ABSTRACT
BACKGROUND AND AIMS: Modifiable lifestyle factors, such as physical activity (PA) and Mediterranean diet (MD), decrease metabolic syndrome (MetS). The aim was to assess 1-year changes of leisure-time physical activity (LTPA), sedentary behavior, and diet quality according to MetS severity in older population at high cardiovascular risk. METHODS AND RESULTS: Prospective analysis of 55-75-year-old 4359 overweight/obese participants with MetS (PREDIMED-Plus trial) categorized in tertiles according to 1-year changes of a validated MetS severity score (MetSSS). Anthropometrics, visceral adiposity index, triglycerides and glucose index, dietary nutrient intake, biochemical marker levels, dietary inflammatory index, and depression symptoms were measured. Diet quality was assessed by 17-item MD questionnaire. PAs were self-reported using the Minnesota-REGICOR Short Physical Activity Questionnaire and 30-s chair stand test. Sedentary behaviors were measured using the Spanish version of the Nurses' Health Study questionnaire. After 1-year follow-up, decreasing MetSSS was associated with an anti-inflammatory dietary pattern, high intake of vegetables, fruits, legumes, nuts, whole grain cereals, white fish, and bluefish and low intake of refined cereals, red and processed meat, cookies/sweets, and snacks/ready-to-eat-meals. It resulted in high intake of polyunsaturated fatty acids, omega-3 fatty acids, protein, fiber, vitamins B1, B6, B9, C, D, potassium, magnesium, and phosphorus and low glycemic index and saturated fatty acid, trans fatty acid, and carbohydrates intake. Regarding PA and sedentary behavior, decreasing MetSSS was associated with increased moderate-to-vigorous LTPA, chair stand test, and decreased sedentary and TV-viewing time. CONCLUSION: Decreasing MetSSS was associated with an anti-inflammatory dietary pattern, high LTPA, high MD adherence, low sedentary time, and low depression risk.
Subject(s)
Cardiovascular Diseases/prevention & control , Diet, Healthy , Diet, Mediterranean , Exercise , Metabolic Syndrome/prevention & control , Risk Reduction Behavior , Sedentary Behavior , Aged , Cardiometabolic Risk Factors , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/physiopathology , Feeding Behavior , Female , Functional Status , Humans , Longitudinal Studies , Male , Metabolic Syndrome/diagnosis , Metabolic Syndrome/epidemiology , Metabolic Syndrome/physiopathology , Middle Aged , Nutritive Value , Prognosis , Prospective Studies , Protective Factors , Randomized Controlled Trials as Topic , Risk Assessment , Severity of Illness Index , Spain/epidemiology , Time FactorsABSTRACT
One-year dietary quality change according to the preceding maximum weight in a lifestyle intervention program (PREDIMED-Plus trial, 55-75-year-old overweight or obese adults; n = 5695) was assessed. A validated food frequency questionnaire was used to assess dietary intake. A total of 3 groups were made according to the difference between baseline measured weight and lifetime maximum reported weight: (a) participants entering the study at their maximum weight, (b) moderate weight loss maintainers (WLM), and (c) large WLM. Data were analyzed by General Linear Model. All participants improved average lifestyle. Participants entering the study at their maximum weight were the most susceptible to improve significantly their dietary quality, assessed by adherence to Mediterranean diet, DII and both healthful and unhealthful provegetarian patterns. People at maximum weight are the most benefitted in the short term by a weight management program. Long term weight loss efforts may also reduce the effect of a weight management program.
Subject(s)
Diet, Healthy/statistics & numerical data , Obesity/therapy , Overweight/therapy , Patient Compliance/statistics & numerical data , Weight Reduction Programs/methods , Aged , Behavior Therapy/methods , Body-Weight Trajectory , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Diet Surveys , Diet, Mediterranean , Female , Humans , Life Style , Linear Models , Longitudinal Studies , Male , Middle Aged , Obesity/complications , Obesity/physiopathology , Overweight/complications , Overweight/physiopathology , Prospective Studies , Treatment Outcome , Weight LossABSTRACT
The increase in the prevalence of type 2 diabetes and the worldwide expansion of overweight and obesity are intrinsically linked. The percentage of diabetes attributable to weight gain amounts to more than 80% in many countries. This relationship is addressed in a Spanish Consensus Document from SEMI, SED, redGDPS, SEC, SEEDO, SEEN, SEMERGEN and SEMFYC published in 2015 and which gathers best available evidences. Based on the statements of this consensus document, we propose five recommendations for clinical practice to establish a diagnosis of precision and the most appropriate treatment for joint diabetes and obesity. These recommendations have been agreed by the SENDIMAD, SOMAMFYC, SEMG Madrid and RedGDPS Working Groups: 1. For every patient with diabetes and obesity, in addition to the calculation of the body mass index, the percentage of body fat and the approximation to the assessment of body composition should be evaluated throughout the whole process (both at the beginning and follow up). 2. The approximation to the degree and distribution of body fat requires the measurement and recording of the waist circumference of these patients. 3. The integrated assessment of the patient with type 2 diabetes-obesity requires the evaluation of the degree of physical activity and/or characterization of the sedentary condition. 4. The prescription of lifestyle changes should be incorporated into therapeutic education (individualized, flexible, autonomous and sustainable diet and physical activity plan. 5. The pharmacological approach in the treatment of type 2 diabetes-obesity implies the choice of anti-diabetic drugs that facilitate the loss of fat.
El aumento en la prevalencia de diabetes tipo 2 y la expansión a nivel mundial de los estados de sobrepeso y obesidad están intrínsecamente vinculados, de forma que el porcentaje de diabetes atribuible al aumento de peso llega a ser superior al 80% en muchos países. En 2015 se publica un Documento de Consenso español de SEMI, SED, redGDPS, SEC, SEEDO, SEEN, SEMERGEN y SEMFYC que aborda esta doble condición de acuerdo con las mejores evidencias. Desde las afirmaciones de dicho consenso proponemos cinco recomendaciones para la práctica clínica consensuadas por los Grupos de trabajo de SENDIMAD, SOMAMFYC, SEMG Madrid y RedGDPS, con el fin de establecer un diagnóstico de precisión y el tratamiento más adecuado:1. En todo paciente con diabetes y obesidad debe abordarse, tanto al inicio como en el seguimiento, además del cálculo del índice de masa corporal (IMC), el porcentaje de grasa corporal y la valoración de la composición corporal.2. La aproximación al grado y distribución de la grasa corporal requiere incluir la medición y registro del perímetro de cintura de estos pacientes.3. La valoración integral del paciente con diabetes tipo 2-obesidad exige la evaluación del grado de actividad física y/o caracterizar la condición de sedentarismo.4. La prescripción de cambios del estilo de vida debe ser incorporada a la educación terapéutica (plan dietético y de actividad física individualizado, flexible, autónomo y sostenible).5. El abordaje farmacológico en el tratamiento de la diabetes-obesidad implica la elección de fármacos antidiabéticos que faciliten la pérdida de grasa.
Subject(s)
Diabetes Complications/therapy , Diabetes Mellitus/therapy , Obesity/therapy , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/therapy , Evidence-Based Medicine , Health Education , Humans , Obesity/complications , SpainABSTRACT
El aumento en la prevalencia de diabetes tipo 2 y la expansión a nivel mundial de los estados de sobrepeso y obesidad están intrínsecamente vinculados, de forma que el porcentaje de diabetes atribuible al aumento de peso llega a ser superior al 80% en muchos países. En 2015 se publica un Documento de Consenso español de SEMI, SED, redGDPS, SEC, SEEDO, SEEN, SEMERGEN y SEMFYC que aborda esta doble condición de acuerdo con las mejores evidencias. Desde las afirmaciones de dicho consenso proponemos cinco recomendaciones para la práctica clínica consensuadas por los Grupos de trabajo de SENDIMAD, SOMAMFYC, SEMG Madrid y RedGDPS, con el fi n de establecer un diagnóstico de precisión y el tratamiento más adecuado: 1. En todo paciente con diabetes y obesidad debe abordarse, tanto al inicio como en el seguimiento, además del cálculo del índice de masa corporal (IMC), el porcentaje de grasa corporal y la valoración de la composición corporal. 2. La aproximación al grado y distribución de la grasa corporal requiere incluir la medición y registro del perímetro de cintura de estos pacientes. 3. La valoración integral del paciente con diabetes tipo 2-obesidad exige la evaluación del grado de actividad física y/o caracterizar la condición de sedentarismo. 4. La prescripción de cambios del estilo de vida debe ser incorporada a la educación terapéutica (plan dietético y de actividad física individualizado, flexible, autónomo y sostenible). 5. El abordaje farmacológico en el tratamiento de la diabetes-obesidad implica la elección de fármacos antidiabéticos que faciliten la pérdida de grasa
The increase in the prevalence of type 2 diabetes and the worldwide expansion of overweight and obesity are intrinsically linked. The percentage of diabetes attributable to weight gain amounts to more than 80% in many countries. This relationship is addressed in a Spanish Consensus Document from SEMI, SED, redGDPS, SEC, SEEDO, SEEN, SEMERGEN and SEMFYC published in 2015 and which gathers best available evidences. Based on the statements of this consensus document, we propose five recommendations for clinical practice to establish a diagnosis of precision and the most appropriate treatment for joint diabetes and obesity. These recommendations have been agreed by the SENDIMAD, SOMAMFYC, SEMG Madrid and RedGDPS Working Groups: 1. For every patient with diabetes and obesity, in addition to the calculation of the body mass index, the percentage of body fat and the approximation to the assessment of body composition should be evaluated throughout the whole process (both at the beginning and follow up). 2. The approximation to the degree and distribution of body fat requires the measurement and recording of the waist circumference of these patients. 3. The integrated assessment of the patient with type 2 diabetes-obesity requires the evaluation of the degree of physical activity and/or characterization of the sedentary condition. 4. The prescription of lifestyle changes should be incorporated into therapeutic education (individualized, fl exible, autonomous and sustainable diet and physical activity plan. 5. The pharmacological approach in the treatment of type 2 diabetes-obesity implies the choice of anti-diabetic drugs that facilitate the loss of fat
Subject(s)
Humans , Diabetes Complications/therapy , Diabetes Mellitus/therapy , Obesity/therapy , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/therapy , Evidence-Based Medicine , Health Education , Obesity/complications , SpainABSTRACT
BACKGROUND: functional bowel disorders are characterized by an absence of structural or biochemical damage, but can lead to chronic diarrhea and intestinal malabsorption. If not properly treated, they predispose to a state of malnutrition that, depending on the underlying pathologies, could affect the evolution of other concomitant diseases. CASE REPORT: the relevance of this case stems from the fact that our 43-year-old patient, with multiple comorbidities, with progressive weight and muscle mass loss, after five years of inefficiency in the treatment of chronic diarrhea, achieves, on a peptide enteral formula basis, a good nutritional status and quality of life, which finally leads to the control of the chronic diarrhea and malnutrition. DISCUSSION: in the unintentional weight loss caused by long-term functional diarrhea, the choice of a peptide diet may have a fundamental role for a satisfactory patient's progress.
Subject(s)
Diarrhea/complications , Diarrhea/diet therapy , Malnutrition/diet therapy , Malnutrition/etiology , Peptides/therapeutic use , Adult , Enteral Nutrition , Female , Humans , Malabsorption Syndromes/diet therapy , Malabsorption Syndromes/etiology , Nutritional Status , Treatment Outcome , Weight LossABSTRACT
Introducción: los trastornos funcionales del intestino se caracterizan por una ausencia de daño estructural o bioquímico, pero pueden causar diarrea crónica y malabsorción intestinal. Sin tratamiento adecuado, predisponen a un estado de desnutrición que, dependiendo de las patologías de base, podría condicionar la evolución de otras enfermedades concomitantes. Caso clínico: la relevancia de este caso se debe a que nuestra paciente pluripatológica, de 43 años de edad, con pérdida progresiva de peso y masa muscular, tras cinco años de ineficiencia en el tratamiento nutricional y soporte estándar de la diarrea crónica consigue, después de unos meses de tratamiento con dieta peptídica, un buen estado nutricional y calidad de vida, habiendo logrado controlar la diarrea crónica y la desnutrición. Discusión: en la pérdida inintencionada de peso que causa una diarrea de perfil funcional de larga evolución, la elección de una dieta peptídica puede ser muy útil para que la evolución del paciente sea satisfactoria
Background: functional bowel disorders are characterized by an absence of structural or biochemical damage, but can lead to chronic diarrhea and intestinal malabsorption. If not properly treated, they predispose to a state of malnutrition that, depending on the underlying pathologies, could affect the evolution of other concomitant diseases. Case report: the relevance of this case stems from the fact that our 43-year-old patient, with multiple comorbidities, with progressive weight and muscle mass loss, after five years of inefficiency in the treatment of chronic diarrhea, achieves, on a peptide enteral formula basis, a good nutritional status and quality of life, which finally leads to the control of the chronic diarrhea and malnutrition. Discussion: in the unintentional weight loss caused by long-term functional diarrhea, the choice of a peptide diet may have a fundamental role for a satisfactory patient's progress
