RESUMEN
OBJECTIVE: We assessed the prevalence of and risk factors for metabolic syndrome (MetS) among adults 25-64 years of age from Medellin and surrounding municipalities, Colombia. METHOD: We used 2008-2010 data from the Antioquia STEPwise approach to Surveillance (STEPS), a multi-stage complex cross-sectional survey designed according to World Health Organization guidelines. The revised 2005 International Diabetes Federation definition of MetS was used. RESULTS: There were a total of 3000 participants. Of these, 21.4% had high blood pressure (HBP) and 64% had abdominal obesity (AO). In the subsample with serum data (n = 943), 19.8% had high fasting serum glucose, 43.9% had high triglycerides (HTG), and 56.6% had low HDL cholesterol (L-HDL). Among those with data to define MetS (n = 901), 41% had MetS. Older age was associated with MetS and all components except L-HDL. Female sex [odds ratio (OR) = 2.85, 95% confidence interval (CI): 2.20-3.70], being married (OR = 1.40, CI: 1.09-1.82), and high physical activity (OR = 0.59, CI: 0.39-0.91) were associated with AO, smoking with HTG (OR = 1.76, CI: 1.16-2.67) and L-HDL (OR = 1.67, CI: 1.10-2.51) and rural residence with HBP (OR = 3.42, CI: 1.83-6.37) and L-HDL (OR = 1.18, CI: 1.10-2.51). CONCLUSION: The prevalence of MetS and AO was high in this Colombian region. Targeted strategies for promoting healthy behaviors are needed.
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Síndrome Metabólico/epidemiología , Síndrome Metabólico/etiología , Adulto , Distribución por Edad , Colombia/epidemiología , Intervalos de Confianza , Femenino , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Vigilancia de la Población , Prevalencia , Factores de Riesgo , Distribución por Sexo , Adulto JovenRESUMEN
BACKGROUND: Stepped-care approaches to weight loss have shown some success among adults. A 'stepped-down' version of the stepped-care approach to adolescent weight loss has never been evaluated. OBJECTIVES: We conducted a one-year randomized controlled trial to compare a stepped-down weight loss intervention versus enhanced usual care (EUC). METHODS: Study participants were obese adolescents age 11-13 (N = 106, 51% girls, and 82% Hispanic) recruited from primary care clinics in San Diego, California. The stepped-down intervention was delivered through clinician and health educator counseling (in-person and by phone) and mailed content. The intervention consisted of four-month 'steps' beginning with the most intensive contact followed by reduced contact if treatment goals were met. The EUC group received an initial physician visit, one session with a health counselor, and monthly mailed materials. Body mass index (BMI kg/m(2) ) was measured at baseline, 4, 8, and 12 months. Mixed-model regression analyses were stratified by sex. RESULTS: Results indicated a clinically significant treatment effect for boys on BMI (p < 0.001) but not girls. No between group differences were found for adiposity and biometric outcomes. Only 13% of intervention participants succeeded in stepping down from step 1 to step 2 or step 3. CONCLUSIONS: A stepped-down approach to weight loss showed some evidence of efficacy for weight loss in boys but not girls. The findings suggest the program as designed was not intensive enough to result in weight loss in this population segment.
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Conducta del Adolescente/psicología , Terapia Conductista , Consejo Dirigido/métodos , Obesidad Infantil/prevención & control , Adolescente , Índice de Masa Corporal , California/epidemiología , Niño , Femenino , Humanos , Masculino , Obesidad Infantil/psicología , Obesidad Infantil/terapia , Evaluación de Programas y Proyectos de Salud , Pérdida de Peso , Programas de Reducción de PesoRESUMEN
INTRODUCTION: Unhealthy weight loss practices are common among female college students. It is unknown if these practices are also most common among women in the subset of overweight or obese college students or if these practices are related to depression. We examined the relationship between gender, depression, and unhealthy weight loss practices among overweight or obese college students. METHODS: Students (body mass index between 25.0 and 34.9 kg/m(2)) from three Southern California universities (M(age) = 22 years, SD = 4; 70% women) were recruited from May 2011 to May 2012 for participation in a weight loss clinical trial (N = 404). Logistic regressions were performed with baseline data to assess the cross-sectional relationship between self-reported unhealthy weight loss practices and gender and depression as measured by the Center for Epidemiologic Studies Depression short form. RESULTS: Twenty-nine percent of participants reported engaging in at least one unhealthy weight loss behavior (e.g., fasting, purging) over the last 30 days, with no differences by gender. Self-report of at least one unhealthy weight loss behavior was associated with report of symptoms of depression (e(B) = 1.14 [confidence interval, CI: 1.08-1.20]), adjusting for potential confounders. Interactions between gender and depression were not significant (e(B) = 1.04 [CI: 0.93-1.16]). CONCLUSION: Among an overweight or obese sample of college students, unhealthy weight loss practices were equally common in both genders, and students with depressive symptomatology were at greatest risk. Obesity interventions targeting overweight or obese college students should educate both men and women about the dangers of unhealthy weight loss practices. In addition, screening for depression can help identify students who would benefit from additional supportive and coping strategies and resources.
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Depresión/psicología , Ayuno/psicología , Obesidad/psicología , Sobrepeso/psicología , Estudiantes/psicología , Vómitos/psicología , Pérdida de Peso , Adolescente , Adulto , California , Estudios Transversales , Femenino , Humanos , Masculino , Factores de Riesgo , Factores Sexuales , Estudiantes/estadística & datos numéricos , Universidades , Adulto JovenRESUMEN
PURPOSE: To describe the theoretical rationale, intervention design, and clinical trial of a two-year weight control intervention for young adults deployed via social and mobile media. METHODS: A total of 404 overweight or obese college students from three Southern California universities (M(age) = 22( ± 4) years; M(BMI) = 29( ± 2.8); 70% female) were randomized to participate in the intervention or to receive an informational web-based weight loss program. The intervention is based on behavioral theory and integrates intervention elements across multiple touch points, including Facebook, text messaging, smartphone applications, blogs, and e-mail. Participants are encouraged to seek social support among their friends, self-monitor their weight weekly, post their health behaviors on Facebook, and e-mail their weight loss questions/concerns to a health coach. The intervention is adaptive because new theory-driven and iteratively tailored intervention elements are developed and released over the course of the two-year intervention in response to patterns of use and user feedback. Measures of body mass index, waist circumference, diet, physical activity, sedentary behavior, weight management practices, smoking, alcohol, sleep, body image, self-esteem, and depression occur at 6, 12, 18, and 24 months. Currently, all participants have been recruited, and all are in the final year of the trial. CONCLUSION: Theory-driven, evidence-based strategies for physical activity, sedentary behavior, and dietary intake can be embedded in an intervention using social and mobile technologies to promote healthy weight-related behaviors in young adults.