Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.824
Filtrar
2.
Medicine (Baltimore) ; 98(38): e17274, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31568007

RESUMO

BACKGROUND: Weight status and autism spectrum disorder (ASD) are rising public health concerns. An increasing number of reports indicate that individuals with ASD may have unhealthy weight status, but the evidence is mixed. To understand the weight status in individuals with ASD and provide strategies for prevention and intervention, we describe the protocol for a systematic review and meta-analysis aimed at assessing the prevalence of obesity, overweight, and underweight in ASD. METHODS: A broad range of key bibliographic databases including MEDLINE (PubMed), Embase, Cochrane, and ISI Web of Science will be searched to identify studies reporting the prevalence of obesity, overweight, and underweight in patients with ASD. Retrieved records will be independently screened by 2 authors and relevant estimates will be extracted from studies reporting data on obesity, overweight, and underweight prevalence among individuals with ASD. The assessment of study quality will be conducted primarily using the Newcastle-Ottawa scale and checklist proposed by the Joanna Briggs Institute. Prevalence estimates of obesity and overweight will be separately pooled using random-effects model. The pooled estimates will be summarized and presented by regional groupings. Subgroup analysis will be conducted for variables (such as study setting, participants' age, and geographical region) across studies, depending on data availability. Between-study heterogeneity will be assessed using the I statistic and explored through subgroup analyses. This systematic review and meta-analysis will be reported following the preferred reporting items for systematic reviews and meta-analyses checklist and the meta-analysis of observational studies in epidemiology statements guidelines for meta-analysis and systematic reviews of observational studies. RESULTS: In this study, we will outline details of the aims and methods on the meta-analysis of weight status of individuals with ASD. CONCLUSION: The results of this study will summarize the current data of weight status of individuals with ASD. REGISTRATION: PROSPERO-National Institute of Health Research (NIHR) Prospective Register of Systematic Reviews (CRD42019130790).


Assuntos
Transtorno do Espectro Autista/complicações , Peso Corporal , Criança , Humanos , Obesidade/complicações , Obesidade/psicologia , Sobrepeso/complicações , Sobrepeso/psicologia , Obesidade Pediátrica/complicações , Obesidade Pediátrica/psicologia , Magreza/complicações , Magreza/psicologia
3.
Rev Lat Am Enfermagem ; 27: e3177, 2019.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31596412

RESUMO

OBJECTIVE: analyze associations between demographic, academic, health, stress, overweight and obesity characteristics among nursing students. METHOD: this is a cross-sectional study with 95 students from a private university in Rio Grande do Sul, Brazil. A demographic, academic and health characterization questionnaire and the Assessment of Stress in Nursing Students (ASNS) scale were applied. Anthropometric measures were taken and descriptive and bivariate analyses were performed. RESULTS: female students predominated in this study, mean age: 25.6±5.87 years. Weight gain was observed in 52.6% of the students, with the 'Professional training' session reporting high (29.5%) and very high (36.8%) levels of stress. None of the stress scale sessions was associated with overweight and obesity. CONCLUSION: overweight and obesity were associated with male participants, high blood pressure, weight gain since the beginning of the course, altered waist circumference, no physical activity, eating more in stressful situations, and consumption of unhealthy foods.


Assuntos
Sobrepeso/psicologia , Estresse Psicológico/epidemiologia , Estudantes de Enfermagem/psicologia , Adulto , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/prevenção & controle , Obesidade/psicologia , Sobrepeso/prevenção & controle , Circunferência da Cintura
5.
Health Qual Life Outcomes ; 17(1): 134, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31362763

RESUMO

BACKGROUND: The psychosocial consequences of obesity are important but often underrated. The Attitudes Toward Obese Persons (ATOP) and Beliefs About Obese Persons (BAOP) scales used to measure weight-related bias have little psychometric information, especially in East Asian contexts. The objective of this study was to use rigorous statistical methods to demonstrate the psychometric properties of these two instruments in Hong Kong and Taiwanese college students. METHODS: A convenience sample of 707 students was recruited from the universities in Hong Kong and Taiwan. Several competing confirmatory factor analyses (CFAs) were conducted to confirm the factorial structure of the ATOP and BAOP. The best fit models for the ATOP and BAOP were chosen for the examination of the measurement invariance across subcultures. We then compared configurable models with or without loading and/or intercept constrained before correlating the latent constructs between the best models for the ATOP and BAOP. RESULTS: The comparison in multiple CFAs found that the model with one factor and two correlated-wording-method factors outperformed the other models for both the ATOP and BOAP. However, the internal consistency was suboptimal (ATOP: α = .56 to .80; BTOP: α = .57 to .65) and the measurement invariance was somewhat unsupported among the Hong Kong and Taiwan samples. Moreover, after controlling wording effects, the latent construct of the ATOP was moderately associated with that of BAOP (r = .356; p < .001). CONCLUSION: Chinese versions of the ATOP and BAOP can be treated as a unidimensional factor for use in Hong Kong and Taiwan university students. However, further refinements of both instruments may be needed before using them to capture the social attitudes and beliefs toward obesity individuals, which is expected to advance our understanding of weight-related bias in East Asian contexts.


Assuntos
Atitude , Obesidade/psicologia , Inquéritos e Questionários/normas , Adulto , Estudos Transversais , Análise Fatorial , Feminino , Hong Kong , Humanos , Masculino , Qualidade de Vida , Taiwan , Traduções , Adulto Jovem
6.
Rev Med Chil ; 147(3): 314-321, 2019 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-31344168

RESUMO

BACKGROUND: Weight-based stigmatization is frequent among overweight and obese people. AIM: To determine the association between weight-based stigmatization, psychological stress, cortisol, negative emotions, and eating behavior in a sample of middle-aged women. MATERIAL AND METHODS: Eighty-two women aged 45 ± 8 years, 55% with overweight or obesity, were randomly allocated to watch a video called "Stigma: the human cost of obesity" or a control video about planet earth. The effect of watching either video on calorie consumption, psychological stress and cortisol reactivity was assessed. Cortisol was measured on four salivary samples. Psychological stress and negative emotions were self-reported. RESULTS: Among women who watched the stigmatizing video, there was a direct association between psychological stress and calorie intake, but negative emotions did not mediate this association. Moreover, psychological stress moderated the association between watching the stigmatizing video and the cortisol output (ß = 0.32; p = 0.005). CONCLUSIONS: Women with high psychological stress have a greater intake of calories. After watching the stigmatizing video, a greater psychological stress is associated with greater cortisol output.


Assuntos
Ingestão de Energia , Obesidade/psicologia , Sobrepeso/psicologia , Estigma Social , Estereotipagem , Estresse Psicológico/psicologia , Adulto , Peso Corporal , Comportamento Alimentar/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/metabolismo , Sobrepeso/metabolismo
7.
Einstein (Sao Paulo) ; 17(3): eAO4782, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31271610

RESUMO

OBJECTIVE: To determine the prevalence of risky sexual behavior and its association with overweight and obesity among adolescent students. METHODS: This is a cross-sectional study, conducted in public schools with adolescents aged 12 to 17 years. We used the questionnaire Youth Risk Behavior Survey. The body mass index percentiles were calculated by means of table from the Center for Control and Prevention of Diseases. Possible associations were assessed using the χ2 test and binary logistic regression model. The odds ratio and 95%CI were calculated. RESULTS: We evaluated 1,169 students, and 33.9% reported having had sexual intercourse. Of those, 33% did not use a condom during their last intercourse, and 32.7% had had four or more sexual partners thus far. Regarding nutritional status, 15.3% were overweight or obese. In relation to the non-use of condoms, we observed only an association with the number of lifetime sexual partners (OR: 0.50; 95%CI: 0.28-0.88). The number of lifetime sexual partners was associated with males (OR: 9.17; 95%CI: 4.16-20.22), sexual debut age at 13 years or less (OR: 2.51; 95%CI: 1.23-5.13) and drinking alcohol or using drugs before the last intercourse (OR: 6.16; 95%CI: 2.14-17.73). CONCLUSION: Risky sexual behavior rates were high and no association was found between risky sexual behaviors and overweight and obesity.


Assuntos
Comportamento do Adolescente/psicologia , Obesidade/psicologia , Sobrepeso/psicologia , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Adolescente , Índice de Massa Corporal , Criança , Estudos Transversais , Humanos , Obesidade/complicações , Sobrepeso/complicações , Assunção de Riscos , Fatores Sexuais , Parceiros Sexuais
8.
J Agric Food Chem ; 67(25): 7040-7049, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31199141

RESUMO

Obesity is a metabolic syndrome worldwide that causes many chronic diseases. Recently, we found an antiobesity effect of flaxseed polysaccharide (FP), but the mechanism remains to be elucidated. In this study, rats were first induced to develop obesity by being fed a high-fat diet. The obese rats were then fed a control diet, AIN-93M (group HFD), or a 10% FP diet (group FPD). The body weight, body fat, adipose tissue and liver sections, serous total triglycerides, levels of fasting blood glucose in serum, serous insulin, inflammatory cytokines in serum, and serous proteins within the leptin-neuropeptide Y (NPY) and AMP-activated protein kinase (AMPK) signaling pathway were determined and analyzed. FP intervention significantly reduced body weight and abdominal fat from 530 ± 16 g and 2.15% ± 0.30% in group HFD to 478 ± 10 g and 1.38% ± 0.48% in group FPD, respectively. This effect was achieved by removing leptin resistance possibly by inhibiting inflammation and recovering satiety through the significant downregulation of NPY and the upregulation of glucagon-like peptide 1. Adiponectin was then significantly upregulated probably via the gut-brain axis and further activated the AMPK signaling pathway to improve lipid metabolism including the improvement of lipolysis and fatty acid oxidation and the suppression of lipogenesis. This is the first report of the proposed antiobesity mechanism of FP, thereby providing a comprehensive understanding of nonstarch polysaccharides and obesity.


Assuntos
Proteínas Quinases Ativadas por AMP/metabolismo , Linho/química , Leptina/metabolismo , Metabolismo dos Lipídeos/efeitos dos fármacos , Obesidade/tratamento farmacológico , Extratos Vegetais/administração & dosagem , Polissacarídeos/administração & dosagem , Saciação/efeitos dos fármacos , Proteínas Quinases Ativadas por AMP/genética , Animais , Dieta Hiperlipídica/efeitos adversos , Humanos , Masculino , Obesidade/metabolismo , Obesidade/psicologia , Extratos Vegetais/química , Polissacarídeos/química , Ratos , Ratos Wistar , Sementes/química , Transdução de Sinais/efeitos dos fármacos
9.
BMC Public Health ; 19(Suppl 4): 547, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196031

RESUMO

BACKGROUND: Poor oral health has an impact on food choices and intake of important nutrients among older population. The use of oral health-related quality of life instruments along with the clinical dental indicators can help to assess the oral problems that lead to nutritional problems in this group. This study aims to determine the association between oral health-related quality of life (OHRQoL) and nutritional status among a group of older adults in Kuala Pilah district, Malaysia. METHODS: A cross-sectional study was carried out on 446 older adults aged 50 years and above from 20 randomly selected villages. Respondents were interviewed to collect information on their demographic characteristics and oral health perception, followed by physical examination to measure height, weight and body mass index (BMI) of respondents. The validated Malay version of General Oral Health Assessment Index (GOHAI) was used to measure OHRQoL. RESULTS: About one-third (35.8%) of the respondents had normal BMI. Majority of the respondents were overweight (40.4%) and obese (19.9%), while only a small proportion was underweight (3.9%). Mean GOHAI score was 53.3 (SD = 4.7), indicating low perception of oral health. About 81.6% respondents had moderate to low perception of oral health. Logistic regression analysis showed a statistically significant association between the GOHAI and BMI scores (OR = 2.3; p < 0.01). CONCLUSIONS: Oral health-related quality of life was significantly associated with nutritional condition of respondents. Older adults with poor perception of their oral health were more likely to have unsatisfactory BMI compared to those who perceived their oral health to be good.


Assuntos
Estado Nutricional , Saúde Bucal , Qualidade de Vida , Idoso , Índice de Massa Corporal , Estudos Transversais , Inquéritos de Saúde Bucal , Feminino , Avaliação Geriátrica , Humanos , Modelos Logísticos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/psicologia , Magreza/epidemiologia , Magreza/psicologia
10.
BMC Public Health ; 19(1): 697, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170967

RESUMO

BACKGROUND: Many studies have demonstrated positive effects of physical activity on children's health such as improved cardiorespiratory function and decreased obesity. Physical activity has also been found to have positive effects on academic achievement and cognitive function. However, there are few high quality RCT studies on this topic at present and the findings remain controversial. METHODS: This protocol describes cluster randomized controlled trials assessing the impact of school-based exercise intervention among children in Mongolia. The intervention consists of 3-min sessions of high intensity interval training combined with music implemented two times a week at school during study periods. The participants are children in the fourth grade in public elementary schools in the Sukhbaatar district in Ulaanbaatar, Mongolia. The participants are cluster randomized by school and allocated either to the intervention or control group. The primary outcome is academic achievement. Secondary outcomes are obesity/overweight, physical fitness function, lifestyle, mental health, and cognitive function. DISCUSSION: This cluster-RCT is designed and implemented to assess the effectiveness of exercise intervention on academic achievement, cognitive function, and physical and mental health among school-age children in Mongolia. This study will provide evidence to promote physical activities among children in low- and middle- income countries. TRIAL REGISTRATION: UMIN: UMIN000031062 . Registered on 1st February 2018.


Assuntos
Sucesso Acadêmico , Cognição , Terapia por Exercício/psicologia , Exercício/psicologia , Serviços de Saúde Escolar , Criança , Análise por Conglomerados , Terapia por Exercício/métodos , Feminino , Humanos , Estilo de Vida , Masculino , Saúde Mental , Mongólia , Obesidade/prevenção & controle , Obesidade/psicologia , Sobrepeso/prevenção & controle , Sobrepeso/psicologia , Aptidão Física/psicologia , Avaliação de Programas e Projetos de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Instituições Acadêmicas
11.
BMC Public Health ; 19(Suppl 2): 454, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31159781

RESUMO

BACKGROUND: Over the last 150 years, advanced economies have seen the burden of disease shift to non-communicable diseases. The risk factors for these diseases are often co-morbidities associated with unhealthy weight. The prevalence of overweight/obesity among adults in the advanced countries of the English-speaking world is currently more than two-thirds of the adult population. However, while much attention has concentrated on changes in diet that might have provoked this rapid increase in unhealthy weight, changes in patterns of eating have received little attention. METHODS: This article examines a sequence of large-scale, time use surveys in urban Australia stretching from 1974 to 2006. The earliest survey in 1974 (conducted by the Cities Commission) was limited to respondents aged between 18 and 69 years, while the later surveys (by the Australian Bureau of Statistics) included all adult (15 years of age or over) living private dwellings. Since time use surveys capture every activity in a day, they contain much information about mealtimes and the patterns of eating. This includes duration of eating, number of eating occasions and the timing of eating. Inferential statistics were used to test the statistical significance of these changes and the size of the effects. RESULTS: The eating patterns of urban Australian adults have changed significantly over a 32-year period and the magnitude of this change is non-trivial. Total average eating time as main activity has diminished by about a third, as have eating occasions, affecting particularly luncheon and evening meals. However, there is evidence that eating as secondary activity that accompanies another activity is now almost as frequent as eating at mealtimes. Moreover, participants seem not to report it. CONCLUSIONS: Contemporary urban Australians are spending less time in organized shared meals. These changes have occurred the over same period during which there has been a public health concern about the prevalence of unhealthy weight. Preliminary indications are that societies that emphasize eating as a commensal, shared activity through maintaining definite, generous lunch breaks and prioritizing eating at mealtimes, achieve better public health outcomes. This has implications for a strategy of health promotion, but to be sure of this we need to study countries with these more socially organized eating patterns.


Assuntos
Ingestão de Alimentos/psicologia , Comportamento Alimentar/psicologia , Obesidade/psicologia , Sobrepeso/psicologia , Adolescente , Adulto , Idoso , Anomia (Social) , Austrália/epidemiologia , Peso Corporal , Estudos Transversais , Dieta/psicologia , Dieta/estatística & dados numéricos , Epidemias , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Inquéritos Epidemiológicos/métodos , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Masculino , Refeições , Pessoa de Meia-Idade , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Prevalência , Comportamento Social , Fatores de Tempo , População Urbana/estatística & dados numéricos , Adulto Jovem
12.
BMC Public Health ; 19(1): 816, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31234818

RESUMO

BACKGROUND: Adherence to weight loss interventions is crucial to successful outcomes, yet little is known about how best to improve it. This suggests a need for developing and improving adherence strategies, such as formal commitments. This review aims to identify the effect of including a commitment device alongside lifestyle interventions on weight loss, and identify the most appropriate delivery mechanisms and target behaviours. METHODS: We searched five databases and hand-searched reference lists for trials of behavioural interventions to achieve weight loss among adults with excess weight or obesity. Interventions incorporating commitment devices were included in a narrative review and meta-analysis where appropriate. Commitment devices with financial incentives were excluded. RESULTS: Of 2675 unique studies, ten met the inclusion criteria. Data from three randomised trials including 409 participants suggests that commitment interventions increases short-term weight loss by a mean of 1.5 kg (95% CI: 0.7, 2.4). Data from two randomised trials including 302 patients suggests that benefits were sustained at 12 months (mean difference 1.7 kg; 95% CI: 0.0, 3.4). Commitment devices appeared most successful when made publicly, and targeting diet rather than physical activity. CONCLUSIONS: Using commitment devices, such as behavioural contracts, as part of a weight loss intervention may be useful in improving weight loss outcomes and dietary changes, at least in the short-term. However, evidence is limited and of variable quality so results must be interpreted with caution. Poor reporting of intervention details may have limited the number of identified studies. More rigorous methodology and longer term follow-ups are required to determine the effectiveness of behavioural contracts given their potential for use in public health interventions.


Assuntos
Terapia Comportamental , Obesidade/psicologia , Sobrepeso/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Programas de Redução de Peso , Adulto , Dieta/psicologia , Exercício/psicologia , Feminino , Humanos , Estilo de Vida , Masculino , Obesidade/terapia , Sobrepeso/terapia , Resultado do Tratamento , Perda de Peso
13.
BMC Public Health ; 19(1): 734, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31185963

RESUMO

BACKGROUND: Little is known about the role of social class in the association between adiposity measures and self-rated health, and several studies have evaluated its influence as a confounder. The aim of the study is to investigate whether social class is an effect modifier in the association between adiposity measures and self-rated health in participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHOD: Cross-sectional design, including 6453 men and 7686 women. Body mass index (kg/m2) and waist circumference (cms) were assessed. Self-rated health was categorized as good, fair and poor. Socio-occupational class was based on the participants' occupation, education and per capita income. Multicovariate ordinal logistic model was used to evaluate the association between adiposity measures and self-rated health. RESULTS: For women, the low and medium socio-occupational class effects were higher for those with waist circumference between 80 and 88 cm or overweight. For men, the low and medium socio-occupational class effects were higher for those with adequate waist circumference or normal body mass index. CONCLUSIONS: Social class is an effect modifier in the association between body mass index or waist circumference and self-rated health.


Assuntos
Adiposidade , Autoavaliação Diagnóstica , Emprego/psicologia , Ocupações , Classe Social , Adulto , Índice de Massa Corporal , Brasil , Estudos Transversais , Feminino , Humanos , Renda , Modelos Logísticos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Obesidade/psicologia , Sobrepeso/psicologia , Fatores Sexuais , Circunferência da Cintura
14.
Sante Publique ; Vol. 31(1): 7-17, 2019 January February.
Artigo em Francês | MEDLINE | ID: mdl-31210519

RESUMO

BACKGROUND: Overweight patients feel stigmatized and are reluctant to talk about weight. Physicians question the efficiency of weight management. This work explored how the weight topic was initiated in GP consultations and the experience of patients about this action, whatever their weight or reason for consultation. METHODS: Mixed method study conducted in parallel with direct observation of GPs' consultations by trainees (with a standardized observation grid) and semi directive interview (with guide) after the consultation. Analyses were descriptive on quantitative data, and thematic on verbatim (double blind coding). RESULTS: 187 consultations were observed and 81 patients interviewed. In consultation, GPs initiated the majority of the weight discussions, with three types of approach: discussion alone, discussion and/or weighing, and weighing alone. GP's demands of weighing were very directive and sometimes seemed to make patients feel uncomfortable. The discussion about weight without weighing seemed to enhance a reflection on a possible change of patient's behavior.The joint analysis questions the scale's role in consultation since the discussion approach to the weight debate led to more patient mobilization and, according to them, "the weight is seen". For the patient, the eye appeared as a tool to measure weight, especially since the doctor could see variations. CONCLUSION: Comparing the results of the two exploratory studies, in order to better understand this little studied phenomenon, allowed for the emergence of hypotheses and questions the role of the scale in consultations.


Assuntos
Medicina Geral , Clínicos Gerais , Obesidade/psicologia , Relações Médico-Paciente , Adulto , Medicina de Família e Comunidade , Humanos , Encaminhamento e Consulta
15.
Rev Assoc Med Bras (1992) ; 65(5): 731-738, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31166453

RESUMO

OBJECTIVE: To evaluate the association between depression, anthropometric parameters and body image in adults through a systematic review of the literature. METHOD: Medline, Lilacs and PsycInfo databases were searched by two independent reviewers up to August 2018, without language restriction, including cross-sectional, case-control, and cohort studies in adults (18-65 years), of both genders. The quality of the studies was assessed using the Newcastle-Ottawa Scale instrument. The PRISMA standards were adopted for the conduct of this review, whose protocol is registered in PROSPERO, number CRD42018105248. RESULTS: The search resulted in 1,770 articles; however, a total of 5 articles were included in this review, whose designs were transversal. Quality scores ranged from 8 to 9 points. The association between depression, anthropometric parameters, and body image was found in all included studies, regardless of the different statistical methods employed. Women perceived their body larger than it really was by idealizing a lean body, whereas in men the perception of being underweight or dissatisfaction was observed by idealizing a larger body, both conditions were associated with the presence of depression or depressive symptoms and body mass index in the same time. CONCLUSION: Depression, anthropometric parameters and body image were associated. It is necessary to conduct other studies, especially longitudinal studies to elucidate the relationship among depression, weight, body image, and other associated factors.


Assuntos
Antropometria , Imagem Corporal/psicologia , Depressão/psicologia , Adulto , Índice de Massa Corporal , Feminino , Humanos , Masculino , Obesidade/psicologia
16.
BMC Public Health ; 19(1): 596, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101037

RESUMO

BACKGROUND: For patients with obesity who are not ready for or experience barriers to weight loss, clinical practice guidelines recommend provider counseling on preventing further weight gain as a first-line treatment approach. Unfortunately, evidence-based weight gain prevention interventions are not routinely available within primary care. To address this gap, we will implement a pragmatic 12-month randomized controlled trial of a digital weight gain prevention intervention delivered to patients receiving primary care within a network of Federally Qualified Community Health Centers in central North Carolina. METHODS: Balance (Equilibrio in Spanish) is a pragmatic effectiveness trial that will randomize adult patients who have overweight or obesity (BMI of 25-40 kg/m2) to either: 1) a weight gain prevention intervention with tailored behavior change goals and tracking, daily weighing on a network-connected electronic scale, and responsive weight and goal coaching delivered remotely by health center registered dietitians; or 2) a usual care program with automated healthy living text messages and print materials and routine primary care. The primary outcome will be weight gain prevention at 24-months, defined as ≤3% change in baseline weight. To align with its pragmatic design, trial outcome data will be pulled from the electronic health record of the community health center network. DISCUSSION: For underserved, often rurally-located patients with obesity, digital approaches to promote a healthy lifestyle can curb further weight gain. Yet enrolling medically vulnerable patients into a weight gain prevention trial, many of whom are from racial/ethnic minorities, can be difficult. Despite these potential challenges, we plan to recruit a large, diverse sample from rural areas, and will implement a remotely-delivered weight gain prevention intervention to medically vulnerable patients. Upcoming trial results will demonstrate the effectiveness of this pragmatic approach to implement and evaluate a digital weight gain prevention intervention within primary care. TRIALS REGISTRATION: NCT03003403 . Registered December 28, 2016.


Assuntos
Aconselhamento/métodos , Obesidade/terapia , Sobrepeso/terapia , Atenção Primária à Saúde/métodos , Programas de Redução de Peso/métodos , Adulto , Centros Comunitários de Saúde , Feminino , Hispano-Americanos , Humanos , Masculino , Tutoria , North Carolina , Obesidade/psicologia , Sobrepeso/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , População Rural , Mensagem de Texto , Resultado do Tratamento , Populações Vulneráveis , Ganho de Peso , Perda de Peso
17.
Work ; 63(1): 49-56, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31127744

RESUMO

BACKGROUND: Health coaching promotes healthy lifestyles and may be particularly helpful for employees with chronic disease. OBJECTIVE: Evaluate the effects of a health coaching program that targeted health-system employees with at least one cardiovascular disease (CVD) risk factor. METHODS: Fifty-four employees volunteered for a health coaching program (6-session, 12-week program, at least one cycle). 40 (74%) completed (mean age [SD] = 53.3 [10.3] years, Female = 95%, Caucasian = 83%). A certified and integrative health coach/nutritionist provided coaching. Self-reported outcomes were collected using a pre-post design. RESULTS: Participants reported high rates of obesity (75%), hypertension (52.5%), diabetes/prediabetes (47.5%), and hyperlipidemia (40%). In addition, 20% reported chronic pain/rehabilitation needs, 17.5% seasonal depression, and 30% other significant co-morbidities. Following coaching, participants reported significant weight loss (mean [SD] 7.2 [6.6] pounds, p < 0.0001, d = 1.11), increased exercise (from 0.8 to 2.3 sessions/week, p < 0.001, d = .89), reduced perceived stress (p < 0.04, d = .42), and a trend for improved sleep (p = 0.06, d = .38). Reduced stress correlated with both increased exercise (r = -.39, p < 0.05) and decreased fatigue (r = .36, p = 0.07). CONCLUSION: Health coaching for healthcare employees with obesity and other CVD risk factors is a promising approach to losing weight, reducing stress, making healthy lifestyle changes, and improving health and well-being.


Assuntos
Doença Crônica/psicologia , Pessoal de Saúde/psicologia , Tutoria/métodos , Adulto , Idoso , Doença Crônica/epidemiologia , Feminino , Promoção da Saúde/métodos , Promoção da Saúde/estatística & dados numéricos , Humanos , Hiperlipidemias/epidemiologia , Hiperlipidemias/psicologia , Hipertensão/epidemiologia , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/psicologia , Projetos Piloto , Autorrelato
18.
BMC Public Health ; 19(1): 621, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31118019

RESUMO

BACKGROUND: For the past decades, Malaysia has seen an increased prevalence of overweight and obesity which leads to significant health threats. Physical activity is beneficial in maintaining healthy body weight. The objective of this study was to measure physical activity of adults in Malaysia using objective measurement (accelerometer) and self-reported methods, as well as to determine their associations with (body mass index (BMI) and waist circumference (WC) measurements. METHODS: Four-hundred and ninety Malaysian adults (n = 490) aged 20 to 65 years old participated in this cross-sectional study. Their body weight, height, and WC measurements were measured according to standard procedures. Physical activity was assessed objectively with accelerometers for five to seven consecutive days. The International Physical Activity Questionnaire (IPAQ) was used to estimate the amount of time spent on various domains of physical activity. Mixed models were used to determine the associations between physical activity variables and both BMI and WC. RESULTS: The mean value of objectively measured moderate-to-vigorous physical activity (MVPA) was 13.5 min per day, in which male participants recorded a significantly higher amount of time compared to females. On the other hand, the mean self-reported total physical activity was 380 min per week; male participants reported a significantly higher amount of time on physical activity in the occupation/work and leisure/recreation domains while female participants spent significantly more time in the domestic/household chores domain. We also observed that the mean values of objectively measured total MVPA, self-reported time spent on walking for leisure/recreation, and total time amount of time spent on MVPA for leisure/recreation were significantly higher among participants with BMI of less than 25 kg/m2. The final statistical model yielded a significant negative association between objectively measured total MVPA and BMI, but not with WC measurement. No significant association was reported between self-reported total physical activity with BMI and WC measurement. CONCLUSIONS: Objectively measured MVPA was inversely associated with BMI, but not WC measurement. No significant association was observed between self-reported total physical activity and physical activity time measures across domains with both BMI and WC measurement.


Assuntos
Acelerometria/estatística & dados numéricos , Exercício/psicologia , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , Peso Corporal , Estudos Transversais , Feminino , Humanos , Atividades de Lazer , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/psicologia , Sobrepeso/psicologia , Prevalência , Autorrelato , Circunferência da Cintura , Caminhada , Adulto Jovem
19.
Wiad Lek ; 72(4): 519-522, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31055524

RESUMO

OBJECTIVE: Introduction: According to the World Health Organization, depression is a common mental disorder characterized by despair, loss of interest or joy, feelings of guilt and low self-esteem, sleep disturbance or appetite, lethargy, and poor concentration. There is a series of studies that show the presence of depressive disorders in patients with obesity concomitant type 2 diabetes mellitus, but in our study, we wanted to demonstrate the degree of severity of these changes. The aim: Diagnose depression in patients with obesity and concomitant type 2 diabetes mellitus. PATIENTS AND METHODS: Materials and methods: Examine patients with obesity and concomitant type 2 diabetes mellitus and select them for research. For the diagnosis of depression were used: Patient Health Questionnaire - 2 and 9, Hospital Anxiety and Depression Scale and Hamilton Depression Scale. Along with hypoglycemic therapy, all patients with diagnosed depression were given individual psychotherapy: cognitive behavioral therapy - 12 sessions per week, interpersonal therapy - 12 sessions per week and bibliotherapy. RESULTS: Results: Using the questionnaires scales, we found depressive disorders in patients with obesity and concomitant type 2 diabetes mellitus. Along with the diagnosis of depression, we managed to correct it using individual psychotherapy. CONCLUSION: Conclusions: Patients with obesity and concomitant type 2 diabetes mellitus are in a cohort with an increased risk of depression and should be diagnosed early. Given these patients polypharmacotherapy, treatment for depression should begin with non-drug therapy.


Assuntos
Depressão/diagnóstico , Diabetes Mellitus Tipo 2/psicologia , Obesidade/psicologia , Terapia Cognitivo-Comportamental , Depressão/terapia , Diabetes Mellitus Tipo 2/complicações , Humanos , Obesidade/complicações , Psicoterapia , Inquéritos e Questionários
20.
Health Psychol ; 38(7): 586-595, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31120270

RESUMO

OBJECTIVE: To investigate the separate and combined associations of obesity and metabolic syndrome (MetS) with depression and the role of inflammation. METHOD: Depression was assessed with the Patient Health Questionnaire-9 (PHQ-9) and was defined with a cutpoint of ≥10. Obesity was defined as body mass index (BMI) ≥30 kg/m2 from measured height and weight. MetS was defined based on the American Heart Association consensus definition. Participants were divided into four groups: healthy normal weight (MHN), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUN), and metabolic unhealthy obese (MUO). C-Reactive protein was assessed in a subsample. RESULTS: A total of 18,025 subjects were included in the analysis. Participants with MUO had the highest prevalence of depression compared with the MHN group (14.8% vs. 6.8, p < .001). While both obesity and MetS were independently associated with depression, there was a significant interaction between the two (p < .001), indicating that the associations of obesity and MetS with depression were synergistic. After adjusting for baseline characteristics, compared with the MHN group, the MUO group had the highest odds of depression (odds ratio [OR] = 2.30, 95% CI [2.03, 2.61]), followed by MHO group (OR = 1.51, 95% CI [1.30, 1.74]) and the MUN group (OR = 1.39, 95% CI [1.18, 1.64]). The MUO group also showed the highest level of C-reactive protein, and the latter partially mediated the effect between MUO and depressive symptoms (20.5% of the total effect). CONCLUSION: Both obesity and MetS are associated with depression independent of each other, but when present together, these conditions have a synergistic association with depression. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Depressão/epidemiologia , Depressão/psicologia , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/psicologia , Obesidade/epidemiologia , Obesidade/psicologia , Adulto , Idoso , Antropometria/métodos , Índice de Massa Corporal , Peso Corporal/fisiologia , Estudos Transversais , Depressão/diagnóstico , Feminino , Humanos , Inflamação/diagnóstico , Inflamação/epidemiologia , Inflamação/psicologia , Masculino , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Inquéritos Nutricionais/métodos , Obesidade/diagnóstico , Reprodutibilidade dos Testes , Circunferência da Cintura/fisiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA