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1.
Scand J Prim Health Care ; 39(3): 382-388, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34474641

RESUMO

OBJECTIVE: Overweight and obesity are increasing globally. General practitioners (GP's) are at the first point of contact for medical support and consequently have a major role in resolving this overwhelming problem. The aim of this study was to assess the effectiveness of a brief lifestyle counselling on weight management and on the participants' quality of life (QoL). DESIGN: A cohort study with a one-year follow-up. SETTING: Occupational health care, city of Pori in southwestern Finland. PARTICIPANTS: Female municipal employees (n = 625) with a mean age of 48 (SD 9) years. INTERVENTION: A nurse and a physiotherapist gave lifestyle counselling to all the participants; however, only the overweight/obese subjects were recommended to lose at least 5% of their initial weight. MAIN OUTCOME MEASURE: Success in weight management and quality of life. RESULTS: At the follow-up visit, 10.4% (95% CI: 7.5-14.0) of the overweight/obese subjects had lost at least 5% of their weight, but 10.0% (95% CI: 6.7-14.3) of the normal-weight participants had become overweight. The mean weight change was +0.1 kg (95% CI: -0.3-0.5) in the overweight/obese group and +0.5 kg (95% CI: 0.2-0.8) in the normal weight group. The change in QoL was inversely correlated with relative weight change in overweight/obese subjects, albeit the effect size was small. CONCLUSION: Weight management counselling should also be directed to individuals with a normal weight. Even with brief lifestyle counselling it may be possible to stabilize weight gain. Successful weight loss may improve the QoL of overweight/obese individuals.KEY POINTSPrimary health care has to deal with the increasing problem of overweight and obesity.Brief lifestyle counselling performed by a nurse and a physiotherapist seems to be quite effective in weight stabilization, considering the effort needed.People with normal weight tend to gain weight and weight management counselling should also be directed to them. Successful weight management may improve the quality of life of overweight/obese people.


Assuntos
Sobrepeso , Qualidade de Vida , Estudos de Coortes , Aconselhamento , Feminino , Humanos , Estilo de Vida , Pessoa de Meia-Idade , Sobrepeso/terapia
2.
Transl Psychiatry ; 11(1): 481, 2021 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-34535631

RESUMO

Imaginal retraining is a variant of approach bias modification and transfers the method into one's own mind. As the technique contains multiple elements, this pilot study aimed to dismantle which of its components is most efficient in reducing craving for high-calorie food. A total of 113 women were randomly allocated to one out of six conditions containing a short intervention to mentally manipulate a picture displaying high-calorie foods. Four of the interventions involved different combinations of elements of the imaginal retraining technique, while the remaining two conditions comprised thought suppression or merely observing a picture. Participants rated their level of craving, as well as three pictures containing healthy and unhealthy foods regarding their pleasantness before and after the interventions took place. Within-group changes were assessed with paired t-tests (in case of non-normal data Wilcoxon paired t-tests) and between-group differences with one-way ANOVAs (non-parametric Kruskal-Wallis tests). A trend level reduction in craving was found in the imaginal retraining condition with and without a movement. A post hoc analysis of both conditions joint together showed a statistically significant reduction in craving. In addition, positive picture appraisal for unhealthy foods was significantly reduced in both imaginal retraining conditions (with and without movement) with medium to large effect sizes. This study demonstrated that imaginal retraining with an arm movement can reduce craving and picture appraisal for high-calorie foods significantly in a one-time application. It is a promising technique to reduce appraisal for unhealthy high-calorie foods. Future studies should repeat the experiment in situations of high craving and allow for a personalized selection of stimuli.


Assuntos
Fissura , Sobrepeso , Feminino , Alimentos , Humanos , Obesidade/terapia , Sobrepeso/terapia , Projetos Piloto
5.
J Consult Clin Psychol ; 89(8): 682-694, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34472895

RESUMO

Objective: Obesity and depression are major, inter-related health concerns for men, yet many do not receive support to manage these conditions. This study investigated whether a self-guided, eHealth program (SHED-IT: Recharge) could reduce weight and depressive symptoms in men with overweight or obesity and low mood. Method: Overall, 125 men [Body Mass Index (BMI) 25-42 kg/m2] with depressive symptoms [Patient Health Questionnaire-9 (PHQ-9) score ≥5] were recruited for a 6-month RCT. Men were randomized to (a) the SHED-IT: Recharge group (n = 62) or (b) a wait-list control group (n = 63). The 3-month program included printed and online resources (e.g., website, interactive modules). It was adapted from an evidence-based weight loss program for men to include an additional focus on "mental fitness". The primary outcomes were weight (kg) and depressive symptoms (PHQ-9) at 3 months. Men were assessed at baseline, 3 months (post-intervention), and 6 months. Intention-to-treat linear mixed models examined program outcomes. Results: At 3 months, medium-sized treatment effects were detected for both weight, adjusted mean difference -3.1 kg, 95% CI [-4.3, -1.9], d = 0.9, and depressive symptoms, adjusted mean difference -2.4 units, 95% CI [-4.0, -0.9], d = 0.6. These effects were maintained at 6 months and supported by sustained improvements in other health outcomes. Conclusions: A self-guided, eHealth program that combined behavioral weight loss advice with mental health support decreased weight and depressive symptoms in men. Integrated interventions targeting physical and mental health may be an effective strategy to engage and support men with overweight or obesity and low mood. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Depressão/complicações , Depressão/terapia , Sobrepeso/complicações , Sobrepeso/terapia , Autocuidado , Telemedicina , Perda de Peso , Programas de Redução de Peso , Humanos , Masculino , Pessoa de Meia-Idade , Sobrepeso/psicologia
6.
Nutrients ; 13(8)2021 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-34444958

RESUMO

We investigated the effect of an antenatal lifestyle intervention of a low-glycaemic index (GI) diet and physical activity on energy-adjusted dietary inflammatory index (E-DIITM) and explored its relationship with maternal and child health in women with overweight and obesity. This was a secondary analysis of 434 mother-child pairs from the Pregnancy Exercise and Nutrition Study (PEARS) trial in Dublin, Ireland. E-DIITM scores were calculated for early (10-16 weeks) and late (28 weeks) pregnancy. Outcomes included lipids, inflammation markers, insulin resistance, mode of delivery, infant size, pre-eclampsia, and gestational diabetes. T-tests were used to assess changes in E-DIITM. Chi-square, correlations, and multiple regression were employed to investigate relationships with outcomes. The mean (SD) age of participants was 32.45 (4.29) years with median (IQR) BMI 28.25 (26.70, 31.34) kg/m2. There was no change in E-DIITM in the controls (-0.14 (1.19) vs. -0.07 (1.09), p = 0.465) but E-DIITM reduced by 10% after the intervention (0.01 (1.07) vs -0.75 (1.05), p < 0.001). No associations were found between early pregnancy E-DIITM and maternal and child outcomes, except for increased odds of adverse cardiometabolic phenotype in women who delivered male (OR = 2.29, p = 0.010) but not female infants (OR = 0.99, p = 0.960). A low-GI antenatal intervention can reduce the inflammatory potential of diets. Sex differences should be explored further in future research.


Assuntos
Dieta Saudável/estatística & dados numéricos , Obesidade/terapia , Sobrepeso/terapia , Complicações na Gravidez/terapia , Cuidado Pré-Natal/métodos , Adulto , Fatores de Risco Cardiometabólico , Dieta com Restrição de Carboidratos/métodos , Exercício Físico , Feminino , Índice Glicêmico , Humanos , Recém-Nascido , Inflamação , Irlanda , Estilo de Vida , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Gravidez , Complicações na Gravidez/fisiopatologia , Resultado da Gravidez , Resultado do Tratamento
7.
Nutrients ; 13(7)2021 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-34371884

RESUMO

The dietary supplement, trans-resveratrol and hesperetin combination (tRES-HESP), induces expression of glyoxalase 1, countering the accumulation of reactive dicarbonyl glycating agent, methylglyoxal (MG), in overweight and obese subjects. tRES-HESP produced reversal of insulin resistance, improving dysglycemia and low-grade inflammation in a randomized, double-blind, placebo-controlled crossover study. Herein, we report further analysis of study variables. MG metabolism-related variables correlated with BMI, dysglycemia, vascular inflammation, blood pressure, and dyslipidemia. With tRES-HESP treatment, plasma MG correlated negatively with endothelial independent arterial dilatation (r = -0.48, p < 0.05) and negatively with peripheral blood mononuclear cell (PBMC) quinone reductase activity (r = -0.68, p < 0.05)-a marker of the activation status of transcription factor Nrf2. For change from baseline of PBMC gene expression with tRES-HESP treatment, Glo1 expression correlated negatively with change in the oral glucose tolerance test area-under-the-curve plasma glucose (ΔAUGg) (r = -0.56, p < 0.05) and thioredoxin interacting protein (TXNIP) correlated positively with ΔAUGg (r = 0.59, p < 0.05). Tumor necrosis factor-α (TNFα) correlated positively with change in fasting plasma glucose (r = 0.70, p < 0.001) and negatively with change in insulin sensitivity (r = -0.68, p < 0.01). These correlations were not present with placebo. tRES-HESP decreased low-grade inflammation, characterized by decreased expression of CCL2, COX-2, IL-8, and RAGE. Changes in CCL2, IL-8, and RAGE were intercorrelated and all correlated positively with changes in MLXIP, MAFF, MAFG, NCF1, and FTH1, and negatively with changes in HMOX1 and TKT; changes in IL-8 also correlated positively with change in COX-2. Total urinary excretion of tRES and HESP metabolites were strongly correlated. These findings suggest tRES-HESP counters MG accumulation and protein glycation, decreasing activation of the unfolded protein response and expression of TXNIP and TNFα, producing reversal of insulin resistance. tRES-HESP is suitable for further evaluation for treatment of insulin resistance and related disorders.


Assuntos
Hesperidina/administração & dosagem , Resistência à Insulina , Obesidade/terapia , Sobrepeso/terapia , Resveratrol/administração & dosagem , Adulto , Pressão Sanguínea/efeitos dos fármacos , Índice de Massa Corporal , Proteínas de Transporte/sangue , Correlação de Dados , Estudos Cross-Over , Suplementos Nutricionais , Método Duplo-Cego , Quimioterapia Combinada , Dislipidemias/sangue , Dislipidemias/terapia , Feminino , Transtornos do Metabolismo de Glucose/sangue , Transtornos do Metabolismo de Glucose/terapia , Glicosilação/efeitos dos fármacos , Humanos , Inflamação , Mediadores da Inflamação/sangue , Leucócitos Mononucleares/metabolismo , Masculino , Obesidade/sangue , Sobrepeso/sangue , Aldeído Pirúvico/sangue , Fator de Necrose Tumoral alfa/sangue
8.
Nutrients ; 13(8)2021 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-34445008

RESUMO

The purpose of this study was to compare changes in bone mineral density (BMD) over a 6 month follow up (period of weight regain) in overweight, postmenopausal women having previously completed a 6 month weight loss (WL) intervention with and without aerobic exercise (AEX). Women (BMI > 25 kg/m2) underwent VO2max and DEXA scans at baseline, after 6 months of WL or AEX + WL, and at 12 months ad libitum follow up. Both groups lost ~9% body weight from 0 to 6 months and regained ~2% from 6 to 12 months, while losing ~4% of appendicular lean mass (ALM) across the 12-month study duration. VO2max increased 10% from 0 to 6 months and declined 12% from 6 to 12 months for AEX + WL, with no changes for WL. Total body (p < 0.01) and total femur (p = 0.03) BMD decreased similar between groups across time (combined groups: 0-6 months: total body: -1.2% and total femur: -1.2%; 6-12 months: total body: -0.26% and total femur: -0.09%). Less ALM loss and greater VO2max increases during the WL phase were associated with attenuated BMD loss at various anatomical sites during periods of weight regain (6-12 months) p's < 0.05). Results suggest that BMD loss may continue following WL, despite weight regain. Further, this study adds to the literature by suggesting that preventing declines in muscle quality and function during WL may attenuate the loss of BMD during weight regain. Future studies are needed to identify mechanisms underlying WL-induced bone loss so that effective practices can be designed to minimize the loss of BMD during WL and weight maintenance in older women.


Assuntos
Densidade Óssea , Dieta Saudável , Terapia por Exercício , Sobrepeso/terapia , Ganho de Peso , Perda de Peso , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Baltimore , Composição Corporal , Restrição Calórica , Feminino , Humanos , Corrida Moderada , Pessoa de Meia-Idade , Sobrepeso/diagnóstico , Sobrepeso/fisiopatologia , Aptidão Física , Pós-Menopausa , Treinamento de Força , Fatores de Tempo , Resultado do Tratamento , Caminhada
9.
Nutrients ; 13(7)2021 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-34371972

RESUMO

Resistance training (RT) and n-3 polyunsaturated fatty acids (n-3 PUFA) supplementation have emerged as strategies to improve muscle function in older adults. Overweight/obese postmenopausal women (55-70 years) were randomly allocated to one of four experimental groups, receiving placebo (olive oil) or docosahexaenoic acid (DHA)-rich n-3 PUFA supplementation alone or in combination with a supervised RT-program for 16 weeks. At baseline and at end of the trial, body composition, anthropometrical measures, blood pressure and serum glucose and lipid biomarkers were analyzed. Oral glucose tolerance tests (OGTT) and strength tests were also performed. All groups exhibit a similar moderate reduction in body weight and fat mass, but the RT-groups maintained bone mineral content, increased upper limbs lean mass, decreased lower limbs fat mass, and increased muscle strength and quality compared to untrained-groups. The RT-program also improved glucose tolerance (lowering the OGTT incremental area under the curve). The DHA-rich supplementation lowered diastolic blood pressure and circulating triglycerides and increased muscle quality in lower limbs. In conclusion, 16-week RT-program improved segmented body composition, bone mineral content, and glucose tolerance, while the DHA-rich supplement had beneficial effects on cardiovascular health markers in overweight/obese postmenopausal women. No synergistic effects were observed for DHA supplementation and RT-program combination.


Assuntos
Composição Corporal , Fatores de Risco Cardiometabólico , Ácidos Docosa-Hexaenoicos/administração & dosagem , Sobrepeso/terapia , Pós-Menopausa , Treinamento de Força , Idoso , Glicemia/análise , Suplementos Nutricionais , Método Duplo-Cego , Ácidos Graxos Ômega-3/administração & dosagem , Feminino , Teste de Tolerância a Glucose , Humanos , Metabolismo dos Lipídeos , Pessoa de Meia-Idade , Força Muscular , Obesidade/fisiopatologia , Obesidade/terapia , Sobrepeso/fisiopatologia , Placebos
10.
Nutrients ; 13(7)2021 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-34371975

RESUMO

This three-arm randomised controlled trial evaluated whether (1) a multi-component weight loss intervention targeting diet, physical activity (PA), and sleep was effective at improving dietary intake over six months and 12 months, compared with a control, and (2) the enhanced diet, PA, and sleep intervention was more effective at improving dietary intake than the traditional diet and PA intervention. A total of 116 adults (70% female, 44.5 years, BMI 31.7 kg/m2) were randomised to either traditional diet and PA intervention; enhanced diet, PA, and sleep intervention; or wait-list control. To examine between-group differences, intervention groups were pooled and compared with the control. Then, the two intervention groups were compared. At six months, the pooled intervention group consumed 1011 fewer kilojoules/day (95% CI -1922, -101), less sodium (-313.2 mg/day; 95% CI -591.3, -35.0), and higher %EI from fruit (+2.1%EI; 95% CI 0.1, 4.1) than the controls. There were no differences in intake between the enhanced and traditional groups at six months. At 12 months, the pooled intervention and control groups reported no significant differences. However, compared to the traditional group, the enhanced reported higher %EI from nutrient-dense foods (+7.4%EI; 95% CI 1.3, 13.5) and protein (+2.4%EI; 95% CI 0.1, 4.6), and reduced %EI from fried/takeaway foods (-3.6%EI; 95% CI -6.5, -0.7), baked sweet products (-2.0%EI; 95% CI -3.6, -0.4), and packaged snacks (-1.1%EI; 95% CI -2.2, -0.3). This weight loss intervention reduced total energy and sodium intakes as well as increased fruit intake in adults at six months. The enhanced intervention group reported improved dietary intake relative to the traditional group at 12 months.


Assuntos
Dieta Saudável , Ingestão de Alimentos , Exercício Físico , Obesidade/terapia , Sobrepeso/terapia , Sono/fisiologia , Adulto , Índice de Massa Corporal , Ingestão de Energia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Perda de Peso
11.
Nutrients ; 13(7)2021 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-34371977

RESUMO

The effectiveness of weight loss treatment displays dramatic inter-individual variabilities, even with well-controlled energy intake/expenditure. This study aimed to determine the association between daily rhythms of cardiac autonomic control and weight loss efficiency and to explore the potential relevance to weight loss resistance in humans carrying the genetic variant C at CLOCK 3111T/C. A total of 39 overweight/obese Caucasian women (20 CLOCK 3111C carriers and 19 non-carriers) completed a behaviour-dietary obesity treatment of ~20 weeks, during which body weight was assessed weekly. Ambulatory electrocardiographic data were continuously collected for up to 3.5 days and used to quantify the daily rhythm of fractal cardiac dynamics (FCD), a non-linear measure of autonomic function. FCD showed a 24 h rhythm (p < 0.001). Independent of energy intake and physical activity level, faster weight loss was observed in individuals with the phase (peak) of the rhythm between ~2-8 p.m. and with a larger amplitude. Interestingly, the phase effect was significant only in C carriers (p = 0.008), while the amplitude effect was only significant in TT carriers (p < 0.0001). The daily rhythm of FCD and CLOCK 3111T/C genotype is linked to weight loss response interactively, suggesting complex interactions between the genetics of the circadian clock, the daily rhythm of autonomic control, and energy balance control.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Proteínas CLOCK/genética , Ritmo Circadiano/genética , Coração/inervação , Sobrepeso/terapia , Perda de Peso/genética , Adulto , Estudos de Casos e Controles , Ritmo Circadiano/fisiologia , Eletrocardiografia Ambulatorial , Ingestão de Energia , Exercício Físico , Feminino , Fractais , Genótipo , Coração/fisiopatologia , Humanos , Pessoa de Meia-Idade , Obesidade/genética , Obesidade/fisiopatologia , Obesidade/terapia , Sobrepeso/genética , Sobrepeso/fisiopatologia , Polimorfismo de Nucleotídeo Único/genética
12.
Artigo em Inglês | MEDLINE | ID: mdl-34360151

RESUMO

This study investigated if music tempo can prompt a desired walking cadence, and if music can provide a stimulus to regulate physical activity intensity in a longitudinal physical activity intervention with free-living adults. Overweight adults (n = 37; 94.26 ± 17.11 kg; 49.63 ± 12.37 years) were randomly assigned to an intervention (IG, n = 17) or usual care group (UC, n = 20) as part of a novel nine-month walking intervention. IG participants walked to self-selected music with a predetermined tempo and received a behavioural change support programme. At baseline, four-, six- and nine-months participants were asked to walk around an elliptical track at their habitual pace (0-2 min) and then in time to a predetermined tempo (2-8 min) designed to elicit moderate intensity. Cadence response (steps/min) was assessed and intensity (heart rate (bpm) recorded using wireless telemetry. A repeated measures general linear model (GLM) examined differences between groups over time (p < 0.05). All data is presented as means ± SD. At each assessment point both groups displayed an immediate cadence adjustment in response to music tempo (p < 0.01) i.e., habitual cadence vs. 3 METs target cadence (p < 0.05) and 3 METs target cadence vs. 5 METs target cadence (p < 0.05). Additionally, IG participants displayed an increased habitual cadence (0-2 min) at each assessment point (p < 0.05; 110 ± 9, 121.80 ± 7.5, 121.46 ± 10, 121.93 ± 7 steps/min respectively). UC participant's habitual cadence was unchanged from 0-9 months (p > 0.05; 120 ± 10, 116 ± 13, 119 ± 12 and 119 ± 9 steps/min respectively). Music tempo may be a useful regulatory tool to prompt the free-living individual to reach an appropriate stride rate to achieve a walking pace that is at least moderate intensity. It also appears that results may be trainable as throughout the study an increased habitual walking cadence was observed, in the absence of music.


Assuntos
Música , Caminhada , Adulto , Exercício Físico , Teste de Esforço , Humanos , Sobrepeso/terapia
13.
BMC Public Health ; 21(1): 1529, 2021 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-34376181

RESUMO

BACKGROUND: Healthy behavior is an essential component in type 2 diabetes (T2D) management. Promoting healthy lifestyle is one of the priorities of primary health care in Oman. This study aims to evaluate the effectiveness of a multi-component intervention in promoting physical activity (PA) and healthy diet and its implications on body mass index and glycemic control in adults with diabetes attending primary care. METHODS: A one year 1:1 cluster randomized controlled trial will be utilized to compare the use of phone consultations, a multi component interactive phone application and pedometers with the usual diabetes care on promoting PA and healthy diet. Participants will be screened for inactivity and should be T2D, aged18-65 years, and overweight or obese. Eight primary centers will be randomly selected in each arm (n = 375). The primary outcome is the between arms differences in PA and diet scores, BMI and HbA1c over 12 months from baseline. Additionally, secondary outcomes will include cardiovascular outcomes (BP, and lipids). The trial has received ethical approval from the Omani Research and Ethical Review and Approval Committee. All eligible participants will be invited to their respected health centers to provide informed consent. DISCUSSION: This study will contribute to the integration of healthy lifestyle approach using artificial intelligence to primary diabetes care. Results from this study will be disseminated through workshops, policy briefs, and peer-reviewed publications, local and international conferences. TRIAL REGISTRATION: Trial registration number ISRCTN71889430 . Date applied: 28/11/2020. Date assigned: 01/12/2020.


Assuntos
Diabetes Mellitus Tipo 2 , Dieta Saudável , Adulto , Inteligência Artificial , Atenção à Saúde , Diabetes Mellitus Tipo 2/terapia , Exercício Físico , Humanos , Obesidade , Omã , Sobrepeso/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto
14.
BMJ ; 374: n1840, 2021 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-34404631

RESUMO

OBJECTIVE: To determine if the characteristics of behavioural weight loss programmes influence the rate of change in weight after the end of the programme. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Trial registries, 11 electronic databases, and forward citation searching (from database inception; latest search December 2019). Randomised trials of behavioural weight loss programmes in adults with overweight or obesity, reporting outcomes at ≥12 months, including at the end of the programme and after the end of the programme. REVIEW METHODS: Studies were screened by two independent reviewers with discrepancies resolved by discussion. 5% of the studies identified in the searches met the inclusion criteria. One reviewer extracted the data and a second reviewer checked the data. Risk of bias was assessed with Cochrane's risk of bias tool (version 1). The rate of change in weight was calculated (kg/month; converted to kg/year for interpretability) after the end of the programme in the intervention versus control groups by a mixed model with a random intercept. Associations between the rate of change in weight and prespecified variables were tested. RESULTS: Data were analysed from 249 trials (n=59 081) with a mean length of follow-up of two years (longest 30 years). 56% of studies (n=140) had an unclear risk of bias, 21% (n=52) a low risk, and 23% (n=57) a high risk of bias. Regain in weight was faster in the intervention versus the no intervention control groups (0.12-0.32 kg/year) but the difference between groups was maintained for at least five years. Each kilogram of weight lost at the end of the programme was associated with faster regain in weight at a rate of 0.13-0.19 kg/year. Financial incentives for weight loss were associated with faster regain in weight at a rate of 1-1.5 kg/year. Compared with programmes with no meal replacements, interventions involving partial meal replacements were associated with faster regain in weight but not after adjustment for weight loss during the programme. Access to the programme outside of the study was associated with slower regain in weight. Programmes where the intensity of the interaction reduced gradually were also associated with slower regain in weight in the multivariable analysis, although the point estimate suggested that the association was small. Other characteristics did not explain the heterogeneity in regain in weight. CONCLUSION: Faster regain in weight after weight loss was associated with greater initial weight loss, but greater initial weight loss was still associated with reduced weight for at least five years after the end of the programme, after which data were limited. Continued availability of the programme to participants outside of the study predicted a slower regain in weight, and provision of financial incentives predicted faster regain in weight; no other clear associations were found. STUDY REGISTRATION: PROSPERO CRD42018105744.


Assuntos
Terapia Comportamental/métodos , Trajetória do Peso do Corpo , Obesidade/terapia , Sobrepeso/terapia , Programas de Redução de Peso/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Avaliação de Programas e Projetos de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Perda de Peso
15.
Artigo em Inglês | MEDLINE | ID: mdl-34444573

RESUMO

BACKGROUND AND OBJECTIVE: Overweight or obesity, as an independent risk factor for chronic diseases, has been on the rise globally. Adopting a healthy lifestyle is positive to weight control. Mobile-based lifestyle interventions have shown potential benefits in weight loss, but most studies were carried out among non-elderly population, so it is necessary to perform well-designed randomized controlled trials among the elderly with overweight or obesity. The purpose of this study is to assess the effect of mobile-based lifestyle intervention on weight loss among the overweight and obese elderly population in China. METHODS: This is a prospective, open-labeled, three-month, multicenter, randomized controlled trial involving 750 participants from five cities who were randomly assigned to dietary and physical activity interventions group (DPG; mobile phone with the App and bracelet), physical activity interventions group (PG; mobile phone with the App and bracelet) and control group (CG; no interventions and kept their lifestyle as before). The outcomes evaluated were changes in weight, body mass index (BMI), waist circumference (WC), and hip circumference (HC). RESULTS: In total, 642 (85.6%) participants completed the study, 237 (94.8%), 203 (81.2%), and 202 (80.8%) for DPG, PG, and CG respectively. Comparing with PG and CG, the DPG showed a significant decrease in all outcomes after three months, including body weight (-4.1 kg vs. -1.0 kg; -4.1 kg vs. -0.8 kg; p < 0.05), BMI (-1.6 kg/m2 vs. -0.4 kg/m2; -1.6 kg/m2 vs. -0.3 kg/m2; p < 0.05), WC (-2.8 cm vs. -0.1 cm; -2.8 cm vs. -0.5 cm; p < 0.05), and HC (-3.8 cm vs. -1.3 cm; -3.8 cm vs. -1.3 cm; p < 0.05). Similar effects were seen across sex and BMI subgroups. CONCLUSIONS: Mobile-based lifestyle intervention obtained beneficial effect in weight loss among the elderly with overweight or obesity. Nevertheless, further studies are needed to confirm the effectiveness and its sustainability.


Assuntos
Sobrepeso , Perda de Peso , Idoso , Índice de Massa Corporal , Humanos , Estilo de Vida , Obesidade/terapia , Sobrepeso/terapia , Estudos Prospectivos
16.
Clin Nutr ESPEN ; 44: 337-341, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34330487

RESUMO

BACKGROUND AND AIMS: Obesity is associated with increased inflammation leading to a higher risk for non-communicable diseases. There was a controversy about whether exercise has a better influence on reducing inflammation during a lifestyle modification program among individuals with obesity. The objective of this study was to evaluate whether exercise could provide a benefit in reducing inflammatory markers in the context of a weight loss program. METHODS: This is an experimental study with control. Subjects were pre-menopausal adult women with overweight and assigned for low-calorie diet only (LCD) or low-calorie diet and exercise (LCDex) without randomization. We compared the effect of LCDex (n = 36) and LCD (n = 36) on inflammation markers (leptin and interleukin 6/IL6) for 8 weeks. RESULTS: We showed that after the weight loss program, there was a significant increase in IL6 (p = 0.009) but no changes in leptin (p = 0.760) concentration in both groups. There were no difference in changes of IL6 between LCDex and LCD (p = 0.483). CONCLUSIONS: A weight loss program was associated with increased inflammation. Among premenopausal women with overweight, a combination of LCD with exercise does not provide a greater benefit in reducing inflammation than those with LCD alone. TRIAL REGISTRATION: KE/0700/06/2018.


Assuntos
Programas de Redução de Peso , Adulto , Dieta Redutora , Exercício Físico , Feminino , Humanos , Obesidade/terapia , Sobrepeso/terapia
17.
Am J Cardiol ; 154: 7-13, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34238446

RESUMO

Effective long-term prevention after myocardial infarction (MI) is crucial to reduce recurrent events. In this study the effects of a 12-months intensive prevention program (IPP), based on repetitive contacts between non-physician "prevention assistants" and patients, were evaluated. Patients after MI were randomly assigned to the IPP versus usual care (UC). Effects of IPP on risk factor control, clinical events and costs were investigated after 24 months. In a substudy efficacy of short reinterventions after more than 24 months ("Prevention Boosts") was analyzed. IPP was associated with a significantly better risk factor control compared to UC after 24 months and a trend towards less serious clinical events (12.5% vs 20.9%, log-rank p = 0.06). Economic analyses revealed that already after 24 months cost savings due to event reduction outweighted the costs of the prevention program (costs per patient 1,070 € in IPP vs 1,170 € in UC). Short reinterventions ("Prevention Boosts") more than 24 months after MI further improved risk factor control, such as LDL cholesterol and blood pressure lowering. In conclusion, IPP was associated with numerous beneficial effects on risk factor control, clinical events and costs. The study thereby demonstrates the efficacy of preventive long-term concepts after MI, based on repetitive contacts between non-physician coworkers and patients.


Assuntos
Exercício Físico , Infarto do Miocárdio/terapia , Educação de Pacientes como Assunto/métodos , Prevenção Secundária/métodos , Telemedicina/métodos , Idoso , Angina Instável/epidemiologia , Pressão Sanguínea , Reabilitação Cardíaca , LDL-Colesterol , Comorbidade , Análise Custo-Benefício , Custos e Análise de Custo , Feminino , Custos de Cuidados de Saúde , Hospitalização/estatística & dados numéricos , Humanos , Hiperlipidemias/epidemiologia , Hiperlipidemias/terapia , Masculino , Pessoa de Meia-Idade , Mortalidade , Infarto do Miocárdio/epidemiologia , Revascularização Miocárdica/estatística & dados numéricos , Obesidade/epidemiologia , Obesidade/terapia , Sobrepeso/epidemiologia , Sobrepeso/terapia , Educação de Pacientes como Assunto/economia , Recidiva , Comportamento de Redução do Risco , Prevenção Secundária/economia , Fumar/epidemiologia , Fumar/terapia , Abandono do Hábito de Fumar , Acidente Vascular Cerebral/epidemiologia , Telemedicina/economia , Telemetria/economia , Telemetria/métodos , Telefone , Perda de Peso
18.
BMC Psychiatry ; 21(1): 335, 2021 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-34225693

RESUMO

BACKGROUND: The present study aimed to investigate the psychometric properties of the Persian version of the weight-related experiential avoidance (AAQW) in overweight and obese treatment seeker in the clinical setting. METHODS: This sample consists of 220 male and female overweight or obesity treatment seeker from Overweight and obesity centers who agreed to fill out the self-reported measures. RESULTS: Confirmatory factor analysis (CFA) supported 3-factor structures of AAQW, including (weight as a barrier to living, Food as Control, and weight-stigma). Furthermore, the internal consistency of AAQW indicates an acceptable range (α = .70); Also, expected associations between AAQW and external correlates (e.g., BES, AAQ-II, KIMS, BDI-II, and CFQ) supported the measure's convergent validity in a sample of overweight and obese treatment seeker in the clinical setting. CONCLUSIONS: Overall, our study offers that the Persian version of weight-related experiential avoidance has psychometrically valid and reliable tools to assess experiential avoidance. Furthermore, weight-related experiential avoidance is associated with higher severity of binge eating symptoms, higher psychological inflexibility levels, experiential avoidance, and more cognitive fusion and depression symptomology.


Assuntos
Transtorno da Compulsão Alimentar , Bulimia , Feminino , Humanos , Masculino , Obesidade/terapia , Sobrepeso/terapia , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
19.
Z Evid Fortbild Qual Gesundhwes ; 165: 21-26, 2021 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-34303649

RESUMO

BACKGROUND/OBJECTIVE: Evidence-based clinical pathways can be a useful tool for guideline implementation. However, there seem to be barriers to the use of clinical pathways. The aim of the present questionnaire survey was to assess the perceived usability of the clinical pathway "Overweight/obesity in children and adolescents at primary care level" and to identify factors promoting and hindering the use of the clinical pathway. METHODS: In January 2020, an online questionnaire survey was sent out to 3,916 general practitioners and 470 pediatricians in Austria. The data collected were analysed descriptively. RESULTS: A total of 148 people took part in the questionnaire survey (response rate 3.7 %). The majority of respondents indicated that they, in general, perceive evidence-based clinical pathways as helpful (90 %) and also make use of them (57 %). Few respondents (9 %) felt well-informed about new clinical pathways developed in Austria. Most of the respondents considered the clinical pathway "Overweight/obesity in children and adolescents at primary care level" as a useful support (60 %), as a reference work (72 %) or as a facilitator for justifying their approach to their patients (68 %). However, a large proportion of the respondents stated that the clinical pathway is not easily applicable in everyday practice. The three most frequently cited barriers to using the clinical pathway were lack of time resources, lack of structures and lack of financial incentives. Other display and access options (e. g., individualisation, integration into practice software) were most frequently cited as factors that might promote the use of the pathway. CONCLUSION: Although the majority of the respondents had positive expectations regarding the use of the clinical pathway "Overweight/obesity in children and adolescents at primary care level", many of them still perceived its usability in everyday clinical practice as difficult. The necessary next steps to improve the use of evidence-based clinical pathways seem to be: an economic and practicable design, easy accessibility of clinical pathways and the creation of framework conditions that facilitate their use in everyday practice.


Assuntos
Obesidade Pediátrica , Adolescente , Criança , Procedimentos Clínicos , Alemanha , Humanos , Motivação , Sobrepeso/terapia , Obesidade Pediátrica/terapia
20.
Artigo em Inglês | MEDLINE | ID: mdl-34203513

RESUMO

Tackling obesity among adolescents requires the optimization of existing obesity treatment strategies. For this purpose, social and personal circumstances, individual needs and behavior of therapy participants need to be analyzed to tailor aims, content and methods of therapy interventions to the target groups. A total of 432 obesity therapy participants between 11 and 17 years completed a written survey in a national multi-center study conducted in 2015. The data collection on behavior, in terms of physical activity, media use and sociodemographic variables, was based on questionnaires from the KiGGS, HBSC and JIM studies. The results show that participants were found to be physically active together with friends (75.5%), alone (41.4%) and in sports clubs (34.9%). Girls (OR 1.55) were less likely to participate in sports clubs. Social networks, especially YouTube, WhatsApp, Instagram and Facebook, were widely used. However, differences emerged among sociodemographic groups (e.g., boys vs. girls) regarding the use of social network features. A third of participants reported that smartphone apps regularly encouraged them to exercise. The findings imply that obesity therapy approaches need to be adapted and more differentiated according to the specific needs of the target groups.


Assuntos
Exercício Físico , Esportes , Adolescente , Feminino , Humanos , Masculino , Obesidade/epidemiologia , Obesidade/terapia , Sobrepeso/epidemiologia , Sobrepeso/terapia , Rede Social
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