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1.
J Affect Disord ; 320: 319-329, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36183818

RESUMO

BACKGROUND: Social and interpersonal context are associated with the onset and persistence of psychiatric disorders. We compared the effects of short-term interpersonal psychotherapy (IPT) on weight loss, binge eating behaviors, and depressive symptoms against cognitive-behavioral therapy (CBT), health education (HE), and behavioral weight loss (BWL). METHODS: We searched until May 28th, 2022 following databases: PubMed, CINAHL, Science Direct, Web of Science, EMBASE, and Scopus. Articles on parallel randomized clinical trials were included. Outcomes were body mass index (BMI), binge days (bulimic episode), and depressive symptoms. These outcomes were self-reported or measured with specific scales (BMI) or instrument (depressive symptoms). RESULTS: The initial search retrieved 820 articles, a total of 10 studies met the eligibility criteria, and seven were included in the meta-analysis. Participants with overweight/obesity were women (62-100 %), aged between 11 and 50 years. There was a trivial to small effect on BMI favoring IPT over other interventions (standardized mean difference [SMD] = -0.10; 95%CI: -0.27 to 0.07, I2 = 0 %), especially when compared to health education (SMD = -0.21; 95%CI: -0.54 to 0.12, I2 = 0 %); no effect on number of binge days (SMD = -0.09; 95%CI: -0.30 to 0.11, I2 = 0 %); and a small effect on depressive symptoms (SMD = -0.25, 95%CI = -0.50 to 0.00, I2 = 0 %). LIMITATIONS: Small number of studies, the discrepancy in age cohorts, and racial diversity. Psychotherapeutic protocols and assessment tools had to be adapted across studies. CONCLUSIONS: Patients with overweight/obesity and depression had some benefit from IPT when compared with other interventions. In view of existing evidence, an IPT program adapted to obesity could help to achieve reliable and long-term effects.


Assuntos
Psicoterapia Interpessoal , Psicoterapia , Humanos , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Masculino , Psicoterapia/métodos , Sobrepeso/terapia , Obesidade/terapia , Obesidade/psicologia , Redução de Peso
2.
Fam Community Health ; 46(1): 39-50, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36190961

RESUMO

The typical pattern of weight change associated with behavioral obesity treatments has been some loss in weight through approximately 6 months, followed by near complete regain. However, patterns vary widely across individuals. The objectives are to determine whether recent prediction model-based indications of relations among changes in psychosocial correlates of the weight loss behaviors of physical activity and controlled eating vary by patterns of weight change. Women with obesity enrolled in a community-based behavioral obesity treatment who failed to lose at least 5% of their baseline weight (Minimal Effect group, n = 44), lost 5% or greater and then regained most during months 6 to 24 (Loss/Regain group, n = 42), or lost 5% or greater and then maintained/continued loss (Loss/Loss group n = 42) were evaluated. Improvements in physical activity- and eating-related self-regulation and self-efficacy, mood, and emotional eating over 6 months were significant overall and generally most favorable in the Loss/Loss group and least favorable in the Minimal Effect group. Expected model-based relationships between 6-month changes in the aforementioned psychosocial variables were significant and generally not significantly affected by weight change group. However, group substantially affected the prediction of self-regulation of eating at month 24-a key correlate of long-term weight loss. Findings suggested community-based obesity treatment targets and emphases.


Assuntos
Ingestão de Alimentos , Redução de Peso , Humanos , Feminino , Ingestão de Alimentos/psicologia , Redução de Peso/fisiologia , Obesidade/terapia , Obesidade/psicologia , Autoeficácia , Exercício Físico/psicologia , Comportamento Alimentar/psicologia
3.
Rev. bras. med. esporte ; 29(spe1): e2022_0185, 2023. tab
Artigo em Inglês | LILACS | ID: biblio-1394853

RESUMO

ABSTRACT Introduction Disparate to the development of society, health indices in Chinese college students have shown a pronounced decline in recent years. Government concern over this recent challenge has encouraged research for practical solutions, including optimized physical activity protocols. Objective Explore the effects of an exercise intervention on the health of Chinese university students. Methods Full-time university students (80 males and 55 females) were selected and randomly assigned into two groups. Before and after the experiment, the college students' body composition scale and exercise experience were tested, focusing on the relationship between exercise prescription and changes in physical and mental health indicators. Results The body fat percentage of male and female students decreased significantly after the experiment. After eight weeks of the exercise prescription experiment, the weight of male and female college students was controlled or reduced. The suggested exercise prescription achieved a good moderating effect on the weight of the volunteers. There was a significant difference between the two groups, indicating that the experiment had a beneficial effect on vital capacity (p<0.01). Conclusion The suggested exercise prescription proved to be feasible to guide and intervene in the physical exercise of college students aiming at a beneficial impact on the physical health of college students. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.


RESUMO Introdução Díspares ao desenvolvimento da sociedade, os índices de saúde nos estudantes universitários chineses apresentam uma queda acentuada nos últimos anos. A preocupação governamental sobre esse recente desafio tem incentivado pesquisas para soluções práticas, incluindo protocolos de atividades físicas otimizados. Objetivo Explorar os efeitos da intervenção por exercícios físicos na saúde dos estudantes universitários chineses. Métodos Universitários de período integral (80 homens e 55 mulheres) foram selecionados e distribuídos aleatoriamente em dois grupos. Antes e depois do experimento, foi testada a escala de composição corporal e experiência de exercício dos universitários, com foco na relação entre prescrição de exercício e mudanças nos indicadores de saúde física e mental. Resultados O percentual de gordura corporal de estudantes do sexo masculino e feminino diminuiu significativamente após o experimento. Após 8 semanas de experimento de prescrição de exercícios, o peso de estudantes universitários do sexo masculino e feminino foi controlado ou reduzido. A prescrição de exercícios sugerida alcançou um bom efeito moderador no peso dos voluntários. Houve diferença significativa entre os dois grupos, indicando que o experimento teve efeito benéfico sobre a capacidade vital (p<0,01). Conclusão A prescrição de exercícios sugerida demonstrou-se viável para orientar e intervir no exercício físico dos universitários visando um impacto benéfico sobre a saúde física nos universitários. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.


RESUMEN Introducción A diferencia del desarrollo de la sociedad, los índices de salud de los estudiantes universitarios chinos muestran un fuerte descenso en los últimos años. La preocupación de los gobiernos por este reciente desafío ha fomentado la investigación de soluciones prácticas, entre ellas la optimización de los protocolos de actividad física. Objetivo Explorar los efectos de la intervención de ejercicio en la salud de los estudiantes universitarios chinos. Métodos Se seleccionaron estudiantes universitarios a tiempo completo (80 hombres y 55 mujeres) y se asignaron al azar en dos grupos. Antes y después del experimento, se analizó la escala de composición corporal de los estudiantes universitarios y su experiencia con el ejercicio, centrándose en la relación entre la prescripción de ejercicio y los cambios en los indicadores de salud física y mental. Resultados El porcentaje de grasa corporal de los estudiantes masculinos y femeninos disminuyó significativamente después del experimento. Tras 8 semanas del experimento de prescripción de ejercicio, el peso de los estudiantes universitarios de ambos sexos se controló o redujo. La prescripción de ejercicio sugerida logró un buen efecto moderador en el peso de los voluntarios. Hubo una diferencia significativa entre los dos grupos, lo que indica que el experimento tuvo un efecto beneficioso sobre la capacidad vital (p<0,01). Conclusión La prescripción de ejercicio sugerida demostró ser factible para guiar e intervenir en el ejercicio físico de los estudiantes universitarios apuntando a un impacto beneficioso en la salud física de los estudiantes universitarios. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.


Assuntos
Humanos , Masculino , Feminino , Serviços de Saúde para Estudantes , Terapia por Exercício , Obesidade/terapia , Redução de Peso , Índice de Massa Corporal , Estudos de Casos e Controles
4.
Rev. bras. med. esporte ; 29: e2022_0172, 2023. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1394831

RESUMO

ABSTRACT Introduction: The unregulated development in the current life pattern has strengthened obesity among adolescents, and this problem is becoming more serious. Objective: Compare the impact of two exercise methods on the physical health of obese adolescents. Methods: 24 obese adolescents (12 females; BMI>30% ± 3%; age concentrated between 10 and 16 years) were selected and divided into group I and group II for a 4-week experimental study, and changes in physical fitness and function were recorded. Results: After four weeks of aerobic exercise control (group I), waist circumference, hip circumference, skinfold thickness, and abdominal fold thickness were significantly reduced in boys (p<0.05), and girls' body shape indicators were significantly altered (p<0.05). After four weeks of aerobic exercise combined with resistance training (group II), the effects of weight, BMI, and body size were significant in boys and girls. Conclusion: Aerobic exercise can effectively improve the physical problems of obese adolescents. Under the same external conditions, the effect of aerobic exercise was shown to be more effective when combined with resistance training in the physical improvement of the analyzed group. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.


RESUMO Introdução: O desenvolvimento desregrado no padrão de vida atual fortaleceu a obesidade entre os adolescentes e esse problema está se tornando cada vez mais grave. Objetivo: Comparar o impacto entre dois métodos de exercício na saúde física de adolescentes obesos. Métodos: Foram selecionados 24 adolescentes obesos (12 mulheres; IMC>30% ± 3%; idade concentrada entre 10 e 16 anos) e divididos no grupo I e no grupo II para um estudo experimental de 4 semanas, sendo registradas as alterações no condicionamento e função física. Resultados: Após 4 semanas de controle de exercício aeróbico (grupo I), a circunferência da cintura, circunferência do quadril, espessura da dobra cutânea e espessura da dobra abdominal foram significativamente reduzidas em meninos (p<0,05), e os indicadores de forma corporal das meninas foram significativamente alterados (p<0,05). Após 4 semanas de exercício aeróbico combinado com treinamento de resistência (grupo II), os efeitos do peso, IMC e tamanho do corpo foram significativos em meninos e meninas. Conclusão: O exercício aeróbico pode melhorar efetivamente os problemas físicos dos adolescentes obesos. Sob as mesmas condições externas, o efeito do exercício aeróbico demonstrou-se mais eficaz quando aliado ao treinamento de resistência na melhoria física do grupo analisado. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.


RESUMEN Introducción: El desarrollo desordenado en el patrón de vida actual ha potenciado la obesidad entre los adolescentes y este problema es cada vez más grave. Objetivo: Comparar el impacto de dos métodos de ejercicio en la salud física de adolescentes obesos. Métodos: Se seleccionaron 24 adolescentes obesos (12 mujeres; IMC>30% ± 3%; edad concentrada entre 10 y 16 años) y se dividieron en el grupo I y el grupo II para un estudio experimental de 4 semanas, y se registraron los cambios en la aptitud física y la función. Resultados: Después de 4 semanas de control de ejercicio aeróbico (grupo I), la circunferencia de la cintura, la circunferencia de la cadera, el grosor de los pliegues cutáneos y el grosor de los pliegues abdominales se redujeron significativamente en los niños (p<0,05), y los indicadores de la forma corporal de las niñas se alteraron significativamente (p<0,05). Tras 4 semanas de ejercicio aeróbico combinado con entrenamiento de resistencia (grupo II), los efectos del peso, el IMC y el tamaño corporal fueron significativos en chicos y chicas. Conclusión: El ejercicio aeróbico puede mejorar eficazmente los problemas físicos de los adolescentes obesos. En las mismas condiciones externas, el efecto del ejercicio aeróbico se mostró más eficaz cuando se combinó con el entrenamiento de resistencia en la mejora física del grupo analizado. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Terapia por Exercício/métodos , Obesidade/terapia , Redução de Peso , Índice de Massa Corporal , Capacidade Inspiratória , Pressão Arterial/fisiologia , Frequência Cardíaca/fisiologia
5.
Nutr Diabetes ; 12(1): 47, 2022 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-36335092

RESUMO

BACKGROUND: To better support participants to achieve long-lasting results within interventions aiming for weight loss and maintenance, more information is needed about the maintenance of behavioral changes. Therefore, we examined whether perceived stress predicts the maintenance of changes in eating behavior (flexible and rigid restraint of eating, disinhibition, and hunger). METHODS: The present study was a secondary analysis of the PREVIEW intervention including participants with overweight (BMI ≥ 25 kg/m2) at baseline and high risk of type 2 diabetes (n = 1311). Intervention included a 2-month low-energy diet phase and a 34-month subsequent weight maintenance phase. The first 6 months were considered an active behavior change stage and the remaining 2.5 years were considered a behavior maintenance stage. Eating behavior was measured using the Three Factor Eating Questionnaire and stress using the Perceived Stress Scale. The associations between stress and eating behavior were analyzed using linear mixed effects models for repeated measurements. RESULTS: Perceived stress measured after the active behavior change stage (at 6 months) did not predict changes in eating behavior during the behavior maintenance stage. However, frequent high stress during this period was associated with greater lapse of improved flexible restraint (p = 0.026). The mean (SD) change in flexible restraint from 6 to 36 months was -1.1 (2.1) in participants with frequent stress and -0.7 (1.8) in participants without frequent stress (Cohen's ds (95% CI) = 0.24 (0.04-0.43)). Higher perceived stress at 6 months was associated with less flexible restraint and more disinhibition and hunger throughout the behavior maintenance stage (all p < 0.001). CONCLUSIONS: Perceived stress was associated with features of eating behavior that may impair successful weight loss maintenance. Future interventions should investigate, whether incorporating stress reduction techniques results in more effective treatment, particularly for participants experiencing a high stress level.


Assuntos
Diabetes Mellitus Tipo 2 , Dieta Redutora , Humanos , Obesidade/terapia , Comportamento Alimentar/fisiologia , Redução de Peso/fisiologia , Estilo de Vida , Estresse Psicológico , Índice de Massa Corporal
6.
Transl Behav Med ; 12(11): 1029-1037, 2022 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-36408955

RESUMO

Obesity is a well-established risk factor for increased morbidity and mortality. Comprehensive lifestyle interventions, pharmacotherapy, and bariatric surgery are three effective treatment approaches for obesity. The Veterans Health Administration (VHA) offers all three domains but in different configurations across medical facilities. Study aim was to explore the relationship between configurations of three types of obesity treatments, context, and population impact across VHA using coincidence analysis. This was a cross-sectional analysis of survey data describing weight management treatment components linked with administrative data to compute population impact for each facility. Coincidence analysis was used to identify combinations of treatment components that led to higher population impact. Facilities with higher impact were in the top two quintiles for (1) reach to eligible patients and (2) weight outcomes. Sixty-nine facilities were included in the analyses. The final model explained 88% (29/33) of the higher-impact facilities with 91% consistency (29/32) and was comprised of five distinct pathways. Each of the five pathways depended on facility complexity-level plus factors from one or more of the three domains of weight management: comprehensive lifestyle interventions, pharmacotherapy, and/or bariatric surgery. Three pathways include components from multiple treatment domains. Combinations of conditions formed "recipes" that lead to higher population impact. Our coincidence analyses highlighted both the importance of local context and how combinations of specific conditions consistently and uniquely distinguished higher impact facilities from lower impact facilities for weight management.


Obesity can contribute to increased rates of ill health and earlier death. Proven treatments for obesity include programs that help people improve lifestyle behaviors (e.g., being physically active), medications, and/or bariatric surgery. In the Veterans Health Administration (VHA), all three types of treatments are offered, but not at every medical center­in practice, individual medical centers offer different combinations of treatment options to their patients. VHA medical centers also have a wide range of population impact. We identified high-impact medical centers (centers with the most patients participating in obesity treatment who would benefit from treatment AND that reported the most weight loss for their patients) and examined which treatment configurations led to better population-level outcomes (i.e., higher population impact). We used a novel analysis approach that allows us to compare combinations of treatment components, instead of analyzing them one-by-one. We found that optimal combinations are context-sensitive and depend on the type of center (e.g., large centers affiliated with a university vs. smaller rural centers). We list five different "recipes" of treatment combinations leading to higher population-level impact. This information can be used by clinical leaders to design treatment programs to maximize benefits for their patients.


Assuntos
Saúde dos Veteranos , Veteranos , Estados Unidos/epidemiologia , Humanos , United States Department of Veterans Affairs , Estudos Transversais , Obesidade/terapia , Obesidade/epidemiologia
7.
Soc Sci Med ; 314: 115468, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36327638

RESUMO

Metabolic syndrome (MetS) prevalence has increased globally with considerable morbidity and economic burden at both individual and national levels. Japan is the first and only country that has introduced a nationwide lifestyle guidance intervention program to manage and control MetS. We conducted a quasi-experiment approach-regression discontinuity design-to evaluate the impact of this intervention on health outcomes at the population level. We retrospectively collected data of adults aged ≥35 years who participated in health checkups in 2015. Age in 2015 was used as the assignment variable, and an age of 40 years old was the threshold because those with MetS aged ≥40 were required to receive lifestyle guidance intervention. Among 26,772 MetS adults, those who received the intervention had significant reductions in obesity measurements (bodyweight, waist circumference, and body mass index [BMI]) after 1 year of this intervention. Blood pressure was also significantly reduced in men after 1 year of undertaking the intervention. The results were similar when including demographic, socioeconomic, and behavioral covariates and using alternative functional forms to estimate the impact, or when bandwidths around intervention thresholds were changed. Our results showed that lifestyle guidance intervention for MetS has an important impact on weight loss and blood pressure reduction at the population level. This intervention could address the high burden of obesity and cardiovascular diseases in Japan and other countries with an unmet need for MetS prevention and management.


Assuntos
Síndrome Metabólica , Adulto , Masculino , Pessoa de Meia-Idade , Humanos , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/terapia , Japão/epidemiologia , Estudos Retrospectivos , Estilo de Vida , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/terapia , Avaliação de Resultados em Cuidados de Saúde
8.
Front Endocrinol (Lausanne) ; 13: 1032235, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36387850

RESUMO

Aims: Non-weight-bearing high-intensity interval training (HIIT) involving several muscle groups may efficiently improve metabolic health without compromising adherence in obesity and type 2 diabetes. In a non-randomized intervention study, we examined the effect of a novel HIIT-protocol, recruiting both lower and upper body muscles, on insulin sensitivity, measures of metabolic health and adherence in obesity and type 2 diabetes. Methods: In 15 obese men with type 2 diabetes and age-matched obese (n=15) and lean (n=18) glucose-tolerant men, the effects of 8-weeks supervised HIIT combining rowing and cycling on ergometers (3 sessions/week) were examined by DXA-scan, incremental exercise test and hyperinsulinemic-euglycemic clamp combined with indirect calorimetry. Results: At baseline, insulin-stimulated glucose disposal rate (GDR) was ~40% reduced in the diabetic vs the non-diabetic groups (all p<0.01). In response to HIIT, insulin-stimulated GDR increased ~30-40% in all groups (all p<0.01) entirely explained by increased glucose storage. These changes were accompanied by ~8-15% increases in VO2max, (all p<0.01), decreased total fat mass and increased lean body mass in all groups (all p<0.05). There were no correlations between these training adaptations and no group-differences in these responses. HbA1c showed a clinically relevant decrease in men with type 2 diabetes (4±2 mmol/mol; p<0.05). Importantly, adherence was high (>95%) in all groups and no injuries were reported. Conclusions: A novel HIIT-protocol recruiting lower and upper body muscles efficiently improves insulin sensitivity, VO2max and body composition with intact responses in obesity and type 2 diabetes. The high adherence and lack of injuries show that non-weight-bearing HIIT involving several muscle groups is a promising mode of exercise training in obesity and type 2 diabetes.


Assuntos
Diabetes Mellitus Tipo 2 , Treinamento Intervalado de Alta Intensidade , Resistência à Insulina , Esportes Aquáticos , Masculino , Humanos , Lactente , Resistência à Insulina/fisiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/metabolismo , Composição Corporal/fisiologia , Obesidade/complicações , Obesidade/terapia , Obesidade/metabolismo , Insulina/metabolismo , Glucose/metabolismo
9.
Front Endocrinol (Lausanne) ; 13: 1010806, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36387852

RESUMO

Estrogens protect against weight gain and metabolic disruption in women and female rodents. Aberrations in the gut microbiota composition are linked to obesity and metabolic disorders. Furthermore, estrogen-mediated protection against diet-induced metabolic disruption is associated with modifications in gut microbiota. In this study, we tested if estradiol (E2)-mediated protection against obesity and metabolic disorders in female mice is dependent on gut microbiota. Specifically, we tested if fecal microbiota transplantation (FMT) from E2-treated lean female mice, supplemented with or without Akkermansia muciniphila, prevented high fat diet (HFD)-induced body weight gain, fat mass gain, and hyperglycemia in female recipients. FMT from, and cohousing with, E2-treated lean donors was not sufficient to transfer the metabolic benefits to the E2-deficient female recipients. Moreover, FMT from lean donors supplemented with A. muciniphila exacerbated HFD-induced hyperglycemia in E2-deficient recipients, suggesting its detrimental effect on the metabolic health of E2-deficient female rodents fed a HFD. Given that A. muciniphila attenuates HFD-induced metabolic insults in males, the present findings suggest a sex difference in the impact of this microbe on metabolic health.


Assuntos
Dieta Hiperlipídica , Hiperglicemia , Feminino , Camundongos , Masculino , Animais , Dieta Hiperlipídica/efeitos adversos , Akkermansia , Transplante de Microbiota Fecal , Camundongos Endogâmicos C57BL , Obesidade/etiologia , Obesidade/terapia , Obesidade/metabolismo , Aumento de Peso
10.
BMC Cancer ; 22(1): 1187, 2022 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-36401194

RESUMO

Obesity plays an important role in the development and progression of breast cancer via various oncogenic pathways. However, the biological mechanisms underlying this relationship are not fully understood. Moreover, it is unclear whether obesity-related and further associated biomarkers could be suitable targets for lifestyle interventions. This systematic review was conducted to examine relationships between obesity-related blood parameters and prognosis for breast cancer survivors enrolled in lifestyle intervention studies. A systematic, computerized literature search was conducted from inception through August 26th, 2020 in PubMed, EMBASE, and CENTRAL. The focus was on observational data from randomized controlled lifestyle intervention trials investigating associations between selected baseline biomarkers, measured in remission, and breast cancer recurrence, breast cancer mortality and/or all-cause mortality. Four studies with data from 5234 women met the inclusion criteria.Studies herein provide moderate evidence that bioavailable or serum testosterone may be positively linked to breast cancer recurrence and inversely linked to disease-free survival. Limited evidence suggests no associations with circulating estradiol or insulin levels on prognosis outcomes, whereas HDL cholesterol was inversely associated with breast cancer recurrence. For some other biomarkers, such as growth factors, adipokines, and CRP, the evidence for associations with disease prognosis was too weak to draw conclusions.Overall, despite potential candidates, there is insufficient evidence to confirm or refute that obesity-related biomarkers and sex hormones have a prognostic value for breast cancer survival. More longitudinal studies in breast cancer survivors to examine the clinical utility of obesity-related biomarkers are needed.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Humanos , Feminino , Exercício Físico , Recidiva Local de Neoplasia/complicações , Prognóstico , Estilo de Vida , Obesidade/complicações , Obesidade/terapia , Obesidade/metabolismo , Biomarcadores
11.
J Telemed Telecare ; 28(10): 764-770, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36346936

RESUMO

Long-term weight loss can reduce the risk of type 2 diabetes for people living with obesity and reduce complications for patients diagnosed with type 2 diabetes. We investigated whether a telehealth lifestyle-coaching program (Liva) leads to long-term (24 months) weight loss compared to usual care. In a randomized controlled trial, n = 340 participants living with obesity with or without type 2 diabetes were enrolled and randomized via an automated computer algorithm to an intervention group (n = 200) or to a control group (n = 140). The telehealth lifestyle-coaching program comprised of an initial one-hour face-to-face motivational interview followed by asynchronous telehealth coaching. The behavioural change techniques used were enabled by individual live monitoring. The primary outcome was a change in body weight from baseline to 24 months. Data were assessed for n = 136 participants (40%), n = 81 from the intervention group and n = 55 from the control group, who completed the 24-month follow-up. After 24 months mean body weight and body mass index were reduced significantly for completers in both groups, but almost twice as much was registered for those in the intervention group which was not significant between groups -4.4 (CI -6.1; -2.8) kg versus -2.5 (CI -3.9; -1.1) kg, P = 0.101. Haemoglobin A1c was significantly reduced in the intervention group -3.1 (CI -5.0; -1.2) mmol/mol, but not in the control group -0.2 (CI -2.4; -2.0) mmol/mol without a significant between group difference (P = 0.223). Low completion was partly due to coronavirus disease 2019. Telehealth lifestyle coaching improve long-term weight loss (> 24 months) for obese people with and without type 2 diabetes compared to usual care.


Assuntos
COVID-19 , Diabetes Mellitus Tipo 2 , Tutoria , Telemedicina , Humanos , Diabetes Mellitus Tipo 2/prevenção & controle , Redução de Peso , Telemedicina/métodos , Estilo de Vida , Obesidade/terapia , Atenção Primária à Saúde
12.
Psychosom Med ; 84(9): 1041-1049, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36346956

RESUMO

OBJECTIVE: This pilot randomized controlled trial evaluates the preliminary efficacy of a 4-month well-being therapy (WBT) and lifestyle intervention among adults with type 2 diabetes and overweight/obesity. METHODS: Fifty-eight patients were recruited from two outpatient clinics and randomized to receive the WBT-lifestyle intervention or the lifestyle intervention alone. Data were collected at baseline (T0), immediate postintervention (T1), 6-month follow-up (T2), and 12-month follow-up (T3). Primary efficacy outcomes included changes in weight, psychological distress, and well-being, whereas secondary efficacy outcomes included changes in lifestyle and physiological parameters. RESULTS: Compared with the lifestyle-alone intervention, the WBT-lifestyle intervention showed greater improvements in depression (p = .009, d = -0.6), hostility (p = .018, d = -0.6), and personal growth (p = .026, d = 0.5) at T1, in self-reported physical activity at T2 (p = .013, d = 0.7) and T3 (p = .040, d = 0.5), and in triglycerides (p = .019, d = -1.12) at T3. There were no differences between treatment groups in weight and other physiological parameters. CONCLUSIONS: These findings suggest that WBT may be a valuable addition to lifestyle interventions for improving short-term psychological outcomes and promoting long-term healthy changes in physical activity, with a potential impact on physiological outcomes.Trial Registration:ClinicalTrials.gov identifier: NCT03609463.


Assuntos
Diabetes Mellitus Tipo 2 , Adulto , Humanos , Diabetes Mellitus Tipo 2/terapia , Projetos Piloto , Estilo de Vida , Sobrepeso/terapia , Obesidade/terapia
13.
BMC Endocr Disord ; 22(1): 264, 2022 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-36316682

RESUMO

AIMS: Proneurotensin (Pro-NT) is a strong predictor of cardiometabolic disease including type 2 diabetes and obesity, however, the effect of lifestyle change on Pro-NT has not been investigated in this context. Middle Eastern (ME) immigrants represent the largest and fastest growing minority population in Europe and are a high-risk population for obesity and type 2 diabetes. In this randomised controlled lifestyle intervention (RCT) addressing ME immigrants to Sweden where weight-loss was previously studied as the main outcome, as a secondary analysis we aimed to study change in Pro-NT during follow-up and if baseline Pro-NT predicted weight loss. METHODS: Immigrants from the Middle East at high risk for type 2 diabetes were invited to participate in this RCT adapted lifestyle intervention of four months' duration. The intervention group (N = 48) received a culturally adapted lifestyle intervention comprising seven group sessions and a cooking class addressing healthier diet and increased physical activity. The control group (N = 44) received treatment as usual with information to improve lifestyle habits on their own. Data assessed using mixed effects regression. OUTCOMES: Primary outcome; change in Pro-NT. Secondary outcome; change in BMI in relation to baseline plasma concentration of Pro-NT. RESULTS: During the four months follow up, weight was significantly reduced in the intervention (-2.5 kg) compared to the control group (0.8 kg) (ß -0.12, 95% CI -0.24 to -0.01, P = 0.028). Pro-NT increased to a significantly greater extent in the intervention compared to the control group during follow up (28.2 vs. 3.5 pmol/L) (ß 11.4; 4.8 to 18.02, P < 0.001). Change over time in BMI was associated with baseline Pro-NT (ß 0.02; 0.01 to 0.04, P = 0.041). CONCLUSION: In consistence with data from surgical weight loss, this RCT paradoxically shows increased levels of Pro-NT during a multifactorial lifestyle intervention resulting in weight loss. Long term studies of Pro-NT following weight loss are needed. TRIAL REGISTRATION: This study is a secondary analysis of the RCT trial registered at www. CLINICALTRIALS: gov . REGISTRATION NUMBER: NCT01420198. Date of registration 19/08/2011. The performance and results of this trial conform to the CONSORT 2010 guidelines.


Assuntos
Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/complicações , Exercício Físico , Estilo de Vida , Redução de Peso , Obesidade/terapia , Obesidade/complicações
14.
Medicine (Baltimore) ; 101(43): e31148, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36316908

RESUMO

BACKGROUND: To evaluate the clinical efficacy of acupuncture and moxibustion therapy compared to non-acupuncture therapy in the treatment of simple obesity in adult. METHODS: Randomized clinical trials concerning acupuncture and moxibustion therapy as a treatment of simple adult obesity were searched in the following Chinese and English databases: Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, WanFang Database, Chinese Biomedical Literature Database, PubMed, Web of Science, Embase, Medline and Cochrane Library. Two researchers independently screened suitable literature according to inclusion and exclusion criteria, extracted data, and evaluated the quality of included studies using the Jadad score scale. After that, data analysis was performed using RevMan 5.4.1 software, Stata 17.0 software and SPSS 25.0 software. RESULTS: A total of 14 studies involving 1116 adults with simple obesity were included in the meta-analysis. Results revealed that BMI, body weight, waist circumference, total effective rate, triglyceride in the acupuncture group were superior to those in the non-acupuncture group, while there was no statistical difference in improving low density lipoprotein, high density lipoprotein and total cholesterol. As to the selection of acupoints, the acupoints of the stomach meridian of Foot Yangming have the highest frequency of use, with a frequency of 30 times, accounting for 35%. The acupoints can be divided into three clusters: the first category: RN9-SP9-SP6-RN4; the second category: ST40-RN6-SP15-ST36; the third category: ST25-RN12. CONCLUSION: Acupuncture and moxibustion is effective in treating adult simple obesity; however, due to the low score of the included studies, we still expect the results of higher-quality literature to provide a higher-level evidence-based basis for clinical decision-making. Furthermore, for the treatment of adult simple obesity, acupoints analysis revealed that Tianshu (ST25), Zhongwan (RN12), Zusanli (ST36), Fenglong (ST40) and Qihai (RN6) can form the basis for the treatment of simple obesity in adult.


Assuntos
Terapia por Acupuntura , Moxibustão , Obesidade Mórbida , Adulto , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia por Acupuntura/métodos , Pontos de Acupuntura , Obesidade/terapia
15.
Artigo em Inglês | MEDLINE | ID: mdl-36360781

RESUMO

Lifestyle and physical characteristics affect body weight, and understanding these factors improves the precision of weight loss treatment. Many obese patients in Korea are receiving Korean medicine (KM) treatment, including herbal medicine and acupuncture, for weight loss. However, the real-world data (RWD) are insufficient in terms of being longitudinal and diverse. Weight Control Registry using KM is a prospective registry study that enrolls patients receiving KM treatment for weight loss and collects RWD from multiple clinics. The patients who are eligible for this study are aged 19-65 years, receive KM weight loss treatment, understand the study objectives, and consent voluntarily. Clinical data of patient characteristics and KM treatment patterns will be regularly collected until 2026. The longitudinal accumulation of various RWD will establish a high-quality study database for KM weight loss treatment. With this study, we expect to contribute to understanding the current trend of weight loss treatment with KM and solve further questions regarding this treatment.


Assuntos
Obesidade , Redução de Peso , Humanos , Estudos Prospectivos , República da Coreia , Obesidade/epidemiologia , Obesidade/terapia , Sistema de Registros
16.
BMC Public Health ; 22(1): 2036, 2022 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-36344975

RESUMO

BACKGROUND: Little research has investigated the associations between proximity to physical activity facilities and behavior-related health and the majority have focused on proximity from home address. We add to the literature by examining proximity of these facilities to work and home address and including a wide range of physical activity facilities. We assess the associations for proximity of physical activity facilities from home and work address with self-reported frequency of exercise and obesity. METHODS: Our analytical sample of 7358 participants was from the 2018 wave of the Swedish Longitudinal Occupational Survey of Health. We used logistic binomial regression adjusting for age, sex, education, civil status, individual socioeconomic status, neighborhood socioeconomic status, number of children under 12 years of age, work strain, and chronic disease. RESULTS: Longer distance from home to paid outdoor and paid indoor physical activity facilities was associated with low frequency of exercise (fully adjusted Relative Risk for both 1.01, 95% CI 1.01-1.02). Associations of any or free outdoor facility with low frequency of exercise were not robust. Findings also indicated associations between long distance from workplace to any and paid outdoor facility and low frequency of exercise. Results for obesity were in the similar direction, however, these were not statistically significant. CONCLUSION: Increased distance of paid outdoor and paid indoor physical activity facilities from home and of paid outdoor facilities from work was associated with low frequency of exercise. Longitudinal and larger studies are needed to confirm our findings, particularly regarding obesity.


Assuntos
Exercício Físico , Obesidade , Criança , Humanos , Estudos Transversais , Obesidade/epidemiologia , Obesidade/terapia , Características de Residência , Classe Social
17.
BMC Public Health ; 22(1): 2051, 2022 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-36352373

RESUMO

BACKGROUND: The management of chronic diseases such as diabetes, obesity and high blood pressure is a major global health challenge, particularly among the most disadvantaged populations. Beyond the biomedical management of these diseases, comprehensive support that takes into account the peoples' economic and social situation is fundamental. The objective of this scoping review is to create an inventory and an analysis of the different types of support for these chronic diseases among disadvantaged, immigrant or minority populations to contribute to a better definition and characterization of what should be global support for these vulnerable populations suffering from these diseases. METHODS: A search of PubMed, PsycINFO, Sages Journals and Web of Science was conducted (between March and May 2021) for articles published between January 2000 and May 2021. Articles were selected after screening titles, abstracts and full texts according to our 5 inclusion criteria. RESULTS: We included 16 articles. The diabetes, obesity and high blood pressure support programs described in these articles operate to improve physical and mental health and access to care. The approaches of these interventions are focused on the training and participation of people and the implementation of support actions adapted to the person. The majority of these interventions have a real attachment to the community. CONCLUSIONS: This review of the literature shows that support for people with chronic diseases such as diabetes, obesity or high blood pressure is based on three pillars: empowerment, peer mediation and holistic and tailor-made support for the individual. The empowerment approach, which considers the capacities and resources of individuals and whose goal is to strengthen their ability to act on their health, appears to be entirely suited to the support of these chronic diseases. This review underlines the importance of moving away from a biomedical approach to a holistic approach truly focused on the person, their capacities and their needs.


Assuntos
Diabetes Mellitus , Hipertensão , Humanos , Populações Vulneráveis , Diabetes Mellitus/terapia , Doença Crônica , Obesidade/terapia
18.
Artigo em Inglês | MEDLINE | ID: mdl-36361210

RESUMO

Metformin, a drug widely used to treat insulin resistance, and training that combines aerobic and strength exercise modalities (i.e., concurrent training) may improve insulin sensitivity. However, there is a paucity of clinical trials investigating the effects of concurrent training, particularly on insulin resistance and fat oxidation in overweight and obese patients. Furthermore, only a few studies have compared the effects of concurrent training with metformin treatment. Therefore, the aim of this study was to examine the effects of a 12-week concurrent training program versus pharmaceutical treatment with metformin on maximum fat oxidation, glucose metabolism, and insulin resistance in overweight or obese adult patients. Male and female patients with insulin resistance were allocated by convenience to a concurrent training group (n = 7 (2 males); age = 32.9 ± 8.3 years; body mass index = 30 ± 4.0 kg·m-2) or a metformin group (n = 7 (2 males); age = 34.4 ± 14.0 years; body mass index = 34.4 ± 6.0 kg·m-2). Before and after the interventions, all participants were assessed for total body mass, body mass index, fat mass, fat-free mass, maximum oxygen consumption, maximal fat oxidization during exercise, fasting glucose, and insulin resistance through the homeostatic model assessment (HOMA-IR). Due to non-normal distribution of the variable maximal fat oxidation, the Mann-Whitney U test was applied and revealed better maximal fat oxidization (Δ = 308%) in the exercise compared with the metformin group (Δ = -30.3%; p = 0.035). All other outcome variables were normally distributed, and significant group-by-time interactions were found for HOMA-IR (p < 0.001, Δ = -84.5%), fasting insulin (p < 0.001, Δ = -84.6%), and increased maximum oxygen consumption (p = 0.046, Δ = 12.3%) in favor of the exercise group. Similar changes were found in both groups for the remaining dependent variables. Concurrent training seems to be more effective compared with pharmaceutical metformin treatment to improve insulin resistance and fat oxidation in overweight and obese adult patients with insulin resistance. The rather small sample size calls for more research in this area.


Assuntos
Resistência à Insulina , Metformina , Treinamento de Força , Adulto , Humanos , Masculino , Feminino , Adulto Jovem , Pessoa de Meia-Idade , Sobrepeso/terapia , Metformina/uso terapêutico , Obesidade/terapia , Índice de Massa Corporal , Insulina/metabolismo , Preparações Farmacêuticas
19.
Artigo em Inglês | MEDLINE | ID: mdl-36361434

RESUMO

Resistance exercise effectively improves bone mineral density (BMD) and muscle quality (e.g., muscle mass and muscle strength). The present study aimed to examine the effect of a 24-week resistance exercise training (RT) program on body composition, BMD, functional fitness, and isokinetic muscle strength in obese older women. Forty obese older women were initially enrolled. Among them, 30 participants (age: 80.55 ± 4.94 years; body fat percentage: 36.25 ± 3.44%) completed the study. The participants were randomly assigned into two groups: the RT group (n = 15) and the control (CON) group (n = 15). The RT group participated in the exercise for 60 min per session and two sessions per week for 24 weeks. Pre-test and post-test body composition, BMD, functional fitness, and isokinetic muscle strength were evaluated. The RT group increased significantly in functional fitness (hand grip strength: 1.70 kg, p < 0.01, and lower body strength: 3.87 n, p < 0.001), and isokinetic muscle strength (non-dominant leg extensor peak torque %BW at 60°/s: 13.20%, p < 0.05, dominant leg (DL) flexor peak torque at 60°/s: 3.87 Nm, p < 0.05, and DL flexor peak torque %BW at 60°/s: 7.60%, p < 0.05). However, the CON group showed negative changes in body composition (fat mass: 1.15 kg, p < 0.001, body fat percentage: 1.59%, p < 0.001, and fat-free mass: -0.58 kg, p < 0.05), BMD (whole-body: -0.01 g/cm2, p < 0.001 and forearm: -0.01 g/cm2, p < 0.05), functional fitness (lower body flexibility: -3.23 cm, p < 0.01, upper body strength: -2.06 n, p < 0.01, and agility and dynamic balance: 0.54 s, p < 0.01), and isokinetic muscle strength at 60°/s and 180°/s (all peak torque % body weight variables: -7.31--1.50, p < 0.05). Our findings show that the CON group negatively affects body composition, BMD, functional fitness, and isokinetic muscle strength in obese older women for 24 weeks.


Assuntos
Treinamento de Força , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea/fisiologia , Força da Mão/fisiologia , Músculo Esquelético/fisiologia , Força Muscular/fisiologia , Composição Corporal/fisiologia , Obesidade/terapia
20.
BMJ Open ; 12(11): e065995, 2022 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-36343999

RESUMO

OBJECTIVES: To explore ways to enhance the design of risk factor management and weight-loss services for people with overweight/obesity and atrial fibrillation (AF). BACKGROUND: AF is the most common cardiac arrhythmia, with serious consequences for health and quality of life. Some evidence indicates weight reduction in people with AF and overweight/obesity may improve symptoms. This population may require additional support with weight management due to factors associated with ageing and health. DESIGN: Qualitative investigation based on semi-structured interviews. METHODS: 12 adult participants (4 female, 8 male) with diagnosed AF and a current or previous body mass index >27 kg/m2 were recruited at a large tertiary cardiac referral centre in southern England between September 2020 and January 2021. Participants completed quality of life and AF symptom questionnaires using Think-Aloud technique and semi-structured interviews relating to their weight management experiences, needs and preferences. Interviews were audio recorded and analysed thematically using the Capability, Opportunity and Motivation-Behaviour model as a theoretical framework. RESULTS: Three main themes were identified. Being out of rhythm explores the psychological and physical impact of AF on weight management; doing the right thing discusses participants' weight management experiences and broaching the subject explores participants' perspectives on weight management conversations with clinicians. CONCLUSIONS: There was dissatisfaction with the weight management advice received from healthcare professionals including cardiologists. Participants wanted open, non-judgemental discussion of cardiac health implications of overweight/obesity supported by referral to weight management services. Improved communication including research findings regarding the benefits of weight loss as a factor in AF management might increase motivation to adhere to weight-loss advice in this population.


Assuntos
Fibrilação Atrial , Adulto , Humanos , Masculino , Feminino , Fibrilação Atrial/terapia , Fibrilação Atrial/psicologia , Sobrepeso/terapia , Qualidade de Vida , Redução de Peso , Obesidade/terapia , Obesidade/psicologia , Pesquisa Qualitativa
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