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Waziry R, Ryan CP, Corcoran DL, Huffman KM, Kobor MS, Kothari M, Graf GH, Kraus VB, Kraus WE, Lin DTS, Pieper CF, Ramaker ME, Bhapkar M, Das SK, Ferrucci L, Hastings WJ, Kebbe M, Parker DC, Racette SB, Shalev I, Schilling B, Belsky DW. Author Correction: Effect of long-term caloric restriction on DNA methylation measures of biological aging in healthy adults from the CALERIE trial. Nat Aging 2023:10.1038/s43587-023-00432-y. [PMID: 37161091 DOI: 10.1038/s43587-023-00432-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- R Waziry
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - C P Ryan
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - D L Corcoran
- Department of Genetics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - K M Huffman
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - M S Kobor
- Department of Medical Genetics, Edwin S.H. Leong Healthy Aging Program, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - M Kothari
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - G H Graf
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - V B Kraus
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - W E Kraus
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - D T S Lin
- Department of Medical Genetics, Edwin S.H. Leong Healthy Aging Program, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - C F Pieper
- Center on Aging and Development, Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - M E Ramaker
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - M Bhapkar
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - S K Das
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - L Ferrucci
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - W J Hastings
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA, USA
| | - M Kebbe
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - D C Parker
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - S B Racette
- Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - I Shalev
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA, USA
| | - B Schilling
- Buck Institute for Research on Aging, Novato, CA, USA
| | - D W Belsky
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA.
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
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Waziry R, Ryan CP, Corcoran DL, Huffman KM, Kobor MS, Kothari M, Graf GH, Kraus VB, Kraus WE, Lin DTS, Pieper CF, Ramaker ME, Bhapkar M, Das SK, Ferrucci L, Hastings WJ, Kebbe M, Parker DC, Racette SB, Shalev I, Schilling B, Belsky DW. Effect of long-term caloric restriction on DNA methylation measures of biological aging in healthy adults from the CALERIE trial. Nat Aging 2023; 3:248-257. [PMID: 37118425 PMCID: PMC10148951 DOI: 10.1038/s43587-022-00357-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/22/2022] [Indexed: 04/30/2023]
Abstract
The geroscience hypothesis proposes that therapy to slow or reverse molecular changes that occur with aging can delay or prevent multiple chronic diseases and extend healthy lifespan1-3. Caloric restriction (CR), defined as lessening caloric intake without depriving essential nutrients4, results in changes in molecular processes that have been associated with aging, including DNA methylation (DNAm)5-7, and is established to increase healthy lifespan in multiple species8,9. Here we report the results of a post hoc analysis of the influence of CR on DNAm measures of aging in blood samples from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) trial, a randomized controlled trial in which n = 220 adults without obesity were randomized to 25% CR or ad libitum control diet for 2 yr (ref. 10). We found that CALERIE intervention slowed the pace of aging, as measured by the DunedinPACE DNAm algorithm, but did not lead to significant changes in biological age estimates measured by various DNAm clocks including PhenoAge and GrimAge. Treatment effect sizes were small. Nevertheless, modest slowing of the pace of aging can have profound effects on population health11-13. The finding that CR modified DunedinPACE in a randomized controlled trial supports the geroscience hypothesis, building on evidence from small and uncontrolled studies14-16 and contrasting with reports that biological aging may not be modifiable17. Ultimately, a conclusive test of the geroscience hypothesis will require trials with long-term follow-up to establish effects of intervention on primary healthy-aging endpoints, including incidence of chronic disease and mortality18-20.
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Affiliation(s)
- R Waziry
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - C P Ryan
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - D L Corcoran
- Department of Genetics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - K M Huffman
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - M S Kobor
- Department of Medical Genetics, Edwin S.H. Leong Healthy Aging Program, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - M Kothari
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - G H Graf
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - V B Kraus
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - W E Kraus
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - D T S Lin
- Department of Medical Genetics, Edwin S.H. Leong Healthy Aging Program, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - C F Pieper
- Center on Aging and Development, Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - M E Ramaker
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - M Bhapkar
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - S K Das
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - L Ferrucci
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - W J Hastings
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA, USA
| | - M Kebbe
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - D C Parker
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - S B Racette
- Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - I Shalev
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA, USA
| | - B Schilling
- Buck Institute for Research on Aging, Novato, CA, USA
| | - D W Belsky
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA.
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
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Sopcak N, Fernandes C, O'Brien MA, Ofosu D, Wong M, Wong T, Kebbe M, Manca D. What is a prevention visit? A qualitative study of a structured approach to prevention and screening - the BETTER WISE project. BMC Fam Pract 2021; 22:153. [PMID: 34275453 PMCID: PMC8287802 DOI: 10.1186/s12875-021-01503-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 06/22/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND This qualitative study is a sub-component of BETTER WISE, a comprehensive and structured approach that proactively addresses chronic disease prevention, screening, and cancer survivorship, including screening for poverty and addressing lifestyle risks for patients aged 40 to 65. Patients (n = 527) from 13 primary care clinics (urban, rural, and remote) in Alberta, Ontario, and Newfoundland & Labrador, Canada agreed to participate in the study and were invited to a one-hour prevention visit delivered by a Prevention Practitioner (PP) as part of BETTER WISE. We identified the key components of a BETTER WISE prevention visit based on patients' and primary care providers' perspectives. METHODS Primary care providers (PPs, physicians and their staff) participated in 14 focus groups and 19 key informant interviews to share their perspectives on the BETTER WISE project. Of 527 patients who agreed to participate in the study and were invited for a BETTER WISE prevention visit with a PP, we received 356 patient feedback forms. We also collected field notes and memos and employed thematic analysis using a constant comparative method focusing on the BETTER WISE prevention visit. RESULTS We identified four key themes related to a BETTER WISE prevention visit: 1) Creating a safe environment and building trust with patients: PPs provided sufficient time and a safe space for patients to share what was important to them, including their concerns related to poverty, alcohol consumption, and mental health, topics that were often not shared with physicians; 2) Providing personalized health education: PPs used the BETTER WISE tools to provide patients with a personalized overview of their health status and eligible screening; 3) Non-judgmental empowering of patients: Instead of directing patients on what to do, PPs evoked patients' preferences and helped them to set goals (if desired); and 4) Integrating care for patients: PPs clarified information from patients' charts and surveys with physicians and helped patients to navigate resources within and outside of the primary care team. CONCLUSIONS The results of this study underscore the importance of personalized, trusting, non-judgmental, and integrated relationships between primary care providers and patients to effectively address chronic disease prevention, screening, and cancer survivorship as demonstrated by the BETTER WISE prevention visits. TRIAL REGISTRATION This qualitative study is a sub-component of the BETTER WISE pragmatic, cRCT, trial registration ISRCTN21333761 (date of registration 19/12/2016).
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Affiliation(s)
- N Sopcak
- Department of Family Medicine, University of Alberta, Edmonton, Canada.
| | - C Fernandes
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - M A O'Brien
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - D Ofosu
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - M Wong
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - T Wong
- Strategic Clinical Networks, Alberta Health Services, Calgary, Canada
| | - M Kebbe
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, USA
| | - D Manca
- Department of Family Medicine, University of Alberta, Edmonton, Canada
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Kebbe M, Perez A, Buchholz A, Scott SD, McHugh TLF, Dyson MP, Ball GDC. Health care providers' weight management practices for adolescent obesity and alignment with clinical practice guidelines: a multi-centre, qualitative study. BMC Health Serv Res 2020; 20:850. [PMID: 32912259 PMCID: PMC7488259 DOI: 10.1186/s12913-020-05702-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/31/2020] [Indexed: 12/02/2022] Open
Abstract
Background Clinical practice guidelines (CPGs) include evidence-based recommendations for managing obesity in adolescents. However, information on how health care providers (HCPs) implement these recommendations in day-to-day practice is limited. Our objectives were to explore how HCPs deliver weight management health services to adolescents with obesity and describe the extent to which their reported practices align with recent CPGs for managing pediatric obesity. Methods From July 2017 to January 2018, we conducted a qualitative study that used purposeful sampling to recruit HCPs with experience in adolescent weight management from multidisciplinary, pediatric weight management clinics in Edmonton and Ottawa, Canada. Data were collected using audio-recorded focus groups (4–6 participants/group; 60–90 min in length). We applied inductive, semantic thematic analysis and the congruent methodological approach to analyze our data, which included transcripts, field notes, and memos. Qualitative data were compared to recent CPGs for pediatric obesity that were published by the Endocrine Society in 2017. Of the 12 obesity ‘treatment-related’ recommendations, four were directly relevant to the current study. Results Data were collected through three focus groups with 16 HCPs (n = 10 Edmonton; n = 6 Ottawa; 94% female; 100% Caucasian), including dietitians, exercise specialists, nurses, pediatricians, psychologists, and social workers. We identified three main themes that we later compared with CPG recommendations, including: (i) discuss realistic expectations regarding weight management (e.g., shift focus from weight to health; explore family cohesiveness; foster delayed vs instant gratification), (ii) personalize weight management (e.g., address personal barriers to change; consider developmental readiness), and (iii) exhibit non-biased attitudes and practices (e.g., de-emphasize individual causes of obesity; avoid making assumptions about lifestyle behaviors based on weight). Based on these qualitative findings, HCPs applied all four CPG recommendations in their practices. Conclusions HCPs provided practical insights into what and how they delivered weight management for adolescents, which included operationalizing relevant CPG recommendations in their practices.
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Affiliation(s)
- M Kebbe
- Department of Pediatrics, Faculty of Medicine & Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Avenue, Edmonton, Alberta, T6G 1C9, Canada
| | - A Perez
- Department of Pediatrics, Faculty of Medicine & Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Avenue, Edmonton, Alberta, T6G 1C9, Canada
| | - A Buchholz
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - S D Scott
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - T-L F McHugh
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - M P Dyson
- Department of Pediatrics, Faculty of Medicine & Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Avenue, Edmonton, Alberta, T6G 1C9, Canada
| | - G D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Avenue, Edmonton, Alberta, T6G 1C9, Canada.
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Kebbe M, Farmer A, Dyson MP, Scott SD, McHugh TLF, Lappa S, Rajani H, Ladha T, Islam B, Jacoby L, Nasir F, Talwar K, Wincott JL, Zhang M, Ball GDC. Feasibility, user experiences, and preliminary effect of Conversation Cards for Adolescents© on collaborative goal-setting and behavior change: protocol for a pilot randomized controlled trial. Pilot Feasibility Stud 2019; 5:149. [PMID: 31890261 PMCID: PMC6918564 DOI: 10.1186/s40814-019-0533-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 11/22/2019] [Indexed: 01/29/2023] Open
Abstract
Background Adolescents and providers can benefit from practical tools targeting lifestyle modification for obesity prevention and management. We created Conversation Cards for Adolescents© (CCAs), a patient-centered communication and behavior change tool for adolescents and providers to use in clinical practice. The purpose of our study is to (i) assess the feasibility of CCAs in a real-world, practice setting to inform full-scale trial procedures, (ii) assess user experiences of CCAs, and (iii) determine the preliminary effect of CCAs on changing behavioral and affective-cognitive outcomes among adolescents. Methods Starting in early 2019, this prospective study is a nested mixed-methods, theory-driven, and pragmatic pilot randomized controlled trial with a goal to enroll 50 adolescents (13–17 years old) and 9 physicians practicing at the Northeast Community Health Centre in Edmonton, Alberta, Canada. Adolescents will collaboratively set one S.M.A.R.T. (specific, measurable, attainable, realistic, timely) goal with their physician to implement over a 3-week period; however, only those randomized to the experimental group will use CCAs to inform their goal. Outcome assessments at baseline and follow-up (3 weeks post-baseline) will include behavioral, affective-cognitive, and process-related outcomes. Discussion In examining the feasibility, user experiences, and preliminary effect of CCAs, our study will add contributions to the obesity literature on lifestyle modifications among adolescents in a real-world, practice setting as well as inform the scalability of our approach for a full-scale effectiveness randomized controlled trial on behavior change. Trial registration ClinicalTrials.gov Identifier: NCT03821896.
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Affiliation(s)
- M Kebbe
- 1Department of Pediatrics, Faculty of Medicine & Dentistry, 4-515 Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Avenue, Edmonton, Alberta T6G 1C9 Canada
| | - A Farmer
- 2Department of Agricultural, Food, and Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, Alberta Canada
| | - M P Dyson
- 1Department of Pediatrics, Faculty of Medicine & Dentistry, 4-515 Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Avenue, Edmonton, Alberta T6G 1C9 Canada
| | - S D Scott
- 3Faculty of Nursing, University of Alberta, Edmonton, Alberta Canada
| | - T L F McHugh
- 4Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta Canada
| | - S Lappa
- Northeast Community Health Centre, Edmonton, Alberta Canada
| | - H Rajani
- Northeast Community Health Centre, Edmonton, Alberta Canada
| | - T Ladha
- Northeast Community Health Centre, Edmonton, Alberta Canada
| | - B Islam
- Northeast Community Health Centre, Edmonton, Alberta Canada
| | - L Jacoby
- Northeast Community Health Centre, Edmonton, Alberta Canada
| | - F Nasir
- Northeast Community Health Centre, Edmonton, Alberta Canada
| | - K Talwar
- Northeast Community Health Centre, Edmonton, Alberta Canada
| | - J L Wincott
- Northeast Community Health Centre, Edmonton, Alberta Canada
| | - M Zhang
- Northeast Community Health Centre, Edmonton, Alberta Canada
| | - G D C Ball
- 1Department of Pediatrics, Faculty of Medicine & Dentistry, 4-515 Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Avenue, Edmonton, Alberta T6G 1C9 Canada
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Kebbe M, Perez A, Buchholz A, McHugh TLF, Scott SD, Richard C, Dyson MP, Ball GDC. End-user perspectives to inform policy and program decisions: a qualitative and quantitative content analysis of lifestyle treatment recommendations by adolescents with obesity. BMC Pediatr 2019; 19:418. [PMID: 31699060 PMCID: PMC6839254 DOI: 10.1186/s12887-019-1749-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 09/25/2019] [Indexed: 11/12/2022] Open
Abstract
Background Lifestyle modifications represent the first line of treatment in obesity management; however, many adolescents with obesity do not meet lifestyle recommendations. Given that adolescents are rarely consulted during health policy development and in the design of lifestyle interventions, their first-hand experiences, preferences, and priorities may not be represented. Accordingly, our purpose was to explore adolescents’ lifestyle treatment recommendations to inform policy and program decisions. Methods Conducted from July 2017 to January 2018, this study adhered to a qualitative, crosslanguage, patient-oriented design. We recruited 19 13–17-year-old adolescents (body mass index [BMI] ≥85th percentile) seeking multidisciplinary treatment for obesity in geographically and culturally diverse regions of Canada. Adolescents participated in one-on-one, in-person, semi-structured interviews in English or French. Interviews were audio-recorded, transcribed verbatim, managed using NVivo 11, and analyzed using quantitative and qualitative content analysis by two independent researchers. Results Adolescents’ recommendations were organized into five categories, each of which denotes health as a collective responsibility: (i) establish parental support within limits, (ii) improve accessibility and availability of ‘healthy foods’, (iii) limit deceptive practices in food marketing, (iv) improve accessibility and availability of varied physical activity opportunities, and (v) delay school start times. Respect for individual autonomy and decision-making capacity were identified as particularly important, however these were confronted with adolescents’ partial knowledge on nutrition and food literacy. Conclusions Adolescents’ recommendations highlighted multi-level, multi-component factors that influenced their ability to lead healthy lifestyles. Uptake of these recommendations by policy-makers and program developers may be of added value for lifestyle treatment targeting adolescents with obesity.
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Affiliation(s)
- M Kebbe
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Avenue, Edmonton, Alberta, Canada
| | - A Perez
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Avenue, Edmonton, Alberta, Canada
| | - A Buchholz
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - T-L F McHugh
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - S D Scott
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - C Richard
- Department of Agricultural, Food, and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - M P Dyson
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Avenue, Edmonton, Alberta, Canada
| | - G D C Ball
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Avenue, Edmonton, Alberta, Canada.
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Ball GDC, Kebbe M. Preventing and managing paediatric obesity: a special edition on randomized controlled trials. Pediatr Obes 2018; 13:635-638. [PMID: 30362290 DOI: 10.1111/ijpo.12482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 09/08/2018] [Indexed: 12/18/2022]
Affiliation(s)
- G D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - M Kebbe
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
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Kebbe M, Damanhoury S, Browne N, Dyson MP, McHugh TLF, Ball GDC. Barriers to and enablers of healthy lifestyle behaviours in adolescents with obesity: a scoping review and stakeholder consultation. Obes Rev 2017; 18:1439-1453. [PMID: 28925065 DOI: 10.1111/obr.12602] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/14/2017] [Accepted: 07/29/2017] [Indexed: 11/29/2022]
Abstract
Healthy lifestyle behaviours are key to successful weight management, but have proven to be challenging to attain for adolescents with obesity. The purpose of our scoping review was to (i) describe barriers and enablers that adolescents with obesity encounter for healthy nutrition, physical activity, sedentary behaviour and sleep habits and (ii) identify gaps in the literature. We adhered to established methodology for scoping reviews. Six databases were searched (1980-June 2016) for original articles published in English or French that focused on lifestyle behaviours of 13- to 17-year-olds in paediatric weight management. Following screening and data extraction, findings of selected articles were synthesized thematically using a social ecological framework. Stakeholder consultation (n = 20) with adolescents with obesity and health professionals was completed to enhance methodological rigour. Our search yielded 17 articles for inclusion, including 546 unique participants. Barriers to healthy nutrition and physical activity were more consistently related to individual-level and interpersonal-level factors; enablers tended to be linked with interpersonal-level factors. Knowledge gaps identified related to sedentary behaviour and sleep as well as environmental and policy levels of influence. Our review revealed that some barriers and enablers were unique to adolescents with obesity, which were either within or beyond their control. These findings highlight the importance of multilevel interventions to enable healthy lifestyle behaviours for weight management.
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Affiliation(s)
- M Kebbe
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - S Damanhoury
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, Canada
| | - N Browne
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - M P Dyson
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - T-L F McHugh
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada
| | - G D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
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