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Zheng Y, Wang X, Wang J, Yang J, Wang T, Li Q, Zhu W, Wang Y, Sui J, Qiang W, Guo H, Wang Y, Shi B, He M. Effects of time-restricted eating and low-carbohydrate diet on psychosocial health and appetite in individuals with metabolic syndrome: A secondary analysis of a randomized controlled trial. Clin Nutr 2024; 43:2316-2324. [PMID: 39226719 DOI: 10.1016/j.clnu.2024.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 07/18/2024] [Accepted: 08/26/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND & AIMS Time-restricted eating (TRE) and low-carbohydrate diet (LCD) can improve multiple cardiometabolic parameters in patients with metabolic syndrome (MetS), but their effects on psychosocial health and satiety are unclear. In this study, we aimed to evaluate the effects of TRE, LCD, and their combination (TRE + LCD) on quality of life (QoL), sleep, mood, appetite, and metabolic hormones in patients with MetS. METHODS This is a secondary analysis of a single-center, 3-month, open-label, randomized clinical trial investigating the effects of TRE, LCD, and TRE + LCD on weight and cardiometabolic parameters in individuals with MetS. This secondary analysis examined QoL, sleep, mood, and appetite using the Rand 36-Item Short Form (SF-36); Pittsburgh Sleep Quality Index (PSQI); Depression, Anxiety, and Stress Scale; and Eating Behavior Rating Scale, respectively, as well as measured levels of metabolic hormones including leptin, amylin, glucose-dependent insulinotropic polypeptide, glucagon-like peptide-1 (GLP-1), pancreatic polypeptide (PP), and peptide YY. Between-group comparisons were conducted via one-way ANOVAs and post hoc LSD tests for normally distributed variables or Kruskal‒Wallis H tests and the Nemenyi test for abnormally distributed variables. P < 0.017 was considered significant in multiple comparisons following Bonferroni adjustment. RESULTS A total of 162 participants (mean [SD] age, 41.2 [9.9] years; mean [SD] body mass index, 29.3 [3.4] kg/m2; 102 [63%] men) who started the intervention were analyzed. After 3 months, only the TRE group decreased GLP-1 levels (-0.9 [IQR, -1.9 to -0.3] pg/mL; P = 0.002), increased PP levels (8.9 [IQR, -7.6 to 71.8] pg/mL; P = 0.011), physical functioning in the SF-36 (5.2 [95% CI, 1.9 to 8.5]; P = 0.001), social functioning in the SF-36 (9.1 [95% CI, 2.5 to 15.6]; P = 0.005), role-physical in the SF-36 (24.1 [95% CI, 11.8 to 36.4]; P < 0.001), role-emotional in the SF-36 (22.4 [95% CI, 12.6 to 32.2]; P < 0.001), and sleep efficiency in the PSQI (0.29 [95% CI, 0.03 to 0.55]; P = 0.021). Compared with changes in LCD, TRE further increased general health in the SF-36 (9.7 [95% CI, 3.3 to 16.0]; P = 0.006). Relative to the changes of TRE + LCD, TRE significantly increased role-emotional in the SF-36 (19.9 [95% CI 4.9 to 34.8]; P = 0.006). Changes in sleep quality, mood status, appetite, and metabolic hormones did not differ among three groups. Greater weight loss was associated with decreased leptin levels (r = 0.538), decreased amylin levels (r = 0.294), reduced total appetite scores (r = 0.220), and improved general health (r = -0.253) (all P ≤ 0.01). CONCLUSIONS TRE, LCD, and TRE + LCD all could improve psychosocial health and reduce appetite. Notably, TRE yielded greater benefits in QoL compared with LCD or TRE + LCD in individuals with MetS. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04475822.
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Affiliation(s)
- Yixuan Zheng
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Xin Wang
- Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Jingya Wang
- Department of Gastroenterology, Xi'an Children's Hospital, Shaanxi Research Institute for Pediatric Diseases, The Affiliated Children's Hospital of Xi'an JiaoTong University and National Regional Medical Center for Children (Northwest), No 69, Xiju Yuan Lane, Xi'an, Shaanxi 710003, PR China
| | - Jing Yang
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China; Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Ting Wang
- Department of Cardiovascular Medicine, Shaanxi Provincial People's Hospital, 256 Youyi West Road, Beilin District, Xi'an, Shaanxi 710068, PR China
| | - Qian Li
- Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Wenzhi Zhu
- Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Yue Wang
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Jing Sui
- Department of Endocrinology and International Medical Center, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Wei Qiang
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Hui Guo
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Yanan Wang
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China; Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Bingyin Shi
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Mingqian He
- Department of Endocrinology, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China; Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi'an JiaoTong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, PR China.
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Walczuk S, Burk M, Furmaga E, Ghassemi S, McCarren M, Bukowski K, Glassman P, Cunningham F. Weight management medications for chronic use in 37 veterans affairs medical centers-A medication use evaluation. Obes Sci Pract 2024; 10:e70002. [PMID: 39219745 PMCID: PMC11362804 DOI: 10.1002/osp4.70002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 07/28/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
Rationale Controlled trials have demonstrated successful weight loss associated with certain weight management medications (WMMs). However, there are limited real-world data on prescribing patterns and efficacy and safety profiles of WMMs in Veterans Affairs (VA) patients. Objective To evaluate: utilization patterns of WMMs liraglutide, naltrexone/bupropion, orlistat, phentermine, phentermine/topiramate, and semaglutide; weight loss at three, six, twelve, and more than 12 months; safety; and treatment barriers. Methods A retrospective, cross-sectional medication use evaluation (MUE) was conducted using electronic health records of outpatient Veterans newly initiated on WMMs at 37 VA Medical Centers between 1 March 2020 and 31 March 2022. Chart review was used to identify WMM utilization and capture rates of clinical response, defined as 5% and 10% or greater weight loss at the final weight, adverse drug events (ADEs), non-adherence, and discontinuations. Site-specific surveys evaluated local practices and barriers. Results Among 1959 eligible Veterans, semaglutide, phentermine/topiramate, and orlistat were most frequently prescribed. The clinical response was highest among phentermine/topiramate, liraglutide, and semaglutide. Naltrexone/bupropion and phentermine demonstrated the highest and lowest ADE rates, respectively. Potential barriers to WMM utilization and successful treatment by site reports were drug shortages, patient perceptions of therapeutic course, personal preferences, and VA WMM use criteria. Conclusions Smaller weight loss and higher discontinuation rates were observed relative to clinical trials. The MUE data allow for better assessment of benefits and risks for Veterans prescribed WMMs.
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Affiliation(s)
- Samantha Walczuk
- Veterans Affairs (VA) Center for Medication SafetyHinesIllinoisUSA
- Present address:
Jesse Brown VA Medical CenterChicagoIllinoisUSA.
| | - Muriel Burk
- Veterans Affairs (VA) Center for Medication SafetyHinesIllinoisUSA
- United States Department of Veterans AffairsVA Pharmacy Benefits Management ServicesWashingtonDistrict of ColumbiaUSA
| | - Elaine Furmaga
- United States Department of Veterans AffairsVA Pharmacy Benefits Management ServicesWashingtonDistrict of ColumbiaUSA
| | - Samaneh Ghassemi
- Veterans Affairs (VA) Center for Medication SafetyHinesIllinoisUSA
| | | | - Kenneth Bukowski
- Veterans Affairs (VA) Center for Medication SafetyHinesIllinoisUSA
| | - Peter Glassman
- United States Department of Veterans AffairsVA Pharmacy Benefits Management ServicesWashingtonDistrict of ColumbiaUSA
- VA Greater Los Angeles Healthcare SystemLos AngelesCaliforniaUSA
- David Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Fran Cunningham
- Veterans Affairs (VA) Center for Medication SafetyHinesIllinoisUSA
- United States Department of Veterans AffairsVA Pharmacy Benefits Management ServicesWashingtonDistrict of ColumbiaUSA
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Tomé-Fernández M, Sánchez-Sansegundo M, Berbegal-Bernabeu M, Zaragoza-Martí A, Tuells J, Hurtado-Sánchez JA. Understanding the relationship between quality of life, anthropometric measures and mental health in individuals with obesity. J Public Health (Oxf) 2024; 46:e460-e467. [PMID: 38857603 DOI: 10.1093/pubmed/fdae097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/03/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Obesity is a chronic medical condition caused by an excessive accumulation of body fat that represents a major risk factor for public health. The relationship between obesity, quality of life (QoL) and mental health has been examined in some previous literature. However, the studies found have not linked anthropometric variables with QoL factors, as they have used generic questionnaires. OBJECTIVE The present study aimed to analyse the influence of anthropometric variables on the QoL of people with obesity and examine its relationship with psychological variables. METHODS It was a cross-sectional study composed of 77 Spanish participants adults (M = 45.12 years; SD = 10.29) collected from two different research projects. The measurements were carried out in the Faculty of Health Sciences of the University of Alicante (Spain), including sociodemographic variables, anthropometric data and psychological questionnaires. RESULTS The finding demonstrated the relationship between anthropometric variables and all QoL factors. Also, individuals with lower QoL exhibit more symptoms of depression, anxiety and stress and are more prone to emotional eating. CONCLUSIONS The findings highlight the necessity of integrating psychological support into obesity treatment strategies, as well as the importance of using QoL questionnaires specific to people with obesity.
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Affiliation(s)
- Mario Tomé-Fernández
- Department of Health Psychology, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain
| | - Miriam Sánchez-Sansegundo
- Department of Health Psychology, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain
- Alicante Health and Biomedical Research Institute, ISABIAL Foundation, 03010 Alicante, Spain
| | - Marina Berbegal-Bernabeu
- Department of Health Psychology, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain
| | - Ana Zaragoza-Martí
- Alicante Health and Biomedical Research Institute, ISABIAL Foundation, 03010 Alicante, Spain
- Department of Nursing, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain
| | - José Tuells
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain
| | - Jose Antonio Hurtado-Sánchez
- Department of Health Psychology, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain
- Alicante Health and Biomedical Research Institute, ISABIAL Foundation, 03010 Alicante, Spain
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Lee KM, Ghanei B, Tomiyama AJ. A brief induction of loving kindness meditation to reduce anti-fat bias. PLoS One 2024; 19:e0302039. [PMID: 38900806 PMCID: PMC11189228 DOI: 10.1371/journal.pone.0302039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 03/27/2024] [Indexed: 06/22/2024] Open
Abstract
Weight stigma is highly prevalent. However, existing weight stigma interventions are only modestly effective at reducing anti-fat attitudes. The current research proposes a novel approach using a loving kindness meditation (LKM). Experiment 1 tests whether random assignment to the LKM intervention reduces explicit and implicit anti-fat bias and increases empathy based on the LKM recipient with higher weight (close other vs. stranger). Experiment 2 tests whether LKM outperforms an empathy intervention or control to increase empathy or reduce stigmatizing behavior. Results revealed that the LKM increased empathic care but did not reduce anti-fat bias compared to control; the LKM intervention, but not the empathy intervention, reported greater empathy compared to control in unadjusted analyses; and participants in the LKM and empathy interventions (vs. control) were more likely to engage in stigmatizing behavior. These findings suggest that the LKM may not be effective at reducing weight stigma despite increasing empathy.
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Affiliation(s)
- Kristen M. Lee
- Department of Psychology, University of California Los Angeles, Los Angeles, California, United States of America
| | - Bita Ghanei
- Department of Psychology, University of California Los Angeles, Los Angeles, California, United States of America
| | - A. Janet Tomiyama
- Department of Psychology, University of California Los Angeles, Los Angeles, California, United States of America
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5
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Griffin SB, Palmer MA, Strodl E, Lai R, Guo C, Chuah TL, Burstow MJ, Ross LJ. Impact of a dietitian-led very low calorie diet clinic on perioperative risk for patients with obesity awaiting elective, non-bariatric surgery: A retrospective cohort study. Surgery 2024; 175:463-470. [PMID: 37953146 DOI: 10.1016/j.surg.2023.09.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/18/2023] [Accepted: 09/26/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Despite a lack of evidence that intentional weight loss reduces the risk of postoperative complications, adults with obesity are commonly asked to lose weight before elective surgery. We hypothesized that patients undertaking dietitian-led preoperative, very low calorie diet treatment could reduce perioperative surgery risks, as per validated risk scoring systems. The purpose of this study was to measure the impact of a dietitian-led preoperative very low calorie diet clinic on the American Society of Anesthesiologists physical status scores and National Surgical Quality Improvement Program Surgical Risk Calculator scores for patients with obesity awaiting non-bariatric elective surgery. METHODS This retrospective cohort study included patients referred to the preoperative dietitian-led very low calorie diet clinic before elective surgical procedures over a 2-year-9-month period. The dietitian prescribed individualized, very low calorie diet-based treatment. Primary outcomes were changes in the American Society of Anesthesiologists and Surgical Risk Calculator scores from pretreatment until surgery. RESULTS A total of 141 eligible participants (48 ± 13.4 years, 76% women, body mass index 41.7 ± 6.3 kg/m2) demonstrated clinically significant weight loss (mean 7.1 ± 6.1kg, 5.2% body weight, P < .001). Median treatment duration was 13 weeks (interquartile range 6.2-19.2 weeks). Five participants (3.5%) avoided surgery due to weight loss-related improvements in their condition. American Society of Anesthesiologists scores improved for 16% (n = 22/141) of participants. Overall, the median surgical risk calculator estimated risk of 'serious' and 'any' postoperative complication reduced from 4.8% to 3.9% (P < .001) and 6% to 5.1% (P < .001), respectively. Reduction in all Surgical Risk Calculator scores occurred, including surgical site infection, re-admission, and cardiac events (P < .05). CONCLUSION The dietitian-led preoperative, very low calorie diet clinic improved American Society of Anesthesiologists and Surgical Risk Calculator scores for non-bariatric elective surgery patients with obesity. Randomized controlled trials comparing this approach with a control group are warranted.
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Affiliation(s)
- Sally B Griffin
- Department of Nutrition & Dietetics, Logan Hospital, Queensland, Australia; School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Michelle A Palmer
- Department of Nutrition & Dietetics, Logan Hospital, Queensland, Australia
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Rainbow Lai
- Department of Nutrition & Dietetics, Logan Hospital, Queensland, Australia
| | - Cathy Guo
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Teong L Chuah
- Surgical and Critical Care Services, Logan Hospital, Queensland, Australia; Department of Surgery, Mater Hospital, South Brisbane, Queensland, Australia; Mayne Academy of Surgery, Faculty of Medicine, University of Queensland, St Lucia, Queensland, Australia
| | - Matthew J Burstow
- Surgical and Critical Care Services, Logan Hospital, Queensland, Australia; School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Lynda J Ross
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
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Blumenthal JA, Smith PJ, Mabe S, Hinderliter A, Craighead L, Watkins LL, Ingle K, Tyson CC, Lin PH, Kraus WE, Liao L, Sherwood A. Effects of Lifestyle Modification on Psychosocial Function in Patients With Resistant Hypertension: SECONDARY OUTCOMES FROM THE TRIUMPH RANDOMIZED CLINICAL TRIAL. J Cardiopulm Rehabil Prev 2024; 44:64-70. [PMID: 37220236 PMCID: PMC10667561 DOI: 10.1097/hcr.0000000000000801] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
PURPOSE In a secondary analysis of the TRIUMPH clinical trial, psychological outcomes in patients with resistant hypertension (RH) receiving a diet and exercise intervention delivered in a cardiac rehabilitation setting were compared with those receiving a similar prescription of diet and exercise provided in a single counseling session by a health educator. METHODS One hundred forty patients with RH were randomly assigned to a 4-mo program of dietary counseling, behavioral weight management, and exercise (C-LIFE) or a single counseling session providing standardized education and physician advice (SEPA). Participants completed a battery of questionnaires to assess psychological functioning before and after the intervention. A global measure of psychological functioning was derived from the General Health Questionnaire (GHQ), Perceived Stress Scale (PSS), Medical Outcomes Study 36-item Short Form Health Survey, Spielberger State-Trait Anxiety Inventory, Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory-II, and Patient-Reported Outcomes Measurement Information System (PROMIS) Anger scale. RESULTS Participants in the C-LIFE intervention achieved greater improvements in psychological functioning compared with SEPA (C-LIFE: 58.9 [56.1, 61.8] vs SEPA: 66.5 [62.1, 70.9]; P = .024). Greater improvements were especially evident for the GHQ, PSS, and HADS. Examination of mediation revealed that greater weight loss ( B =-0.17, P = .004) and improved oxygen uptake ( B =-0.12, P = .044) were associated with improved psychological functioning. CONCLUSION Compared with standard education and physician advice, a structured program of diet and exercise not only reduced blood pressure but also improved psychological functioning in patients with RH.
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Affiliation(s)
- James A. Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Patrick J. Smith
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Stephanie Mabe
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Alan Hinderliter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Linda Craighead
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Lana L. Watkins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Krista Ingle
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Crystal C. Tyson
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Pao-Hwa Lin
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - William E. Kraus
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Lawrence Liao
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
| | - Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal, Watkins, Ingle, and Sherwood and Ms Mabe); Departments of Psychiatry (Dr Smith) and Medicine (Dr Hinderliter), University of North Carolina at Chapel Hill, Chapel Hill; Department of Psychology, Emory University, Atlanta, Georgia (Dr Craighead), and Department of Medicine, Duke University Medical Center, Durham, North Carolina (Drs Tyson, Lin, Kraus, and Liao)
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Lin S, Cienfuegos S, Ezpeleta M, Pavlou V, Chakos K, McStay M, Runchey MC, Alexandria SJ, Varady KA. Effect of Time-Restricted Eating versus Daily Calorie Restriction on Mood and Quality of Life in Adults with Obesity. Nutrients 2023; 15:4313. [PMID: 37892388 PMCID: PMC10609268 DOI: 10.3390/nu15204313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
The purpose of this secondary analysis is to compare the effects of two popular weight loss regimens, time-restricted eating (TRE) and daily calorie restriction (CR), on mood and quality-of-life measures in adults with obesity. Ninety participants were randomized to one of three interventions for 12 months: 8 h TRE (eating only between 12:00 and 8:00 p.m., with no calorie counting); CR (25% energy restriction daily); or no-intervention control group. Questionnaires were administered to measure mood (Beck Depression Inventory-II (BDI-II), and Profile of Mood States (POMS)) and quality of life (Rand 36-Item Short Form) at baseline and month 12. Body weight decreased in the TRE group (-4.87%, 95%CI: -7.61, -2.13) and CR group (-5.30%, 95%CI: -9.06, -1.54) versus controls, with no difference between TRE and CR. The BDI-II depression score did not change in the TRE or CR group, versus controls, by month 12. Likewise, there were no changes in any of the POMS subscales (tension, depression, anger, fatigue, anger, confusion, or vigor) or the total mood disturbance score in the TRE or CR group versus controls. As for quality of life, there were no significant changes in the SF-36 constructs of mental health, bodily pain, and general physical health in the TRE or CR group versus controls. However, there was a trend towards increased vitality in the TRE group (7.77 [95% CI: 0.15, 15.39] p = 0.05) relative to controls. There were no associations between changes in body weight, physical activity, mood, and quality of life in any group by the end of the study. These findings suggest that TRE and CR produce similar degrees of weight loss, but impact neither mood nor quality of life in adults with obesity over 12 months. Future well-powered studies will be needed to confirm these findings.
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Affiliation(s)
- Shuhao Lin
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
| | - Sofia Cienfuegos
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
| | - Mark Ezpeleta
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
| | - Vasiliki Pavlou
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
| | - Kaitlin Chakos
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
| | - Mara McStay
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
| | - Mary-Claire Runchey
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
| | - Shaina J. Alexandria
- Department of Preventative Medicine (Biostatistics), Northwestern University, Chicago, IL 60612, USA
| | - Krista A. Varady
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
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8
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Riedel O, Braitmaier M, Dankhoff M, Hornschuch M, Klein M, Zachariassen W, Hoyer J. Quality of life in bariatric patients up to twelve years after surgery - Results from a nationwide retrospective cohort study. Obes Res Clin Pract 2023; 17:353-360. [PMID: 37591765 DOI: 10.1016/j.orcp.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/07/2023] [Accepted: 08/11/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Bariatric interventions (BI, including surgical interventions) are effective in patients with massive obesity, i.e., a body mass index (BMI) > 40, and their number has steadily increased during the past decade. Yet, the stability of improvements in quality of life (QoL) in post-interventional patients is understudied and restricted to studies with small samples and short follow-ups. METHODS Patients with BI between 2004 and 2018 were identified in a health claims database and invited to fill in a survey, comprising sociodemographic and lifestyle information and psychometric scales. QoL was assessed with the Bariatric QoL (BQL) scale with lower scores denoting worse QoL. BMI and excess weight loss (EWL) were calculated for the time soon after intervention (EWL-T1) and when filling the survey (EWL-T2). RESULTS The majority of n = 2151 patients were female (80.7 %), had a mean age of 54.5 years and a mean BMI of 34.8. The mean EWL-T1 was 79 % (EWL-T2: 64.6 %). The mean BQL score was 47.6 and decreased with BMI (18.5-24.9: 52.6 vs. >40: 38.7), EWL-T2 (>66 %: 51.3 vs. <65 %: 42.1) and years since intervention (3-4: 48.2 vs >8: 45.1, each p < .001). For EWL-T1, the association between higher EWLs and higher BQL scores was stronger in females than in males (p < .005); for EWL at T2, both sexes did not differ in this regard (p = .848). Among normal-weight persons, males scored significantly lower on the BQL than females (44.9 vs. 54.9). CONCLUSIONS Post-interventional QoL improvements diminish over time and depend on the weight loss, with significant differences between men and women.
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Affiliation(s)
- Oliver Riedel
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
| | - M Braitmaier
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | | | - Michel Hornschuch
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | | | | | - Jana Hoyer
- Adipositas-Zentrum, Städtisches Klinikum Dresden, Dresden, Germany
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9
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Goessl CL, VanWormer JJ, Pathak RD, Ellerbeck EF, Kurz DL, Befort CA. Weight change and mental health status in a behavioral weight loss trial. J Affect Disord 2023; 334:302-306. [PMID: 37156276 DOI: 10.1016/j.jad.2023.04.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 04/12/2023] [Accepted: 04/29/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Obesity, depression, and anxiety often co-occur, but research on weight change and mental health status is limited. This analysis examined how the mental component score (MCS-12) from the Short Form health survey changed over 24 months in weight loss trial participants with vs. without treatment seeking for affective symptoms (TxASx) and by weight change quintiles. METHODS Participants with complete data (n = 1163) were analyzed from enrollees in a cluster-randomized, behavioral weight loss trial in rural U.S. Midwestern primary care practices. Participants received a lifestyle intervention with different delivery models, including in-clinic individual, in-clinic group, or telephone group counseling visits. Participants were stratified by baseline TxASx status and 24-month weight change quintiles. Mixed models were used to estimate MCS-12 scores. RESULTS There was a significant group-by-time interaction at the 24-month follow-up. The largest 0-24 month increase in MCS-12 scores (+5.3 points [12 %]) was observed in participants with TxASx who lost the most weight during the trial, while the largest decrease in MCS-12 scores (-1.8 points [-3 %]) was observed in participants without TxASx who gained the most weight (p < 0.001). LIMITATIONS Notable limitations included self-reported mental health, the observational analytical design, and a largely homogenous source population, as well as the possibility of reverse causation biasing some findings. CONCLUSIONS Mental health status generally improved, particularly among participants with TxASx who experienced significant weight loss. Those without TxASx who gained weight, however, had a decline in mental health status over 24 months. Replication of these findings is warranted.
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Affiliation(s)
- Cody L Goessl
- Marshfield Clinic Research Institute, Center for Clinical Epidemiology & Population Health, Marshfield, WI, USA; Marshfield Clinic-Marshfield Medical Center, Department of Occupational Medicine, Marshfield, WI, USA
| | - Jeffrey J VanWormer
- Marshfield Clinic Research Institute, Center for Clinical Epidemiology & Population Health, Marshfield, WI, USA.
| | - Ram D Pathak
- Marshfield Clinic-Marshfield Medical Center, Department of Endocrinology, Marshfield, WI, USA
| | - Edward F Ellerbeck
- University of Kansas Medical Center, Department of Population Health, Kansas City, KS, USA
| | - Daniel L Kurz
- University of Kansas Medical Center, Department of Population Health, Kansas City, KS, USA
| | - Christie A Befort
- University of Kansas Medical Center, Department of Population Health, Kansas City, KS, USA
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10
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Jobanputra R, Sargeant JA, Almaqhawi A, Ahmad E, Arsenyadis F, Webb DR, Herring LY, Khunti K, Davies MJ, Yates T. The effects of weight-lowering pharmacotherapies on physical activity, function and fitness: A systematic review and meta-analysis of randomized controlled trials. Obes Rev 2023; 24:e13553. [PMID: 36721366 DOI: 10.1111/obr.13553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 12/16/2022] [Accepted: 01/11/2023] [Indexed: 02/02/2023]
Abstract
Weight-lowering pharmacotherapies provide an option for weight management; however, their effects on physical activity, function, and cardiorespiratory fitness are not fully understood. We conducted a systematic review and meta-analysis of randomized controlled trials to investigate the effect of licensed weight loss pharmacotherapies on physical activity, physical function, and cardiorespiratory fitness in individuals with obesity. Fourteen trials met our prespecified inclusion criteria: Five investigated liraglutide, four semaglutide, three naltrexone/bupropion, and two phentermine/topiramate. All 14 trials included a self-reported measure of physical function, with the pooled findings suggesting an improvement favoring the pharmacotherapy intervention groups (SMD: 0.27; 95% CI: 0.22 to 0.32) and effects generally consistent across different therapies. Results were also consistent when stratified by the two most commonly used measures: The Short-Form 36-Item Questionnaire (SF-36) (0.24; 0.17 to 0.32) and the Impact of Weight on Quality Of Life-Lite (IWQOL-Lite) (0.29; 0.23 to 0.35). Meta-regression confirmed a significant association between pharmacotherapy induced weight loss and improved physical function for IWQOL-Lite (p = 0.003). None of the studies reported a physical activity outcome, and only one study reported objectively measured cardiorespiratory fitness. Improvements in self-reported physical function were observed with weight loss therapy, but the effect on physical activity or objectively measured physical function and fitness could not be determined.
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Affiliation(s)
- Rishi Jobanputra
- Diabetes Research Centre, University of Leicester, Leicester, UK.,National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK.,Department of Health Sciences, University of Leicester, Leicester, UK
| | - Jack A Sargeant
- Diabetes Research Centre, University of Leicester, Leicester, UK.,National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Abdullah Almaqhawi
- Diabetes Research Centre, University of Leicester, Leicester, UK.,National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK.,Department of Family and Community Medicine, College Of Medicine, King Faisal University, Dammam, Saudi Arabia
| | - Ehtasham Ahmad
- Diabetes Research Centre, University of Leicester, Leicester, UK.,National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Franciskos Arsenyadis
- Diabetes Research Centre, University of Leicester, Leicester, UK.,National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - David R Webb
- Diabetes Research Centre, University of Leicester, Leicester, UK.,National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Louisa Y Herring
- Diabetes Research Centre, University of Leicester, Leicester, UK.,National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK.,National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK.,NIHR Applied Research Collaboration East Midlands, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK.,National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK.,National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
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11
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Azuri J, Hammerman A, Aboalhasan E, Sluckis B, Arbel R. Tirzepatide versus semaglutide for weight loss in patients with type 2 diabetes mellitus: A value for money analysis. Diabetes Obes Metab 2023; 25:961-964. [PMID: 36507900 DOI: 10.1111/dom.14940] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/01/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
AIMS Higher doses of the glucagon-like peptide-1 agonist semaglutide and, more recently, tirzepatide, a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 agonist showed a significant reduction in body weight in patients with type 2 diabetes mellitus. However, their comparative value for money for this indication is unclear. Therefore, we aimed to establish which provides better value for money. MATERIALS AND METHODS We calculated the cost needed to treat to achieve a 1% reduction in body weight using high-dose tirzepatide (15 mg) versus semaglutide (2.4 mg). The body weight reductions were extracted from published results of SURMOUNT-1 and STEP 1 trials, respectively. In addition, we performed a scenario analysis to mitigate the primary differences between the two study populations. Drug costs were based on US GoodRx prices as of October 2022. RESULTS Using tirzepatide resulted in a weight loss of 17.8% (95% CI: 16.3%-19.3%) compared with 12.4% (95% CI: 11.5%-13.4%) for semaglutide. The total cost of 72 weeks of tirzepatide was estimated at $17 527 compared with $22 878 for 68 weeks of semaglutide. Accordingly, the cost needed to treat per 1% of body weight reduction with tirzepatide is estimated at $985 (95% CI: $908-$1075) compared with $1845 (95% CI: $1707-$1989) with semaglutide. Scenario analysis confirmed these findings. CONCLUSIONS Tirzepatide provides better value for money than semaglutide for weight reduction.
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Affiliation(s)
- Joseph Azuri
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Maccabi Healthcare Services, Tel Aviv, Israel
| | | | | | | | - Ronen Arbel
- Clalit Health Services, Tel Aviv, Israel
- Sapir College, Ashkelon, Israel
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12
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Murton LM, Plank LD, Cutfield R, Kim D, Booth MWC, Murphy R, Serlachius A. Bariatric Surgery and Psychological Health: A Randomised Clinical Trial in Patients with Obesity and Type 2 Diabetes. Obes Surg 2023; 33:1536-1544. [PMID: 36964319 PMCID: PMC10156786 DOI: 10.1007/s11695-023-06537-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 03/26/2023]
Abstract
PURPOSE This study investigated the impact of either Roux-en-Y gastric bypass with silastic ring (SR-RYGB) or sleeve gastrectomy (SG) types of bariatric surgery on psychological health and explored the role of pre-existing depressive symptoms on weight loss. MATERIALS AND METHODS A total of 114 participants with obesity and type 2 diabetes were randomized to receive SR-RYGB or SG at a single centre. Data from the Hospital Anxiety and Depression Scale (HADS), RAND 36-item Health Survey and body weight were collected before surgery and annually for 5 years. RESULTS Sixteen patients were lost to follow-up at 5 years. Of the 98 patients who completed 5-year psychological follow-up assessments, 13 had mild to severe depressive symptoms (SR-RYGB n = 6, SG n = 7). SR-RYGB and SG resulted in similar psychological health improvement but percent weight loss at 5 years was greater for SR-RYGB by 10.6% (95% CI: 7.2 to 14.0, P < 0.0001). Scores for depressive symptoms and most RAND-36 domains improved significantly from baseline to 5 years in both groups. Patients with pre-existing depressive symptoms had similar percent weight loss at 5 years compared to patients without depressive symptoms, irrespective of procedural type. CONCLUSION Patients receiving either SR-RYGB or SG had comparable psychosocial functioning, which was maintained to 5 years post-surgery. Pre-existing depressive symptoms did not affect weight loss achieved at 5 years. These findings confirm previous longitudinal studies demonstrating that bariatric surgery is generally associated with improved psychosocial functioning.
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Affiliation(s)
- Lynn M Murton
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand
| | - Lindsay D Plank
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand
| | - Rick Cutfield
- Department of Endocrinology, North Shore Hospital, Waitemata District Health Board, 124 Shakespeare Road, Takapuna, Auckland, 0620, New Zealand
| | - David Kim
- Department of Endocrinology, North Shore Hospital, Waitemata District Health Board, 124 Shakespeare Road, Takapuna, Auckland, 0620, New Zealand
| | - Michael W C Booth
- Department of Surgery, North Shore Hospital, Waitemata District Health Board, 124 Shakespeare Road, Takapuna, Auckland, 0620, New Zealand
| | - Rinki Murphy
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand.
| | - Anna Serlachius
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand
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13
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Yu J, Huang HC, Cheng TCE, Wong MK, Teng CI. Effects of Playing Exergames on Quality of Life among Young Adults: A 12-Week Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1359. [PMID: 36674115 PMCID: PMC9858715 DOI: 10.3390/ijerph20021359] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/04/2023] [Accepted: 01/07/2023] [Indexed: 05/13/2023]
Abstract
Objective: The purpose of this paper is to investigate whether playing exergames can enhance quality of life among young adults and it examines the potential moderators. Methods: A 12-week randomized controlled trial was conducted. Quality of life was measured using the short-form 36-item version (SF-36) scale. All the participants were between 20 and 24 years old in Taiwan. Participants in the intervention group (n = 55) were asked to play exergames for 12 weeks, three times a week and 30 minutes at a time, while participants in the control group (n = 62) did not play exergames. The changes in the scores on quality of life between the beginning and the end of the 12-week trial were calculated. Independent t-tests were used to analyze the differences. Results: The intervention group participants experienced an enhanced quality of life in terms of physical functioning, role-physical (role limitations due to physical health), general health, and social functioning. Moreover, the intervention group participants who were not enthusiastic about exercisers experienced an enhanced quality of life in physical functioning, role-physical, and general health. The intervention group participants who attempted to control their weight experienced enhanced general health, vitality, and mental health. Conclusion: Playing exergaming could contribute to users' quality of life in terms of both physical and mental health.
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Affiliation(s)
- Jiajun Yu
- School of Management, Guangzhou Huashang College, Guangzhou 511300, China
- School of Innovation and Entrepreneurship, Guangzhou Huashang College, Guangzhou 511300, China
- Graduate Institute of Management, Chang Gung University, Taoyuan 333, Taiwan
| | - Han-Chung Huang
- Center for General Education, China University of Technology, Taipei 219, Taiwan
| | - T. C. E. Cheng
- Department of Logistics and Maritime Studies, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - May-Kuen Wong
- Taoyuan Branch, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Ching-I Teng
- Graduate Institute of Management, Chang Gung University, Taoyuan 333, Taiwan
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
- Department of Business and Management, Ming Chi University of Technology, New Taipei 243, Taiwan
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14
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Potential Roles of Glucagon-Like Peptide 1 Receptor Agonists (GLP-1 RAs) in Nondiabetic Populations. Cardiovasc Ther 2022; 2022:6820377. [PMID: 36474714 PMCID: PMC9683988 DOI: 10.1155/2022/6820377] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 10/29/2022] [Accepted: 11/01/2022] [Indexed: 11/17/2022] Open
Abstract
Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have been observed in several large cardiovascular outcome trials to significantly reduce the incidence of major cardiovascular event (MACE) with type 2 diabetic patients. The clinical trials of GLP-1 RAs, including lixisenatide, exenatide, liraglutide, semaglutide, albiglutide, and dulaglutide, are associated with a significantly 14% lower risk of MACE in patients with T2DM and a history of CV disease, and with a nonsignificantly 6% lower risk in patients without history of CV disease. Some of the interpretation with GLP-1 RA trials suggested the possible role of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in primary prevention of cardiovascular diseases in nondiabetic individual, echoed by a recent editorial redefining the role of GLP-1 RAs being beyond glycaemic control. The narrative review provides an in-depth insight into GLP-1 RA use guideline in different countries and regions of the world and examines the safety and concern of GLP-1 RA use. The narrative review draws the comparison of GLP-1 RA use between diabetic and nondiabetic individual in terms of cardiovascular and metabolic benefits and points out the direction of future clinical trials of GLP-1 RAs in nondiabetic individuals. The focus of the review is on GLP-1 RAs' preventive roles in nondiabetic individuals with cardiovascular disease, chronic kidney diseases, obesity, dyslipidaemia, hypertension, nonalcoholic fatty liver diseases, polycystic ovarian syndrome (PCOS), and perioperative complications of bariatric surgery, albeit in small studies and subset analysis of clinical trials of diabetic patients.
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15
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Breeze P, Gray LA, Thomas C, Bates SE, Brennan A. Estimating the impact of changes in weight and BMI on EQ-5D-3L: a longitudinal analysis of a behavioural group-based weight loss intervention. Qual Life Res 2022; 31:3283-3292. [PMID: 35796997 PMCID: PMC9546944 DOI: 10.1007/s11136-022-03178-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 12/04/2022]
Abstract
PURPOSE To estimate the association between changes in BMI and changes in Health-Related Quality of Life (EQ-5D-3L). METHODS The WRAP trial was a multicentre, randomised controlled trial with parallel design and recruited 1267 adults (BMI ≥ 28 kg/m2). Participants were allocated to Brief Intervention, a Commercial weight management Programme (WW, formerly Weight Watchers) for 12 weeks, or the same Programme for 52 weeks. Participants were assessed at 0, 3, 12, 24, and 60 months. We analysed the relationship between BMI and EQ-5D-3L, adjusting for age and comorbidities, using a fixed effects model. Test for attrition, model specification and missing data were conducted. Secondary analyses investigated a non-symmetric gradient for weight loss vs. regain. RESULTS A unit increase in BMI was associated with a - 0.011 (95% CI - 0.01546, - 0.00877) change in EQ-5D-3L. A unit change in BMI between periods of observation was associated with - 0.016 017 (95% CI - 0.0077009, - 0.025086) change in EQ-5D-3L. The negative association was reduced during weight loss, as opposed to weight gain, but the difference was not statistically significant. CONCLUSIONS We have identified a strong and statistically significant negative relationship between BMI changes and HRQoL. These estimates could be used in economic evaluations of weight loss interventions to inform policymaking. CLINICAL TRIAL REGISTRATION This trial was registered with Current Controlled Trials, number ISRCTN82857232.
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Affiliation(s)
- Penny Breeze
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Laura A. Gray
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Chloe Thomas
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Sarah E. Bates
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
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16
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Usta E, Bozdemir H, Şen S. Validity and reliability of the Turkish version of the Obesity-Related Well-Being Questionnaire (ORWELL 97-TR). Perspect Psychiatr Care 2022; 58:1991-2002. [PMID: 34997933 DOI: 10.1111/ppc.13021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/26/2021] [Accepted: 12/26/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study aimed to perform the validity and reliability of the Turkish version of the Obesity-Related Well-Being Questionnaire (ORWELL 97-TR) for the Turkish society. DESIGN AND METHODS This methodological study involved 125 people for obesity treatment. Data collection tools were the Patient Information Form, the ORWELL 97-TR, and the Obesity and Weight-Loss Quality of Life Instrument (OWLQOL). FINDINGS The content validity index of the scale was 0.94, and Cronbach's alpha value was 0.906. The findings indicate that the three-factor structure of the scale, which was reduced from 18 items to 15, showed a good agreement. PRACTICAL IMPLICATIONS The ORWELL 97-TR scale can be used to assess the life quality of Turkish patients seeking obesity treatment.
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Affiliation(s)
- Esra Usta
- Department of Health Care, Vocational School of Health Services, Düzce University, Düzce, Turkey
| | - Havva Bozdemir
- Department of Nursing, Faculty of Health Sciences, Kocaeli University, Kocaeli, Turkey
| | - Sevim Şen
- Department of Nursing, Keşan Hakkı Yörük School of Health, Trakya University, Edirne, Turkey
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17
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Liao YN, Chen HY, Yang CW, Lee PW, Hsu CY, Huang YT, Yang TH. Chinese herbal medicine is associated with higher body weight reduction than liraglutide among the obese population: A real-world comparative cohort study. Front Pharmacol 2022; 13:978814. [DOI: 10.3389/fphar.2022.978814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction: In Taiwan, many people receive Chinese herbal medicine (CHM) as an alternative choice to help control body weight. However, the clinical effectiveness of CHM on weight control has not been well studied, while potential risks and adverse effects are still unknown. The aim of our study is to find out a safe and efficient treatment model of CHM for weight control compared to liraglutide in a real-world setting.Methods: we retrospectively analyzed obese subjects [body mass index (BMI)≧25 kg/m2] from Chang Gung Research Database (2013–2018). We evaluated the effect on body weight and BMI changes in obese groups receiving CHM or western medicine (WM, represented liraglutide) within 180 days. The proportion of subjects who achieved 5 and 10% weight reduction was calculated as well. Furthermore, the potential adverse events were analyzed during the study period. Overlap weighting was used to balance the baseline differences between CHM and WM groups.Results: The full cohort comprised 1,360 participants: 701 in the CHM group and 659 in the WM group. At baseline, the CHM group was younger (42.75 ± 12.12 years old in CHM vs. 52.31 ± 11.7 years old in WM, p-value <0.001) and has more female subjects (77.6% in CHM vs. 53.0% in WM, p-value <0.001). On the other hand, CHM users had lower body weight (79.83 ± 15.66 kg vs. 84.68 ± 17.14 kg, p-value <0.001) and BMI (30.58 ± 5.20 vs. 32.84 ± 6.95, p-value <0.001). At day 180, CHM users lost more body weight (−4.5 ± 4.07 kg vs. −2.15 ± 4.05 kg, p-value <0.001) and higher reduction in BMI (−1.77 ± 1.73 vs. −0.9 ± 2.14, p-value <0.001). A total of 53.21% (n = 373) CHM users lost at least 5% of body weight (22.46% for WM users, p-value <0.001), and 18.97% (n = 132) lost at least 10% of body weight (4.55% for WM users, p-value <0.001). The benefit remained consistent with and without overlap weighting. For adverse events, 18 cases of hypertension occurred in 659 subjects in the WM group (2.7%) in comparison to 1 of 701 subjects in the CHM group (0.1%).Conclusion: CHM led to clinically meaningful weight loss without serious adverse events in a real-world setting. Further clinical trials are warranted to validate this result.
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18
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Jacobsen AL, DeVries CEE, Poulsen L, Mou D, Klassen AF, Pusic AL, Makarawung DJS, Wiezer MJ, van Veen RN, Sørensen JA. The impact of body mass index (BMI) on satisfaction with work life: An international BODY-Q study. Clin Obes 2022; 12:e12527. [PMID: 35575285 PMCID: PMC9539700 DOI: 10.1111/cob.12527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/07/2022] [Accepted: 04/11/2022] [Indexed: 12/05/2022]
Abstract
Obesity is a global health issue known to have a major influence on health-related quality of life (HR-QOL). HR-QOL is a concept evaluating physical and psychological health. Work life can impact HR-QOL in people with obesity. The aim of this study was to measure the association between body mass index (BMI) and satisfaction with work life. This study included participants from an international multicenter field-test study of BODY-Q scales. Recruitment took place at hospitals in Denmark, The Netherlands and USA between June 2019 and January 2020. The BODY-Q Work Life scale was used to measure work life satisfaction. The difference between BMI groups and work life satisfaction was examined using one-way analysis of variance. Multivariable linear regression analysis was used to examine the association between BMI and work life satisfaction, adjusted for significant confounders. Of 4123 participants, 2515 completed the BODY-Q Work Life scale. BMI groups showed significant difference in work life satisfaction (p < .0001). The Work Life scale mean score was 77.6 for the normal BMI group, 78.5 for the overweight group and 75.0, 68.9 and 63.8 for Class 1, 2 and 3 obesity, respectively. Furthermore, BMI was significantly associated with satisfaction with work life (adjusted regression coefficient -.962, p < .0001). Higher BMI was associated with lower work life satisfaction. This finding suggests that a reduction in BMI may have a positive influence on work life satisfaction in people with obesity.
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Affiliation(s)
- Amalie L. Jacobsen
- Research Unit for Plastic SurgeryOdense University HospitalOdenseDenmark
- OPEN, Open Patient data Explorative NetworkOdense University HospitalOdenseDenmark
| | - Claire E. E. DeVries
- Department of SurgeryBrigham and Women's HospitalBostonMassachusettsUSA
- Department of SurgeryOLVG WestAmsterdamThe Netherlands
| | - Lotte Poulsen
- Research Unit for Plastic SurgeryOdense University HospitalOdenseDenmark
- OPEN, Open Patient data Explorative NetworkOdense University HospitalOdenseDenmark
| | - Danny Mou
- Department of SurgeryBrigham and Women's HospitalBostonMassachusettsUSA
| | - Anne F. Klassen
- Department of PediatricsMcMaster UniversityHamiltonOntarioCanada
| | - Andrea L. Pusic
- Department of SurgeryBrigham and Women's HospitalBostonMassachusettsUSA
| | | | | | | | - Jens A. Sørensen
- Research Unit for Plastic SurgeryOdense University HospitalOdenseDenmark
- Department of Plastic SurgeryUniversity of Southern DenmarkOdenseDenmark
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19
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Li L, Soll D, Leupelt V, Spranger J, Mai K. Weight loss-induced improvement of body weight and insulin sensitivity is not amplified by a subsequent 12-month weight maintenance intervention but is predicted by adaption of adipose atrial natriuretic peptide system: 48-month results of a randomized controlled trial. BMC Med 2022; 20:238. [PMID: 35897098 PMCID: PMC9330651 DOI: 10.1186/s12916-022-02435-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Behavioral weight loss interventions are frequently hampered by long-term inefficacy. As metabolic improvements and health-related quality of life (HRQoL) are diminished by weight regain, effective long-term strategies are highly desirable. We aimed to analyze whether an additional weight maintenance intervention could delay body weight regain and can induce a long-term improvement of metabolism and HRQoL for up to 48 months in humans. Given the short-term metabolic effects of natriuretic peptides (NP), we also investigated the role of the adipose atrial NP (ANP) system in this long-term context. METHODS After a successful 12-week weight reduction program 143 subjects (age>18; BMI≥27 kg/m2) were randomized (1:1) to a control group or a 12-month multimodal weight maintenance intervention focusing on nutritional counseling and physical exercises. Secondary trial outcomes including course of BMI, HOMA-IR, glucose response after oGTT (glucoseAUC), and HRQoL (SF-36) were analyzed yearly for 48 months. Adipose ANP receptor mRNA expression was analyzed during weight loss. RESULTS Initial weight loss (- 4.7±1.5 kg/m2) improved glucoseAUC, HOMA-IR, and HRQoL. Although BMI was still reduced after 48 months (-1.98 [95% CI -2.61, -1.35] kg/m2), benefits on HOMA-IR, glucoseAUC, and mental health disappeared after 36 (-0.49 [-1.00, 0.02]), 18 (0.61 [-9.57, 10.79] mg dl-1 min-1), and 18 months (2.06 [-0.08, 4.20]), respectively, while improved physical health persisted up to months 48 (2.95 [0.49, 5.40]). Weight maintenance intervention inhibited weight regain and delayed impairment of HOMA-IR and glucoseAUC (but not HRQoL) for up to 12 months. However, no metabolic long-term effect was seen beyond the intervention period. Lower adipose NPR-C and higher NPR-A mRNA expression after weight loss predicted smaller regain of weight (r=0.398; p<0.05)/fat mass (FM) (r=0.391; p<0.05) and longer improvement of HOMA-IR (r=-0.422; p<0.05), respectively. CONCLUSIONS Additional benefits of a behavioral 12-month weight maintenance intervention after weight loss regarding body weight regain and metabolic improvement does not persist beyond the intervention period. However, weight loss-induced modulation of the adipose ANP system is probably involved in the long-term control of body weight regain and insulin sensitivity. TRIAL REGISTRATION ClinicalTrials.gov NCT00850629 . Registered on February 25, 2009.
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Affiliation(s)
- Linna Li
- Department of Endocrinology and Metabolism, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117, Berlin, Germany.,Charité-Center for Cardiovascular Research (CCR), Berlin, Germany
| | - Dominik Soll
- Department of Endocrinology and Metabolism, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117, Berlin, Germany.,Charité-Center for Cardiovascular Research (CCR), Berlin, Germany
| | - Verena Leupelt
- Department of Endocrinology and Metabolism, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117, Berlin, Germany.,Charité-Center for Cardiovascular Research (CCR), Berlin, Germany
| | - Joachim Spranger
- Department of Endocrinology and Metabolism, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117, Berlin, Germany.,Charité-Center for Cardiovascular Research (CCR), Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Knut Mai
- Department of Endocrinology and Metabolism, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117, Berlin, Germany. .,Charité-Center for Cardiovascular Research (CCR), Berlin, Germany. .,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany.
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20
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Pedroso I, Kumbhare SV, Joshi B, Saravanan SK, Mongad DS, Singh-Rambiritch S, Uday T, Muthukumar KM, Irudayanathan C, Reddy-Sinha C, Dulai PS, Sinha R, Almonacid DE. Mental Health Symptom Reduction Using Digital Therapeutics Care Informed by Genomic SNPs and Gut Microbiome Signatures. J Pers Med 2022; 12:1237. [PMID: 36013186 PMCID: PMC9409755 DOI: 10.3390/jpm12081237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
Neuropsychiatric diseases and obesity are major components of morbidity and health care costs, with genetic, lifestyle, and gut microbiome factors linked to their etiology. Dietary and weight-loss interventions can help improve mental health, but there is conflicting evidence regarding their efficacy; and moreover, there is substantial interindividual heterogeneity that needs to be understood. We aimed to identify genetic and gut microbiome factors that explain interindividual differences in mental health improvement after a dietary and lifestyle intervention for weight loss. We recruited 369 individuals participating in Digbi Health’s personalized digital therapeutics care program and evaluated the association of 23 genetic scores, the abundance of 178 gut microbial genera, and 42 bacterial pathways with mental health. We studied the presence/absence of anxiety or depression, or sleep problems at baseline and improvement on anxiety, depression, and insomnia after losing at least 2% body weight. Participants lost on average 5.4% body weight and >95% reported improving mental health symptom intensity. There were statistically significant correlations between: (a) genetic scores with anxiety or depression at baseline, gut microbial functions with sleep problems at baseline, and (b) genetic scores and gut microbial taxa and functions with anxiety, depression, and insomnia improvement. Our results are concordant with previous findings, including the association between anxiety or depression at baseline with genetic scores for alcohol use disorder and major depressive disorder. As well, our results uncovered new associations in line with previous epidemiological literature. As evident from previous literature, we also observed associations of gut microbial signatures with mental health including short-chain fatty acids and bacterial neurotoxic metabolites specifically with depression. Our results also show that microbiome and genetic factors explain self-reported mental health status and improvement better than demographic variables independently. The genetic and microbiome factors identified in this study provide the basis for designing and personalizing dietary interventions to improve mental health.
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Affiliation(s)
- Inti Pedroso
- Digbi Health, Mountain View, CA 94040, USA; (I.P.); (S.V.K.); (B.J.); (S.K.S.); (S.S.-R.); (T.U.); (K.M.M.); (C.I.); (C.R.-S.); (R.S.)
| | - Shreyas Vivek Kumbhare
- Digbi Health, Mountain View, CA 94040, USA; (I.P.); (S.V.K.); (B.J.); (S.K.S.); (S.S.-R.); (T.U.); (K.M.M.); (C.I.); (C.R.-S.); (R.S.)
| | - Bharat Joshi
- Digbi Health, Mountain View, CA 94040, USA; (I.P.); (S.V.K.); (B.J.); (S.K.S.); (S.S.-R.); (T.U.); (K.M.M.); (C.I.); (C.R.-S.); (R.S.)
| | - Santosh K. Saravanan
- Digbi Health, Mountain View, CA 94040, USA; (I.P.); (S.V.K.); (B.J.); (S.K.S.); (S.S.-R.); (T.U.); (K.M.M.); (C.I.); (C.R.-S.); (R.S.)
| | | | - Simitha Singh-Rambiritch
- Digbi Health, Mountain View, CA 94040, USA; (I.P.); (S.V.K.); (B.J.); (S.K.S.); (S.S.-R.); (T.U.); (K.M.M.); (C.I.); (C.R.-S.); (R.S.)
| | - Tejaswini Uday
- Digbi Health, Mountain View, CA 94040, USA; (I.P.); (S.V.K.); (B.J.); (S.K.S.); (S.S.-R.); (T.U.); (K.M.M.); (C.I.); (C.R.-S.); (R.S.)
| | - Karthik Marimuthu Muthukumar
- Digbi Health, Mountain View, CA 94040, USA; (I.P.); (S.V.K.); (B.J.); (S.K.S.); (S.S.-R.); (T.U.); (K.M.M.); (C.I.); (C.R.-S.); (R.S.)
| | - Carmel Irudayanathan
- Digbi Health, Mountain View, CA 94040, USA; (I.P.); (S.V.K.); (B.J.); (S.K.S.); (S.S.-R.); (T.U.); (K.M.M.); (C.I.); (C.R.-S.); (R.S.)
| | - Chandana Reddy-Sinha
- Digbi Health, Mountain View, CA 94040, USA; (I.P.); (S.V.K.); (B.J.); (S.K.S.); (S.S.-R.); (T.U.); (K.M.M.); (C.I.); (C.R.-S.); (R.S.)
| | - Parambir S. Dulai
- Division of Gastroenterology, Northwestern University, Chicago, IL 60208, USA;
| | - Ranjan Sinha
- Digbi Health, Mountain View, CA 94040, USA; (I.P.); (S.V.K.); (B.J.); (S.K.S.); (S.S.-R.); (T.U.); (K.M.M.); (C.I.); (C.R.-S.); (R.S.)
| | - Daniel Eduardo Almonacid
- Digbi Health, Mountain View, CA 94040, USA; (I.P.); (S.V.K.); (B.J.); (S.K.S.); (S.S.-R.); (T.U.); (K.M.M.); (C.I.); (C.R.-S.); (R.S.)
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21
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Kheniser K, Aminian A, Kashyap SR. Effects of Metabolic Medicine and Metabolic Surgery on Patient-Reported Outcomes Among Patients with Type 2 Diabetes. Metab Syndr Relat Disord 2022; 20:497-508. [PMID: 35881869 DOI: 10.1089/met.2022.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The assessment and management of patient-reported outcomes (PROs) is considered secondary to that of cardiometabolic outcomes. When assessed, health-related quality of life (HRQOL), a PRO, can yield pertinent information that cannot be obtained from cardiometabolic assessments. For instance, physical and mental distress can be quantified and treated. Moreover, treatment convenience and satisfaction can be gaged. Behavioral modification, bariatric surgery, and pharmacotherapy can improve PROs. Typically, HRQOL is responsive to changes in weight. Specifically, weight loss and weight gain are associated with positive and negative changes in quality of life, respectively. In addition, patient satisfaction can be influenced by glycemic control. Therefore, hypoglycemia and hyperglycemic episodes can negatively affect patient satisfaction. When managing type 2 diabetes (T2D), it is important to consider how therapies impact PROs. Generally, changes in clinical outcomes mirror changes in PROs. To best manage T2D, integrating the assessment of PROs with clinical outcomes is needed.
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Affiliation(s)
- Karim Kheniser
- Department of General Surgery, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ali Aminian
- Department of General Surgery, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sangeeta R Kashyap
- Department of Endocrinology and Metabolism, Cleveland Clinic, Cleveland, Ohio, USA
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22
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Bouzas C, Bibiloni MDM, Garcia S, Mateos D, Martínez-González MÁ, Salas-Salvadó J, Corella D, Goday A, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, Lopez-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Serra-Majem L, Riquelme-Gallego B, Martín-Sánchez V, Pintó X, Gaforio JJ, Matía P, Vidal J, Vázquez C, Daimiel L, Ros E, Pascual-Roquet-Jalmar E, Babio N, Gonzalez-Monge I, Castañer O, Abete I, Sorto-Sánchez C, Carlos Benavente-Marín J, Torres-Collado L, Martin M, García-Ríos A, Castro-Barquero S, Fernández-García JC, Santos-Lozano JM, Fernandez-Lazaro CI, Salas-Huetos A, Guillem-Saiz P, Zomeño MD, Ángeles Zulet M, Goikoetxea-Bahon A, Gea A, Nishi SK, Schröder H, Tur JA. Desired weight loss and its association with health, health behaviors and perceptions in an adult population with weight excess: One-year follow-up. Front Nutr 2022; 9:848055. [PMID: 35938116 PMCID: PMC9355147 DOI: 10.3389/fnut.2022.848055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 06/27/2022] [Indexed: 01/10/2023] Open
Abstract
BackgroundMetabolic syndrome (MetS) worsens quality of life and increases mortality. Dissatisfaction with weight in patients with MetS may modify the effect of lifestyle interventions to achieve changes in health-related behaviors.ObjectiveTo assess 1-year changes in cardiovascular risk scores, self-perceived general health and health-related behaviors according to observed changes in desired weight loss during the first year of intervention in a large cardiovascular prevention trial.DesignProspective analysis of the PREDIMED-PLUS trial, including 5,499 adults (55–75 years old) with overweight or obesity at baseline.MethodsThe desired weight loss was the difference between ideal and measured weight. Tertiles of change in desired weight loss (1 year vs. baseline) were defined by the following cut-off points: ≥0.0 kg (T1, n = 1,638); 0.0 to −4.0 kg (T2, n = 1,903); ≤−4.0 kg (T3, n = 1,958). A food frequency questionnaire assessed diet and the Minnesota-REGICOR questionnaire assessed physical activity. The Framingham equation assessed cardiovascular risks. The changes in the severity of MetS were also assessed. The Beck Depression Inventory assessed depressive symptoms and the SF-36 assessed health-related quality of life. Data were analyzed using general linear models.ResultsBMI decreased at T2 and T3 (T1: 0.3, T2: −0.7, T3: −1.9). The most significant improvement in diet quality was observed at T3. Cardiovascular risk decreased at T2 and T3. Mean reductions in MetS severity score were: −0.02 at T1, −0.39 at T2 and −0.78 at T3. The perception of physical health increases in successive tertiles.ConclusionsIn older adults with MetS, more ambitious desired weight loss goals were associated with improvements in diet, cardiovascular health and perceived physical health during the first year of a healthy lifestyle intervention programme. Weight dissatisfaction needs to be considered by health professionals.Clinical trial registrationhttp://www.isrctn.com/ISRCTN89898870, identifier 89898870.
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Affiliation(s)
- Cristina Bouzas
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Maria del Mar Bibiloni
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Silvia Garcia
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - David Mateos
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Miguel Ángel Martínez-González
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IDISNA), University of Navarra, Pamplona, Spain
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Human Nutrition Unit, Biochemistry and Biotechnology Department, Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Albert Goday
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
| | - J. Alfredo Martínez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Cardiometabolics Precision Nutrition Program, Instituto Madrileño de Estudios Avanzados (IMDEA) Food, Campus Excelencia Internacional (CEI UAM + CSIC), Madrid, Spain
- Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Ángel M. Alonso-Gómez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain
- Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain
- Department of Medicine, University of the Basque Country, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, Málaga, Spain
| | - Jesús Vioque
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Dora Romaguera
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - José Lopez-Miranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain
| | - Ramon Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Francisco J. Tinahones
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Virgen de la Victoria Hospital, Department of Endocrinology, University of Málaga, Málaga, Spain
| | - José Lapetra
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Lluís Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institute for Biomedical Research, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Blanca Riquelme-Gallego
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Granada, Granada, Spain
| | - Vicente Martín-Sánchez
- CIBER Diabetes y enfermedades metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, Leon, Spain
| | - Xavier Pintó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - José J. Gaforio
- Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, Málaga, Spain
- Department of Health Sciences, Center for Advanced Studies in Olive Grove and Olive Oils, University of Jaen, Jaen, Spain
| | - Pilar Matía
- Department of Endocrinology and Nutrition, Fundación Para la Investigación Biomedica de El Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Josep Vidal
- Department of Endocrinology, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Clotilde Vázquez
- Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain
| | - Lidia Daimiel
- Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, Campus Excelencia Internacional (CEI UAM + CSIC), Madrid, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Elena Pascual-Roquet-Jalmar
- Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IDISNA), University of Navarra, Pamplona, Spain
- Osasunbidea, Servicio Navarro de Salud, Atención Primaria, Pamplona, Spain
| | - Nancy Babio
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Human Nutrition Unit, Biochemistry and Biotechnology Department, Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
| | | | - Olga Castañer
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
| | - Itziar Abete
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IDISNA), University of Navarra, Pamplona, Spain
| | - Carolina Sorto-Sánchez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain
- Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain
- Department of Medicine, University of the Basque Country, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Juan Carlos Benavente-Marín
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, Málaga, Spain
| | - Laura Torres-Collado
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Marian Martin
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Antonio García-Ríos
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain
| | - Sara Castro-Barquero
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Jose C. Fernández-García
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Virgen de la Victoria Hospital, Department of Endocrinology, University of Málaga, Málaga, Spain
| | - José Manuel Santos-Lozano
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Cesar I. Fernandez-Lazaro
- Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IDISNA), University of Navarra, Pamplona, Spain
| | - Albert Salas-Huetos
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Human Nutrition Unit, Biochemistry and Biotechnology Department, Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
| | - Patricia Guillem-Saiz
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - María Dolores Zomeño
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
| | - Maria Ángeles Zulet
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IDISNA), University of Navarra, Pamplona, Spain
| | - Amaia Goikoetxea-Bahon
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain
- Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain
- Department of Medicine, University of the Basque Country, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IDISNA), University of Navarra, Pamplona, Spain
| | - Stephanie K. Nishi
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Human Nutrition Unit, Biochemistry and Biotechnology Department, Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
| | - Helmut Schröder
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Josep A. Tur
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- *Correspondence: Josep A. Tur
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Effectiveness of logotherapy and nutrition counseling on psychological status, quality of life, and dietary intake among breast cancer survivors with depressive disorder: a randomized clinical trial. Support Care Cancer 2022; 30:7997-8009. [PMID: 35759049 DOI: 10.1007/s00520-022-07237-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/17/2022] [Indexed: 11/12/2022]
Abstract
Breast cancer (BC) can negatively influence multiple facets of survivors' lives including mental health, quality of life (QoL), and dietary behavior. Logotherapy as a psycho-education program may help breast cancer survivors (BCSs) discover their meaning of life throughout distressful events. The present study aimed to determine the effects of logotherapy along with nutrition counseling on psychological status, QoL, and dietary intake among BCSs who were diagnosed with depression.This randomized clinical trial was conducted on 90 BCSs who scored ≥ 14 on Beck's depression test. Participants were randomly assigned into two groups to receive nutrition counseling plus logotherapy (n = 46) or nutrition counseling alone (n = 44) for 8 weeks. Primary outcomes (depression, anxiety, and QoL) and secondary outcomes (anthropometric indices, dietary intake, and eating disorder status) were measured at baseline and after 8 weeks.All dimensions of QoL, anthropometric measurements, and the compulsive eating scale improved significantly in both groups after 8 weeks. A combination of nutrition counseling and logotherapy resulted in a significant reduction in anxiety (P < 0.001) and depression (P < 0.001) scores compared with the nutrition counseling alone. In addition, participants who received logotherapy plus nutrition counseling significantly consumed less energy, carbohydrate, and fat intake after 8 weeks compared with the control group (P < 0.001).It can be concluded that logotherapy along with nutrition education would be an important step in improving anxiety, depression, and QoL of patients with BC who had depressive symptoms.Trial registration number: (IR.ACECR.IBCRC.REC.1396.17).
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Raji Lahiji M, Vafa S, de Souza RJ, Zarrati M, Sajadian A, Razmpoosh E, Jaberzadeh S. Effect of Dietary-Based Lifestyle Modification Approaches on Anthropometric Indices and Dietary Intake Parameters in Women with Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2022; 13:1974-1988. [PMID: 35641019 PMCID: PMC9526840 DOI: 10.1093/advances/nmac062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/26/2022] [Accepted: 05/26/2022] [Indexed: 01/28/2023] Open
Abstract
This systematic review and meta-analysis aimed to investigate the effect of dietary-based lifestyle modification interventions ("diet," or "diet + exercise," or "diet + exercise + behavioral" intervention) on the measures of anthropometric and dietary intake parameters in women with breas cancer (BC). Databases were searched until June 2021. Inclusion criteria were randomized controlled trials that enrolled only women with BC. Studies that used exercise or behavioral interventions alone were not included. Mean ± SD changes were extracted for each outcome, and pooled using a random-effects model; 7315 studies were identified. Fifty-one studies (n = 7743) were included. The median ± SD duration of treatment was 24 ± 16.65 wk. Dietary-based interventions significantly reduced body weight [45 studies (n = 7239), weighted mean difference (WMD) (95% CI): -2.6 (-3.2, -2.1) kg], BMI [31 studies (n = 5384); WMD (95% CI): -1.0 (-1.3, -0.7) kg/m2], lean body mass [15 studies (n = 1194); WMD (95% CI): -0.6(-0.7, -0.4) kg], fat mass [11 studies (n = 913); WMD (95% CI): -2.6 (-3.3, -1.8) kg], fat percentage [17 studies (n = 897); WMD (95% CI): -1.5 (-1.9, -1.3)%], hip circumference [9 studies (n = 489); WMD (95% CI): -2.43 (-3.34, -1.54) cm], and waist circumference [7 studies (n = 309); WMD (95% CI): 0.02 (-0.03, -0.005) cm]. Significant reductions in energy intakes [20 studies (n = 4608), WMD (95% CI): -162 (-220, 104) kcal/d] and fat intakes [7 studies (n = 4316), WMD (95% CI): -7.5 (-7.8, -7.2)% of energy/d], and an increase in fiber intakes [11 studies (n = 4241), WMD (95% CI): 2.4 (0.7, 4.1) g/d] were observed. No significant changes were seen in protein, carbohydrate, and fruit and vegetable intakes. Subgroup analyses showed that changes in anthropometric and dietary intake indices were significant in studies that enrolled patients with both obesity and normal weight, studies that used diet therapy in combination with exercise and behavioral therapy, and studies that started the intervention during the treatment period. Overall, a multimodal dietary-based lifestyle intervention had significant effects on anthropometric and dietary intake parameters in women with BC, specifically when started as early as the diagnosis. This meta-analysis was registered at PROSPERO as CRD42021291488.
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Affiliation(s)
- Mahsa Raji Lahiji
- Deparment of Integrative Oncology and Quality of Life, Breast Cancer Research Center, Motamed Cancer Institute, Academic Centre for Education, Culture, and Research, Tehran, Iran,Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Saeideh Vafa
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Russell J de Souza
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada,Population Health Research Institute, Hamilton, ON, Canada
| | - Mitra Zarrati
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Akram Sajadian
- Deparment of Integrative Oncology and Quality of Life, Breast Cancer Research Center, Motamed Cancer Institute, Academic Centre for Education, Culture, and Research, Tehran, Iran
| | | | - Shapour Jaberzadeh
- Non-invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
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25
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The prototype of a preference-based index of weight-related quality of life: demonstrating the possibilities. Qual Life Res 2022; 31:3061-3075. [PMID: 35608809 DOI: 10.1007/s11136-022-03156-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Evidence for comparative and cost-effectiveness of weight-loss interventions is lacking as there are no obesity-specific measures fit for this purpose. This study aimed to estimate the extent to which a prototype of a brief, multi-dimensional obesity-specific Preference-Based Index of Weight-Related Quality of Life (PBI-WRQL) could fill this gap. METHODS Longitudinal data from a Canadian bariatric cohort was used. Forty-eight items from the IWQoL-Lite, EQ-5D-3L, and SF-12V2 were mapped onto the WHO ICF domains, and one item was chosen for the dimension based on fit to the Rasch model. Individuals' health ratings (0-100) were regressed on each dimension, and the regression coefficients for the response options were used as weights to generate a total score. Generalized estimation equations were used to compare measure parameters across groups and levels of converging constructs. RESULTS Pre-surgery data were available on 201 people (Women: 82%; BMI: 48.8 ± 6.7 kg/m2; age: 43 ± 9.0 years) and on 125 (62%) at 6 months post-bariatric surgery. Seven dimensions with three response options formed the PB-WRQL prototype: Mobility/Physical Function, Pain, Depression, Participation, Energy, Peripheral Edema, and Dyspnea. The prototype showed substantial change (mean + 40) with bariatric surgery, higher than the EQ-5D (mean + 11.5). The prototype showed the strongest relationship with BMI at baseline (t = - 3.68) and was the most sensitive to change in BMI (t = - 3.42). CONCLUSION This study demonstrates that a brief, 7-dimension index weighted by health impact performed as well as the 31-item IWQoL-Lite and better than the EQ-5D-3L. These findings demonstrate the potential value of the brief PB-WRQL prototype index and support its further development using preference weights to reflect the current generation's needs and concerns.
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26
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Rajaie SH, Soltani S, Yazdanpanah Z, Zohrabi T, Beigrezaei S, Mohseni-Takalloo S, Kaviani M, Forbes SC, Baker JS, Salehi-Abargouei A. Effect of exercise as adjuvant to energy-restricted diets on quality of life and depression outcomes: a meta-analysis of randomized controlled trials. Qual Life Res 2022; 31:3123-3137. [PMID: 35522360 DOI: 10.1007/s11136-022-03146-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM Obesity and related co-morbidities lead to a decrease in health-related quality of life (HRQOL) and mood. Lifestyle strategies may improve these outcomes. However, the efficacy of exercise in conjunction with a weight-loss diet on HRQOL and mood is unclear. The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to examine whether the addition of exercise to energy-restricted dietary programs improves HRQOL and mood status when compared with energy-restricted diets alone in overweight and obese adults. METHODS Eligible RCTs were identified by searching PubMed/MEDLINE, EMBASE, ISI (Web of sciences), Scopus, and Google Scholar up to April 2021. Summary effects were derived using a random-effects model. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. RESULTS The meta-analysis revealed that an energy-restricted diet plus exercise compared with an energy-restricted diet alone had no significant effects on depression (n = 6, hedges'g = - 0.04, 95% CI: - 0.28,0.20), MOS 36-Item Short-Form Health Survey (SF-36)-physical component summary scores (n = 8, weighted mean difference (WMD) = 1.51, 95% CI: - 0.16, 3.18), SF36-mental component summary scores (n = 7, WMD = 0.64, 95% CI: - 1.00, 2.28), and HRQOL disease-specific questionnaire scores (n = 5, hedges'g = 0.16, 95% CI: - 0.09, 0.40). The GRADE revealed that the quality of evidence was low for disease-specific HRQOL scores, and depression status; and high for physical and mental health assessed by SF-36. CONCLUSION In our sample of overweight and obese adults, no beneficial effect of adding exercise to an energy-restricted diet was found in terms of HRQOL and Depression.
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Affiliation(s)
- Seyede Hamide Rajaie
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Code, Yazd, 8915173160, Iran.,Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sepideh Soltani
- Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zeinab Yazdanpanah
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Code, Yazd, 8915173160, Iran.,Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Tayebeh Zohrabi
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Code, Yazd, 8915173160, Iran.,Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sara Beigrezaei
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Code, Yazd, 8915173160, Iran.,Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sahar Mohseni-Takalloo
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Code, Yazd, 8915173160, Iran.,Noncommunicable Diseases Research Center, Bam University of Medical Sciences, Bam, Iran
| | - Mojtaba Kaviani
- School of Nutrition and Dietetics, Faculty of Pure & Applied Science, Acadia University, Wolfville, NS, Canada
| | - Scott C Forbes
- Department of Physical Education Studies, Faculty of Education, Brandon University, Brandon, MB, Canada
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Amin Salehi-Abargouei
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Code, Yazd, 8915173160, Iran. .,Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Tyler DE, Lobban PF, Hadarag MB, Jones PS. A systematic review of psychosocial functioning and quality of life in older people with bipolar disorder. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 9:100371. [PMID: 35845859 PMCID: PMC9272766 DOI: 10.1016/j.jadr.2022.100371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022] Open
Abstract
The Global Assessment of Functioning (GAF; Endicott et al., 1976) is the most widely used functioning measure used with older adults with bipolar disorder. Older adults with bipolar disorder demonstrate a wide range of functioning. No existing validated measure assessing the psychosocial functioning or quality of life of older people with BD could be identified. There is a significant lack of research in the area of older people with bipolar disorder compared to the younger population.
Background There is evidence to suggest that older people with Bipolar Disorder (BD) are more likely to demonstrate poor levels of functioning and score lower on well-being scales compared to non-clinical controls, even when in remission (Depp et al., 2006). To our knowledge, this is the first review paper to identify how quality of life and functioning has been measured in an older adult BD population. Methods We conducted a systematic review of studies including a quantitative measure of psychosocial functioning or quality of life and older people over the age of 50 with a formal diagnosis of BD I or II. Results Eleven studies (N = 726, mean age range 59.8 to 71.1) were included in the review, demonstrating a significant lack of research in the area compered to younger people with BD. The most commonly used measure of functioning was the Global Assessment of Functioning Scale (GAF) and results indicated that older adults with BD demonstrate a wide range of functioning. Limitations The review used a comprehensive and systematic search strategy, however, very few eligible studies were available for review. The pooled analyses and reported means must be interpreted with caution due to the relatively small sample sizes. Conclusions Older people with BD present with a wide range of functioning, ranging ‘major impairment’ to ‘superior’ scores. No existing validated measure assessing the psychosocial functioning or quality of life of older people with BD could be identified. Such a tool should be developed for use in future research.
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Affiliation(s)
- Dr Elizabeth Tyler
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK
- Corresponding author.
| | - Professor Fiona Lobban
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK
| | | | - Professor Steven Jones
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK
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Association between weight loss, change in physical activity, and change in quality of life following a corporately sponsored, online weight loss program. BMC Public Health 2022; 22:451. [PMID: 35255862 PMCID: PMC8900429 DOI: 10.1186/s12889-022-12835-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/22/2022] [Indexed: 11/27/2022] Open
Abstract
Background The physiological benefits associated with corporately sponsored weight loss programs are increasingly well documented. However, less is known about how these programs affect employees’ quality of life (QoL). The purpose of the present analysis was to examine the association between weight loss, change in physical activity, and change in QoL following a corporately sponsored, online weight loss program. Methods We examined the relationship between weight loss, self-reported change in physical activity, and change in several QoL indices in 26,658 participants (79% women) after the initial 10 weeks of the online weight loss program. The trend in changes in each QoL index with increasing weight loss and change in physical activity was examined using logistic regression analysis. Results We observed greater improvements in each QoL index with increasing weight loss (p-for-trend, < 0.001) as well as with progressive increases in physical activity (p-for-trend, < 0.001). The combination of increasing weight loss and increases in physical activity were associated with the greatest improvements in each QoL index (additive effect). The percentage of employees reporting improvements in QoL (“improved” or “very much improved”) was 64% for energy, 63% for mood, 33% for sleep, 65% for self-confidence, 68% for indigestion, and 39% for musculoskeletal pain. Conclusions Among people, who engage with a commercial weight loss program, greater weight loss during the program was associated with greater improvements in QoL, and increases in physical activity further enhanced the QoL-related benefits.
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29
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Utilizing Patient Reported Outcomes and Quality of Life Measures in the Management of Obesity. J Dr Nurs Pract 2022; 15:57-64. [DOI: 10.1891/jdnp-2021-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BackgroundPatient-reported outcome measures (PROMs) assess health-related quality of life (HRQOL). These tools can facilitate assessment of weight-related successes and challenges.ObjectiveImplement surveys to better understand individual experiences with obesity and explore factors that may be associated with HRQOL.MethodsPatients completed Obesity and Weight Loss Quality of Life Instrument (OWLQOL) and Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 surveys. Three scores were calculated from survey results: global physical health (GPH), global mental health (GMH), and OWLQOL. The association between these scores and body mass index (BMI) was examined using multiple linear regression analyses.Results114 surveys were analyzed. GPH and OWLQOL scores were negatively associated with BMI. OWLQOL scores were higher in those who lost more than 10% body weight compared to those who lost less weight. OWLQOL scores for return patients were significantly higher than those for new patients.ConclusionsVarious factors may affect HRQOL. Higher BMI may adversely affect HRQOL, but weight loss greater than 10% and an ongoing clinical relationship may have a positive effect.Implications for NursingThese surveys can promote quality care, providing relevant information to enhance the clinical visit and offering another means to evaluate interventions over time.
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30
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Heath L, Jebb S, Stevens R, Wheeler G, Ahern A, Boyland E, Halford J, Aveyard P. Effects of a group-based weight management programme on anxiety and depression: A randomised controlled trial (RCT). PLoS One 2022; 17:e0263228. [PMID: 35113940 PMCID: PMC8812921 DOI: 10.1371/journal.pone.0263228] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 01/09/2022] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES The aim was to investigate the impact of a group-based weight management programme on symptoms of depression and anxiety compared with self-help in a randomised controlled trial (RCT). METHOD People with overweight (Body Mass Index [BMI]≥28kg/m2) were randomly allocated self-help (n = 211) or a group-based weight management programme for 12 weeks (n = 528) or 52 weeks (n = 528) between 18/10/2012 and 10/02/2014. Symptoms were assessed using the Hospital Anxiety and Depression Scale, at baseline, 3, 12 and 24 months. Linear regression modelling examined changes in Hospital Anxiety and Depression Scale between trial arms. RESULTS At 3 months, there was a -0.6 point difference (95% confidence interval [CI], -1.1, -0.1) in depression score and -0.1 difference (95% CI, -0.7, 0.4) in anxiety score between group-based weight management programme and self-help. At subsequent time points there was no consistent evidence of a difference in depression or anxiety scores between trial arms. There was no evidence that depression or anxiety worsened at any time point. CONCLUSIONS There was no evidence of harm to depression or anxiety symptoms as a result of attending a group-based weight loss programme. There was a transient reduction in symptoms of depression, but not anxiety, compared to self-help. This effect equates to less than 1 point out of 21 on the Hospital Anxiety and Depression Scale and is not clinically significant.
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Affiliation(s)
- Laura Heath
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- * E-mail:
| | - Susan Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Richard Stevens
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Graham Wheeler
- Cancer Research UK & UCL Cancer Trials Centre, University College London, London, United Kingdom
- Imperial Clinical Trials Unit, Imperial College London, London, United Kingdom
| | - Amy Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Emma Boyland
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Jason Halford
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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31
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Wu W, Zhou Q, Yuan P, Qiao D, Deng S, Cheng H, Ren Y. A Novel Multiphase Modified Ketogenic Diet: An Effective and Safe Tool for Weight Loss in Chinese Obese Patients. Diabetes Metab Syndr Obes 2022; 15:2521-2534. [PMID: 35999869 PMCID: PMC9393022 DOI: 10.2147/dmso.s365192] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 08/10/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The aim of the present study was to investigate the effect and safety of a multiphase modified ketogenic diet (MMKD) compared to beinaglutide treatment or lifestyle modification (LM) alone on weight loss in obese patients in China. PATIENTS AND METHODS The present study was conducted in adults with obesity who did not have diabetes with two phases as follows: a 4-week run-in phase to guide diet and exercise, followed by a 12-week intervention phase aiming to lose weight. All participants performed aerobic and resistance exercise, and they were free to select any one of three weight-loss strategies as follows: LM group, 12 weeks of hypocaloric balanced diet (HBD); MMKD group, two cycles of a multiphase diet with each cycle comprised of 2 weeks of ketogenic diet (KD), 2 weeks of transition diet and 2 weeks of HBD; and beinaglutide group, 12 weeks of HBD plus daily injection of beinaglutide (0.4 mg per day). Body weight, body composition and metabolic variables were measured before and after the 12 weeks of treatment. RESULTS All intervention strategies had significant weight loss, and the MMKD led to greater weight loss than LM (difference, -3.7 kg; 95% confidence interval [CI], -6.1 to -1.4; P = 0.001) but not beinaglutide (difference, -1.5 kg; 95% CI, -4.3 to 1.3; P = 0.587). Waist circumference (WC), fat mass, body fat percentage (BFP) and visceral fat area (VFA) were also significantly decreased, and the MMKD had a greater effect on these parameters than LM or beinaglutide. In addition, significant reductions in blood pressure and homoeostatic model assessment of insulin resistance (HOMA-IR) were observed in all three groups, but the MMKD resulted in the most significant improvement in insulin resistance. Almost no adverse events, except for two cases of dizziness, were observed in the MMKD group, which was significantly fewer events than the other two groups. CONCLUSION These findings demonstrated that the MMKD is an effective and safe treatment for weight loss, thus providing an additional option for obese Chinese patients.
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Affiliation(s)
- Wenjun Wu
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, People’s Republic of China
- Correspondence: Wenjun Wu, Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, No. 299 Qingyang Road, Wuxi, People’s Republic of China, 214023, Tel +86 510 85351181, Fax +86 510 85737592, Email
| | - Qunyan Zhou
- Department of Clinical Nutrition, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, People’s Republic of China
- Qunyan Zhou, Department of Clinical Nutrition, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, No. 299 Qingyang Road, Wuxi, People’s Republic of China, 214023, Tel +86 510 85350757, Fax +86 510 85737592, Email
| | - Peng Yuan
- Department of Rehabilitation Medicine, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, People’s Republic of China
| | - Dan Qiao
- Department of Clinical Nutrition, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, People’s Republic of China
| | - Shukun Deng
- Department of Rehabilitation Medicine, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, People’s Republic of China
| | - Haiyan Cheng
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, People’s Republic of China
| | - Ye Ren
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, People’s Republic of China
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Lemmon G, Jensen JM, Kuljanin G. A primer with purpose: Research implications of the objectification of weight in the workplace. JOURNAL OF OCCUPATIONAL AND ORGANIZATIONAL PSYCHOLOGY 2021. [DOI: 10.1111/joop.12378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Grace Lemmon
- Department of Management & Entrepreneurship DePaul University Chicago Illinois USA
| | - Jaclyn M. Jensen
- Department of Management & Entrepreneurship DePaul University Chicago Illinois USA
| | - Goran Kuljanin
- Department of Management & Entrepreneurship DePaul University Chicago Illinois USA
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Gao L, Huang H, Zhang L, Zhang N, Fu Y, Zhu D, Bi Y, Feng W. Comparison of Beinaglutide Versus Metformin for Weight Loss in Overweight and Obese Non-diabetic Patients. Exp Clin Endocrinol Diabetes 2021; 130:358-367. [PMID: 34856624 PMCID: PMC9286864 DOI: 10.1055/a-1608-0345] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE We compared the efficacy and safety of beinaglutide, a glucagon-like peptide-1 (GLP-1) analogue with metformin in lowering the bodyweight of patients who were overweight/obese and non-diabetic. PATIENTS AND METHODS Seventy-eight non-diabetic patients were randomly selected and beinaglutide or metformin was administered for 12 weeks. The primary endpoints were changes in body weight and the proportions of patients who lost≥5 and≥10% of their baseline body weights. RESULTS A total of 64 patients completed the study; patients in the beinaglutide group exhibited more bodyweight loss than those in the metformin group [(9.5±0.8%; 9.1±0.9 kg) and (5.1±0.9%; 4.5±0.8 kg), respectively, corresponding to a difference of approximately 4.5 kg (95% confidence interval, 2.2-6.9 kg; P<0.01)]. In the beinaglutide group, 90.6 and 40.6% of the patients lost≥5 and≥10% of their body weight, respectively, whereas, in the metformin group, these rates were 46.9 and 12.5%, respectively (P<0.01 and P<0.05). Weight loss following beinaglutide treatment mainly resulted from the loss of fat mass. Compared to metformin, beinaglutide induced a greater decrease in the body mass index, weight circumference, percent body fat, and body fat mass (total, trunk, limb, android, and gynoid). Additionally, beinaglutide decreased serum insulin levels and ameliorated insulin resistance. CONCLUSIONS Beinaglutide is more efficient than metformin at reducing weight and fat mass in patients who are overweight/obese and non-diabetic. Beinaglutide may be a useful therapeutic option for overweight/obesity control in the Chinese population.
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Affiliation(s)
- Lijun Gao
- Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
| | - Hong Huang
- Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
| | - Lu Zhang
- Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
| | - Ningjing Zhang
- Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
| | - Yuzhe Fu
- Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
| | - Dalong Zhu
- Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
| | - Yan Bi
- Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
| | - Wenhuan Feng
- Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
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Philippens N, Janssen E, Verjans-Janssen S, Kremers S, Crutzen R. HealthyLIFE, a Combined Lifestyle Intervention for Overweight and Obese Adults: A Descriptive Case Series Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211861. [PMID: 34831617 PMCID: PMC8620604 DOI: 10.3390/ijerph182211861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/05/2021] [Accepted: 11/10/2021] [Indexed: 11/22/2022]
Abstract
(1) Background: The aim of this study is to investigate changes over time in participants of healthyLIFE, a Combined Lifestyle Intervention (CLI) based on the Coaching on Lifestyle (CooL) intervention. This study focuses on changes in behavior, physical fitness, motivation and Positive Health eight months after the start of the intervention. (2) Methods: In total, 602 Dutch adults, meeting the CLI inclusion criteria, were included from January 2018 until October 2020 in this descriptive case series study. We collected a broad set of data regarding weight/BMI, physical fitness, motivation, self-efficacy, social influence, personal barriers and needs towards food and physical activity and perceived personal health by means of the six dimensions of Positive Health. (3) Results: Eight months after baseline, positive effects of the intervention were found on most outcome measures. We found an increase in all measured aspects of physical fitness (stamina, flexibility, mobility, hand grip strength and BMI). Dietary changes were limited during the healthyLIFE intervention, except for fruit consumption (increase with an effect size of 0.42). The largest effect sizes were found for the dimensions of Positive Health ranging from 0.41 to 0.68. (4) Conclusion: The healthyLIFE intervention is successful in improving participants’ BMI, physical fitness, and perceived physical, mental and social health. A broad health perspective, beyond physical measurements, is recommended when studying effects of the CLI.
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Affiliation(s)
- Nicole Philippens
- Department of Health Promotion, Maastricht University, 6211 LK Maastricht, The Netherlands; (N.P.); (S.K.); (R.C.)
| | - Ester Janssen
- Department of Health Promotion, Maastricht University, 6211 LK Maastricht, The Netherlands; (N.P.); (S.K.); (R.C.)
- Correspondence:
| | | | - Stef Kremers
- Department of Health Promotion, Maastricht University, 6211 LK Maastricht, The Netherlands; (N.P.); (S.K.); (R.C.)
| | - Rik Crutzen
- Department of Health Promotion, Maastricht University, 6211 LK Maastricht, The Netherlands; (N.P.); (S.K.); (R.C.)
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Buckell J, Mei XW, Clarke P, Aveyard P, Jebb SA. Weight loss interventions on health-related quality of life in those with moderate to severe obesity: Findings from an individual patient data meta-analysis of randomized trials. Obes Rev 2021; 22:e13317. [PMID: 34374197 DOI: 10.1111/obr.13317] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 11/26/2022]
Abstract
The relationship between BMI and health-related quality of life (HRQoL) critically affects regulatory approval of interventions for weight loss, but evidence of the association is inconsistent. A higher standard of evidence than that available was sought with an IPD meta-analysis of 10,884 people enrolled in five randomized controlled trials of intentional weight loss interventions. Cross-sectional and longitudinal associations of BMI and HRQoL were estimated in mixed effects models specifying a latent variable for HRQoL. Spline regressions captured nonlinear associations across the range of BMI. In cross-sectional spline regressions, BMI was not associated with HRQoL for people with a BMI < 30 kg/m2 but was for those with a higher BMI. In longitudinal spline regressions, decreases in BMI were positively associated with HRQoL for people with a BMI ≥ 25 kg/m2 . The impact of change in BMI was larger for people with higher BMIs than for those with BMIs under 30 kg/m2 . Lower BMI and decreases in BMI were related to higher HRQoL for people living with obesity but not in the population without excess weight. HRQoL gains from weight loss are greater for more severe obesity. Commissioners should use these estimates for future decision making.
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Affiliation(s)
- John Buckell
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Xue W Mei
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
| | - Philip Clarke
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Paul Aveyard
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
| | - Susan A Jebb
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
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36
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Kolotkin RL, Williams VSL, von Huth Smith L, Meincke HH, Qin S, Williams N, Fehnel SE. Confirmatory psychometric evaluations of the Impact of Weight on Quality of Life-Lite Clinical Trials Version (IWQOL-Lite-CT). Clin Obes 2021; 11:e12477. [PMID: 34296522 PMCID: PMC9285468 DOI: 10.1111/cob.12477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/24/2021] [Accepted: 06/20/2021] [Indexed: 01/20/2023]
Abstract
The Impact of Weight on Quality of Life-Lite Clinical Trials Version (IWQOL-Lite-CT) was developed to assess weight-related physical and psychosocial functioning in the context of clinical trials. Data from two pivotal trials of once-weekly subcutaneous semaglutide for the purpose of weight management (NCT03548935 and NCT03552757) were analysed to confirm the structure, reliability, validity, and responsiveness of the IWQOL-Lite-CT and evaluate the magnitude of meaningful within-patient change in patients with overweight or obesity, with and without type 2 diabetes. Factor analyses and inter-item correlations confirmed the IWQOL-Lite-CT structure and scoring algorithm. Each composite score (physical, physical function, psychosocial, and total) demonstrated excellent internal consistency (Cronbach's alphas ≥ 0.82) and test-retest reliability (intraclass correlation coefficients ≥ 0.85) in both trials. Patterns of cross-sectional and longitudinal construct validity correlations were generally consistent with hypotheses. Each of the IWQOL-Lite-CT composites was able to discriminate between known groups. Effect sizes and paired t tests comparing IWQOL-Lite-CT scores at baseline and Week 68 were statistically significant for all composites in both trials (P < 0.0001), providing strong support for the ability to detect change. Results of anchor-based analyses supported responder thresholds ranging from 13.5 to 16.6 across composite scores. The IWQOL-Lite-CT, a comprehensive assessment of weight-related functioning from the patient perspective, is appropriate for use in clinical trials evaluating the efficacy of new treatments for weight management.
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Affiliation(s)
- Ronette L. Kolotkin
- Quality of Life ConsultingDurhamNorth CarolinaUSA
- Department of Family Medicine and Community HealthDuke University School of MedicineDurhamNorth CarolinaUSA
- Faculty of Health and Social SciencesWestern Norway University of Applied SciencesFørdeNorway
- Centre of Health ResearchFørde Hospital TrustFørdeNorway
- Morbid Obesity CentreVestfold Hospital TrustTønsbergNorway
| | - Valerie S. L. Williams
- Department of Patient Reported OutcomesRTI Health SolutionsResearch Triangle ParkNorth CarolinaUSA
| | | | | | - Shanshan Qin
- Department of Patient Reported OutcomesRTI Health SolutionsResearch Triangle ParkNorth CarolinaUSA
| | - Nicole Williams
- Department of Patient Reported OutcomesRTI Health SolutionsResearch Triangle ParkNorth CarolinaUSA
| | - Sheri E. Fehnel
- Department of Patient Reported OutcomesRTI Health SolutionsResearch Triangle ParkNorth CarolinaUSA
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Silva AM, Nunes CL, Jesus F, Francisco R, Matias CN, Cardoso M, Santos I, Carraça EV, Finlayson G, Silva MN, Dickinson S, Allison D, Minderico CS, Martins P, Sardinha LB. Effectiveness of a lifestyle weight-loss intervention targeting inactive former elite athletes: the Champ4Life randomised controlled trial. Br J Sports Med 2021; 56:394-401. [PMID: 34598935 DOI: 10.1136/bjsports-2021-104212] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Many athletes struggle in managing the end of their career, often gaining weight and adopting unhealthy lifestyles. Lifestyle programmes targeting former athletes who have gained substantial fat mass (FM) postsports career are lacking. We studied the effects of the Champ4Life programme on body composition and other health-related outcomes in former elite athletes with overweight or obesity. METHODS Ninety-four former athletes(42.4±7.3 y, 34.0% female) were recruited and randomly assigned to either an intervention group (IG; n=49) or a control group (CG; n=45). The IG attended 12 educational sessions addressing physical activity, weight management and nutrition. They also had a nutrition appointment aimed to prescribe a moderate caloric deficit(~300-500 kcal/day). Dual-energy X-ray absorptiometry was used to assess body composition. The Short-Form Health Survey-36 questionnaire was used to measure general health-related quality of life. Blood samples were collected to assess cardiometabolic health parameters. RESULTS At 12 months, the IG lost more weight (estimated difference (ED)=-5.3 kg; -6.9 to -3.8), total FM (ED=-4.1 kg; -5.4 to -2.8) and abdominal FM (ED=-0.49 kg; -0.64 to -0.33) than did the CG (p's<0.001). Cardiometabolic health markers also improved significantly (p<0.05) more in the IG at 12 months (insulin (ED=-4.9 μU/mL;-8.0 to -1.8); homoeostatic model assessment (ED=-1.2; -2.1 to -0.4); total cholesterol (ED=-21.8 mg/dL; -35.4 to -8.2); low-density lipoprotein (ED=18.2 mg/dL;-29.2 to -7.1)), as did quality-of-life dimensions (physical functioning (ED=11.7; 6.5 to 16.9); physical role (ED=17.6; 2.1 to 33.0); general health (ED=19.4; 11.4 to 27.4); vitality (ED=13.3; 5.3 to 21.3) and mental health (ED=12.3; 4.1 to 20.6)). CONCLUSIONS The Champ4Life programme was effective in substantially reducing total and abdominal FM while preserving fat-free mass and improving health-related markers. These findings will enable evidence-based decisions when implementing lifestyle interventions targeting retired elite athletes. TRIAL REGISTERATION NUMBER NCT03031951.
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Affiliation(s)
- Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Catarina L Nunes
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Filipe Jesus
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Ruben Francisco
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Catarina N Matias
- CIDEFES, Universidade Lusófona, Lisboa, Portugal.,Bioperformance & Nutrition Research Unit, Bettery, Lisboa, Portugal
| | - Miguel Cardoso
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Inês Santos
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal.,CIDEFES, Universidade Lusófona, Lisboa, Portugal.,Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Eliana V Carraça
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal.,CIDEFES, Universidade Lusófona, Lisboa, Portugal
| | - Graham Finlayson
- Appetite Control Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Marlene Nunes Silva
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal.,CIDEFES, Universidade Lusófona, Lisboa, Portugal
| | - Stephanie Dickinson
- Indiana University Bloomington School of Public Health, Bloomington, Indiana, USA
| | - David Allison
- Indiana University Bloomington School of Public Health, Bloomington, Indiana, USA
| | - Cláudia S Minderico
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Paulo Martins
- Laboratory of Sport Psychology, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal
| | - Luis B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal
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Vesikansa A, Mehtälä J, Jokelainen J, Mutanen K, Lundqvist A, Laatikainen T, Ylisaukko-Oja T, Saukkonen T, Pietiläinen KH. The association of body mass index with quality of life and working ability: a Finnish population-based study. Qual Life Res 2021; 31:413-423. [PMID: 34533758 DOI: 10.1007/s11136-021-02993-0] [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] [Accepted: 09/04/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The impact of obesity on quality of life (QoL) and working ability vary in different dimensions. This study investigated the association of obesity with QoL and working ability in Finnish adults. Comorbidities as associative factors were also characterised. METHODS This cross-sectional study included 4956 randomly selected adults. QoL (EUROHIS-QOL 8 total score and individual components), perceived physical and psychological working ability, and sick leave days were analysed in different body mass index (BMI) groups. Regression models were used to study the role of comorbidities as associative factors. RESULTS EUROHIS-QOL 8 total score was significantly lower in BMI group 25.0-29.9 kg/m2 (4.01; 95% confidence interval 3.97-4.05), BMI 30.0-34.9 kg/m2 (3.85; 3.79-3.91), BMI 35.0-39.9 kg/m2 (3.75; 3.66-3.85), and BMI ≥ 40.0 kg/m2 (3.73; 3.46-4.00) compared to individuals with normal (18.5-24.9 kg/m2) BMI (4.08; 4.04-4.12). Individuals with obesity (BMI ≥ 30.0 kg/m2) rated their QoL lower than individuals with normal BMI in seven of the eight EUROHIS-QOL 8 components. A lesser proportion of individuals (53-73%) with obesity rated their physical working ability as very or fairly good compared to individuals with normal BMI (90%, p values < 0.001). The psychological working ability was rated as very or fairly good by 71-75% of individuals with obesity compared to 85% of individuals with normal BMI (p = 0.008 and p = 0.001 in individuals with BMI 30.0-34.9 and BMI 35.0-39.9 kg/m2, respectively). CONCLUSIONS Obesity was negatively associated with both physical and psychological components of QoL, even after accounting for obesity-related comorbidities. Obesity treatment can benefit from a holistic approach that considers these multifaceted associations.
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Affiliation(s)
| | - Juha Mehtälä
- MedEngine Oy, Eteläranta 14, 00130, Helsinki, Finland
| | - Jari Jokelainen
- MedEngine Oy, Eteläranta 14, 00130, Helsinki, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | | | | | - Tiina Laatikainen
- Finnish Institute for Health and Welfare, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Joensuu, Finland
| | - Tero Ylisaukko-Oja
- MedEngine Oy, Eteläranta 14, 00130, Helsinki, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | | | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Obesity Center, Abdominal Center, Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Drapkina OM, Karamnova NS, Kontsevaya AV, Gorny BE, Dadaeva VA, Drozdova LY, Yeganyan RA, Eliashevich SO, Izmailova OV, Lavrenova EA, Lischenko OV, Skripnikova IA, Shvabskaya OB, Shishkova VN. Russian Society for the Prevention of Noncommunicable Diseases (ROPNIZ). Alimentary-dependent risk factors for chronic non-communicable diseases and eating habits: dietary correction within the framework of preventive counseling. Methodological Guidelines. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-2952] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The methodological guidelines are developed as a practical document for medical specialists working in the field of preventive medicine, in order to expand and improve the provision of this type of medical service to the adult population. The methodological guidelines include an informational and informative part for medical specialists and a practical part for patients, presented in the format of memos, contain the main sections-healthy nutrition, correction of eating habits, issues of modifying the diet for the main alimentary-dependent risk factors for chronic non-communicable diseases, such as arterial hypertension, obesity, disorders of lipid, carbohydrate and purine metabolism, a decrease in bone mineral density. They are intended for medical specialists working in the field of prevention, for doctors and secondary medical personnel of offices and departments of medical prevention, public health and medical prevention centers, healthy lifestyle specialists, teachers of medical educational institutions, for specialists who develop and implement educational programs for patients, as well as for medical specialists of a therapeutic profile.
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Affiliation(s)
- O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
| | - N. S. Karamnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. V. Kontsevaya
- National Medical Research Center for Therapy and Preventive Medicine
| | - B. E. Gorny
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. A. Dadaeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - L. Yu. Drozdova
- National Medical Research Center for Therapy and Preventive Medicine
| | - R. A. Yeganyan
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. O. Eliashevich
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. V. Izmailova
- National Medical Research Center for Therapy and Preventive Medicine
| | - E. A. Lavrenova
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. V. Lischenko
- National Medical Research Center for Therapy and Preventive Medicine
| | - I. A. Skripnikova
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. B. Shvabskaya
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. N. Shishkova
- National Medical Research Center for Therapy and Preventive Medicine
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Brown JC, Sarwer DB, Troxel AB, Sturgeon K, DeMichele AM, Denlinger CS, Schmitz KH. A randomized trial of exercise and diet on health-related quality of life in survivors of breast cancer with overweight or obesity. Cancer 2021; 127:3856-3864. [PMID: 34161602 DOI: 10.1002/cncr.33752] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/22/2021] [Accepted: 05/19/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Obesity is a chronic, relapsing, and progressive disease; it is associated with poor health-related quality of life (HRQOL) in survivors of breast cancer. METHODS In this 2 × 2 factorial trial, 351 survivors of breast cancer with overweight or obesity were randomized to 1 of 4 treatment groups for 52 weeks: control, exercise alone, diet alone, or exercise plus diet. HRQOL end points were measured at baseline and at week 52 using the 36-Item Medical Outcomes Survey-Short Form (SF-36). Repeated measures analysis of covariance quantified the estimated treatment difference (ETD). RESULTS At baseline, participants had a mean (SD) age of 59.4 years (8.7), body mass index of 34.0 kg/m2 (5.9), and 71 participants (20.2%) self-reported fair or poor general health. After 52 weeks, compared with control, the exercise plus diet improved the physical health summary score (ETD: 5.39; 95% CI, 0.55-10.22); exercise alone (ETD: -1.91; 95% CI, -6.60 to 2.79) and diet alone (ETD: 3.16; 95% CI, -1.52 to 7.83) did not change the physical health summary score. Compared with control, exercise alone (ETD: -0.27; 95% CI, -6.60 to 2.79), diet alone (ETD: 3.25; 95% CI, -1.41 to 7.91), and the exercise plus diet (ETD: 1.75; 95% CI, -2.90 to 6.39) did not change the mental health summary score. Exercise alone did not impact any HRQOL subscale; diet alone improved the vitality subscale; exercise plus diet improved the physical functioning, role-physical and vitality subscales. CONCLUSION In survivors of breast cancer with overweight or obesity, exercise plus diet improved select HRQOL end points at week 52.
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Affiliation(s)
- Justin C Brown
- Division of Population and Public Health Sciences, Department of Cancer Energetics, Pennington Biomedical Research Center, Baton Rouge, Louisiana
- Department of Genetics, LSU Health Sciences Center, New Orleans School of Medicine, New Orleans, Louisiana
- Department of Interdisciplinary Oncology, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - David B Sarwer
- Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, Pennsylvania
| | - Andrea B Troxel
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, New York
| | - Kathleen Sturgeon
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Angela M DeMichele
- Division of Medical Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Crystal S Denlinger
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Kathryn H Schmitz
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
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Linge AD, Jensen C, Laake P, Bjørkly SK. Changes to body mass index, work self-efficacy, health-related quality of life, and work participation in people with obesity after vocational rehabilitation: a prospective observational study. BMC Public Health 2021; 21:936. [PMID: 34001067 PMCID: PMC8130265 DOI: 10.1186/s12889-021-10954-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 05/03/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND People on or at risk of sick leave from work due to obesity or obesity-related problems participated in a new vocational rehabilitation (VR). The study aimed to examine the outcome changes in the participants' health-related quality of life (HRQoL), body mass index (BMI), return to work self-efficacy (RTWSE), work ability scale (WAS) and degree of work participation (DWP) after their participation in the 12-month VR programme. The secondary aim was to examine associations between the outcome changes and HRQoL at 12-month follow-up, measured with the HRQoL 15D instrument (15D). METHODS This prospective observational study included 95 participants. The one-year multidisciplinary VR programme with an integrated work and lifestyle intervention included 4 weeks of inpatient stay followed-up by 5 meetings. A paired sample t-test was used to examine changes in HRQoL, BMI, RTWSE, WAS, and DWP between baseline and the 12-month follow-up. Multiple linear regression analyses explored associations between changes in HRQoL and the outcome variables. RESULTS The participants achieved statistically significant changes in HRQoL (2.57, 95% CI: 1.35 to 3.79), BMI (- 2.33, 95% CI: - 3.10 to - 1.56), RTWSE (15.89, 95% CI: 4.07 to 27.71), WAS (1.51, 95% CI: 0.83 to 2.20) and DWP (18.69, 95% CI: 8.35 to 29.02). At 12 months, a significant association was found between HRQoL and BMI (B = - 0.34, 95% CI: - 0.65 to - 0.04), RTWSE (B = 0.02, 95% CI: 0.004 to 0.04), WAS (B = 0.91, 95% CI: 0.55 to 1.28), DWP (B = - 0.02, 95% CI: - 0.04 to 0.001) and work absence (B = - 0.01, 95% CI: - 0.02 to - 0.002). The regression model explained 71.8% of the HRQoL variance. CONCLUSION The results indicated positive changes in HRQoL, BMI, RTWSE, WAS and DWP from baseline to the 12-month follow-up. Factors associated with HRQoL at the 12-month follow-up were decreased BMI, increased RTWSE, improved WAS and reduced work absence. Future studies examining VR programmes with lifestyle interventions for people with obesity are recommended. TRIAL REGISTRATION Norwegian Regional Committee for Medical and Health Research Ethics (REC) 2017/573, Clinical Trials NCT03286374 , registered 18. September 2017. https://clinicaltrials.gov/ct2/results?cond=Obesity&term=Anita+Dyb+Linge&cntry=NO&state=&city=&dist=.
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Affiliation(s)
- Anita Dyb Linge
- Institute of Social Sciences, Volda University College, Mailbox 500, 6101, Volda, Norway.
| | - Chris Jensen
- Norwegian National Advisory Unit on Occupational Rehabilitation, Haddlandsvegen 20, 3864, Rauland, Norway
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Håkon Jarls gate 11 and Mauritz Hanssens Gate 2, 7491, Trondheim, Norway
| | - Petter Laake
- Faculty of Health Sciences and Social Care, Molde University College, Britvegen 2, 6410, Molde, Norway
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, University of Oslo, Sognsvannsveien 9, 0372, Oslo, Norway
| | - Stål Kapstø Bjørkly
- Faculty of Health Sciences and Social Care, Molde University College, Britvegen 2, 6410, Molde, Norway
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Hood SR, Berkeley AW, Moore EA. Evaluation of Pharmacologic Interventions for Weight Management in a Veteran Population. Fed Pract 2021; 38:220-226. [PMID: 34177231 DOI: 10.12788/fp.0117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Veterans are disproportionately impacted by weight-related morbidity: 40% of veterans are categorized as obese and an additional 38.5% are overweight. Medications are recommended as an adjunct to lifestyle and dietary changes. Guidelines recommend 7 weight management medications, including orlistat, liraglutide, phentermine, phentermine/topiramate, lorcaserin, and naltrexone/bupropion. Methods A single-center, retrospective chart review was conducted for patients who started weight management medications at Veteran Health Indiana in Indianapolis. The primary outcomes included total weight loss and weight loss as a percentage of baseline weight at 3, 6, 12, and > 12 months of therapy. Secondary outcomes included weight loss of 5% from baseline, rate of successful weight maintenance after initial weight loss of 5% from baseline, adverse drug reaction monitoring, and use of weight management medications across clinics at this site. Results The absolute weight difference over 12 months of weight management medication therapy was 15.8 kg. At each time point, weight loss was found to be statistically significant when compared with baseline (P < .001). Average weight change was greatest with orlistat (-25.9 kg) and naltrexone/bupropion was associated with a gain of 2.1 kg over the duration of the study. A majority of the patients analyzed lost the guideline-recommended 5 to 10% from baseline while taking weight management medication. Conclusions Weight management medications in a veteran population produced initial weight loss consistent with previous studies. However, there is room for improvement in follow-up strategies to promote greater weight maintenance after initial weight loss. Considering the high health care costs, personal burden, and potential long-term complications associated with obesity, efforts to promote continued development of programs that support weight management and maintenance are imperative.
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Affiliation(s)
- Sarah R Hood
- was a PGY-1 Pharmacy Practice Resident at the time of the study; and are Clinical Pharmacy Specialists, all at Veteran Health Indiana in Indianapolis
| | - Ashley W Berkeley
- was a PGY-1 Pharmacy Practice Resident at the time of the study; and are Clinical Pharmacy Specialists, all at Veteran Health Indiana in Indianapolis
| | - Emily A Moore
- was a PGY-1 Pharmacy Practice Resident at the time of the study; and are Clinical Pharmacy Specialists, all at Veteran Health Indiana in Indianapolis
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Jones RA, Lawlor ER, Birch JM, Patel MI, Werneck A, Hoare E, Griffin SJ, van Sluijs EM, Sharp SJ, Ahern AL. The impact of adult behavioural weight management interventions on mental health: A systematic review and meta-analysis. Obes Rev 2021; 22:e13150. [PMID: 33103340 PMCID: PMC7116866 DOI: 10.1111/obr.13150] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/04/2020] [Accepted: 09/14/2020] [Indexed: 12/27/2022]
Abstract
There is good evidence that behavioural weight management interventions improve physical health; however, the impact on mental health remains unclear. We evaluated the impact of behavioural weight management interventions on mental health-related outcomes in adults with overweight or obesity at intervention-end and 12 months from baseline. Eligible studies were randomized controlled trials (RCTs) or cluster RCTs of adult behavioural weight loss interventions reporting affect, anxiety, binge eating, body image, depression, emotional eating, quality of life, self-esteem and stress. We searched seven databases from inception to 7 May 2019 and included 43 articles reporting 42 RCTs. Eighteen studies were deemed to be at high risk of bias. We conducted random-effects meta-analyses, stratified analyses and meta-regression using Stata. Interventions generated greater improvements than comparators for depression, mental health-related quality of life and self-efficacy at intervention-end and 12 months from baseline. There was no difference between groups for anxiety, overall quality of life, self-esteem or stress at intervention-end. There was insufficient evidence to assess the impact on anxiety, binge eating, body image, emotional eating, affect, life satisfaction, self-esteem or stress at intervention-end and/or 12 months from baseline. Although evidence suggests that interventions benefit some aspects of mental health, high-quality, transparently reported RCTs measuring a range of mental health outcomes over longer durations are required to strengthen the evidence base.
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Affiliation(s)
| | - Emma R. Lawlor
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - Jack M. Birch
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Manal I. Patel
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Andre Werneck
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Erin Hoare
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Food and Mood Centre, Centre for Innovation in Mental and Physical Health and Clinical Treatment, School of Medicine, Faculty of Health, Deakin University, Melbourne, VIC 3004, Australia
| | - Simon J. Griffin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Esther M.F. van Sluijs
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | | | - Amy L. Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Oliver A, Hooper S, Lau R, Hutchinson A. Effect of a multidisciplinary rehabilitation program for patients receiving weight management interventions on eating behaviours and health-related quality of life. Obes Res Clin Pract 2021; 15:268-274. [PMID: 33736958 DOI: 10.1016/j.orcp.2021.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
The rapid rise in obesity prevalence is life-style related and tackling this problem requires a pro-active multi-faceted approach to management. A private health care provider in Melbourne, Australia, developed a multidisciplinary rehabilitation program for patients who had undergone bariatric surgery or receiving pharmacological weight loss treatments. The study aim was to assess the programs' effect on patients' quality of life, mental well-being, and eating behaviours. METHODS A prospective, observational, before and after study design was used. A total of 54 patients, 27 who had bariatric surgery and 27 receiving pharmacotherapy participated. Outcome measures were: change in weight and BMI, intuitive eating scale, impact of weight on quality of life scale and the depression, anxiety and stress scale. RESULTS Both medical and surgical patients reported improvements in their health-related quality of life and eating behaviours. Despite this, at program completion 71.4% of patients who had bariatric surgery reported severe anxiety and 52.4% severe stress levels. CONCLUSION Participation in a rehabilitation program that provided patients with peer support and access to expert advice supported patients to make healthy eating choices and improved their quality of life. The high prevalence of stress and anxiety related symptoms highlights the need to provide individuals who have undergone bariatric surgery with ongoing mental health support.
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Affiliation(s)
- Abigail Oliver
- Prevention and Chronic Illness Care, Merri Health, Melbourne, Australia; Epworth Rehabilitation and Mental Health, Epworth HealthCare, Melbourne, Australia.
| | - Suzie Hooper
- Epworth Rehabilitation and Mental Health, Epworth HealthCare, Melbourne, Australia.
| | - Rosalind Lau
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research Epworth/Deakin Partnership, Faculty of Health, Deakin University, Geelong, Australia.
| | - Ana Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research Epworth/Deakin Partnership, Faculty of Health, Deakin University, Geelong, Australia.
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Gill L, Mackey S. Obstetrician-Gynecologists' Strategies for Patient Initiation and Maintenance of Antiobesity Treatment with Glucagon-Like Peptide-1 Receptor Agonists. J Womens Health (Larchmt) 2021; 30:1016-1027. [PMID: 33626287 PMCID: PMC8290308 DOI: 10.1089/jwh.2020.8683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Obesity is a chronic disease affecting women at higher rates than men. In an obstetrics and gynecology setting, frequently encountered obesity-related complications are polycystic ovary syndrome, fertility and pregnancy complications, and increased risk of breast and gynecological cancers. Obstetrician-gynecologists (OBGYNs) are uniquely positioned to diagnose and treat obesity, given their role in women's primary health care and the increasing prevalence of obesity-related fertility and pregnancy complications. The metabolic processes of bodyweight regulation are complex, which makes weight-loss maintenance challenging, despite dietary modifications and exercise. Antiobesity medications (AOMs) can facilitate weight loss by targeting appetite regulation. There are four AOMs currently approved for long-term use in the United States, of which liraglutide 3.0 mg is among the most efficacious. Liraglutide 3.0 mg, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), is superior to placebo in achieving weight loss and improving cardiometabolic profile, in both clinical trial and real-world settings. In addition, women with fertility complications receiving liraglutide 1.8–3.0 mg can benefit from improved ovarian function and fertility. Liraglutide 3.0 mg is generally well tolerated, but associated with transient gastrointestinal side effects, which can be mitigated. In this review, we present the risks of obesity and benefits of weight loss for women, and summarize clinical development of GLP-1 RAs for weight management. Finally, we provide practical advice and recommendations for OBGYNs to open the discussion about bodyweight with their patients, initiate lifestyle modification and GLP-1 RA treatment, and help them persist with these interventions to achieve optimal weight loss with associated health benefits.
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Affiliation(s)
- Lisa Gill
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Suzanne Mackey
- Salvéo Weight Management, Voorhees Township, New Jersey, USA
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The Effect of Lifestyle Intervention on Health-Related Quality of Life in Adults with Metabolic Syndrome: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030887. [PMID: 33498570 PMCID: PMC7908372 DOI: 10.3390/ijerph18030887] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 01/22/2023]
Abstract
The aim of this meta-analysis was to assess the effects of a lifestyle intervention through health education on nutrition, physical activity, and healthy habits on physical and mental health-related quality of life (HRQoL), in adults with metabolic syndrome (MetS). The databases used were PubMed, WOS, and Scopus. The inclusion criteria were: observational, longitudinal and randomized clinical trial (RCT) study designs, adults (both sexes), with at least two criteria of MetS, lifestyle intervention and comparison with a control group, and a measurement of HRQoL with a validated questionnaire. We analyzed the Hedges’ g and SF-36 score. I2 statistics were calculated and possible publication and small study biases were assessed using Egger’s test and funnel plots. Seven RCTs were selected for meta-analysis, based on 637 study participants. Significant improvements were found in the physical dimensions of the HRQoL scores for subjects in the active intervention compared to the group that received general lifestyle information (Hedges’ g 0.61, 95% confidence interval (CI) = 0.31–0.91). Mental health-related quality of life was also significantly improved in the intervention group compared with the control group (Hedges’ g 0.84, 95% CI = 0.64–1.03). In conclusion, our results suggest that, according to the RCTs selected for this meta-analysis, a lifestyle intervention significantly improves HRQoL in all its domains.
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Mohd-Sidik S, Lekhraj R, Foo CN. Prevalence, Associated Factors and Psychological Determinants of Obesity among Adults in Selangor, Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:868. [PMID: 33498401 PMCID: PMC7908089 DOI: 10.3390/ijerph18030868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/07/2021] [Accepted: 01/12/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The pervasiveness of obesity is a growing concern in the world. This study aims to determine the prevalence of obesity among a segment of the Malaysian population, as well as investigate associated factors and psychological determinants of obesity. METHODS A cross-sectional study design was carried out in Selangor, Malaysia. A total of 1380 Malaysian adults (≥18 years old) participated in a structured and validated questionnaire survey. TANITA body scale and SECA 206 body meter were used to measure the respondents' weight and height, from which measurements of their body mass index (BMI) were calculated. RESULTS The overall prevalence of obesity (BMI ≥ 30 kg/m2) among adults in Selangor, Malaysia, was 18.6%. Factors significantly associated with increased risk of obesity were: being female (OR = 1.61, 95% CI [1.20-2.17]), aged between 30 to 39 years old (OR = 1.40, 95% CI [1.04-1.88]), being Indian (OR = 1.55, 95% CI [1.13-2.12]), married (OR = 1.37, 95% CI [1.03-1.83]), and having only primary school education (OR = 1.80, 95% CI [1.17-2.78] or secondary school education (OR = 1.37, 95% CI [1.04-1.81]). In the multiple linear regression analysis (stepwise method), perceived stress (B = -0.107, p = 0.041), suicidal ideation (B = -2.423, p = 0.003), and quality of life in the physical health domain (B = -0.350, p = 0.003) inversely and significantly contributed to BMI among males. Among females, stressful life events contributed positively to BMI (B = 0.711, p < 0.001, whereas quality of life in the psychological domain had a negative effect (B = -0.478, p < 0.001) in this respect. CONCLUSION There is an urgent need to integrate psychological approaches to enhance the effectiveness of obesity prevention strategies and weight-loss programs.
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Affiliation(s)
- Sherina Mohd-Sidik
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Rampal Lekhraj
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
| | - Chai Nien Foo
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang 43000, Malaysia
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Tozetto WR, Leonel LDS, Benedet J, Duca GFD. Quality of life and its relationship with different anthropometric indicators in adults with obesity. FISIOTERAPIA EM MOVIMENTO 2021. [DOI: 10.1590/fm.2021.34102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abtract Introduction: Obesity compromises the quality of life. However, few studies have investigated the influence of different anthropometric indicators on the quality of life of this population. Objective: We aimed to correlate the physical and mental components of quality of life and verify its association with different anthropometric indicators in adults with obesity. Methods: A cross-sectional study was conducted in adults with obesity [body mass index (BMI) ≥ 30 kg/m²]. The quality of life was investigated using the SF-36 questionnaire, with scores ranging from 0 (worst-case scenario) to 100 (best scenario for the outcome). The anthropometric indicators used were BMI, waist circumference, waist/height ratio (WHR), and lean and fat body mass. For analysis, Spearman’s correlation and crude and adjusted linear regression for sociodemographic variables were used. Results: A total of 75 subjects (nfemales = 47; µage= 34.8 ± 7.1 years) were included, and their means of the physical and mental components were 64.5 ± 15.9 and 50.8 ± 21.3 points, respectively. The social functioning domain presented a strong positive correlation (r = 0.760) with the mental health domain, and eight moderate correlations (0.400 ≤ r ≥ 0.699) were found between the different domains of the questionnaire. The functional capacity domain and the physical component presented a moderate negative correlation with the WHR (r = -0.402 and r = -0.407, respectively). After adjustment, the WHR was inversely associated with the physical component (β = -1.197; p = 0.002). Conclusion: In adults with obesity, important correlations were observed between the physical and mental components of quality of life, and the waist/height ratio was the only anthropometric indicator correlated and associated with the physical component of the outcome.
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Ervin CM, Whalley D, von Huth Smith L, Crawford R, Dine J, Fehnel SE. Development of the impact of weight on daily activities questionnaire: A patient-reported outcome measure. Clin Obes 2020; 10:e12387. [PMID: 32935465 PMCID: PMC7685113 DOI: 10.1111/cob.12387] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/03/2020] [Accepted: 06/07/2020] [Indexed: 12/02/2022]
Abstract
While patient-reported outcome measures are available to evaluate health-related quality of life and functioning in obesity, existing measures do not evaluate the impact of excess weight and weight loss on the ability to perform regularly occurring daily activities. Three iterative sets of qualitative interviews were conducted in two countries (United States, n = 23; United Kingdom, n = 23) with individuals with body mass index ≥30 kg/m2 to inform development of the Impact of Weight on Daily Activities Questionnaire (IWDAQ) for use in clinical trials to evaluate daily activity limitations associated with excess weight. Candidate concepts were selected based on the literature, expert opinion, and previously conducted qualitative research, after which the draft IWDAQ was developed and tested. Interviews included a brief concept elicitation phase, followed by cognitive debriefing during which the IWDAQ was refined based upon participants' feedback. The IWDAQ uses a novel, adaptive questionnaire design, such that clinical trial participants choose the three IWDAQ activities they would most like to improve with weight loss and rate the degree of limitation in each of these activities at baseline. By allowing individuals participating in trials to identify and monitor changes in the activities they most want to see improve with weight loss, the 19-item IWDAQ has the potential to detect the benefits of weight-loss treatment that individuals with obesity value most.
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Affiliation(s)
- Claire M. Ervin
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth CarolinaUSA
| | - Diane Whalley
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsManchesterUK
| | | | - Rebecca Crawford
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsManchesterUK
| | - Jennifer Dine
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth CarolinaUSA
| | - Sheri E Fehnel
- Patient‐Centered Outcomes AssessmentRTI Health SolutionsResearch Triangle ParkNorth CarolinaUSA
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Fastenau J, Rozjabek H, Qin S, McLeod L, Nelson L, Ma J, Harris N. Psychometric evaluation of the DAILY EATS questionnaire in individuals living with obesity. J Patient Rep Outcomes 2020; 4:99. [PMID: 33226548 PMCID: PMC7683653 DOI: 10.1186/s41687-020-00259-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 10/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physiological and behavioral factors including hunger, satiety, food intake, and cravings are health determinants contributing to obesity. Patient-reported outcome (PRO) measures focused on eating-related factors provide insight into the relationships between food choice and quantity, weight change, and weight-loss treatment for individuals living with obesity. The DAILY EATS is a novel 5-item, patient-reported measure evaluating key eating-related factors (Worst and Average Hunger, Appetite, Cravings, and Satiety). METHODS Psychometric analyses, consistent with regulatory standards, were conducted to evaluate the DAILY EATS using data from two randomized trials that included individuals with severe obesity without diabetes (NCT03486392) and with severe obesity and type 2 diabetes (NCT03586830). Additional measures included Patient Global Impression of Status (PGIS) and Patient Global Impression of Change items, Impact of Weight on Quality of Life-Lite, Ease of Weight Management, and Patient-Reported Outcomes Measurement Information System Physical Function Short Form 8b and 10a. The reliability, validity, and responsiveness of the DAILY EATS were assessed, and a scoring algorithm and thresholds to interpret meaningful score changes were developed. RESULTS Item-level analyses of the DAILY EATS supported computation of an Eating Drivers Index (EDI), comprising the related items Worst Hunger, Appetite, and Cravings. Internal consistency (Cronbach's coefficient alphas ≥0.80) and test-retest reliability (coefficients > 0.7) of the EDI were robust. Construct validity correlation patterns with other PRO measures were as hypothesized, with moderate to strong significant correlations between the EDI and PGIS-Hunger (0.30 ≤ r ≤ 0.68), PGIS-Cravings (0.33 ≤ r ≤ 0.77) and PGIS-Appetite (0.52 ≤ r ≤ 0.77). Anchor- and distribution-based analyses support reductions ranging from 1.6 to 2.1 as responder thresholds for the EDI, representing meaningful within-person improvement. CONCLUSIONS The DAILY EATS individual items and the composite EDI are reliable, sensitive, and valid in evaluating the concepts of hunger, appetite, and cravings for use in individuals with severe obesity with or without type 2 diabetes.
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Affiliation(s)
- John Fastenau
- Janssen, 700 US Highway Route 202, Raritan, NJ, 08869, USA.
| | | | - Shanshan Qin
- RTI Health Solutions, 3040 East Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Lori McLeod
- RTI Health Solutions, 3040 East Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Lauren Nelson
- RTI Health Solutions, 3040 East Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Jia Ma
- RTI Health Solutions, 3040 East Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Nimanee Harris
- RTI Health Solutions, 3040 East Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC, 27709-2194, USA
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