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Lowry DE, Feng Z, Jeejeebhoy K, Dhaliwal R, Brauer P, Royall D, Tremblay A, Klein D, Mutch DM. Prediction modelling of 1-year outcomes to a personalized lifestyle intervention for Canadians with metabolic syndrome. Appl Physiol Nutr Metab 2020; 45:621-627. [PMID: 31738589 DOI: 10.1139/apnm-2019-0375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Metabolic syndrome (MetS) comprises a cluster of risk factors that includes central obesity, hypertension, dyslipidemia, and impaired glucose homeostasis. Although lifestyle interventions reduce MetS risk, not everyone responds to the same extent. The primary objective of this study was to identify variables that could predict 1-year changes in MetS risk in individuals participating in the Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) program. Participants were allocated into training (n = 157) and test (n = 29) datasets by availability of genetic data. A linear mixed-effect model revealed that age, medication, fasting glucose, triglycerides, high-density lipoprotein cholesterol, waist circumference, systolic blood pressure, and fibre intake were associated with continuous MetS (cMetS) score across all time points. Multiple linear regressions were then used to build 2 prediction models using 1-year cMetS score as the outcome variable. Model 1 included only baseline variables and was 38% accurate for predicting cMetS score. Model 2 included both baseline variables and the 3-month change in cMetS score and was 86% accurate. As a secondary objective, we also examined if we could build a model to predict a person's categorical response bin (i.e., positive responder, nonresponder, or adverse responder) at 1 year using the same variables. We found 72% concordance between predicted and observed outcomes. These various prediction models need to be further tested in independent cohorts but provide a potentially promising new tool to project patient outcomes during lifestyle interventions for MetS. Novelty Short-term changes in cMetS score improve prediction model performance compared with only baseline variables. Predictive models could potentially facilitate clinical decision-making for personalized treatment plans.
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Affiliation(s)
- Dana E Lowry
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Zeny Feng
- Department of Mathematics and Statistics, University of Guelph, Guelph, ON N1G 2W1, Canada
| | | | | | - Paula Brauer
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Dawna Royall
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Angelo Tremblay
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - Doug Klein
- Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2R7, Canada
| | - David M Mutch
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
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Mahadzir MDA, Quek KF, Ramadas A. Nutrition and Lifestyle Behavior Peer Support Program for Adults with Metabolic Syndrome: Outcomes and Lessons Learned from a Feasibility Trial. Nutrients 2020; 12:E1091. [PMID: 32326541 PMCID: PMC7230344 DOI: 10.3390/nu12041091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 03/26/2020] [Accepted: 04/13/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND While peer support interventions have shown to benefit adults with certain chronic conditions, there is limited evidence on its feasibility and effectiveness among people with metabolic syndrome (MetS). This paper describes the outcomes of a pre-post feasibility trial of "PEeR SUpport program for ADults with mEtabolic syndrome" (PERSUADE), an evidence-based and community-specific nutrition and lifestyle behavior peer support program for Malaysian adults with MetS. METHODS We recruited 48 peers (median age: 46 (IQR = 11) years old) into four peer groups, who underwent 3 months of PERSUADE, followed by 3 months of follow-up period. Statistical analyses were conducted at post-intervention and post-follow-up to assess the changes in nutrition intake, anthropometry, and metabolic parameters. RESULTS Although there were significant overall increases in total carbohydrate intake and glycemic load (both p < 0.001), we noted significant reductions in the intakes of total energy and fat (both p < 0.001). Physical activity (total METS/week) also showed a significant improvement (p < 0.001). Overall, significant but marginal improvements in anthropometric and vital metabolic parameters were also observed. CONCLUSIONS The feasibility trial supported the adoption of PERSUADE, though there is a need to assess the long-term impact of the peer support program in local community settings.
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Affiliation(s)
- Muhammad Daniel Azlan Mahadzir
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Malaysia;
| | | | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Malaysia;
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Paineiras-Domingos LL, Sá-Caputo DDC, Francisca-Santos A, Reis-Silva A, Carvalho-Lima RP, Neves MFT, Xavier VL, Quinart H, Boyer FC, Sartorio A, Taiar R, Bernardo-Filho M. Can whole body vibration exercises promote improvement on quality of life and on chronic pain level of metabolic syndrome patients? A pseudorandomized crossover study. J Appl Physiol (1985) 2020; 128:934-940. [PMID: 32078471 DOI: 10.1152/japplphysiol.00068.2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Quality of life (QoL) is one of the most important health outcome concepts expressed subjectively. Chronic pain (CP) is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Taking into account the poor QoL and the CP already described in metabolic syndrome (MSy) individuals, this study aimed to evaluate the effects of whole body vibration exercises (WBVE) on these parameters in this population. Thirty-three MSy patients were divided in subgroups A [whole body vibration exercise group (WBVeG), n = 17, 15 females/2 males, 61.1 ± 8.4 yr] and B (control group, n = 16, 14 females/2 males, 58.2 ± 9.1 yr). Subgroup A performed 10 sessions (2 times/wk) of WBVE (18 min/session, with a frequency from 5 up to 14 Hz and a peak-to-peak displacement of 2.5, 5.0, and 7.5 mm) on a side-alternating vibrating platform (VP). Subgroup B did the same protocol, but the VP was turned off. The individuals answered the World Health Organization Quality of Life bref (WHOQoL-bref) questionnaire before the first and after the 10th session. The chronic pain level (CPL) was measured by a numeric rating scale (0-10) before and at the end of each session. Significant improvements were found in physical health (P = 0.05) and psychological health (P = 0.04) domains of WHOQoL-bref in WBVeG. A significant acute reduction of the CPL was found in the WBVeG after the protocol, considering the first session and at the last session. WBVE marginally improved physical health and psychological health and decrease the CPL in acute interventions.NEW & NOTEWORTHY Metabolic syndrome patients experience poor quality of life, frequently associated with lack of exercise and bad dietary habits. Additionally, factors such as obesity, neuromusculoskeletal impairment, and peripheral endothelial dysfunction result in a chronic pain level. Whole body vibration exercise might represent a suitable physical therapy, since it is easy to perform, low cost, safe, and capable of promoting an improvement of quality of life and reducing chronic pain level during acute interventions in metabolic syndrome individuals.
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Affiliation(s)
- Laisa Liane Paineiras-Domingos
- Programa de Pós-Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes e Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Faculdade Bezerra de Araújo, Rio de Janeiro, Brazil
| | - Danúbia da Cunha Sá-Caputo
- Programa de Pós-Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes e Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Faculdade Bezerra de Araújo, Rio de Janeiro, Brazil
| | - Arlete Francisca-Santos
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes e Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Faculdade Bezerra de Araújo, Rio de Janeiro, Brazil
| | - Aline Reis-Silva
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes e Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Mestrado Profissional em Saúde, Medicina Laboratorial e Tecnologia Forense, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafaelle Pacheco Carvalho-Lima
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes e Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mario Fritsch T Neves
- Departamento de Clínica Médica do HUPE, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vinicius Layter Xavier
- Departamento de Estatística, Instituto de Matemática e Estatística, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Hervé Quinart
- Institut de Formation en Masso-kinésithérapie, Reims, France
| | - François Constant Boyer
- Physical and Rehabilitation Medicine Department, Sebastopol Hospital, University of Reims Champagne-Ardenne, France
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-endocrinological Research, Milan and Verbania, Italy
| | - Redha Taiar
- University of Reims Champagne-Ardenne, France
| | - Mario Bernardo-Filho
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes e Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Gill DP, Blunt W, Boa Sorte Silva NC, Stiller-Moldovan C, Zou GY, Petrella RJ. The HealtheSteps™ lifestyle prescription program to improve physical activity and modifiable risk factors for chronic disease: a pragmatic randomized controlled trial. BMC Public Health 2019; 19:841. [PMID: 31253112 PMCID: PMC6599363 DOI: 10.1186/s12889-019-7141-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 06/10/2019] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Our objective was to determine the influence of the HealtheSteps™ lifestyle prescription program on physical activity and modifiable risk factors for chronic disease in individuals at risk. METHODS One hundred eighteen participants were recruited from 5 sites in Southwestern Ontario, Canada and randomized to either the intervention (HealtheSteps™ program, n = 59) or a wait-list control group (n = 59). The study comprised three phases: an Active Phase (0 to 6 months) consisted of bi-monthly in-person lifestyle coaching with access to a suite of eHealth technology supports (Heathesteps app, telephone coaching and a private HealtheSteps™ social network) followed by a Minimally-Supported Phase I (6 to 12 months), in which in-person coaching was removed, but participants still had access to the full suite of eHealth technology supports. In the final stage, Minimally-Supported Phase II (12 to 18 months), access to the eHealth technology supports was restricted to the HealtheSteps™ app. Assessments were conducted at baseline, 6, 12 and 18 months. The study primary outcome was the 6-month change in average number of steps per day. Secondary outcomes included: self-reported physical activity and sedentary time; self-reported eating habits; weight and body composition measures; blood pressure and health-related quality of life. Data from all participants were analyzed using an intent-to-treat approach. We applied mixed effects models for repeated measurements and adjusted for age, sex, and site in the statistical analyses. RESULTS Participants in HealtheSteps™ increased step counts (between-group [95% confidence interval]: 3132 [1969 to 4294], p < 0.001), decreased their sitting time (- 0.08 [- 0.16 to - 0.006], p = 0.03), and improved their overall healthful eating (- 1.5 [- 2.42 to - 0.58], p = 0.002) to a greater extent compared to control at 6 months. Furthermore, exploratory results showed that these individuals maintained these outcomes 12 months later, after a minimally-supported phase; and retained improvements in sedentary time and improved healthful eating after 18 months. No differences in self-reported physical activity, health-related quality of life, weight, waist circumference or blood pressure were observed between groups at 6 months. CONCLUSIONS Our findings suggest that HealtheSteps™ is effective at increasing physical activity (i.e., step counts per day), decreasing weekday sitting time, and improving healthful eating in adults at increased risk for chronic disease after 6 months; however, we did not see change in other risk factors. Nonetheless, the maintenance of these behaviours with minimal support after 12 and even 18 months indicates the promise of HealtheSteps™ for long-term sustainability. TRIAL REGISTRATION The trial was registered on April 6, 2015 with ClinicalTrials.gov (identifier: NCT02413385 ).
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Affiliation(s)
- D. P. Gill
- Centre for Studies in Family Medicine – Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond St., London, ON N6G 2M1 Canada
- School of Health Studies, Faculty of Health Sciences, Western University, London, ON Canada
| | - W. Blunt
- Centre for Studies in Family Medicine – Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond St., London, ON N6G 2M1 Canada
| | - N. C. Boa Sorte Silva
- Centre for Studies in Family Medicine – Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond St., London, ON N6G 2M1 Canada
- School of Kinesiology, Faculty of Health Sciences, Western University, London, ON Canada
| | - C. Stiller-Moldovan
- Centre for Studies in Family Medicine – Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond St., London, ON N6G 2M1 Canada
| | - G. Y. Zou
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON Canada
- Robarts Clinical Trials Inc., London, ON Canada
| | - R. J. Petrella
- Centre for Studies in Family Medicine – Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond St., London, ON N6G 2M1 Canada
- School of Kinesiology, Faculty of Health Sciences, Western University, London, ON Canada
- Lawson Health Research Institute, London, ON Canada
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Taylor TR, Dash C, Sheppard V, Makambi K, Ma X, Adams-Campbell LL. The effect of a randomized controlled physical activity trial on health related quality of life in metabolically unhealthy African-American women: FIERCE STUDY. Contemp Clin Trials 2018; 67:121-128. [PMID: 29428830 PMCID: PMC5871580 DOI: 10.1016/j.cct.2018.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 02/02/2018] [Accepted: 02/04/2018] [Indexed: 01/09/2023]
Abstract
PURPOSE African-American women (AAW) are more likely to be metabolically unhealthy than White women (WW). Metabolic syndrome (MetS) is associated with increased breast cancer risk and mortality from breast cancer is greater in AAW compared to WW. Data show MetS affects health-related quality of life (HRQoL). Exercise studies report improvements in MetS, however, no study to date has examined HRQoL in metabolically unhealthy AAW enrolled in an exercise trial. METHODS This report examined the effect of a 6-month, 3-arm (supervised exercise, home-based exercise, control) randomized exercise controlled trial on HRQoL among 213 obese, metabolically unhealthy, postmenopausal AAW at high risk for breast cancer. RESULTS Certain baseline participant characteristics were related to baseline HRQoL dimensions. The "exercise group" (supervised group combined with the home-based group) showed significantly greater improvement in health change scores (M = 13.6, SD = 3.1) compared to the control group (M = 0.7, SD = 4.4) (p = 0.02) over the 6-month study period. There were no significant differences in HRQoL change scores between the 3 study groups, however, although non-significant, data indicated most HRQoL change scores were more favorable in the supervised group. CONCLUSION While significant improvement occurred in health change scores in the combined supervised and home-based group compared to the control group, we did not observe any significant differences on HRQoL change scores between all three study groups. However, while non-significant, there was a trend for more favorable HRQoL change scores in the supervised group versus the home-based and control groups. Additional research is needed to further explore this topic.
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Affiliation(s)
- Teletia R Taylor
- Howard University Cancer Center, Howard University, Washington, DC, United States
| | - Chiranjeev Dash
- Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, United States
| | - Vanessa Sheppard
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Kepher Makambi
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University Medical Center, Washington, DC, United States
| | - Xiaoyang Ma
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University Medical Center, Washington, DC, United States
| | - Lucile L Adams-Campbell
- Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, United States.
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Saboya PP, Bodanese LC, Zimmermann PR, Gustavo ADS, Assumpção CM, Londero F. Metabolic syndrome and quality of life: a systematic review. Rev Lat Am Enfermagem 2016; 24:e2848. [PMID: 27901223 PMCID: PMC5172619 DOI: 10.1590/1518-8345.1573.2848] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 09/23/2016] [Indexed: 02/08/2023] Open
Abstract
Objectives: to present currently available evidence to verify the association between
metabolic syndrome and quality of life. Method: Cochrane Library, EMBASE, Medline and LILACS databases were studied for all
studies investigating the association with metabolic syndrome and quality of life.
Two blinded reviewers extracted data and one more was chosen in case of doubt.
Results: a total of 30 studies were included, considering inclusion and exclusion criteria,
which involved 62.063 patients. Almost all studies suggested that metabolic
syndrome is significantly associated with impaired quality of life. Some, however,
found association only in women, or only if associated with depression or Body
Mass Index. Merely one study did not find association after adjusted for
confounding factors. Conclusion: although there are a few studies available about the relationship between
metabolic syndrome and quality of life, a growing body of evidence has shown
significant association between metabolic syndrome and the worsening of quality of
life. However, it is necessary to carry out further longitudinal studies to
confirm this association and verify whether this relationship is linear, or only
an association factor.
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Affiliation(s)
| | - Luiz Carlos Bodanese
- PhD, Full Professor, Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Paulo Roberto Zimmermann
- PhD, Full Professor, Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Andréia da Silva Gustavo
- PhD, Professor Adjunto, Faculdade de Enfermagem, Nutrição e Fisioterapia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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