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James DL, Larkey LK, Evans B, Sebren A, Goldsmith K, Ahlich E, Hawley NA, Kechter A, Sears DD. Mechanisms of improved body composition among perimenopausal women practicing Meditative Movement: a proposed biobehavioral model. Menopause 2023; 30:1114-1123. [PMID: 37788427 DOI: 10.1097/gme.0000000000002262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
OBJECTIVES Weight gain and unfavorable body composition are prevalent among midlife/older women throughout menopause. These shifts may negatively impact health, well-being, and longevity. Efforts to attenuate weight and body composition changes are traditionally driven by manipulation of diet and/or exercise; however, sustained results are limited, possibly because the full spectrum of biobehavioral systems is not addressed by diet and exercise alone. We propose a biobehavioral model detailing mechanisms of body composition decline among perimenopausal women and the associated components of Meditative Movement (ie, tai chi, qigong, yoga) that address each of these factors. METHODS Based on our previous work and extensive review of the literature, we developed a multifactorial and multidimensional biobehavioral model including factors that most directly relate to body composition among perimenopausal women: 1) psychological (ie, stress and mood, mindfulness and self-compassion, body awareness), 2) behavioral (ie, sleep, physical activity, eating behaviors), and 3) physiological (ie, cortisol, estrogen). Relationships between each factor, Meditative Movement practice components, and predicted effects on body composition were explored in detail. RESULTS Our model describes select psychological, behavioral, and physiological factors, and potential mechanistic pathways of Meditative Movement practice driving improved changes in body composition and weight outcomes for perimenopausal women. CONCLUSIONS The proposed model details a novel, evidence-supported means to reduce the risk of deleterious shifts in body composition throughout perimenopause and menopause thereafter. We suggest that these changes may occur directly and/or indirectly through psychological, behavioral, and physiological mechanisms that facilitate the desired changes in body composition.
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Affiliation(s)
| | - Linda K Larkey
- From the Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Bronwynne Evans
- From the Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Ann Sebren
- College of Health Solutions, Arizona State University, Phoenix, AZ
| | - Kimberley Goldsmith
- Department of Biostatistics & Informatics, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Erica Ahlich
- Department of Psychology, University of South Alabama, Mobile, AL
| | - Nanako A Hawley
- Department of Psychology, University of South Alabama, Mobile, AL
| | | | - Dorothy D Sears
- College of Health Solutions, Arizona State University, Phoenix, AZ
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Unick JL, Dunsiger SI, Bock BC, Sherman SA, Braun TD, Hayes JF, Goldstein SP, Wing RR. A randomized trial examining the effect of yoga on dietary lapses and lapse triggers following behavioral weight loss treatment. Obes Sci Pract 2023; 9:484-492. [PMID: 37810521 PMCID: PMC10551112 DOI: 10.1002/osp4.678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/12/2023] [Accepted: 04/16/2023] [Indexed: 10/10/2023] Open
Abstract
Background Dietary lapses can hinder weight loss and yoga can improve self-regulation, which may protect against lapses. This study examined the effect of yoga on dietary lapses, potential lapse triggers (e.g., affective states, cravings, dietary temptations), and reasons for initiating eating following weight loss treatment. Methods Sixty women with overweight/obesity (34.3 ± 3.9 kg/m2) were randomized to a 12 week yoga intervention (2x/week; YOGA) or contact-matched control (cooking/nutrition classes; CON) following a 12-week behavioral weight loss program. Participants responded to smartphone surveys (5x/day) over a 10-day period at baseline, 12, and 24 weeks to assess lapses and triggers. Results At 24 weeks, YOGA and CON differed on several types of lapses (i.e., less eating past full, eating more than usual, loss of control when eating, self-identified overeating, difficulty stopping eating in YOGA), and YOGA was less likely to eat to feel better or in response to stress (ps < 0.05). YOGA also reported less stress and anxiety and more positive affect (ps < 0.01); dietary temptations and cravings did not differ from CON. Conclusion Yoga resulted in fewer dietary lapses and improved affect among women with overweight/obesity following weight loss. While preliminary, findings suggest that yoga should be considered as a potential component of weight loss treatment to target dietary lapses.
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Affiliation(s)
- Jessica L. Unick
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Department of Psychiatry and Human BehaviorWarren Alpert Medical School at Brown UniversityProvidenceRhode IslandUSA
| | - Shira I. Dunsiger
- Department of Behavioral and Social SciencesBrown University School of Public HealthProvidenceRhode IslandUSA
| | - Beth C. Bock
- Department of Psychiatry and Human BehaviorWarren Alpert Medical School at Brown UniversityProvidenceRhode IslandUSA
- Department of Behavioral and Social SciencesBrown University School of Public HealthProvidenceRhode IslandUSA
- Behavioral Medicine and Addictions Research GroupButler HospitalProvidenceRhode IslandUSA
| | - Sally A. Sherman
- Department of Health and Human DevelopmentSchool of EducationUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Tosca D. Braun
- Department of Psychiatry and Human BehaviorWarren Alpert Medical School at Brown UniversityProvidenceRhode IslandUSA
- Behavioral Medicine and Addictions Research GroupButler HospitalProvidenceRhode IslandUSA
| | - Jacqueline F. Hayes
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Department of Psychiatry and Human BehaviorWarren Alpert Medical School at Brown UniversityProvidenceRhode IslandUSA
| | - Stephanie P. Goldstein
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Department of Psychiatry and Human BehaviorWarren Alpert Medical School at Brown UniversityProvidenceRhode IslandUSA
| | - Rena R. Wing
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Department of Psychiatry and Human BehaviorWarren Alpert Medical School at Brown UniversityProvidenceRhode IslandUSA
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Gu YJ, Chen LM, Gu ME, Xu HX, Li J, Wu LY. Body mass index-based predictions and personalized clinical strategies for colorectal cancer in the context of PPPM. EPMA J 2022; 13:615-632. [PMID: 36505896 PMCID: PMC9727065 DOI: 10.1007/s13167-022-00306-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/07/2022] [Indexed: 12/03/2022]
Abstract
Currently colorectal cancer (CRC) is the third most prevalent cancer worldwide. Body mass index (BMI) is frequently used in CRC screening and risk assessment to quantitatively evaluate weight. However, the impact of BMI on clinical strategies for CRC has received little attention. Within the framework of the predictive, preventive, and personalized medicine (3PM/PPPM), we hypothesized that BMI stratification would affect the primary, secondary, and tertiary care options for CRC and we conducted a critical evidence-based review. BMI dynamically influences CRC outcomes, which helps avoiding adverse treatment effects. The outcome of surgical and radiation treatment is adversely affected by overweight (BMI ≥ 30) or underweight (BMI < 20). A number of interventions, such as enhanced recovery after surgery and robotic surgery, can be applied to CRC at all levels of BMI. BMI-controlling modalities such as exercise, diet control, nutritional therapy, and medications may be potentially beneficial for patients with CRC. Patients with overweight are advised to lose weight through diet, medication, and physical activity while patients suffering of underweight require more focus on nutrition. BMI assists patients with CRC in better managing their weight, which decreases the incidence of adverse prognostic events during treatment. BMI is accessible, noninvasive, and highly predictive of clinical outcomes in CRC. The cost-benefit of the PPPM paradigm in developing countries can be advanced, and the clinical benefit for patients can be improved with the promotion of BMI-based clinical strategy models for CRC.
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Affiliation(s)
- Yun-Jia Gu
- grid.412540.60000 0001 2372 7462Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No.110 Ganhe Road, Shanghai, 200437 China ,grid.412540.60000 0001 2372 7462Shanghai Qigong Research Institute, Shanghai University of Traditional Chinese Medicine, No. 650 South Wanping Road, Shanghai, 200030 China
| | - Li-Ming Chen
- grid.412540.60000 0001 2372 7462Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No.110 Ganhe Road, Shanghai, 200437 China
| | - Mu-En Gu
- grid.412540.60000 0001 2372 7462Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No.110 Ganhe Road, Shanghai, 200437 China
| | - Hong-Xiao Xu
- grid.412540.60000 0001 2372 7462Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No.110 Ganhe Road, Shanghai, 200437 China
| | - Jing Li
- grid.412540.60000 0001 2372 7462Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No.110 Ganhe Road, Shanghai, 200437 China
| | - Lu-Yi Wu
- grid.412540.60000 0001 2372 7462Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No.110 Ganhe Road, Shanghai, 200437 China
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Psychophysiological Adaptations to Yoga Practice in Overweight and Obese Individuals: A Topical Review. Diseases 2022; 10:diseases10040107. [PMID: 36412601 PMCID: PMC9680480 DOI: 10.3390/diseases10040107] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/10/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
Physical activity has been documented as a foundational approach for weight management and obesity, improving several cardiometabolic and mental health indices. However, it is not clear whether yoga practice can induce beneficial improvements in anthropometric and body composition parameters, performance, metabolic health, and well-being among overweight/obese people. The aim of this topical review was to catalog training studies examining the psychophysiological responses to yoga interventions in order to detect which outcomes have been investigated, the research methods applied, and the conclusions. The inclusion/exclusion criteria were met by 22 published articles involving 1178 (56% female) overweight/obese participants. This brief review on yoga-induced adaptations demonstrates that this widely used meditative movement activity can meaningfully improve the vast majority of the selected markers. These beneficial alterations are focused mostly on various anthropometric and body composition variables, cardiovascular disease risk factors, physical fitness parameters, quality of life, and stress in previously inactive overweight/obese individuals. Instead, yoga-based physical exercise interventions investigating anxiety, depression, mood state, exercise enjoyment, affect valence, and adherence were limited. Further research should focus on the yoga intervention configuration and potential mechanisms behind favorable changes in various psychophysiological indices through large-scale, rigorously designed randomized controlled trials implementing long-term interventions in overweight/obese individuals.
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Caldwell AE, Purcell SA, Gray B, Smieja H, Catenacci VA. The impact of yoga on components of energy balance in adults with overweight or obesity: A systematic review. Obes Sci Pract 2022; 8:219-232. [PMID: 35388342 PMCID: PMC8976548 DOI: 10.1002/osp4.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/02/2021] [Accepted: 07/08/2021] [Indexed: 12/02/2022] Open
Abstract
Background Yoga may reduce body weight in individuals with overweight or obesity, but whether this occurs through decreased energy intake (EI) or increased energy expenditure (EE)/physical activity (PA) is unclear. Methods A systematic search of PubMed, Web of Science, Embase, and PsychINFO was conducted from inception until April 26, 2021. Eligible studies included randomized controlled trials or single‐arm pre‐post studies with any type and duration of yoga intervention in adults with overweight or obesity. Studies with measures related to EI , EE, or PA were eligible. The review initially identified 1,373 articles. Results Of the 10 included studies, one used indirect calorimeter measures of resting EE, while nine used self‐reported measures of EI and PA. Of the seven studies measuring parameters related to EI, only one found greater decreases in EI relative to the control group, although three other investigations reported trends toward improved dietary intake. Of the eight studies measuring PA, two reported greater increases in resting EE or PA in the yoga group relative to the control group. Two reported significant within‐group increases in PA from pre‐post intervention, and four studies reported a trend for increased PA with no p‐values reported. Conclusions Limited evidence suggests yoga may reduce EI and increase PA in adults with overweight or obesity. Additional studies that investigate the effects of yoga interventions on energy balance parameters using objective techniques are warranted.
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Affiliation(s)
- Ann E. Caldwell
- Division of Endocrinology, Metabolism, and Diabetes School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
- Anschutz Health and Wellness Center School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
| | - Sarah A. Purcell
- Division of Endocrinology, Metabolism, and Diabetes School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
- Anschutz Health and Wellness Center School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
| | - Bethany Gray
- Anschutz Health and Wellness Center School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
| | - Hailey Smieja
- Anschutz Health and Wellness Center School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
| | - Victoria A. Catenacci
- Division of Endocrinology, Metabolism, and Diabetes School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
- Anschutz Health and Wellness Center School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
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Vuong V, Rao V, Ee C. Mindfulness-based Interventions and Yoga for Managing Obesity/Overweight After Breast Cancer: A Scoping Review. Integr Cancer Ther 2022; 21:15347354221137321. [DOI: 10.1177/15347354221137321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Weight gain after breast cancer is common, and obesity after breast cancer increases breast cancer recurrence and mortality. Mindfulness-based interventions (MBIs) and yoga have been shown to be effective in managing obesity/overweight in people without breast cancer. There is a need to systematically map the extent and range of evidence on yoga and MBIs for managing obesity/overweight after breast cancer in order to aid planning and commissioning of future research. Methods We conducted a scoping review informed by methods described by Levac et al. Five electronic databases were searched for any peer-reviewed original research (including systematic reviews) that examined the role of yoga and/or MBIs for managing overweight/obesity after breast cancer. Data were extracted on study, population, intervention, comparator and outcome characteristics, and described narratively. Results: We found 18 publications representing 15 unique studies (11 clinical trials, 2 systematic reviews, and 2 observational studies). There were 10 studies on yoga, and 5 on MBIs. Of the clinical trials, only 4/11 examined a weight-related outcome as the primary outcome. The remaining trials examined lifestyle or metabolic outcomes (5/11) or unrelated outcomes such as psychological health (2/11). Gaps in the literature included small sample sizes, lack of cultural diversity amongst participants, inadequate reporting of the intervention, few lifestyle co-interventions offered, lack of active comparator groups, and inadequate safety reporting. Conclusions: There is a need for adequately-powered RCTs that adhere to reporting guidelines. The use of gold-standard methods for measuring outcomes, and active comparator groups, is also recommended.
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Affiliation(s)
- Vicki Vuong
- School of Medicine, Western Sydney University, NSW, Australia
| | - Vibhuti Rao
- WNICM Health Research Institute, Western Sydney University, NSW, Australia
| | - Carolyn Ee
- WNICM Health Research Institute, Western Sydney University, NSW, Australia
- Translational Health Research Institute, Western Sydney University, NSW, Australia
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