbidity and mortality. OBJECTIVE To review the benefits and harms of behavioral counseling interventions to improve diet and physical activity in adults with cardiovascular risk factors. DATA SOURCES MEDLINE, PubMed, PsycINFO, and the Cochrane Central Register of Controlled Trials through September 2019; literature surveillance through July 24, 2020. STUDY SELECTION English-language randomized clinical trials (RCTs) of behavioral counseling interventions to help people with elevated blood pressure or lipid levels improve their diet and increase physical activity. DATA EXTRACTION AND SYNTHESIS Data were extracted from studies by one reviewer and checked by a second. Random-effects meta-analysis and qualitative synthesis were used. MAIN OUTCOMES AND MEASURES Cardiovascular events, mortality, subjective well-being, cardiovascular risk factors, diet and physical activity measures (eg, minutes of physical activity, meeting physical activity recommendations), and harms. Interventions were categorized according to estimated contact time as low (≤30 minutes), medium (31-360 minutes), and high (>360 minutes). RESULTS Ninety-four RCTs were included (N = 52 174). Behavioral counseling interventions involved a median of 6 contact hours and 12 sessions over the course of 12 months and varied in format and dietary recommendations; only 5% addressed physical activity alone. Interventions were associated with a lower risk of cardiovascular events (pooled relative risk, 0.80 [95% CI, 0.73-0.87]; 9 RCTs [n = 12 551]; I2 = 0%). Event rates were variable; in the largest trial (Prevención con Dieta Mediterránea [PREDIMED]), 3.6% in the intervention groups experienced a cardiovascular event, compared with 4.4% in the control group. Behavioral counseling interventions were associated with small, statistically significant reductions in continuous measures of blood pressure, low-density lipoprotein cholesterol levels, fasting glucose levels, and adiposity at 12 to 24 months' follow-up. Measurement of diet and physical activity was heterogeneous, and evidence suggested small improvements in diet consistent with the intervention recommendation targets but mixed findings and a more limited evidence base for physical activity. Adverse events were rare, with generally no group differences in serious adverse events, any adverse events, hospitalizations, musculoskeletal injuries, or withdrawals due to adverse events. CONCLUSIONS AND RELEVANCE Medium- and high-contact multisession behavioral counseling interventions to improve diet and increase physical activity for people with elevated blood pressure and lipid levels were effective in reducing cardiovascular events, blood pressure, low-density lipoproteins, and adiposity-related outcomes, with little to no risk of serious harm.
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Affiliation(s)
- Elizabeth A O'Connor
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Corinne V Evans
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Megan C Rushkin
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Nadia Redmond
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Jennifer S Lin
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
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13
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Pearl RL, Wadden TA, Chao AM, Walsh O, Alamuddin N, Berkowitz RI, Tronieri JS. Weight Bias Internalization and Long-Term Weight Loss in Patients With Obesity. Ann Behav Med 2020; 53:782-787. [PMID: 30304382 DOI: 10.1093/abm/kay084] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The relationship between weight bias internalization (WBI) and long-term weight loss is largely unknown. PURPOSE To determine the effects of weight loss on WBI and assess whether WBI impairs long-term weight loss. METHODS One hundred thirty-three adults with obesity completed the Weight Bias Internalization Scale (WBIS) at baseline, after a 14-week lifestyle intervention in which they lost ≥5 per cent of initial weight, and at weeks 24 and 52 of a subsequent randomized controlled trial (RCT) for weight-loss maintenance (66 weeks total). Linear mixed models were used to examine the effects of weight loss on WBIS scores and the effects of baseline WBIS scores on weight change over time. Logistic regression was used to determine the effects of baseline WBIS scores on achieving ≥5 and ≥10 per cent weight loss. RESULTS Changes in weight did not predict changes in WBIS scores. Baseline WBIS scores predicted reduced odds of achieving ≥5 and ≥10 per cent weight loss at week 24 of the RCT (p values < .05). At week 52, the interaction between participant race and WBIS scores predicted weight loss (p = .046) such that nonblack (but not black) participants with higher baseline WBIS scores had lower odds of achieving ≥10 per cent weight loss (OR = 0.38, p = .01). Baseline WBIS scores did not significantly predict rate of weight change over time. CONCLUSIONS Among participants in a weight loss maintenance trial, WBI did not change in relation to changes in weight. More research is needed to clarify the effects of WBI on long-term weight loss and maintenance across race/ethnicity. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov identifier NCT02388568.
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Affiliation(s)
- Rebecca L Pearl
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.,Department of Surgery, Edwin and Fannie Gray Hall Center for Human Appearance, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Thomas A Wadden
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Ariana M Chao
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.,Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - Olivia Walsh
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Naji Alamuddin
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.,Department of Medicine, Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Robert I Berkowitz
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, PA
| | - Jena Shaw Tronieri
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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14
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Hoerster KD, Collins MP, Au DH, Lane A, Epler E, McDowell J, Barón AE, Rise P, Plumley R, Nguyen T, Schooler M, Schuttner L, Ma J. Testing a self-directed lifestyle intervention among veterans: The D-ELITE pragmatic clinical trial. Contemp Clin Trials 2020; 95:106045. [PMID: 32473403 PMCID: PMC7253950 DOI: 10.1016/j.cct.2020.106045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/12/2020] [Accepted: 05/25/2020] [Indexed: 02/04/2023]
Abstract
Nearly half of Veterans have obesity, fueling chronic diseases. The Department of Veterans Affairs (VA) offers an evidence-based behavioral weight management intervention called MOVE!, mostly delivered through in-person group sessions. Few eligible Veterans participate due to factors like distance and preferences, mirroring barriers in the general population. Practical alternatives to standard in-person programs are needed to improve access and engagement. A self-directed lifestyle intervention called D-ELITE-delivered through pre-recorded videos by DVD or online streaming-previously efficacious in a general primary care population, may provide such an alternative. This pragmatic clinical trial will evaluate whether D-ELITE improves weight and general health status among Veterans with obesity, relative to VA usual care. The yearlong intervention includes one orientation by phone, supplemental lifestyle coaching primarily via technology-based messages, 12 DVD or online streaming sessions over 3 months, and continued self-directed weight management for months 4-12. Participants use MyFitnessPal.com or paper booklets for self-monitoring weight, diet, and physical activity. Follow-up assessments at 12 and 24 months are administered by mail or phone. The study hypothesis is that compared with usual care, D-ELITE will lead to greater improvements in 12-month weight loss, per VA electronic health records, and general physical health status, assessed using the self-reported SF-12 physical composite score. We will also explore D-ELITE's effects on secondary biometric (e.g., HbA1c) and intermediate (e.g., diet) outcomes, reach, and budget impact. If effective, D-ELITE will offer a potentially scalable, low-cost alternative to VA's existing weight loss interventions by mitigating barriers presented by distance and technology.
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Affiliation(s)
- Katherine D Hoerster
- VA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States; VA Puget Sound Healthcare System, Seattle Division, Mental Health Service, 1660 South Columbian Way (S-116), Seattle, WA 98108, United States; University of Washington, Department of Psychiatry and Behavioral Sciences, 1100 NE 45(th) Street, Suite 300, Seattle, WA 98105, United States.
| | - Margaret P Collins
- VA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States.
| | - David H Au
- VA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States; University of Washington, Department of Medicine, 1959 NE Pacific St, Seattle, WA 98195, United States.
| | - Amber Lane
- VA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States.
| | - Eric Epler
- VA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States.
| | - Jennifer McDowell
- VA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States.
| | - Anna E Barón
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13001 E. 17(th) Place, Aurora, CO 80045, United States.
| | - Peter Rise
- VA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States.
| | - Robert Plumley
- VA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States.
| | - Tanya Nguyen
- VA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States.
| | - Mary Schooler
- VA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States.
| | - Linnaea Schuttner
- VA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development, 1660 South Columbian Way (S-152), Seattle, WA 98108, United States; University of Washington, Department of Medicine, 1959 NE Pacific St, Seattle, WA 98195, United States.
| | - Jun Ma
- University of Illinois at Chicago, Department of Medicine, 1747 W. Roosevelt Rd, Room 586 (MC 275), Chicago, IL 60608, United States.
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15
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Tate DF, Quesnel DA, Lutes L, Hatley KE, Nezami BT, Wojtanowski AC, Pinto AM, Power J, Diamond M, Polzien K, Foster G. Examination of a partial dietary self-monitoring approach for behavioral weight management. Obes Sci Pract 2020; 6:353-364. [PMID: 32874670 PMCID: PMC7448156 DOI: 10.1002/osp4.416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 02/18/2020] [Accepted: 02/21/2020] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Dietary self-monitoring in behavioral weight loss programmes traditionally involves keeping track of all foods and beverages to achieve a calorie deficit. While effective, adherence declines over time. WW™ (formerly Weight Watchers), a widely available commercial weight management programme, sought to pilot an approach that permitted participants to consume over 200 foods without monitoring them. METHODS The current study used a pre-post evaluation design with anthropometric, psychosocial and physical health assessments at baseline, 3 and 6 months. RESULTS Participants (N = 152) were, on average, 48.4 (±12.3) years old, with body mass index (BMI) of 32.8 (±4.8) m/kg2 and 94% female. Mean weight loss was 6.97 + 5.55 kg or 7.9 ± 6.1% of initial body weight (ps < .0001) at 6 months. One third (32.6%) of the sample lost 10% or more of initial body weight. Significant improvements in hunger, cravings, happiness, sleep, quality of life, aerobic stamina, flexibility and blood pressure were observed. Attendance at group meetings, as well as decreases in hunger, and fast food cravings from baseline to 3 months were associated with achieving 10% weight loss at 6 months (p < .01). CONCLUSIONS Using an approach that does not require self-monitoring of all foods and beverages produced significant weight losses and other physical and psychosocial improvements.
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Affiliation(s)
- Deborah F. Tate
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of Health BehaviorUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- WWNew YorkNYUSA
| | - Danika A. Quesnel
- Department of PsychologyUniversity of British Columbia, Okanagan CampusKelownaBritish ColumbiaCanada
| | - Lesley Lutes
- Department of PsychologyUniversity of British Columbia, Okanagan CampusKelownaBritish ColumbiaCanada
| | - Karen E. Hatley
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Brooke T. Nezami
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | | | | | - Julianne Power
- Department of Health BehaviorUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Molly Diamond
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Kristen Polzien
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Gary Foster
- WWNew YorkNYUSA
- Center for Weight and Eating Disorders, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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16
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Sánchez-Ferrer ML, Adoamnei E, Prieto-Sánchez MT, Mendiola J, Corbalán-Biyang S, Moñino-García M, Palomar-Rodríguez JA, Torres-Cantero AM. Health-related quality of life in women with polycystic ovary syndrome attending to a tertiary hospital in Southeastern Spain: a case-control study. Health Qual Life Outcomes 2020; 18:232. [PMID: 32677953 PMCID: PMC7364602 DOI: 10.1186/s12955-020-01484-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 07/08/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a chronic condition with symptoms affecting many women at reproductive age and evaluating their health-related quality of Life (HRQoL) is an important issue. Moreover, differences in the HRQoL between women with different PCOS phenotypes have never been analyzed. Therefore, the aim of our study was to compare the HRQoL between women with PCOS -and its phenotypes- and controls attending to a tertiary hospital. METHODS A group of 117 women with PCOS and 153 controls were studied between 2014 and 2016. Controls were women without PCOS attending the gynecological outpatient clinic for routine examinations. Cases were women attending the same setting and diagnosed with PCOS. PCOS diagnose was performed following the Rotterdam Criteria and women were further classified by anovulatory or ovulatory phenotypic subtype. Women underwent physical and gynecological exams and completed health questionnaires including the Short Form-12v2. Eight scales and two component summary scores [Physical (PCS) and Mental (MCS), respectively] were calculated. Bivariate and multivariate analyses were performed to assess differences in HRQoL between women with PCOS and controls. RESULTS All women with PCOS and anovulatory PCOS presented lower score in PCS compared to controls [mean (95%CI): 53.7 (52.5-54.9) and 52.9 (51.5-54.4) vs. 55.8 (54.8-56.8); p-values< 0.01], as well as lower scores for five out of the eight scales (p-values < 0.05) after adjusting by age, body mass index, infertility, educational level and current occupation. No significant differences were observed for the MCS between women with or without PCOS or its phenotypic subtypes. CONCLUSIONS HRQoL was significantly decreased in adult women with PCOS and its anovulatory phenotype compared to controls attending the outpatient clinic of a tertiary hospital. These results may have implications for the clinical practice and suggest the need for specific interventions in women with PCOS.
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Affiliation(s)
- María L Sánchez-Ferrer
- Department of Obstetrics & Gynecology, "Virgen de la Arrixaca" University Clinical Hospital, 30120, El Palmar (Murcia), Spain.,Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120, El Palmar (Murcia), Spain
| | - Evdochia Adoamnei
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120, El Palmar (Murcia), Spain. .,Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, 30100, Espinardo (Murcia), Spain.
| | - María T Prieto-Sánchez
- Department of Obstetrics & Gynecology, "Virgen de la Arrixaca" University Clinical Hospital, 30120, El Palmar (Murcia), Spain.,Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120, El Palmar (Murcia), Spain
| | - Jaime Mendiola
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120, El Palmar (Murcia), Spain.,Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, 30100, Espinardo (Murcia), Spain.,Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain
| | - Shiana Corbalán-Biyang
- Department of Obstetrics & Gynecology, "Virgen de la Arrixaca" University Clinical Hospital, 30120, El Palmar (Murcia), Spain
| | - Miriam Moñino-García
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120, El Palmar (Murcia), Spain.,Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, 30100, Espinardo (Murcia), Spain
| | - Joaquín A Palomar-Rodríguez
- Servicio de Planificación y Financiación Sanitaria, Consejería de Salud, Región de Murcia, 30001, Murcia, Spain
| | - Alberto M Torres-Cantero
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120, El Palmar (Murcia), Spain.,Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, 30100, Espinardo (Murcia), Spain.,Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain.,Department of Preventive Medicine, "Virgen de la Arrixaca" University Clinical Hospital, 30120, El Palmar (Murcia), Spain
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Bauer K, Lau T, Schwille‐Kiuntke J, Schild S, Hauner H, Stengel A, Zipfel S, Mack I. Conventional weight loss interventions across the different
BMI
obesity classes: A systematic review and quantitative comparative analysis. EUROPEAN EATING DISORDERS REVIEW 2020; 28:492-512. [DOI: 10.1002/erv.2741] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/29/2020] [Accepted: 04/13/2020] [Indexed: 01/16/2023]
Affiliation(s)
- Kerstin Bauer
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
| | - Teresa Lau
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
| | - Juliane Schwille‐Kiuntke
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
- Institute of Occupational and Social Medicine and Health Services Research University of Tübingen Tübingen Germany
| | - Sandra Schild
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
| | - Hans Hauner
- Institute of Nutritional Medicine, School of Medicine Technical university of Munich Munich Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine Charité‐Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
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Paineiras-Domingos LL, Sá-Caputo DDC, Francisca-Santos A, Reis-Silva A, Carvalho-Lima RP, Neves MFT, Xavier VL, Quinart H, Boyer FC, Sartorio A, Taiar R, Bernardo-Filho M. Can whole body vibration exercises promote improvement on quality of life and on chronic pain level of metabolic syndrome patients? A pseudorandomized crossover study. J Appl Physiol (1985) 2020; 128:934-940. [PMID: 32078471 DOI: 10.1152/japplphysiol.00068.2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Quality of life (QoL) is one of the most important health outcome concepts expressed subjectively. Chronic pain (CP) is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Taking into account the poor QoL and the CP already described in metabolic syndrome (MSy) individuals, this study aimed to evaluate the effects of whole body vibration exercises (WBVE) on these parameters in this population. Thirty-three MSy patients were divided in subgroups A [whole body vibration exercise group (WBVeG), n = 17, 15 females/2 males, 61.1 ± 8.4 yr] and B (control group, n = 16, 14 females/2 males, 58.2 ± 9.1 yr). Subgroup A performed 10 sessions (2 times/wk) of WBVE (18 min/session, with a frequency from 5 up to 14 Hz and a peak-to-peak displacement of 2.5, 5.0, and 7.5 mm) on a side-alternating vibrating platform (VP). Subgroup B did the same protocol, but the VP was turned off. The individuals answered the World Health Organization Quality of Life bref (WHOQoL-bref) questionnaire before the first and after the 10th session. The chronic pain level (CPL) was measured by a numeric rating scale (0-10) before and at the end of each session. Significant improvements were found in physical health (P = 0.05) and psychological health (P = 0.04) domains of WHOQoL-bref in WBVeG. A significant acute reduction of the CPL was found in the WBVeG after the protocol, considering the first session and at the last session. WBVE marginally improved physical health and psychological health and decrease the CPL in acute interventions.NEW & NOTEWORTHY Metabolic syndrome patients experience poor quality of life, frequently associated with lack of exercise and bad dietary habits. Additionally, factors such as obesity, neuromusculoskeletal impairment, and peripheral endothelial dysfunction result in a chronic pain level. Whole body vibration exercise might represent a suitable physical therapy, since it is easy to perform, low cost, safe, and capable of promoting an improvement of quality of life and reducing chronic pain level during acute interventions in metabolic syndrome individuals.
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Affiliation(s)
- Laisa Liane Paineiras-Domingos
- Programa de Pós-Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes e Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Faculdade Bezerra de Araújo, Rio de Janeiro, Brazil
| | - Danúbia da Cunha Sá-Caputo
- Programa de Pós-Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes e Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Faculdade Bezerra de Araújo, Rio de Janeiro, Brazil
| | - Arlete Francisca-Santos
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes e Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Faculdade Bezerra de Araújo, Rio de Janeiro, Brazil
| | - Aline Reis-Silva
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes e Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Mestrado Profissional em Saúde, Medicina Laboratorial e Tecnologia Forense, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafaelle Pacheco Carvalho-Lima
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes e Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mario Fritsch T Neves
- Departamento de Clínica Médica do HUPE, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vinicius Layter Xavier
- Departamento de Estatística, Instituto de Matemática e Estatística, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Hervé Quinart
- Institut de Formation en Masso-kinésithérapie, Reims, France
| | - François Constant Boyer
- Physical and Rehabilitation Medicine Department, Sebastopol Hospital, University of Reims Champagne-Ardenne, France
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-endocrinological Research, Milan and Verbania, Italy
| | - Redha Taiar
- University of Reims Champagne-Ardenne, France
| | - Mario Bernardo-Filho
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes e Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Hollis G, Franz R, Bauer J, Bell J. Implementation of a very low calorie diet program into the pre‐operative model of care for obese general elective surgery patients: Outcomes of a feasibility randomised control trial. Nutr Diet 2020; 77:490-498. [DOI: 10.1111/1747-0080.12601] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 11/15/2019] [Accepted: 11/22/2019] [Indexed: 12/29/2022]
Affiliation(s)
| | - Robert Franz
- Department of General Surgery The Prince Charles Hospital Brisbane Australia
| | - Judy Bauer
- School of Human Movement and Nutrition Sciences The University of Queensland Brisbane Queensland Australia
| | - Jack Bell
- The Prince Charles Hospital Brisbane Australia
- School of Human Movement and Nutrition Sciences The University of Queensland Brisbane Queensland Australia
- Allied Health Research Collaborative Metro North Hospital and Health Service Brisbane Australia
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Langston K, Ross LJ, Byrnes A, Hay R. Secondary-prevention behaviour-change strategy for high-risk patients: Benefits for all classes of body mass index. Nutr Diet 2020; 77:499-507. [PMID: 31919951 DOI: 10.1111/1747-0080.12605] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 11/01/2019] [Accepted: 11/29/2019] [Indexed: 10/25/2022]
Abstract
AIM Research is needed to support the long-term benefits of lifestyle interventions for management of high-risk patients with different BMI classifications. This prospective multicentre study assessed two-year outcomes of hospital-referred patients (BMI 25-61 kg/m2 ) attending a dietitian-led multidisciplinary Healthy Eating and Lifestyle Behaviour-Change Program in group or individual formats in hospital outpatient settings. METHODS Bodyweight, quality of life (Short Form-12) and intuitive eating (Intuitive Eating Scale) data were collected at pre-intervention, post-intervention and 2 years. Outcomes were reported in BMI classes. RESULTS At pre-intervention (n = 493), 11% had pre-obesity, 25% obesity class I, 30% obesity class II and 34% obesity class III. Characteristics of participants with available data at post-intervention (n = 290) and 2 years (n = 178) were comparable (P > .05). Significant mean weight loss was seen at post-intervention (-2.0 ± 0.4 kg, P < .001, n = 290) and 2 years (-4.3 ± 0.5 kg, P < .001, n = 178). All BMI classes had significant weight losses (P < .05). Participants with higher obesity (classes II and III) had greater improvements in mental quality of life (P < .05) and initial weight reductions (P < .05) than those with lower classes. However, those with obesity class I had the greatest long-term weight reductions and significant improvements in physical quality of life at 2 years (P < .05). All BMI classes reported similar improvements in intuitive eating. No effect was found for differences in intervention format, duration or setting (P > .05). CONCLUSIONS The results support dietitian-led multidisciplinary lifestyle interventions for multidisciplinary management of high-risk patients of all BMI classes.
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Affiliation(s)
- Keanne Langston
- Nutrition & Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Lynda J Ross
- Nutrition & Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.,Nutrition and Dietetics Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Southport, Queensland, Australia
| | - Angela Byrnes
- Nutrition & Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.,Nutrition and Dietetics Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Robin Hay
- Nutrition and Dietetics Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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Weight loss is associated with improved quality of life among rural women completers of a web-based lifestyle intervention. PLoS One 2019; 14:e0225446. [PMID: 31743365 PMCID: PMC6863546 DOI: 10.1371/journal.pone.0225446] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 11/01/2019] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The evidence for whether weight loss following longer-term lifestyle interventions results in improved health-related quality of life (HRQoL) is inconclusive. This study examines whether women who lose weight after completing an 18-month web-based lifestyle modification intervention would report a corresponding improvement in HRQoL as measured using the Patient-Reported Outcomes Measurement Information System 29-item profile (PROMIS-29 v1.0). METHODS Data from 216 rural women, ages 40 to 69, with baseline and 18-month PROMIS-29 data were analyzed in this secondary analysis of the Women Weigh-in for Wellness clinical trial. This trial promoted lifestyle modification for initial weight loss (baseline to 6 months) and guided weight loss (6 months to 18 months) using a web-delivery format. RESULTS After adjusting for age, number of comorbidities, change in physical activity from baseline, intervention group, and baseline PROMIS-29 scores, change in weight was associated with improved health-related quality of life (HRQoL) in the domains of depression, physical function, pain interference, fatigue, and satisfaction with social role. Logistic regressions, adjusting for the same factors, indicated women with ≥ 10% weight loss were more likely to report lower depression, higher physical function and less pain interference, compared to women who gained weight or lost < 5%. CONCLUSIONS Among our rural women, a loss in weight from baseline appeared to be associated with overall improvement in multiple PROMIS-29 v 1.0 domains, noting the likelihood of achieving improvement was significantly higher among women who attained ≥ 10% weight loss. These findings may positively influence a woman's adherence to lifestyle modification weight loss and weight maintenance program. TRIAL REGISTRATION ClinicalTrials.gov NCT01307644.
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Haas K, Hayoz S, Maurer-Wiesner S. Effectiveness and Feasibility of a Remote Lifestyle Intervention by Dietitians for Overweight and Obese Adults: Pilot Study. JMIR Mhealth Uhealth 2019; 7:e12289. [PMID: 30973338 PMCID: PMC6482396 DOI: 10.2196/12289] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/10/2019] [Accepted: 02/12/2019] [Indexed: 12/24/2022] Open
Abstract
Background To tackle the problem of obesity and related diseases in Switzerland, cost-efficient, effective, and innovative primary health care interventions for weight management are required. In this context, Oviva has developed a scalable technology for registered dietitians to counsel overweight and obese patients via a mobile phone app. Objective The aim of this study was to evaluate the effectiveness and feasibility of weight loss counseling by dietitians using a mobile phone app for patients with overweight and obesity. Methods In this pre- and posttest pilot study, overweight and obese adults participated in a 1-year behavioral intervention to lose weight through remote counseling by dietitians in the German-speaking part of Switzerland. The study started in April 2016 and finished in May 2018. Participants received individual counseling through the app and the exchange with the dietitian focused on regular feedback on photo-based food log, motivation, and education. The contents were tailored to the individual lifestyle goal set. The predefined intensity of remote counseling decreased during the year. Group chat could be used. The outcomes examined were changes in weight (primary outcome), hemoglobin A1c, fasting glucose, fasting insulin, triglyceride, high-density lipoprotein cholesterol, blood pressure (BP), body mass index (BMI), waist circumference, body fat, and responses to a self-administered questionnaire with questions regarding participants’ physical activity, dietary assessment, and health-related quality of life. Changes were tested at baseline, after 3 months, and after 12 months, as well as between the third and the 12th month. Results In total, 36 women and 7 men, with a mean age of 40.6 years, participated and 36 participants completed the study. Median weight change after the first 12 weeks was −3.8 kg (range: −15 to 2.4 and P<.001), between week 12 and week 52 it was −1.1 kg (range: −9.7 to 7 and P=.08), and the median change during the entire period of intervention was −4.9 kg (range: −21.9 to 7.5 and P<.001). Furthermore, changes in BMI, waist circumference, body fat, and BP between baseline and 12 weeks and between baseline and 52 weeks were also significant. Significant changes in certain eating habits were also demonstrated (higher frequency of vegetable, fruit, and breakfast consumption and lower frequency of alcohol, sweet, and fat consumption). Conclusions In addition to the professional skills of a dietitian, a profession-specific app such as Oviva can provide effective support that meets the needs of dietitians and clients on the long path of behavioral change and sustainable weight reduction. Trial Registration ClinicalTrials.gov NCT02694614; https://clinicaltrials.gov/ct2/show/NCT02694614 (Archived by WebCite at http://www.webcitation.org/76gYkGOIc)
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Affiliation(s)
- Karin Haas
- Applied Research & Development Nutrition and Dietetics, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Stefanie Hayoz
- Applied Research & Development Nutrition and Dietetics, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
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Lillis J, Thomas JG, Olson K, Wing RR. Weight self-stigma and weight loss during behavioural weight loss intervention. Obes Sci Pract 2019; 5:21-27. [PMID: 30847224 PMCID: PMC6381303 DOI: 10.1002/osp4.314] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 11/21/2018] [Accepted: 11/24/2018] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Despite the myriad negative effects of weight self-stigma, its role in weight loss intervention has not been thoroughly examined. The aim of this study was to examine the association between weight self-stigma and weight loss. METHODS This longitudinal study examined the association between weight loss and changes in self-stigma, assessed by the Weight Self-Stigma Questionnaire, which distinguished between self-devaluation and fear of enacted stigma. Participants were adults with overweight or obesity enrolled in a 24-month weight loss intervention trial (groups were collapsed for this post hoc analysis) who were assessed at baseline, 6, 12, 18 and 24 months. RESULTS Baseline levels of self-stigma were not associated with weight loss outcomes. However, mixed models analysis showed that reductions in one aspect of weight self-stigma, self-devaluation, was associated with greater weight loss (p = 0.01). Cross products mediation analysis showed that increases in use of weight control strategies mediated the association between reductions in self-devaluation and greater weight loss (F = 14.86, p < 0.001; CI 0.09-0.37). CONCLUSIONS Results suggest that there may be potential for incorporating intervention methods targeting the reduction of self-stigma in order to improve weight loss outcomes.
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Affiliation(s)
- J. Lillis
- Department of Psychiatry and Human BehaviorAlpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research CenterProvidenceRIUSA
| | - J. G. Thomas
- Department of Psychiatry and Human BehaviorAlpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research CenterProvidenceRIUSA
| | - K. Olson
- Department of Psychiatry and Human BehaviorAlpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research CenterProvidenceRIUSA
| | - R. R. Wing
- Department of Psychiatry and Human BehaviorAlpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research CenterProvidenceRIUSA
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LeBlanc ES, Patnode CD, Webber EM, Redmond N, Rushkin M, O'Connor EA. Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2018; 320:1172-1191. [PMID: 30326501 DOI: 10.1001/jama.2018.7777] [Citation(s) in RCA: 269] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Overweight and obesity have been associated with adverse health effects. OBJECTIVE To systematically review evidence on benefits and harms of behavioral and pharmacotherapy weight loss and weight loss maintenance interventions in adults to inform the US Preventive Services Task Force. DATA SOURCES MEDLINE, PubMed Publisher-Supplied Records, PsycINFO, and the Cochrane Central Register of Controlled Trials for studies published through June 6, 2017; ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials through August 2017; and ongoing surveillance in targeted publications through March 23, 2018. Studies from previous reviews were reevaluated for inclusion. STUDY SELECTION Randomized clinical trials (RCTs) focusing on weight loss or weight loss maintenance in adults. DATA EXTRACTION AND SYNTHESIS Data were abstracted by one reviewer and confirmed by another. Random-effects meta-analyses were conducted for weight loss outcomes in behavior-based interventions. MAIN OUTCOMES AND MEASURES Health outcomes, weight loss or weight loss maintenance, reduction in obesity-related conditions, and adverse events. RESULTS A total of 122 RCTs (N = 62 533) and 2 observational studies (N = 209 993) were identified. Compared with controls, participants in behavior-based interventions had greater mean weight loss at 12 to 18 months (-2.39 kg [95% CI, -2.86 to -1.93]; 67 studies [n = 22065]) and less weight regain (-1.59 kg [95% CI, -2.38 to -0.79]; 8 studies [n = 1408]). Studies of medication-based weight loss and maintenance interventions also reported greater weight loss or less weight regain in intervention compared with placebo groups at 12 to 18 months (range, -0.6 to -5.8 kg; no meta-analysis). Participants with prediabetes in weight loss interventions had a lower risk of developing diabetes compared with controls (relative risk, 0.67 [95% CI, 0.51 to 0.89]). There was no evidence of other benefits, but most health outcomes such as mortality, cardiovascular disease, and cancer were infrequently reported. Small improvements in quality of life in some medication trials were noted but were of unclear clinical significance. There was no evidence of harm such as cardiovascular disease from behavior-based interventions; higher rates of adverse events were associated with higher dropout rates in medication groups than in placebo groups. CONCLUSIONS AND RELEVANCE Behavior-based weight loss interventions with or without weight loss medications were associated with more weight loss and a lower risk of developing diabetes than control conditions. Weight loss medications, but not behavior-based interventions, were associated with higher rates of harms. Long-term weight and health outcomes data, as well as data on important subgroups, were limited.
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Affiliation(s)
- Erin S LeBlanc
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Carrie D Patnode
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Elizabeth M Webber
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Nadia Redmond
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Megan Rushkin
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Elizabeth A O'Connor
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
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Holmes VA, Draffin CR, Patterson CC, Francis L, Irwin J, McConnell M, Farrell B, Brennan SF, McSorley O, Wotherspoon AC, Davies M, McCance DR. Postnatal Lifestyle Intervention for Overweight Women With Previous Gestational Diabetes: A Randomized Controlled Trial. J Clin Endocrinol Metab 2018; 103:2478-2487. [PMID: 29762737 DOI: 10.1210/jc.2017-02654] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 05/07/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is associated with a sevenfold increased lifetime risk of type 2 diabetes. Excessive gestational weight gain and postpartum weight retention are established predictors of long-term obesity. OBJECTIVE To determine the impact of a postnatal lifestyle intervention program for overweight women with previous gestational diabetes mellitus (PAIGE). DESIGN Postnatal overweight women with previous GDM participated in a multicenter randomized controlled trial between June 2013 and December 2014. The intervention comprised a 1-hour educational program, a free 3-month referral to a commercial weight management organization (Slimming World), a pedometer, and structured telephone and text support, in addition to usual care. The control group received usual care only. The primary outcome was weight loss at 6 months. RESULTS Sixty women were randomized (29 intervention; 31 control) in two centers based on their week of attendance. The intervention group demonstrated significant weight loss at 6 months after randomization compared with the control group: mean ±SD, 3.9 ± 7.0 kg vs 0.7 ±3.8 kg (P = 0.02). Blood glucose levels did not significantly differ. With respect to well-being measures, a bodily pain was significantly reduced in the intervention group (P = 0.007). CONCLUSIONS PAIGE resulted in significantly greater weight loss at 6 months compared with usual care. Such weight loss could prove beneficial in terms of better long-term health and subsequent prevention of type 2 diabetes in overweight women with previous GDM. Future interventions must consider recruitment strategies, timing of the intervention, and inclusion of partners and/or other family members.
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Affiliation(s)
- Valerie A Holmes
- Centre for Public Health, Queen's University, Belfast, United Kingdom
| | - Claire R Draffin
- Centre for Public Health, Queen's University, Belfast, United Kingdom
| | - Chris C Patterson
- Centre for Public Health, Queen's University, Belfast, United Kingdom
| | - Loraine Francis
- Regional Centre for Endocrinology and Diabetes, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Joanne Irwin
- Regional Centre for Endocrinology and Diabetes, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Mae McConnell
- Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, United Kingdom
| | | | - Sarah F Brennan
- Centre for Public Health, Queen's University, Belfast, United Kingdom
| | - Oonagh McSorley
- Centre for Public Health, Queen's University, Belfast, United Kingdom
| | - Amy C Wotherspoon
- Centre for Public Health, Queen's University, Belfast, United Kingdom
| | - Mark Davies
- Regional Centre for Endocrinology and Diabetes, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - David R McCance
- Regional Centre for Endocrinology and Diabetes, Belfast Health and Social Care Trust, Belfast, United Kingdom
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Pearl RL, Wadden TA, Tronieri JS, Berkowitz RI, Chao AM, Alamuddin N, Leonard SM, Carvajal R, Bakizada ZM, Pinkasavage E, Gruber KA, Walsh OA, Alfaris N. Short- and Long-Term Changes in Health-Related Quality of Life with Weight Loss: Results from a Randomized Controlled Trial. Obesity (Silver Spring) 2018; 26:985-991. [PMID: 29676530 PMCID: PMC5970047 DOI: 10.1002/oby.22187] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of this study was to determine the effects of weight loss and weight loss maintenance (WLM) on weight-specific health-related quality of life in a 66-week trial. METHODS Adults with obesity (N = 137, 86.1% female, 68.6% black, mean age = 46.1 years) who had lost ≥ 5% of initial weight in a 14-week intensive lifestyle intervention/low-calorie diet (LCD) program were randomly assigned to lorcaserin or placebo for an additional 52-week WLM program. The Impact of Weight on Quality of Life-Lite (IWQOL-Lite) scale (including five subscales), Patient Health Questionnaire-9 (depression), and Perceived Stress Scale were administered at the start of the 14-week LCD program, randomization, and week 52 of the randomized controlled trial (i.e., 66 weeks total). RESULTS Significant improvements in all outcomes, except weight-related public distress, were found following the 14-week LCD program (P values < 0.05). Improvements were largely maintained during the 52-week randomized controlled trial, despite weight regain of 2.0 to 2.5 kg across treatment groups. Participants who lost ≥ 10% of initial weight achieved greater improvements in physical function, self-esteem, sexual life, and the IWQOL-Lite total score than those who lost < 5% and did not differ from those who lost 5% to 9.9%. CONCLUSIONS Improvements in weight-specific health-related quality of life were achieved with moderate weight loss and were sustained during WLM.
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Affiliation(s)
- Rebecca L. Pearl
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Edwin & Fannie Gray Hall Center for Human Appearance, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Thomas A. Wadden
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Jena Shaw Tronieri
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Robert I. Berkowitz
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, PA
| | - Ariana M. Chao
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - Naji Alamuddin
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Institute for Diabetes, Obesity, and Metabolism, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Sharon M. Leonard
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Ray Carvajal
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Zayna M. Bakizada
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Emilie Pinkasavage
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Kathryn A. Gruber
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Olivia A. Walsh
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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Taylor TR, Dash C, Sheppard V, Makambi K, Ma X, Adams-Campbell LL. The effect of a randomized controlled physical activity trial on health related quality of life in metabolically unhealthy African-American women: FIERCE STUDY. Contemp Clin Trials 2018; 67:121-128. [PMID: 29428830 PMCID: PMC5871580 DOI: 10.1016/j.cct.2018.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 02/02/2018] [Accepted: 02/04/2018] [Indexed: 01/09/2023]
Abstract
PURPOSE African-American women (AAW) are more likely to be metabolically unhealthy than White women (WW). Metabolic syndrome (MetS) is associated with increased breast cancer risk and mortality from breast cancer is greater in AAW compared to WW. Data show MetS affects health-related quality of life (HRQoL). Exercise studies report improvements in MetS, however, no study to date has examined HRQoL in metabolically unhealthy AAW enrolled in an exercise trial. METHODS This report examined the effect of a 6-month, 3-arm (supervised exercise, home-based exercise, control) randomized exercise controlled trial on HRQoL among 213 obese, metabolically unhealthy, postmenopausal AAW at high risk for breast cancer. RESULTS Certain baseline participant characteristics were related to baseline HRQoL dimensions. The "exercise group" (supervised group combined with the home-based group) showed significantly greater improvement in health change scores (M = 13.6, SD = 3.1) compared to the control group (M = 0.7, SD = 4.4) (p = 0.02) over the 6-month study period. There were no significant differences in HRQoL change scores between the 3 study groups, however, although non-significant, data indicated most HRQoL change scores were more favorable in the supervised group. CONCLUSION While significant improvement occurred in health change scores in the combined supervised and home-based group compared to the control group, we did not observe any significant differences on HRQoL change scores between all three study groups. However, while non-significant, there was a trend for more favorable HRQoL change scores in the supervised group versus the home-based and control groups. Additional research is needed to further explore this topic.
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Affiliation(s)
- Teletia R Taylor
- Howard University Cancer Center, Howard University, Washington, DC, United States
| | - Chiranjeev Dash
- Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, United States
| | - Vanessa Sheppard
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Kepher Makambi
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University Medical Center, Washington, DC, United States
| | - Xiaoyang Ma
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University Medical Center, Washington, DC, United States
| | - Lucile L Adams-Campbell
- Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, United States.
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Sturgiss EA, Elmitt N, Haesler E, van Weel C, Douglas KA. Role of the family doctor in the management of adults with obesity: a scoping review. BMJ Open 2018; 8:e019367. [PMID: 29453301 PMCID: PMC5829928 DOI: 10.1136/bmjopen-2017-019367] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/13/2017] [Accepted: 12/19/2017] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Obesity management is an important issue for the international primary care community. This scoping review examines the literature describing the role of the family doctor in managing adults with obesity. The methods were prospectively published and followed Joanna Briggs Institute methodology. SETTING Primary care. Adult patients. INCLUDED PAPERS Peer-reviewed and grey literature with the keywords obesity, primary care and family doctors. All literature published up to September 2015. 3294 non-duplicate papers were identified and 225 articles included after full-text review. PRIMARY AND SECONDARY OUTCOME MEASURES Data were extracted on the family doctors' involvement in different aspects of management, and whether whole person and person-centred care were explicitly mentioned. RESULTS 110 papers described interventions in primary care and family doctors were always involved in diagnosing obesity and often in recruitment of participants. A clear description of the provider involved in an intervention was often lacking. It was difficult to determine if interventions took account of whole person and person-centredness. Most opinion papers and clinical overviews described an extensive role for the family doctor in management; in contrast, research on current practices depicted obesity as undermanaged by family doctors. International guidelines varied in their description of the role of the family doctor with a more extensive role suggested by guidelines from family medicine organisations. CONCLUSIONS There is a disconnect between how family doctors are involved in primary care interventions, the message in clinical overviews and opinion papers, and observed current practice of family doctors. The role of family doctors in international guidelines for obesity may reflect the strength of primary care in the originating health system. Reporting of primary care interventions could be improved by enhanced descriptions of the providers involved and explanation of how the pillars of primary care are used in intervention development.
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Affiliation(s)
- Elizabeth A Sturgiss
- Academic Unit of General Practice, Australian Nation University Medical School, Canberra, Australia
| | - Nicholas Elmitt
- Academic Unit of General Practice, Australian Nation University Medical School, Canberra, Australia
| | - Emily Haesler
- Academic Unit of General Practice, Australian Nation University Medical School, Canberra, Australia
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Chris van Weel
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Health Services Research and Policy, Australian National University, Canberra, Australia
| | - Kirsty A Douglas
- Academic Unit of General Practice, Australian Nation University Medical School, Canberra, Australia
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Maciel NM, De Conti MHS, Simeão SFAP, Genebra CVDS, Corrente JE, De Vitta A. Sociodemographic factors, level of physical activity and health-related quality of life in adults from the north-east of São Paulo, Brazil: a cross-sectional population study. BMJ Open 2018; 8:e017804. [PMID: 29317412 PMCID: PMC5780712 DOI: 10.1136/bmjopen-2017-017804] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To verify the association among sociodemographic variables, physical activity level and health-related quality of life in adults aged 20 years and over. METHODS Population-based study, with household sample by clusters. The dependent variables were the PCS and MCS scores of the instrument 36-Item Short-Form Health Survey (SF-36), the independent variables were gathered in sociodemographic characteristics and the level of physical activity. Absolute and relative frequency distributions were used for categorical variables and bivariate analysis, using Student's t-test and ANOVA and multivariate using non-conditional logistic regression. RESULTS Of the 600 interviewees, the mean PCS score for men was 80.2 and for women 74.6, while for MCS, 83.8 (±16.9) and 76.5 (±23.3), for men and women, respectively. Women tend to report lower scores than men in all domains: men (OR=4.83) and women (OR=4.80) were older (OR=4.34) (OR=3.57) and sedentary women (OR=1.90) were associated with lower PCS scores, while older men (OR=3.96) and widowed and separated' (OR=3.03) had lower MSC scores. CONCLUSION HRQoL was associated with advancing age and schooling, in both sexes, sedentary women and widowed and separated men.
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Affiliation(s)
| | | | | | | | - José Eduardo Corrente
- Department of Biostatistics, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Alberto De Vitta
- Physiotherapy Department, Universidade do Sagrado Coração, Bauru, São Paulo, Brazil
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Winik CL, Bonham CE. Implementation of a Screening and Management of Overweight and Obesity Clinical Practice Guideline in an Ambulatory Care Setting. Mil Med 2018; 183:e32-e39. [PMID: 29401347 DOI: 10.1093/milmed/usx022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Indexed: 11/15/2022] Open
Abstract
Introduction Obesity is a rapidly growing health problem reaching epidemic levels around the world (World Health Organization, 2014). According to the World Health Organization, the current incident rate of obesity makes it the leading risk for deaths across the globe. The United States (USA) is amidst in this growing global epidemic. The obesity epidemic is a nondiscriminatory health problem affecting millions of individuals from a variety of backgrounds and social status. One group impacted by this disease is the US military. The health-related consequences of overweight and obesity has increased our military health care expenditures and has a direct impact on our nation's military readiness (Veterans Affairs/Department of Defense, 2014). Materials and Methods The purpose of this Doctor of Nursing Practice project was to implement the Veterans Affairs/Department of Defense's Clinical Practice Guideline on Screening and Management of Overweight and Obesity at a military treatment facility in the Midwest. The goal of the project was to reduce the incidence rate of overweight and obese active duty military service members assigned to a military installation in the Midwest. With institutional review board approval, project implementation results were analyzed with descriptive and inferential statistics (paired t- tests). Results The goal to reduce the incident rate of overweight and obese by 5% was not achieved, but in turn the rate of overweight and obese increased by 1.57% over the 6-mo period. There were decreases in the normal with an increase in the overweight and obesity rate. This inverse outcome was unexpected and concerning. Conclusion Based on the project's finding, there is a need to address the perceived barriers to maintaining healthy behaviors to plan future activities. An in-depth look at whether there is a knowledge deficit, a perceived lack of self-efficacy, competing life priorities preventing engagement in health promotion behaviors, or some other element influencing the motivation to change would be beneficial to understanding how to curb the growing rate of obesity. The utilization of the transtheoretical model of behavior change would make a sound theoretical framework to base such a new study, focusing on the stages of change as it relates to health promotion behaviors.
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Affiliation(s)
- Connie L Winik
- 55th Medical Group, Ehrling Bergquist Clinic, United States Air Force, 2501 Capehart Road, Offutt Air Force Base, NE 68113
| | - C Elizabeth Bonham
- College of Nursing and Health Professions, University of Southern Indiana, 8600 University Boulevard, Evansville IN 47712
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Abstract
AIM There is a need to develop sound healthcare practices where patients and providers are able to succeed in meeting weight management goals. The aim of this analysis is to develop a better understanding the concept of weight management. BACKGROUND Obesity is a rapidly growing healthcare issue, reaching epidemic levels around the world. According to the World Health Organization, the current incident rate of obesity makes it the leading risk for death across the globe. DESIGN Walker and Avant's model for concept analysis. DATA SOURCE A literature search was accomplished using Cumulative Index to Nursing and Allied Health, Health Source: Nursing Academic Edition, Medline, and ProQuest Health and Medical Complete. REVIEW METHODS Keywords included weight management, weight control, weight loss, obesity, weight, and management. RESULTS Weight management is complex concept. Strategies to develop successful weight management programs need to be multifaceted to have impact on this healthcare crisis. CONCLUSION The critical attributes for weight management are dietary measures, physical activity, behavior modification, motivation, education, and lifelong changes. Unsuccessful weight management results in metabolic disorders and increased risk of mortality. Successful weight management practices include the prevention of weight gain, weight loss, and maintenance of ideal body weight.
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Affiliation(s)
- Connie L Winik
- Student, College of Nursing and Health Professions, University of Southern Indiana, Evansville, IN
| | - C Elizabeth Bonham
- Student, College of Nursing and Health Professions, University of Southern Indiana, Evansville, IN
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The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes. Nutr Diabetes 2017; 7:e256. [PMID: 28319109 PMCID: PMC5380896 DOI: 10.1038/nutd.2017.3] [Citation(s) in RCA: 153] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 12/20/2016] [Accepted: 12/27/2016] [Indexed: 12/19/2022] Open
Abstract
Background/Objective: There is little randomised evidence using a whole food plant-based (WFPB) diet as intervention for elevated body mass index (BMI) or dyslipidaemia. We investigated the effectiveness of a community-based dietary programme. Primary end points: BMI and cholesterol at 6 months (subsequently extended). Subjects: Ages 35–70, from one general practice in Gisborne, New Zealand. Diagnosed with obesity or overweight and at least one of type 2 diabetes, ischaemic heart disease, hypertension or hypercholesterolaemia. Of 65 subjects randomised (control n=32, intervention n=33), 49 (75.4%) completed the study to 6 months. Twenty-three (70%) intervention participants were followed up at 12 months. Methods: All participants received normal care. Intervention participants attended facilitated meetings twice-weekly for 12 weeks, and followed a non-energy-restricted WFPB diet with vitamin B12 supplementation. Results: At 6 months, mean BMI reduction was greater with the WFPB diet compared with normal care (4.4 vs 0.4, difference: 3.9 kg m−2 (95% confidence interval (CI)±1), P<0.0001). Mean cholesterol reduction was greater with the WFPB diet, but the difference was not significant compared with normal care (0.71 vs 0.26, difference: 0.45 mmol l−1 (95% CI±0.54), P=0.1), unless dropouts were excluded (difference: 0.56 mmol l−1 (95% CI±0.54), P=0.05). Twelve-month mean reductions for the WFPB diet group were 4.2 (±0.8) kg m−2 BMI points and 0.55 (±0.54, P=0.05) mmol l−1 total cholesterol. No serious harms were reported. Conclusions: This programme led to significant improvements in BMI, cholesterol and other risk factors. To the best of our knowledge, this research has achieved greater weight loss at 6 and 12 months than any other trial that does not limit energy intake or mandate regular exercise.
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Saboya PP, Bodanese LC, Zimmermann PR, Gustavo ADS, Macagnan FE, Feoli AP, Oliveira MDS. Lifestyle Intervention on Metabolic Syndrome and its Impact on Quality of Life: A Randomized Controlled Trial. Arq Bras Cardiol 2016; 108:60-69. [PMID: 27982160 PMCID: PMC5245849 DOI: 10.5935/abc.20160186] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 09/13/2016] [Indexed: 12/22/2022] Open
Abstract
Background Lifestyle intervention programs can reduce the prevalence of metabolic
syndrome (MetS) and, therefore, reduce the risk for cardiac disease, one of
the main public health problems nowadays. Objective The aim of this study was to compare the effects of three types of approach
for lifestyle change programs in the reduction of metabolic parameters, and
to identify its impact on the quality of life (QOL) of individuals with
MetS. Methods A randomized controlled trial included 72 individuals with MetS aged 30-59
years. Individuals were randomized into three groups of multidisciplinary
intervention [Standard Intervention (SI) - control group; Group Intervention
(GI); and Individual Intervention (II)] during 12 weeks. The primary outcome
was change in the metabolic parameters, and secondarily, the improvement in
QOL measures at three moments: baseline, 3 and 9 months. Results Group and individual interventions resulted in a significant reduction in
body mass index, waist circumference, systolic blood pressure at 3 months
and the improvement of QOL, although it was significantly associated with
the physical functioning domain. However, these changes did not remain 6
months after the end of intervention. Depression and anxiety were
significantly associated with worse QOL, although they showed no effect on
the response to intervention. Conclusion Multidisciplinary intervention, especially in a group, might be an effective
and economically feasible strategy in the control of metabolic parameters of
MetS and improvement of QOL compared to SI, even in a dose-effect
relationship.
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Mkhatshwa VB, Ogunbanjo GA, Mabuza LH. Knowledge, attitudes and management skills of medical practitioners regarding weight management. Afr J Prim Health Care Fam Med 2016; 8:e1-e9. [PMID: 28155319 PMCID: PMC5153405 DOI: 10.4102/phcfm.v8i1.1187] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 09/19/2016] [Accepted: 07/21/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Overweight and obesity have become a global problem. Health professionals are poorly prepared in weight management, which has an effect on their attitudes and management skills with regard to overweight and obese patients.Aim and setting: To assess the knowledge, attitudes and management skills of medical practitioners regarding weight management at Odi District Hospital, Gauteng Province, South Africa. METHODS We conducted a cross-sectional study on 48 medical practitioners at Odi Hospital between 01 October and 31 October 2013. A self-administered questionnaire was used to assess their knowledge, attitudes and management skills in weight management. The SPSS® statistical software (Version 22) was used for data analysis. A p < 0.05 was considered significant. RESULTS Fifty medical practitioners were recruited, 48 consented to participate and 28 (58.3%) were male. Their categories were community service doctors (3), medical officers (21), registrars (22) and others (2). Thirty-seven (77.1%) never received training in weight management (p < 0.001). Thirty-two (66.7%) regarded weight management as not confined to a dietician (p < 0.001) and 27 (56.2%) regarded weight management as usually unsuccessful (p = 0.004). Forty-seven (97.9%) provided lifestyle modifications and 43 (89.6%) involved the patient's family in weight management (p < 0.001). More non-registrars [14 (77.8%)] than registrars [8 (38.1%)] measured the body mass index (BMI) routinely (p = 0.013). CONCLUSION Few medical practitioners received training in weight management. They regarded weight management as usually unsuccessful and lacked confidence in the same owing to lack of training. They provided lifestyle modifications and involved the patient's family in weight management. Non-registrars measured the BMI routinely. There is a need for training in weight management at undergraduate and post-graduate levels.
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Affiliation(s)
| | | | - Langalibalele H Mabuza
- Department of Family Medicine and Primary Health Care, Sefako Makgatho Health Sciences University.
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Saboya PP, Bodanese LC, Zimmermann PR, Gustavo ADS, Assumpção CM, Londero F. Metabolic syndrome and quality of life: a systematic review. Rev Lat Am Enfermagem 2016; 24:e2848. [PMID: 27901223 PMCID: PMC5172619 DOI: 10.1590/1518-8345.1573.2848] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 09/23/2016] [Indexed: 02/08/2023] Open
Abstract
Objectives: to present currently available evidence to verify the association between
metabolic syndrome and quality of life. Method: Cochrane Library, EMBASE, Medline and LILACS databases were studied for all
studies investigating the association with metabolic syndrome and quality of life.
Two blinded reviewers extracted data and one more was chosen in case of doubt.
Results: a total of 30 studies were included, considering inclusion and exclusion criteria,
which involved 62.063 patients. Almost all studies suggested that metabolic
syndrome is significantly associated with impaired quality of life. Some, however,
found association only in women, or only if associated with depression or Body
Mass Index. Merely one study did not find association after adjusted for
confounding factors. Conclusion: although there are a few studies available about the relationship between
metabolic syndrome and quality of life, a growing body of evidence has shown
significant association between metabolic syndrome and the worsening of quality of
life. However, it is necessary to carry out further longitudinal studies to
confirm this association and verify whether this relationship is linear, or only
an association factor.
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Affiliation(s)
| | - Luiz Carlos Bodanese
- PhD, Full Professor, Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Paulo Roberto Zimmermann
- PhD, Full Professor, Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Andréia da Silva Gustavo
- PhD, Professor Adjunto, Faculdade de Enfermagem, Nutrição e Fisioterapia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Dokras A, Sarwer DB, Allison KC, Milman L, Kris-Etherton PM, Kunselman AR, Stetter CM, Williams NI, Gnatuk CL, Estes SJ, Fleming J, Coutifaris C, Legro RS. Weight Loss and Lowering Androgens Predict Improvements in Health-Related Quality of Life in Women With PCOS. J Clin Endocrinol Metab 2016; 101:2966-74. [PMID: 27253669 PMCID: PMC4971336 DOI: 10.1210/jc.2016-1896] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
CONTEXT Polycystic ovary syndrome (PCOS) is associated with reduced health-related quality of life (HRQOL) and increased prevalence of depressive and anxiety disorders. The impact of PCOS-specific treatments on these co-morbidities is unclear. OBJECTIVE To assess the impact of weight loss and decreasing hyperandrogenism on HRQOL and mood and anxiety disorders in women with PCOS. DESIGN/SETTING/PARTICIPANTS A secondary analysis of a randomized controlled trial (OWL-PCOS) of preconception treatment conducted at two academic centers in women (age, 18-40 years; body mass index, 27-42 kg/m(2)) with PCOS defined by Rotterdam criteria. INTERVENTION Continuous oral contraceptive pill (OCP) or intensive lifestyle intervention or the combination (Combined) for 16 weeks. MAIN OUTCOME MEASURE(S) Changes in HRQOL assessed by PCOSQ and SF-36 and prevalence of depression and anxiety disorder assessed by PRIME-MD PHQ. RESULTS The lowest scores were noted on the general health domain of the SF-36 and the weight and infertility domains on the PCOSQ. All three interventions resulted in significant improvement in the general health score on the SF-36. Both the OCP and Combined groups showed improvements in all domains of the PCOSQ (P < .01) compared to baseline scores. The Combined group had significant improvements in the weight, body hair, and infertility domains compared to a single treatment group (P < .05). In a linear regression model, change in weight correlated with improvements in the weight domain (P < .001) and physical well-being (P < .02), change in T correlated with improvements in the hair domain (P < .001), and change in both weight and T correlated with the infertility (P < .001) and menstrual domains (P < .05). CONCLUSIONS Both weight loss and OCP use result in significant improvements in several physical and mental domains related to quality of life, depressive symptoms, and anxiety disorders, and combined therapies offer further benefits in overweight/obese women with PCOS.
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Affiliation(s)
- Anuja Dokras
- Departments of Obstetrics and Gynecology (A.D., L.M., C.C.) and Psychiatry (D.B.S., K.C.A.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104; Departments of Obstetrics and Gynecology (C.L.G., S.J.E., R.S.L.), and Public Health Sciences (A.R.K., C.M.S., R.S.L.), Penn State College of Medicine, Hershey, Pennsylvania 17033; and Departments of Nutritional Sciences (P.M.K.-E., J.F.) and Kinesiology (N.I.W.), Penn State College of Health and Human Development, University Park, Pennsylvania 16802
| | - David B Sarwer
- Departments of Obstetrics and Gynecology (A.D., L.M., C.C.) and Psychiatry (D.B.S., K.C.A.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104; Departments of Obstetrics and Gynecology (C.L.G., S.J.E., R.S.L.), and Public Health Sciences (A.R.K., C.M.S., R.S.L.), Penn State College of Medicine, Hershey, Pennsylvania 17033; and Departments of Nutritional Sciences (P.M.K.-E., J.F.) and Kinesiology (N.I.W.), Penn State College of Health and Human Development, University Park, Pennsylvania 16802
| | - Kelly C Allison
- Departments of Obstetrics and Gynecology (A.D., L.M., C.C.) and Psychiatry (D.B.S., K.C.A.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104; Departments of Obstetrics and Gynecology (C.L.G., S.J.E., R.S.L.), and Public Health Sciences (A.R.K., C.M.S., R.S.L.), Penn State College of Medicine, Hershey, Pennsylvania 17033; and Departments of Nutritional Sciences (P.M.K.-E., J.F.) and Kinesiology (N.I.W.), Penn State College of Health and Human Development, University Park, Pennsylvania 16802
| | - Lauren Milman
- Departments of Obstetrics and Gynecology (A.D., L.M., C.C.) and Psychiatry (D.B.S., K.C.A.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104; Departments of Obstetrics and Gynecology (C.L.G., S.J.E., R.S.L.), and Public Health Sciences (A.R.K., C.M.S., R.S.L.), Penn State College of Medicine, Hershey, Pennsylvania 17033; and Departments of Nutritional Sciences (P.M.K.-E., J.F.) and Kinesiology (N.I.W.), Penn State College of Health and Human Development, University Park, Pennsylvania 16802
| | - Penny M Kris-Etherton
- Departments of Obstetrics and Gynecology (A.D., L.M., C.C.) and Psychiatry (D.B.S., K.C.A.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104; Departments of Obstetrics and Gynecology (C.L.G., S.J.E., R.S.L.), and Public Health Sciences (A.R.K., C.M.S., R.S.L.), Penn State College of Medicine, Hershey, Pennsylvania 17033; and Departments of Nutritional Sciences (P.M.K.-E., J.F.) and Kinesiology (N.I.W.), Penn State College of Health and Human Development, University Park, Pennsylvania 16802
| | - Allen R Kunselman
- Departments of Obstetrics and Gynecology (A.D., L.M., C.C.) and Psychiatry (D.B.S., K.C.A.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104; Departments of Obstetrics and Gynecology (C.L.G., S.J.E., R.S.L.), and Public Health Sciences (A.R.K., C.M.S., R.S.L.), Penn State College of Medicine, Hershey, Pennsylvania 17033; and Departments of Nutritional Sciences (P.M.K.-E., J.F.) and Kinesiology (N.I.W.), Penn State College of Health and Human Development, University Park, Pennsylvania 16802
| | - Christy M Stetter
- Departments of Obstetrics and Gynecology (A.D., L.M., C.C.) and Psychiatry (D.B.S., K.C.A.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104; Departments of Obstetrics and Gynecology (C.L.G., S.J.E., R.S.L.), and Public Health Sciences (A.R.K., C.M.S., R.S.L.), Penn State College of Medicine, Hershey, Pennsylvania 17033; and Departments of Nutritional Sciences (P.M.K.-E., J.F.) and Kinesiology (N.I.W.), Penn State College of Health and Human Development, University Park, Pennsylvania 16802
| | - Nancy I Williams
- Departments of Obstetrics and Gynecology (A.D., L.M., C.C.) and Psychiatry (D.B.S., K.C.A.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104; Departments of Obstetrics and Gynecology (C.L.G., S.J.E., R.S.L.), and Public Health Sciences (A.R.K., C.M.S., R.S.L.), Penn State College of Medicine, Hershey, Pennsylvania 17033; and Departments of Nutritional Sciences (P.M.K.-E., J.F.) and Kinesiology (N.I.W.), Penn State College of Health and Human Development, University Park, Pennsylvania 16802
| | - Carol L Gnatuk
- Departments of Obstetrics and Gynecology (A.D., L.M., C.C.) and Psychiatry (D.B.S., K.C.A.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104; Departments of Obstetrics and Gynecology (C.L.G., S.J.E., R.S.L.), and Public Health Sciences (A.R.K., C.M.S., R.S.L.), Penn State College of Medicine, Hershey, Pennsylvania 17033; and Departments of Nutritional Sciences (P.M.K.-E., J.F.) and Kinesiology (N.I.W.), Penn State College of Health and Human Development, University Park, Pennsylvania 16802
| | - Stephanie J Estes
- Departments of Obstetrics and Gynecology (A.D., L.M., C.C.) and Psychiatry (D.B.S., K.C.A.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104; Departments of Obstetrics and Gynecology (C.L.G., S.J.E., R.S.L.), and Public Health Sciences (A.R.K., C.M.S., R.S.L.), Penn State College of Medicine, Hershey, Pennsylvania 17033; and Departments of Nutritional Sciences (P.M.K.-E., J.F.) and Kinesiology (N.I.W.), Penn State College of Health and Human Development, University Park, Pennsylvania 16802
| | - Jennifer Fleming
- Departments of Obstetrics and Gynecology (A.D., L.M., C.C.) and Psychiatry (D.B.S., K.C.A.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104; Departments of Obstetrics and Gynecology (C.L.G., S.J.E., R.S.L.), and Public Health Sciences (A.R.K., C.M.S., R.S.L.), Penn State College of Medicine, Hershey, Pennsylvania 17033; and Departments of Nutritional Sciences (P.M.K.-E., J.F.) and Kinesiology (N.I.W.), Penn State College of Health and Human Development, University Park, Pennsylvania 16802
| | - Christos Coutifaris
- Departments of Obstetrics and Gynecology (A.D., L.M., C.C.) and Psychiatry (D.B.S., K.C.A.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104; Departments of Obstetrics and Gynecology (C.L.G., S.J.E., R.S.L.), and Public Health Sciences (A.R.K., C.M.S., R.S.L.), Penn State College of Medicine, Hershey, Pennsylvania 17033; and Departments of Nutritional Sciences (P.M.K.-E., J.F.) and Kinesiology (N.I.W.), Penn State College of Health and Human Development, University Park, Pennsylvania 16802
| | - Richard S Legro
- Departments of Obstetrics and Gynecology (A.D., L.M., C.C.) and Psychiatry (D.B.S., K.C.A.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104; Departments of Obstetrics and Gynecology (C.L.G., S.J.E., R.S.L.), and Public Health Sciences (A.R.K., C.M.S., R.S.L.), Penn State College of Medicine, Hershey, Pennsylvania 17033; and Departments of Nutritional Sciences (P.M.K.-E., J.F.) and Kinesiology (N.I.W.), Penn State College of Health and Human Development, University Park, Pennsylvania 16802
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Noronha DD, Martins AMEDBL, Dias DDS, Silveira MF, Paula AMBD, Haikal DSA. Qualidade de vida relacionada à saúde entre adultos e fatores associados: um estudo de base populacional. CIENCIA & SAUDE COLETIVA 2016; 21:463-74. [DOI: 10.1590/1413-81232015212.01102015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 05/07/2015] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivou-se investigar fatores associados aos Componentes Físico (CF) e Mental (CM) da Qualidade de Vida Relacionada à Saúde (QVRS) entre adultos. Estudo de base populacional, com amostra domiciliar por conglomerados. As variáveis dependentes foram os escores do CF e CM do instrumento 12-Item Short-Form Health Survey (SF-12), as independentes foram reunidas em características sociodemográficas, relativas à saúde e comportamentais. Conduziu-se regressão múltipla pelo Modelo Linear Geral com correção pelo desenho amostral. Dos 841 entrevistados, 31% e 37,2% apresentavam comprometimento no CF e CM, respectivamente, e 57% apresentaram comprometimento em pelo menos um domínio. Os escores médios foram 49,9 para CF e 47,1 para CM. Ser do sexo masculino (β = 1,94), possuir automóvel na família (β = 0,89), ter utilizado serviços odontológicos recentemente (β = 1,86), não possuir doença crônica (β = 4,60), não fazer uso de medicamento (β = 2,09), não ser tabagista (β = 2,04) e praticar atividades físicas (β = 1,73) foram associados a maiores escores do CF, enquanto não fazer uso de medicamento (β = 1,91) e não ser tabagista (β = 1,26) a maiores escores do CM. Há necessidade de mais estudos e políticas voltadas à manutenção e/ou recuperação do bem estar físico e mental de adultos sem doenças específicas.
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Castro ADAE, Skare TL, Nassif PAN, Sakuma AK, Barros WH. TENDINOPATHY AND OBESITY. ACTA ACUST UNITED AC 2016; 29Suppl 1:107-110. [PMID: 27683789 PMCID: PMC5064259 DOI: 10.1590/0102-6720201600s10026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 05/17/2016] [Indexed: 12/14/2022]
Abstract
Introduction Tendinopathies and tendon tears account for over 30% of all musculoskeletal consultations. Obesity, which is becoming one of the world´s most prevalent public health issues, may be associated with this condition. Objective To review the literature about tendinopathies and obesity association. Methods This is a descriptive exploratory study using the portal Medline. Literature in English language from 2006 to 2014 were reviewed. Results The pathogenesis of tendinopathies includes inflammatory, regenerative and degenerative processes that happen simultaneously from early to late phases of the disease. Mechanical stress upon tendons seems to be one of the most important factors to initiate the inflammatory response, but it´s not the only one that can deflagrate it: there are other extrinsic, genetic and metabolic factors that may be involved. Therefore, tendinopathies in obese patients can be due to tendon overload because of the excess of weight, but also because of increased production of pro-inflammatory mediators related to fat tissue such as adipokines. This pro-inflammatory state that obese people can suffer is known as adiposopathy, or sick fat syndrome. Weight loss is associated with decrease in adipokines and improvement of musculoskeletal symptoms. Conclusion The relation of obesity and tendinopathies is supported by evidences of recent studies, exemplified in this review of literature.
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Affiliation(s)
- Adham do Amaral E Castro
- Postgraduate Program in Principles of Surgery, Evangelic Faculty of Paraná/University Evangelic Hospital of Curitiba/Medical Research Institute, Curitiba, PR, Brazil
| | - Thelma Larocca Skare
- Postgraduate Program in Principles of Surgery, Evangelic Faculty of Paraná/University Evangelic Hospital of Curitiba/Medical Research Institute, Curitiba, PR, Brazil
| | - Paulo Afonso Nunes Nassif
- Postgraduate Program in Principles of Surgery, Evangelic Faculty of Paraná/University Evangelic Hospital of Curitiba/Medical Research Institute, Curitiba, PR, Brazil
| | - Alexandre Kaue Sakuma
- Postgraduate Program in Principles of Surgery, Evangelic Faculty of Paraná/University Evangelic Hospital of Curitiba/Medical Research Institute, Curitiba, PR, Brazil
| | - Wagner Haese Barros
- Postgraduate Program in Principles of Surgery, Evangelic Faculty of Paraná/University Evangelic Hospital of Curitiba/Medical Research Institute, Curitiba, PR, Brazil
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Kroes M, Osei-Assibey G, Baker-Searle R, Huang J. Impact of weight change on quality of life in adults with overweight/obesity in the United States: a systematic review. Curr Med Res Opin 2016; 32:485-508. [PMID: 26652030 DOI: 10.1185/03007995.2015.1128403] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To review published evidence on the impact of weight/BMI change on health-related quality of life (HRQoL) in adults from the US with overweight/obesity. METHODS The systematic review was conducted in accordance with PRISMA guidelines. MEDLINE, Embase, EconLit, and Cochrane Library databases were reviewed using pre-defined eligibility criteria to identify relevant US studies in adults with overweight/obesity, with ≥1 year follow-up, quantified weight change, and measured HRQoL. This manuscript focuses on HRQoL derived using the Short-Form 36 (SF-36) and Impact of Weight on Quality of Life-Lite (IWQOL-Lite) instruments. RESULTS In total, 32 of 6793 identified publications reported HRQoL according to SF-36 or IWQOL-Lite; 20 provided adequate data for inclusion in this review. Although study design and outcomes were heterogeneous, improvements in HRQoL were generally observed with weight loss. Bariatric surgery studies provided the most evidence (12 publications) and demonstrated dramatic (≥20%) weight loss and associated HRQoL improvements. Sustained weight loss was associated with maintenance of HRQoL improvements out to 6 years in some studies. In lifestyle and pharmaceutical intervention studies showing weight loss of 5%-10%, some aspects of HRQoL improved, although the association with weight was not typically explored. Across the 20 publications, physical versus mental HRQoL improvements were more commonly statistically significant. CONCLUSION Overweight/obesity is typically associated with poorer HRQoL than normal weight (BMI 18.5-24.9 kg/m(2)). This systematic review of US literature demonstrated that significant weight loss after bariatric surgery may be associated with improvements in HRQoL. In non-bariatric studies with weight loss of ≥5%, improvements in some aspects of HRQoL were noted, although the causal nature of the relationship is uncertain. Although many SF-36 and IWQOL-Lite domain scores increased, improvements were typically only significant for physical, rather than mental, HRQoL. This systematic review provides evidence supporting that weight loss may improve HRQoL in people with overweight/obesity.
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Burke LE, Ewing LJ, Ye L, Styn M, Zheng Y, Music E, Loar I, Mancino J, Imes CC, Hu L, Goode R, Sereika SM. The SELF trial: A self-efficacy-based behavioral intervention trial for weight loss maintenance. Obesity (Silver Spring) 2015; 23:2175-82. [PMID: 26381151 PMCID: PMC4633334 DOI: 10.1002/oby.21238] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 06/08/2015] [Accepted: 06/28/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The SELF Trial examined the effect of adding individual self-efficacy (SE) enhancement sessions to standard behavioral weight loss treatment (SBT). METHODS Participants were randomly assigned to SBT or SBT plus SE sessions (SBT+SE). Outcome measures were weight loss maintenance, quality of life, intervention adherence, and self-efficacy at 12 and 18 months. RESULTS The sample (N = 130) was female (83.08%) with a mean (SD) body mass index of 33.15 (4.11) kg m(2) . There was a significant time effect for percent weight change (P = 0.002) yet no significant group or group-by-time effects. The weight loss for the SBT+SE group was 8.38% (7.48) at 12 months and 8.00% (7.87) at 18 months, with no significant difference between the two time points (P = 0.06). However, weight loss for the SBT group was 6.95% (6.67) at 12 months and 5.96% (7.35) at 18 months, which was significantly different between the two time points (P = 0.005), indicating that the SBT group had significant weight regain. CONCLUSIONS Both groups achieved clinically significant weight loss. The group receiving an intervention targeting enhanced self-efficacy had greater weight loss maintenance whereas the SBT group demonstrated significant weight regain possibly related to the greater attention provided to the SBT+SE group.
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Affiliation(s)
- Lora E. Burke
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
- University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA, USA
- University of Pittsburgh Clinical and Translational Science Institute, Pittsburgh, PA, USA
| | - Linda J. Ewing
- University of Pittsburgh Graduate School of Public Health, Department of Biostatistics, Pittsburgh, PA, USA
| | - Lei Ye
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
- University of Pittsburgh Graduate School of Public Health, Department of Biostatistics, Pittsburgh, PA, USA
| | - Mindi Styn
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
- University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA, USA
| | - Yaguang Zheng
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Edvin Music
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - India Loar
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Juliet Mancino
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | | | - Lu Hu
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Rachel Goode
- University of Pittsburgh School of Social Work, Pittsburgh, PA, USA
| | - Susan M. Sereika
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
- University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA, USA
- University of Pittsburgh Graduate School of Public Health, Department of Biostatistics, Pittsburgh, PA, USA
- University of Pittsburgh Clinical and Translational Science Institute, Pittsburgh, PA, USA
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Garbers S, McDonnell C, Fogel SC, Eliason M, Ingraham N, McElroy JA, Radix A, Haynes SG. Aging, Weight, and Health Among Adult Lesbian and Bisexual Women: A Metasynthesis of the Multisite “Healthy Weight Initiative” Focus Groups. LGBT Health 2015; 2:176-87. [DOI: 10.1089/lgbt.2014.0082] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Samantha Garbers
- Research & Evaluation Unit, Public Health Solutions, New York, New York
- Heilbrunn Department of Population & Family Health, Mailman School of Public Health, Columbia University, New York, New York
| | | | - Sarah C. Fogel
- School of Nursing, Vanderbilt University, Nashville, Tennessee
| | - Michele Eliason
- Department of Health Education, San Francisco State University, San Francisco, California
| | | | - Jane A. McElroy
- Department of Community & Family Medicine, University of Missouri, Columbia, Missouri
| | - Anita Radix
- Department of Medicine, New York University, New York, New York
- Callen-Lorde Community Health Center, New York, New York
| | - Suzanne G. Haynes
- Office on Women's Health, U.S. Department of Health & Human Services, Washington, D.C
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Groh CJ, Urbancic JC. The impact of a lifestyle change program on the mental health of obese under-served African American women. Arch Psychiatr Nurs 2015; 29:76-82. [PMID: 25858198 DOI: 10.1016/j.apnu.2014.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 11/03/2014] [Accepted: 11/10/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Obesity is a critical social and health issue, adversely impacting life expectancy, quality of life, and mental health. Minorities are disproportionately impacted by obesity with African Americans experiencing the highest prevalence among minority groups. PURPOSE The aim of this study was to determine if a lifestyle program that integrated chair exercises, nutrition and educational counseling, and scripture readings would help under-served obese African American women make lifestyle changes that would positively impact their quality of life, especially mental health. METHODS A repeated measures intervention study was conducted (24-weeks). Weeks 1-12 involved meeting twice a week for a total of 4h with participants engaged in chair exercises, educational counseling, and scripture readings. During weeks 13-24, the participants were "on their own" but were encouraged to exercise and eat healthy. Focus groups were held at 12 and 24-weeks. Participants were recruited from a nurse managed center and a primary care clinic for the uninsured. Mental health data were collected at baseline, 12, and 24-weeks. The Medical Outcomes Study Short Form Version 2 (SF-36v2) was used to measure changes in mental health. Higher scores indicate better perceived health status. Group scores less than 47 indicate impaired functioning. FINDINGS 55 women had complete data for all three data collection points, with a mean age of 50 and a mean BMI of 41.2. Repeated ANOVAs detected significant differences on the mental component summary of the SF-36v2: this score improved from baseline (M=44.1) to 12-weeks (M=50.7) but decreased at 24-weeks (M=47.9) (p=.000). The four domains (vitality, social functioning, role emotional, mental health) were also significantly different over the three data collection points. IMPLICATIONS The findings have significant implications for psychiatric nurses in terms of education, clinical practice, and future research. The study contributed to the participants' mental health through the various group activities including scripture readings, socialization with "like minded" women and structured exercises. These findings offer psychiatric nurses additional tools for effective care.
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Affiliation(s)
- Carla J Groh
- University of Detroit Mercy, College of Health Professions, McAuley School of Nursing, Detroit, MI.
| | - Joan C Urbancic
- University of Detroit Mercy, College of Health Professions, McAuley School of Nursing, Detroit, MI.
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Kloosterboer SM, van den Brekel K, Rengers AH, Peek N, de Wit NJ. An exploration of beliefs and attitudes regarding healthy lifestyle behaviour in an urban population in The Netherlands: Results from a focus group study in a community-based prevention project. Eur J Public Health 2014; 25:467-71. [DOI: 10.1093/eurpub/cku140] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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