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Okamura T, Tsukamoto K, Arai H, Fujioka Y, Ishigaki Y, Koba S, Ohmura H, Shoji T, Yokote K, Yoshida H, Yoshida M, Deguchi J, Dobashi K, Fujiyoshi A, Hamaguchi H, Hara M, Harada-Shiba M, Hirata T, Iida M, Ikeda Y, Ishibashi S, Kanda H, Kihara S, Kitagawa K, Kodama S, Koseki M, Maezawa Y, Masuda D, Miida T, Miyamoto Y, Nishimura R, Node K, Noguchi M, Ohishi M, Saito I, Sawada S, Sone H, Takemoto M, Wakatsuki A, Yanai H. Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022. J Atheroscler Thromb 2024; 31:641-853. [PMID: 38123343 DOI: 10.5551/jat.gl2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Tomonori Okamura
- Preventive Medicine and Public Health, Keio University School of Medicine
| | | | | | - Yoshio Fujioka
- Faculty of Nutrition, Division of Clinical Nutrition, Kobe Gakuin University
| | - Yasushi Ishigaki
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Hirotoshi Ohmura
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Tetsuo Shoji
- Department of Vascular Medicine, Osaka Metropolitan University Graduate school of Medicine
| | - Koutaro Yokote
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital
| | | | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University
| | - Kazushige Dobashi
- Department of Pediatrics, School of Medicine, University of Yamanashi
| | | | | | - Masumi Hara
- Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine
| | - Mariko Harada-Shiba
- Cardiovascular Center, Osaka Medical and Pharmaceutical University
- Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center Research Institute
| | - Takumi Hirata
- Institute for Clinical and Translational Science, Nara Medical University
| | - Mami Iida
- Department of Internal Medicine and Cardiology, Gifu Prefectural General Medical Center
| | - Yoshiyuki Ikeda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, School of Medicine
- Current affiliation: Ishibashi Diabetes and Endocrine Clinic
| | - Hideyuki Kanda
- Department of Public Health, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Shinji Kihara
- Medical Laboratory Science and Technology, Division of Health Sciences, Osaka University graduate School of medicine
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University Hospital
| | - Satoru Kodama
- Department of Prevention of Noncommunicable Diseases and Promotion of Health Checkup, Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Masahiro Koseki
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Yoshiro Maezawa
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Daisaku Masuda
- Department of Cardiology, Center for Innovative Medicine and Therapeutics, Dementia Care Center, Doctor's Support Center, Health Care Center, Rinku General Medical Center
| | - Takashi Miida
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine
| | | | - Rimei Nishimura
- Department of Diabetes, Metabolism and Endocrinology, The Jikei University School of Medicine
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Midori Noguchi
- Division of Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University
| | - Shojiro Sawada
- Division of Metabolism and Diabetes, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Hirohito Sone
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Minoru Takemoto
- Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare
| | | | - Hidekatsu Yanai
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Kohnodai Hospital
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Willeke K, Janson P, Kirchner A, Tischer C, D'Souza A, Heuschmann PU, Zapf A, Wildner M, Stupp C, Keil T. Effects of occupational health promotion interventions on health-related outcomes among employees of small businesses and self-employed individuals: A systematic review. Work 2024:WOR230441. [PMID: 38848153 DOI: 10.3233/wor-230441] [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: 06/09/2024] Open
Abstract
BACKGROUND Compared to workers of larger companies it is less clear what health promoting interventions might be beneficial for employees of small businesses and self-employed individuals. OBJECTIVE Our aim was to critically appraise trials investigating health promotion programs among small business workers and self-employed individuals, by means of a systematic review. METHODS We conducted a search of primary studies using MEDLINE, Web of Science, LIVIVO and the Cochrane library. Our assessment followed the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA. RESULTS We identified six trials including 5,854 participants from Asia, North America and Australia. Most were of moderate methodological quality, only one was of low quality. Some of the supervised psycho-educational lifestyle programs focusing on individual behavior changes showed benefits in terms of stress reduction and increased physical activity levels among small enterprise employees. CONCLUSIONS There is a huge knowledge gap on evidence-based health promotion interventions for self-employed and for small business workers, especially in Europe.
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Affiliation(s)
- Kristina Willeke
- State Institute of Health I, Bavarian Health and Food Safety Authority, Erlangen, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Patrick Janson
- State Institute of Health I, Bavarian Health and Food Safety Authority, Erlangen, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Anna Kirchner
- State Institute of Health I, Bavarian Health and Food Safety Authority, Erlangen, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Christina Tischer
- State Institute of Health I, Bavarian Health and Food Safety Authority, Erlangen, Germany
- Department of Health Security, Finnish Institute of Health and Welfare, Kuopio, Finland
| | - Arun D'Souza
- State Institute of Health I, Bavarian Health and Food Safety Authority, Erlangen, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Peter U Heuschmann
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Clinical Trial Center Würzburg, University Hospital Würzburg, Würzburg, Germany
| | - Andreas Zapf
- Bavarian State Ministry of the Environment and Consumer Protection, Munich, Germany
- Pettenkofer School of Public Health, University of Munich, Munich, Germany
| | - Manfred Wildner
- State Institute of Health I, Bavarian Health and Food Safety Authority, Erlangen, Germany
- Pettenkofer School of Public Health, University of Munich, Munich, Germany
| | - Carolin Stupp
- State Institute of Health I, Bavarian Health and Food Safety Authority, Erlangen, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Thomas Keil
- State Institute of Health I, Bavarian Health and Food Safety Authority, Erlangen, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Yao W, Han Y, Yang L, Chen Y, Yan S, Cheng Y. Electronic Interactive Games for Glycemic Control in Individuals With Diabetes: Systematic Review and Meta-Analysis. JMIR Serious Games 2024; 12:e43574. [PMID: 38345856 PMCID: PMC10897792 DOI: 10.2196/43574] [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: 10/16/2022] [Revised: 05/05/2023] [Accepted: 10/24/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Several electronic interventions have been used to improve glycemic control in patients with diabetes. Electronic interactive games specific to physical activity are available, but it is unclear if these are effective at improving glycemic control in patients with diabetes. OBJECTIVE This study aimed to determine the effects of electronic game-based interventions on glycemic control in patients with diabetes. METHODS Relevant studies that were published before April 1, 2023, were searched from 5 databases: PubMed, Embase, Web of Science, Scopus, and Cochrane Library. Eligibility criteria included prospective studies examining the relationship between electronic games with physical activities or diet education and glycemic control as the outcome. The risk of bias was assessed using the Cochrane risk-of-bias tool. All analyses were conducted using RevMan5.4.1. Depending on the heterogeneity across studies, the pooled effects were calculated using fixed-effects or random-effects models. RESULTS Participants from 9 studies were included and assessed. Glycated hemoglobin (HbA1c) and fasting blood glucose improved in the intervention group, although the analysis revealed no significant reduction in HbA1c (-0.09%, 95% CI -0.29% to 0.10%) or fasting blood glucose (-0.94 mg/dL, 95% CI -9.34 to 7.46 mg/dL). However, the physical activity of individuals in the intervention group was significantly higher than that of those in the control group (standardized mean difference=0.84, 95% CI 0.30 to 1.38; P=.002). Other outcomes, such as weight and blood lipids, exhibited no significant improvement (all P>.05). CONCLUSIONS Electronic games had a good impact on participants' physical activity and offered an advantage in glycemic control without reaching statistical significance. Electronic games are convenient for reminders and education. Low-intensity exercise games may not be considered a better adjuvant intervention to improve diabetes self-management care.
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Affiliation(s)
- WenQi Yao
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - YiBing Han
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Li Yang
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
- Department of Nutrition, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Ying Chen
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - ShengZhe Yan
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - YanZhen Cheng
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
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Cha JY, Kim SY, Lim YW, Choi KH, Shin IS. Comparative Effectiveness of Cognitive Behavioral Therapy and Behavioral Therapy in Obesity: A Systematic Review and Network Meta-Analysis. J Clin Psychol Med Settings 2024:10.1007/s10880-023-10000-6. [PMID: 38285378 DOI: 10.1007/s10880-023-10000-6] [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: 12/15/2023] [Indexed: 01/30/2024]
Abstract
We aimed to evaluate the effects of obesity treatment with behavioral therapy (BT) and cognitive behavioral therapy (CBT) interventions compared with multiple comparators and find effective techniques or combinations of techniques in BT and CBT interventions for weight loss. We systematically searched electronic databases and selected randomized controlled trials using CBT or BT intervention for obesity treatment in overweight adults or adults with obesity without psychological symptoms. Both pairwise meta-analysis and network meta-analysis were performed to comprehensively evaluate the comparative effects between interventions. We classified the techniques used in BT and CBT interventions and compared the treatment effects between techniques. Compared with no treatment as a common comparator, CBT was most effective for weight loss, followed by BT, usual care (UC), and minimal care (MC). CBT was a more effective intervention than BT, but the effect of CBT compared to BT was not remarkable in network estimates. The most used BT techniques were feedback and monitoring, and the most used CBT technique was cognitive restructuring. Our results indicated that CBT and BT are effective interventions for weight loss, and that successful weight loss requires more aggressive interventions such as BT or CBT than MC and UC.
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Affiliation(s)
- Jin-Young Cha
- Nubebe Obesity Research Institute, Seoul, South Korea
| | - Seo-Young Kim
- Nubebe Obesity Research Institute, Seoul, South Korea
- Nubebe Korean Medical Clinic (Incheon Center), Incheon, South Korea
| | - Young-Woo Lim
- Nubebe Obesity Research Institute, Seoul, South Korea
- Nubebe Korean Medical Clinic (Bundang Center), Seongnam, South Korea
| | - Ka-Hye Choi
- Nubebe Korean Medical Clinic (Hongdae Center), Seoul, South Korea
| | - In-Soo Shin
- Graduate School of Education, Dongguk University, 30, Pildong-ro 1 gil, Jung-gu, Seoul, 04620, South Korea.
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Stubelj M, Širok K, Laporšek S, Perčič S. Factors Influencing the Degree of Employee Involvement in Preventive Nutrition and Physical Activity Web-Based Programs in Medium and Small Enterprises. Nutrients 2023; 15:5129. [PMID: 38140388 PMCID: PMC10747149 DOI: 10.3390/nu15245129] [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: 11/05/2023] [Revised: 12/15/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
This cross-sectional study was part of a comprehensive workplace health promotion program (WHPP) implemented in the work environment of small- and medium-sized enterprises (SMEs) in Western Slovenia, which included web-based educational campaigns aimed at promoting positive lifestyle changes among workers, including healthy eating habits and physical activity. As part of this program, which included campaigns in the areas of stress management, ergonomics, sleep hygiene, communication, work climate, and absenteeism, we developed and examined the engagement frequency in web-based content on healthy eating and physical activity for the companies included in the WHPP. This part of the project lasted from 2020 to 2022. Prior to the educational campaign, participants voluntarily completed a screening questionnaire. We analyzed the patterns of 370 workers in terms of their job classification (predominantly sedentary, predominantly standing, or predominantly physical), body mass index (BMI), gender, age, and selected indicators of diet and physical activity. Of the 88 companies participating in the WHPP, 26 took part in our web-based educational campaigns on nutrition and physical activity. Through an empirical analysis using descriptive and inferential statistics and a linear regression, we found that, on average, the engagement frequency (i.e., proportion of educational personal e-mails read) was highest among men with sedentary work, with older employees participating more actively than expected. Moreover, workers with good dietary habits and a favorable BMI proved to be the most avid readers of the web-based campaigns. Despite the overall low participant engagement frequency, it is clear that web-based educational campaigns are more appealing to workers with sedentary jobs and good dietary habits. This study provides valuable information on the potential effectiveness of appropriate workplace health promotion campaigns for SMEs and public health practices.
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Affiliation(s)
- Mojca Stubelj
- Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenia; (M.S.); (K.Š.)
| | - Klemen Širok
- Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenia; (M.S.); (K.Š.)
| | - Suzana Laporšek
- Faculty of Management, University of Primorska, 6000 Koper, Slovenia;
| | - Simona Perčič
- National Institute of Public Health Ljubljana, 1000 Ljubljana, Slovenia
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Morgan-Bathke M, Baxter SD, Halliday TM, Lynch A, Malik N, Raynor HA, Garay JL, Rozga M. Weight Management Interventions Provided by a Dietitian for Adults with Overweight or Obesity: An Evidence Analysis Center Systematic Review and Meta-Analysis. J Acad Nutr Diet 2023; 123:1621-1661.e25. [PMID: 35788061 DOI: 10.1016/j.jand.2022.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 03/04/2022] [Accepted: 03/21/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Obesity is associated with a multitude of comorbidities and considerable health care costs. OBJECTIVE The objective of this review was to examine the efficacy of weight management interventions provided by a registered dietitian or international equivalent (referred to as "dietitian"). METHODS This systematic review and meta-analysis of randomized controlled trials (RCTs) examined the effect of weight management interventions provided by a dietitian, compared with usual care or no intervention, on several cardiometabolic outcomes and quality of life in adults with overweight or obesity. MEDLINE, Embase, PsycINFO, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, and CINAHL databases were searched for eligible RCTs published between January 2008 and January 2021 in the English language. Meta-analyses were conducted using a random-effects model, publication bias was assessed using funnel plots and Egger's statistics, and heterogeneity was assessed by interpreting I2 values. Efficacy of intervention components, such as telehealth or group contacts, were explored in sub-group analyses. Version 2 of the risk-of-bias tool for RCTs was used to assess risk of bias. The Grading of Recommendations Assessment, Development and Evaluation method was used to determine certainty of evidence. RESULTS This systematic review included 62 RCTs. Compared with control conditions, weight management interventions provided by a dietitian resulted in improved body mass index (mean difference [MD] -1.5; 95% CI -1.74 to -1.26; moderate evidence certainty); percent weight loss (MD -4.01%; 95% CI -5.26% to -2.75%; high evidence certainty); waist circumference (MD -3.45 cm; 95% CI -4.39 to -2.51 cm; high evidence certainty); blood pressure (MD -3.04 mm Hg; 95% CI -5.10 to -0.98 mm Hg and MD -1.99 mm Hg; 95% CI -3.02 to -0.96 mm Hg for systolic blood pressure and diastolic blood pressure, respectively; moderate and low evidence certainty); and quality of life using the 36-Item Short Form Survey (MD 5.84; 95% CI 2.27 to 9.41 and 2.39; 95% CI 1.55 to 3.23 for physical and mental quality of life, respectively; low and moderate evidence certainty). CONCLUSIONS For adults with overweight or obesity, weight management interventions provided by a dietitian are efficacious for improving several examined cardiometabolic outcomes and quality of life.
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Affiliation(s)
| | | | - Tanya M Halliday
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT
| | - Amanda Lynch
- Department of Interdisciplinary Health Sciences, Oakland University, Rochester, MI
| | - Neal Malik
- Department of Health Science and Human Ecology, California State University, San Bernardino, San Bernardino, CA
| | - Hollie A Raynor
- College of Education, Health, and Human Sciences, University of Tennessee Knoxville, Knoxville, TN
| | - Jessica L Garay
- Department of Nutrition and Food Studies, Syracuse University, Syracuse NY
| | - Mary Rozga
- Academy of Nutrition and Dietetics, Chicago, IL.
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Jamshidi-Naeini Y, Roberts SB, Dickinson S, Owora A, Agley J, Zoh RS, Chen X, Allison DB. Factors associated with choice of behavioural weight loss program by adults with obesity. Clin Obes 2023; 13:e12591. [PMID: 37038768 PMCID: PMC10524530 DOI: 10.1111/cob.12591] [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: 11/23/2022] [Revised: 02/24/2023] [Accepted: 03/12/2023] [Indexed: 04/12/2023]
Abstract
We assessed the preference for two behavioural weight loss programs, Diabetes Prevention Program (DPP) and Healthy Weight for Living (HWL) in adults with obesity. A cross-sectional survey was fielded on the Amazon Mechanical Turk. Eligibility criteria included reporting BMI ≥30 and at least two chronic health conditions. Participants read about the programs, selected their preferred program, and answered follow-up questions. The estimated probability of choosing either program was not significantly different from .5 (N = 1005, 50.8% DPP and 49.2% HWL, p = .61). Participants' expectations about adherence, weight loss magnitude, and dropout likelihood were associated with their choice (p < .0001). Non-White participants (p = .040) and those with monthly income greater than $4999 (p = .002) were less likely to choose DPP. Participants who had postgraduate education (p = .007), did not report high serum cholesterol (p = .028), and reported not having tried losing weight before (p = .025) were more likely to choose DPP. Those who chose HWL were marginally more likely to report that being offered two different programs rather than one would likely affect their decision to enrol in one of the two (p = .052). The enrolment into DPP and HWL was balanced, but race, educational attainment, income, previous attempt to lose weight, and serum cholesterol levels had significant associations with the choice of weight loss program.
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Affiliation(s)
- Yasaman Jamshidi-Naeini
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Susan B. Roberts
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Stephanie Dickinson
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Arthur Owora
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Jon Agley
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Roger S. Zoh
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Xiwei Chen
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - David B. Allison
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
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Chekima K, Yan SW, Lee SWH, Wong TZ, Noor MI, Ooi YB, Metzendorf MI, Lai NM. Low glycaemic index or low glycaemic load diets for people with overweight or obesity. Cochrane Database Syst Rev 2023; 6:CD005105. [PMID: 37345841 PMCID: PMC10313499 DOI: 10.1002/14651858.cd005105.pub3] [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] [Indexed: 06/23/2023]
Abstract
BACKGROUND The prevalence of obesity is increasing worldwide, yet nutritional management remains contentious. It has been suggested that low glycaemic index (GI) or low glycaemic load (GL) diets may stimulate greater weight loss than higher GI/GL diets or other weight reduction diets. The previous version of this review, published in 2007, found mainly short-term intervention studies. Since then, randomised controlled trials (RCTs) with longer-term follow-up have become available, warranting an update of this review. OBJECTIVES To assess the effects of low glycaemic index or low glycaemic load diets on weight loss in people with overweight or obesity. SEARCH METHODS We searched CENTRAL, MEDLINE, one other database, and two clinical trials registers from their inception to 25 May 2022. We did not apply any language restrictions. SELECTION CRITERIA We included RCTs with a minimum duration of eight weeks comparing low GI/GL diets to higher GI/GL diets or any other diets in people with overweight or obesity. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. We conducted two main comparisons: low GI/GL diets versus higher GI/GL diets and low GI/GL diets versus any other diet. Our main outcomes included change in body weight and body mass index, adverse events, health-related quality of life, and mortality. We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS In this updated review, we included 10 studies (1210 participants); nine were newly-identified studies. We included only one study from the previous version of this review, following a revision of inclusion criteria. We listed five studies as 'awaiting classification' and one study as 'ongoing'. Of the 10 included studies, seven compared low GI/GL diets (233 participants) with higher GI/GL diets (222 participants) and three studies compared low GI/GL diets (379 participants) with any other diet (376 participants). One study included children (50 participants); one study included adults aged over 65 years (24 participants); the remaining studies included adults (1136 participants). The duration of the interventions varied from eight weeks to 18 months. All trials had an unclear or high risk of bias across several domains. Low GI/GL diets versus higher GI/GL diets Low GI/GL diets probably result in little to no difference in change in body weight compared to higher GI/GL diets (mean difference (MD) -0.82 kg, 95% confidence interval (CI) -1.92 to 0.28; I2 = 52%; 7 studies, 403 participants; moderate-certainty evidence). Evidence from four studies reporting change in body mass index (BMI) indicated low GI/GL diets may result in little to no difference in change in BMI compared to higher GI/GL diets (MD -0.45 kg/m2, 95% CI -1.02 to 0.12; I2 = 22%; 186 participants; low-certainty evidence)at the end of the study periods. One study assessing participants' mood indicated that low GI/GL diets may improve mood compared to higher GI/GL diets, but the evidence is very uncertain (MD -3.5, 95% CI -9.33 to 2.33; 42 participants; very low-certainty evidence). Two studies assessing adverse events did not report any adverse events; we judged this outcome to have very low-certainty evidence. No studies reported on all-cause mortality. For the secondary outcomes, low GI/GL diets may result in little to no difference in fat mass compared to higher GI/GL diets (MD -0.86 kg, 95% CI -1.52 to -0.20; I2 = 6%; 6 studies, 295 participants; low certainty-evidence). Similarly, low GI/GL diets may result in little to no difference in fasting blood glucose level compared to higher GI/GL diets (MD 0.12 mmol/L, 95% CI 0.03 to 0.21; I2 = 0%; 6 studies, 344 participants; low-certainty evidence). Low GI/GL diets versus any other diet Low GI/GL diets probably result in little to no difference in change in body weight compared to other diets (MD -1.24 kg, 95% CI -2.82 to 0.34; I2 = 70%; 3 studies, 723 participants; moderate-certainty evidence). The evidence suggests that low GI/GL diets probably result in little to no difference in change in BMI compared to other diets (MD -0.30 kg in favour of low GI/GL diets, 95% CI -0.59 to -0.01; I2 = 0%; 2 studies, 650 participants; moderate-certainty evidence). Two adverse events were reported in one study: one was not related to the intervention, and the other, an eating disorder, may have been related to the intervention. Another study reported 11 adverse events, including hypoglycaemia following an oral glucose tolerance test. The same study reported seven serious adverse events, including kidney stones and diverticulitis. We judged this outcome to have low-certainty evidence. No studies reported on health-related quality of life or all-cause mortality. For the secondary outcomes, none of the studies reported on fat mass. Low GI/GL diets probably do not reduce fasting blood glucose level compared to other diets (MD 0.03 mmol/L, 95% CI -0.05 to 0.12; I2 = 0%; 3 studies, 732 participants; moderate-certainty evidence). AUTHORS' CONCLUSIONS: The current evidence indicates there may be little to no difference for all main outcomes between low GI/GL diets versus higher GI/GL diets or any other diet. There is insufficient information to draw firm conclusions about the effect of low GI/GL diets on people with overweight or obesity. Most studies had a small sample size, with only a few participants in each comparison group. We rated the certainty of the evidence as moderate to very low. More well-designed and adequately-powered studies are needed. They should follow a standardised intervention protocol, adopt objective outcome measurement since blinding may be difficult to achieve, and make efforts to minimise loss to follow-up. Furthermore, studies in people from a wide range of ethnicities and with a wide range of dietary habits, as well as studies in low- and middle-income countries, are needed.
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Affiliation(s)
- Khadidja Chekima
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - See Wan Yan
- School of Hospitality Management, Macao Institute for Tourism Studies, Macao, Macao
| | | | - Tziak Ze Wong
- School of Food Studies and Gastronomy, Taylor's University, Subang Jaya, Malaysia
| | - Mohd Ismail Noor
- School of Culinary Arts and Food Studies, Taylor's University, Subang Jaya, Malaysia
- Faculty of Medicine and Health Sciences, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Yasmin Bh Ooi
- Faculty of Food Science and Nutrition, University Malaysia Sabah (UMS), Kota Kinabalu, Malaysia
| | - Maria-Inti Metzendorf
- Institute of General Practice, Medical Faculty of the Heinrich-Heine University, Düsseldorf, Germany
| | - Nai Ming Lai
- School of Medicine, Taylor's University, Subang Jaya, Malaysia
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Perkison WB, Rodriguez SA, Velasco-Huerta F, Mathews PD, Pulicken C, Beg SS, Heredia NI, Fwelo P, White GE, Reininger BM, McWhorter JW, Chenier R, Fernandez ME. Application of implementation mapping to develop strategies for integrating the National Diabetes Prevention Program into primary care clinics. Front Public Health 2023; 11:933253. [PMID: 37181720 PMCID: PMC10169622 DOI: 10.3389/fpubh.2023.933253] [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: 04/30/2022] [Accepted: 03/27/2023] [Indexed: 05/16/2023] Open
Abstract
Background Diabetes is considered one of the most prevalent and preventable chronic health conditions in the United States. Research has shown that evidence-based prevention measures and lifestyle changes can help lower the risk of developing diabetes. The National Diabetes Prevention Program (National DPP) is an evidence-based program recognized by the Centers for Disease Control and Prevention; it is designed to reduce diabetes risk through intensive group counseling in nutrition, physical activity, and behavioral management. Factors known to influence this program's implementation, especially in primary care settings, have included limited awareness of the program, lack of standard clinical processes to facilitate referrals, and limited reimbursement incentives to support program delivery. A framework or approach that can address these and other barriers of practice is needed. Objective We used Implementation Mapping, a systematic planning framework, to plan for the adoption, implementation, and maintenance of the National DPP in primary care clinics in the Greater Houston area. We followed the framework's five iterative tasks to develop strategies that helped to increase awareness and adoption of the National DPP and facilitate program implementation. Methods We conducted a needs assessment survey and interviews with participating clinics. We identified clinic personnel who were responsible for program use, including adopters, implementers, maintainers, and potential facilitators and barriers to program implementation. The performance objectives, or sub-behaviors necessary to achieve each clinic's goals, were identified for each stage of implementation. We used classic behavioral science theory and dissemination and implementation models and frameworks to identify the determinants of program adoption, implementation, and maintenance. Evidence- and theory-based methods were selected and operationalized into tailored strategies that were executed in the four participating clinic sites. Implementation outcomes are being measured by several different approaches. Electronic Health Records (EHR) will measure referral rates to the National DPP. Surveys will be used to assess the level of the clinic providers and staff's acceptability, appropriateness of use, feasibility, and usefulness of the National DPP, and aggregate biometric data will measure the level of the clinic's disease management of prediabetes and diabetes. Results Participating clinics included a Federally Qualified Health Center, a rural health center, and two private practices. Most personnel, including the leadership at the four clinic sites, were not aware of the National DPP. Steps for planning implementation strategies included the development of performance objectives (implementation actions) and identifying psychosocial and contextual implementation determinants. Implementation strategies included provider-to-provider education, electronic health record optimization, and the development of implementation protocols and materials (e.g., clinic project plan, policies). Conclusion The National DPP has been shown to help prevent or delay the development of diabetes among at-risk patients. Yet, there remain many challenges to program implementation. The Implementation Mapping framework helped to systematically identify implementation barriers and facilitators and to design strategies to address them. To further advance diabetes prevention, future program, and research efforts should examine and promote other strategies such as increased reimbursement or use of incentives and a better billing infrastructure to assist in the scale and spread of the National DPP across the U.S.
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Affiliation(s)
- William B. Perkison
- The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
- Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Serena A. Rodriguez
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
- The University of Texas Health Science Center School of Public Health, Dallas, TX, United States
| | - Fernanda Velasco-Huerta
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Patenne D. Mathews
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Catherine Pulicken
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Sidra S. Beg
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Natalia I. Heredia
- The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Pierre Fwelo
- The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Grace E. White
- The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Belinda M. Reininger
- The University of Texas Health Science Center School of Public Health, Brownsville, TX, United States
| | - John W. McWhorter
- The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Roshanda Chenier
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Maria E. Fernandez
- The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
- Institute for Implementation Science, The University of Texas Health Science Center at Houston, Houston, TX, United States
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10
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Schaller N, Blume K, Hornig M, Senker L, Wolfarth B, Schuster T, Halle M, Esefeld K. Occupational life-style programme over 12 months and changes of metabolic risk profile, vascular function, and physical fitness in blue-collar workers. J Occup Med Toxicol 2023; 18:4. [PMID: 36949505 PMCID: PMC10031996 DOI: 10.1186/s12995-023-00370-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 03/07/2023] [Indexed: 03/24/2023] Open
Abstract
PURPOSE Occupational health programmes have been successfully implemented to improve body composition, physical fitness and cardiovascular risk. However, most programmes have been small and have not included long-term evaluation. Therefore, we evaluated a twelve-month life-style change programme in a German refinery. METHODS We offered a supervised six-week endurance exercise programme (2 × 90 min/week), starting after a two-day life-style seminar. After the active intervention and a half-day refresher seminar, employees were encouraged to continue exercising over one year on their own, with monthly supervised sessions to maintain adherence. Anthropometry, bicycle ergometry, cardio-metabolic risk profile, inflammatory parameters, and vascular function e.g. endothelial function was studied at baseline, after three and after twelve months. RESULTS Of 550 employees, n = 327 (age 40.8 ± 9.7 years, 88% males) participated in the study. Twelve-month intervention was associated with a reduced waist circumference (92.6 ± 12.2 to 90.8 ± 11.7 cm, 95% confidence interval for the mean change (CI): -2.5 to -1.1 cm) and a gain in maximal exercise capacity (202 ± 39.6 to 210 ± 38.9 Watt; 95% CI: + 5.1 to + 10.9 Watt). Metabolic and inflammatory parameters likewise HbA1c and C-reactive protein improved in central tendency at a local 95% level of confidence. Vascular function e.g. Reactive-Hyperaemia-Index revealed a slight reduction, whereas no statistically robust changes in mean Cardio-Ankle-Vascular-Index and mean Ankle-Brachial-Index were observed. CONCLUSION Health education added by a six-week supervised exercise programme was associated with minor long-term twelve-month improvements of body composition as well as physical fitness and a concomitant improvement of inflammatory state. These changes were, however, not clinically relevant and not accompanied by statistically robust improvements of vascular function. TRIAL REGISTRATION ClinTrialsGov: NCT01919632; date of registration: August 9, 2013; retrospectively registered.
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Affiliation(s)
- Nina Schaller
- Department of Prevention, Rehabilitation and Sports Medicine, University Hospital (Klinikum rechts der Isar), Technical University of Munich, Georg-Brauchle-Ring 56, 80992, Munich, Germany.
| | - Katharina Blume
- Department of Prevention, Rehabilitation and Sports Medicine, University Hospital (Klinikum rechts der Isar), Technical University of Munich, Georg-Brauchle-Ring 56, 80992, Munich, Germany
- Department of Sports Medicine, Humboldt-University, Charité University Medicine, Berlin, Germany
| | - Markus Hornig
- Moving - Gesundheitsmanagement GmbH, Berlin, Germany
| | - Ludger Senker
- Occupational Medicine Centers Northwest e.V. (Arbeitsmedizinische Zentren Nordwest e.V.), AMZ Lingen (Ems), Nordhorn, Germany
- BP Europa SE, Lingen Refinery, Lingen (Ems), Germany
| | - Bernd Wolfarth
- Department of Prevention, Rehabilitation and Sports Medicine, University Hospital (Klinikum rechts der Isar), Technical University of Munich, Georg-Brauchle-Ring 56, 80992, Munich, Germany
- Department of Sports Medicine, Humboldt-University, Charité University Medicine, Berlin, Germany
- Department of Sports Medicine, Institute for Applied Scientific Training, Leipzig, Germany
| | - Tibor Schuster
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Martin Halle
- Department of Prevention, Rehabilitation and Sports Medicine, University Hospital (Klinikum rechts der Isar), Technical University of Munich, Georg-Brauchle-Ring 56, 80992, Munich, Germany
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Partner Site Munich, Munich Heart Alliance, Munich, Germany
| | - Katrin Esefeld
- Department of Prevention, Rehabilitation and Sports Medicine, University Hospital (Klinikum rechts der Isar), Technical University of Munich, Georg-Brauchle-Ring 56, 80992, Munich, Germany
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11
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Morgan-Bathke M, Raynor HA, Baxter SD, Halliday TM, Lynch A, Malik N, Garay JL, Rozga M. Medical Nutrition Therapy Interventions Provided by Dietitians for Adult Overweight and Obesity Management: An Academy of Nutrition and Dietetics Evidence-Based Practice Guideline. J Acad Nutr Diet 2023; 123:520-545.e10. [PMID: 36462613 DOI: 10.1016/j.jand.2022.11.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022]
Abstract
Overweight and obesity affect most adults living in the United States and are causally linked to several adverse health outcomes. Registered dietitian nutritionists or international equivalents (dietitians) collaborate with each client and other health care professionals to meet client-centered goals, informed by the best available evidence, and translated through a lens of clinical expertise and client circumstances and preferences. Since the last iteration of the Academy of Nutrition and Dietetics guideline on adult weight management in 2014, considerable research has been conducted and circumstances confronting dietitians have evolved. Thus, updated guidance is needed. The objective of this evidence-based practice guideline is to provide recommendations for dietitians who deliver medical nutrition therapy behavioral interventions for adults (18 years and older) with overweight and obesity to improve cardiometabolic outcomes, quality of life, and weight outcomes, when appropriate for and desired by the client. Recommendations in this guideline highlight the importance of considering complex contributors to overweight and obesity and individualizing interventions to client-centered goals based on specific needs and preferences and shared decision making. The described recommendations have the potential to increase access to care and decrease costs through utilization of telehealth and group counseling as effective delivery methods, and to address other barriers to overweight and obesity management interventions. It is essential for dietitians to collaborate with clients and interprofessional health care teams to provide high-quality medical nutrition therapy interventions using the nutrition care process to promote attainment of client-centered outcomes for adults with overweight or obesity.
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Affiliation(s)
- Maria Morgan-Bathke
- Department of Nutrition and Dietetics, Viterbo University, La Crosse, Wisconsin
| | - Hollie A Raynor
- College of Education, Health, and Human Sciences, University of Tennessee, Knoxville, Tennessee
| | | | - Tanya M Halliday
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah
| | - Amanda Lynch
- Department of Interdisciplinary Health Sciences, Oakland University, Rochester, MI
| | - Neal Malik
- Department of Health Science and Human Ecology, California State University, San Bernardino, San Bernardino, California
| | - Jessica L Garay
- Department of Nutrition and Food Studies, Syracuse University, Syracuse
| | - Mary Rozga
- Academy of Nutrition and Dietetics, Chicago, Illinois.
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12
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Das SK, Silver RE, Vail TA, Chin MK, Blanchard CM, Dickinson SL, Chen X, Ceglia L, Saltzman E, Allison DB, Roberts SB. Randomized controlled trial of a novel lifestyle intervention used with or without meal replacements in work sites. Obesity (Silver Spring) 2023; 31:374-389. [PMID: 36695057 PMCID: PMC10184298 DOI: 10.1002/oby.23636] [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: 06/24/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Lifestyle interventions have had limited effectiveness in work sites when evaluated in randomized trials. This study assessed the effectiveness of a novel lifestyle intervention for weight loss (Healthy Weight for Living [HWL]) implemented with or without meal replacements (MR) in work sites. HWL used a new behavioral approach emphasizing reducing hunger and building healthy food preferences, and, unlike traditional lifestyle interventions, it did not require calorie counting. METHODS Twelve work sites were randomized to an 18-month intervention (n = 8; randomization within work sites to HWL, HWL + MR) or 6-month wait-listed control (n = 4). Participants were employees with overweight or obesity (N = 335; age = 48 [SD 10] years; BMI = 33 [6] kg/m2 ; 83% female). HWL was group-delivered in person or by videoconference. The primary outcome was 6-month weight change; secondary outcomes included weight and cardiometabolic risk factors measured at 6, 12, and 18 months in intervention groups. RESULTS Mean 6-month weight change was -8.8% (95% CI: -11.2% to -6.4%) for enrollees in HWL and -8.0% (-10.4% to -5.5%) for HWL + MR (p < 0.001 for both groups vs. controls), with no difference between interventions (p = 0.40). Clinically meaningful weight loss (≥5%) was maintained at 18 months in both groups (p < 0.001). CONCLUSIONS A new lifestyle intervention approach, deliverable by videoconference with or without MR, supported clinically impactful weight loss in employees.
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Affiliation(s)
- Sai Krupa Das
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Rachel E. Silver
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Taylor A. Vail
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Meghan K. Chin
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Caroline M. Blanchard
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Stephanie L. Dickinson
- Department of Epidemiology, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Xiwei Chen
- Department of Epidemiology, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Lisa Ceglia
- Division of Endocrinology, Diabetes, and Metabolism, Tufts Medical Center, Boston, MA, USA
| | - Edward Saltzman
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - David B. Allison
- Department of Epidemiology, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Susan B. Roberts
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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13
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Nailufar F, Khomsan A, Baliwati YF, Riyadi H. The Effectiveness of Implementation of Healthy Living Community Movement in Overcoming Metabolic Syndrome Among Female Workers in East Kalimantan, Indonesia. CURRENT RESEARCH IN NUTRITION AND FOOD SCIENCE JOURNAL 2022. [DOI: 10.12944/crnfsj.10.3.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The metabolic syndrome occurs in almost 25% of the world’s adult population. A workplace is an ideal place for implementing health interventions to reduce metabolic syndrome risk factor. One of the Indonesian government’s health programs to improve public health and prevent non-communicable diseases is called Healthy Living Community Movement (HLCM). This research aims to determine the effectiveness of HLCM implementation to overcome metabolic syndrome among female workers in Indonesia. This quasi-experimental study included 42 female workers with metabolic syndrome, which were divided into an intervention group and a control group. The intervention group was given an 8-weeks combination of health education and implementation of HLCM activities that consisted of fruit and vegetables provision as much as 400 grams per day and physical exercise for at least 150 minutes per week. The intervention for control group included only health education. Subjects’ parameters were measured and adherence to HLCM activities was evaluated by a questionnaire. Adherence to HLCM implementation was carried out by 52.4% of the subjects which resulted in a significant reduction in their waist circumference, systolic and diastolic blood pressure, and triglyceride levels (p < 0.05, respectively). After 8 weeks of interventions, 13 subjects (65%) from the intervention group were no longer included in the metabolic syndrome criteria, while in the control group only 2 subjects (10.5%) were not included. Therefore, the implementation of HLCM in the workplace is effective in overcoming the metabolic syndrome.
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Affiliation(s)
- Farida Nailufar
- 1Department of Nutrition, Health Polytechnic of East Kalimantan, Indonesia
| | - Ali Khomsan
- 2Department of Community Nutrition, Faculty of Human Ecology, IPB University, Bogor, Indonesia
| | - Yayuk Farida Baliwati
- 2Department of Community Nutrition, Faculty of Human Ecology, IPB University, Bogor, Indonesia
| | - Hadi Riyadi
- 2Department of Community Nutrition, Faculty of Human Ecology, IPB University, Bogor, Indonesia
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14
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Dao MC, Yu Z, Maafs‐Rodríguez A, Moser B, Cuevas AG, Economos CD, Roberts SB. Perceived intrinsic, social, and environmental barriers for weight management in older Hispanic/Latino adults with obesity. Obes Sci Pract 2022; 9:145-157. [PMID: 37034568 PMCID: PMC10073816 DOI: 10.1002/osp4.631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 11/07/2022] Open
Abstract
Background The burden of obesity and chronic disease is increasing in the older US Hispanic/Latino adult population. There is limited evidence on successful weight management strategies as perceived by this population. Assessing barriers and opportunities for weight management using mixed methods is a robust approach to collect in-depth information that can be applied to the development of well-tailored weight management interventions for this population. Objective The objective of this study was to assess perceived individual, interpersonal, and environmental factors that influence weight management in older Hispanic/Latino adults. Methods This community-based cross-sectional study included 23 Hispanic/Latino older (>50y) adults with obesity (BMI >30 kg/m2). Perceived barriers and opportunities for weight management were assessed through validated questionnaires and focus groups. Prospectively registered on ClinicalTrials.gov (NCT03978416) on 7 June 2019. Results In this demographically heterogeneous population, language acculturation was generally low, and the frequency of poor dietary behaviors was high. Participants linked financial strain to lower diet quality, as well as anxiety to uncontrolled eating and food cravings. Social support and trust in healthcare professionals were perceived as priorities for healthy eating. Structural and environmental barriers such as affordability and availability of culturally preferred foods were also identified as influences on food choices and eating behavior. Conclusions This study revealed opportunities for culturally tailored weight management interventions in older Hispanic/Latino adults with obesity. Clinical Trial Registry Number NCT03978416 (ClinicalTrials.gov).
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Affiliation(s)
- Maria Carlota Dao
- Energy Metabolism Laboratory Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. Boston MA United States Durham
- Department of Agriculture University of New Hampshire. Durham Nutritionand Food Systems NH United States Durham
| | - Zihan Yu
- Energy Metabolism Laboratory Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. Boston MA United States Durham
| | - Ana Maafs‐Rodríguez
- Energy Metabolism Laboratory Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. Boston MA United States Durham
- Friedman School of Nutrition Science and Policy Tufts University. Boston MA United States Boston
| | - Brandy Moser
- Energy Metabolism Laboratory Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. Boston MA United States Durham
| | - Adolfo G. Cuevas
- Department of Community Health School of Arts and Sciences Tufts University. Medford MA United States Boston
| | - Christina D. Economos
- Friedman School of Nutrition Science and Policy Tufts University. Boston MA United States Boston
| | - Susan B. Roberts
- Energy Metabolism Laboratory Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. Boston MA United States Durham
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15
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Obesity Prevention is the Key to a Nation’s Health. Fam Med 2022. [DOI: 10.30841/2307-5112.1-2.2022.260505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The overweight and obesity is increasing problem for the health care system and for the health of the general population. The number of overweight people with varying degrees of obesity is growing in most countries around the world each year, a third of the world’s population suffers from this condition.
According to scientists, lack of sleep, stress, use of certain pharmacological drugs can lead to obesity. The causes and factors of weight gain are varied, not only in personal life, such as eating habits and physical activity, but also include factors that can not be controlled, such as environmental factors, socio-economic factors, genetic factors and more.
Obesity is a major risk factor for many diseases such as diabetes, cardiovascular disease, stroke and some cancers.
Obesity prevention should be one of the top priorities for the health care system. Preventive measures aimed to prevent the development of overweight and obesity have three levels of intervention: primary, secondary and tertiary. The purpose of the primary prevention is to minimize weight gain and prevent the development of overweight or obesity. Secondary prevention aimes to reduce the impact of the existing disease. Tertiary prevention concentraits on reduction of the complications that have developed as a result of the disease.
To prevent overweight and obesity, doctors advise to limit the caloric content of diet by reducing the consumption of fats and sugars; increase the consumption of fruits and vegetables, as well as whole grains and nuts; perform regular exercise.
Regular weighing by health professionals can help identify patterns and factors that contribute to weight gain. The success of obesity therapy depends on the patient’s trust to his doctor and the knowledge of the clinician in this area.
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16
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Collatuzzo G, Boffetta P. Application of P4 (Predictive, Preventive, Personalized, Participatory) Approach to Occupational Medicine. LA MEDICINA DEL LAVORO 2022; 113:e2022009. [PMID: 35226650 PMCID: PMC8902745 DOI: 10.23749/mdl.v113i1.12622] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 12/22/2021] [Indexed: 11/05/2022]
Abstract
In recent years there has been a growth in the role of prevention in controlling the disease burden. Increasing efforts have been conveyed in the screening implementation and public health policies, and the spreading knowledge on risk factors reflects on major attention to health checks. Despite this, lifestyle changes are difficult to be adopted and the adherence to current public health services like screening and vaccinations remains suboptimal. Additionally, the prevalence and outcome of different chronic diseases and cancers is burdened by social disparities. P4 [predictive, preventive, personalized, participatory] medicine is the conceptualization of a new health care model, based on multidimensional data and machine-learning algorithms in order to develop public health intervention and monitoring the health status of the population with focus on wellbeing and healthy ageing. Each of the characteristics of P4 medicine is relevant to occupational medicine, and indeed the P4 approach appears to be particularly relevant to this discipline. In this review, we discuss the potential applications of P4 to occupational medicine, showing examples of its introduction on workplaces and hypothesizing its further implementation at the occupational level.
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Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy, Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA
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17
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Anton S, Das SK, McLaren C, Roberts SB. Application of social cognitive theory in weight management: Time for a biological component? Obesity (Silver Spring) 2021; 29:1982-1986. [PMID: 34705335 PMCID: PMC8612961 DOI: 10.1002/oby.23257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 12/22/2022]
Abstract
Despite the utility of social cognitive theory for facilitating individual behavior changes needed for initial weight loss, this model has been less effective in facilitating adherence to recommended lifestyle changes required for sustainable weight-loss maintenance. One potential reason for the limited long-term effectiveness of lifestyle interventions guided by this model is that the model does not consider the important influence that biology can have on weight-relevant behaviors, during both weight loss and weight-loss maintenance, via sensations of hunger and satiety and changes in energy metabolism (expenditure and fat oxidation). We describe here a proposed revision to social cognitive theory that allows for biological factors to exist in reciprocal determinism with behavioral, environmental, and personal factors, with the goal of creating a theoretical basis for lifestyle interventions with greater personalization in order to facilitate better long-term adherence and improve weight-loss maintenance.
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Affiliation(s)
- Stephen Anton
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida, USA
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Sai Krupa Das
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Christian McLaren
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida, USA
| | - Susan B Roberts
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
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18
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Rachmah Q, Martiana T, Mulyono M, Paskarini I, Dwiyanti E, Widajati N, Ernawati M, Ardyanto YD, Tualeka AR, Haqi DN, Arini SY, Alayyannur PA. The effectiveness of nutrition and health intervention in workplace setting: a systematic review. J Public Health Res 2021; 11. [PMID: 34781627 PMCID: PMC8859724 DOI: 10.4081/jphr.2021.2312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/13/2021] [Indexed: 11/23/2022] Open
Abstract
Health status of workers are crucial to maintain their productivity and it will impact on output per capita. This systematic review aims to evaluate the effectiveness of nutrition and health intervention in workplace setting and implication for further research. Articles were searched from PubMed, PMC, Cochrane Library (Trial), Science-direct, and Google scholar published from 2005-2020. Inclusion criteria were the intervention subject aged 19-64 years old with experimental randomized control trial (RCT) or non-RCT study design. Several keywords used for literature searching including “nutrition education in workplace”, “nutrition intervention in workplace”, and “workplace intervention”. Data were narratively described. Eleven studies were meet inclusion and exclusion criteria and further be reviewed. Five studies focused on intervene food environment in the workplace, four studies focused on nutrition education using different channels i.e., workplace visiting and emails, the other two interventions were objected to decrease health risk regarding occupational health. Positive outcomes were recorded for all workplace intervention, including increase in nutrition knowledge, self-efficacy, reduce risky behavior, and also improved body mass index and blood biomarkers. Workplace nutrition and health intervention proved to be an effective way to enhanced balanced nutrition behavior and improve health status. This study implies an urgency of nutrition and health intervention in a workplace. Significance for public health This systematic review proved several nutrition and health intervention in workplace setting that resulting in improvement of healthy behavior, anthropometric and biochemical indicators. Further, nutrition and health intervention can be implemented in workplace as a way to increase work productivity, reduce the disease burden costs of employee, and improve general health status.
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Affiliation(s)
- Qonita Rachmah
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya.
| | - Tri Martiana
- Department of Occupational Health and Safety, Faculty of Public Health, Universitas Airlangga, Surabaya.
| | - Mulyono Mulyono
- Department of Occupational Health and Safety, Faculty of Public Health, Universitas Airlangga, Surabaya.
| | - Indriati Paskarini
- Department of Occupational Health and Safety, Faculty of Public Health, Universitas Airlangga, Surabaya.
| | - Endang Dwiyanti
- Department of Occupational Health and Safety, Faculty of Public Health, Universitas Airlangga, Surabaya.
| | - Noeroel Widajati
- Department of Occupational Health and Safety, Faculty of Public Health, Universitas Airlangga.
| | - Meirina Ernawati
- Department of Occupational Health and Safety, Faculty of Public Health, Universitas Airlangga, Surabaya.
| | - Yustinus D Ardyanto
- Department of Occupational Health and Safety, Faculty of Public Health, Universitas Airlangga, Surabaya.
| | - Abdul R Tualeka
- Department of Occupational Health and Safety, Faculty of Public Health, Universitas Airlangga, Surabaya.
| | - Dani N Haqi
- Department of Occupational Health and Safety, Faculty of Public Health, Universitas Airlangga, Surabaya.
| | - Shintia Y Arini
- Department of Occupational Health and Safety, Faculty of Public Health, Universitas Airlangga, Surabaya.
| | - Putri A Alayyannur
- Department of Occupational Health and Safety, Faculty of Public Health, Universitas Airlangga, Surabaya.
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19
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Melián-Fleitas L, Franco-Pérez Á, Caballero P, Sanz-Lorente M, Wanden-Berghe C, Sanz-Valero J. Influence of Nutrition, Food and Diet-Related Interventions in the Workplace: A Meta-Analysis with Meta-Regression. Nutrients 2021; 13:3945. [PMID: 34836200 PMCID: PMC8622081 DOI: 10.3390/nu13113945] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/28/2021] [Accepted: 11/02/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To review the scientific literature on the influence of verified nutrition, food and diet interventions on occupational health. METHOD This study involved a critical analysis of articles retrieved from MEDLINE (via PubMed), Embase, Cochrane Library, PsycINFO, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS) and Medicina en Español (MEDES) using the descriptors "Diet, Food, and Nutrition" and "Occupational Health" and applying the filters "Clinical Trial", "Humans" and "Adult: 19+ years"; the search was conducted on 29 May 2021. RESULTS A total of 401 references were retrieved from the bibliographic databases, with an additional 16 identified through a secondary search; among the studies retrieved, 34 clinical trials were selected after applying the inclusion and exclusion criteria. The interventions were grouped into seven categories: (1) dietary interventions associated with exercise or educational programs; (2) individual environmental interventions or other educational actions; (3) educational interventions oriented toward lifestyle, dietetics, physical activity and stress management; (4) economic incentives; (5) multicomponent interventions (combination of mindfulness, e-coaching and the addition of fruits and vegetables); or dietary interventions (facilitating greater food supply in cafeterias); or interventions focused on physical exercise. CONCLUSIONS Given that most people spend a large part of their time in the workplace and, therefore, eat at least one of their daily meals there, well-planned interventions-preferably including several strategies-have been demonstrated, in general, as useful for combating overweight and obesity. From the meta-regression study, it was observed that the interventions give better results in people who presented high Body Mass Index (BMI) values (obesity). In contrast, intervention 2 (interventions related to workplace environment) would not give the expected results (it would increase the BMI).
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Affiliation(s)
- Liliana Melián-Fleitas
- Nutrition Department, University of Granada, 18012 Granada, Spain;
- Geriatric Service, Insular Hospital, Health Services Management of the Health Area of Lanzarote, 35500 Arrecife, Spain
| | - Álvaro Franco-Pérez
- Playa Blanca Health Center, Health Services Management of the Health Area of Lanzarote, 35580 Playa Blanca, Spain;
| | - Pablo Caballero
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, San Vicente del Raspeig, 03690 Alicante, Spain;
| | - María Sanz-Lorente
- Department of Public Health & History of Science, University Miguel Hernandez, 03550 Alicante, Spain;
- Center of Public Health, Consellería of Universal Health and Public Health, 46940 Manises, Spain
| | - Carmina Wanden-Berghe
- Health and Biomedical Research Institute of Alicante, University General Hospital, 03010 Alicante, Spain;
| | - Javier Sanz-Valero
- Department of Public Health & History of Science, University Miguel Hernandez, 03550 Alicante, Spain;
- National School of Occupational Medicine, Carlos III Health Institute, 28029 Madrid, Spain
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20
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Das SK, Bukhari AS, Taetzsch AG, Ernst AK, Rogers GT, Gilhooly CH, Hatch-McChesney A, Blanchard CM, Livingston KA, Silver RE, Martin E, McGraw SM, Chin MK, Vail TA, Lutz LJ, Montain SJ, Pittas AG, Lichtenstein AH, Allison DB, Dickinson S, Chen X, Saltzman E, Young AJ, Roberts SB. Randomized trial of a novel lifestyle intervention compared with the Diabetes Prevention Program for weight loss in adult dependents of military service members. Am J Clin Nutr 2021; 114:1546-1559. [PMID: 34375387 DOI: 10.1093/ajcn/nqab259] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 07/14/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Lifestyle interventions are the first-line treatment for obesity, but participant weight loss is typically low. OBJECTIVES We evaluated the efficacy of an alternative lifestyle intervention [Healthy Weight for Living (HWL)] compared with a modified Diabetes Prevention Program (m-DPP). HWL was based on a revised health behavior change model emphasizing hunger management and the development of healthy food preferences. m-DPP was a standard Diabetes Prevention Program implemented with counselor time matched to HWL. Participants were adult dependents of military personnel and had overweight or obesity. METHODS Participants were randomly assigned to HWL (n = 121) or m-DPP (n = 117), delivered primarily by group videoconference with additional midweek emails. The primary outcome was 12-mo weight change. Secondary outcomes included 6-mo changes in cardiometabolic risk factors and diet. Intention-to-treat (ITT) and complete case (CC) analyses were performed using linear mixed models. RESULTS Retention did not differ between groups (72% and 66% for HWL and m-DPP at 12 mo, respectively; P = 0.30). Mean ± SE adjusted 12-mo weight loss in the ITT cohort was 7.46 ± 0.85 kg for HWL and 7.32 ± 0.87 kg for m-DPP (P = 0.91); in the CC cohort, it was 7.83 ± 0.82 kg for HWL and 6.86 ± 0.88 kg for m-DPP (P = 0.43). Thirty-eight percent of HWL and 30% of m-DPP completers achieved ≥10% weight loss (P = 0.32). Improvements in systolic blood pressure, LDL cholesterol, triglycerides, fasting glucose, general health, sleep, and mood were similar across groups; improvements in diastolic blood pressure were greater in m-DPP. Adjusted group mean reductions in energy intake were not significantly different between groups, but HWL participants were more adherent to their dietary prescription for lower glycemic index and high fiber and protein (P = 0.05 to <0.001 for ITT). CONCLUSIONS HWL and m-DPP showed equivalent and clinically impactful mean weight loss with cardiometabolic benefits. These results identify an alternative approach for behavioral treatment of overweight and obesity.This trial was registered at clinicaltrials.gov as NCT02348853.
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Affiliation(s)
- Sai Krupa Das
- Energy Metabolism, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.,Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Asma S Bukhari
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Amy G Taetzsch
- Energy Metabolism, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Amy K Ernst
- Energy Metabolism, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Gail T Rogers
- Biostatistics and Data Management Unit, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Cheryl H Gilhooly
- Metabolic Research Unit, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Adrienne Hatch-McChesney
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Caroline M Blanchard
- Energy Metabolism, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Kara A Livingston
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Rachel E Silver
- Energy Metabolism, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.,Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Edward Martin
- Energy Metabolism, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Susan M McGraw
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Meghan K Chin
- Energy Metabolism, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Taylor A Vail
- Energy Metabolism, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Laura J Lutz
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Scott J Montain
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Anastassios G Pittas
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA, USA
| | - Alice H Lichtenstein
- Cardiovascular Nutrition, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - David B Allison
- Department of Epidemiology, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Stephanie Dickinson
- Department of Epidemiology, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Xiwei Chen
- Department of Epidemiology, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Edward Saltzman
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Andrew J Young
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Susan B Roberts
- Energy Metabolism, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.,Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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21
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Shi M, Tang R, Huang F, Zhong T, Chen Y, Li X, Zhou Z. Cardiovascular disease in patients with type 1 diabetes: Early evaluation, risk factors and possible relation with cardiac autoimmunity. Diabetes Metab Res Rev 2021; 37:e3423. [PMID: 33252830 DOI: 10.1002/dmrr.3423] [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: 07/02/2020] [Revised: 09/28/2020] [Accepted: 11/01/2020] [Indexed: 12/23/2022]
Abstract
Cardiovascular disease now is the leading cause of mortality among patients with type 1 diabetes (T1D). The risk of death from cardiovascular events in subjects with T1D is 2-10 times higher than the general population, depending on blood glucose control. Although complications of cardiovascular disease occur in middle and old age, pathological processes begin in childhood. Some methods used to evaluate subclinical cardiovascular disease, such as carotid intima-media thickness and pulse wave velocity, can detect early cardiovascular abnormalities in adolescence. The effect of risk factors including hypertension, dyslipidemia and diabetic nephropathy on cardiovascular disease has been well studied. According to the current clinical practice recommendations from the American Diabetes Association, cardiovascular risk factors should be systematically assessed at least annually and treated as recommended. And yet, the effects of intensive insulin therapy on cardiovascular risk, as well as the mechanisms of cardiac autoimmunity require further studying. This review concentrates on the cardiovascular risk in type 1 diabetes in order to provide a comprehensive outlook of its epidemiology, early assessment, risk factors and possible relations with cardiac autoimmunity, aiming to propose promising therapeutic strategies.
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Affiliation(s)
- Mei Shi
- Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Changsha, Hunan, China
| | - Rong Tang
- Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Changsha, Hunan, China
| | - Fansu Huang
- Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Changsha, Hunan, China
| | - Ting Zhong
- Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Changsha, Hunan, China
| | - Yan Chen
- Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Changsha, Hunan, China
| | - Xia Li
- Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Changsha, Hunan, China
| | - Zhiguang Zhou
- Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Changsha, Hunan, China
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22
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Peñalvo JL, Sagastume D, Mertens E, Uzhova I, Smith J, Wu JHY, Bishop E, Onopa J, Shi P, Micha R, Mozaffarian D. Effectiveness of workplace wellness programmes for dietary habits, overweight, and cardiometabolic health: a systematic review and meta-analysis. LANCET PUBLIC HEALTH 2021; 6:e648-e660. [PMID: 34454642 PMCID: PMC8627548 DOI: 10.1016/s2468-2667(21)00140-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 12/17/2022]
Abstract
Background The workplace offers a unique opportunity for effective health
promotion. We aimed to comprehensively study the effectiveness of
multicomponent worksite wellness programmes for improving diet and
cardiometabolic risk factors. Methods We did a systematic literature review and meta-analysis, following
PRISMA guidelines. We searched PubMed-MEDLINE, Embase, the Cochrane Library,
Web of Science, and Education Resources Information Center, from Jan 1,
1990, to June 30, 2020, for studies with controlled evaluation designs that
assessed multicomponent workplace wellness programmes. Investigators
independently appraised the evidence and extracted the data. Outcomes were
dietary factors, anthropometric measures, and cardiometabolic risk factors.
Pooled effects were calculated by inverse-variance random-effects
meta-analysis. Potential sources of heterogeneity and study biases were
evaluated. Findings From 10 169 abstracts reviewed, 121 studies (82 [68%] randomised
controlled trials and 39 [32%] quasi-experimental interventions) met the
eligibility criteria. Most studies were done in North America (57 [47%]),
and Europe, Australia, or New Zealand (36 [30%]). The median number of
participants was 413·0 (IQR 124·0–904·0), and
median duration of intervention was 9·0 months
(4·5–18·0). Workplace wellness programmes improved
fruit and vegetable consumption (0·27 servings per day [95% CI
0·16 to 0·37]), fruit consumption (0·20 servings per
day [0·11 to 0·28]), body-mass index (−0·22
kg/m2 [−0·28 to −0·17]), waist
circumference (−1·47 cm [−1·96 to
−0·98]), systolic blood pressure (−2·03 mm Hg
[−3·16 to −0·89]), and LDL cholesterol
(−5·18 mg/dL [−7·83 to −2·53]),
and to a lesser extent improved total fat intake (−1·18% of
daily energy intake [−1·78 to −0·58]), saturated
fat intake (−0·70% of daily energy [−1·22 to
−0·18]), bodyweight (−0·92 kg
[−1·11 to −0·72]), diastolic blood pressure
(−1·11 mm Hg [−1·78 to −0·44]),
fasting blood glucose (−1·81 mg/dL [−3·33 to
−0·28]), HDL cholesterol (1·11 mg/dL [0·48 to
1·74]), and triglycerides (−5·38 mg/dL
[−9·18 to −1·59]). No significant benefits were
observed for intake of vegetables (0·03 servings per day [95% CI
−0·04 to 0·10]), fibre (0·26 g per day
[−0·15 to 0·67]), polyunsaturated fat
(−0·23% of daily energy [−0·59 to 0·13]),
or for body fat (−0·80% [−1·80 to 0·21]),
waist-to-hip ratio (−0·00 ratio [−0·01 to
0·00]), or lean mass (1·01 kg [−0·82 to
2·83]). Heterogeneity values ranged from 46·9% to
91·5%. Between-study differences in outcomes were not significantly
explained by study design, location, population, or similar factors in
heterogeneity analyses. Interpretation Workplace wellness programmes are associated with improvements in
specific dietary, anthropometric, and cardiometabolic risk indicators. The
heterogeneity identified in study designs and results should be considered
when using these programmes as strategies to improve cardiometabolic
health.
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Affiliation(s)
- José L Peñalvo
- Non-Communicable Diseases Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
| | - Diana Sagastume
- Non-Communicable Diseases Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Elly Mertens
- Non-Communicable Diseases Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Irina Uzhova
- Department of Health and Nutritional Sciences, Institute of Technology Sligo, Sligo, Ireland
| | - Jessica Smith
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA; Bell Institute of Health and Nutrition, General Mills, Minneapolis, MN, USA
| | - Jason H Y Wu
- George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Eve Bishop
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jennifer Onopa
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Peilin Shi
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Renata Micha
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA; Department of Food Science and Human Nutrition, University of Thessaly, Thessaly, Greece
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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23
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Berthoud HR, Seeley RJ, Roberts SB. Physiology of Energy Intake in the Weight-Reduced State. Obesity (Silver Spring) 2021; 29 Suppl 1:S25-S30. [PMID: 33759396 DOI: 10.1002/oby.23080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/28/2020] [Accepted: 11/09/2020] [Indexed: 11/09/2022]
Abstract
Physiological adaptations to intentional weight loss can facilitate weight regain. This review summarizes emerging findings on hypothalamic and brainstem circuitry in the regulation of body weight and identifies promising areas for research to improve therapeutic interventions for sustainable weight loss. There is good evidence that body weight is actively regulated in a homeostatic fashion similar to other physiological parameters. However, the defended level of body weight is not fixed but rather depends on environmental conditions and genetic background in an allostatic fashion. In an environment with plenty of easily available energy-dense food and low levels of physical activity, prone individuals develop obesity. In a majority of individuals with obesity, body weight is strongly defended through counterregulatory mechanisms, such as hunger and hypometabolism, making weight loss challenging. Among the options for treatment or prevention of obesity, those directly changing the defended body weight would appear to be the most effective ones. There is strong evidence that the mediobasal hypothalamus is a master sensor of the metabolic state and an integrator of effector actions responsible for the defense of adequate body weight. However, other brain areas, such as the brainstem and limbic system, are also increasingly implicated in body weight defense mechanisms and may thus be additional targets for successful therapies.
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Affiliation(s)
- Hans-Rudolf Berthoud
- Neurobiology of Nutrition and Metabolism Department, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - Randy J Seeley
- Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Susan B Roberts
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
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24
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Dao MC, Das SK, Silver RE, Roberts SB. Association of counselor weight status and demographics with participant weight loss in a structured lifestyle intervention. Obes Res Clin Pract 2021; 15:69-72. [DOI: 10.1016/j.orcp.2020.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 07/13/2020] [Accepted: 11/20/2020] [Indexed: 11/26/2022]
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25
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Glympi A, Chasioti A, Bälter K. Dietary Interventions to Promote Healthy Eating among Office Workers: A Literature Review. Nutrients 2020; 12:nu12123754. [PMID: 33297328 PMCID: PMC7762282 DOI: 10.3390/nu12123754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 12/02/2020] [Indexed: 11/16/2022] Open
Abstract
Our aim is to review published studies on dietary interventions to promote healthy eating habits among office workers. The databases PubMed, EBSCO (MEDLINE, Academic Search Elite, CINAHL Plus, PsycARTICLES, PsycINFO), Cochrane Library, SCOPUS, and Google Scholar were searched between February and April 2019. Initially, 6647 articles were identified, and the final number of articles that met the inclusion criteria was 25. We identified four different types of interventions that included educational and/or environmental components, where environmental components provided healthy food in a work-related context. The interventions at the offices included web-based material, availability of food, provision of information in various ways, and a combination of environmental, educational and theory-based psychological approaches (i.e., multicomponent). The most commonly used designs were web-based and information interventions, respectively, which are the least expensive ways to intervene. The interventions assessed a range of outcomes, but this literature review focused on three, i.e., dietary intake, dietary behavior and health-related outcomes. Although the studies were heterogenous in terms of outcomes, design, number of participants, gender distribution and duration, all studies reported at least one positive effect. Thus, workplace dietary interventions are an unutilized area to positively influence dietary intake and health outcomes among office workers. However, the intervention needs to be tailored to the workplace.
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Affiliation(s)
- Alkyoni Glympi
- School of Health, Care and Social Welfare, Division of Public Health Sciences, Mälardalen University, 722 20 Västerås, Sweden; (A.C.); (K.B.)
- Correspondence: ; Tel.:+30-694-953-3872
| | - Amalia Chasioti
- School of Health, Care and Social Welfare, Division of Public Health Sciences, Mälardalen University, 722 20 Västerås, Sweden; (A.C.); (K.B.)
| | - Katarina Bälter
- School of Health, Care and Social Welfare, Division of Public Health Sciences, Mälardalen University, 722 20 Västerås, Sweden; (A.C.); (K.B.)
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden
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26
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Impact of a Digital Diabetes Prevention Program on Risk Factors for Chronic Disease in a Workforce Cohort. J Occup Environ Med 2020; 62:1040-1045. [PMID: 33055524 DOI: 10.1097/jom.0000000000002044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Evaluate the effect of a digital Diabetes Prevention Program (dDPP) on chronic disease risk factors in a workplace population. METHODS dDPP participants were employees and spouses with BMI ≥ 24 kg/m and prediabetes or diabetes (n = 84). Annual change in risk factors before and after dDPP were assessed in the dDPP group and in a retrospectively identified matched control group drawn from those who participated in a dDPP after the conclusion of this study (n = 252). RESULTS In the dDPP group, body weight, BMI, fasting glucose, triglycerides, total cholesterol and LDL-cholesterol decreased in the post-dDPP period compared with the pre-dDPP period (P < 0.05). In the control group, no difference between the annual change before and after dDPP was observed (P > 0.37). CONCLUSION The dDPP was effective in reducing risk factors for chronic disease in a workplace setting.
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27
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Kirkham AA, Beka V, Prado CM. The effect of caloric restriction on blood pressure and cardiovascular function: A systematic review and meta-analysis of randomized controlled trials. Clin Nutr 2020; 40:728-739. [PMID: 32675017 DOI: 10.1016/j.clnu.2020.06.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/15/2020] [Accepted: 06/26/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND & AIMS Preclinical evidence suggests that caloric restriction is an effective therapy for a number of cardiovascular insults. Whether caloric restriction has cardio-protective effects in humans is not well understood. The aim was to systematically review and meta-analyze human randomized control trials (RCTs) testing the effect of caloric restriction on blood pressure (BP) and cardiovascular function. METHODS A systematic review was performed using Medline, EMBASE, CINAHL (up to June 2017) to search for RCTs of adults receiving a calorie-restricted intervention versus a control/standard diet. Random-effect meta-analyses were performed to calculate weighted mean difference and 95% CI. RESULTS Thirty-two RCTs with 1722 participants assessing BP (n = 29 studies), heart rate (n = 10), VO2peak (n = 8), muscle sympathetic nerve activity (MSNA, n = 4), and endothelial function (n = 4) were included. Calorie-restricted interventions lasting 1-4 weeks had the largest effect on systolic (-5.5 mmHg, p < 0.001, 95% CI: -3.8, -7.1) and diastolic (-2.9 mmHg, p = 0.005, 95% CI: -5.0, -0.9) BP, but no effect on HR. Interventions lasting 1.5-6 months had similar effects on BP, and reduced HR (-4.4 beats/minute, p < 0.001, 95% CI: -6.1,-2.8). Relative VO2peak improved (1.8 mL/kg/min, p < 0.001, 95% CI: 1.3, 2.2). There were also potential positive effects on MSNA and endothelial function. CONCLUSIONS The effect of 1-4 weeks of calorie restriction on BP was similar to that expected with medications, and larger than that reported for other lifestyle interventions or supplements. Cardiovascular risk could be further reduced by caloric restriction lasting up to six months to lower heart rate and improve VO2peak.
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Affiliation(s)
- Amy A Kirkham
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, M5S 2C9, Canada.
| | - Vanesa Beka
- Faculty of Nursing, University of Alberta, Edmonton, T6G 2R3, Canada.
| | - Carla M Prado
- Department of Agricultural Food and Nutritional Science, University of Alberta, Edmonton, T6G 2R3, Canada.
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28
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Gudzune KA, Clark JM. Role of Commercial Weight-Loss Programs in Medical Management of Obesity. Endocrinol Metab Clin North Am 2020; 49:275-287. [PMID: 32418590 DOI: 10.1016/j.ecl.2020.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Rates of obesity counseling are low among physicians because of the lack of time and training in this area. In recognition of this challenge, recent national guidelines encourage physicians to refer patients with obesity to intensive, comprehensive lifestyle programs to lose weight. Some commercial weight-loss programs meet these criteria, and this article reviews the evidence from randomized controlled trials regarding such programs' weight-loss efficacy and safety as well as glycemic outcomes among patients with and without diabetes mellitus. A discussion of how physicians might approach the referral process and continued management of patients participating in these programs is included.
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Affiliation(s)
- Kimberly A Gudzune
- Department of Medicine, Johns Hopkins University School of Medicine, 2024 East Monument Street, Room 2-621, Baltimore, MD 21224, USA.
| | - Jeanne M Clark
- Department of Medicine, Johns Hopkins University School of Medicine, 2024 East Monument Street, Room 2-600, Baltimore, MD 21224, USA. https://twitter.com/jmclark_md
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Hwang WJ, Kang SJ. Interventions to Reduce the Risk of Cardiovascular Disease among Workers: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2267. [PMID: 32230939 PMCID: PMC7177901 DOI: 10.3390/ijerph17072267] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 11/17/2022]
Abstract
This study examined the effect of lifestyle interventions on cardiovascular disease risk factors among workers. The study comprised a systematic review and meta-analysis of controlled trials. Relevant controlled trials were searched, with selections based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed using the Scottish Intercollegiate Guidelines Network (SIGN). Of 1174 identified publications, one low-quality study was excluded. Finally, 10 were analyzed. The effect sizes were analyzed for heterogeneity, and random effect models (Hedge's g) were used. A subgroup analysis was performed on the follow-up point of intervention (≤ 12 months vs. > 12 months). Publication bias was also analyzed. Interventions were effective for systolic (g = 0.66, 95% CI: 0.27-1.60) and diastolic blood pressure (g = 0.63, 95% CI: 0.21-1.06), and BMI (g = 0.71, 95% CI: 0.15-1.11). Interventions were ineffective for weight (g = 0.18, 95% CI: -0.04, 0.40) and LDL-cholesterol (g = 0.46, 95% CI: -0.02, 0.93). There was high heterogeneity between studies (I2 =78.45 to I2 = 94.61). There was no statistically significant publication bias, except for systolic blood pressure. Interventions to reduce risk of cardiovascular disease risk might be effective in improving physical outcomes, but additional high-quality trials are needed in the future.
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Affiliation(s)
- Won Ju Hwang
- College of Nursing Science, Kyung Hee University, 26 Kyunghee-daero, Dongaemun-gu, Seoul 02247, Korea;
| | - Soo Jin Kang
- Department of Nursing, Daegu University, 33 Seongdang-ro 50-gil, Nam-gu, Daegu 42400, Korea
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Hassani B, Amani R, Haghighizadeh MH, Araban M. A priority oriented nutrition education program to improve nutritional and cardiometabolic status in the workplace: a randomized field trial. J Occup Med Toxicol 2020; 15:2. [PMID: 32082404 PMCID: PMC7020354 DOI: 10.1186/s12995-020-0252-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/13/2020] [Indexed: 11/17/2022] Open
Abstract
Background Workplace nutrition has been identified as a priority setting that can significantly reduce cardiovascular diseases (CVD) risk factors. This study was conducted as a part of the workplace education program to improve nutritional practices and cardiometabolic status in industrial personnel. Methods The present research was a randomized controlled field trial conducted on employees of a regional petrochemical company. The health-related priorities of the program were defined and addressed in the study in which 104 employees with dyslipidemia were randomly divided into two groups of education and control. Data were collected pre- and post-intervention, using valid and reliable multi-session questionnaires on demographic data, nutritional knowledge, and nutritional intake. Anthropometric measures, serum FBS, HbA1C, hs-CRP and homocysteine (Hcy) were assessed in both groups. In the education group, the nutrition program included five educational workshops about healthy nutrition and regular exercise along with educational messages over a 3-month period. The controls did not receive any education during the study. Results There were no statistically significant differences between the two groups regarding the baseline variables. The education group significantly improved their nutritional knowledge (p < 0.001), dietary intakes (p < 0.005), serum FBS (p < 0.001) and Hcy levels (p < 0.001) and anthropometric indices. Conclusion Workplace nutrition education programs can improve knowledge and reduce important CVD risk factors.
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Affiliation(s)
- Bahar Hassani
- 1Department of Nutrition, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Health Safety and Environment (HSE), Razi Petrochemical Company, Mahshahr, Iran
| | - Reza Amani
- 3Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hussein Haghighizadeh
- 4Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marzieh Araban
- 5Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Park SH, Kim SY. Effectiveness of worksite-based dietary interventions on employees' obesity: a systematic review and meta-analysis. Nutr Res Pract 2019; 13:399-409. [PMID: 31583059 PMCID: PMC6760977 DOI: 10.4162/nrp.2019.13.5.399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/17/2018] [Accepted: 12/11/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study was designed to provide scientific evidence on the effectiveness of worksite-based dietary intervention to reduce obesity among overweight/obese employees. MATERIALS/METHODS Electronic search was performed using Ovid Medline, Embase, Cochrane Library, and CINAHL databases. The keywords used were “obesity,” “nutrition therapy,” and “worksite.” The internal validity of the randomized controlled trials (RCTs) was assessed using the Cochrane's Risk of Bias. Meta-analysis of selected studies was performed using Review Manager 5.3. RESULTS A total of seven RCTs with 2,854 participants were identified. The effectiveness of dietary interventions was analyzed in terms of changes in weight, body mass index (BMI), total cholesterol, and blood pressure. The results showed that weight decreased with weighted mean difference (WMD) of −4.37 (95% confidence interval (CI): −6.54 to −2.20), but the effectiveness was statistically significant only in short-term programs < 6 months (P = 0.001). BMI also decreased with WMD of −1.26 (95% CI: −1.98 to −0.55), but the effectiveness was statistically significant only in short-term programs < 6 months (P = 0.001). Total cholesterol decreased with WMD of −5.57 (95% CI: −9.07 to −2.07) mg/dL, demonstrating significant effectiveness (P = 0.002). Both systolic (WMD: −4.90 mmHg) and diastolic (WMD: −2.88 mmHg) blood pressure decreased, demonstrating effectiveness, but with no statistical significance. CONCLUSIONS The worksite-based dietary interventions for overweight/obese employees showed modest short-term effects. These interventions can be considered successful because weight loss was below approximately 5-10 kg of the initial body weight, which is the threshold for the management of obesity recommended by the Scottish Intercollegiate Guideline Network (SIGN).
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Affiliation(s)
- Seong-Hi Park
- School of Nursing, Soonchunhyang University, Chungnam 31538, Korea
| | - So-Young Kim
- Department of Food Science and Nutrition, Soonchunhyang University, 22 Soonchunhyang-ro, Asan, Chungnam 31538, Korea
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An J, Yoon SR, Lee JH, Kim H, Kim OY. Importance of Adherence to Personalized Diet Intervention in Obesity Related Metabolic Improvement in Overweight and Obese Korean Adults. Clin Nutr Res 2019; 8:171-183. [PMID: 31384596 PMCID: PMC6675957 DOI: 10.7762/cnr.2019.8.3.171] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 11/19/2022] Open
Abstract
We investigated weight loss effect of personalized diet education in overweight/obese Korean adults. Overweight/obese Korean adults (body mass index [BMI] ≥ 23 kg/m2 or waist circumference [WC] ≥ 90 cm for men, ≥ 85 cm for women) were recruited, and 40 participants who completed the 10-week intervention were finally included in the analyses. At first visit, study participants (small group with individual counseling) were educated for optimal diet by clinical dietitian, and checked for their compliance through telephone/text message every 1-2 week during the intervention. Anthropometric and biochemical parameters and dietary intake were investigated. Body weight, BMI, WC, and body fat mass were significantly reduced in whole participants. Hemoglobin A1c, insulin, and low-density lipoprotein cholesterol were also significantly decreased after the intervention. Total energy intake (EI) during the intervention was not significantly decreased compared to the baseline value, but the proportions of energy derived from macronutrients were within the ranges recommended by 2015 Dietary Reference Intake for Koreans. Based on actual EI, participants were classified into high-adherence (HA) (prescribed EI ± 25%, n = 29), low-adherence I (LA-I) (< 75% of prescribed EI, n = 7), and low-adherence II (LA-II) group (> 125% of prescribed EI, n = 4). Only HA group showed significant improvements in anthropometric parameters, glycemic control and lipid profile. Interestingly, LA-I group showed significant increases in glucose, insulin, C-peptide and insulin resistance. In conclusion, a shift from overweight/obesity to healthy weight can be accomplished by high adherence to personalized diet modification, not by EI reduction.
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Affiliation(s)
- Juhyun An
- Department of Food Science and Nutrition, Dong-A University, Busan 49315, Korea
| | - So Ra Yoon
- Department of Food Science and Nutrition, Dong-A University, Busan 49315, Korea.,Center for Silver-targeted Biomaterials, Brain Busan 21 Plus Program, Dong-A University, Busan 49315, Korea.,Institute of Health Insurance and Clinical Research, National Health Insurance Service Ilsan Hospital, Goyang 10444, Korea
| | - Jae Hyang Lee
- Busan Cardiocerebrovascular Center, Dong-A University Hospital, College of Medicine, Busan 49201, Korea
| | - Hyunyoung Kim
- Department of Food Science and Nutrition, Dong-A University, Busan 49315, Korea.,Center for Silver-targeted Biomaterials, Brain Busan 21 Plus Program, Dong-A University, Busan 49315, Korea
| | - Oh Yoen Kim
- Department of Food Science and Nutrition, Dong-A University, Busan 49315, Korea.,Center for Silver-targeted Biomaterials, Brain Busan 21 Plus Program, Dong-A University, Busan 49315, Korea
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Sandercock V, Andrade J. Evaluation of Worksite Wellness Nutrition and Physical Activity Programs and Their Subsequent Impact on Participants' Body Composition. J Obes 2018; 2018:1035871. [PMID: 30631593 PMCID: PMC6304910 DOI: 10.1155/2018/1035871] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/17/2018] [Accepted: 11/05/2018] [Indexed: 12/14/2022] Open
Abstract
Background Adult obesity is globally recognized as a public health concern. As adults spend most of their weekdays at work, worksite wellness programs may include topics of nutrition education and physical activity to improve an employee's body composition. However, results are inconsistent with the impact they have on employees' body composition. Objective The purpose of this systematic review was to evaluate worksite wellness nutrition and physical activity programs and their subsequent impact on participants' body composition. Methods Extraction of articles was completed through 4 databases: PubMed, CINAHL, SCOPUS, and PsycINFO using keywords such as "nutrition and physical activity interventions/programs" and "weight." A 9-point inclusion criterion was established. Evaluation of the articles was assessed using the Academy of Nutrition and Dietetics Evidence-Based Manual. Results A total of 962 articles were identified. Twenty-three met the inclusion criterion. Seventeen studies resulted in a change in body composition (e.g., decreased BMI (kg/m2), waist circumference, and body fat percentage), and six studies did not show any changes. Programs that had professionals frequently interact with participants, regardless if the interactions were done daily, weekly, or monthly, led to a change in body composition. Additionally, programs that incorporated a motivation theory and provided content relevant to participants' needs resulted in a change in body composition. Conclusion Evidence supports that future worksite wellness programs that are designed using a motivational theory and content that is created relevant to participants' needs and that has frequent interactions with participants may result in a change in body composition.
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Affiliation(s)
- Victoria Sandercock
- School of Family and Consumer Sciences, Eastern Illinois University, Charleston 61920, USA
| | - Jeanette Andrade
- Food Science and Human Nutrition, University of Florida, Gainesville, FL 32611, USA
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Wolfenden L, Goldman S, Stacey FG, Grady A, Kingsland M, Williams CM, Wiggers J, Milat A, Rissel C, Bauman A, Farrell MM, Légaré F, Ben Charif A, Zomahoun HTV, Hodder RK, Jones J, Booth D, Parmenter B, Regan T, Yoong SL. Strategies to improve the implementation of workplace-based policies or practices targeting tobacco, alcohol, diet, physical activity and obesity. Cochrane Database Syst Rev 2018; 11:CD012439. [PMID: 30480770 PMCID: PMC6362433 DOI: 10.1002/14651858.cd012439.pub2] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Given the substantial period of time adults spend in their workplaces each day, these provide an opportune setting for interventions addressing modifiable behavioural risk factors for chronic disease. Previous reviews of trials of workplace-based interventions suggest they can be effective in modifying a range of risk factors including diet, physical activity, obesity, risky alcohol use and tobacco use. However, such interventions are often poorly implemented in workplaces, limiting their impact on employee health. Identifying strategies that are effective in improving the implementation of workplace-based interventions has the potential to improve their effects on health outcomes. OBJECTIVES To assess the effects of strategies for improving the implementation of workplace-based policies or practices targeting diet, physical activity, obesity, tobacco use and alcohol use.Secondary objectives were to assess the impact of such strategies on employee health behaviours, including dietary intake, physical activity, weight status, and alcohol and tobacco use; evaluate their cost-effectiveness; and identify any unintended adverse effects of implementation strategies on workplaces or workplace staff. SEARCH METHODS We searched the following electronic databases on 31 August 2017: CENTRAL; MEDLINE; MEDLINE In Process; the Campbell Library; PsycINFO; Education Resource Information Center (ERIC); Cumulative Index to Nursing and Allied Health Literature (CINAHL); and Scopus. We also handsearched all publications between August 2012 and September 2017 in two speciality journals: Implementation Science and Journal of Translational Behavioral Medicine. We conducted searches up to September 2017 in Dissertations and Theses, the WHO International Clinical Trials Registry Platform, and the US National Institutes of Health Registry. We screened the reference lists of included trials and contacted authors to identify other potentially relevant trials. We also consulted experts in the field to identify other relevant research. SELECTION CRITERIA Implementation strategies were defined as strategies specifically employed to improve the implementation of health interventions into routine practice within specific settings. We included any trial with a parallel control group (randomised or non-randomised) and conducted at any scale that compared strategies to support implementation of workplace policies or practices targeting diet, physical activity, obesity, risky alcohol use or tobacco use versus no intervention (i.e. wait-list, usual practice or minimal support control) or another implementation strategy. Implementation strategies could include those identified by the Effective Practice and Organisation of Care (EPOC) taxonomy such as quality improvement initiatives and education and training, as well as other strategies. Implementation interventions could target policies or practices directly instituted in the workplace environment, as well as workplace-instituted efforts encouraging the use of external health promotion services (e.g. gym membership subsidies). DATA COLLECTION AND ANALYSIS Review authors working in pairs independently performed citation screening, data extraction and 'Risk of bias' assessment, resolving disagreements via consensus or a third reviewer. We narratively synthesised findings for all included trials by first describing trial characteristics, participants, interventions and outcomes. We then described the effect size of the outcome measure for policy or practice implementation. We performed meta-analysis of implementation outcomes for trials of comparable design and outcome. MAIN RESULTS We included six trials, four of which took place in the USA. Four trials employed randomised controlled trial (RCT) designs. Trials were conducted in workplaces from the manufacturing, industrial and services-based sectors. The sample sizes of workplaces ranged from 12 to 114. Workplace policies and practices targeted included: healthy catering policies; point-of-purchase nutrition labelling; environmental supports for healthy eating and physical activity; tobacco control policies; weight management programmes; and adherence to guidelines for staff health promotion. All implementation interventions utilised multiple implementation strategies, the most common of which were educational meetings, tailored interventions and local consensus processes. Four trials compared an implementation strategy intervention with a no intervention control, one trial compared different implementation interventions, and one three-arm trial compared two implementation strategies with each other and a control. Four trials reported a single implementation outcome, whilst the other two reported multiple outcomes. Investigators assessed outcomes using surveys, audits and environmental observations. We judged most trials to be at high risk of performance and detection bias and at unclear risk of reporting and attrition bias.Of the five trials comparing implementation strategies with a no intervention control, pooled analysis was possible for three RCTs reporting continuous score-based measures of implementation outcomes. The meta-analysis found no difference in standardised effects (standardised mean difference (SMD) -0.01, 95% CI -0.32 to 0.30; 164 participants; 3 studies; low certainty evidence), suggesting no benefit of implementation support in improving policy or practice implementation, relative to control. Findings for other continuous or dichotomous implementation outcomes reported across these five trials were mixed. For the two non-randomised trials examining comparative effectiveness, both reported improvements in implementation, favouring the more intensive implementation group (very low certainty evidence). Three trials examined the impact of implementation strategies on employee health behaviours, reporting mixed effects for diet and weight status (very low certainty evidence) and no effect for physical activity (very low certainty evidence) or tobacco use (low certainty evidence). One trial reported an increase in absolute workplace costs for health promotion in the implementation group (low certainty evidence). None of the included trials assessed adverse consequences. Limitations of the review included the small number of trials identified and the lack of consistent terminology applied in the implementation science field, which may have resulted in us overlooking potentially relevant trials in the search. AUTHORS' CONCLUSIONS Available evidence regarding the effectiveness of implementation strategies for improving implementation of health-promoting policies and practices in the workplace setting is sparse and inconsistent. Low certainty evidence suggests that such strategies may make little or no difference on measures of implementation fidelity or different employee health behaviour outcomes. It is also unclear if such strategies are cost-effective or have potential unintended adverse consequences. The limited number of trials identified suggests implementation research in the workplace setting is in its infancy, warranting further research to guide evidence translation in this setting.
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Affiliation(s)
- Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Sharni Goldman
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Fiona G Stacey
- University of Newcastle, Hunter Medical Research Institute, Priority Research Centre in Health Behaviour, and Priority Research Centre in Physical Activity and NutritionSchool of Medicine and Public HealthCallaghanNSWAustralia2287
| | - Alice Grady
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Melanie Kingsland
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Christopher M Williams
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - John Wiggers
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Andrew Milat
- NSW Ministry of HealthCentre for Epidemiology and EvidenceNorth SydneyNSWAustralia2060
- The University of SydneySchool of Public HealthSydneyAustralia
| | - Chris Rissel
- Sydney South West Local Health DistrictOffice of Preventive HealthLiverpoolNSWAustralia2170
| | - Adrian Bauman
- The University of SydneySchool of Public HealthSydneyAustralia
- Sax InstituteThe Australian Prevention Partnership CentreSydneyAustralia
| | - Margaret M Farrell
- US National Cancer InstituteDivision of Cancer Control and Population Sciences/Implementation Sciences Team9609 Medical Center DriveBethesdaMarylandUSA20892
| | - France Légaré
- Université LavalCentre de recherche sur les soins et les services de première ligne de l'Université Laval (CERSSPL‐UL)2525, Chemin de la CanardièreQuebecQuébecCanadaG1J 0A4
| | - Ali Ben Charif
- Centre de recherche sur les soins et les services de première ligne de l'Université Laval (CERSSPL‐UL)Université Laval2525, Chemin de la CanardièreQuebecQuebecCanadaG1J 0A4
| | - Hervé Tchala Vignon Zomahoun
- Centre de recherche sur les soins et les services de première ligne ‐ Université LavalHealth and Social Services Systems, Knowledge Translation and Implementation Component of the SPOR‐SUPPORT Unit of Québec2525, Chemin de la CanardièreQuebecQCCanadaG1J 0A4
| | - Rebecca K Hodder
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Jannah Jones
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Debbie Booth
- University of NewcastleAuchmuty LibraryUniversity DriveCallaghanNSWAustralia2308
| | - Benjamin Parmenter
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Tim Regan
- University of NewcastleThe School of PsychologyCallaghanAustralia
| | - Sze Lin Yoong
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
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The Relationships Between Physical Activity and Cardiometabolic Risk Factors Among Women Participating in a University-Based Worksite Wellness Program. J Occup Environ Med 2018; 60:1098-1107. [PMID: 30188493 DOI: 10.1097/jom.0000000000001439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Associations between changes in physical activity (PA) and cardiometabolic risk factors among women with overweight/obesity enrolled in a university-based worksite wellness program (WWP) were examined. METHODS Data from 173 women who completed a 26-week WWP were analyzed retrospectively. Participants completed diet and PA assessments and received client-centered diet/lifestyle counseling at baseline, and 12 and 26 weeks thereafter. Anthropometrics, blood pressure, and total cholesterol were measured; PA was self-reported using the International Physical Activity Questionnaire-short form at each visit. RESULTS Significant improvements in anthropometrics (P < 0.001), blood pressure (P < 0.001), total cholesterol (P = 0.014), and PA (P = 0.007) were found at 26 weeks. In adjusted linear regression models, a 10 metabolic-equivalent-minute increase in PA was associated with 0.01% corresponding decreases in weight and waist circumference. CONCLUSION Among women who completed this WWP, increased PA was associated with reductions in anthropometric measures.
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Li X, Jiang L, Yang M, Wu YW, Sun JZ. Impact of weight cycling on CTRP3 expression, adipose tissue inflammation and insulin sensitivity in C57BL/6J mice. Exp Ther Med 2018; 16:2052-2059. [PMID: 30186439 DOI: 10.3892/etm.2018.6399] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 05/11/2018] [Indexed: 12/17/2022] Open
Abstract
Impacts of weight cycling on C1q/tumor necrosis factor (TNF)-related protein-3 (CTRP3) expression, adipose tissue inflammation and insulin sensitivity in C57BL/6J mice were evaluated in the current study. A total of 30 male C57Bl/6J mice were divided randomly into three groups; normal control (n=10), high-fat diet (OB, n=10) and weight cycling (WC, n=10), which were fed with high-fat diet in the first and last 8 weeks and regular chow in between. Systemic glucose metabolic status and insulin sensitivity were detected by intraperitoneal glucose tolerance test and hyperinsulinemic-euglycemic clamp, respectively. Blood levels of interleukin (IL)-6 and TNF-α were determined using ELISA. Relative CTRP3, IL-6, TNF-α and glucose transporter (GLUT)4 mRNA expression in adipose tissue was detected using reverse transcription-quantitative polymerase chain reaction assays. Relative CTRP3, phosphatidylinositide 3-kinases (PI3K) and protein kinase B (PKB; Ser473) protein expression were detected by western blot analysis. Area under the curve of glucose and glucose infusion rate of the WC group were significantly increased compared with the OB group (P<0.01). CTRP3 mRNA and protein levels of the WC group were significantly decreased by 20.3 and 23.1%, respectively, compared with the OB group (P<0.01). IL-6 and TNF-α protein plasma levels and gene expression in adipose tissue of the WC group were significantly increased compared with the OB group (P<0.01). Expression and phosphorylation of insulin signaling molecules PI3K and PKB (Ser473), respectively and GLUT4 gene expression in adipose tissue of the WC group were significantly decreased compared with the OB group (P<0.01). In conclusion, weight cycling impaired glucose metabolism and insulin sensitivity by decreasing CTRP3, PI3K, phosphorylated-PKB (Ser473) and GLUT4 expression, and increasing IL-6 and TNF-α levels.
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Affiliation(s)
- Xin Li
- Department of Endocrinology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Li Jiang
- Department of Internal Medicine, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Miao Yang
- Department of Endocrinology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Yu-Wen Wu
- Department of Endocrinology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Jia-Zhong Sun
- Department of Endocrinology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China
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Gutermuth LK, Hager ER, Pollack Porter K. Using the CDC's Worksite Health ScoreCard as a Framework to Examine Worksite Health Promotion and Physical Activity. Prev Chronic Dis 2018; 15:E84. [PMID: 29935077 PMCID: PMC6016402 DOI: 10.5888/pcd15.170463] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Introduction Worksite health promotion programs are emerging as an effective approach for addressing the adult obesity epidemic and improving the overall health of employees. Methods We conducted a scoping review to identify articles that described a physical activity component (eg, promoted increased physical or reduced sitting time) of a worksite health promotion intervention. Our search specified full-length articles published in English from January 2000 through July 2015. We used the Centers for Disease Control and Prevention’s Worksite Health ScoreCard, a validated tool, as a framework to summarize information on organizational supports strategies (18 questions) and physical activity strategies (9 questions) implemented by worksite health promotion programs. We also determined whether or not the included studies reported significant (P < .05) improvements in physical activity. Results We identified 18 worksite health promotion programs; 11 produced significant improvements in physical activity. Incentives, health risk assessments, health promotion committees, leadership support, marketing, and subsidies or discounts for use of exercise facilities were the most effective organizational supports strategies cited, and physical activity seminars, classes, and workshops were the most effective physical activity strategies cited. Conclusion The use of the Health ScoreCard allowed for a practical interpretation of our findings, which can inform next steps for the field. Future research should explore the relationships between components of worksite health promotion programs and their outcomes to further develop best practices that can improve worker health and promote physical activity.
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Affiliation(s)
- Leah K Gutermuth
- Department of Pediatrics, Growth and Nutrition Division, University of Maryland School of Medicine, 737 W. Lombard St, 163, Baltimore, MD 21201.
| | - Erin R Hager
- Department of Pediatrics, Growth and Nutrition Division, University of Maryland School of Medicine, Baltimore, Maryland
| | - Keshia Pollack Porter
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Hjorth MF, Zohar Y, Hill JO, Astrup A. Personalized Dietary Management of Overweight and Obesity Based on Measures of Insulin and Glucose. Annu Rev Nutr 2018; 38:245-272. [PMID: 29856931 DOI: 10.1146/annurev-nutr-082117-051606] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
During the past several decades, numerous trials have compared various diets for the management of overweight and obesity, assuming that a single dietary strategy would be appropriate for all individuals. These studies have failed to provide strong evidence for the efficacy of any particular diet, and it is likely that different people will have different levels of success on different diets. We identified studies investigating pretreatment glycemia or insulinemia status, or both, of the individual as prognostic markers of weight loss during periods in which the composition of a participant's diet was known. Overall, research suggests that providing specific diets for weight management based on pretreatment glycemia and insulinemia statuses holds great promise for advancing personalized nutrition.
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Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, 1958 Frederiksberg C, Denmark; ,
| | | | - James O Hill
- Colorado Nutrition Obesity Research Center, University of Colorado Denver, Aurora, Colorado 80045, USA;
| | - Arne Astrup
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, 1958 Frederiksberg C, Denmark; ,
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Sisti LG, Dajko M, Campanella P, Shkurti E, Ricciardi W, de Waure C. The effect of multifactorial lifestyle interventions on cardiovascular risk factors: a systematic review and meta-analysis of trials conducted in the general population and high risk groups. Prev Med 2018; 109:82-97. [PMID: 29291422 DOI: 10.1016/j.ypmed.2017.12.027] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 12/21/2017] [Accepted: 12/24/2017] [Indexed: 01/31/2023]
Abstract
Cardiovascular diseases (CVDs) are the leading cause of premature mortality and disability accounting for one third of all deaths worldwide with considerable impacts on economics and on the quality of life. The evidence suggests that a multifactorial lifestyle intervention might have a role in the CVDs risk reduction, especially in the risk populations, nonetheless the effects on modifiable CVDs risk factors have not been completely explored. Our work aimed at evaluating the impact of multifactorial lifestyle interventions on cardiovascular risk modification, both in the general and risk population. A systematic review and meta-analysis of the randomized controlled trials (RCTs) were performed by including articles published up to April 16th, 2016. RCTs were selected if they had investigated the impact of multifactorial lifestyle interventions on lipids, blood pressure, BMI and waist circumference, smoking and physical activity. Changes in the level of modifiable risk factors from baseline were evaluated. Search resulted in 19,847 studies, of which 36 were included in the analysis. Compared to a usual care, the multifactorial lifestyle intervention is able to lower the blood pressure, total cholesterol, BMI and waist circumference, at both 6 and 12months, and to increase physical activity at 12months. Better results were obtained in primary prevention and in moderate and high risk groups. Multifactorial lifestyle interventions clearly represent a valid tool for reducing the cardiovascular risk factors and should be implemented in the risk groups and in primary prevention.
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Affiliation(s)
- L G Sisti
- Institute of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy.
| | - M Dajko
- Institute of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
| | - P Campanella
- Institute of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
| | - E Shkurti
- University of Medicine, Tirana, Albania
| | - W Ricciardi
- President - Italian National Institute of Health, Rome, Italy
| | - C de Waure
- Institute of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
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Abstract
Purpose
Food consumed at work can be brought from home or taken in private or university restaurants. Knowing the contribution of food consumption in the workplace allows for the identification of bad practices to modulate food availability in the work environment and raise consumer awareness for a more balanced food intake. This paper aims to characterize food consumption and to determine the contribution of food consumption at the workplace to daily food intake of employees of the University of Porto (UP).
Design/methodology/approach
A cross-sectional observational study was conducted. The project was approved by Ethical Commission of the UP. The principles of Helsínquia Declaration were respected and the workers under examine accept to participate in the study, through an inform consent. Data were obtained through the application of a self-administrated questionnaire and through the application of a questionnaire including a 24 h recall. There were assessed 513 individuals randomly selected, and the majority of them were women.
Findings
In total, 92.8 per cent of them preferred to have meals at the workplace that contributed to about 39.6 per cent of the daily energy intake. Reported food consumption at the workplace contributed about 42.6 per cent of carbohydrates, 39.4 per cent of total fat and 36.8 per cent of proteins for daily intake. A low intake of water (39.2 per cent of whole ingestion) and a huge amount and contribution of the workplace (48.4 per cent) to daily sugar intake was observed. Higher nutritional intake was observed for women (p < 0.05). The energy contribution of meals at the workplace is in accordance with recommendations, except for breakfast, that is below.
Originality/value
This work allows to characterize food habits of university employees at the workplace and the identification of the contribution of meals eaten at the workplace for daily energy and nutritional intake. These data allow to modulate food availability in the work environment and raise consumer awareness for a more balanced food intake.
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Ing CT, Miyamoto RES, Fang R, Antonio M, Paloma D, Braun KL, Kaholokula JK. Comparing Weight Loss-Maintenance Outcomes of a Worksite-Based Lifestyle Program Delivered via DVD and Face-to-Face: A Randomized Trial. HEALTH EDUCATION & BEHAVIOR 2018; 45:569-580. [PMID: 29504468 DOI: 10.1177/1090198118757824] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Native Hawaiians and other Pacific Islanders have high rates of overweight and obesity compared with other ethnic groups in Hawai'i. Effective weight loss and weight loss-maintenance programs are needed to address obesity and obesity-related health inequities for this group. AIMS Compare the effectiveness of a 9-month, worksite-based, weight loss-maintenance intervention delivered via DVD versus face-to-face in continued weight reduction and weight loss maintenance beyond the initial weight loss phase. METHOD We tested DVD versus face-to-face delivery of the PILI@Work Program's 9-month, weight loss-maintenance phase in Native Hawaiian-serving organizations. After completing the 3-month weight loss phase, participants ( n = 217) were randomized to receive the weight loss-maintenance phase delivered via trained peer facilitators or DVDs. Participant assessments at randomization and postintervention included weight, height, blood pressure, physical functioning, exercise frequency, and fat intake. RESULTS Eighty-three face-to-face participants were retained at 12 months (74.1%) compared with 73 DVD participants (69.5%). There was no significant difference between groups in weight loss or weight loss maintenance. The number of lessons attended in Phase 1 of the intervention (β = 0.358, p = .022) and baseline systolic blood pressure (β = -0.038, p = .048) predicted percent weight loss at 12 months. DISCUSSION AND CONCLUSION Weight loss maintenance was similar across groups. This suggests that low-cost delivery methods for worksite-based interventions targeting at-risk populations can help address obesity and obesity-related disparities. Additionally, attendance during the weight loss phase and lower baseline systolic blood pressure predicted greater percent weight loss during the weight loss-maintenance phase, suggesting that early engagement and initial physical functioning improve long-term weight loss outcomes.
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Affiliation(s)
| | | | - Rui Fang
- 1 University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | | | - Diane Paloma
- 2 Queen's Health Systems, Honolulu, Hawai'i, USA
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Shrestha A, Karmacharya BM, Khudyakov P, Weber MB, Spiegelman D. Dietary interventions to prevent and manage diabetes in worksite settings: a meta-analysis. J Occup Health 2017; 60:31-45. [PMID: 29187673 PMCID: PMC5799099 DOI: 10.1539/joh.17-0121-ra] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The translation of lifestyle intervention to improve glucose tolerance into the workplace has been rare. The objective of this meta-analysis is to summarize the evidence for the effectiveness of dietary interventions in worksite settings on lowering blood sugar levels. METHODS We searched for studies in PubMed, Embase, Econlit, Ovid, Cochrane, Web of Science, and Cumulative Index to Nursing and Allied Health Literature. Search terms were as follows: (1) Exposure-based: nutrition/diet/dietary intervention/health promotion/primary prevention/health behavior/health education/food /program evaluation; (2) Outcome-based: diabetes/hyperglycemia/glucose/HbA1c/glycated hemoglobin; and (3) Setting-based: workplace/worksite/occupational/industry/job/employee. We manually searched review articles and reference lists of articles identified from 1969 to December 2016. We tested for between-studies heterogeneity and calculated the pooled effect sizes for changes in HbA1c (%) and fasting glucose (mg/dl) using random effect models for meta-analysis in 2016. RESULTS A total of 17 articles out of 1663 initially selected articles were included in the meta-analysis. With a random-effects model, worksite dietary interventions led to a pooled -0.18% (95% CI, -0.29 to -0.06; P<0.001) difference in HbA1c. With the random-effects model, the interventions resulted in 2.60 mg/dl lower fasting glucose with borderline significance (95% CI: -5.27 to 0.08, P=0.06). In the multivariate meta-regression model, the interventions with high percent of female participants and that used the intervention directly delivered to individuals, rather the environment changes, were associated with more effective interventions. CONCLUSION Workplace dietary interventions can improve HbA1c. The effects were larger for the interventions with greater number of female participants and with individual-level interventions.
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Affiliation(s)
- Archana Shrestha
- Department of Epidemiology, Harvard T.H Chan School of Public Health
| | - Biraj Man Karmacharya
- Division of Cardiology, University of Washington.,Department of Community Medicine, Kathmandu University
| | - Polyna Khudyakov
- Department of Biostatistics, Harvard T.H Chan School of Public Health
| | - Mary Beth Weber
- Department of Global Health and Epidemiology, Rollins School of Public Health
| | - Donna Spiegelman
- Department of Epidemiology, Harvard T.H Chan School of Public Health.,Department of Biostatistics, Harvard T.H Chan School of Public Health.,Department of Nutrition, Harvard T.H Chan School of Public Health.,Department of Global Health and Population, Harvard T.H Chan School of Public Health
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Das SK, Brown C, Urban LE, O'Toole J, Gamache MMG, Weerasekara YK, Roberts SB. Weight loss in videoconference and in-person iDiet weight loss programs in worksites and community groups. Obesity (Silver Spring) 2017; 25:1033-1041. [PMID: 28452452 DOI: 10.1002/oby.21854] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 03/03/2017] [Accepted: 03/23/2017] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To examine the association of program delivery factors with weight loss (WL) in enrollees in iDiet® , a commercial WL program. METHODS Data were from 644 adults enrolling in an 11-week group WL program and 461 who reported weight to 11 weeks (complete reporters). Predictors of %WL were analyzed using ANCOVA, including meeting type (in-person vs. videoconference), participant type (worksite employees vs. community members), age, gender, BMI, and payment structure. RESULTS Mean starting BMI was 32.4 ± 7.1 (mean ± SD); WL was 6.1 ± 3.9% in all enrollees in an intention-to-treat analysis and 7.4 ± 3.4% in complete reporters. Videoconference participants, older adults, and enrollees in incentivized programs were more likely to be complete reporters (P < 0.004). %WL at 11 weeks was not associated with gender, starting BMI, or videoconference versus in-person groups. Worksite participants had greater %WL than community participants (+1.2%, P < 0.001), and there was no significant difference in %WL between programs paid by the employee or employer. Greater %WL was achieved by individuals ≥30 versus < 30 years (+2.2%, P < 0.001) and by those enrolling in January-March versus April-June (+1.4%, P = 0.02). CONCLUSIONS iDiet participants had clinically impactful mean WL. The observed high mean WL in worksites and videoconference-delivered programs broadens options for scalable WL program implementation.
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Affiliation(s)
- Sai Krupa Das
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Carrie Brown
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | | | - James O'Toole
- Instinct Health Science LLC, Rowley, Massachusetts, USA
| | - Madeleine M Gould Gamache
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Yasoma K Weerasekara
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Susan B Roberts
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
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Meng L, Wolff MB, Mattick KA, DeJoy DM, Wilson MG, Smith ML. Strategies for Worksite Health Interventions to Employees with Elevated Risk of Chronic Diseases. Saf Health Work 2017; 8:117-129. [PMID: 28593067 PMCID: PMC5447415 DOI: 10.1016/j.shaw.2016.11.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 10/20/2016] [Accepted: 11/07/2016] [Indexed: 10/27/2022] Open
Abstract
Chronic disease rates have become more prevalent in the modern American workforce, which has negative implications for workplace productivity and healthcare costs. Offering workplace health interventions is recognized as an effective strategy to reduce chronic disease progression, absenteeism, and healthcare costs as well as improve population health. This review documents intervention and evaluation strategies used for health promotion programs delivered in workplaces. Using predetermined search terms in five online databases, we identified 1,131 published items from 1995 to 2014. Of these items, 27 peer-reviewed articles met the inclusion criteria; reporting data from completed United States-based workplace interventions that recruited at-risk employees based on their disease or disease-related risk factors. A content rubric was developed and used to catalogue these 27 published field studies. Selected workplace interventions targeted obesity (n = 13), cardiovascular diseases (n = 8), and diabetes (n = 6). Intervention strategies included instructional education/counseling (n = 20), workplace environmental change (n = 6), physical activity (n = 10), use of technology (n = 10), and incentives (n = 13). Self-reported data (n = 21), anthropometric measurements (n = 17), and laboratory tests (n = 14) were used most often in studies with outcome evaluation. This is the first literature review to focus on interventions for employees with elevated risk for chronic diseases. The review has the potential to inform future workplace health interventions by presenting strategies related to implementation and evaluation strategies in workplace settings. These strategies can help determine optimal worksite health programs based on the unique characteristics of work settings and the health risk factors of their employee populations.
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Affiliation(s)
- Lu Meng
- Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
| | - Marilyn B. Wolff
- Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
| | - Kelly A. Mattick
- Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
| | - David M. DeJoy
- Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
| | - Mark G. Wilson
- Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
| | - Matthew Lee Smith
- Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center, College Station, TX, USA
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45
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Yakoob MY, Micha R, Khatibzadeh S, Singh GM, Shi P, Ahsan H, Balakrishna N, Brahmam GNV, Chen Y, Afshin A, Fahimi S, Danaei G, Powles JW, Ezzati M, Mozaffarian D. Impact of Dietary and Metabolic Risk Factors on Cardiovascular and Diabetes Mortality in South Asia: Analysis From the 2010 Global Burden of Disease Study. Am J Public Health 2016; 106:2113-2125. [PMID: 27736219 PMCID: PMC5104988 DOI: 10.2105/ajph.2016.303368] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries. METHODS We used the 2010 Global Burden of Disease national surveys to characterize risk factor levels by age and sex. We derived etiological effects of risk factors-disease endpoints, by age, from meta-analyses. We defined optimal levels. We combined these inputs with cause-specific mortality rates to compute population-attributable fractions as a percentage of total cardiometabolic deaths. RESULTS Suboptimal diet was the leading cause of cardiometabolic mortality in 4 of 5 countries, with population-attributable fractions from 40.7% (95% uncertainty interval = 37.4, 44.1) in Bangladesh to 56.9% (95% uncertainty interval = 52.4, 61.5) in Pakistan. High systolic blood pressure was the second leading cause, except in Bangladesh, where it superseded suboptimal diet. This was followed in all nations by high fasting plasma glucose, low fruit intake, and low whole grain intake. Other prominent burdens were more variable, such as low intake of vegetables, low omega-3 fats, and high sodium intake in India, Nepal, and Pakistan. CONCLUSIONS Important similarities and differences are evident in cardiometabolic mortality burdens of modifiable dietary and metabolic risks across these countries, informing health policy and program priorities.
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Affiliation(s)
- Mohammad Y Yakoob
- Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Renata Micha
- Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Shahab Khatibzadeh
- Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Gitanjali M Singh
- Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Peilin Shi
- Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Habibul Ahsan
- Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Nagalla Balakrishna
- Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Ginnela N V Brahmam
- Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Yu Chen
- Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Ashkan Afshin
- Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Saman Fahimi
- Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Goodarz Danaei
- Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - John W Powles
- Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Majid Ezzati
- Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Dariush Mozaffarian
- Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
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Jamal SN, Moy FM, Azmi Mohamed MN, Mukhtar F. Effectiveness of a Group Support Lifestyle Modification (GSLiM) Programme among Obese Adults in Workplace: A Randomised Controlled Trial. PLoS One 2016; 11:e0160343. [PMID: 27537687 PMCID: PMC4990415 DOI: 10.1371/journal.pone.0160343] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 07/18/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There was an increasing trend in the prevalence of obesity and its comorbidities over the past decades in Malaysia. Effective intervention for obesity remains limited. This study aimed to compare the effectiveness of a group based lifestyle modification programme amongst obese individuals with an existing dietary counseling programme. METHODS We recruited one hundred and ninety four overweight and obese (BMI>27.5 kg/m2) employees from a local university. They were randomly allocated to either Group Support Lifestyle Modification (GSLiM) (intervention)(n = 97) or dietary counseling (comparison)(n = 97). The GSLIM activities included self monitoring, cognitive-behaviour sessions, exercise as well as dietary change advocacy, which were conducted through seminars and group sessions over 24 weeks. The comparison group was given dietary counselling once in 12 weeks. Both groups were followed up for additional 12 weeks to check for intervention effect sustenance. Anthropometric and biochemical parameters were measured at baseline, 12, 24 and 36 weeks; while dietary intake, physical activities, psychological measures and quality of life measured at baseline, 24 and 36 weeks. Data analysis was conducted using ANOVA repeated measures with intention to treat principle. RESULTS The participants were predominantly women with mean (standard deviation) age of 40.5 (9.3) years. A total of 19.6% of the participants in GSLiM achieved 6% weight loss compared to 4.1% in the comparison group (Risk Ratio 4.75; 95% CI: 1.68, 13.45). At 24 weeks, the retention rate was 83.5% for GSLiM and 82.5% for comparison group. GSLiM participants also achieved significant improvement in total weight self-efficacy score, negative emotions and physical discomfort subscales, MDPSS friend subscale and all domains in quality of life. Participants in the comparison group experienced reduction in negative self-thoughts. CONCLUSION The GSLiM programme proved to be more effective in achieving targeted weight loss, improving weight self-efficacy, friend social support, and quality of life compared to dietary counseling. TRIAL REGISTRATION Iranian Registry of Clinical Trials IRCT201104056127N1.
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Affiliation(s)
- Siti Noraida Jamal
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | - Foong Ming Moy
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mohd Nahar Azmi Mohamed
- Department of Sports Medicine, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | - Firdaus Mukhtar
- Departments of Psychiatry, Faculty of Medicine, University Putra Malaysia, 43400 Serdang, Malaysia
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CVD Prevention Through Policy: a Review of Mass Media, Food/Menu Labeling, Taxation/Subsidies, Built Environment, School Procurement, Worksite Wellness, and Marketing Standards to Improve Diet. Curr Cardiol Rep 2016; 17:98. [PMID: 26370554 PMCID: PMC4569662 DOI: 10.1007/s11886-015-0658-9] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Poor diet is the leading cause of cardiovascular disease in the USA and globally. Evidence-based policies are crucial to improve diet and population health. We reviewed the effectiveness for a range of policy levers to alter diet and diet-related risk factors. We identified evidence to support benefits of focused mass media campaigns (especially for fruits, vegetables, salt), food pricing strategies (both subsidies and taxation, with stronger effects at lower income levels), school procurement policies (for increasing healthful or reducing unhealthful choices), and worksite wellness programs (especially when comprehensive and multicomponent). Evidence was inconclusive for food and menu labeling (for consumer or industry behavior) and changes in local built environment (e.g., availability or accessibility of supermarkets, fast food outlets). We found little empiric evidence evaluating marketing restrictions, although broad principles and large resources spent on marketing suggest utility. Widespread implementation and evaluation of evidence-based policy strategies, with further research on other strategies with mixed/limited evidence, are essential “population medicine” to reduce health and economic burdens and inequities of diet-related illness worldwide.
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Weerasekara YK, Roberts SB, Kahn MA, LaVertu AE, Hoffman B, Das SK. Effectiveness of Workplace Weight Management Interventions: a Systematic Review. Curr Obes Rep 2016; 5:298-306. [PMID: 27023071 DOI: 10.1007/s13679-016-0205-z] [Citation(s) in RCA: 16] [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] [Indexed: 10/22/2022]
Abstract
A systematic review was conducted of randomized trials of workplace weight management interventions, including trials with dietary, physical activity, environmental, behavioral, and incentive-based components. Main outcomes were defined as change in weight-related measures. Keywords related to weight management and workplace interventions were used to search relevant databases, and 23 eligible studies were reviewed in detail using a data extraction form and quality assessment checklist. The trials were conducted mainly in the USA and Europe, with four additional countries represented. Interventions were mostly multicomponent and were implemented in both sexes and in a range of employment categories. Intervention effectiveness appeared unrelated to region of the world and was highest in 6-12-month trials. The results ranged widely from clinically significant 8.8-kg weight loss in one trial to less effective than the control treatment in others. Some workplace interventions achieve clinically significant benefits, and further studies are needed to replicate those results in wider sociocultural and geographical contexts.
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Affiliation(s)
- Yasoma Kumari Weerasekara
- Obesity and Energetics Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111, USA
| | - Susan B Roberts
- Obesity and Energetics Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111, USA
| | - Mira A Kahn
- Obesity and Energetics Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111, USA
| | - Amy E LaVertu
- Hirsh Health Sciences Library, Tufts University, Boston, MA, USA
| | - Ben Hoffman
- General Electric Medical Services, GE, Chicago, IL, USA
- University of Texas School of Public Health, San Antonio, TX, USA
| | - Sai Krupa Das
- Obesity and Energetics Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111, USA.
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49
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Jackson CL, Wee CC, Hurtado DA, Kawachi I. Obesity trends by industry of employment in the United States, 2004 to 2011. BMC OBESITY 2016; 3:20. [PMID: 27047665 PMCID: PMC4818929 DOI: 10.1186/s40608-016-0100-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 03/18/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Obesity is associated with increased morbidity, occupational injuries, and premature mortality. Obesity also disproportionately affects blacks and socioeconomically disadvantaged workers. However, few studies have evaluated national trends of obesity by employment industry overall and especially by race. METHODS To investigate national trends of obesity by employment industry overall and by race, we estimated the age-standardized obesity prevalence from 2004 to 2011. We used direct age-standardization with the 2000 US Census population as the standard among 136,923 adults in the US National Health Interview Survey. We also estimated prevalence ratios (PRs) for obesity in black women and men compared to their white counterparts for each employment industry using adjusted Poisson regression models with robust variance. RESULTS Obesity prevalence increased for men and women over the study period across all employment industry categories, and the healthcare industry had the highest overall age-standardized prevalence (30 %). Black women had a significantly higher obesity prevalence than white women across all employment industry categories, ranging from 33 % (95 % confidence interval (CI): 1.16,1.52) in Professional/Management to 74 % in Education (95 % CI: 1.56,1.93). Obesity prevalence was higher among black than white men for Healthcare (PR = 1.39 [1.15,1.69]), Education (PR = 1.39 [1.17,1.67]), Public Administration (PR = 1.34 [1.20,1.49]), and Manufacturing (PR = 1.19 [1.11,1.27]). Differences in obesity prevalence by race were generally widest in professional/management occupations. CONCLUSIONS Obesity trends varied substantially overall as well as within and between race-gender groups across employment industries. These findings demonstrate the need for further investigation of racial and sociocultural disparities in the work-obesity relationship to employ strategies designed to address these disparities while improving health among all US workers. Further research and interventions among workers in industries with an increasing or high prevalence of obesity should be prioritized.
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Affiliation(s)
- Chandra L Jackson
- Clinical and Translational Science Center, Harvard Catalyst, Harvard Medical School, Boston, MA USA
| | - Christina C Wee
- Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA
| | - David A Hurtado
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA USA
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Sharma SV, Winston Paolicelli C, Jyothi V, Baun W, Perkison B, Phipps M, Montgomery C, Feltovich M, Griffith J, Alfaro V, Pompeii LA. Evaluation of worksite policies and practices promoting nutrition and physical activity among hospital workers. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2016. [DOI: 10.1108/ijwhm-03-2014-0005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– As posited by the ecological model of health, improvements in the nutrition and physical activity environments of worksites may facilitate healthier dietary intakes and physical activity patterns of employees. This cross-sectional study describes current policies and practices targeting these environments in five large Texas-based hospitals employing approximately 40,000 adults. The paper aims to discuss these issues.
Design/methodology/approach
– The environmental assessment tool survey, an observation tool, was used to assess these policies and practices in August and September 2012.
Findings
– Results demonstrated major policy and practice deficiencies, including a lack of policies supporting on and offsite employee physical fitness, no healthy catering or healthy meeting policies, minimal subsidizing of healthy food and beverage options, few health-promoting vending services, and no performance objectives related to worksite health improvement. Hospitals having an active employee wellness staff consistently performed better on implementation of policies and practices supporting healthy eating and physical activity.
Practical implications
– This study supports practice recommendations including engaging executive leadership to prioritize worksite wellness and using policies to create an infrastructure that promotes healthy eating and encourages physical activity among employees.
Originality/value
– This study is the first to compare and contrast the nutrition and the physical activity environments of large hospitals, allowing for the identification of common environmental barriers and supports across multiple hospital and foodservice systems.
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