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Hawkins LK, Burns L, Swancutt D, Moghadam S, Pinkney J, Tarrant M. Which components of behavioral weight management programs are essential for weight loss in people living with obesity? A rapid review of systematic reviews. Obes Rev 2024:e13798. [PMID: 38952041 DOI: 10.1111/obr.13798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/10/2024] [Accepted: 06/12/2024] [Indexed: 07/03/2024]
Abstract
The optimal treatment and organization of care for people with obesity is one of the greatest challenges facing today's health services. While surgery and pharmacotherapy offer effective treatment options for some people with obesity, behavioral interventions are important to support long-term behavioral change. However, little is known about the most effective components of behavioral interventions, and this is especially the case for people with complex or severe obesity (i.e. body mass index [BMI] > 35 kg/m2). Accordingly, the current rapid review aimed to identify which behavior change techniques (BCTs) are effective for weight loss in adults with (severe) obesity. A secondary aim was to review the effects of BCTs on dietary behaviors and physical activity, and psychological outcomes, recognizing that behavioral interventions commonly target these. A search of Scopus, Ovid Medline, and Web of Science resulted in 1227 results, with 22 reviews eligible for inclusion. The most commonly reported BCTs were self-monitoring and goal setting, but these had variable effects on weight in adults with obesity. Combining these BCTs with other self-regulatory techniques led to increased weight loss. Further, for adults with severe obesity, so-called 'nudge' techniques and self-regulatory techniques were associated with greater weight loss. Three reviews also found that while self-monitoring increased physical activity, behavioral commitments increased changes to dietary behaviors. BCTs were not associated with psychological well-being. The review confirms that behavioral interventions have an impact in weight management, including for individuals with more complex or severe obesity, but highlights the need for further investigation of their use within clinical settings.
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Affiliation(s)
- Lily K Hawkins
- Faculty of Health and Life Sciences, University of Exeter, Exeter, EX1 2LU, UK
| | - Lorna Burns
- Faculty of Health, University of Plymouth, Plymouth, PL6 8BX, UK
| | - Dawn Swancutt
- Faculty of Health, University of Plymouth, Plymouth, PL6 8BX, UK
| | - Shokraneh Moghadam
- Faculty of Health and Life Sciences, University of Exeter, Exeter, EX1 2LU, UK
| | - Jonathan Pinkney
- Faculty of Health, University of Plymouth, Plymouth, PL6 8BX, UK
| | - Mark Tarrant
- Faculty of Health, University of Plymouth, Plymouth, PL6 8BX, UK
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Meneguelli TS, Kravchychyn ACP, Wendling AL, Dionísio AP, Bressan J, Martino HSD, Tako E, Hermsdorff HHM. Cashew nut ( Anacardium occidentale L.) and cashew nut oil reduce cardiovascular risk factors in adults on weight-loss treatment: a randomized controlled three-arm trial (Brazilian Nuts Study). Front Nutr 2024; 11:1407028. [PMID: 38988854 PMCID: PMC11234893 DOI: 10.3389/fnut.2024.1407028] [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: 03/26/2024] [Accepted: 05/15/2024] [Indexed: 07/12/2024] Open
Abstract
Introduction Cashew nut contains bioactive compounds that modulate satiety and food intake, but its effects on body fat during energy restriction remains unknown. This study aimed to assess the effects of cashew nut and cashew nut oil on body fat (primary outcome) as well as adiposity, cardiometabolic and liver function markers (secondary outcomes). Materials and methods An eight-week (8-wk) randomized controlled-feeding study involved 68 adults with overweight/obesity (40 women, BMI: 33 ± 4 kg/m2). Participants were randomly assigned to one of the energy-restricted (-500 kcal/d) groups: control (CT, free-nuts), cashew nut (CN, 30 g/d), or cashew nut oil (OL, 30 mL/d). Body weight, body composition, and blood collection were assessed at the baseline and endpoint of the study. Results After 8-wk, all groups reduced significantly body fat (CT: -3.1 ± 2.8 kg; CN: -3.3 ± 2.7 kg; OL: -1.8 ± 2.6 kg), body weight (CT: -4.2 ± 3.8 kg; CN: -3.9 ± 3.1 kg; OL: -3.4 ± 2.4 kg), waist (CT: -5.1 ± 4.6 cm; CN: -3.9 ± 3.9 cm; OL: -3.7 ± 5.3 cm) and hip circumferences (CT: -2.9 ± 3.0 cm; CN: -2.7 ± 3.1 cm; OL: -2.9 ± 2.3 cm). CN-group reduced liver enzymes (AST: -3.1 ± 5.3 U/L; ALT: -6.0 ± 9.9 U/L), while the OL-group reduced LDL-c (-11.5 ± 21.8 mg/dL) and atherogenic index (-0.2 ± 0.5). Both intervention groups decreased neck circumference (CN: -1.0 ± 1.2 cm; OL: -0.5 ± 1.2 cm) and apo B (CN: -6.6 ± 10.7 mg/dL; OL: -7.0 ± 15.3 mg/dL). Conclusion After an 8-wk energy-restricted intervention, all groups reduced body fat (kg), weight, and some others adiposity indicators, with no different effect of cashew nut or cashew nut oil. However, participants in the intervention groups experienced additional reductions in atherogenic marker, liver function biomarkers, and cardiovascular risk factors (neck circumference and apo B levels), with these effects observed across the OL group, CN group, and both intervention groups, respectively.Clinical trial registration:https://ensaiosclinicos.gov.br/rg/RBR-8xzkyp2, identifier 8xzkyp2.
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Affiliation(s)
- Talitha Silva Meneguelli
- Laboratory of Clinical Analysis and Genomics, Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
- Laboratory of Energy Metabolism and Body Composition (LAMECC), Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Ana Claudia Pelissari Kravchychyn
- Laboratory of Clinical Analysis and Genomics, Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
- Laboratory of Energy Metabolism and Body Composition (LAMECC), Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Aline Lage Wendling
- Laboratory of Clinical Analysis and Genomics, Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
- Laboratory of Energy Metabolism and Body Composition (LAMECC), Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Ana Paula Dionísio
- Brazilian Agricultural Research Corporation (Embrapa) Agroindústria Tropical-CNPAT, Brasília, Brazil
| | - Josefina Bressan
- Laboratory of Clinical Analysis and Genomics, Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
- Laboratory of Energy Metabolism and Body Composition (LAMECC), Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Hercia Stampini Duarte Martino
- Laboratory of Experimental Nutrition, Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
| | - Elad Tako
- Trace Minerals and Nutrition Lab, Department of Food Science, Cornell University, Ithaca, NY, United States
| | - Helen Hermana Miranda Hermsdorff
- Laboratory of Clinical Analysis and Genomics, Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
- Laboratory of Energy Metabolism and Body Composition (LAMECC), Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
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Junker D, Wu M, Reik A, Raspe J, Rupp S, Han J, Näbauer SM, Wiechert M, Somasundaram A, Burian E, Waschulzik B, Makowski MR, Hauner H, Holzapfel C, Karampinos DC. Impact of baseline adipose tissue characteristics on change in adipose tissue volume during a low calorie diet in people with obesity-results from the LION study. Int J Obes (Lond) 2024:10.1038/s41366-024-01568-6. [PMID: 38926461 DOI: 10.1038/s41366-024-01568-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND/OBJECTIVES Weight loss outcomes vary individually. Magnetic resonance imaging (MRI)-based evaluation of adipose tissue (AT) might help to identify AT characteristics that predict AT loss. This study aimed to assess the impact of an 8-week low-calorie diet (LCD) on different AT depots and to identify predictors of short-term AT loss using MRI in adults with obesity. METHODS Eighty-one adults with obesity (mean BMI 34.08 ± 2.75 kg/m², mean age 46.3 ± 10.97 years, 49 females) prospectively underwent baseline MRI (liver dome to femoral head) and anthropometric measurements (BMI, waist-to-hip-ratio, body fat), followed by a post-LCD-examination. Visceral and subcutaneous AT (VAT and SAT) volumes and AT fat fraction were extracted from the MRI data. Apparent lipid volumes based on MRI were calculated as approximation for the lipid contained in the AT. SAT and VAT volumes were subdivided into equidistant thirds along the craniocaudal axis and normalized by length of the segmentation. T-tests compared baseline and follow-up measurements and sex differences. Effect sizes on subdivided AT volumes were compared. Spearman Rank correlation explored associations between baseline parameters and AT loss. Multiple regression analysis identified baseline predictors for AT loss. RESULTS Following the LCD, participants exhibited significant weight loss (11.61 ± 3.07 kg, p < 0.01) and reductions in all MRI-based AT parameters (p < 0.01). Absolute SAT loss exceeded VAT loss, while relative apparent lipid loss was higher in VAT (both p < 0.01). The lower abdominopelvic third showed the most significant SAT and VAT reduction. The predictor of most AT and apparent lipid losses was the normalized baseline SAT volume in the lower abdominopelvic third, with smaller volumes favoring greater AT loss (p < 0.01 for SAT and VAT loss and SAT apparent lipid volume loss). CONCLUSIONS The LCD primarily reduces lower abdominopelvic SAT and VAT. Furthermore, lower abdominopelvic SAT volume was detected as a potential predictor for short-term AT loss in persons with obesity.
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Affiliation(s)
- Daniela Junker
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany.
| | - Mingming Wu
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Anna Reik
- Institute for Nutritional Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Johannes Raspe
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Selina Rupp
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Jessie Han
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Stella M Näbauer
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Meike Wiechert
- Institute for Nutritional Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Arun Somasundaram
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Egon Burian
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Birgit Waschulzik
- Institute of AI and Informatics in Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Marcus R Makowski
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Hans Hauner
- Institute for Nutritional Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Else Kroener-Fresenius-Center of Nutritional Medicine, School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Christina Holzapfel
- Institute for Nutritional Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda, Germany
| | - Dimitrios C Karampinos
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, Garching, Germany
- Munich Data Science Institute, Technical University of Munich, Garching, Germany
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Madigan CD, King JA, Taylor C, Hoekstra SP, Graham HE, Kirk N, Fenton JM, Goosey-Tolfrey VL. A systematic review and qualitative synthesis of weight management interventions for people with spinal cord injury. Obes Rev 2024:e13785. [PMID: 38853150 DOI: 10.1111/obr.13785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 05/10/2024] [Accepted: 05/20/2024] [Indexed: 06/11/2024]
Abstract
People with spinal cord injury (SCI) are at greater risk of developing obesity and related co-morbidities than those without SCI. The objectives of this systematic review were to examine the effectiveness of weight management interventions for people with SCI and to synthesize the experiences of people involved with SCI weight management (e.g., SCI healthcare professionals and caregivers). Five databases were searched (up to July 31, 2023) and 5,491 potentially eligible articles were identified. Following screening, 22 articles were included, comprising 562 adults. There was considerable heterogeneity in study design and weight loss interventions included behavioral nutritional and exercise education sessions, recalling food diaries, exercise interventions, and pharmaceuticals. The mean percentage change of the pooled body mass data equated to -4.0 ± 2.3%, with a range from -0.5 to -7.6%. In addition, 38% of the individuals with SCI who completed a weight loss intervention (N = 262) had a ≥5% reduction in body weight. Collectively, although on average the included interventions led to moderate weight loss, the finding that just over a third of individuals achieved clinically meaningful 5% weight loss suggests that available interventions for this population may need to be improved.
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Affiliation(s)
- Claire D Madigan
- Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - James A King
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- The Peter Harrison Centre for Disability Sport, The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK
| | - Carolyn Taylor
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Sven P Hoekstra
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- The Peter Harrison Centre for Disability Sport, The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Heneritta E Graham
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Natasha Kirk
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- The Peter Harrison Centre for Disability Sport, The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Jordan M Fenton
- The Peter Harrison Centre for Disability Sport, The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Vicky L Goosey-Tolfrey
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- The Peter Harrison Centre for Disability Sport, The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Atlantis E, Kormas N, Piya M, Sahebol-Amri M, Williams K, Huang HCC, Bishay R, Chikani V, Girolamo T, Prodan A, Fahey P. Developing a Decision Aid for Clinical Obesity Services in the Real World: the DACOS Nationwide Pilot Study. Obes Surg 2024; 34:2073-2083. [PMID: 38467898 PMCID: PMC11127827 DOI: 10.1007/s11695-024-07123-6] [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: 10/05/2023] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/13/2024]
Abstract
PURPOSE The purpose of this study is to develop a decision aid tool using "real-world" data within the Australian health system to predict weight loss after bariatric surgery and non-surgical care. MATERIALS AND METHODS We analyzed patient record data (aged 16+years) from initial review between 2015 and 2020 with 6-month (n=219) and 9-/12-month (n=153) follow-ups at eight clinical obesity services. Primary outcome was percentage total weight loss (%TWL) at 6 months and 9/12 months. Predictors were selected by statistical evidence (p<0.20), effect size (±2%), and clinical judgment. Multiple linear regression and bariatric surgery were used to create simple predictive models. Accuracy was measured using percentage of predictions within 5% of the observed value, and sensitivity and specificity for predicting target weight loss of 5% (non-surgical care) and 15% (bariatric surgery). RESULTS Observed %TWL with bariatric surgery vs. non-surgical care was 19% vs. 5% at 6 months and 22% vs. 5% at 9/12 months. Predictors at 6 months with intercept (non-surgical care) of 6% include bariatric surgery (+11%), BMI>60 (-3%), depression (-2%), anxiety (-2%), and eating disorder (-2%). Accuracy, sensitivity, and specificity were 58%, 69%, and 56%. Predictors at 9/12 months with intercept of 5% include bariatric surgery (+15%), type 2 diabetes (+5%), eating disorder (+4%), fatty liver (+2%), atrial fibrillation (-4%), osteoarthritis (-3%), sleep/mental disorders (-2-3%), and ≥10 alcohol drinks/week (-2%). Accuracy, sensitivity, and specificity were 55%, 86%, and 53%. CONCLUSION Clinicians may use DACOS to discuss potential weight loss predictors with patients after surgery or non-surgical care.
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Affiliation(s)
- Evan Atlantis
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, Australia.
| | - Nic Kormas
- Department of Endocrinology, Concord Hospital, Concord, New South Wales, Australia
- South Western Sydney Metabolic Rehabilitation and Bariatric Program, Camden and Campbelltown Hospitals, Campbelltown, New South Wales, Australia
| | - Milan Piya
- South Western Sydney Metabolic Rehabilitation and Bariatric Program, Camden and Campbelltown Hospitals, Campbelltown, New South Wales, Australia
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Mehdi Sahebol-Amri
- Ryde Hospital, Northern Sydney Local Health District, Ryde, New South Wales, Australia
| | - Kathryn Williams
- Department of Endocrinology, Nepean Hospital, Nepean Blue Mountains Local Health District, Kingswood, New South Wales, Australia
- Charles Perkins Centre-Nepean, The University of Sydney, Kingswood, New South Wales, Australia
| | - Hsin-Chia Carol Huang
- Respiratory & Sleep Medicine, Canberra Hospital, Garran, Canberra, Australian Capital Territory, Australia
- Canberra Obesity Management Service, Canberra Health Services, Belconnen, Canberra, Australian Capital Territory, Australia
- College of Health and Medicine, Australian National University, Acton, Australian Capital Territory, Australia
| | - Ramy Bishay
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
- Metabolic & Weight Loss Clinic, University Clinics, Western Sydney University, Blacktown Hospital, Blacktown, New South Wales, Australia
| | - Viral Chikani
- Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Teresa Girolamo
- Re:You Health, Adelaide Weight Management and Wellness, Adelaide, South Australia, Australia
| | - Ante Prodan
- School of Computer, Data and Mathematical Sciences, Western Sydney University, Sydney, Australia
| | - Paul Fahey
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, Australia
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Dashti HS, Scheer FAJL, Saxena R, Garaulet M. Impact of polygenic score for BMI on weight loss effectiveness and genome-wide association analysis. Int J Obes (Lond) 2024; 48:694-701. [PMID: 38267484 DOI: 10.1038/s41366-024-01470-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 01/05/2024] [Accepted: 01/12/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND While environmental factors play an important role in weight loss effectiveness, genetics may also influence its success. We examined whether a genome-wide polygenic score for BMI was associated with weight loss effectiveness and aimed to identify common genetic variants associated with weight loss. METHODS Participants in the ONTIME study (n = 1210) followed a uniform, multimodal behavioral weight-loss intervention. We first tested associations between a genome-wide polygenic score for higher BMI and weight loss effectiveness (total weight loss, rate of weight loss, and attrition). We then conducted a genome-wide association study (GWAS) for weight loss in the ONTIME study and performed the largest weight loss meta-analysis with earlier studies (n = 3056). Lastly, we ran exploratory GWAS in the ONTIME study for other weight loss outcomes and related factors. RESULTS We found that each standard deviation increment in the polygenic score was associated with a decrease in the rate of weight loss (Beta (95% CI) = -0.04 kg per week (-0.06, -0.01); P = 3.7 × 10-03) and with higher attrition after adjusting by treatment duration. No associations reached genome-wide significance in meta-analysis with previous GWAS studies for weight loss. However, associations in the ONTIME study showed effects consistent with published studies for rs545936 (MIR486/NKX6.3/ANK1), a previously noted weight loss locus. In the meta-analysis, each copy of the minor A allele was associated with 0.12 (0.03) kg/m2 higher BMI at week five of treatment (P = 3.9 × 10-06). In the ONTIME study, we also identified two genome-wide significant (P < 5×10-08) loci for the rate of weight loss near genes implicated in lipolysis, body weight, and metabolic regulation: rs146905606 near NFIP1/SPRY4/FGF1; and rs151313458 near LSAMP. CONCLUSION Our findings are expected to help in developing personalized weight loss approaches based on genetics. CLINICAL TRIAL REGISTRATION Obesity, Nutrigenetics, Timing, and Mediterranean (ONTIME; clinicaltrials.gov: NCT02829619) study.
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Affiliation(s)
- Hassan S Dashti
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
- Broad Institute, Cambridge, MA, USA.
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
| | - Frank A J L Scheer
- Broad Institute, Cambridge, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Richa Saxena
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute, Cambridge, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Marta Garaulet
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.
- Department of Physiology, Regional Campus of International Excellence, University of Murcia, 30100, Murcia, Spain.
- Biomedical Research Institute of Murcia, IMIB-Arrixaca-UMU, University Clinical Hospital, 30120, Murcia, Spain.
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Kaur J, Lee YL, Stortz E, Palani G, Elkin B, Gravely A, Westanmo A, Billington CJ, Ercan-Fang N, Sibley SD. Telephone Virtual Versus In-Person Pharmacotherapy-Based Obesity Care: A COVID-19-Related Experience at a Veterans Administration Facility. Telemed J E Health 2024; 30:e1110-e1118. [PMID: 37883630 DOI: 10.1089/tmj.2023.0049] [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] [Indexed: 10/28/2023] Open
Abstract
Background: Most of the Veterans Administration (VA) population is either overweight or obese, which is a serious health concern. Medical weight management visits have traditionally occurred through in-person clinics. However, the COVID-19 pandemic forced care delivery to virtual platforms. Methods: We compared weight loss with in-person versus telephone-based medical weight management (lifestyle counseling coupled with pharmacotherapy) delivered by physician and nurse practitioner visits during the pandemic. We designed a program evaluation utilizing a naturalistic (pragmatic) observational study structure, including both newly enrolled and previously established participants in the Minneapolis VA MOVE! program between 2017 and 2021. A "transition" cohort (n = 74) received in-person care from March 2019 to March 2020, and then transitioned to virtual care. A "new start" virtual care cohort (n = 149) enrolled after March 2020 was compared to a separate historical group (n = 180) that received in-person care between January 2017 and December 2019. Weight loss was accessed over a 9-month period in both cohorts. Results: Mean weight loss over 9 months was -6.5 ± 18.2 and -2.5 ± 13.3 lbs in the in-person and virtual phases of the transition cohort, respectively, without significant difference between the two phases (p = 0.22). Mean weight loss over 9 months in the new start (virtual) cohort was -14.4 ± 17.0 lbs compared to -16.7 ± 21.0 lbs in the historical cohort, without significant difference between groups (p = 0.44). Conclusions: In our naturalistic study in a single-site VA clinic setting, weight loss with telephone-based medical weight management during the pandemic was comparable to in-person care. These findings are important for veterans living in rural and/or underserved areas.
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Affiliation(s)
- Jasleen Kaur
- Division of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Yee L Lee
- Division of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ethan Stortz
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Guru Palani
- Division of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Baila Elkin
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Amy Gravely
- Research Service, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
| | - Anders Westanmo
- Department of Pharmacy, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
| | - Charles J Billington
- Division of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Medicine, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
| | - Nacide Ercan-Fang
- Division of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Medicine, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
| | - Shalamar D Sibley
- Division of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Medicine, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
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Coleman CD, Kiel JR, Guarneiri LL, Bell M, Wilcox ML, Maki KC, Unick JL, Jonnalagadda SS. Importance of early weight loss and other predictors of lower weight loss in a commercial program: A secondary data analysis. Obes Sci Pract 2024; 10:e724. [PMID: 38263985 PMCID: PMC10804349 DOI: 10.1002/osp4.724] [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: 07/18/2023] [Revised: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 01/25/2024] Open
Abstract
Objective There is substantial inter-individual variability in response to weight loss interventions and emerging evidence suggests that weight loss during the early weeks of an intervention may be predictive of longer-term weight loss. This secondary analysis of data from a commercial program therefore examined 1) the associations between early weight loss (i.e., week 4) with final visit weight loss and duration on the program, and 2) other predictors of lower weight loss at final visit. Methods Client charts of adults with overweight or obesity (N = 748) were analyzed. Clients were stratified into categories of weight loss at the week 4 (< and ≥2%, 3% and 4%) and final visits (< and ≥5% and 10%). Multivariate logistic regression was used to assess predictors of <5% and <10% final visit weight loss. Results The odds ratios for losing <5% or <10% of weight at the final visit were higher (49.0 (95% CI: 13.84, 173.63) and 20.1 (95% CI: 6.96, 58.06)) for clients who lost <2% or <3% compared to those who lost ≥2% or ≥3% at week 4. Other predictors of not losing a clinically relevant amount of weight included female sex, use of higher calorie meal plans and shorter time in the program, among others. Those who lost ≥2% at week 4 also had a significantly greater percent program completion (109.2 ± 75.2% vs. 82.3 ± 82.4, p < 0.01) compared with those who did not meet the 2% threshold. Conclusions Lower 4-week weight loss was identified as a strong predictor of not losing a clinically relevant amount of weight. These results may be useful for the early identification of individuals who can be targeted for additional counseling and support to aid in attaining weight loss goals.
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Affiliation(s)
| | - Jessica R Kiel
- Department of Scientific and Clinical Affairs Medifast, Inc. Baltimore Maryland USA
| | | | | | | | - Kevin C Maki
- Midwest Biomedical Research Addison Illinois USA
- Indiana University Department of Applied Health Science School of Public Health-Bloomington Bloomington Indiana USA
| | - Jessica L Unick
- The Miriam Hospital's Weight Control and Diabetes Research Center Warren Alpert Medical School at Brown University Providence Rhode Island USA
| | - Satya S Jonnalagadda
- Department of Scientific and Clinical Affairs Medifast, Inc. Baltimore Maryland USA
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9
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Garner NJ, Smith JR, Sampson MJ, Greaves CJ. Quantity and specificity of action-plans as predictors of weight loss: analysis of data from the Norfolk Diabetes Prevention Study (NDPS). Psychol Health 2024; 39:42-67. [PMID: 35333685 DOI: 10.1080/08870446.2022.2055026] [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: 06/09/2021] [Accepted: 03/11/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Investigate associations between quantity, content and specificity of action-plans and weight loss in a diabetes prevention study. DESIGN Prospective cohort study nested within a randomised controlled trial. Participants completed action-planning worksheets during intervention sessions. MAIN OUTCOME MEASURES Action-plans were coded in terms of: number of plans set, their content, and specificity. Multivariate regression analyses assessed associations with weight loss at four-months. RESULTS 890 planning-worksheets from 106 participants were analysed. Participants wrote a mean of 2.12 (SD = 1.20) action-plans per worksheet, using a mean of 2.20 (SD = 0.68) specificity components per action-plan. Quantity of action-plans per worksheet decreased over time (r = -0.137, p < 0.001) and increased quantity was associated with reduced specificity [r = -.215, p < 0.001]. Walking (34.9% of action-plans) and reducing high fat/sugar snacks (26.1%) were the most commonly planned lifestyle actions. In multivariate modelling, increased quantity of action-plans was associated with greater weight loss (R2 = 0.135, Unstandardised Beta = 0.144, p = 0.002). Specificity was not significantly associated with weight-loss (p = 0.096). CONCLUSION Producing more action-plans was associated with greater weight loss. Further research should directly compare more versus less specific action-plans and explore ways to sustain engagement in action-planning. Our findings imply that participants should freely set numerous action-plans, rather than being encouraged to focus on specificity. Supplemental data for this article is available online at https://doi.org/10.1080/08870446.2022.2055026 .
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Affiliation(s)
- Nikki J Garner
- Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
- University of Exeter Medical School, College of Medicine & Health, University of Exeter, Exeter, UK
| | - Jane R Smith
- University of Exeter Medical School, College of Medicine & Health, University of Exeter, Exeter, UK
| | - Mike J Sampson
- Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Colin J Greaves
- School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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10
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Verma A, Malhotra A, Ranjan P, Kumari A, Chopra S, Khan MA, Kaloiya GS, Singh A, Prakash B, Ahuja M. A comprehensive evaluation of predictors of obesity in women during the perimenopausal period: A systematic review and narrative synthesis. Diabetes Metab Syndr 2024; 18:102933. [PMID: 38181722 DOI: 10.1016/j.dsx.2023.102933] [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: 07/13/2023] [Revised: 11/16/2023] [Accepted: 12/17/2023] [Indexed: 01/07/2024]
Abstract
INTRODUCTION Obesity during perimenopausal transition can be attributed to various factors. Identifying these factors is crucial in preventing obesity and developing effective strategies to manage weight during this phase. This review aimed to systematically understand predictors of obesity during menopausal transition. METHODS The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and searched databases like PubMed, Wiley Online Library, and Cochrane Reviews. Cohort and cross-sectional studies in English language assessing obesity among menopausal women were included. The methodological quality was assessed using Joanna Briggs Checklist for critical appraisal. Risk of Bias (RoB) was generated using Review Manager 5.4.1 (RevMan). Identified predictors were assessed for overall quality of evidence using adopted Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS This review encompassed 42 studies, (21 cross-sectional and 21 cohort) with sample ranging from 164 to 107,243 across studies. Higher parity( ≥ 3 children) emerged as a strong predictor of obesity across seven studies, with good-quality evidence. Lower physical activity was another predictor, supported by eight studies with good-quality evidence. Sociodemographic factors like lower education(<8 years or < than college degree), socioeconomic background, menopausal transition, and older age at menarche showed associations with weight gain, with moderate-quality evidence. Lifestyle factors (high-fat consumption, sedentariness, active smoking status, and psychological difficulties) also showed moderate-quality evidence. CONCLUSION This review underscores the multifaceted factors associated with obesity during the perimenopausal transition. Identifying these factors will be helpful in prevention and management of obesity among these women.
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Affiliation(s)
- Aditi Verma
- Department of Home Science, University of Delhi, New Delhi, India
| | - Anita Malhotra
- Lakshmibai College, Department of Home Science, University of Delhi, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Archana Kumari
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Sakshi Chopra
- Department of Home Science, University of Delhi, New Delhi, India
| | - Maroof A Khan
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Amandeep Singh
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Bindu Prakash
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Maninder Ahuja
- Indian Menopause Society, Society of Meaningful Life Management, India
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11
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Jøranli KT, Vefring LT, Dalen M, Garnweidner-Holme L, Molin M. Experiences of social support by participants with morbid obesity who participate in a rehabilitation program for health-behavior change: a qualitative study. BMC Nutr 2023; 9:149. [PMID: 38098104 PMCID: PMC10722673 DOI: 10.1186/s40795-023-00810-0] [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: 10/02/2023] [Accepted: 12/11/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Obesity is a global public health concern with significant implications for individuals' physical health and overall well-being. Health-behavior change programs are crucial for addressing obesity and its associated health risks. Social support plays a central role in facilitating successful outcomes in these programs, yet limited qualitative research exists on the experiences of individuals with morbid obesity participating in such interventions. Thus, this study explores how participants with morbid obesity experienced social support in a group-based rehabilitation program for health-behavior change. METHODS Fourteen participants in a group-based rehabilitation health-behavior change program in Norway were interviewed using semi-structured interviews. Data were analyzed with thematic analysis. RESULTS The thematic analysis revealed three primary sources of social support: support from other participants in the group, social support from family and friends, and support from the interdisciplinary team. The participants emphasized the significance of ongoing social support throughout their health-behavior change program. Participants appreciated fostering a sense of community and regular interaction with other members of the program to ensure ongoing social support. CONCLUSIONS Participants outlined the importance of maintaining a sense of community in the group and appreciated platforms for facilitating ongoing interactions and support among group participants. Future studies should focus on long-term interventions, tailored approaches for individuals with diverse needs involving family and friends, and the impact of enhanced peer support. By understanding the role of social support in health-behavior change programs, interventions can be optimized to better support individuals with morbid obesity.
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Affiliation(s)
- Karoline Thomlevold Jøranli
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, St. Olavs plass, P.O. 4, Oslo, 0130, Norway
| | - Linn Tennefoss Vefring
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, St. Olavs plass, P.O. 4, Oslo, 0130, Norway
| | - Maria Dalen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, St. Olavs plass, P.O. 4, Oslo, 0130, Norway
| | - Lisa Garnweidner-Holme
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, St. Olavs plass, P.O. 4, Oslo, 0130, Norway.
| | - Marianne Molin
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, St. Olavs plass, P.O. 4, Oslo, 0130, Norway
- Department of Health and Exercise, School of Health Sciences, Kristiania University College, PB1190 Sentrum, Oslo, 0107, Norway
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12
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Oldervoll LM, Gjestad R, Hilmarsen C C, Ose A, Gullikstad L, Wisløff U, Kulseng B, Grimsmo J. Diastolic function and cardiovascular risk among patients with severe obesity referred to a lifestyle-program - a pilot study. Scand Cardiovasc J Suppl 2023; 57:8-16. [PMID: 36404730 DOI: 10.1080/14017431.2022.2146185] [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: 11/22/2022]
Abstract
Objectives. Severe obesity is associated with a high risk of comorbidities and alterations of cardiac structure and function. The primary aim of the study was to investigate the proportion of diastolic dysfunction (DD) at baseline, and changes in cardiac function from baseline (T1) to 6 months follow-up (T2) among participants with severe obesity attending a lifestyle-intervention. The secondary aim was to explore changes in body mass index (BMI), physical fitness (VO2peak) and cardiovascular risk from T1 to T2 and 12 months follow-up (T3).Design. This was an open single-site prospective observational study. Patients were recruited from an obesity clinic to a lifestyle-intervention consisting of three 3-weeks intermittent stays over 12-months period. Echocardiography was performed at T1 and T2 and BMI, VO2peak and cardiovascular risk measured at T1, T2 and T3.Results. Fifty-six patients were included (mean age 45.1 years; BMI 41.9). Six of 52 patients (12%) had grade 1 DD at T1, while five subjects had DD at T2. E/A ratio (11%, p = .005) and mitral deceleration time (9%, p = .014) were improved at T2. A reduction in BMI (-1.8, p < .001) and improvement in VO2peak (1.6 mL/kg min, p = .026) were assessed at T2 and this improvement persisted at T3. The total cardiovascular risk score was not significantly changed.Conclusion. The patients with severe obesity had low prevalence of DD. For all participants, an improvement in diastolic parameters, and an important initial weight loss was observed.Clinical Trial number: NCT02826122.
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Affiliation(s)
- Line M Oldervoll
- Faculty of Psychology, Centre for Crisis Psychology, University of Bergen, Bergen, Norway.,Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, NTNU, Trondheim, Norway
| | - Rolf Gjestad
- Faculty of Psychology, Centre for Crisis Psychology, University of Bergen, Bergen, Norway
| | | | - Anders Ose
- Unicare Røros Rehabilitation, Røros, Norway
| | | | - Ulrik Wisløff
- Faculty of Medicine and Health Sciences, Department of Circulation and Medical Imaging, NTNU, Trondheim, Norway.,School of Human Movement and Nutrition Science, University of Queensland, Queensland, Australia
| | - Baard Kulseng
- Centre for Obesity Research, St. Olavs Hospital, Trondheim, Norway
| | - Jostein Grimsmo
- Department of Cardiac Rehabilitation, LHL (National Organization for Heart and Lung Diseases) Hospital Gardermoen, Jessheim, Norway
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13
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Phelan S, Cardel MI, Lee AM, Alarcon N, Foster GD. Behavioral, psychological, and environmental predictors of weight regain in a group of successful weight losers in a widely available weight-management program. Obesity (Silver Spring) 2023; 31:2709-2719. [PMID: 37840409 DOI: 10.1002/oby.23903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE The aim of this study was to identify predictors of weight regain and continued weight maintenance among individuals already successful at long-term weight loss in a widely available weight-management program. METHODS Participants were 2843 weight-loss maintainers in WeightWatchers who had maintained weight loss ≥9.1 kg for ≥1 year (average 25.5 kg for 3.5 years; BMI = 26.7 kg/m2 ). Validated behavioral, psychosocial, and home environmental questionnaires were administered at study entry and 1 year later. Discriminant analysis identified variables that discriminated gainers (≥2.3-kg gain) from maintainers (±2.3-kg change). RESULTS Over the 1 year of follow-up, 43% were gainers (mean [SD], 7.2 [5.4] kg), and 57% were maintainers (0.4 [1.2] kg). Compared with maintainers, gainers were younger and had higher initial weight, more recent weight losses, and larger initial weight losses. Standardized canonical coefficients indicated that the 1-year changes that most discriminated gainers from maintainers were greater decreases in the ability to accept uncomfortable food cravings, urges, and desires to overeat (0.232); self-monitoring (0.166); body image (0.363); and body satisfaction (0.194) and greater increases in disinhibition (0.309) and bodily pain (0.147). The canonical correlation was 0.505 (p < 0.001). CONCLUSIONS Future interventions to prevent regain should consider targeting overeating in response to internal and external food cues and declines in self-monitoring and body image.
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Affiliation(s)
- Suzanne Phelan
- Department of Kinesiology & Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, California, USA
| | - Michelle I Cardel
- WW International, Inc., New York, New York, USA
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
| | | | - Noemi Alarcon
- Department of Kinesiology & Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, California, USA
| | - Gary D Foster
- WW International, Inc., New York, New York, USA
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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14
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Xu J, Wang S, Wu H, Chen D, Han J, Lin Q. Engineering a potent and long-acting GLP-1/Y 2 receptor dual agonist as a multi-agonist therapy for diabetes and obesity. Peptides 2023; 169:171073. [PMID: 37536423 DOI: 10.1016/j.peptides.2023.171073] [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: 06/21/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023]
Abstract
Novel dual agonists for the glucagon-like peptide-1 (GLP-1) and Y2 receptor hold the potential for enhanced efficacy over GLP-1 receptor (GLP-1R) agonists in treating obesity and diabetes. In this study, we aimed to improve the stability and increase the drug development success rate of our previously identified GLP-1/Y2 receptor dual agonist, 6q. To achieve this, we first optimized the structure of the linker within 6q. Additionally, we explored various fatty acid albumin binders to further enhance the stability of 6q. These binders were mainly selected from approved or clinically developed GLP-1R agonists or GLP-1-based multi-agonists. Through this process, we were able to identify a lead peptide, xGLP/PYY-6, that exhibited comparable in vitro potency toward the GLP-1 and Y2 receptors as 6q but with significantly improved stability compared to 6q. In Kunming and DIO mice, xGLP/PYY-6 showed a comparable hypoglycemic effect to semaglutide, and a significantly better effect on inhibiting food intake than semaglutide. In a chronic study in DIO mice, xGLP/PYY-6 exhibited significant metabolic benefits, as reflected by regulation of lipid levels, improved glucose tolerance, weight loss, decreased hepatocellular vacuolation, and the reversal of steatosis effects caused by xGLP/PYY-6. These results indicate the potential of developing xGLP/PYY-6 as an antiobesity, lipid regulation, antisteatotic, and antidiabetic agent.
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Affiliation(s)
- Jing Xu
- Department of Pharmacy, Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyungang, Lianyungang 222000, PR China
| | - Shuang Wang
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou 221116, PR China
| | - Han Wu
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou 221116, PR China
| | - De Chen
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou 221116, PR China
| | - Jing Han
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, China; Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Nanning 530021, China.; School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou 221116, PR China.
| | - Qisi Lin
- School of Pharmacy, Xuzhou Medical University, Xuzhou 221004, PR China.
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15
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Rodriguez Espinosa P, Xiao L, Ma J, Rosas LG. What matters for weight loss in behavioral trials in the Latinx community: Learnings from three randomized controlled trials. Obes Res Clin Pract 2023; 17:519-528. [PMID: 38071165 PMCID: PMC10810045 DOI: 10.1016/j.orcp.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/29/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Nearly half of Latinx adults in the US are obese, making effective weight loss interventions crucial to prevent associated chronic conditions. OBJECTIVE To identify factors associated with increased session attendance and clinically significant weight loss among Latinx adults. PARTICIPANTS Latinx participants from the Vivamos Activos (n = 207), Vida Sana (n = 191), and HOMBRE (n = 424 Latinx men) randomized clinical trials. DESIGN Post-hoc analysis of randomized controlled trial data. INTERVENTION Culturally-adapted behavioral weight loss interventions based on the Diabetes Prevention Program among Latinx adults over 12 months. MAIN OUTCOME MEASURE Demographic, clinical, and psychosocial predictors of session attendance and 5% weight loss at 12-months. STATISTICAL ANALYSIS PERFORMED Bi-variable associations between baseline characteristics and outcomes were tested with chi-square and t-tests. Those with p-value< 0.15 were then included in stepwise logistic regressions. RESULTS Participants (N = 822) were middle age with diverse socioeconomic backgrounds. Older age in the Vivamos Activos and Vida Sana trials, and lower acculturation in the HOMBRE trial were significant predictors of increased session attendance. Factors associated with 5% weight loss varied by trials. These included younger age (OR 0.96 95% CI 0.92, 0.99) in Vivamos Activos, higher acculturation (OR 1.88 95% CI 1.05, 3.37) in Vida Sana, and higher education (OR 3.20 95% CI 1.3, 7.03) and greater body image dissatisfaction (OR 1.29, 95% CI 1.04, 1.6), and lower acculturation (0.69 95% CI 0.5, 0.96) in HOMBRE. CONCLUSIONS Few and conflicting baseline characteristics were associated with session attendance and clinically significant weight loss, suggesting that alternative approaches to optimizing interventions are needed.
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Affiliation(s)
- Patricia Rodriguez Espinosa
- Department of Epidemiology and Population Health, Stanford University School of Medicine, California, US; Office of Community Engagement, Stanford School of Medicine, California, US
| | - Lan Xiao
- Department of Epidemiology and Population Health, Stanford University School of Medicine, California, US
| | - Jun Ma
- Center for Health Behavior Research, University of Illinois Chicago, US
| | - Lisa G Rosas
- Department of Epidemiology and Population Health, Stanford University School of Medicine, California, US; Office of Community Engagement, Stanford School of Medicine, California, US.
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16
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Patel ML, Rodriguez Espinosa P, King AC. Moderators of a Diet and Physical Activity Intervention: who Responds Best to Sequential vs. Simultaneous Approaches. Int J Behav Med 2023:10.1007/s12529-023-10223-9. [PMID: 37816943 PMCID: PMC11004089 DOI: 10.1007/s12529-023-10223-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Given that low physical activity levels and poor dietary intake are co-occurring risk factors for chronic disease, there is a need for interventions that target both health behaviors, either sequentially or simultaneously. Little is known about participant characteristics that are associated with better or worse response to sequential and simultaneous interventions. METHOD The 12-month Counseling Advice for Lifestyle Management (CALM) randomized trial (N = 150; Mage = 55.3 years) targeted these two behaviors either via a sequential approach - dietary advice first then exercise advice added ("Diet-First") or exercise advice first then dietary advice added ("Exercise-First") - or via a simultaneous approach. The objective was to examine demographic, clinical, and psychosocial moderators of intervention effects on 12-month change in (1) moderate-to-vigorous physical activity (MVPA), (2) fruit/vegetable intake, (3) caloric intake from saturated fat, and (4) weight. Hierarchical regressions first compared Diet-First to Exercise-First, followed by comparisons of these arms combined ("sequential") to the simultaneous arm. RESULTS Older age, higher baseline BMI, and lower social support were associated with higher MVPA in Exercise-First vs. Diet-First, while lower tangible support was associated with higher fruit/vegetable intake in Exercise-First but not in Diet-First. Poor sleep was associated with higher levels of MVPA in the sequential arm than in the simultaneous arm. Lower vitality was associated with greater weight loss in the sequential arm than in the simultaneous arm, while the opposite was true for those who were not married. CONCLUSION Identifying moderators of treatment response can allow the behavioral medicine field to enhance intervention efficacy by matching participant subgroups to their best-fitting interventions. TRIAL REGISTRATION NCT00131105.
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Affiliation(s)
- Michele L Patel
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA.
| | | | - Abby C King
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
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17
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Höchsmann C, Martin CK, Apolzan JW, Dorling JL, Newton RL, Denstel KD, Mire EF, Johnson WD, Zhang D, Arnold CL, Davis TC, Fonseca V, Thethi TK, Lavie CJ, Springgate B, Katzmarzyk PT. Initial weight loss and early intervention adherence predict long-term weight loss during the Promoting Successful Weight Loss in Primary Care in Louisiana lifestyle intervention. Obesity (Silver Spring) 2023; 31:2272-2282. [PMID: 37551762 PMCID: PMC10597572 DOI: 10.1002/oby.23854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 05/30/2023] [Accepted: 06/03/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE This study tested whether initial weight change (WC), self-weighing, and adherence to the expected WC trajectory predict longer-term WC in an underserved primary-care population with obesity. METHODS Data from the intervention group (n = 452; 88% women; 74% Black; BMI 37.3 kg/m2 [SD: 4.6]) of the Promoting Successful Weight Loss in Primary Care in Louisiana trial were analyzed. Initial (2-, 4-, and 8-week) percentage WC was calculated from baseline clinic weights and daily at-home weights. Weights were considered adherent if they were on the expected WC trajectory (10% at 6 months with lower [7.5%] and upper [12.5%] bounds). Linear mixed-effects models tested whether initial WC and the number of daily and adherent weights predicted WC at 6, 12, and 24 months. RESULTS Percentage WC during the initial 2, 4, and 8 weeks predicted percentage WC at 6 (R2 = 0.15, R2 = 0.28, and R2 = 0.50), 12 (R2 = 0.11, R2 = 0.19, and R2 = 0.32), and 24 (R2 = 0.09, R2 = 0.11, and R2 = 0.16) months (all p < 0.01). Initial daily and adherent weights were significantly associated with WC as individual predictors, but they only marginally improved predictions beyond initial weight loss alone in multivariable models. CONCLUSIONS These results highlight the importance of initial WC for predicting long-term WC and show that self-weighing and adherence to the expected WC trajectory can improve WC prediction.
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Affiliation(s)
- Christoph Höchsmann
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - John W Apolzan
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - James L Dorling
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Robert L Newton
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Kara D Denstel
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Emily F Mire
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | | | - Dachuan Zhang
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Connie L Arnold
- Department of Medicine and Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Terry C Davis
- Department of Medicine and Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Vivian Fonseca
- AdventHealth, Translational Research Institute, Orlando, Florida, USA
| | - Tina K Thethi
- AdventHealth, Translational Research Institute, Orlando, Florida, USA
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, New Orleans, Louisiana, USA
| | - Benjamin Springgate
- Department of Internal Medicine, Louisiana State University School of Medicine, New Orleans, Louisiana, USA
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Bensignor MO, Bramante CT, Bomberg EM, Fox CK, Hale PM, Kelly AS, Mamadi R, Prabhu N, Harder-Lauridsen NM, Gross AC. Evaluating potential predictors of weight loss response to liraglutide in adolescents with obesity: A post hoc analysis of the randomized, placebo-controlled SCALE Teens trial. Pediatr Obes 2023; 18:e13061. [PMID: 37264767 PMCID: PMC10926323 DOI: 10.1111/ijpo.13061] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 04/26/2023] [Accepted: 05/15/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND As childhood obesity prevalence increases, determining which patients respond to anti-obesity medications would strengthen personalized approaches to obesity treatment. In the SCALE Teens trial among pubertal adolescents with obesity (NCT02918279), liraglutide 3.0 mg (or maximum tolerated dose) significantly reduced body mass index (BMI) standard deviation score on average versus placebo. That said, liraglutide effects on BMI reduction varied greatly among adolescents, similar to adults. OBJECTIVES To identify post hoc characteristics predictive of achieving ≥5% and ≥10% BMI reductions at 56 weeks with liraglutide versus placebo in adolescents from the SCALE Teens trial. METHODS Logistic regression analysis was performed in 251 adolescents treated with liraglutide (n = 125) or placebo (n = 126) for 56 weeks. Baseline characteristics (selected a priori) included sex, race, ethnicity, age, Tanner (pubertal) stage, glycemic status (hyperglycemia [type 2 diabetes/prediabetes] vs. normoglycemia), obesity category (Class II/III vs. I), severity of depression symptoms (Patient Health Questionnaire-9), and weight variability (weight fluctuations over time). The effects of early responder status (≥4% BMI reduction at week 16) on week 56 response were assessed using descriptive statistics. RESULTS Baseline characteristics did not affect achievement of ≥5% and ≥10% BMI reductions at week 56 in adolescents treated with liraglutide. Further, there was no association between weight variability and BMI reduction. Early liraglutide responders appeared to have greater BMI and body weight reductions at week 56 compared with early non-responders. CONCLUSIONS This secondary analysis suggests that adolescents with obesity may experience significant BMI reductions after 56 weeks of liraglutide treatment, regardless of their sex, race, ethnicity, age, pubertal stage, glycemic status, obesity category, severity of depression symptoms, or weight variability. Early response may predict greater week 56 response.
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Affiliation(s)
- Megan O. Bensignor
- Department of Pediatrics, Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Carolyn T. Bramante
- Department of Pediatrics, Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Eric M. Bomberg
- Department of Pediatrics, Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Claudia K. Fox
- Department of Pediatrics, Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Paula M. Hale
- Clinical Development, Medical & Regulatory Affairs, Novo Nordisk Inc., Plainsboro, New Jersey, USA
| | - Aaron S. Kelly
- Department of Pediatrics, Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Rashmi Mamadi
- Global Medical Affairs, Novo Nordisk, Bangalore, India
| | | | | | - Amy C. Gross
- Department of Pediatrics, Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, Minnesota, USA
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19
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Weintraub MA, D’Angelo D, Tchang BG, Sahagun AD, Andre C, Aronne LJ, Shukla AP. Five-year Weight Loss Maintenance With Obesity Pharmacotherapy. J Clin Endocrinol Metab 2023; 108:e832-e841. [PMID: 36810608 PMCID: PMC10438886 DOI: 10.1210/clinem/dgad100] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023]
Abstract
CONTEXT Long-term treatment of obesity with lifestyle changes alone is unsustainable for most individuals because of several factors including adherence and metabolic adaptation. Medical management of obesity has proven efficacy for up to 3 years in randomized controlled trials. However, there is a dearth of information regarding real-world outcomes beyond 3 years. OBJECTIVE This work aimed to assess long-term weight loss outcomes over a 2.5- to 5.5-year period with US Food and Drug Administration (FDA)-approved and off-label antiobesity medications (AOMs). METHODS A cohort of 428 patients with overweight or obesity were treated with AOMs at an academic weight management center with an initial visit between April 1, 2014, and April 1, 2016. Intervention included FDA-approved and off-label AOMs. The primary outcome was percentage weight loss from initial to final visit. Key secondary outcomes included weight reduction targets as well as demographic and clinical predictors of long-term weight loss. RESULTS The average weight loss was 10.4% at a mean follow-up duration of 4.4 years. The proportions of patients who met the weight reduction targets of 5% or greater, 10% or greater, 15% or greater, and 20% or greater were 70.8%, 48.1%, 29.9%, and 17.1%, respectively. On average, 51% of maximum weight loss was regained, while 40.2% of patients maintained their weight loss. In a multivariable regression analysis, a higher number of clinic visits was associated with more weight loss. Metformin, topiramate, and bupropion were associated with increased odds of maintaining 10% or greater weight loss. CONCLUSION Clinically significant long-term weight loss of 10% or more beyond 4 years is achievable in clinical practice settings with obesity pharmacotherapy.
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Affiliation(s)
- Michael A Weintraub
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, Weill Cornell Medicine, New York, NY 10021, USA
| | - Debra D’Angelo
- Division of Biostatistics, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10021, USA
| | - Beverly G Tchang
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, Weill Cornell Medicine, New York, NY 10021, USA
| | - Ageline D Sahagun
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, Weill Cornell Medicine, New York, NY 10021, USA
| | - Clarissa Andre
- Department of Internal Medicine, New York Presbyterian Hospital–Weill Cornell, New York, NY 10021, USA
| | - Louis J Aronne
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, Weill Cornell Medicine, New York, NY 10021, USA
| | - Alpana P Shukla
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, Weill Cornell Medicine, New York, NY 10021, USA
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20
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Jabłonowska-Lietz B, Nowicka G, Włodarczyk M, Rejowski S, Stasiowska M, Wrzosek M. Initial Weight Loss, Anthropometric Parameters, and Proinflammatory Transcript Levels in Patients with Class I Obesity. Biomedicines 2023; 11:2304. [PMID: 37626800 PMCID: PMC10452077 DOI: 10.3390/biomedicines11082304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/09/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Research into early predictors of effective weight loss could help determine more effective therapeutic interventions. In this study, 106 subjects with class I obesity, genotyped with the fat mass and obesity-associated (FTO) rs9930506 gene variant, were enrolled into a 12-week weight loss program (WLP). Anthropometric and body composition measurements were controlled with bioelectrical impedance analysis (BIA) at baseline and after 4 and 12 weeks. Biopsies of abdominal subcutaneous adipose tissue (AT) and venous blood samples were collected to monitor changes in interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), and nuclear factor kappa B (NF-κB) mRNA levels in white blood cells (WBCs) and to assess if changes in WBC gene expression reflected changes in adipose tissue. The FTO rs9930506 variant had no effect on weight loss and no reduction in proinflammatory transcripts in WBCs or AT. Changes in anthropometric parameters were associated with changes in carbohydrate metabolism. A linear regression model showed that initial weight loss (after 4 weeks of the WLP) was the most predictive factor of weight loss success after 12 weeks of the WLP. Changes in plasma lipids or proinflammatory transcript levels in WBCs or AT were not associated with weight loss effectiveness. However, the gene expression in WBCs did reflect changes occurring in subcutaneous AT.
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Affiliation(s)
- Beata Jabłonowska-Lietz
- Medical Center, National Institute of Public Health NIH—National Research Institute, 24 Chocimska St., 00-791 Warsaw, Poland
| | - Grażyna Nowicka
- Department of Biochemistry and Pharmacogenomics, Center for Preclinical Research, Medical University of Warsaw, 1 Banacha St., 02-097 Warsaw, Poland
| | - Marta Włodarczyk
- Department of Biochemistry and Pharmacogenomics, Center for Preclinical Research, Medical University of Warsaw, 1 Banacha St., 02-097 Warsaw, Poland
| | - Sławomir Rejowski
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 1A Banacha St., 02-097 Warsaw, Poland
| | - Maria Stasiowska
- Department of Anaesthesia and Intensive Care, University College London Hospital, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
| | - Małgorzata Wrzosek
- Department of Biochemistry and Pharmacogenomics, Center for Preclinical Research, Medical University of Warsaw, 1 Banacha St., 02-097 Warsaw, Poland
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21
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Aldhamin RA, Al-Ghareeb G, Al Saif A, Al-Ahmed Z. Health Coaching for Weight Loss Among Overweight and Obese Individuals in Saudi Arabia: A Retrospective Analysis. Cureus 2023; 15:e41658. [PMID: 37565116 PMCID: PMC10411960 DOI: 10.7759/cureus.41658] [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] [Accepted: 07/10/2023] [Indexed: 08/12/2023] Open
Abstract
Background Health coaching is an increasingly used strategy to help in adopting lifestyle changes for weight loss. While Saudi Arabia has one of the highest obesity prevalences worldwide, research on lifestyle interventions for weight loss is limited. Aim We aimed to investigate the effectiveness of health coaching for weight loss among the Saudi population in real-world primary healthcare settings. Methods This is a retrospective observational study. Secondary data from the health coach national program in the Eastern Health Cluster were retrieved. Obese and overweight individuals aged 15 years or older with weight-related goals who completed at least 12 weeks of coaching were included in the analysis. The primary outcomes are weight change (kg) and weight change percent (%) of the initial weight. We further compared the weight change% between different follow-up methods (i.e., physical, virtual, and hybrid) and studied the factors associated with -5% weight loss. Results In total, 465 participants were included in the analysis, with a female predominance (66.2%) and a median initial weight of 90 kg (interquartile range (IQR): 77, 101). The median follow-up duration was 127 days (IQR: 101, 157), and the median total number of coaching sessions was three (IQR: 2, 5). The mean weight change was -2.68 kg (95% confidence interval (CI): -3.12, -2.24), p<0.001. Comparing each follow-up group, no statistically significant difference was found when controlling for number of visits (p=0.059). The adjusted means for weight change% were -3.77%, -2.59%, and -2.54% for hybrid, physical, and virtual visits, respectively. Factors that were associated with achieving at least -5% weight loss were male sex (adjusted odds ratio (aOR)=1.87, 95% CI: 1.16, 3.02), five or more total coaching visits (aOR=5.23, 95% CI: 2.88, 9.50), longer follow-up duration (aOR=1.09, 95% CI: 1.03, 1.15), and having a weight management goal (aOR=4.5, 95% CI: 1.63, 12.45) as the reason for initial coaching visit. Conclusion We found statistically significant weight change among clients who completed 12 weeks of coaching in primary care settings. The findings in this paper contribute to the importance of lifestyle interventions for weight loss among the Saudi population. However, stronger controlled studies are needed to confirm this finding.
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Affiliation(s)
| | | | - Ahmed Al Saif
- Keep Well Unit, Model of Care Department, Eastern Health Cluster, Dammam, SAU
| | - Zahra Al-Ahmed
- Keep Well Unit, Model of Care Department, Eastern Health Cluster, Dammam, SAU
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22
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Griauzde DH, Hershey C, Michaels J, Evans RR, Richardson CR, Heisler M, Kullgren JT, Saslow LR. A very low-carbohydrate diabetes prevention program for veterans with prediabetes: a single-arm mixed methods pilot study. Front Nutr 2023; 10:1069266. [PMID: 37266128 PMCID: PMC10230095 DOI: 10.3389/fnut.2023.1069266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/27/2023] [Indexed: 06/03/2023] Open
Abstract
Introduction All Veterans Affairs (VA) Medical Centers offer the MOVE! Weight Management Program to help patients achieve and maintain a healthy weight through a calorie-restricted, low-fat diet and increased physical activity. Yet, most MOVE! participants do not achieve clinically significant weight loss of ≥5%. A carbohydrate-restricted diet may help more Veterans to achieve ≥5% weight loss. Methods This was a single-arm explanatory sequential mixed methods pilot study conducted in one VA health care system. Veterans with prediabetes and body mass index ≥25 kg/m2 were invited to participate in a group-based, virtual, very low-carbohydrate Diabetes Prevention Program (VLC-DPP) consisting of 23 sessions over 12 months. Participants were taught to follow a very low-carbohydrate eating pattern, defined as 20-35 grams of net carbohydrates per day. The primary outcomes were measures of feasibility and acceptability, including program uptake and session attendance. Secondary outcomes included change in weight, hemoglobin A1c, lipids, and patient-reported measures of food cravings, stress eating, perceived health status, and motivation. Interviews were conducted at 6 months to identify factors that facilitated or hindered participants' achievement of ≥5% weight loss. Results Among 108 screened Veterans, 21 enrolled in the study (19%), and 18 were included in the analytic cohort. On average, participants attended 12.4/16 weekly sessions and 3.6/8 bimonthly or monthly sessions. At 12 months, mean percent weight loss was 9.4% (SD = 10.7) with 9 participants (50%) achieving ≥5% weight loss. Three factors facilitated achievement of ≥5% weight loss among 10/16 interviewees: (1) enjoyment of low-carbohydrate foods; (2) careful monitoring of carbohydrate intake; and (3) reduced hunger and food cravings. Three factors hindered achievement of ≥5% weight loss among 6/16 interviewees: (1) food cravings, particularly for sweets; (2) challenges with maintaining a food log; and (3) difficulty with meal planning. Conclusion A VLC-DPP is feasible and acceptable and shows preliminary efficacy among Veterans with prediabetes. The program's weight loss effectiveness compared to standard MOVE! should be evaluated in a larger-scale trial. Such a program may be offered in addition to the standard MOVE! program to expand the menu of evidence-based lifestyle counseling options for Veterans. Clinical Trial Registration https://clinicaltrials.gov/ct2/show/NCT04881890, identifier NCT04881890.
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Affiliation(s)
- Dina H. Griauzde
- VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, United States
- University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, United States
| | - Cheryl Hershey
- VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - Jamie Michaels
- VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | | | - Caroline R. Richardson
- University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, United States
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Michele Heisler
- VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, United States
- University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, United States
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Jeffrey T. Kullgren
- VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, United States
- University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, United States
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Laura R. Saslow
- University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, United States
- University of Michigan School of Nursing, Ann Arbor, MI, United States
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23
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Gao X, Li P, Dai S, Wang G, Li W, Song Z, Zhu L, Zhu S. Is prior bariatric surgery associated with poor COVID-19 outcomes? A systematic review and meta-analysis of case-control studies. J Glob Health 2023; 13:06012. [PMID: 37058575 PMCID: PMC10104427 DOI: 10.7189/jogh.13.06012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023] Open
Abstract
Background Obesity is an independent risk factor for severe coronavirus disease 2019 (COVID-19), but there is little evidence on whether prior bariatric surgery benefits the outcomes of patients with COVID-19. We aimed to summarize this relationship by conducting a systematic review and meta-analysis of current case-control studies. Methods We searched several electronic databases for case-control studies conducted between January 2020 and March 2022. We compared the rates of mortality, mechanical ventilation, intensive care unit (ICU) admission, dialysis, hospitalization, and length of hospital stay between COVID-19 patients with and without a history of bariatric surgery. Results We included six studies with 137 903 patients; 5270 (3.8%) had prior bariatric surgery, while 132 633 (96.2%) did not. COVID-19 patients with a history of bariatric surgery had significantly lower mortality (odds ratio (OR) = 0.42; 95% confidence interval (CI) = 0.23-0.74), ICU admission (OR = 0.48; 95% CI = 0.36-0.65), and mechanical ventilation rates than those with a history of non-bariatric surgery (OR = 0.51; 95% CI = 0.35-0.75). Conclusions Prior bariatric surgery was associated with a reduced risk of mortality and reduced severity of COVID-19 in patients with obesity compared to those with no prior bariatric surgery. Further large-sample prospective studies are needed to support these results. Registration CRD42022323745.
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24
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Conti C, Di Nardo M, Lanzara R, Guagnano MT, Cardi V, Porcelli P. Improvement in binge eating and alexithymia predicts weight loss at 9-month follow-up of the lifestyle modification program. Eat Weight Disord 2023; 28:30. [PMID: 36947261 PMCID: PMC10033561 DOI: 10.1007/s40519-023-01560-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/25/2022] [Indexed: 03/23/2023] Open
Abstract
PURPOSE The aim of this longitudinal study was to examine the extent to which improved levels of binge eating (BE) behaviors, alexithymia, self-esteem, and psychological distress would predict a reduction in body mass at 9-month follow-up, following a lifestyle modification program for weight loss in obese or overweight patients. METHODS A convenience sample of 120 obese or overweight patients were recruited. Body mass index (BMI), binge eating (BES), levels of alexithymia (TAS-20), perceived stress (PSS), depressive symptoms (SDS), and self-esteem (RSE) were assessed during their first medical examination (T1), and after a weight-loss treatment period of 9 months (T2). RESULTS Compared with unimproved patients, improved patients reported a significant decrease in binge eating (p = 0.04) and perceived stress symptoms (p = 0.03), and a significant improvement in self-esteem (p = 0.02) over time. After controlling for gender, self-esteem, depressive symptoms, and perceived stress, baseline BMI (OR = 1.11, 95% CI [1.04,1.19]), ΔBES (OR = 0.99, 95% CI [0.98,0.99]), and ΔTAS-20 (OR = 1.03, 95% CI [1.01,1.05]) significantly and independently predicted a ≥ 5% reduction in body mass from baseline. CONCLUSIONS Our finding supports the suggestion to consider psychological outcomes such as emotional aspects and dysfunctional eating behaviors when planning a weight loss programs to prevent a negative outcome. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Affiliation(s)
- Chiara Conti
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Maria Di Nardo
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Roberta Lanzara
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy.
| | - Maria Teresa Guagnano
- Department of Medicine and Aging, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Valentina Cardi
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of General Psychology, University of Padova, Padua, Italy
| | - Piero Porcelli
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
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Uncovering Barriers and Facilitators of Weight Loss and Weight Loss Maintenance: Insights from Qualitative Research. Nutrients 2023; 15:nu15051297. [PMID: 36904294 PMCID: PMC10005538 DOI: 10.3390/nu15051297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 03/08/2023] Open
Abstract
Long-term weight loss maintenance is often difficult to achieve. This review analysed qualitative data on self-perceived barriers and facilitators of weight loss and weight loss maintenance among weight loss intervention participants. A literature search was conducted using electronic databases. Qualitative studies written in English and published between 2011-2021 were eligible for inclusion if they explored the perspectives and experiences of individuals who received standardised dietary and behavioural support for weight loss. Studies were excluded if weight loss was achieved through self-directed methods, only increasing physical activity, or surgical or pharmacological interventions. Fourteen studies were included, totaling 501 participants from six countries. Thematic analysis was used to identify four aggregate themes: internal factors (i.e., motivation and self-efficacy), programme-specific factors (i.e., the intervention diet), social factors (i.e., supporters and saboteurs), and environmental factors (i.e., an obesogenic environment). Our findings demonstrate that internal, social, and environmental factors all influence weight loss success, as well as the acceptability of the weight loss intervention. Future interventions may be more successful if they prioritise participant acceptability and engagement by, for example, providing tailored interventions, a structured relapse management plan, strategies to enhance autonomous motivation and emotional self-regulation, and extended contact during weight loss maintenance.
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26
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Imhagen A, Karlsson J, Jansson S, Anderzén-Carlsson A. A lifelong struggle for a lighter tomorrow: A qualitative study on experiences of obesity in primary healthcare patients. J Clin Nurs 2023; 32:834-846. [PMID: 35655375 PMCID: PMC10084391 DOI: 10.1111/jocn.16379] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/25/2022] [Accepted: 05/17/2022] [Indexed: 11/30/2022]
Abstract
AIM To describe experiences of living with obesity before the start of a group-based lifestyle intervention. BACKGROUND Obesity is a chronic disease that affects a person's physical and psychological health. Increased knowledge of experiences of living with obesity is required. DESIGN A qualitative study with a descriptive design. METHODS Semi-structured individual interviews with 17 participants living with obesity (Body Mass Index 32-49) were conducted between October and November 2019. The interviews were analysed using qualitative content analysis. The COREQ checklist was followed. RESULTS The analysis resulted in one main theme: Struggling for a lighter tomorrow and three subthemes: Suffering, Resilience and Need for support in making changes. For the majority of the participants, living with obesity was a lifelong struggle involving suffering on different levels. Yet despite this, the participants had not given up and hoped for a better life. They showed a degree of resilience and motivation, and a perceived ability to achieve lifestyle changes. However, there was a pronounced need for support to help them achieve this. CONCLUSION Living with obesity is complex and carries a risk of medical complications as well as psychosocial suffering. Healthy lifestyle habits to achieve better health and to lose weight should be encouraged, taking patient resources into account. Patients also need help in handling weight stigmatisation, and both healthcare professionals and society must engage with this. RELEVANCE TO CLINICAL PRACTICE Obesity is a chronic disease, and patients need ongoing support. Therefore, care for patients with obesity in primary health care must be further developed. Patient resources and strengths have to be acknowledged and encouraged in the process of helping them adopt healthy lifestyle habits. The findings of this study can contribute to ending weight stigmatisation by increasing the knowledge of living with obesity.
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Affiliation(s)
- Annika Imhagen
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Jan Karlsson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Stefan Jansson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Agneta Anderzén-Carlsson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
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27
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Tan LJ, Yun YR, Hong SW, Shin S. Effect of kimchi intake on body weight of general community dwellers: a prospective cohort study. Food Funct 2023; 14:2162-2171. [PMID: 36752575 DOI: 10.1039/d2fo03900a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The impact of kimchi intake on weight management has been a topic of interest. We aimed to conduct an epidemiological study to investigate the association between kimchi intake and weight loss. Participants were selected from the Health Examinees cohort study. Kimchi intake was assessed by a 106-item semi-quantitative food frequency questionnaire, including four types of kimchi. Obesity was defined according to the Korean Society for the Study of Obesity guidelines. We performed a correlation analysis among all participants (N = 58 290) and conducted a prospective risk assessment analysis among participants with a baseline BMI value ≥25 kg m-2 (N = 20 066). In the correlation analysis, higher kimchi consumption was found to be associated with a lower increment in BMI change (men, β 0.169, 95% CI (0.025, 0.313); women, β 0.140, 95% CI (0.046, 0.236)) compared with the lower group. The risk assessment analysis indicated that moderate kimchi consumption is associated with normal weight development in men (Q3, hazard ratio, 1.28, 95% CI (1.06, 1.54)). Baechu [cabbage] kimchi intake also showed a significant association among men participants (all p for trend <0.05). In conclusion, moderate kimchi intake was associated with weight loss among middle-aged and older Koreans, especially in men.
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Affiliation(s)
- Li-Juan Tan
- Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, South Korea.
| | - Ye-Rang Yun
- Technology Innovation Research Division, World Institute of Kimchi, Gwangju 61755, South Korea.
| | - Sung Wook Hong
- Technology Innovation Research Division, World Institute of Kimchi, Gwangju 61755, South Korea.
| | - Sangah Shin
- Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, South Korea.
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28
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Valladales-Restrepo LF, Sánchez-Ramírez N, Usma-Valencia AF, Gaviria-Mendoza A, Machado-Duque ME, Machado-Alba JE. Effectiveness, persistence of use, and safety of orlistat and liraglutide in a group of patients with obesity. Expert Opin Pharmacother 2023; 24:535-543. [PMID: 36755412 DOI: 10.1080/14656566.2023.2178900] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
BACKGROUND To determine the effectiveness, persistence of use, adverse reactions, interactions of orlistat and liraglutide taken for weight loss by a group of obese patients in Colombia. RESEARCH DESIGN AND METHODS A retrospective follow-up study of a cohort of patients with obesity treated with orlistat or liraglutide. Sociodemographic, clinical, and pharmacological variables were identified. The effectiveness for weight loss at 12-16 and 52 weeks, persistence of use, and safety were determined. RESULTS A total of 294 patients were followed up. At 12-16 weeks after starting orlistat and liraglutide, weight losses of -1.2kg (p=0.002) and -4.1kg (p<0.001) were observed, respectively, and at 52 weeks, reductions of -1.6kg (p=0.208) and -7.8kg (p<0.001) were observed. A total of 8.8% and 31.3% of patients treated with orlistat and liraglutide, respectively, persisted with treatment 1 year after initiation. A total of 17.3% had adverse drug reactions. Older adults with grade II or III obesity who performed physical activity and those treated with liraglutide were more likely to have lost at least 5% of their body weight at 12-16 weeks. CONCLUSION Orlistat and liraglutide users presented weight loss at 12-16 weeks. However, this effect was greater and sustained with liraglutide, especially when combined with physical activity.
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Affiliation(s)
- Luis Fernando Valladales-Restrepo
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma SA. Pereira, Colombia.,Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | - Nicolás Sánchez-Ramírez
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma SA. Pereira, Colombia
| | - Andrés Felipe Usma-Valencia
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma SA. Pereira, Colombia
| | - Andrés Gaviria-Mendoza
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma SA. Pereira, Colombia.,Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | - Manuel Enrique Machado-Duque
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma SA. Pereira, Colombia.,Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | - Jorge Enrique Machado-Alba
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma SA. Pereira, Colombia
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Ernesti I, Baratta F, Watanabe M, Risi R, Camajani E, Persichetti A, Tuccinardi D, Mariani S, Lubrano C, Genco A, Spera G, Gnessi L, Basciani S. Predictors of weight loss in patients with obesity treated with a Very Low-Calorie Ketogenic Diet. Front Nutr 2023; 10:1058364. [PMID: 36761216 PMCID: PMC9905243 DOI: 10.3389/fnut.2023.1058364] [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: 09/30/2022] [Accepted: 01/05/2023] [Indexed: 01/27/2023] Open
Abstract
Introduction The Very Low-Calorie Ketogenic Diet (VLCKD) has emerged as a safe and effective intervention for the management of metabolic disease. Studies examining weight loss predictors are scarce and none has investigated such factors upon VLCKD treatment. Among the molecules involved in energy homeostasis and, more specifically, in metabolic changes induced by ketogenic diets, Fibroblast Growth Factor 21 (FGF21) is a hepatokine with physiology that is still unclear. Methods We evaluated the impact of a VLCKD on weight loss and metabolic parameters and assessed weight loss predictors, including FGF21. VLCKD is a severely restricted diet (<800 Kcal/die), characterized by a very low carbohydrate intake (<50 g/day), 1.2-1.5 g protein/kg of ideal body weight and 15-30 g of fat/day. We treated 34 patients with obesity with a VLCKD for 45 days. Anthropometric parameters, body composition, and blood and urine chemistry were measured before and after treatment. Results We found a significant improvement in body weight and composition and most metabolic parameters. Circulating FGF21 decreased significantly after the VLCKD [194.0 (137.6-284.6) to 167.8 (90.9-281.5) p < 0.001] and greater weight loss was predicted by lower baseline FGF21 (Beta = -0.410; p = 0.012), male sex (Beta = 0.472; p = 0.011), and central obesity (Beta = 0.481; p = 0.005). Discussion VLCKD is a safe and effective treatment for obesity and obesity related metabolic derangements. Men with central obesity and lower circulating FGF21 may benefit more than others in terms of weight loss obtained following this diet. Further studies investigating whether this is specific to this diet or to any caloric restriction are warranted.
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Affiliation(s)
- Ilaria Ernesti
- Surgical Endoscopy Unit, Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy,*Correspondence: Ilaria Ernesti,
| | - Francesco Baratta
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Mikiko Watanabe
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Renata Risi
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Elisabetta Camajani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, Rome, Italy
| | - Agnese Persichetti
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Dario Tuccinardi
- Department of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy
| | - Stefania Mariani
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Carla Lubrano
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Alfredo Genco
- Surgical Endoscopy Unit, Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Spera
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Lucio Gnessi
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Sabrina Basciani
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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Pedretti RFE, Hansen D, Ambrosetti M, Back M, Berger T, Ferreira MC, Cornelissen V, Davos CH, Doehner W, de Pablo Y Zarzosa C, Frederix I, Greco A, Kurpas D, Michal M, Osto E, Pedersen SS, Salvador RE, Simonenko M, Steca P, Thompson DR, Wilhelm M, Abreu A. How to optimize the adherence to a guideline-directed medical therapy in the secondary prevention of cardiovascular diseases: a clinical consensus statement from the European Association of Preventive Cardiology. Eur J Prev Cardiol 2023; 30:149-166. [PMID: 36098041 DOI: 10.1093/eurjpc/zwac204] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/20/2022] [Accepted: 09/07/2022] [Indexed: 01/27/2023]
Abstract
A key factor to successful secondary prevention of cardiovascular disease (CVD) is optimal patient adherence to treatment. However, unsatisfactory rates of adherence to treatment for CVD risk factors and CVD have been observed consistently over the last few decades. Hence, achieving optimal adherence to lifestyle measures and guideline-directed medical therapy in secondary prevention and rehabilitation is a great challenge to many healthcare professionals. Therefore, in this European Association of Preventive Cardiology clinical consensus document, a modern reappraisal of the adherence to optimal treatment is provided, together with simple, practical, and feasible suggestions to achieve this goal in the clinical setting, focusing on evidence-based concepts.
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Affiliation(s)
| | - Dominique Hansen
- REVAL/BIOMED, Hasselt University, Hasselt, Belgium
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
| | - Marco Ambrosetti
- Cardiovascular Rehabilitation Unit, ASST Crema, Santa Marta Hospital, Rivolta D'Adda, Italy
| | - Maria Back
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
| | - Thomas Berger
- Cardiomed Linz, St.John of God Hospital Linz, Linz, Austria
| | - Mariana Cordeiro Ferreira
- Psychologist, Centro de Reabilitação Cardiovascular do Centro Universitário Hospitalar Lisboa Norte, Portugal
| | | | - Constantinos H Davos
- Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Wolfram Doehner
- BIH Center for Regenerative Therapies (BCRT), Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Cardiology (Virchow Klinikum), Charité Universitätsmedizin Berlin and German, Berlin, Germany
- Centre for Cardiovascular Research (DZHK), partner site Berlin, Berlin, Germany
- Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Ines Frederix
- Heart Centre Hasselt, Jessa Hospital Hasselt Belgium, Hasselt University, Hasselt, Belgium
- Faculty of Medicine and Life Sciences Diepenbeek Belgium, University of Antwerp, Antwerp, Belgium
- Faculty of Medicine and Health Sciences Antwerp Belgium, Antwerp University Hospital, Edegem, Belgium
| | - Andrea Greco
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Donata Kurpas
- Department of Family Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Elena Osto
- Institute of Clinical Chemistry & Department of Cardiology, Heart Center, University & University Hospital Zurich, Zurich, Switzerland
| | - Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | | | - Maria Simonenko
- Heart Transplantation Outpatient Department, Cardiopulmonary Exercise Test Research Department, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - Patrizia Steca
- Department of Psychology, University of Milan-Bicocca, Milano, Italy
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Matthias Wilhelm
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ana Abreu
- Department of Cardiology of Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Institute of Preventive Medicine and Institute of Environmental Health of the Faculty of Medicine of University of Lisbon, Centre of Cardiovascular Investigation of University of Lisbon (CCUL) and Academic Centre of Medicine of University of Lisbon (CAML), Lisbon, Portugal
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Predictors of Effectiveness and Adherence in a Multimodal Obesity Treatment Program for Children and Adolescents in Routine Care. Nutrients 2022; 15:nu15010136. [PMID: 36615793 PMCID: PMC9824499 DOI: 10.3390/nu15010136] [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: 11/28/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
Multimodal obesity treatments for children and adolescents generally showed only small to modest treatment effects and high dropout rates. Potential variations by patients' clinical and sociodemographic factors remain, however, largely unclear. For this reason, our study analyzed psychological, physical, and sociodemographic predictors of treatment success and adherence in a multimodal obesity treatment over 12 months. The intent-to-treat sample included n = 361 children and adolescents (ages 3-17 years), of which n = 214 or 59.28% of patients completed treatment. A younger age and, in the sensitivity analysis, additionally a greater eating disorder psychopathology and treatment initiation before COVID-19 pandemic predicted greater BMI-SDS reductions (Body Mass Index-Standard Deviation Score). In contrast, predictors of treatment adherence were not found. The results underline the importance of early treatment of juvenile obesity. Additionally, eating disorder psychopathology includes restrained eating, which implies the ability to self-regulate eating behavior and therefore may have a positive effect on the treatment goal of controlled food intake. Challenges from altered treatment procedures due to the COVID-19 pandemic nonetheless remain.
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32
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Prevention and Treatment of Obesity-Related Inflammatory Diseases by Edible and Medicinal Plants and Their Active Compounds. IMMUNO 2022. [DOI: 10.3390/immuno2040038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Obesity, defined by excessive fat mass and its associated low-grade chronic inflammation, leads to insulin resistance, diabetes, and metabolic dysfunctions. The immunomodulatory properties of natural agents have gained much interest in recent decades. Some of the plant-derived agents are known to be immunomodulators that can affect both innate and adaptive immunity, e.g., thymoquinone, curcumin, punicalagin, resveratrol, quercetin, and genistein. Natural immunomodulators may contribute to the treatment of a number of inflammatory diseases, as they have significant efficacy and safety profiles. The immunomodulatory effects of traditional Greco-Arab and Islamic diets and medicinal plants are well acknowledged in abundant in vitro studies as well as in animal studies and clinical trials. This review highlights the role of Greco-Arab and Islamic diets and medicinal plants in the management of inflammation associated with obesity. Although previously published review articles address the effects of medicinal plants and phytochemicals on obesity-related inflammation, there is no systematic review that emphasizes clinical trials of the clinical significance of these plants and phytochemicals. Given this limitation, the objective of this comprehensive review is to critically evaluate the potential of the most used herbs in the management of obesity-related inflammation based on clinical trials.
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Dorling JL, Martin CK, Yu Q, Cao W, Höchsmann C, Apolzan JW, Newton RL, Denstel KD, Mire EF, Katzmarzyk PT. Mediators of weight change in underserved patients with obesity: exploratory analyses from the Promoting Successful Weight Loss in Primary Care in Louisiana (PROPEL) cluster-randomized trial. Am J Clin Nutr 2022; 116:1112-1122. [PMID: 35762659 PMCID: PMC9535544 DOI: 10.1093/ajcn/nqac179] [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: 03/15/2022] [Revised: 05/26/2022] [Accepted: 06/21/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Intensive lifestyle interventions (ILIs) stimulate weight loss in underserved patients with obesity, but the mediators of weight change are unknown. OBJECTIVES We aimed to identify the mediators of weight change during an ILI compared with usual care (UC) in underserved patients with obesity. METHODS The PROPEL (Promoting Successful Weight Loss in Primary Care in Louisiana) trial randomly assigned 18 clinics (n = 803) to either an ILI or UC for 24 mo. The ILI group received an intensive lifestyle program; the UC group had routine care. Body weight was measured; further, eating behaviors (restraint, disinhibition), dietary intake (percentage fat intake, fruit and vegetable intake), physical activity, and weight- and health-related quality of life constructs were measured through questionnaires. Mediation analyses assessed whether questionnaire variables explained between-group variations in weight change during 2 periods: baseline to month 12 (n = 779) and month 12 to month 24 (n = 767). RESULTS The ILI induced greater weight loss at month 12 compared with UC (between-group difference: -7.19 kg; 95% CI: -8.43, -6.07 kg). Improvements in disinhibition (-0.33 kg; 95% CI: -0.55, -0.10 kg), percentage fat intake (-0.25 kg; 95% CI: -0.50, -0.01 kg), physical activity (-0.26 kg; 95% CI: -0.41, -0.09 kg), and subjective fatigue (-0.28 kg; 95% CI: -0.46, -0.10 kg) at month 6 during the ILI partially explained this between-group difference. Greater weight loss occurred in the ILI at month 24, yet the ILI group gained 2.24 kg (95% CI: 1.32, 3.26 kg) compared with UC from month 12 to month 24. Change in fruit and vegetable intake (0.13 kg; 95% CI: 0.05, 0.21 kg) partially explained this response, and no variables attenuated the weight regain of the ILI group. CONCLUSIONS In an underserved sample, weight change induced by an ILI compared with UC was mediated by several psychological and behavioral variables. These findings could help refine weight management regimens in underserved patients with obesity.This trial was registered at clinicaltrials.gov as NCT02561221.
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Affiliation(s)
- James L Dorling
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Qingzhao Yu
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Wentao Cao
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Christoph Höchsmann
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - John W Apolzan
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | | - Kara D Denstel
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Emily F Mire
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
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Street S, Avenell A. Are individual or group interventions more effective for long-term weight loss in adults with obesity? A systematic review. Clin Obes 2022; 12:e12539. [PMID: 35765718 PMCID: PMC9542282 DOI: 10.1111/cob.12539] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/03/2022] [Accepted: 05/18/2022] [Indexed: 11/15/2022]
Abstract
Guidelines recommend individual and group interventions for weight loss, based on preference. Our 2009 systematic review compared long-term effectiveness of individual or group approaches to the same intervention, but there are new randomized controlled trials (RCTs) of high-quality data. We updated and expanded our previous systematic review. We searched Medline and Embase from 1966 to May 2021, and a clinical trial register from 1966 to 2017. Review Manager (5.4.1) was used to conduct meta-analysis. Ten RCTs were included. The primary outcome, mean weight change at final follow-up, was -1.33 kg (95% confidence interval CI: -2.04, -0.62; 10 trials, 2169 participants), favouring group interventions (p < .001). For the secondary outcomes, attainment of ≥5% body weight loss at final follow-up, the risk ratio (RR) was 1.36 (95% CI 1.05, 1.77; three trials, 1520 participants), favouring group interventions (p = .02); attrition at final follow-up was similar between group and individual arms of trials, RR 0.93 (95% CI 0.82, 1.07) (p = .31). Group interventions can be more effective than individual interventions for long-term weight loss in adults with obesity. However, few studies were included in the clinically relevant, secondary outcome measures. Research on delivering group processes in weight management is needed.
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Affiliation(s)
- Sarah Street
- Health Services Research Unit, Institute of Applied Health SciencesUniversity of AberdeenAberdeenScotland
| | - Alison Avenell
- Health Services Research Unit, Institute of Applied Health SciencesUniversity of AberdeenAberdeenScotland
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Martinez M, Salazar-Collier CL, Pena J, Wilkinson AV, Chavarria EA, Reininger BM. Motivation for weight loss among completers of a free community-based weight loss program in a US-Mexico border region: A self-determination theory perspective. Front Public Health 2022; 10:652271. [PMID: 36203664 PMCID: PMC9530817 DOI: 10.3389/fpubh.2022.652271] [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: 01/12/2021] [Accepted: 08/16/2022] [Indexed: 01/21/2023] Open
Abstract
This study explores the perceptions and motivation for weight loss among participants who completed a free community-based weight loss program in a predominantly Hispanic and low-income region along the US-Mexico border using a Self-Determination Theory (SDT) perspective. This manuscript is timely as qualitative research on the effect of motivation as a factor in behavioral interventions to reduce overweight or obesity is currently lacking. Individual semi-structured interviews were conducted with 20 participants (80%, n = 16 female) who completed a community weight-loss intervention to assess motivation for weight loss and participating, and the role of social support and self-efficacy in weight loss. Directed content analysis was used with SDT guiding the questions and subsequent theme analysis. The findings communicate perspectives of participants relevant to 8 prominent themes. The regulation types and constructs related to SDT included: non-regulation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic regulation as well as competence and relatedness. Participants mentioned external sources of motivation, such as wanting to improve their physical appearance, and motivation due to financial incentives. Fewer participants reported intrinsic motivators, which the literature suggests are more likely to create lasting change and improved health behaviors. Understanding the motivation for behavior change and completion of weight loss programs is essential to help participants reach their goals effectively and sustain weight loss. A greater emphasis during weight loss programs on the motives for individuals to lose weight may help improve outcomes in weight-loss interventions. Additionally, increasing strategies targeted at enhancing intrinsic motivation for weight loss may be beneficial.
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Affiliation(s)
- Miriam Martinez
- Texas Tech University Health Science Center, El Paso, TX, United States
| | - Cindy L. Salazar-Collier
- College of Nursing & Health Sciences, Texas A&M International University, Laredo, TX, United States,*Correspondence: Cindy L. Salazar-Collier
| | - Jessica Pena
- School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX, United States
| | - Anna V. Wilkinson
- School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX, United States
| | | | - Belinda M. Reininger
- School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX, United States
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Ahmad SR. Plant-based diet for obesity treatment. Front Nutr 2022; 9:952553. [PMID: 36159462 PMCID: PMC9493195 DOI: 10.3389/fnut.2022.952553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Obesity rates continue to rise, resulting in a global epidemic that shows no sign of slowing down. Our understanding of this complex disease is also constantly evolving, requiring healthcare providers to stay up to date with best practices. The application of plant-based diets (PBDs) may hold the key to a successful weight-control strategy. PBD refers to any dietary pattern that emphasizes the consumption of plant foods while excluding the consumption of most or all animal products. The purpose of this mini-review is to report on the application of PBDs as a potential treatment for obesity. PBDs have also been shown to be beneficial in the treatment of other non-communicable diseases, such as the prevention and treatment of type 2 diabetes. Many of the reported RCTs were of short duration. Longer-term studies, as well as studies focusing on strict adherence to the PBD regime, are needed. PBD is a beneficial approach to improving health, particularly in obese patients. Benefits include weight loss, improved cardiovascular health, lower blood pressure, and improved glucose metabolism.
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Chopra S, Ranjan P, Malhotra A, Sarkar S, Kumari A, Prakash B, Kaloiya GS, Dwivedi SN, Siddhu A, Vikram NK. Validation of Tools to Assess Predictors of Successful Weight Loss Outcome in Individuals With Overweight and Obesity. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:878-885. [PMID: 35764452 DOI: 10.1016/j.jneb.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 11/30/2021] [Accepted: 12/05/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To develop and validate questionnaires to assess the behavioral, psychosocial, and environmental predictors of successful weight loss outcomes. DESIGN Mixed method study. Questionnaires were developed using 5 steps: item generation by literature review and preexisting questionnaires, expert evaluation, pilot testing, factor analysis, and internal consistency. SETTING Adults with obesity recruited via web-based survey hyperlink. PARTICIPANTS One hundred participants with a mean body mass index of 28.7 ± 4.4 kg/m2. VARIABLES MEASURED The questionnaires were generated using 221 items. Establishing content, face and construct validity, and internal consistency. ANALYSIS Content validity was analyzed using content validity index and content validity ratio, internal consistency through Cronbach α (CA), and structural validity by factor analysis via principal varimax rotation. RESULTS All three questionnaires had good content validity. The Behavioral Predictor Questionnaire had good internal consistency (CA, 0.7) and excellent structural validity (69.7%). Psychosocial Predictors Questionnaire (CA, 0.8, 67.5%) and Environmental Predictors Questionnaire (CA: 0.8, 72.2%) had excellent internal consistency and structural validity. CONCLUSION AND IMPLICATION Questionnaires seem to be practical, valid, and reliable tools for baseline assessment of individual-specific factors related to weight loss success.
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Affiliation(s)
- Sakshi Chopra
- Department of Home Science, University of Delhi, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Anita Malhotra
- Department of Home Science, Lakshmibai College, University of Delhi, New Delhi, India
| | - Siddharth Sarkar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Archana Kumari
- Department of Gynaecology and Obstetrics, All India Institute of Medical Sciences, New Delhi, India
| | - Bindu Prakash
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | | | - Sada Nand Dwivedi
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Anupa Siddhu
- Department of Home Science, University of Delhi, New Delhi, India
| | - Naval K Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Ho AS, Behr H, Mitchell ES, Yang Q, Lee J, May CN, Michaelides A. Goal language is associated with attrition and weight loss on a digital program: Observational study. PLOS DIGITAL HEALTH 2022; 1:e0000050. [PMID: 36812521 PMCID: PMC9931249 DOI: 10.1371/journal.pdig.0000050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 04/24/2022] [Indexed: 06/18/2023]
Abstract
Behavioral weight loss reduces risk of weight-related health complications. Outcomes of behavioral weight loss programs include attrition and weight loss. There is reason to believe that individuals' written language on a weight management program may be associated with outcomes. Exploring associations between written language and these outcomes could potentially inform future efforts towards real-time automated identification of moments or individuals at high risk of suboptimal outcomes. Thus, in the first study of its kind, we explored whether individuals' written language in actual use of a program (i.e., outside of a controlled trial) is associated with attrition and weight loss. We examined two types of language: goal setting (i.e., language used in setting a goal at the start of the program) and goal striving (i.e., language used in conversations with a coach about the process of striving for goals) and whether they are associated with attrition and weight loss on a mobile weight management program. We used the most established automated text analysis program, Linguistic Inquiry Word Count (LIWC), to retrospectively analyze transcripts extracted from the program database. The strongest effects emerged for goal striving language. In striving for goals, psychologically distanced language was associated with more weight loss and less attrition, while psychologically immediate language was associated with less weight loss and higher attrition. Our results highlight the potential importance of distanced and immediate language in understanding outcomes like attrition and weight loss. These results, generated from real-world language, attrition, and weight loss (i.e., from individuals' natural usage of the program), have important implications for how future work can better understand outcomes, especially in real-world settings.
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Affiliation(s)
- Annabell Suh Ho
- Academic Research, Noom, Inc., New York, New York, United States of America
| | - Heather Behr
- Academic Research, Noom, Inc., New York, New York, United States of America
- Department of Integrative Health, Saybrook University, Pasadena, California, United States of America
| | | | - Qiuchen Yang
- Academic Research, Noom, Inc., New York, New York, United States of America
| | - Jihye Lee
- Department of Communication, Stanford University, Stanford, California, United States of America
| | - Christine N. May
- Academic Research, Noom, Inc., New York, New York, United States of America
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Chopra S, Ranjan P, Verma A, Kumari A, Malhotra A, Upadhyay AD, Baitha U, Vikram NK. A cross sectional survey of 504 women regarding perceived risk factors and barriers to follow healthy lifestyle and association with sociodemographic factors and menopausal symptoms. Diabetes Metab Syndr 2022; 16:102529. [PMID: 35696899 DOI: 10.1016/j.dsx.2022.102529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Midlife women undergoing menopausal transition are predisposed to weight gain. Weight gain in midlife is driven by two modifiable risk factors: menopausal symptom's severity and lifestyle practices. The independent and interactive nature of menopausal symptoms and lifestyle practices as risk factors of weight gain has not been investigated yet. This study was undertaken to study menopausal symptoms and lifestyle practices as risk factors for weight gain in midlife women and identify midlife -related barriers in managing corrective lifestyle practices. METHODS In this cross-sectional study, menopausal symptom severity and lifestyle practices such as diet, exercise, and sleep were assessed using a pre-validated and reliable questionnaire on a convenience sample of midlife women (43-55 years) via an interview schedule. The association of lifestyle practices and its barriers with socio-demographics and menopausal symptoms were analysed. RESULT A total of 504 women (mean age: 47.3 ± 4.1 years) were recruited. More than half of them followed corrective dietary practices, but only one-fourth engaged in moderate-intensity exercises. Total menopausal symptom severity was associated with increased food intake (P < 0.001), joint pain with limited physical activity and hot flashes and emotional volatility with sleep disturbances (P < 0.01). Demographic variables such as education, economic and employment status were associated with unhealthy lifestyle practices. CONCLUSION Assessment of menopausal symptoms and lifestyle practices as risk factors and associated barriers must be the pivotal component to devise comprehensive women-centric weight management modules. Similar studies should be carried out in future when there is no clear effect of COVID19 on lifestyle factors.
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Affiliation(s)
- Sakshi Chopra
- University of Delhi, Department of Home Science, New Delhi, India
| | - Piyush Ranjan
- All India Institute of Medical Sciences, Department of Medicine, New Delhi, India.
| | - Aditi Verma
- University of Delhi, Department of Home Science, New Delhi, India
| | - Archana Kumari
- All India Institute of Medical Sciences, Department of Gynaecology and Obstetric, New Delhi, India
| | - Anita Malhotra
- Lakshmibai College University of Delhi, Department of Home Science, New Delhi, India
| | - Ashish Datt Upadhyay
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Upendra Baitha
- All India Institute of Medical Sciences, Department of Medicine, New Delhi, India
| | - Naval K Vikram
- All India Institute of Medical Sciences, Department of Medicine, New Delhi, India
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Miranda-Peñarroya G, Zerón-Rugerio MF, Vallejo-Gracia M, Sorio-Fuentes R, Saenger-Ruiz F, Izquierdo-Pulido M. Adherence to Healthy Lifestyle Habits Is a Determinant of the Effectiveness of Weight Loss among Patients Undergoing Endoscopic Bariatric Therapies. Nutrients 2022; 14:nu14112261. [PMID: 35684061 PMCID: PMC9183092 DOI: 10.3390/nu14112261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
Endoscopic bariatric therapies (EBTs) are promising strategies for the treatment of obesity. However, there is still great variability in its effectiveness in weight loss. Thus, we investigated whether adherence to healthy lifestyle habits is a significant determinant of weight loss effectiveness among patients undergoing EBTs. Additionally, the role of eating behaviors and psychological traits in the effectiveness of weight loss was studied. A cohort of 361 participants (81.4% women; age 41.8 ± 9.5 years; BMI 37.8 ± 4.3 kg/m2) was followed for 1 year after EBT. Anthropometric parameters, adherence to healthy lifestyle habits, emotional eating, and psychological traits (anxiety and depression) were evaluated. General linear models were used to compare outcome variables according to weight loss effectiveness groups (poor vs. good weight-loss-responders). Additionally, a hierarchical linear regression model was used to determine whether adherence to healthy lifestyle habits, emotional eating, or psychological traits were significant predictors of excess weight loss (%EWL). One year after EBT, weight loss differed significantly between good and poor weight-loss-responders (67.5% EWL [95% CI: 64.2, 70.8] vs. 28.2% EWL [95% CI: 25.5, 30.9], p < 0.001). Participants who adhered to good lifestyle habits had 4.37 more odds [95% CI: 2.19, 8.88] of being good weight-loss-responders. We also observed that eating four to five meals/day and practicing muscle-strengthening activities >2 times/week were the two lifestyle habits that most significantly determined weight loss response. Furthermore, our results revealed that while adherence to healthy lifestyle habits was a significant determinant of %EWL 3, 6, and 12 months after EBT (p < 0.001), emotional eating was a significant determinant of %EWL only 3 and 6 months after the intervention (p < 0.01 and p < 0.05, respectively). Regarding psychological traits, we observed that neither anxiety nor depression were significant determinants of %EWL. Our results revealed that adherence to healthy lifestyle habits is a significant determinant for weight loss effectiveness among patients with obesity undergoing EBT. These findings highlight the importance of implementing an adequate nutritional intervention program, especially since patients who adhere to good lifestyle habits are able to achieve a weight loss that would be comparable with bariatric surgery.
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Affiliation(s)
- Gemma Miranda-Peñarroya
- Clínica Opción Médica S.L., C. Calvet 24, 08021 Barcelona, Barcelona, Spain; (G.M.-P.); (M.V.-G.); (R.S.-F.); (F.S.-R.)
- Departament d’Infermeria Fonamental i Medicoquirúrgica de la Facultat de Medicina, Universitat de Barcelona, Feixa Llarga, 08907 l’Hospitalet de Llobregat, Barcelona, Spain
- Departament de Nutrició, Ciències de l’Alimentació i Gastronomía, Campus de l’Alimentació Torribera, Universitat de Barcelona, Av. Prat de la Riba 171, 08921 Santa Coloma de Gramenet, Barcelona, Spain;
| | - María Fernanda Zerón-Rugerio
- Departament de Nutrició, Ciències de l’Alimentació i Gastronomía, Campus de l’Alimentació Torribera, Universitat de Barcelona, Av. Prat de la Riba 171, 08921 Santa Coloma de Gramenet, Barcelona, Spain;
- Institut de Recerca i Seguretat Alimentària (INSA-UB), Universitat de Barcelona, Av. Prat de la Riba 171, 08921 Santa Coloma de Gramenet, Barcelona, Spain
| | - Marta Vallejo-Gracia
- Clínica Opción Médica S.L., C. Calvet 24, 08021 Barcelona, Barcelona, Spain; (G.M.-P.); (M.V.-G.); (R.S.-F.); (F.S.-R.)
| | - Ricardo Sorio-Fuentes
- Clínica Opción Médica S.L., C. Calvet 24, 08021 Barcelona, Barcelona, Spain; (G.M.-P.); (M.V.-G.); (R.S.-F.); (F.S.-R.)
| | - Fernando Saenger-Ruiz
- Clínica Opción Médica S.L., C. Calvet 24, 08021 Barcelona, Barcelona, Spain; (G.M.-P.); (M.V.-G.); (R.S.-F.); (F.S.-R.)
| | - Maria Izquierdo-Pulido
- Departament de Nutrició, Ciències de l’Alimentació i Gastronomía, Campus de l’Alimentació Torribera, Universitat de Barcelona, Av. Prat de la Riba 171, 08921 Santa Coloma de Gramenet, Barcelona, Spain;
- Institut de Recerca i Seguretat Alimentària (INSA-UB), Universitat de Barcelona, Av. Prat de la Riba 171, 08921 Santa Coloma de Gramenet, Barcelona, Spain
- Correspondence:
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Weiland A, Nannette LK, Zipfel S, Ehehalt S, Ziser K, Junne F, Mack I. Predictors of Weight Loss and Weight Loss Maintenance in Children and Adolescents With Obesity After Behavioral Weight Loss Intervention. Front Public Health 2022; 10:813822. [PMID: 35400038 PMCID: PMC8989956 DOI: 10.3389/fpubh.2022.813822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 03/02/2022] [Indexed: 12/12/2022] Open
Abstract
Objective Predictors of body weight loss (BWL) and body weight loss maintenance (BWLM) after behavioral weight loss intervention are well-investigated in adults. Less is known for children and adolescents and a systematic overview on the topic for this age group was aim of the review. Methods A systematic research according to PRISMA guidelines using several databases was performed. The outcome was the BMI z-Score of longitudinal studies. The extracted predictors were classified in clusters (Physiology, Behavior, Psychology, Environment) and compared with a theory-driven model based on international guidelines and known predictors for adults. Results Out of 2,623 articles 24 met the eligibility criteria, 23 investigating BWL and 8 BWLM. The expected key predictor in research for adults “Behavior” was hardly investigated in children. The most examined cluster was “Physiology” with the most significant predictors, in particular genetics (BWL) and blood parameters (BWLM). Factors in the cluster “Psychology” also predicted BWL and BWLM. The cluster “Environment,” which was highlighted in most intervention guidelines, was neglected in studies regarding BWLM and hardly investigated in studies with BWL. Conclusion The comparison with the theory-driven children model outlined research gaps and differences between predictors for adults and children providing further direction of research. Systematic Review Registration http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020200505.
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Affiliation(s)
- Alisa Weiland
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Lena Kasemann Nannette
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Stefan Ehehalt
- Public Health Department of Stuttgart, Stuttgart, Germany
| | - Katrin Ziser
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Magdeburg, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
- *Correspondence: Isabelle Mack
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Ranjan P, Vikram NK, Choranur A, Pradeep Y, Ahuja M, Puri M, Malhotra A, Kumari A, Chopra S, Batra A, Balsalkar G, Goswami D, Guleria K, Sarkar S, Kachhawa G, Verma A, Kumari MK, Madan J, Dabral A, Kamath S, Rathore AM, Kumar R, Venkataraman S, Kaloiya G, Bhatla N, Kumari SS, Baitha U, Prakash A, Tiwaskar M, Tewary K, Misra A, Guleria R. Executive summary of evidence and consensus-based Clinical Practice Guidelines for management of obesity and overweight in midlife women: An AIIMS-DST initiative. Diabetes Metab Syndr 2022; 16:102426. [PMID: 35248973 DOI: 10.1016/j.dsx.2022.102426] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Weight gain is an independent risk factor for decline in cardiometabolic and overall health-related quality of life in midlife women. The AIIMS-DST initiative aims to develop and validate stepwise recommendations specific for weight management in midlife women. METHODS The key clinical questions specific to weight management in midlife women were finalised with the help of a multidisciplinary team of experts in the guideline development group (GDG). Phase I included a systematic and/or narrative review to gather evidence, grading of evidence and expert opinion was sought to develop clinical practice recommendations for each clinical question. Phase II focused on validation of clinical practice recommendations using the peer-review, Delphi method and GRADE approach. RESULTS -The guidelines provide clinical practice points to address challenges encountered by midlife women in their attempts to manage obesity via lifestyle modification techniques. The initiation of discussion would help the healthcare provider to identify the weight management needs of the women, educate women on different modalities of weight management, and empower them to incorporate corrective lifestyle behaviours. Before initiating the management, a comprehensive assessment of clinical and lifestylerelated parameters should be completed. A personalised behavioural lifestyle modification program addressing the midlife specific barriers for optimal metabolic, musculoskeletal, and mental health should be planned. A consistent follow-up is required for maintenance of corrective eating and activity habits by addressing midlife specific barriers for sustenance of healthy weight. CONCLUSION These recommendations will be useful in opportunistic screening and management of obesity in midlife women across healthcare settings.
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Affiliation(s)
- Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Naval K Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Ambuja Choranur
- President, Indian Menopause Society, Former Professor and Head, Department of Obstetrics and Gynaecology, Osmania Medical College, Hyderabad, India
| | - Yashodhara Pradeep
- Era Medical College and University, Ex Prof. and Head Department of Obstetrics and Gynaecology, RML Institute of Medical Sciences, KGMU, Lucknow, Vice President Elect, FOGSI, Ex Vice President, IMS, India
| | - Maninder Ahuja
- President, Society of Meaningful Life Management, Associate Editor, Journal of Midlife Health, India
| | - Manju Puri
- Head, Department of Obstetrics and Gynaecology, LHMC and SSK Hospital, New Delhi, India
| | - Anita Malhotra
- Food and Nutrition, Department of Home Science, Vice-principal, Lakshmibai College, University of Delhi, New Delhi, India
| | - Archana Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Sakshi Chopra
- Department of Home Science, University of Delhi, New Delhi, India
| | - Achla Batra
- President, Association of Obstetricians & Gynaecologists of Delhi (AOGD), Professor, Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Geetha Balsalkar
- Department of Obstetrics and Gynaecology Seth G. S. Medical College, Mumbai, India
| | - Deepti Goswami
- Director Professor, Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India
| | - Kiran Guleria
- Department of Obstetrics and Gynaecology, University College of Medical Sciences, New Delhi, India
| | - Siddharth Sarkar
- Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India
| | - Garima Kachhawa
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Aditi Verma
- Department of Home Science, University of Delhi, New Delhi, India
| | | | - Jagmeet Madan
- National President, Indian Dietetic Association, India
| | - Anjali Dabral
- Head, Department of Obstetrics and Gynaecology, VMMC and safdarjung Hospital, New Delhi, India
| | - Sandhya Kamath
- Ex-Professor of Medicine and Dean, Seth G S Medical College and KEM Hospital, Mumbai, and LT Municipal Medical College and General Hospital, Mumbai, India
| | - Asmita Muthal Rathore
- Director Professor and Head, Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India
| | - Raman Kumar
- President, Academy of Family Physicians of India, India
| | - Srikumar Venkataraman
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India
| | - Gaurishankar Kaloiya
- Clinical Psychology, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Neerja Bhatla
- Head, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - S Shantha Kumari
- President, The Federation of Obstetric and Gynaecological Societies of India, India
| | - Upendra Baitha
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anupam Prakash
- Department of Medicine, LHMC and SSK Hospital, New Delhi, India
| | | | - Kamlesh Tewary
- President, Association of the Physicians of India, India
| | - Anoop Misra
- Chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chairman, National Diabetes, Obesity and Cholesterol Foundation (N-DOC) and President, Diabetes Foundation (India), New Delhi, India
| | - Randeep Guleria
- Director, All India Institute of Medical Sciences, New Delhi, India
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Perceived risk factors for weight gain, barriers, and facilitators related to weight loss experienced by perimenopausal women: focus group discussion and thematic analysis. Menopause 2022; 29:219-224. [PMID: 35084375 DOI: 10.1097/gme.0000000000001909] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aims to understand middle-aged perimenopausal women's perspectives and beliefs regarding their body weight status, and evaluate the barriers, and facilitators associated weight loss. METHODS Five focus group discussions were conducted with perimenopausal women (aged 40-55 y) who were recruited through convenience and snowball sampling. Discussions were conducted to understand their experiences related to weight management during the perimenopausal period. The discussions were audio-recorded and transcribed and data analysis was done using Atlas.ti software to generate codes, subthemes, and themes from the discussions. RESULTS A total of 23 women with a mean age of 46.6 ± 5.6 years were recruited. Several themes of risk factors of weight gain emerged like difficulty in physical activity, unhealthy eating, overeating, and religious and cultural practices. Appearance and prevention of health-related issues emerged as motivators of initiating weight loss. Barriers faced during weight loss included themes like difficulty in managing diet and activity, stress, socialization, and lack of time. Facilitators of weight loss included intrinsic motivation, experiencing early results and confidence in self-regulation. CONCLUSION Women during their perimenopausal phase of life encounter a range of barriers and challenges related to weight loss. An understanding of these barriers might be useful to consider while planning strategies to regulate their weight.
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Chopra S, Ranjan P, Malhotra A, Sarkar S, Kumari A, Kaloiya GS, Dwivedi SN, Siddhu A, Vikram NK. Identification of instruments for evaluation of behavioural and psychological parameters associated with obesity management: A systematic review with narrative synthesis of the findings. Diabetes Metab Syndr 2022; 16:102350. [PMID: 34920204 DOI: 10.1016/j.dsx.2021.102350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/31/2021] [Accepted: 11/21/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS To identify instruments used to evaluate the predictors of successful weight loss across weight loss trials. METHODS We searched PubMed, PsychInfo, Cochrane Reviews and Scopus for weight loss trials reporting instruments published in the last 16 years. RESULTS A total of 46 significant behavioral and psychological predictors were identified, of which 32 instruments were finally selected. SF-36 questionnaire and Obesity Related Problem Scale for psychosocial health, TREMORE scale for motivation, Social Support Scale for support, Weight Efficacy Lifestyle Scale for self-efficacy and Body Shape Questionnaire for body image had moderate quality. Barriers to healthy eating questionnaire scale and Dutch Eating Behavior also had moderate quality. CONCLUSION Use of uniform instruments with optimum quality can benefit clinical and community-based researchers to generate reliable datasets.
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Affiliation(s)
- Sakshi Chopra
- University of Delhi, Department of Home Science, New Delhi, India
| | - Piyush Ranjan
- All India Institute of Medical Sciences, Department of Medicine, New Delhi, India.
| | - Anita Malhotra
- Lakshmibai College, University of Delhi, Department of Home Science, New Delhi, India
| | - Siddharth Sarkar
- All India Institute of Medical Sciences, Department of Psychiatry, New Delhi, India
| | - Archana Kumari
- All India Institute of Medical Sciences, Department of Obstetrics and Gynaecology, New Delhi, India
| | | | - S N Dwivedi
- All India Institute of Medical Sciences, Department of Biostatistics, New Delhi, India
| | - Anupa Siddhu
- University of Delhi, Department of Home Science, New Delhi, India
| | - Naval K Vikram
- All India Institute of Medical Sciences, Department of Medicine, New Delhi, India
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Cheng YC, Liu HC, Hsu CY, Lee IT. Duration of Treatment in a Weight Loss Program Using a Mobile App is Associated with Successful Weight Loss During the COVID-19 Pandemic. Diabetes Metab Syndr Obes 2022; 15:1737-1747. [PMID: 35706478 PMCID: PMC9191578 DOI: 10.2147/dmso.s368608] [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: 04/04/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE We aimed to explore the independent factors associated with successful weight loss using a mobile app during the COVID-19 pandemic. PATIENTS AND METHODS For this retrospective cohort study, we collected data from 45 adults in a weight loss program using a mobile app. We defined successful weight loss as a weight reduction by ≥ 5% of the baseline weight. Multivariate logistic analysis was used to assess potential factors influencing successful weight loss. RESULTS All subjects showed a mean 4.1 ± 4.4 kg reduction of baseline weight after using the app for a mean duration of 11 weeks (P < 0.001). Subjects in the successful weight loss group displayed a longer duration of treatment (14.6 ± 6.5 weeks vs 6.9 ± 6.0 weeks, P < 0.001), greater number of dietary records (109.2 ± 84.7 vs 54.7 ± 58.8, P = 0.002), and greater number of outpatient visits (6.1 ± 2.7 vs 3.7 ± 2.3, P < 0.001) than those in the unsuccessful weight loss group. Multivariate logistic analysis showed that duration of treatment was an independent factor associated with successful weight loss (odds ratio = 1.23, 95% confidence interval: 1.08-1.41, P = 0.003). CONCLUSION In a weight management program using a mobile app during the COVID-19 pandemic, the duration of treatment was found to be an independent factor of successful weight loss.
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Affiliation(s)
- Yu-Cheng Cheng
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 407, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, 112, Taiwan
| | - Hsiu-Chen Liu
- Department of Nursing, Taichung Veterans General Hospital, Taichung, 407, Taiwan
| | - Chiann-Yi Hsu
- Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, 407, Taiwan
| | - I-Te Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 407, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, 112, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, 402, Taiwan
- Correspondence: I-Te Lee, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, 1650, Section 4, Taiwan Boulevard, Taichung City, 40705, Taiwan, Tel +886-4-23592525 ext. 3060, Fax +886-4-23593662, Email
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Kaur D, Malhotra A, Ranjan P, Chopra S, Kumari A, Vikram NK. Weight management in postpartum women - An Indian perspective. Diabetes Metab Syndr 2021; 15:102291. [PMID: 34598009 DOI: 10.1016/j.dsx.2021.102291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/31/2021] [Accepted: 09/13/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS This narrative review is intended to present an evidence and opinion-based weight management module for Indian postpartum women to be used by clinicians. MATERIAL AND METHODS Electronic databases such as PubMed and Google Scholar were accessed to extract relevant studies to derive evidence-based information. The reference list of the extracted studies was also checked to obtain further relevant articles. The opinion-based information was achieved from the consensus among the gynaecologists, nutritionists and doctors from Medicine according to their practical experiences in real time. In this review, we have used the term "postpartum" to represent the time period of two years after delivery. RESULTS A postpartum weight management module consisting of information about diet, physical activity, sleep and breastfeeding was devised to be used in regular clinical practice, particularly in the Indian settings. CONCLUSION Postpartum women deal with various unique challenges as compared to other population groups. Individualised weight management strategies should be adopted to facilitate sustainable postpartum weight management.
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Affiliation(s)
- Divjyot Kaur
- Department of Home Science, University of Delhi, India
| | - Anita Malhotra
- Department of Home Science, Lakshmibai College, University of Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Sakshi Chopra
- Department of Home Science, University of Delhi, India
| | - Archana Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Naval K Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Kemp BJ, Thompson DR, Watson CJ, McGuigan K, Woodside JV, Ski CF. Effectiveness of family-based eHealth interventions in cardiovascular disease risk reduction: A systematic review. Prev Med 2021; 149:106608. [PMID: 33984372 DOI: 10.1016/j.ypmed.2021.106608] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/03/2021] [Accepted: 05/09/2021] [Indexed: 11/15/2022]
Abstract
Family-based eHealth interventions to reduce cardiovascular disease risk have potential as a primary prevention strategy to improve the health of parents and their children. This systematic review evaluated the effectiveness of such interventions in modifying parent and child/adolescent risk factors such as body mass index, physical activity, dietary intakes and alcohol use. Five electronic databases were searched up to April 2020. Of 2193 articles identified, seven randomised controlled trials met inclusion criteria and were reviewed. Data were extracted regarding study setting, design, methods, eHealth technology used, intervention and control group components, retention rates, outcome measures, incentives and limitations. Risk of bias and quality assessment were carried out using Cochrane methods. A qualitative narrative data synthesis of the studies was conducted. Our review found that three studies showed an improvement in alcohol use among parents and adolescents as a result of the eHealth intervention. Among children/adolescents, two studies showed an improvement in dietary intake, one study showed an improvement in physical activity, and one study showed an improvement in body mass index as a result of the eHealth intervention. Interventions appeared more likely to be effective if they were theory-based, had longer follow-up periods, were incentivised and included regular interaction. Our findings suggest that, despite a paucity of high-quality trials, there is some evidence that family-based eHealth interventions have potential to reduce cardiovascular disease risk. However, more sufficiently powered, higher-quality trials with theory driven, clearly described interventions and unambiguous outcomes are needed.
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Affiliation(s)
- Bridie J Kemp
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Chris J Watson
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Karen McGuigan
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Jayne V Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, UK.
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Aras M, Tchang BG, Crawford A, Bledsoe M, Fujioka K, Aronne LJ. Impact of Telemedicine During the COVID-19 Pandemic on Patient Attendance. Obesity (Silver Spring) 2021; 29:1093-1094. [PMID: 33963678 PMCID: PMC8242458 DOI: 10.1002/oby.23180] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 11/12/2022]
Affiliation(s)
- Mohini Aras
- Division of EndocrinologyWeill Cornell MedicineComprehensive Weight Control CenterNew YorkNew YorkUSA
| | - Beverly G. Tchang
- Division of EndocrinologyWeill Cornell MedicineComprehensive Weight Control CenterNew YorkNew YorkUSA
| | - Andrew Crawford
- Division of EndocrinologyWeill Cornell MedicineComprehensive Weight Control CenterNew YorkNew YorkUSA
| | - Melissa Bledsoe
- Center for Weight Management at Scripps HealthSan DiegoCaliforniaUSA
| | - Ken Fujioka
- Center for Weight Management at Scripps HealthSan DiegoCaliforniaUSA
| | - Louis J. Aronne
- Division of EndocrinologyWeill Cornell MedicineComprehensive Weight Control CenterNew YorkNew YorkUSA
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Arora C, Malhotra A, Ranjan P, Vikram NK, Dwivedi SN, Singh N. Perceived barriers and facilitators for adherence to lifestyle prescription: Perspective of obese patients with non alcoholic fatty liver disease from north India. Diabetes Metab Syndr 2021; 15:102138. [PMID: 34186359 DOI: 10.1016/j.dsx.2021.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/06/2021] [Accepted: 05/08/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND AIMS This study aims to identify the barriers and facilitators faced by obese patients with NAFLD from north India, while undergoing lifestyle-modification. METHODS 30 obese patients with NAFLD were interviewed regarding the barriers and facilitators to lifestyle change and responses were noted. Inductive thematic analysis was used. RESULTS Eight themes under barriers (lack of family support, difficult intervention, work-related, financial, psychological, social, physical and infrastructure related) and four themes under facilitators (family support, intensive nature of intervention, psychological and physiological) were identified from the reponses. CONCLUSIONS Personalized and socio-culturally appropriate counseling strategies may promote successful treatment outcomes among these patients.
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Affiliation(s)
- Charu Arora
- Department of Home Science, University of Delhi, Delhi, India
| | - Anita Malhotra
- Department of Home Science, Lakshmibai College, University of Delhi, Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Naval K Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sada Nand Dwivedi
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Singh
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
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Fernández-Rodríguez R, Mesas AE, Garrido-Miguel M, Martínez-Ortega IA, Jiménez-López E, Martínez-Vizcaíno V. The Relationship of Tree Nuts and Peanuts with Adiposity Parameters: A Systematic Review and Network Meta-Analysis. Nutrients 2021; 13:nu13072251. [PMID: 34208812 PMCID: PMC8308485 DOI: 10.3390/nu13072251] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/21/2021] [Accepted: 06/28/2021] [Indexed: 02/07/2023] Open
Abstract
The network meta-analysis and systematic review conducted aim to comparatively assess the effects of tree nuts and peanuts on body weight (BW), body mass index (BMI), waist circumference (WC), and body fat percentage (BF%). A systematic search up to 31 December 2020 was performed. A random-effects network meta-analysis was conducted following the PRISMA-NMA statement. A total of 105 randomized controlled trials (RCTs) with measures of BW (n = 6768 participants), BMI (n = 2918), WC (n = 5045), and BF% (n = 1226) were included. The transitivity assumption was met based on baseline characteristics. In the comparisons of nut consumption versus a control diet, there was no significant increase observed in any of the adiposity-related measures examined except for hazelnut-enriched diets, which raised WC. Moreover, almond-enriched diets significantly reduced WC compared to the control diet and to the pistachio-, mixed nuts-, and hazelnut-enriched diets. In subgroup analyses with only RCTs, designed to assess whether nut consumption affected weight loss, almonds were associated with reduced BMI and walnuts with reduced %BF. The evidence supports that: (1) tree nut and peanut consumption do not influence adiposity, and (2) compared to a control diet, the consumption of almond-enriched diets was associated with a reduced waist circumference.
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Affiliation(s)
- Rubén Fernández-Rodríguez
- Health and Social Research Center, Universidad de Castilla La-Mancha, 16071 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (I.A.M.-O.); (E.J.-L.); (V.M.-V.)
| | - Arthur E. Mesas
- Health and Social Research Center, Universidad de Castilla La-Mancha, 16071 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (I.A.M.-O.); (E.J.-L.); (V.M.-V.)
- Health Science Centre, Universidade Estadual de Londrina, Londrina 86038-350, Brazil
- Correspondence: ; Tel.: +34-969179100 (ext. 4686)
| | - Miriam Garrido-Miguel
- Health and Social Research Center, Universidad de Castilla La-Mancha, 16071 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (I.A.M.-O.); (E.J.-L.); (V.M.-V.)
- Facultad de Enfermería, Universidad de Castilla-La Mancha, 02006 Albacete, Spain
| | - Isabel A. Martínez-Ortega
- Health and Social Research Center, Universidad de Castilla La-Mancha, 16071 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (I.A.M.-O.); (E.J.-L.); (V.M.-V.)
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla La-Mancha, 16071 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (I.A.M.-O.); (E.J.-L.); (V.M.-V.)
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla La-Mancha, 16071 Cuenca, Spain; (R.F.-R.); (M.G.-M.); (I.A.M.-O.); (E.J.-L.); (V.M.-V.)
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 1101, Chile
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