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Alzahrani MS, Vennu V. Metabolic syndrome is associated with an increased risk of falls in the elderly. THE NATIONAL MEDICAL JOURNAL OF INDIA 2023; 36:370-373. [PMID: 38909297 DOI: 10.25259/nmji_944_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/24/2024]
Abstract
Numerous studies have investigated the causes of falls in the elderly. However, there is little information about metabolic syndrome (MS) as a risk factor for falls in older adults. No evaluations have given a qualitative overview of studies examining the relationship between MS and falls in the elderly. We did a literature search in electronic databases to look for studies that assessed a link between MS and falls among people over the age of 55 years. We found three studies of high quality. These included 2774 people with an average age of 72 years. Even after controlling for other risk factors, two studies found that MS was significantly associated with an older adult's 1.3-2.5-fold increased risk of falling. We found that MS and its independent components were strongly linked with falls among the elderly, even after correcting for numerous variables.
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Affiliation(s)
- Majed Saeed Alzahrani
- Department of Preventive Medicine, Preventive and Public Health Joint Program, Taif 11454, Makkah, Saudi Arabia
| | - Vishal Vennu
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, 10219 Riyadh 11433, ArRiyadh, Saudi Arabia
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Eglseer D, Traxler M, Embacher S, Reiter L, Schoufour JD, Weijs PJ, Voortman T, Boirie Y, Cruz-Jentoft A, Bauer S. Nutrition and exercise interventions to improve body composition for persons with overweight or obesity near retirement age: A systematic review and network meta-analysis of randomised controlled trials. Adv Nutr 2023; 14:516-538. [PMID: 37028708 DOI: 10.1016/j.advnut.2023.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/16/2023] [Accepted: 04/03/2023] [Indexed: 04/09/2023] Open
Abstract
The retirement phase is an opportunity to integrate healthy (nutrition/exercise) habits into daily life. We conducted this systematic review to assess which nutrition and exercise interventions most effectively improve body composition (fat/muscle mass), body mass index (BMI) and waist circumference (WC) in persons with obesity/overweight near retirement age (ages 55-70). We conducted a systematic review and network-meta-analysis (NMA) of randomised controlled trials, searching four databases from their inception up to 12 July 2022. The NMA was based on a random effects model, pooled mean differences, standardised mean differences, their 95% confidence intervals, and correlations with multi-arm studies. Subgroup and sensitivity analyses were also conducted. 92 studies were included, 66 of which with 4957 participants could be used for the NMA. Identified interventions were clustered into 12 groups: no intervention, energy restriction (i.e. 500-1000 kcal), energy restriction plus high protein (HP) intake (1.1-1.7 g/kg/body weight), intermittent fasting, mixed exercise (aerobic and resistance), resistance training (RT), aerobic training (AT), HP plus RT, energy restriction plus HP plus exercise, energy restriction plus RT, energy restriction plus AT, and energy restriction plus mixed exercise (ME). Intervention durations ranged from 8 weeks to 6 months. Body fat was reduced with energy restriction plus any exercise or plus HP intake. Energy restriction alone was less effective and tended to decrease muscle mass. Muscle mass was only significantly increased with ME. All other interventions including exercise effectively preserved muscle mass. A BMI and/or WC decrease was achieved with all interventions except AT/RT alone or RT plus HP. Overall, the most effective strategy for nearly all outcomes was combining energy restriction with RT or ME and HP. Healthcare professionals involved in the management of persons with obesity need to be aware that an energy-restricted diet alone may contribute to sarcopenic obesity in persons near retirement age. This network meta-analysis is registered at https://www.crd.york.ac.uk/prospero/as CRD42021276465.
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Affiliation(s)
- Doris Eglseer
- Medical University of Graz, Institute of Nursing Science, Universitätsplatz 4, 8010 Graz, Austria.
| | - Mariella Traxler
- Medical University of Graz, Institute of Nursing Science, Universitätsplatz 4, 8010 Graz, Austria.
| | - Stefan Embacher
- Medical University of Graz, Institute for Medical Informatics, Statistics and Documentation, Auenbruggerplatz 2, 8036 Graz.
| | - Lea Reiter
- Medical University of Graz, Institute of Nursing Science, Universitätsplatz 4, 8010 Graz, Austria
| | - Josje D Schoufour
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Dr. Meurerhuis, Dokter Meurerlaan 8, 1067 SM Amsterdam, the Netherlands.
| | - Peter Jm Weijs
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Dr. Meurerhuis, Dokter Meurerlaan 8, 1067 SM Amsterdam, the Netherlands; Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands.
| | - Trudy Voortman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, P.O. Box 176700 AA Wageningen, The Netherlands; Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
| | - Yves Boirie
- University Clermont Auvergne, Human Nutrition Unit, INRA, CRNH Auvergne, CHU Clermont-Ferrand, Clinical Nutrition Department, 63000, Clermont-Ferrand, France.
| | - Alfonso Cruz-Jentoft
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Spain, Ctra. Colmenar Viejo, 28034 Madrid.
| | - Silvia Bauer
- Medical University of Graz, Institute of Nursing Science, Universitätsplatz 4, 8010 Graz, Austria.
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AlMohaisen N, Gittins M, Todd C, Burden S. What is the overlap between malnutrition, frailty and sarcopenia in the older population? Study protocol for cross-sectional study using UK Biobank. PLoS One 2022; 17:e0278371. [PMID: 36472992 PMCID: PMC9725160 DOI: 10.1371/journal.pone.0278371] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In an increasingly older adult population, understanding the inter-relationship between three age related conditions malnutrition, frailty and sarcopenia is important in order to improve their recognition, treatment and prevention. This study aims to determine the overlap between malnutrition, frailty and sarcopenia by measuring estimates of prevalence for each individual condition. In addition, we will compare two models of frailty which are the accumulation of deficits and phenotype models. METHODS/DESIGN This is a cross-sectional study that will use the UK Biobank database, which will include a subset of 381,000 participants: males and females aged 50 years and above who completed the baseline assessments. For the baseline assessments, details of the participants' characteristics will be included. All three conditions will be identified and mapped to variables collected at the baseline assessment. Variables for malnutrition will be mapped according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Frailty will be defined according to two models: the 36 deficits and the phenotype model. Finally, sarcopenia will be assessed according to the European Working Group on Sarcopenia in Older People (EWGSOP) standard. DISCUSSION This proposed study will help to understand the presence of malnutrition, frailty and sarcopenia in the older population and describe any overlap between the conditions. There is little published research on the overlap between these three conditions. Despite the similarity and shared criteria used for the identification of malnutrition, frailty and sarcopenia there is still a lack of cohesive thinking around the overlap of applied definitions and identification criteria. TRIAL REGISTRATION ClinicalTrials.gov NCT04655456 approved on the 10th of December 2020.
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Affiliation(s)
- Nada AlMohaisen
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Department of Clinical Nutrition, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Matthew Gittins
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Chris Todd
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Manchester University Foundation NHS Trust, Manchester, United Kingdom
| | - Sorrel Burden
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Salford Royal Foundation NHS Trust, Salford, United Kingdom
- * E-mail:
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Ting MJM, Hyde Z, Flicker L, Almeida OP, Golledge J, Hankey GJ, Yeap BB. Associations between diabetes, body mass index and frailty: The Western Australian Health In Men Study. Maturitas 2022; 161:58-64. [DOI: 10.1016/j.maturitas.2022.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 01/26/2022] [Accepted: 02/27/2022] [Indexed: 12/25/2022]
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Mulier L, Meersseman E, Vermeir I, Slabbinck H. Food on the Move: The Impact of Implied Motion in Pictures on Food Perceptions through Anticipated Pleasure of Consumption. Foods 2021; 10:2194. [PMID: 34574303 PMCID: PMC8469261 DOI: 10.3390/foods10092194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/07/2021] [Accepted: 09/14/2021] [Indexed: 11/23/2022] Open
Abstract
To tackle obesity, upgrading the image of healthy food is increasingly relevant. Rather than focusing on long-term benefits, an effective way to promote healthy food consumption through visual advertising is to increase its pleasure perception. We investigate whether implied motion, a popular trend in food pictures, affects food perceptions through anticipated consumption pleasure. Prior research shows that motion affects food perceptions, but these studies focused on limited food categories, using experiments with a single food stimulus, and mainly showing unhealthy food effects. Therefore, we aim to (1) replicate prior findings on the effects of food in motion on appeal, tastiness, healthiness, and freshness perceptions; (2) examine whether these effects differ for healthy and unhealthy food; and (3) investigate whether anticipated pleasure of consumption drives the effects of implied motion on food perceptions. Three between-subjects experiments (N = 626) reveal no evidence for the effectiveness of motion (vs. no motion) across a large variety of food products. We further show no differential effects for healthy versus unhealthy foods. Moreover, implied motion does not increase appeal or taste perceptions through anticipated pleasure. Considering the current replication crisis, these findings provide more nuanced insights into the effectiveness of motion in visual food advertising.
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Affiliation(s)
- Lana Mulier
- Department of Marketing, Innovation and Organisation, Faculty of Economics and Business Administration, Ghent University, 9000 Ghent, Belgium; (E.M.); (I.V.); (H.S.)
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Hopstock LA, Deraas TS, Henriksen A, Martiny-Huenger T, Grimsgaard S. Changes in adiposity, physical activity, cardiometabolic risk factors, diet, physical capacity and well-being in inactive women and men aged 57-74 years with obesity and cardiovascular risk - A 6-month complex lifestyle intervention with 6-month follow-up. PLoS One 2021; 16:e0256631. [PMID: 34432850 PMCID: PMC8386855 DOI: 10.1371/journal.pone.0256631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 08/06/2021] [Indexed: 12/16/2022] Open
Abstract
A key challenge in lifestyle interventions is long-term maintenance of favorable lifestyle changes. Middle-aged and older adults are important target groups. The purpose of this analysis was to investigate changes in adiposity, physical activity, cardiometabolic risk factors, diet, physical capacity, and well-being, in inactive middle-aged and older women and men with obesity and elevated cardiovascular disease risk, participating in an interdisciplinary single-arm complex lifestyle intervention pilot study. Participants were recruited from the population-based Tromsø Study 2015-2016 with inclusion criteria age 55-74 years, body mass index (BMI) ≥30kg/m2, sedentary lifestyle, no prior myocardial infarction and elevated cardiovascular risk. Participants (11 men and 5 women aged 57-74 years) underwent a 6-month intervention of two 1-hour group-sessions per week with instructor-led gradually intensified exercise (endurance and strength), one individual and three 2-hour group counselling sessions with nutritionist (Nordic Nutrition Recommendations) and psychologist (Implementation intention strategies). We investigated changes in adiposity (weight, BMI, body composition, waist circumference), physical activity (self-reported and via physical activity trackers), cardiometabolic risk factors (blood pressure, HbA1c, blood lipids), diet (intake of energy, nutrients, foods), physical capacity (aerobic capacity, muscle strength), and psychological well-being, measured at baseline and end-of-intervention, using mean-comparison paired t-tests. Further, we investigated self-reported healthy lifestyle maintenance six months after end-of-intervention, and monthly changes in daily step count, moderate-to-vigorous physical activity (MVPA) and total energy expenditure. From baseline to end-of-intervention, there was a mean decrease in weight, BMI, fat mass, waist circumference, intake of total- and saturated fat, and increase in lean mass, lateral pulldown and leg press. We detected no changes in mean levels of physical activity, cardiometabolic risk factors or well-being. Six months after end-of-intervention, 25% responded healthy lifestyle achievement and maintenance, while objectively measured physical activity remained unchanged. The results are useful for development of a protocol for a full-scale trial. Trial registration: The study was registered at www.ClinicalTrials.gov registry (NCT03807323).
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Affiliation(s)
- Laila A. Hopstock
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Trygve S. Deraas
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Andre Henriksen
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Torsten Martiny-Huenger
- Faculty of Health Sciences, Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Torbahn G, Schoene D, Schwingshackl L, Rücker G, Knüttel H, Kemmler W, Sieber CC, Batsis JA, Villareal DT, Stroebele-Benschop N, Volkert D, Kiesswetter E. Effective SLOPE: EffectS of Lifestyle interventions in Older PEople with obesity: a systematic review and network meta-analysis protocol. BMJ Open 2020; 10:e038330. [PMID: 33033022 PMCID: PMC7542917 DOI: 10.1136/bmjopen-2020-038330] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Obesity is highly prevalent in older adults aged 65 years or older. Different lifestyle interventions (diet, exercise, self-management) are available but benefits and harms have not been fully quantified comparing all available health promotion interventions. Special consideration must be given to functional outcomes and possible adverse effects (loss of muscle and bone mass, hypoglycaemia) of weight loss interventions in this age group. The objective of this study is to synthesise the evidence regarding the effects of different types and modalities of lifestyle interventions, or their combinations, on physical function and obesity-related outcomes such as body composition in older adults with obesity. METHODS AND ANALYSES Six databases (Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Psychinfo and Web of Science) and two trial registries (Clinicaltrials.gov and the WHO International Clinical Trials Registry Platform) will be searched for randomised controlled trials of lifestyle interventions in older adults with obesity. Screening (title/abstract and full-text) and data extraction of references as well as assessment of risk of bias and rating of the certainty of evidence (Grading of Recommendations, Assessment, Development and Evaluation for network meta-analyses) will be performed by two reviewers independently. Frequentist random-effects network meta-analyses will be conducted to determine the pooled effects from each intervention. ETHICS AND DISSEMINATION We will submit our findings to peer-reviewed journals and present at national and international conferences as well as in scientific medical societies. Patient-targeted dissemination will involve local and national advocate groups. PROSPERO REGISTRATION NUMBER CRD42019147286.
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Affiliation(s)
- Gabriel Torbahn
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Bayern, Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Gerta Rücker
- Institute of Medical Biometry and Medical Informatics, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Helge Knüttel
- University Library, University of Regensburg, Regensburg, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Cornel C Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Bayern, Germany
- Department of Medicine, Kantonsspital Winterthur, Winterthur, Zurich, Switzerland
| | - John A Batsis
- Division of Geriatric Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Dennis T Villareal
- Division of Endocrinology, Diabetes and Metabolism, Baylor College of Medicine, Houston, Texas, USA
| | - Nanette Stroebele-Benschop
- Department of Nutritional Psychology, Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Bayern, Germany
| | - Eva Kiesswetter
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Bayern, Germany
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Turchi MJ, Kingma F, Laborda N, Montanelli A, Maldonado JM, Fiolo FE. Roux-en-Y gastric bypass in the elderly: is age a determining factor in our outcomes? Surg Obes Relat Dis 2020; 16:1514-1520. [PMID: 32665112 DOI: 10.1016/j.soard.2020.05.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/16/2020] [Accepted: 05/12/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND While patients are becoming older and the prevalence of obesity increases worldwide, literature on the impact of age on outcomes after laparoscopic Roux-en-Y gastric bypass (LRYGB) is scarce. The balance between surgical risks and clinical benefits of LRYGB are unclear in relation to age. OBJECTIVES To evaluate the impact of age on the risk of postoperative complications, postoperative weight loss, and remission of co-morbidities for patients who underwent LRYGB. SETTING A high-volume center for bariatric surgery. METHODS A retrospective analysis of 582 patients who underwent LRYGB was performed. Linear logistic regression analyses were performed to evaluate the potential impact of age on the postoperative percentage of total weight loss (%TWL). Multivariable binary logistic regression analyses were performed to evaluate whether age was independently associated with the risk of postoperative complications and likelihood of remission of co-morbidities (hypertension, diabetes, and dyslipidemia). In addition, these outcomes were descriptively analyzed for the following 3 age groups: the young (18-39 yr), the middle aged (40-59 yr), and the elderly (≥60 yr). RESULTS Patients with hypertension were more prone to developing postoperative complications (odds ratio 2.435, 95% confidence interval: 1.241-4.777) and no other factors were found to be associated with the risk of postoperative complications. Older age was significantly associated with lower %TWL at a postoperative follow-up of 6 (ß = -.117, P = .004), 12 (ß = -.177, P < .001), and 36 months (ß = -.169, P = .001), but not at 60 months (ß = -.097, P = .161). Nonetheless, a %TWL of 30% was observed in patients who were >60 years at the time of surgery. Age was not associated with the likelihood of co-morbidity resolution after LRYGB. The remission of hypertension was less likely in patients with co-existence of diabetes (odds ratio .334, 95% confidence interval: .136-.821) and in patients with a longer length of postoperative follow-up (odds ratio .982, 95% confidence interval: .966-.998). CONCLUSIONS Although older age seems to be associated with lower postoperative %TWL, elderly patients can still achieve a %TWL of 30% after LRYGB. In this study, age was not found to be an independent predictor of postoperative complications nor the likelihood of co-morbidity resolution. Therefore, older age alone should not be an absolute contraindication for LRYGB.
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Affiliation(s)
- Matías J Turchi
- Bariatric and Metabolic Surgery Section, Department of General Surgery, Hospital Privado de Comunidad, Mar del Plata, Argentina.
| | - Feike Kingma
- University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - Nicolás Laborda
- Bariatric and Metabolic Surgery Section, Department of General Surgery, Hospital Privado de Comunidad, Mar del Plata, Argentina
| | - Agostina Montanelli
- Bariatric and Metabolic Surgery Section, Department of General Surgery, Hospital Privado de Comunidad, Mar del Plata, Argentina
| | - Juan M Maldonado
- Bariatric and Metabolic Surgery Section, Department of General Surgery, Hospital Privado de Comunidad, Mar del Plata, Argentina
| | - Felipe E Fiolo
- Bariatric and Metabolic Surgery Section, Department of General Surgery, Hospital Privado de Comunidad, Mar del Plata, Argentina
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López-Gómez JJ, Izaola-Jauregui O, Primo-Martín D, Torres-Torres B, Gómez-Hoyos E, Ortolá-Buigues A, Martín-Ferrero MA, De Luis-Román DA. Effect of Two Meal Replacement strategies on Cardiovascular Risk Parameters in Advanced Age Patients with Obesity and Osteoarthritis. Nutrients 2020; 12:nu12040976. [PMID: 32244696 PMCID: PMC7230305 DOI: 10.3390/nu12040976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 11/16/2022] Open
Abstract
Background and aims: Meal replacement diets consist of replacing one or more meals with an artificial nutritional supplement. The objective of this study was to compare the effect of one against two meal replacement strategies on body composition and cardiovascular risk parameters in patients with obesity. Methods: A randomized clinical trial was designed with a modified hypocaloric diet with an artificial nutritional preparation replacing one or two meals for three months in patients with obesity and osteoarthritis pending orthopedic surgery. An anthropometric evaluation and a measurement of the body composition were done with bioelectrical impedance measurement at the beginning and at three months. Results: A total of 112 patients were recruited. Fifty-two patients (46.4%) were randomized to one replacement and 60 patients (53.6%) to two meal replacements. Eighty-one patients (72.3%) were women, and the average age was 61 (11.03) years. The percentage of weight loss at three months was 8.27 (4.79)% (one meal replacement: 7.98 (5.97)%; two meal replacements: 8.50 (3.48)%; p = 0.56). A decrease in fat mass measured by the fat mass index (FMI) was detected (one meal replacement: −2.15 (1.45) kg/m2 vs. two meal replacements: −2.78 (2.55) kg/m2; p > 0.05), and a relative increase in fat-free mass was observed (one meal replacement: +3.57 (4.61)% vs. two meal replacements: +2.14 (4.45)%; p > 0.05). A decrease in HOMA-IR, systolic blood pressure (SBP), and total cholesterol was observed in both groups without differences between them. Conclusions: The substitution strategies of one or two meal replacements were effective in weight loss and fat mass decrease without differences between the two groups. An improvement in lipid parameters, glycemic control, and systolic blood pressure was observed without differences between strategies.
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Affiliation(s)
- Juan José López-Gómez
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain; (O.I.-J.); (D.P.-M.); (B.T.-T.); (E.G.-H.); (A.O.-B.); (D.A.D.L.-R.)
- Instituto de Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain
- Correspondence: ; Tel.: +34-699-762-001
| | - Olatz Izaola-Jauregui
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain; (O.I.-J.); (D.P.-M.); (B.T.-T.); (E.G.-H.); (A.O.-B.); (D.A.D.L.-R.)
- Instituto de Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain
| | - David Primo-Martín
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain; (O.I.-J.); (D.P.-M.); (B.T.-T.); (E.G.-H.); (A.O.-B.); (D.A.D.L.-R.)
- Instituto de Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain
| | - Beatriz Torres-Torres
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain; (O.I.-J.); (D.P.-M.); (B.T.-T.); (E.G.-H.); (A.O.-B.); (D.A.D.L.-R.)
- Instituto de Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain
| | - Emilia Gómez-Hoyos
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain; (O.I.-J.); (D.P.-M.); (B.T.-T.); (E.G.-H.); (A.O.-B.); (D.A.D.L.-R.)
- Instituto de Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain
| | - Ana Ortolá-Buigues
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain; (O.I.-J.); (D.P.-M.); (B.T.-T.); (E.G.-H.); (A.O.-B.); (D.A.D.L.-R.)
- Instituto de Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain
| | - Miguel A. Martín-Ferrero
- Servicio de Traumatología, Hospital Clínico Universitario de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain;
| | - Daniel A. De Luis-Román
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain; (O.I.-J.); (D.P.-M.); (B.T.-T.); (E.G.-H.); (A.O.-B.); (D.A.D.L.-R.)
- Instituto de Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain
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Durazo EM, Haan MN, Dang K, Aiello AE, Torres JM. Nativity, Neighborhoods, and Body Composition in the Sacramento Area Latino Study on Aging. THE GERONTOLOGIST 2020; 60:239-249. [PMID: 31774118 PMCID: PMC7039378 DOI: 10.1093/geront/gnz139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Globally, obesity influences the risk of many major chronic diseases. Our study examines the association between individual nativity and neighborhood level concentration of immigrants with 10-year changes in weight, body mass index (BMI), and waist circumference (WC) among older Latinos. RESEARCH DESIGN AND METHODS The Sacramento Area Latino Study on Aging (SALSA) is a population-based prospective study of community-dwelling older adults of Mexican origin (baseline ages 58-101 years). The primary outcome was repeated measures of weight over a 10-year period for 1,628 respondents. Nativity was defined by participants' reported place of birth (US-born or Latin American foreign born). Neighborhood immigrant concentration was measured as the percentage of foreign born at census tract level (2000 US Census). We used linear mixed models with repeated measures of weight, height, BMI, and WC as dependent variables (level 1), clustered within individuals (level 2) and neighborhood migrant concentration (level 3). RESULTS Foreign born (FB) respondents had lower baseline weight than the US-born (mean, 160 vs. 171 lbs, p < .0001). Over time, weight differences between the FB and the US-born decreased by 1.7 lbs/5 years as US-born weight decreased more rapidly. We observed a significant interaction between individual nativity and neighborhood immigrant concentration (p = .012). We found similar patterns for BMI, but did not find statistically significant differences in WC trajectories. DISCUSSION AND IMPLICATIONS Our study observed significant differences by foreign born vs. US nativity in baseline weight/BMI and in their trajectories over time. Additionally, we found weight/BMI differences in neighborhood immigrant concentration for the FB, but not for the US-born.
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Affiliation(s)
- Eva M Durazo
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
- Center for the Study of Adversity and Cardiovascular Disease (NURTURE Center), Division of Cardiology, Department of Medicine, University of California, San Francisco, California
| | - Mary N Haan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
| | - Kristina Dang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
| | - Allison E Aiello
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Jacqueline M Torres
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
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Kim KB, Kim K, Kim C, Kang SJ, Kim HJ, Yoon S, Shin YA. Effects of Exercise on the Body Composition and Lipid Profile of Individuals with Obesity: A Systematic Review and Meta-Analysis. J Obes Metab Syndr 2019; 28:278-294. [PMID: 31909371 PMCID: PMC6939705 DOI: 10.7570/jomes.2019.28.4.278] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/10/2019] [Accepted: 10/30/2019] [Indexed: 12/28/2022] Open
Abstract
Background Numerous researchers have worked to develop treatments for obesity; however, the prevalence of obesity continues to increase in many countries. Moreover, the effects of physical activity and exercise on obesity remain unclear. Therefore, it is necessary to perform a systematic review and meta-analysis to assess the relationship between exercise and obesity using mediator variables such as the mode of exercise. Methods Our review focuses on research tracking the effects of exercise on obesity conducted from 2007 to 2016 and available in any of three databases: Embase, PubMed, and EBSCO Academic Search Premier. The keywords used in the search were “exercise and obesity” and “exercise and obese.” Results The average size of the effects that exercise interventions have on body mass index (standardized mean difference [SMD], 0.533), waist circumference (SMD, 0.666), total cholesterol (SMD, 0.721), and triglyceride (TG; SMD, 0.603) were medium or larger. Exercise had greater effects on the outward appearance of obesity (body mass index, waist circumference) than on its practical factors (weight, % body fat). The effect of exercise on TG (SMD, 0.603) was larger than that on low-density lipoprotein (SMD, 0.406) and high-density lipoprotein (SMD, −0.222). Exercise duration (weeks of exercise) and intensity correlate better than exercise time (minutes per week) with a large and consistent improvement in adult obesity. Conclusion We suggest that individuals with obesity should exercise consistently to achieve significant improvements in their health.
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Affiliation(s)
- Kyoung-Bae Kim
- Department of Physical Education, Korea Military Academy, Seoul, Korea
| | - Kijin Kim
- Department of Physical Education, College of Physical Education, Keimyung University, Daegu, Korea
| | - Changsun Kim
- Department of Physical Education, Dongduk Women's University, Seoul, Korea
| | - Suh-Jung Kang
- Department of Sports and Health Management, Sangmyung University, Seoul, Korea
| | - Hyo Jeong Kim
- Department of Sport and Healthy Aging, Korea National Sport University, Seoul, Korea
| | - Seok Yoon
- Department of Sport Science, Chowan University, Murfreesboro, NC, USA
| | - Yun-A Shin
- Department of Prescription and Rehabilitation of Exercise, College of Sport Science, Dankook University, Cheonan, Korea
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Low-Volume High-Intensity Interval Training (HIIT) versus Moderate-Intensity Continuous Training on Body Composition, Cardiometabolic Profile and Physical Capacity in Older Women. J Aging Phys Act 2019; 27:879-889. [PMID: 31034304 DOI: 10.1123/japa.2018-0309] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To compare the effect of low-volume HIIT to moderate-intensity aerobic training (MICT) on fat mass, cardiometabolic profile and physical capacity and confirm its feasibility in older women. METHODS Inactive older women (60-75 years) were randomly assigned to 8 weeks of either HIIT (75 min/week; n=9) or MICT (150 min/week; n=9). Body composition, fasting metabolic profile, cardiovascular risk (Framingham score), and physical capacity (senior fitness test, VO2peak) were assessed before and after the intervention. Feasibility was evaluated with completion rate (training compliance; dropout rate) and affective response (Feeling scale; pre- and post-exercise). RESULTS Total cholesterol, non-HDL-C levels and the Framingham risk score decreased in both groups (all p≤0.03). Although VO2peak remained unchanged, the 6MWT distance increased (p<0.0001), irrespective of the group. Completion rate and affective responses were not different between groups (all p≥0.38). CONCLUSION A short-term HIIT program is feasible and provides as much benefits as MICT in older women.
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13
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Rice D, McNair P, Huysmans E, Letzen J, Finan P. Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis. J Clin Med 2019; 8:jcm8111769. [PMID: 31652929 PMCID: PMC6912819 DOI: 10.3390/jcm8111769] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 09/30/2019] [Indexed: 02/06/2023] Open
Abstract
Osteoarthritis (OA) is a leading cause of chronic pain and disability in older adults, which most commonly affects the joints of the knee, hip, and hand. To date, there are no established disease modifying interventions that can halt or reverse OA progression. Therefore, treatment is focused on alleviating pain and maintaining or improving physical and psychological function. Rehabilitation is widely recommended as first-line treatment for OA as, in many cases, it is safer and more effective than the best-established pharmacological interventions. In this article, we describe the presentation of OA pain and give an overview of its peripheral and central mechanisms. We then provide a state-of-the-art review of rehabilitation for OA pain—including self-management programs, exercise, weight loss, cognitive behavioral therapy, adjunct therapies, and the use of aids and devices. Next, we explore several promising directions for clinical practice, including novel education strategies to target unhelpful illness and treatment beliefs, methods to enhance the efficacy of exercise interventions, and innovative, brain-directed treatments. Finally, we discuss potential future research in areas, such as treatment adherence and personalized rehabilitation for OA pain.
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Affiliation(s)
- David Rice
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland 1142, New Zealand.
- Waitemata Pain Service, Department of Anaesthesiology and Perioperative Medicine, Waitemata District Health Board, Auckland 1142, New Zealand.
| | - Peter McNair
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland 1142, New Zealand.
| | - Eva Huysmans
- Pain in Motion International Research Group.
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussel, Belgium.
- Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, 1090 Brussels, Belgium.
- I-CHER, Interuniversity Center for Health Economics Research, 1090 Brussels, Belgium.
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium.
| | - Janelle Letzen
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, MD 21287, USA.
| | - Patrick Finan
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, MD 21287, USA.
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Solmi M, Köhler CA, Stubbs B, Koyanagi A, Bortolato B, Monaco F, Vancampfort D, Machado MO, Maes M, Tzoulaki I, Firth J, Ioannidis JPA, Carvalho AF. Environmental risk factors and nonpharmacological and nonsurgical interventions for obesity: An umbrella review of meta-analyses of cohort studies and randomized controlled trials. Eur J Clin Invest 2018; 48:e12982. [PMID: 29923186 DOI: 10.1111/eci.12982] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 06/18/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Multiple environmental factors have been implicated in obesity, and multiple interventions, besides drugs and surgery, have been assessed in obese patients. Results are scattered across many studies and meta-analyses, and they often mix obese and overweight individuals. MATERIALS AND METHODS PubMed and Cochrane Database of Systematic Reviews were searched through 21 January 2017 for meta-analyses of cohort studies assessing environmental risk factors for obesity, and randomized controlled trials investigating nonpharmacological and nonsurgical therapeutic interventions for obesity. We excluded data on overweight participants. Evidence from observational studies was graded according to criteria that included the statistical significance of the random-effects summary estimate and of the largest study in a meta-analysis, the number of obesity cases, heterogeneity between studies, 95% prediction intervals, small-study effects and excess significance. The evidence of intervention studies for obesity was assessed with the GRADE framework. RESULTS Fifty-four articles met eligibility criteria, including 26 meta-analyses of environmental risk factors (166 studies) and 46 meta-analyses of nondrug, nonsurgical interventions (206 trials). In adults, the only risk factor with convincing evidence was depression, and childhood obesity, adolescent obesity, childhood abuse and short sleep duration had highly suggestive evidence. Infancy weight gain during the first year of life, depression and low maternal education had convincing evidence for association with paediatric obesity. All interventions had low or very-low-quality evidence with one exception of moderate-quality evidence for one comparison (no differences in efficacy between brief lifestyle primary care interventions and other interventions for paediatric obesity). Summary effect sizes were mostly small across compared interventions (maximum 5.1 kg in adults and 1.78 kg in children) and even these estimates may be inflated. CONCLUSIONS Depression, obesity in earlier age groups, short sleep duration, childhood abuse and low maternal education have the strongest support among proposed risk factors for obesity. Furthermore, there is no high-quality evidence to recommend treating obesity with a specific nonpharmacological and nonsurgical intervention among many available, and whatever benefits in terms of magnitude of weight loss appear small.
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Affiliation(s)
- Marco Solmi
- Department of Neurosciences, University of Padova, Padova, Italy
| | - Cristiano A Köhler
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Francesco Monaco
- Department of Neurosciences, University of Padova, Padova, Italy
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium.,University Psychiatric Centre, KU Leuven, University of Leuven, Leuven-Kortenberg, Belgium
| | - Myrela O Machado
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,IMPACT Strategic Research Center, Deakin University, Geelong, Vic., Australia
| | - Ioanna Tzoulaki
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,MRC-PHE Centre for Environment, School of Public Health, Imperial College London, London, UK.,Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Joseph Firth
- NICM, School of Science and Health, University of Western Sydney, Sydney, NSW, Australia.,Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - John P A Ioannidis
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California.,Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California.,Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, California.,Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, California
| | - André F Carvalho
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada
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16
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Schultz TJ, Roupas P, Wiechula R, Krause D, Gravier S, Tuckett A, Hines S, Kitson A. Nutritional interventions for optimizing healthy body composition in older adults in the community: an umbrella review of systematic reviews. ACTA ACUST UNITED AC 2018; 14:257-308. [PMID: 27635754 DOI: 10.11124/jbisrir-2016-003063] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Optimizing body composition for healthy aging in the community is a significant challenge. There are a number of potential interventions available for older people to support both weight gain (for those who are underweight) and weight loss (for overweight or obese people). While the benefits of weight gain for underweight people are generally clearly defined, the value of weight loss in overweight or obese people is less clear, particularly for older people. OBJECTIVES This umbrella review aimed to measure the effectiveness of nutritional interventions for optimizing healthy body composition in older adults living in the community and to explore theirqualitative perceptions. INCLUSION CRITERIA TYPES OF PARTICIPANTS The participants were older adults, 60 years of age or older, living in the community. TYPES OF INTERVENTIONS The review examinedsix types of nutritional interventions: (i) dietary programs, (ii) nutritional supplements, (iii) meal replacements, (iv) food groups, (v) food delivery support and eating behavior, and (vi) nutritional counselling or education. TYPES OF STUDIES This umbrella review considered any quantitative systematic reviews and meta-analyses of effectiveness, or qualitative systematic reviews, or a combination (i.e. comprehensive reviews). TYPES OF OUTCOMES The quantitative outcome measures of body composition were: (i) nutritional status (e.g. proportion of overweight or underweight patients); (ii) fat mass (kg), (iii) lean mass or muscle mass (kg), (iv) weight (kg) or BMI (kg/m), (v) bone mass (kg) or bone measures such as bone mineral density, and (vi) hydration status. PHENOMENA OF INTEREST The phenomena of interestwere the qualitative perceptions and experiences of participants. SEARCH STRATEGY We developed an iterative search strategy for nine bibliometric databases and gray literature. METHODOLOGICAL QUALITY Critical appraisal of 13 studies was conducted independently in pairs using standard Joanna Briggs Institute tools. Six medium quality and seven high quality studies were identified. DATA EXTRACTION Data was extracted independently in pairs from all 13 included studies using the standard Joanna Briggs Institute data extraction tool. DATA SUMMARY Only quantitative studies of effectiveness were included. The strength of evidence assessing the effectiveness of interventionswas graded using a traffic light system (green, amber, red). An overall assessment of the quality of the evidence for each comparison was undertaken. RESULTS More systematic reviews investigating weight gain than those investigating weight loss were included. Studies onweight gain showed improved body composition for oral nutritional supplements on its own, for oral nutritional supplements in combination with resistance exercise training, and for oral nutritional supplements in combination with nutrition counselling. Studies on weight loss showed that diet in combination with exercise, diet in combination with exercise and nutrition counselling, and nutrition counselling on its own all can lead to reduced weight in older people. The outcomes of lean mass and weight/BMI were responsive to nutritional interventions, but fat mass did not vary. There were no qualitative reviews identified. CONCLUSIONS Although effective interventions for weight gain and weight loss to optimize body composition of older people in the community were identified,making long term, clinically relevant changes in body composition is difficult. Multiple interventions are more effective than single interventions.
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Affiliation(s)
- Timothy J Schultz
- 1School of Nursing, University of Adelaide, South Australia, Australia 2CSIRO Food and Nutrition, Werribee, Australia 3Centre for Evidence-based Practice South Australia (CEPSA): a Joanna Briggs Institute Centre of Excellence, South Australia, Australia 4School of Nursing, Midwifery and Social Work, The University of Queensland, Queensland, Australia 5Nursing Research Centre and Queensland Centre for Evidence Based Nursing and Midwifery: a Joanna Briggs Centre of Excellence, Mater Misericordiae Limited, Brisbane, Queensland, Australia 6Green Templeton College, University of Oxford, United Kingdom
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So ES. The Impacts of Weight Change and Weight Change Intention on Health-Related Quality of Life in the Korean Elderly. J Aging Health 2018; 31:1106-1120. [PMID: 29504447 DOI: 10.1177/0898264318761908] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective: This study aimed to identify the impacts of weight change and weight change intention on health-related quality of life (HRQL) among community-dwelling Korean elderly individuals. Method: Data on those aged 75 years and above from the Korean National Health and Nutrition Examination Survey were analyzed using multiple regression analysis. Results: Compared with no weight change, unintentional weight loss was associated with significantly lower adjusted overall HRQL and lower scores in the subdimensions of mobility, pain/discomfort, usual activities, and self-care (in order), whereas intentional weight loss was associated with significantly poorer scores for anxiety/depression. Weight gain showed no statistically significant differences in comparison with no weight change. Discussion: These findings suggest that weight maintenance or weight gain should be recommended rather than weight loss, whether unintentional or intentional, regardless of weight status, to improve HRQL among the elderly.
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Affiliation(s)
- Eun Sun So
- 1 Chonbuk National University, Jeonju-si, Republic of Korea
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18
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Gastric Bypass in Older Patients: Complications, Weight Loss, and Resolution of Comorbidities at 2 Years in a Matched Controlled Study. Obes Surg 2018; 26:1806-13. [PMID: 26738894 DOI: 10.1007/s11695-015-2024-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Roux-en-Y gastric bypass (RYGB) has recently been authorized for use in older patients. The objective of this single-center study was to evaluate 2-year weight loss in patients ≥60 years compared with younger matched patients undergoing RYGB. Secondary aims were to record complications and the resolution of comorbidities in a 2-year follow-up. METHODS Of 722 patients with at least 2 years follow-up data, 48 elderly patients were matched with 92 young (<40 years) and 96 middle-aged (40-59 year) patients, according to sex, baseline body mass index, and date of surgery. Weight loss, remission of comorbidities, death, and early (30-day) and 2-year complication rates were compared. RESULTS There were three deaths in the elderly group and none in the other groups. The early complication rate was not significantly different in the elderly group (17.8 %) compared with the young (11.5 %, p = 0.637) and middle-aged (13.7 %, p = 1.000) groups. The 2-year complication rates were not significantly different in the elderly group (9.3 %) compared with the young (23.5 %, p = 0.107) and middle-aged (13.2 %, p = 1.000) groups. The 2-year weight loss was lower in the elderly group (31.8 ± 7.2 %; p < 0.001) than in the young group (38.3 ± 6.9 %) but was not significantly different from that in the middle-aged group (34.4 ± 8.0 %; p = 0.145). Remission rates for diabetes and obstructive sleep apnea were lower in the elderly than in the two younger groups. CONCLUSION After bariatric surgery, major weight loss was observed in patients older than 60, but remission of metabolic comorbidities was less marked than in younger subjects.
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Hiilamo A, Lallukka T, Mänty M, Kouvonen A. Obesity and socioeconomic disadvantage in midlife female public sector employees: a cohort study. BMC Public Health 2017; 17:842. [PMID: 29065863 PMCID: PMC5655943 DOI: 10.1186/s12889-017-4865-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 10/17/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The two-way relationship between obesity and socioeconomic disadvantage is well established but previous studies on social and economic consequences of obesity have primarily focused on relatively young study populations. We examined whether obesity is associated with socioeconomic disadvantage through the 10-12-year follow-up, and how obesity-related socioeconomic inequalities develop during midlife among women. METHODS Baseline data were derived from the female population of the Helsinki Health Study cohort, comprising 40-60 -year-old employees of the City of Helsinki, Finland in 2000-2002 (n = 6913, response rate 69%). The follow-up surveys were carried out in 2007 (n = 5810) and 2012 (n = 5400). Socioeconomic disadvantage was measured by five dichotomous measures. Repeated logistic regression analyses utilising generalized estimating equations (GEE) were used to test the association between baseline self-reported obesity and the likelihood of socioeconomic disadvantage through all phases. The effect of time on the development of inequalities was examined by time interaction terms in random effect logistic regression models. RESULTS After adjustment for educational level, baseline obesity was associated with repeated poverty (OR = 1.23; 95% CI; 1.05-1.44), frequent economic difficulties (OR = 1.74; 95% CI; 1.52-1.99), low household net income (OR = 1.23; 95% CI; 1.07-1.41), low household wealth (OR = 1.90; 95% CI; 1.59-2.26) and low personal income (OR = 1.22; 95% CI; 1.03-1.44). The differences in poverty rate and low personal income between the participants with obesity and participants with normal weight widened during the follow-up. Living without a partner and early exit from paid employment explained the widening of inequalities. CONCLUSIONS Weight status inequalities in socioeconomic disadvantage persisted or widened during the late adulthood.
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Affiliation(s)
- Aapo Hiilamo
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Finnish Institute of Occupational Health, Helsinki, Finland
| | - Minna Mänty
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Unit of Research, Development and Innovation, Laurea University of Applied Sciences, Vantaa, Finland
| | - Anne Kouvonen
- Department of Social Research, University of Helsinki, Helsinki, Finland. .,SWPS University of Social Sciences and Humanities in Wroclaw, Wroclaw, Poland. .,UKCRC Centre of Excellence for Public Health (Northern Ireland), Queen's University Belfast, Belfast, UK. .,Administrative Data Research Centre - Northern Ireland (ADRC-NI), Queen's University Belfast, Centre for Public Health, Institute of Clinical Sciences, Grosvenor Road, Belfast, BT12 6BJ, UK.
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de Roon M, van Gemert WA, Peeters PH, Schuit AJ, Monninkhof EM. Long-term effects of a weight loss intervention with or without exercise component in postmenopausal women: A randomized trial. Prev Med Rep 2017; 5:118-123. [PMID: 27981025 PMCID: PMC5156605 DOI: 10.1016/j.pmedr.2016.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 11/07/2016] [Accepted: 12/05/2016] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to determine the long-term effects of a weight loss intervention with or without an exercise component on body weight and physical activity. Women were randomized to diet (n = 97) or exercise (N = 98) for 16 weeks. During the intervention, both groups had achieved the set goal of 5-6 kg weight loss. All women were re-contacted twelve months after study cessation for follow-up where body weight and physical activity were measured (PASE questionnaire and ActiGraph accelerometer). At follow-up, body weight and physical activity (measured by the PASE questionnaire and accelerometer) were measured again. At follow-up, both mainly exercise (- 4.3 kg, p < 0.001) and diet (- 3.4 kg, p < 0.001) showed significantly reduced body weight compared to baseline. Both the mainly exercise and diet group were significantly more physically active at one year follow-up compared to baseline (PASE: + 33%, p < 0.001 and + 12%, p = 0.040, respectively; ActiGraph: + 16%, p = 0.012. and + 2.2%, p = 0.695 moderate-to-vigorous activity, respectively). Moreover, the increase in physical activity was statistically significantly when comparing exercise to diet (+ 0.6%, p = 0.035). ActiGraph data also showed significantly less sedentary time in mainly exercise group compared to baseline (- 2.1%, p = 0.018) and when comparing exercise to diet (- 1.8%, p = 0.023). No significant within group differences were found for the diet group. This study shows largely sustained weight loss one year after completing a weight loss program with and without exercise in overweight postmenopausal women. Although the mainly exercise group maintained more physically active compared to the diet group, maintenance of weight loss did not differ between groups.
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Affiliation(s)
- Martijn de Roon
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Physical Therapy Sciences, program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Willemijn A van Gemert
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Albertine J Schuit
- Department of Health Science, VU University Amsterdam, The Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Evelyn M Monninkhof
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Beleigoli AM, Diniz MDFH, Boersma E, Silva JL, Lima-Costa MF, Ribeiro AL. The Effects of Weight and Waist Change on the Risk of Long-Term Mortality in Older Adults- The Bambuí (Brazil) Cohort Study of Aging. J Nutr Health Aging 2017; 21:861-866. [PMID: 28972237 DOI: 10.1007/s12603-016-0858-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE We aimed to investigate the risk of long-term mortality associated with weight and waist circumference (WC) change among older adults, particularly the overweight and obese ones. DESIGN Cohort Study. SETTING The Bambuí (Brazil) Cohort Study of Aging. PARTICIPANTS Community-dwelling elderly (n=1138). MEASUREMENTS Weight and WC were reassessed three years after baseline. Mortality risk associated with a 5% weight/WC loss and gain was compared to that of weight/WC stability by Cox models adjusted for clinical, behavioral and social known risk factors for death (age, gender, BMI, smoking, diabetes, total cholesterol, hypertension, Chagas disease, major electrocardiographic changes, physical activity, B-type natriuretic peptide, C-reactive protein, creatinine, education and household income). RESULTS Female sex was predominant (718; 63.1%). Mean age was 68 (6.7) years. Weight stability (696; 61.1%) was more common than weight loss (251; 22.1%) or gain (191; 16.8%). WC remained stable in 422 (37.3%), decreased in 418 (37.0%) and increased in 291 (25.7%) participants. There were 334 (29.3%) deaths over a median follow-up time of 8.0 (6.4-8.0) years from weight/WC reassessment. Weight loss (HR 1.69; 95% CI 1.30-2.21) and gain (HR 1.37; 95% CI 1.01-1.85) were associated with increased mortality, except in those who were physically active in which weight gain was associated with decreased mortality. Results were similar for participants who were overweight/obese or with abdominal obesity at baseline (HR 1.41; 95%CI 1.02-1.97 and HR 2.01; 95%CI 1.29-3.12, for weight loss and gain, respectively). WC change was not significantly associated with mortality. CONCLUSION Although weight loss has been recommended for adults with excessive weight regardless of age, weight change might be detrimental in older adults. Rather than weight loss, clinical interventions should target healthy lifestyle behaviors that contribute to weight stability, particularly physical activity in overweight and obese older adults.
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Affiliation(s)
- A M Beleigoli
- Alline M Beleigoli, Av. Prof. Alfredo Balena, 190 - sala 246 - Cep:30130-100 / Belo Horizonte - MG - Brazil, Phone: +55 31 3409 9746 Fax: +55 31 32233328, E-mail:
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Abstract
The percentage of older obese adults is on the rise. Many clinicians underestimate the health consequences of obesity in the elderly, citing scarce evidence and concerns that weight loss might be detrimental to the health of older adults. Although overweight and obese elders are not at the same risk for morbidity and mortality as younger individuals, quality of life and function are adversely impacted. Weight loss plans in the elderly should include aerobic activities as well as balance and resistance activities to maintain optimal physical function.
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Affiliation(s)
- Virginia B Kalish
- Department of Family Medicine, National Capital Consortium Family Medicine Residency, Fort Belvoir Community Hospital, 9300 Dewitt Loop, Fort Belvoir, VA 22060, USA.
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Tkatch R, Musich S, MacLeod S, Alsgaard K, Hawkins K, Yeh CS. Population Health Management for Older Adults: Review of Interventions for Promoting Successful Aging Across the Health Continuum. Gerontol Geriatr Med 2016; 2:2333721416667877. [PMID: 28680938 PMCID: PMC5486489 DOI: 10.1177/2333721416667877] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 06/09/2016] [Accepted: 08/09/2016] [Indexed: 12/21/2022] Open
Abstract
Background: The older adult population is expanding, living longer, with multiple chronic conditions. Understanding and managing their needs over time is an integral part of defining successful aging. Population health is used to describe the measurement and health outcomes of a population. Objectives: To define population health as applied to older adults, summarize lessons learned from current research, and identify potential interventions designed to promote successful aging and improved health for this population. Method: Online search engines were utilized to identify research on population health and health interventions for older adults. Results: Population health management (PHM) is one strategy to promote the health and well-being of target populations. Interventions promoting health across a continuum tend to be disease, risk, or health behavior specific rather than encompassing a global concept of health. Conclusion: Many existing interventions for older adults are simply research based with limited generalizability; as such, further work in this area is warranted.
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[Obesity in old age and its importance for functionality and frailty]. Z Gerontol Geriatr 2016; 49:573-580. [PMID: 27637579 DOI: 10.1007/s00391-016-1133-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/09/2016] [Accepted: 08/18/2016] [Indexed: 10/21/2022]
Abstract
In later life a high body mass index (BMI) is associated with the lowest age-related mortality rate. The BMI range used by the World Health Organization (WHO) to classify overweight, a BMI of 25-30 kg/m2, can be regarded as normal weight in old age; nevertheless, obesity is associated with an increased risk of disability and of a deterioration in physical functionality, particularly among older age groups. This relationship to obesity has also been established for frailty. For this reason, a reduction in weight may be appropriate under functional aspects if BMI values exceed 30 kg/m2; however, such a decision cannot be made on the basis of an individual BMI alone. The functional status, body composition, comorbidities and, in particular the life perspectives of the patient should also be taken into consideration. If weight loss is intended, it must always be performed under strict medical supervision involving optimized protein intake, a carefully calculated moderate reduction in calories and adequate physical training. In the case of chronically ill elderly patients, weight reduction is not usually appropriate. Restrictive diets of any kind should principally be critically viewed in old age because even temporary inadequate energy intake may lead to accelerated deterioration of muscle and bone structure.
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Pleasure: An under-utilised ‘P’ in social marketing for healthy eating. Appetite 2016; 104:60-9. [DOI: 10.1016/j.appet.2015.10.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 08/23/2015] [Accepted: 10/05/2015] [Indexed: 12/31/2022]
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Chen WC, Chen YM, Huang CC, Tzeng YD. Dehydroepiandrosterone Supplementation Combined with Whole-Body Vibration Training Affects Testosterone Level and Body Composition in Mice. Int J Med Sci 2016; 13:730-740. [PMID: 27766021 PMCID: PMC5069407 DOI: 10.7150/ijms.16132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/19/2016] [Indexed: 11/05/2022] Open
Abstract
Dehydroepiandrosterone (DHEA), the most abundant sex steroid, is primarily secreted by the adrenal gland and a precursor hormone used by athletes for performance enhancement. Whole-body vibration (WBV) is a well-known light-resistance exercise by automatic adaptations to rapid and repeated oscillations from a vibrating platform, which is also a simple and convenient exercise for older adults. However, the potential effects of DHEA supplementation combined with WBV training on to body composition, exercise performance, and hormone regulation are currently unclear. The objective of the study is to investigate the effects of DHEA supplementation combined with WBV training on body composition, exercise performance, and physical fatigue-related biochemical responses and testosterone content in young-adult C57BL/6 mice. In this study, male C57BL/6 mice were divided into four groups (n = 8 per group) for 6-weeks treatment: sedentary controls with vehicle (SC), DHEA supplementation (DHEA, 10.2 mg/kg), WBV training (WBV; 5.6 Hz, 2 mm, 0.13 g), and WBV training with DHEA supplementation (WBV+DHEA; WBV: 5.6 Hz, 2 mm, 0.13 g and DHEA: 10.2 mg/kg). Exercise performance was evaluated by forelimb grip strength and exhaustive swimming time, as well as changes in body composition and anti-fatigue levels of serum lactate, ammonia, glucose, creatine kinase (CK), and blood urea nitrogen (BUN) after a 15-min swimming exercise. In addition, the biochemical parameters and the testosterone content were measured at the end of the experiment. Six-week DHEA supplementation alone significantly increased mice body weight (BW), muscle weight, testosterone level, and glycogen contents (liver and muscle) when compared with SC group. DHEA supplementation alone had no negative impact on all tissue and biochemical profiles, but could not improve exercise performance. However, WBV+DHEA supplementation also significantly decreased BW, testosterone level and glycogen content of liver, as well as serum lactate and ammonia levels after the 15-min swimming exercise when compared with DHEA supplementation alone. Although DHEA supplementation alone had no beneficial effect in the exercise performance of mice, the BW, testosterone level and glycogen content significantly increased. On the other hand, WBV training combined with DHEA decreased the BW gain, testosterone level and glycogen content caused by DHEA supplementation. Therefore, WBV training could inhibit DHEA supplementation to synthesis the testosterone level or may decrease the DHEA supplement absorptive capacity in young-adult mice.
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Affiliation(s)
- Wen-Chyuan Chen
- Center for General Education, Chang Gung University of Science and Technology, Taoyuan 33301, Taiwan;; Department of Otorhinolaryngology-Head and Neck Surgery, Sleep Center, Linkou-Chang Gung Memorial Hospital, Taoyuan 33301, Taiwan
| | - Yi-Ming Chen
- Center for General Education, Chang Gung University of Science and Technology, Taoyuan 33301, Taiwan;; Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
| | - Chi-Chang Huang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
| | - Yen-Dun Tzeng
- Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, 813 Kaohsiung, Taiwan
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Bouaziz W, Schmitt E, Kaltenbach G, Geny B, Vogel T. Health benefits of endurance training alone or combined with diet for obese patients over 60: a review. Int J Clin Pract 2015; 69:1032-49. [PMID: 25963846 DOI: 10.1111/ijcp.12648] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The prevalence of obesity is rapidly increasing in older patients and it is ubiquitous in many developed countries. Obesity is related to various negative health outcomes, making it a major public health target for intervention. PURPOSE The aim of this study was to explore and summarise the literature that addresses endurance training alone or combined with nutrition interventions to combat obesity in obese patients over age 60. METHODS We searched online electronic databases up to September 2014 for original observational and intervention studies published between 1995 and 2014 on the relationship between endurance training alone or combined with a diet in obese patients over 60 regarding health outcomes. RESULTS Twenty-six studies examined interventions aimed specifically at promoting endurance training alone or combined with diet for older obese patients over 60. These studies demonstrated a positive effect of this intervention on the primary prevention of cardiovascular disease, and a significant beneficial effect on the lipid profile. Improvement of body composition and insulin sensitivity, and a reduction in blood pressure were also well established. CONCLUSIONS Overall, this review demonstrates a positive effect of endurance training alone or combined with diet on health outcomes and metabolic benefits in older adults. Clinicians can now use this evidence to formulate actions to encourage the older obese to profit from the health benefits of endurance training and diet. This will not only help reduce the dramatic increase in the number of older obese but also help prevent sarcopenic obesity, which is a complex challenge for healthcare professionals.
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Affiliation(s)
- W Bouaziz
- Geriatric Department, University Hospital, Strasbourg, France
- Department of Physiology and EA-3072, Faculty of Medicine, Strasbourg University, Strasbourg, France
| | - E Schmitt
- Geriatric Department, University Hospital, Strasbourg, France
- Department of Physiology and EA-3072, Faculty of Medicine, Strasbourg University, Strasbourg, France
| | - G Kaltenbach
- Geriatric Department, University Hospital, Strasbourg, France
| | - B Geny
- Department of Physiology and EA-3072, Faculty of Medicine, Strasbourg University, Strasbourg, France
- Functional Explorations Department, University Hospital, Strasbourg, France
| | - T Vogel
- Geriatric Department, University Hospital, Strasbourg, France
- Department of Physiology and EA-3072, Faculty of Medicine, Strasbourg University, Strasbourg, France
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Borek AJ, Abraham C, Smith JR, Greaves CJ, Tarrant M. A checklist to improve reporting of group-based behaviour-change interventions. BMC Public Health 2015; 15:963. [PMID: 26403082 PMCID: PMC4583168 DOI: 10.1186/s12889-015-2300-6] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 09/18/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Published descriptions of group-based behaviour-change interventions (GB-BCIs) often omit design and delivery features specific to the group setting. This impedes the ability to compare behaviour-change interventions, synthesise evidence on their effectiveness and replicate effective interventions. The aim of this study was to develop a checklist of elements that should be described to ensure adequate reporting of GB-BCIs. METHODS A range of characteristics needed to replicate GB-BCIs were extracted from the literature and precisely defined. An abbreviated checklist and a coder manual were developed, pilot tested and refined. The final checklist and coder manual were used to identify the presence or absence of specified reporting elements in 30 published descriptions of GB-BCIs by two independent coders. Reliability of coding was assessed. RESULTS The checklist comprises 26 essential reporting elements, covering intervention design, intervention content, participant characteristics, and facilitator characteristics. Inter-rater reliability for identification of reporting elements was high (95% agreement, Mean AC1 = 0.89). CONCLUSION The checklist is a practical tool that can be used, alongside other reporting guidelines, to ensure comprehensive description and to assess reporting quality of GB-BCIs. It can also be helpful for designing group-based health interventions.
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Affiliation(s)
- Aleksandra J Borek
- Psychology Applied to Health group, University of Exeter Medical School, University of Exeter, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - Charles Abraham
- Psychology Applied to Health group, University of Exeter Medical School, University of Exeter, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - Jane R Smith
- Psychology Applied to Health group, University of Exeter Medical School, University of Exeter, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - Colin J Greaves
- Psychology Applied to Health group, University of Exeter Medical School, University of Exeter, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - Mark Tarrant
- Psychology Applied to Health group, University of Exeter Medical School, University of Exeter, St Luke's Campus, Exeter, EX1 2LU, UK.
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Wirth A, Wabitsch M, Hauner H. The prevention and treatment of obesity. DEUTSCHES ARZTEBLATT INTERNATIONAL 2015; 111:705-13. [PMID: 25385482 DOI: 10.3238/arztebl.2014.0705] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 07/23/2014] [Accepted: 07/23/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND The high prevalence of obesity (24% of the adult population) and its adverse effects on health call for effective prevention and treatment. METHOD Pertinent articles were retrieved by a systematic literature search for the period 2005 to 2012. A total of 4495 abstracts were examined. 119 publications were analyzed, and recommendations were issued in a structured consensus procedure by an interdisciplinary committee with the participation of ten medical specialty societies. RESULTS Obesity (body-mass index [BMI] ge;30 kg/m2) is considered to be a chronic disease. Its prevention is especially important. For obese persons, it is recommended that a diet with an energy deficit of 500 kcal/day and a low energy density should be instituted for the purpose of weight loss and stabilization of a lower weight. The relative proportion of macronutrients is of secondary importance for weight loss. If the BMI exceeds 30 kg/m2, formula products can be used for a limited time. More physical exercise in everyday life and during leisure time promotes weight loss and improves risk factors and obesity-associated diseases. Behavior modification and behavioral therapy support changes in nutrition and exercise in everyday life. With respect to changes in lifestyle, there is no scientific evidence to support any particular order of the measures to be taken. Weight-loss programs whose efficacy has been scientifically evaluated are recommended. Surgical intervention is more effective than conservative treatment with respect to reduction of bodily fat, improvement of obesity-associated diseases, and lowering mortality. Controlled studies indicate that, within 1 to 2 years, a weight loss of ca. 4 to 6 kg can be achieved by dietary therapy, 2 to 3 kg by exercise therapy, and 20 to 40 kg by bariatric surgery. CONCLUSION There is good scientific evidence for effective measures for the prevention and treatment of obesity.
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Affiliation(s)
- Alfred Wirth
- Bad Rothenfelde, Department of Pediatrics and Adolescent Medicine, Section of Pediatric Endocrinology and Diabetes, University Medical Center Ulm, Ulm, Else Kroener-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich
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31
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Goisser S, Kemmler W, Porzel S, Volkert D, Sieber CC, Bollheimer LC, Freiberger E. Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons--a narrative review. Clin Interv Aging 2015; 10:1267-82. [PMID: 26346071 PMCID: PMC4531044 DOI: 10.2147/cia.s82454] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
One of the many threats to independent life is the age-related loss of muscle mass and muscle function commonly referred to as sarcopenia. Another important health risk in old age leading to functional decline is obesity. Obesity prevalence in older persons is increasing, and like sarcopenia, severe obesity has been consistently associated with several negative health outcomes, disabilities, falls, and mobility limitations. Both sarcopenia and obesity pose a health risk for older persons per se, but in combination, they synergistically increase the risk for negative health outcomes and an earlier onset of disability. This combination of sarcopenia and obesity is commonly referred to as sarcopenic obesity. The present narrative review reports the current knowledge on the effects of complex interventions containing nutrition and exercise interventions in community-dwelling older persons with sarcopenic obesity. To date, several complex interventions with different outcomes have been conducted and have shown promise in counteracting either sarcopenia or obesity, but only a few studies have addressed the complex syndrome of sarcopenic obesity. Strong evidence exists on exercise interventions in sarcopenia, especially on strength training, and for obese older persons, strength exercise in combination with a dietary weight loss intervention demonstrated positive effects on muscle function and body fat. The differences in study protocols and target populations make it impossible at the moment to extract data for a meta-analysis or give state-of-the-art recommendations based on reliable evidence. A conclusion that can be drawn from this narrative review is that more exercise programs containing strength and aerobic exercise in combination with dietary interventions including a supervised weight loss program and/or protein supplements should be conducted in order to investigate possible positive effects on sarcopenic obesity.
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Affiliation(s)
- Sabine Goisser
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics (IMP), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Simone Porzel
- Nutricia GmbH, Danone Medical Nutrition, Erlangen, Germany
| | - Dorothee Volkert
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany
| | - Cornel Christian Sieber
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany ; Department of Internal Medicine and Geriatrics, St John of God Hospital (Barmherzige Brüder), Regensburg, Germany
| | - Leo Cornelius Bollheimer
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany ; Department of Internal Medicine and Geriatrics, St John of God Hospital (Barmherzige Brüder), Regensburg, Germany
| | - Ellen Freiberger
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany
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Rueda-Clausen CF, Ogunleye AA, Sharma AM. Health Benefits of Long-Term Weight-Loss Maintenance. Annu Rev Nutr 2015; 35:475-516. [DOI: 10.1146/annurev-nutr-071714-034434] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Christian F. Rueda-Clausen
- Obesity Research & Management, Clinical Research Unit, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2E1 Canada; , ,
| | - Ayodele A. Ogunleye
- Obesity Research & Management, Clinical Research Unit, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2E1 Canada; , ,
| | - Arya M. Sharma
- Obesity Research & Management, Clinical Research Unit, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2E1 Canada; , ,
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Evans EH, Boothroyd LG, Muscariello E, Stephan BCM, Nasti G, Colantuoni A, Siervo M. Lower weight loss expectations and healthier eating attitudes in older overweight and obese women attempting weight loss. Clin Obes 2015; 5:136-44. [PMID: 25872866 DOI: 10.1111/cob.12093] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 02/18/2015] [Accepted: 03/09/2015] [Indexed: 11/27/2022]
Abstract
Weight loss outcomes in overweight and obese individuals may be influenced by individual weight loss expectations (WLEs). Research on these phenomena in older women is lacking. This cross-sectional study compared groups of younger and older women on their WLEs and related attitudes (body dissatisfaction and disordered eating). Twenty-six younger (18-38 years) and 33 older (60-78 years) overweight and obese women were recruited from a weight loss clinic, prior to treatment. Disordered eating attitudes and body dissatisfaction were assessed using validated questionnaires and a pictorial figure-choice scale. Participants reported 10 WLEs categorized according to personal, lifestyle and social factors. Overall, women with a higher body mass index had greater WLEs. Older women reported lower WLEs than younger women (-14.5 kg vs. -22.4 kg) in all categories except past weight. Older women perceived that career success would necessitate the greatest level of weight loss (-18.5 kg), whereas younger women derived their greatest WLEs from mass media (-28.5 kg). Both older and younger groups perceived that their families would be supportive of the smallest amount of weight loss (-8.4 and -17.6 kg, respectively). The groups did not differ on body dissatisfaction, but younger women's disordered eating attitudes were significantly higher (p < .001). Older overweight and obese women have lower WLEs than younger women but experience similar levels of body dissatisfaction and healthier eating attitudes. The attitudinal constructs underlying these differences may be useful in clinical practice to tailor age-specific weight loss interventions.
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Affiliation(s)
- E H Evans
- Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - L G Boothroyd
- Department of Psychology, Durham University, Durham, UK
| | - E Muscariello
- Human Nutrition and Physiology, Department of Neuroscience, University of Naples, Naples, Italy
| | - B C M Stephan
- Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - G Nasti
- Human Nutrition and Physiology, Department of Neuroscience, University of Naples, Naples, Italy
| | - A Colantuoni
- Human Nutrition and Physiology, Department of Neuroscience, University of Naples, Naples, Italy
| | - M Siervo
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, UK
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Miedema B, Reading SA, Hamilton RA, Morrison KS, Thompson AE. Can certified health professionals treat obesity in a community-based programme? A quasi-experimental study. BMJ Open 2015; 5:e006650. [PMID: 25652801 PMCID: PMC4322212 DOI: 10.1136/bmjopen-2014-006650] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To test the effectiveness of a non-pharmaceutical programme for obese participants in a rural Eastern Canadian Province using certified health professionals. DESIGN A prospective quasi-experimental design with repeated premeasure and postmeasure. PARTICIPANTS 146 participants with obesity (body mass index >30 kg/m(2)) from rural and urban communities in an Eastern Canadian Province were divided into four groups. INTERVENTION A 6-month intensive active community-based lifestyle intervention (InI) delivered by Certified Exercise Physiologists, Certified Personal Trainers and Registered Dietitians, followed by 6 months of self-management. A second intervention (InII) was nested in InI and consisted of group-mediated cognitive-behavioral intervention (GMCBI) delivered by an exercise psychologist to two of the four InI groups. OUTCOMES (1) Improving health outcomes among the participants' preactive and postactive 6-month intervention and self-management period, (2) Documenting the impact of InII (GMCBI) and location of the intervention (urban vs rural). RESULTS The 6-month active InI significantly improved cardiovascular health for participants who completed the intervention. InII (GMCBI) significantly lowered the attrition rate among the participants. The self-management period was challenging for the participants and they did not make further gains; however, most were able to maintain the gains achieved during the active intervention. The location of the intervention, urban or rural, had little impact on outcomes. CONCLUSIONS A community-based programme utilising healthcare professionals other than physicians to treat obese patients was effective based on premeasure and postmeasure. During the self-management phase, the participants were able to maintain the gains. Psychological support is essential to participant retention.
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Affiliation(s)
- Baukje Miedema
- Dalhousie University Family Medicine Teaching Unit, Dr. Everett Chalmers Regional Hospital, Fredericton, Canada
| | - Stacey A Reading
- Department of Sport & Exercise Science, University of Auckland, Auckland, New Zealand
| | - Ryan A Hamilton
- Psychology Department, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Katherine S Morrison
- Dalhousie University Family Medicine Teaching Unit, Dr. Everett Chalmers Regional Hospital, Fredericton, Canada
| | - Ashley E Thompson
- Dalhousie University Family Medicine Teaching Unit, Dr. Everett Chalmers Regional Hospital, Fredericton, Canada
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Holt AM, Jancey J, Lee AH, Kerr DA, Hills AP, Anderson AS, Howat PA. A cluster-randomised controlled trial of a physical activity and nutrition programme in retirement villages: a study protocol. BMJ Open 2014; 4:e005107. [PMID: 25256185 PMCID: PMC4179572 DOI: 10.1136/bmjopen-2014-005107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Physical activity levels of Australia's ageing population are declining and coincidentally rates of overweight and obesity are increasing. Adequate levels of physical activity and a healthy diet are recognised as important lifestyle factors for the maintenance of a healthy weight and prevention of chronic diseases. Retirement village (RV) residents rarely engage in physical activity and nutrition programmes offered, with poor attendance and low use of existing facilities such as on-site fitness centres and classes and nutrition seminars. The RV provides a unique setting to access and engage with this older target group, to test the effectiveness of strategies to increase levels of physical activity, improve nutrition and maintain a healthy weight. METHOD AND ANALYSIS This cluster-randomised controlled trial will evaluate a physical activity, nutrition and healthy weight management intervention for insufficiently active ('not achieving 150 min of moderate-intensity physical activity per week') adults aged 60-75 residing in RV's. A total of 400 participants will be recruited from 20 randomly selected RV's in Perth, Western Australia. Villages will be assigned to either the intervention group (n=10) or the control group (n=10) each containing 200 participants. The Retirement Village Physical Activity and Nutrition for Seniors (RVPANS) programme is a home-based physical activity and nutrition programme that includes educational resources, along with facilitators who will motivate and guide the participants during the 6-month intervention. Descriptive statistics and mixed regression models will be performed to assess the intervention effects. This trial will evaluate an intervention for the modification of health risk factors in the RV setting. Such research conducted in RV's has been limited. ETHICS AND DISSEMINATION Curtin University Human Research Ethics Committee (approval number: HR128/2012). Dissemination of the study results will occur through publications, reports, conference presentations and community seminars. TRIAL REGISTRATION NUMBER Australia and New Zealand Clinical Trial Registry (ACTRN12612001168842).
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Affiliation(s)
- Anne-Marie Holt
- Western Australian Centre for Health Promotion, Curtin University, Perth, Western Australia, Australia
| | - Jonine Jancey
- Western Australian Centre for Health Promotion, Curtin University, Perth, Western Australia, Australia School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Andy H Lee
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Deborah A Kerr
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Andrew P Hills
- Griffith Health Institute, Griffith University, Queensland, Australia
| | | | - Peter A Howat
- Western Australian Centre for Health Promotion, Curtin University, Perth, Western Australia, Australia Centre for Behavioural Research in Cancer Control, Curtin University, Perth, Western Australia, Australia
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Pettigrew S, Borys JM, du Plessis HR, Walter L, Huang TTK, Levi J, Vinck J. Process evaluation outcomes from a global child obesity prevention intervention. BMC Public Health 2014; 14:757. [PMID: 25065414 PMCID: PMC4122757 DOI: 10.1186/1471-2458-14-757] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 07/22/2014] [Indexed: 12/22/2022] Open
Abstract
Background While it is acknowledged that child obesity interventions should cover multiple ecological levels (downstream, midstream and upstream) to maximize their effectiveness, there is a lack of evaluation data to guide the development and implementation of such efforts. To commence addressing this knowledge gap, the present study provides process evaluation data relating to the experiences of groups implementing the EPODE approach to child obesity prevention in various locations around the world. The aim of this exploratory study was to investigate the barriers and facilitators to program implementation in program sites around the world to assist in developing strategies to enhance program outcomes. Methods An online survey that included open-ended questions was distributed to the 25 EPODE programs in operation at the time of the survey (May 2012). The survey items asked respondents to comment on those aspects of program implementation that they found challenging and to suggest areas for future improvement. Eighteen programs representing 14 countries responded to the request to participate in the survey, yielding a 72% response rate. The responses were analyzed via the constant comparative method using NVivo qualitative data analysis software. Results The main concerns of the various EPODE programs were their ability to secure ongoing funding and their access to evidence-based intervention methods and policy advice relating to relationships with third parties. These issues were in turn impacted by other factors, including (i) access to user-friendly information relating to the range of intervention strategies available and appropriate evaluation measures; (ii) assistance with building and maintaining stakeholder relationships; and (iii) assurance of the quality, independence, and transparency of policies and practices. Conclusions The findings are facilitating the ongoing refinement of the EPODE approach. In particular, standardized and tailored information packages are being made available to advise program members of (i) the various evaluation methods and tools at their disposal and (ii) methods of acquiring private partner support. Overall, the study results relating to the types of issues encountered by program members are likely to be useful in guiding the future design and implementation of multi-level initiatives seeking to address other complex and intractable health-related problems.
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Affiliation(s)
- Simone Pettigrew
- School of Psychology and Speech Pathology, CurtinUniversity, Kent St, Bentley, WA 6102, Australia.
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Expert Panel Report: Guidelines (2013) for the management of overweight and obesity in adults. Obesity (Silver Spring) 2014; 22 Suppl 2:S41-410. [PMID: 24227637 DOI: 10.1002/oby.20660] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Executive summary: Guidelines (2013) for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society published by the Obesity Society and American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Based on a systematic review from the The Obesity Expert Panel, 2013. Obesity (Silver Spring) 2014; 22 Suppl 2:S5-39. [PMID: 24961825 DOI: 10.1002/oby.20821] [Citation(s) in RCA: 181] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Anderson AS, Craigie AM, Caswell S, Treweek S, Stead M, Macleod M, Daly F, Belch J, Rodger J, Kirk A, Ludbrook A, Rauchhaus P, Norwood P, Thompson J, Wardle J, Steele RJC. The impact of a bodyweight and physical activity intervention (BeWEL) initiated through a national colorectal cancer screening programme: randomised controlled trial. BMJ 2014; 348:g1823. [PMID: 24609919 PMCID: PMC3945930 DOI: 10.1136/bmj.g1823] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the impact of a diet and physical activity intervention (BeWEL) on weight change in people with a body mass index >25 weight (kg)/height (m)(2) at increased risk of colorectal cancer and other obesity related comorbidities. DESIGN Multicentre, parallel group, randomised controlled trial. SETTING Four Scottish National Health Service health boards. PARTICIPANTS 329 overweight or obese adults (aged 50 to 74 years) who had undergone colonoscopy after a positive faecal occult blood test result, as part of the national bowel screening programme, and had a diagnosis of adenoma confirmed by histopathology. 163 were randomised to intervention and 166 to control. INTERVENTION Participants were randomised to a control group (weight loss booklet only) or 12 month intervention group (three face to face visits with a lifestyle counsellor plus monthly 15 minute telephone calls). A goal of 7% reduction in body weight was set and participants received a personalised energy prescription (2508 kJ (600 kcal) below that required for weight maintenance) and bodyweight scales. Motivational interviewing techniques explored self assessed confidence, ambivalence, and personal values concerning weight. Behavioural strategies included goal setting, identifying intentions of implementation, self monitoring of body weight, and counsellor feedback about reported diet, physical activity, and weight change. MAIN OUTCOME MEASURES The primary outcome was weight change over 12 months. Secondary outcomes included changes in waist circumference, blood pressure, fasting cardiovascular biomarkers, and glucose metabolism variables, physical activity, diet, and alcohol consumption. RESULTS At 12 months, data on the primary outcome were available for 148 (91%) participants in the intervention group and 157 (95%) in the control group. Mean weight loss was 3.50 kg (SD 4.91) (95% confidence interval 2.70 to 4.30) in the intervention group compared with 0.78 kg (SD 3.77) (0.19 to 1.38) in the control group. The group difference was 2.69 kg (95% confidence interval 1.70 to 3.67). Differences between groups were significant for waist circumference, body mass index, blood pressure, blood glucose level, diet, and physical activity. No reported adverse events were considered to be related to trial participation. CONCLUSIONS Significant weight loss can be achieved by a diet and physical activity intervention initiated within a national colorectal cancer screening programme, offering considerable potential for risk reduction of disease in older adults. TRIAL REGISTRATION Current Controlled Trials ISRCTN53033856.
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Affiliation(s)
- Annie S Anderson
- Centre for Research into Cancer Prevention and Screening, Cancer Division, Medical Research Institute, Ninewells Medical School, Dundee, UK
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Metabolomics identifies changes in fatty acid and amino acid profiles in serum of overweight older adults following a weight loss intervention. J Physiol Biochem 2014; 70:593-602. [DOI: 10.1007/s13105-013-0311-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 12/22/2013] [Indexed: 12/13/2022]
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Smith-Ray RL, Fitzgibbon ML, Tussing-Humphreys L, Schiffer L, Shah A, Huber GM, Braunschweig C, Campbell RT, Hughes SL. Fit and Strong! Plus: design of a comparative effectiveness evaluation of a weight management program for older adults with osteoarthritis. Contemp Clin Trials 2013; 37:178-88. [PMID: 24316240 DOI: 10.1016/j.cct.2013.11.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 11/27/2013] [Accepted: 11/30/2013] [Indexed: 01/06/2023]
Abstract
Osteoarthritis (OA) is the most common chronic condition and principal cause of disability among older adults. The current obesity epidemic has contributed to this high prevalence rate. Fortunately both OA symptoms and obesity can be ameliorated through lifestyle modifications. Physical activity (PA) combined with weight management improves physical function among obese persons with knee OA but evidence-based interventions that combine PA and weight management are limited for this population. This paper describes a comparative effectiveness trial testing an evidence-based PA program for adults with lower extremity (LE) OA, Fit and Strong!, against an enhanced version that also addresses weight management based on the evidence-based Obesity Reduction Black Intervention Trial (ORBIT). Adult participants (n=400) with LE OA, age 60+, overweight/obese, and not meeting PA requirements of ≥ 150 min per week, are randomized to one of the two programs. Both 8-week interventions meet 3 times per week and include 60 min of strength, flexibility, and aerobic exercise instruction followed by 30 min of education/group discussion. The Fit and Strong! education sessions focus on using PA to manage OA; whereas Fit and Strong! Plus addresses PA and weight loss management strategies. Maintenance of behavior change is reinforced in both groups during months 3-24 through telephone calls and mailed newsletters. Outcomes are assessed at baseline, and 2, 6, 12, 18, and 24 months. Primary outcomes are dietary change at 2 months followed by weight loss at 6 months that is maintained at 24 months. Secondary outcomes assess PA, physical performance, and anxiety/depression.
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Affiliation(s)
- Renae L Smith-Ray
- University of Illinois at Chicago, Institute for Health Research and Policy, Center for Research on Health and Aging, 486 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL 60608, United States.
| | - Marian L Fitzgibbon
- University of Illinois at Chicago, Department of Medicine, Division of Health Promotion Research, 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois at Chicago, Institute for Health Research and Policy, Health Promotion Research Program, 486 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois Cancer Center, Population Health, Behavior and Outcomes Program, 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Lisa Tussing-Humphreys
- University of Illinois at Chicago, Department of Medicine, Division of Health Promotion Research, 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois at Chicago, Institute for Health Research and Policy, Health Promotion Research Program, 486 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois Cancer Center, Population Health, Behavior and Outcomes Program, 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Linda Schiffer
- University of Illinois at Chicago, Department of Medicine, Division of Health Promotion Research, 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Amy Shah
- University of Illinois at Chicago, Institute for Health Research and Policy, Center for Research on Health and Aging, 486 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Gail M Huber
- Northwestern University, Feinberg School of Medicine, Physical Therapy and Human Movement Sciences, 645 N Michigan Avenue, Suite 1100, Chicago, IL 60611, United States
| | - Carol Braunschweig
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, 646 Applied Health Sciences Building, 1919 West Taylor Street, Chicago, IL 60612, United States
| | - Richard T Campbell
- University of Illinois at Chicago, Institute for Health Research and Policy, Center for Research on Health and Aging, 486 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois at Chicago, Institute for Health Research and Policy, Health Promotion Research Program, 486 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL 60608, United States
| | - Susan L Hughes
- University of Illinois at Chicago, Institute for Health Research and Policy, Center for Research on Health and Aging, 486 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois Cancer Center, Population Health, Behavior and Outcomes Program, 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois at Chicago, Department of Kinesiology and Nutrition, 646 Applied Health Sciences Building, 1919 West Taylor Street, Chicago, IL 60612, United States
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Fleg JL, Forman DE, Berra K, Bittner V, Blumenthal JA, Chen MA, Cheng S, Kitzman DW, Maurer MS, Rich MW, Shen WK, Williams MA, Zieman SJ. Secondary prevention of atherosclerotic cardiovascular disease in older adults: a scientific statement from the American Heart Association. Circulation 2013; 128:2422-46. [PMID: 24166575 PMCID: PMC4171129 DOI: 10.1161/01.cir.0000436752.99896.22] [Citation(s) in RCA: 141] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, Hu FB, Hubbard VS, Jakicic JM, Kushner RF, Loria CM, Millen BE, Nonas CA, Pi-Sunyer FX, Stevens J, Stevens VJ, Wadden TA, Wolfe BM, Yanovski SZ. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol 2013; 63:2985-3023. [PMID: 24239920 DOI: 10.1016/j.jacc.2013.11.004] [Citation(s) in RCA: 1420] [Impact Index Per Article: 129.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Dao MC, Meydani SN. Iron biology, immunology, aging, and obesity: four fields connected by the small peptide hormone hepcidin. Adv Nutr 2013; 4:602-17. [PMID: 24228190 PMCID: PMC3823507 DOI: 10.3945/an.113.004424] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Iron status and immune response become impaired in situations that involve chronic inflammation, such as obesity or aging. Little is known, however, about the additional burden that obesity may place on the iron status and immune response in the elderly. This question is relevant given the rising numbers of elderly obese (BMI >30 kg/m(2)) individuals and the high prevalence of iron deficiency worldwide. Iron is necessary for proper function of both the innate and adaptive immune system. Hepcidin, a peptide hormone that regulates cellular iron export, is essential for the maintenance of iron homeostasis. Therefore, since immune cells require iron for proper function hepcidin may also play an important role in immune response. In this review, we summarize the evidence for hepcidin as a link between the fields of gerontology, obesity, iron biology, and immunology. We also identify several gaps in knowledge and unanswered questions pertaining to iron homeostasis and immunity in obese populations. Finally, we review studies that have shown the impact of weight loss, focusing on calorie restriction, iron homeostasis, and immunity. These studies are important both in elucidating mechanistic links between obesity and health impairments and identifying possible approaches to target immune impairment and iron deficiency as comorbidities of obesity.
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Affiliation(s)
- Maria Carlota Dao
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Nutrition Immunology Laboratory, Boston, MA
| | - Simin Nikbin Meydani
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Nutrition Immunology Laboratory, Boston, MA
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Abstract
The rising rate of overweight/obesity among the ever-growing ageing population is imposing massive and rapidly changing burdens of ill health. The observation that the BMI value associated with the lowest relative mortality is slightly higher in older than in younger adults, mainly through its reduced impact on coronary heart disease, has often been misinterpreted that obesity is not as harmful in the elderly, who suffer a large range of disabling consequences of obesity. All medical consequences of obesity are multi-factorial and most alleviated by modest, achievable weight loss (5-10 kg) with an evidence-based maintenance strategy. But severe obesity, e.g. BMI >40 may demand greater weight loss e.g. >15 kg to reverse type 2 diabetes. Since relatively reduced physical activity and reduced muscle mass (sarcopenic obesity) are common in the elderly, combining exercise and modest calorie restriction optimally reduces fat mass and preserves muscle mass - age presents no obstacle and reducing polypharmacy is a valuable outcome. The currently licensed drug orlistat has no age-related hazards and is effective in a low fat diet, but the risks from bariatric surgery begin to outweigh benefits above age 60. For the growing numbers of obese elderly with diabetes, the glucagon-like peptide-1 (GLP-1) receptor analogue liraglutide appears a safe way to promote and maintain substantial weight loss. Obesity and sarcopenia should be prevented from younger age and during life-transitions including retiral to improve future health outcomes and quality of life, with a focus on those in "obese families".
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Affiliation(s)
- T S Han
- Department of Diabetes & Endocrinology, St Peter's NHS Foundation Trust, Chertsey, Surrey KT16 0PZ, United Kingdom
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Fernandes L, Hagen KB, Bijlsma JWJ, Andreassen O, Christensen P, Conaghan PG, Doherty M, Geenen R, Hammond A, Kjeken I, Lohmander LS, Lund H, Mallen CD, Nava T, Oliver S, Pavelka K, Pitsillidou I, da Silva JA, de la Torre J, Zanoli G, Vliet Vlieland TPM. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis 2013; 72:1125-35. [PMID: 23595142 DOI: 10.1136/annrheumdis-2012-202745] [Citation(s) in RCA: 863] [Impact Index Per Article: 78.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The objective was to develop evidence -based recommendations and a research and educational agenda for the non-pharmacological management of hip and knee osteoarthritis (OA). The multidisciplinary task force comprised 21 experts: nurses, occupational therapists, physiotherapists, rheumatologists, orthopaedic surgeons, general practitioner, psychologist, dietician, clinical epidemiologist and patient representatives. After a preliminary literature review, a first task force meeting and five Delphi rounds, provisional recommendations were formulated in order to perform a systematic review. A literature search of Medline and eight other databases was performed up to February 2012. Evidence was graded in categories I-IV and agreement with the recommendations was determined through scores from 0 (total disagreement) to 10 (total agreement). Eleven evidence-based recommendations for the non-pharmacological core management of hip and knee OA were developed, concerning the following nine topics: assessment, general approach, patient information and education, lifestyle changes, exercise, weight loss, assistive technology and adaptations, footwear and work. The average level of agreement ranged between 8.0 and 9.1. The proposed research agenda included an overall need for more research into non-pharmacological interventions for hip OA, moderators to optimise individualised treatment, healthy lifestyle with economic evaluation and long-term follow-up, and the prevention and reduction of work disability. Proposed educational activities included the required skills to teach, initiate and establish lifestyle changes. The 11 recommendations provide guidance on the delivery of non-pharmacological interventions to people with hip or knee OA. More research and educational activities are needed, particularly in the area of lifestyle changes.
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Affiliation(s)
- Linda Fernandes
- National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
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Espeland MA, Rejeski WJ, West DS, Bray GA, Clark JM, Peters AL, Chen H, Johnson KC, Horton ES, Hazuda HP. Intensive weight loss intervention in older individuals: results from the Action for Health in Diabetes Type 2 diabetes mellitus trial. J Am Geriatr Soc 2013; 61:912-922. [PMID: 23668423 PMCID: PMC4123658 DOI: 10.1111/jgs.12271] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To compare the effects of 4 years of intensive lifestyle intervention on weight, fitness, and cardiovascular disease risk factors in older and younger individuals. DESIGN Randomized controlled clinical trial. SETTING Sixteen U.S. clinical sites. PARTICIPANTS Individuals with type 2 diabetes mellitus: 1,053 aged 65 to 76 and 4,092 aged 45 to 64. INTERVENTIONS An intensive behavioral intervention designed to promote and maintain weight loss through caloric restriction and increased physical activity was compared with diabetes mellitus support and education. MEASUREMENTS Standardized assessments of weight, fitness (based on graded exercise testing), and cardiovascular disease risk factors. RESULTS Over 4 years, older individuals had greater intervention-related mean weight losses (6.2%) than younger participants (5.1%; interaction P = .006) and comparable relative mean increases in fitness (0.56 vs 0.53 metabolic equivalents; interaction P = .72). These benefits were seen consistently across subgroups of older adults formed according to many demographic and health factors. Of a panel of age-related health conditions, only self-reported worsening vision was associated with poorer intervention-related weight loss in older individuals. The intensive lifestyle intervention produced mean increases in high-density lipoprotein cholesterol (2.03 mg/dL; P < .001) and decreases in glycated hemoglobin (0.21%; P < .001) and waist circumference (3.52 cm; P < .001) over 4 years that were at least as large in older as in younger individuals. CONCLUSION Intensive lifestyle intervention targeting weight loss and increased physical activity is effective in overweight and obese older individuals to produce sustained weight loss and improvements in fitness and cardiovascular risk factors.
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Affiliation(s)
- Mark A. Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - W. Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC
| | - Delia S. West
- College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
| | - George A. Bray
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - Jeanne M. Clark
- Departments of Medicine and Epidemiology, Johns Hopkins University, Baltimore, MD
| | | | - Haiying Chen
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Karen C. Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | | | - Helen P. Hazuda
- Department of Medicine, University of Texas Health Science Center, San Antonio, TX
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Abstract
PURPOSE OF REVIEW Strategies for weight management in older adults remain controversial as overweight may protect them against mortality whereas weight loss may have harmful effects by promoting sarcopenia and bone loss. It has been suggested that weight management for obese older adults should focus more on maintaining weight and improving physical function than promoting weight loss. This review aims to specify whether intentional weight loss in older adults is a useful or a wasting disease generating strategy. RECENT FINDINGS Recent randomized controlled studies have shown that a supervised, moderate caloric restriction coupled with regular exercise (both aerobic and resistance) in obese older adults do not increase mortality risk and may conversely reduce insulin resistance, metabolic complications, and disabilities without exacerbating lean mass and bone mineral density loss. SUMMARY In obese older adults, moderate weight loss may have beneficial effects on comorbidities, functional performances, and quality of life provided that regular physical activity can be associated. An individual approach considering life expectancy, chronic comorbidities, functional status, personal motivation, and social support should be preferred. More research is needed to define the circumstances in which cautious dietary restrictions are reasonably justified in older adults. In any case, in the oldest (≥80 years) as in frail individuals, it seems reasonable to abstain from recommending weight loss.
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Affiliation(s)
- Patrice Darmon
- Department of Nutrition, Metabolic Diseases and Endocrinology, Sainte-Marguerite University Hospital, INRA UMR1260/INSERM UMR1062, Nutrition, Obesity and Risk of Thrombosis, Aix-Marseille University, Marseille, France.
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