A comparison of diet versus diet + exercise programs for health improvement in middle-aged overweight women

Development and Evaluation of a Mobile Application to Prevent Recurrent Stroke by Enhancing Self-management on Health Outcomes for Stroke Survivors

This study aimed to develop a Mobile Application to Prevent Recurrent Stroke to prevent recurrent stroke by enhancing self-management and to evaluate its effects on stroke survivors' health outcomes. The Mobile Application to Prevent Recurrent Stroke was developed based on social cognitive theory and the model in order of analysis, design, development, implementation, and evaluation process. The Mobile Application to Prevent Recurrent Stroke consisted of health management contents such as information about stroke, its associated risk factors, and required skills to conduct self-management with tailored support and counseling. A quasi-experimental preintervention and postintervention design was used involving a total of 54 stroke survivors. The experimental group (n = 27) was provided the Mobile Application to Prevent Recurrent Stroke for 8 weeks, whereas the control group (n = 27) received an education booklet. The result revealed that medication adherence ( P = .002), healthy eating habit ( P < .001), physical activity ( P < .001), and affected-side grip strength ( P = .002) in the experimental group were significantly better than those in the control group. The systolic blood pressure ( P = .020), diastolic blood pressure ( P < .001), body mass index ( P < .001), and waist circumference ( P < .001) in the experimental group were significantly lower than those in the control group. Stroke survivors can easily use this Mobile Application to Prevent Recurrent Stroke to improve self-management. Nurses can provide tailored care based on the lifelogging data of stroke survivors to prevent recurrent stroke.

Training and retention effects of paced and music-synchronised walking exercises on pre-older females: an interventional study

BACKGROUND

Physical activity at pre-older ages (55-64 years) can greatly affect one's physical fitness, health, physical-activity behaviour, and quality of life at older ages. The objective of this study was to conduct a 24-week walking-exercise programme among sedentary pre-older females and investigate the influence of different walking cadences on cardiorespiratory fitness and associated biomarkers.

METHODS

A total of 78 pre-older sedentary female participants were recruited and randomly assigned to normal (n = 36), paced (n = 15), music-synchronised (n = 15) walking, and no-exercise control (n = 12) groups, respectively. The normal, paced, and music-synchronised walking groups walked at a cadence of 120 steps/min, 125 steps/min, and 120-128 steps/min, respectively, under supervised conditions. Anthropometric characteristics, step length, nutrient intake, blood pressure and composition, and cardiorespiratory fitness were measured at baseline, the 12th week of the programme, the 24th week of the programme (completion), and after a 12-week retention period, which began immediately upon completion of the programme and did not feature any supervised exercises.

RESULTS

All walking conditions improved high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, step length, maximum oxygen consumption (VO₂max), and oxidative capacity at anaerobic threshold (all P < 0.001); however, after the 12-week retention period only the training effects of HDL-C (P < 0.05) and VO₂max (P < 0.05) remained robust. Additionally, music-synchronised walking was found to reduce the fat ratio (P = 0.031), while paced walking was found to reduce body mass (P = 0.049).

CONCLUSIONS

The significant pre-post changes in health-related outcomes across the 24-week walking intervention, including improved blood composition, longer step length, and better cardiorespiratory capacity, show that this intervention is promising for improving health and fitness. When, during the retention period, the participants resumed their usual lifestyles without supervised exercise, most physiological biomarkers deteriorated. Thus, for sedentary middle-aged females, persistent behavioural change is necessary to retain the health benefits of physical exercise.

Executive summary of evidence and consensus-based clinical practice guidelines for management of obesity and overweight in midlife women: An AIIMS-DST initiative

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. The key clinical questions specific to weight management in midlife women were finalized with the help of a multidisciplinary team of experts in the guideline development group. Phase I including a systematic and/or narrative review, 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. 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 health-care 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 behaviors. Before initiating the management, a comprehensive assessment of clinical and lifestyle-related parameters should be completed. A personalized behavioral 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. These recommendations will be useful in opportunistic screening and management of obesity in midlife women across health-care settings.