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1.
PLoS One ; 15(1): e0227761, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31945129

RESUMO

BACKGROUND: Parents' underestimation of their child's weight status can hinder active participation in overweight prevention programs. We examined the level of agreement between the parents' perception of their child's weight status and the child's actual weight status, moderating factors, and change over time. METHODS: This cross-sectional study used data collected in 2009 (n = 8105), 2013 (n = 8844) and 2017 (n = 11,022) from a community-based survey conducted among parents of children age 2-12 years in the Netherlands. Parents classified their perception of their child's weight status on a 5-point Likert scale. In 2009 and 2013, the child's BMI was calculated from self-reported data by parents. The level of agreement between the parent's perception of the weight status and the actual weight status was examined using Cohen's kappa. The role of demographic factors on parents' perception were examined using logistic regression. RESULTS: In 2009, 2013 and 2017, 6%, 6% and 5% of the parents, respectively, classified their child as heavy/extremely heavy. In 2009 and 2013, 64.7% and 61.0% of parents, respectively, underestimated the weight status of their overweight child. This was even higher among parents of obese children. Overall, the agreement between the parents' perception and the actual weight status improved from 2009 (kappa = 0.38) to 2013 (kappa = 0.43) (p<0.05), but remained unsatisfactory. The parents' underestimation of their child's overweight/obesity status was associated with the child's age in 2009 and 2013 (2-7 years; OR: 0.18), the child's gender in 2009 (male; OR: 0.55), and the parents' education level in 2009 (middle and high education; OR: 0.56 and 0.44 respectively). CONCLUSIONS: Parents' underestimation of their child's weight status remains alarmingly high, particularly among parents of young, obese children. This underestimation is a barrier to preventing childhood overweight/obesity. Healthcare professionals should take this underestimation into consideration and should actively encourage parents to take steps to prevent overweight/obesity in their children.


Assuntos
Peso Corporal , Conhecimentos, Atitudes e Prática em Saúde , Pais/psicologia , Obesidade Pediátrica/prevenção & controle , Fatores Etários , Índice de Massa Corporal , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Países Baixos , Obesidade Pediátrica/diagnóstico , Percepção , Inquéritos e Questionários/estatística & dados numéricos , Programas de Redução de Peso
2.
PLoS One ; 15(1): e0227692, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31945095

RESUMO

BACKGROUND: Life-style interventions, including smoking cessation and weight control are of importance for managing future escalating prevalence of obesity. Smoking habits and obesity have jointly great impact on mortality, however mechanisms behind the effect and variables involved in the obesity paradox is still unknown. OBJECTIVES: This study examines risk factors for all-cause, cardiovascular, and cancer mortality in males and females with high cardiovascular risk, mediated by smoking habits, body mass index (BMI, kg/m2), and serum phosphate (S-P) levels. METHODS: Patients were admitted to the Vindeln Patient Education Center in groups of 30 for a four-week residential comprehensive program (114 hours) focusing on smoking cessation, stress reduction, food preferences and selections, and physical exercise. The follow-up, in years from 1984 to 2014 corresponds to 30 years. This study included 2,504 patients (1,408 females and 1,096 males). Cox regression analysis was used to assess mortality risk associated with smoking habits, low and high BMI, and low and high S-P levels. RESULTS: High BMI (>34,2 kg/m2), current smoking, type 2 diabetes mellitus (T2DM), high serum calcium (S-Ca), mmol/L and high systolic blood pressure (SBP, mmHg) were associated with all-cause mortality irrespective of sex. Former and current smoking females had a high all-cause mortality (adjusted hazard ratio [HR] 1.581; 95% CI 1.108-2.256, adjusted hazard ratio [HR] 1.935; 95% CI 1.461-2.562, respectively) while current smoking and high BMI increased risk for cardiovascular mortality (adjusted hazard ratio [HR] 3.505; 95% CI 2.140-5.740 and [HR] 1.536; 95% CI 1.058-2.231, respectively). Neither low nor high levels of S-P predicted all-cause, cardiovascular disease (CVD) and cancer mortality in males or females while low levels of S-P predicted all-cause mortality in smokers (adjusted hazard ratio [HR] 1.713; 95% CI 1.211-2.424). In non-smokers, low BMI (<27.6 kg/m2) was protecting and high BMI a risk for all-cause mortality. In males, ischemic heart disease (IHD), and low serum albumin (S-Alb) were associated with all-cause mortality. In females, an interaction between high BMI and smoking (HbmiSM) decreased the cardiovascular mortality (adjusted hazard ratio [HR] 0.410; 95% CI 0.179-0.937, respectively). CONCLUSIONS: High BMI and current smoking were associated with all-cause mortality in both males and females in the present high cardiovascular-risk cohort. In current smokers and non-smokers, T2DM and high S-Ca were associated with an increase in all-cause mortality, while low S-P was associated with all-cause mortality in smokers. Interaction between high BMI and smoking contribute to the obesity paradox by being protective for cardiovascular mortality in females.


Assuntos
Promoção da Saúde/métodos , Obesidade/mortalidade , Fosfatos/sangue , Fumar/mortalidade , Adulto , Índice de Massa Corporal , Estudos de Coortes , Feminino , Estilo de Vida Saudável , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/terapia , Fatores de Risco , Fumar/sangue , Fumar/terapia , Abandono do Hábito de Fumar , Suécia/epidemiologia , Programas de Redução de Peso
3.
BMC Womens Health ; 19(1): 167, 2019 12 27.
Artigo em Inglês | MEDLINE | ID: mdl-31882009

RESUMO

BACKGROUND: There is evidence showing the effectiveness of a hypocaloric diet and the increase in physical activity on weight loss. However, the combined role of these factors, not only on weight loss but also body composition, remains unclear. The purpose of this study was to investigate the effect of a hypocaloric diet on the body composition of obese adult women throughout different degrees of physical activity during a weight loss program. METHODS: One hundred and seventeen healthy female volunteers were randomly assigned to one of the experimental groups: a control group with a low-level prescription of physical activity (1-4 METs), moderate physical activity group that performed 10.000 steps walking (5-8 METs) and intense physical activity group that trained exercises by at least 70% of VO2max three times a week (> 8 METs). All subjects followed a hypocaloric diet designed with a reduction of 500 kcal/day. Nutritional counseling was provided throughout the study period to help ensure dietary adherence. RESULTS: We found no differences in body weight compared to moderate and intense physical activity (ßstand. = - 0.138 vs. ßstand. = - 0.139). Body fat was lower in women following an intense activity (ßstand. = - 0.436) than those with moderate exercise (ßstand. = - 0.231). The high-intense activity also increased muscle mass at the end of the intervention, standing out above the moderate activity (ßstand. = 0.182 vs. ßstand. = 0.008). CONCLUSIONS: These findings indicate that a hypocaloric diet, without prescription of physical activity, is adequate to lose weight in the short term (12 weeks), but physical activity is vital to modify the body composition in women with obesity. Body fat was lower when women practiced a moderate exercise compared to hypocaloric diet only, but an intense physical activity was the most effective protocol to obtain a reduction of body fat and maintain muscle mass. TRIAL REGISTRATION: The study protocol complied with the Declaration of Helsinki for medical studies, it was approved by the bioethical committee of Córdoba University, in the Department of Health at the Regional Government of Andalusia (Act n°284, ref.4156) and retrospectively registered in clinicaltrials.gov (NCT03833791). Registered 2 January 2019.


Assuntos
Composição Corporal/fisiologia , Dieta Redutora/métodos , Obesidade/terapia , Condicionamento Físico Humano/métodos , Programas de Redução de Peso/métodos , Adulto , Peso Corporal , Exercício Físico/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Estudos Retrospectivos , Comportamento Sedentário , Fatores de Tempo , Resultado do Tratamento , Perda de Peso
4.
Prensa méd. argent ; 105(11): 786-799, dic2019. tab
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1049781

RESUMO

Las intervenciones en mindful eating están siendo cada vez más utilizadas para tratar problemáticas relacionadas con la alimentación. En población con sobrepeso y obesidad esta herramienta busca disminuir los síntomas de atracón, mejorar la regulación emocional y conciencia de los estados internos de hambre y saciedad. Objetivo: conocer la valoración y aprendizajes atribuidos al taller Mindful Eating en un grupo de mujeres en tratamiento de reducción de peso en un centro de salud privado. Método: enfoque metodológico cualitativo, de alcance exploratorio y descriptivo. Para recolectar los datos se utilizaron entrevistas en profundidad semi- estructuradas a 7 mujeres entre 22-54 años, analizadas desde el modelo de la Grounded Theory. Resultados: a partir del taller hubo cambios en el modo de relacionarse con la comida y el sí mismas. Antes del taller las participantes tenían una relación inconsciente con la comida; comer en piloto automático, comer emocional, atracones y modo de relacionarse consigo mismas desde la autocrítica y autocastigo. Posterior al taller, se describen cambios favorables en una relación consciente con la comida, destacándose mayor conexión interna, autocuidado y modo de relacionarse sí mismas autocompasivo. Discusión: las participantes tuvieron una valoración positiva del taller mindful eating, apreciando el rol contendor del grupo, ser una herramienta de utilidad y uso a largo plazo que posibilitaría un cambio hacia una relación más saludable con la comida y si mimas. Sería útil integrar esta herramienta en los programas de control de peso, monitoreando y reforzando continuamente los aprendizajes que los participantes hayan obtenido en el taller. Esta integración podría ayudar a los participantes a continuar utilizando herramienta y, al hacerlo, ayudarlos a integrar hábitos alimenticios más saludables a largo plazo.


Summary Mindful eating interventions are being increasingly used to treat eating behavior problems. In overweight and obese population this tool seeks to reduce symptoms of binge eating, improve emotional regulation, and increase awareness of hunger and satiety.Aim of the study: to investigate how a group of women in weight reduction treatment assessed a mindful eating workshop and what were the main learnings they had from the program. Method: qualitative approach with an exploratory and descriptive scope. Data were collected through semi-structured in-depth interviews. Participants were 7 women between 22-54 years old.  The data analysis was carried out using Grounded Theory model. Results: participants in the workshop reported changes in the way they relate to the food and themselves. Before the workshop, the participants reported not being aware of their relationship to the food, eating on autopilot, eating emotionally, bingeing, and being self-critical and punishing themselves. After the workshop, participants reported changes, experiencing increased awareness of their relationship with food, greater connection to the inner-self, and increased self-care and self-compassion. Discussion: participants had a positive assessment of the  minRPM Nº 11-2019.indd 798 13/12/19 12:50 LA PRENSA MÉDICA ARGENTINA Valoración y aprendizajes atribuidos al taller Mindful Eating en un grupo de mujeres en tratamiento… 799 V.105/Nº11 dful eating  workshop, highlighting the buffering effect of the group, considering mindfulness as a useful and long-term tool that would allow them to have a healthier relationship with food and with one-self. It would be useful to integrate this tool in weight control treatments, monitoring and reinforcing the learnings participants have from the workshop. Having this integration might help participants to continuing using the tool and, by doing that, helping them to integrate healthier eating habits in the long term.


Assuntos
Feminino , Adulto , Pessoa de Meia-Idade , Entrevista , Educação , Sobrepeso/terapia , Comportamento Alimentar , Relatório de Pesquisa , Programas de Redução de Peso , Atenção Plena
5.
BMC Musculoskelet Disord ; 20(1): 610, 2019 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-31861990

RESUMO

BACKGROUND: The aim of this systematic review was to identify principles of exercise interventions associated with improved physical function, weight management or musculoskeletal pain relief among young and middle-aged adults with obesity and propose an evidence-based exercise prescription that could assist in secondary prevention of osteoarthritis. METHODS: A structured electronic review was conducted using MEDLINE, PubMed, and SPORTDiscus. The search string included 1) "obes*" AND "exercise" AND "interven*" AND "musculoskeletal pain OR knee pain OR hip pain". Studies 1) were randomized controlled trials of humans, with a non-exercise control, 2) included participants aged 18-50 years, and 3) had outcomes that included physical function, musculoskeletal pain, and/or body composition. Studies were excluded if participants had peri-menopausal status, cancer, or obesity-related co-morbidities. A recommended exercise prescription was developed based on common principles used in the included exercise interventions with greatest change in function or pain. RESULTS: Seven studies were included. Similarities in exercise intensity (40-80% VO2max), frequency (three times per week), duration (30-60 min), and exercise mode (treadmill, cross-trainer, stationary bike, aquatic exercise) were observed in exercise interventions that resulted in improved physical function and/or pain, compared to non-exercise control groups. CONCLUSION: Common principles in exercise prescription for improvements in weight management, physical function and pain relief among otherwise healthy people with obesity. Exercise prescription including moderate intensity exercise for 30-60 min, three times per week can be considered an effective treatment for weight management and obesity-related musculoskeletal symptoms. Exercise should be recommended to at-risk individuals as part of secondary prevention of osteoarthritis.


Assuntos
Exercício Físico , Obesidade/terapia , Osteoartrite/prevenção & controle , Programas de Redução de Peso , Humanos , Obesidade/complicações , Osteoartrite/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto
6.
BMC Public Health ; 19(1): 1732, 2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31870345

RESUMO

BACKGROUND: Finding effective intervention strategies to combat rising obesity levels could significantly reduce the burden that obesity and associated non-communicable diseases places on both individuals and the National Health Service. METHODS: In this parallel randomised-controlled trial, 76 participants who are overweight or obese (50 female) were given free access to a fitness centre for the duration of the 12-week intervention and randomised to one of three interventions. The commercial intervention, the Healthy Weight Programme, (HWP, n = 25, 10/15 men/women) consisted of twelve 1-h nutrition coaching sessions with a nutritionist delivered as a mixture of group and 1 to 1 sessions. In addition, twice-weekly exercise sessions (24 in total) were delivered by personal trainers for 12 weeks. The NHS intervention (n = 25, 8/17 men/women) consisted of following an entirely self-managed 12-week online NHS resource. The GYM intervention (n = 26, 8/18 men/women) received no guidance or formal intervention. All participants were provided with a gym induction for safety and both the NHS and GYM participants were familiarised with ACSM physical activity guidelines by way of a hand-out. RESULTS: The overall follow-up rate was 83%. Body mass was significantly reduced at post-intervention in all groups (HWP: N = 18, - 5.17 ± 4.22 kg, NHS: N = 21-4.19 ± 5.49 kg; GYM: N = 24-1.17 ± 3.00 kg; p < 0.001) with greater reductions observed in HWP and NHS groups compared to GYM (p < 0.05). Out with body mass and BMI, there were no additional statistically significant time x intervention interaction effects. CONCLUSIONS: This is the first study to evaluate the efficacy of both a free online NHS self-help weight-loss tool and a commercial weight loss programme that provides face-to-face nutritional support and supervised exercise. The findings suggest that both interventions are superior to an active control condition with regard to eliciting short-term weight-loss. TRIAL REGISTRATION: ISRCTN Registry - ISRCTN31489026. Prospectively registered: 27/07/16.


Assuntos
Obesidade/terapia , Sobrepeso/terapia , Programas de Redução de Peso/métodos , Adulto , Feminino , Humanos , Intervenção Baseada em Internet/economia , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Medicina Estatal , Reino Unido , Programas de Redução de Peso/economia , Adulto Jovem
7.
BMC Public Health ; 19(1): 1552, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752815

RESUMO

BACKGROUND: Obesity has become a major public health problem. Innovative treatments are necessary. Internet and new technologies have been reported effective results in weight control programs, especially those with personalized feedback. This paper presents the protocol for a randomized controlled trial to test the effectiveness of an online weight control program, called en_línea, comparing with a standard group therapy and a control group. METHODS: This is a randomized controlled trial with three intervention arms: en_línea, standard group therapy and control group. To perform this study, 305 adults (18-65 years) with overweight type II (27-29.9 kg/m2) or obesity type I (30-34.9 kg/m2) will be invited to participate. Interventions will last 17 weeks with follow-ups 1, 3, 6 and 12 months after the post-treatment appointment. The primary outcome will be post-treatment weight loss and the maintenance during the follow-ups. Secondary outcomes will be adherence rates, drop outs and quality of life. Participants will be assessed before randomization and they will be sign an inform consent. DISCUSSION: The future challenge is to design innovative obesity treatments. Internet could be a useful tool to improve traditional weight control programs. This new intervention format is appropriate for patients who prefer not to share their intimate problems with a group, and for the new generations who feel comfortable using new technologies. Besides, Internet allows reaching a large amount of people at the same time, even if they live far away. TRIAL REGISTRATION: ClinicalTrials.gov NCT04127201. Retrospectively registered 15th October 2019.


Assuntos
Estilo de Vida , Obesidade/terapia , Sobrepeso/terapia , Programas de Redução de Peso/métodos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/psicologia , Sobrepeso/psicologia , Projetos de Pesquisa , Adulto Jovem
8.
J Int Soc Sports Nutr ; 16(1): 52, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718652

RESUMO

BACKGROUND: Similar to other combat sports, mixed martial arts (MMA) includes divisional weight classes. The purpose of our research was to further investigate the amount of weight professional MMA fighters lost prior to weighing in for competition, their methods used to cut weight, and their sources of advice on how to cut weight. METHODS: This survey was administered to 92 male professional MMA athletes. The survey questions included duration of overall weight loss prior to competition, methods of weight-cutting, and their sources of advice regarding weight cutting. RESULTS: When comparing the number of methods of weight cutting with the source of advice, those who received their advice from social media used slightly more methods of weight cutting (M = 4.86, SD = 1.27) than those who did not (M = 4.02, SD = 1.55); t(90) = - 2.53, p < .05. MMA athletes that used the help of a registered dietitian nutritionist also reported using the least amount of methods for weight-cutting than any other category (M = 3.84, SD = 1.67). Those that used teammates and did not use a registered dietitian nutritionist used slightly more methods (M = 4.46, SD = 1.41) than those who used a registered dietitian nutritionist. CONCLUSIONS: The findings of this study report that professional MMA athletes do undergo rapid weight loss through various methods to make weight for competition. This study adds evidence to the literature that most professional MMA athletes undergo RWL for competition without the guidance of a registered dietitian nutritionist. It is unclear what the effect of using a registered dietitian nutritionist may have on an MMA athletes' ability to reduce weight in a safe and effective manner. Future research should seek to investigate if employing a registered dietitian nutritionist may lead to a higher rate of success for MMA athletes to make weight, and help reduce adverse risks of RWL.


Assuntos
Atletas , Artes Marciais , Autorrelato , Perda de Peso , Programas de Redução de Peso/métodos , Humanos , Masculino , Nutricionistas , Mídias Sociais
9.
BMC Public Health ; 19(1): 1287, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31615456

RESUMO

BACKGROUND: Gestational diabetes (GDM) is a known risk factor for type 2 diabetes mellitus (T2DM), and women with a history of GDM have a 7-fold increased risk of developing the disease. Achieving a healthy weight post-delivery is key in reducing the risk of future diabetes in these women. The aim of this trial is to investigate the use of an interactive smartphone application (APP) to restore women to optimal weight following delivery. METHODS: This will be an open-label randomized controlled trial. Two hundred women with gestational diabetes will be randomized to receive the intervention or standard care following delivery. Participants will be reviewed at 6 weeks and 4 months post-delivery. The intervention is an APP serving as a platform for weight, diet and physical activity tracking. The APP provides 3-5 min educational videos suggesting suitable lifestyle adjustments relevant to postnatal period such as breast feeding, diet and exercise. Lastly, the APP will allow real-time interaction between users and the team of dietitians, physiotherapists and occupational therapists to encourage restoration of optimal weight. Women in the control arm will be informed about the increased risk of developing T2DM and advised to maintain a healthy weight. Primary outcome measure is the restoration of participants' booking weight if booking BMI ≤ 23, or weight loss of at least 5% from booking weight if booking BMI > 23 over the 4 month period. Secondary outcome measures will assess serum metabolic and inflammatory markers, quality of life via questionnaires and cost-effectiveness of the intervention at each follow-up visit. DISCUSSION: This will be the first randomised controlled trial investigating the use of a smartphone application for postpartum weight loss in women with gestational diabetes. The major ethnic groups in our study population represent the majority of ethnic groups in Asia, amongst which the prevalence of diabetes is high. If shown to be effective, this APP may be used in wider clinical settings to improve postpartum weight loss and reduce the risk of developing T2DM in these women. TRIAL REGISTRATION: This study was registered on clintrials.gov on the 30th of October 2017, under the trial registration number: NCT03324737 .


Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Gestacional/epidemiologia , Aplicativos Móveis , Smartphone , Programas de Redução de Peso/métodos , Adulto , Protocolos Clínicos , Feminino , Humanos , Gravidez , Singapura/epidemiologia
10.
Health Psychol ; 38(12): 1150-1158, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31566400

RESUMO

OBJECTIVES: Despite increased interest in the development of individually tailored weight management programs, little is known about what factors proximally predict weight change. METHOD: The current study investigated proximal (week-to-week) predictors of weight loss and regain in 74 adults during a 3-month, Internet-based behavioral weight loss program followed by a 9-month "maintenance" period (during which no additional intervention was provided). Participants were asked to self-weigh daily using scales that transmitted weight via the cellular network and to answer a brief questionnaire each week querying mood, behaviors, and cognitions hypothesized to be associated with weight loss and regain. RESULTS: Longitudinal multilevel models demonstrated that weight loss during initial intervention was proximally predicted by (a) greater frequency of self-monitoring weight and caloric intake, consistency between eating choices and weight loss goals, and importance of "staying on track" with these goals and (b) less negative mood, boredom with weight control efforts, hunger, and temptation to eat foods "not on plan" (ps < .05). Greater weight regain after intervention was also proximally predicted by these factors (with effects in the opposite direction) and additionally by less physical activity, less positive mood, more stress, greater temptation to skip planned physical activity, and higher ratings of the amount of effort required to stay on track (ps < .05). CONCLUSIONS: Results confirmed the importance of self-monitoring for weight loss and maintenance and identified other key week-to-week predictors of weight change. Results also supported efforts to develop intervention approaches specifically focused on weight loss maintenance. Future research should investigate whether using identified predictors to tailor intervention content and timing can improve weight outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Obesidade/psicologia , Perda de Peso/fisiologia , Programas de Redução de Peso/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
11.
Clin Exp Rheumatol ; 37 Suppl 120(5): 31-39, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31621558

RESUMO

Osteoarthritis (OA) is a painful joint disease affecting more than 32.5 million adults in the US and over 350 million adults worldwide. The prevalence is expected to rise continually over the next several decades with significant impacts to societal health and economic costs as well as individuals' daily activities and quality of life. In 2008, the Centers for Disease Control and Prevention (CDC) and the Arthritis Foundation (AF) led a collaborative effort to address approaches to reduce the burden of OA via public health interventions, policies (systems and environmental), and communication strategies. This collaboration resulted in the National Public Health Agenda for OA (OA Agenda), which was vetted by more than 75 stakeholder organisations and released in 2010. The OA Agenda listed ten recommendations focused on public health interventions for OA including weight management, physical activity, self-management education, and injury prevention, and policies, systems, communication, research and evaluation. In 2011, the CDC and AF mobilised the OA Action Alliance (OAAA), a national coalition of organisations concerned with mitigating the public health impact of OA, to operationalise the recommendations set forth in the OA Agenda. Since then, the OAAA has grown to include more than 110 organisations that work collectively to increase awareness about the prevention and management of OA, provide educational resources, and expand access to evidence-based programmes for target audiences including individuals with OA, community-based organisations, healthcare systems and providers, and policymakers. This review highlights the OAAA's progress to date in addressing the OA Agenda recommendations; successes and challenges in delivery of effective communication, programmes, and resources; and future implications.


Assuntos
Exercício Físico/fisiologia , Obesidade/complicações , Osteoartrite/complicações , Saúde Pública , Artralgia , Humanos , Qualidade de Vida , Programas de Redução de Peso
12.
Obes Facts ; 12(5): 543-553, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31505515

RESUMO

BACKGROUND: The preferred walking speed (PWS), also known as the "spontaneous" or "self-selected" walking speed, is the speed normally used during daily living activities and may represent an appropriate exercise intensity for weight reduction programs aiming to enhance a more negative energy balance. OBJECTIVES: The aim of this study was to examine, simultaneously, the energetics, mechanics, and perceived exertion determinants of PWS in individuals with obesity. METHODS: Twenty-three adults with obesity (age 32.7 ± 6.8 years, body mass index 33.6 ± 2.6 kg/m2) were recruited. The participants performed 10 min of treadmill familiarization, and PWS was determined. Each subject performed six 5-min walking trials (PWS 0.56, 0.83, 1.11, 1.39, and 1.67 m/s). Gas exchanges were collected and analyzed to obtain the gross energy cost of walking (GCw), rated perceived exertion (RPE) was measured using a 6-20 Borg scale, and the external mechanical work (Wext) and the fraction of mechanical energy recovered by the pendular mechanism (Recovery) were computed using an instrumented treadmill. Second-order least-squares regression was used to calculate the optimal walking speed (OWS) of each variable. RESULTS: No significant difference was found between PWS (1.28 ± 0.13 m/s) and OWS for GCw (1.28 ± 0.10 m/s), RPE cost of walking (1.38 ± 0.14 m/s), and Recovery (1.48 ± 0.27 m/s; p > 0.06 for all), but the PWS was significantly faster than the OWS for Wext (0.98 ± 0.56 m/s; p < 0.02). Multiple regression (r = 0.72; p = 0.003) showed that ∼52% of the variance in PWS was explained by Recovery, Wext, and height. CONCLUSION: The main finding of this study was that obese adults may select their PWS in function of several competing demands, since this speed simultaneously minimizes pendular energy transduction, energy cost, and perceived exertion during walking. Moreover, recovery of mechanical work, external work, and height seem to be the major determinants of PWS in these individuals.


Assuntos
Obesidade , Preferência do Paciente , Velocidade de Caminhada/fisiologia , Caminhada/psicologia , Adolescente , Adulto , Índice de Massa Corporal , Metabolismo Energético/fisiologia , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/metabolismo , Obesidade/fisiopatologia , Obesidade/psicologia , Obesidade/terapia , Consumo de Oxigênio , Preferência do Paciente/psicologia , Percepção/fisiologia , Esforço Físico/fisiologia , Programas de Redução de Peso , Adulto Jovem
13.
Nutrients ; 11(9)2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31480678

RESUMO

Research on weight-loss interventions in emerging adulthood is warranted. Therefore, a cognitive-behavioral group treatment (CBT), including development-specific topics for adolescents and young adults with obesity (YOUTH), was developed. In a controlled study, we compared the efficacy of this age-specific CBT group intervention to an age-unspecific CBT group delivered across ages in an inpatient setting. The primary outcome was body mass index standard deviation score (BMI-SDS) over the course of one year; secondary outcomes were health-related and disease-specific quality of life (QoL). 266 participants aged 16 to 21 years (65% females) were randomized. Intention-to-treat (ITT) and per-protocol analyses (PPA) were performed. For both group interventions, we observed significant and clinically relevant improvements in BMI-SDS and QoL over the course of time with small to large effect sizes. Contrary to our hypothesis, the age-specific intervention was not superior to the age-unspecific CBT-approach.


Assuntos
Envelhecimento , Terapia Comportamental , Terapia Cognitivo-Comportamental , Perda de Peso , Programas de Redução de Peso , Adolescente , Feminino , Humanos , Masculino , Adulto Jovem
15.
Br J Health Psychol ; 24(4): 970-981, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31502377

RESUMO

OBJECTIVE: What happens when people see others making progress toward a goal that they also hold? Is it motivating or could it undermine goal pursuit because people feel that they have made progress themselves (i.e., they experience vicarious goal satiation)? METHODS: We investigated these questions in a longitudinal field context - a group weight loss programme. N = 132 participants who were overweight or obese and attended weekly weight loss classes completed questionnaires over 11 weeks to investigate the consequences of observing other people making progress toward their goal of losing weight RESULTS: Observing others making good progress was associated with participants holding stronger intentions to lose weight themselves (B = 0.04, p = .012), positive goal-related affect (B = 0.27, p = .017), and feeling that they were also making progress themselves (B = 0.22, p < .001). However, observing others making good progress was also associated with losing a smaller amount of weight over the following week (B = .13, p = .005). Mediation analyses showed a significant indirect effect of observing others making good progress, via feelings about their own progress, on changes in weight, B = .02, 95% CI [.00, .04]. CONCLUSIONS: People who view others making progress tend to be less successful at losing weight themselves over the following week. The findings suggest that this is, in part, explained by the person feeling as if they have made progress themselves; thereby providing the first demonstration of vicarious goal satiation in a field context. Statement of contribution What is already known on this subject? Many people strive toward health goals (e.g., try to lose weight) with other people. However, research into vicarious goal satiation (VGS) suggests that seeing someone else achieve their goal may lead people to believe that they have made progress themselves and undermine goal pursuit. What does this study add? A longitudinal test of VGS in a field context, namely weight loss groups. Observing other people do well was motivating for the observer. They also believed that they had made progress themselves and were less successful at losing weight.


Assuntos
Objetivos , Motivação , Sobrepeso/psicologia , Sobrepeso/terapia , Autocontrole/psicologia , Programas de Redução de Peso/métodos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Reino Unido , Perda de Peso
16.
Z Psychosom Med Psychother ; 65(3): 224-238, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31476994

RESUMO

App-controlled feedback devices can support sustainability of weight loss. Multicentre QUANT-study shows additional weight loss and gain of QoL via multiple feedback-devices in OPTIFAST®52-program Objective: Are three app-controlled feedback devices, tested against a simple pedometer in a weight reduction program, supporting sustainable therapy success and quality of life (QoL)? Methods: In this multi-centre randomised controlled study adults with obesity (n = 89, m = 46.5 years, women n = 54), achieved high weight loss (from 42.7 kg/m² to 35.2 kg/m²) while completing the first three month of the OPTIFAST®52-program. Thereafter the intervention group (IG) used feedback devices (BIA scale, blood pressure monitor, step counter), the control group a mechanical pedometer without app for another year. Intention-to-treat analysis (ITT) and As-treated analysis (AT) were carried out. Results: Feedback devices had a positive effect on fat-loss and secondary study objectives like QoL, leading to a better sustainability of these improvements. Participants in IG (AT for t2-t0) had improvements for Waist-to-Height-ratio (WHtR) and physically and mentally quality of life. Conclusion: The results are presumably based on an increase in self-efficacy and the experience of control. Future studies should be preceded by a pilot study to analyse acceptance problems.


Assuntos
Manutenção do Peso Corporal , Retroalimentação , Aplicativos Móveis , Obesidade/terapia , Qualidade de Vida , Perda de Peso , Programas de Redução de Peso/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
18.
Artigo em Inglês | MEDLINE | ID: mdl-31443606

RESUMO

Treatment options are limited for children and adolescents with severe obesity. One alternative treatment is the protein-sparing modified fast (PSMF), a low-carbohydrate, high-protein diet that can result in substantial weight loss. The aim of the study is to evaluate the adherence and efficacy of a revised PSMF (rPSMF) for severe obesity in a pediatric tertiary care weight-management program. The rPSMF with 1200-1800 calories, 40-60 g of carbohydrate/day and 1.2-1.5 g protein/kg of ideal bodyweight was implemented over 12 months. Twenty-one participants enrolled in the study. Mean age 16.2 ± 1.4 years, females (76.2%) and mean weight at baseline was 119 ± 19.9 kg. Regardless of adherence to the rPSMF, the mean weight change at 1 month was -3.7 ± 3.5 kg, (range -13.5 kg to 0.9 kg); at 3 months was -5.5 ± 5.1 kg, (range -19.3 kg to 1.8 kg) and at 6 months was -4.7 ± 6.6 kg, (range -18.3 kg to 8.6 kg). At 12 months, the mean weight change was -1.3 ± 10.6 kg (range -17.7 kg to 14.8 kg). Parent and child-reported physical and psychosocial quality of life (HRQOL) improved. Despite limited adherence, the rPSMF diet resulted in clinically significant weight loss and improved HRQOL for children and adolescents with severe obesity.


Assuntos
Dieta Rica em Proteínas e Pobre em Carboidratos , Obesidade Mórbida/dietoterapia , Cooperação do Paciente/estatística & dados numéricos , Obesidade Pediátrica/dietoterapia , Programas de Redução de Peso/métodos , Adolescente , Criança , Ingestão de Energia , Jejum , Feminino , Humanos , Masculino , Obesidade , Projetos Piloto , Estudos Prospectivos , Qualidade de Vida , Resultado do Tratamento , Perda de Peso , Programas de Redução de Peso/estatística & dados numéricos
19.
PLoS One ; 14(7): e0220104, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31335916

RESUMO

This systematic review aims to identify instruments used to assess motivations for weight loss in individuals with overweight and obesity from different age groups, such as children, adolescents, adults, and older adults. The virtual search was carried out using the PubMed, Scopus, LILACS, and ADOLEC databases, and by manual search. The following descriptors were used: questionnaire, scale, instrument, evaluation, motivation, motive, reason, "lose weight," "losing weight," "weight loss," and slimming. Methodological quality was assessed according to the criteria of the COSMIN checklist. The search yielded 3,524 results, seven of which were included in the review. Six questionnaires assessing motivations for weight loss, which could be applied to various age groups, were identified. All the questionnaires presented items related to appearance and health as the main motivation for weight loss. In addition to these motivations, the questionnaires also included items related to improved sports performance, self-confidence, participation in important social events, family and social pressure, and fitting into different clothes. The most evaluated measurement properties in the studies were internal consistency, reliability, content validity, and construct validity. Regarding internal consistency, one was rated as excellent, one as fair, and three as poor. For reliability, two were rated as being of fair quality, and one as of poor quality. Two studies analyzed the content validity and the questionnaires were rated as being of poor methodological quality. Regarding structural validity, one was rated as excellent, another as fair, and another as poor quality. Only the Weight Loss Motivation Questionnaire presented excellent methodological quality for most of the analyzed criteria. There is a need to develop questionnaires that are of better methodological quality to assess motivations for weight loss. Instruments targeting the adolescent population should also be developed.


Assuntos
Motivação , Obesidade/terapia , Inquéritos e Questionários/normas , Programas de Redução de Peso , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/psicologia
20.
J Surg Res ; 244: 50-56, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31279263

RESUMO

BACKGROUND: Living kidney donors (LKDs) with obesity have increased perioperative risks and risk of end-stage renal disease after donation. Consequently, obesity serves as a barrier to donation, as many transplant centers encourage or require weight loss before donation for obese LKD candidates. Therefore, this study sought to assess patients' perspectives on weight management strategies before donation among obese LKD candidates. We hypothesized that willingness to participate in a weight loss program may be associated with donor-recipient relationship. MATERIALS AND METHODS: Obese (BMI ≥30 kg/m2) LKD candidates evaluated at a single institution from September 2017 to August 2018 were recruited. A survey was administered to assess LKD candidates' baseline exercise and dietary habits and their interest in weight management strategies for the purpose of donation approval. Participants were grouped by relationship to the recipient (close relatives: first-degree relatives or spouses [n = 29], compared with all other relationships [n = 21]). Descriptive statistics were used to summarize the data. RESULTS: 50 of 51 obese LKD candidates who were approached completed the survey. 90% of participants expressed willingness to lose weight if necessary to become eligible for donor nephrectomy. Compared with all other LKD candidates, close relatives were more likely to be interested in combined diet and exercise programs at our institution (P = 0.01). CONCLUSIONS: Among obese LKD candidates, there was an interest in weight loss for the purposes of living kidney donation approval, particularly among close relatives of potential recipients. Future programs designed to promote weight management efforts for obese LKD candidates should be considered.


Assuntos
Doadores Vivos/psicologia , Nefrectomia/efeitos adversos , Obesidade/reabilitação , Coleta de Tecidos e Órgãos/efeitos adversos , Programas de Redução de Peso , Adulto , Exercício Físico/fisiologia , Exercício Físico/psicologia , Relações Familiares/psicologia , Feminino , Humanos , Rim/cirurgia , Falência Renal Crônica/etiologia , Falência Renal Crônica/prevenção & controle , Transplante de Rim/métodos , Transplante de Rim/normas , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Participação do Paciente/psicologia , Período Pré-Operatório , Pesquisa Qualitativa , Inquéritos e Questionários/estatística & dados numéricos , Coleta de Tecidos e Órgãos/psicologia , Coleta de Tecidos e Órgãos/normas , Perda de Peso/fisiologia
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