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Smith DL, Yang Y, Mestre LM, Henschel B, Parker E, Dickinson S, Patki A, Allison DB, Nagy TR. Impact of sustained calorie restriction and weight cycling on body composition in high-fat diet-fed male and female C57BL/6J mice. Obesity (Silver Spring) 2024; 32:959-968. [PMID: 38600047 PMCID: PMC11145641 DOI: 10.1002/oby.24015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/18/2024] [Accepted: 01/31/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE The objective of this study was to investigate body composition changes with weight cycling (WC) among adult C57BL/6J mice with diet-induced obesity. METHODS A total of 555 single-housed mice were fed a high-fat diet ad libitum (AL) from 8 to 43 weeks of age. The 200 heaviest mice of each sex were randomized to the following four groups: ever obese (EO, continued AL feeding); obese weight loser (OWL, calorie-restricted); obese weight loser moderate (OWLM, body weight halfway between EO and OWL); and WC (diet restricted to OWL followed by AL refeeding cycles). Body weight and composition data were collected. Linear regression was used to calculate residuals between predicted and observed fat mass. Linear mixed models were used to compare diet groups. RESULTS Although weight loss and regain resulted in changes in body weight and composition, fat mass, body weight, and relative body fat were not significantly greater for the WC group compared with the EO group. During long-term calorie restriction, males (but not females) in the OWLM group remained relatively fatter than the EO group. CONCLUSIONS WC did not increase body weight or relative fat mass for middle-aged, high-fat diet-fed adult mice. However, long-term moderate calorie restriction resulted in lower body weight but greater "relative" fat in male mice.
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Affiliation(s)
- Daniel L. Smith
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Diabetes Research Center, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Nathan Shock Center of Excellence in the Basic Biology of Aging, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Yongbin Yang
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Luis M. Mestre
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington IN, USA
| | - Beate Henschel
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington IN, USA
| | - Erik Parker
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington IN, USA
| | - Stephanie Dickinson
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington IN, USA
| | - Amit Patki
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - David B. Allison
- Nathan Shock Center of Excellence in the Basic Biology of Aging, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington IN, USA
| | - Tim R. Nagy
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Diabetes Research Center, University of Alabama at Birmingham, Birmingham, AL 35294 USA
- Nathan Shock Center of Excellence in the Basic Biology of Aging, University of Alabama at Birmingham, Birmingham, AL 35294 USA
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Giacone L, Siegrist M, Hartmann C. Food choices for weight loss: what dietary strategies would people use? Br J Nutr 2024; 131:1268-1280. [PMID: 38012836 PMCID: PMC10918523 DOI: 10.1017/s0007114523002726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/04/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023]
Abstract
Previous observational research showed that one of the most common strategies used to lose weight is to avoid or restrict the consumption of specific food items. However, the question of how people behave and implement strategies in actual decision-making situations involving food choices for weight loss purposes remains inconclusive. This experimental study using a food buffet aimed to examine people's different dietary strategies and motives for selecting foods for an entire day for weight loss purposes compared with a normal-day (ND) food selection. A total of 111 participants (55 % women) had to choose foods for both a ND and a weight loss day (WLD) (within-study design). Kilocalories and nutrients were calculated based on the weights of the foods selected, and food choice motives were assessed using a questionnaire. The results showed that for weight loss purposes, the participants selected more vegetables (both sexes) and unsweetened beverages (only men) while reducing their choices of high-fat and high-energy products (both sexes). Participants' food choices in both conditions (ND and WLD) differed from the official nutrition recommendations. They chose less carbohydrates and fibres and more fat and sugar than recommended. Health, kilocalories and nutrient content (carbohydrates, sugar, fat and protein) were more important food choice motives for weight loss purposes than for a ND food selection, while taste became less important. In conclusion, the participants appeared to be well capable of implementing several appropriate dietary strategies. Further research is needed to explore strategies to help them maintain these dietary changes over the long term.
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Affiliation(s)
- Luana Giacone
- ETH Zurich, Department of Health Sciences and Technology, Consumer Behavior, Universitaetstrasse 22, CH-8092 Zurich, Switzerland
| | - Michael Siegrist
- ETH Zurich, Department of Health Sciences and Technology, Consumer Behavior, Universitaetstrasse 22, CH-8092 Zurich, Switzerland
| | - Christina Hartmann
- ETH Zurich, Department of Health Sciences and Technology, Consumer Behavior, Universitaetstrasse 22, CH-8092 Zurich, Switzerland
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Lee K. Weight Loss Attempts Increased in Korean Adults from 2005 to 2021, Excluding Those with Obesity. Metab Syndr Relat Disord 2024; 22:39-48. [PMID: 37816241 DOI: 10.1089/met.2023.0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023] Open
Abstract
Background: Studies on trends in the proportions of past-year weight loss attempts among Asian adults are limited. Our hypotheses were that trends in the proportions would increase and sociodemographic, weight, and health-related factors would be associated with these attempts. Methods: Using data from the Korea National Health and Nutrition Examination Survey 2005-2021, this study evaluated the trends and their related factors among Korean adults. Complex sample design analyses were applied to the data of 80,160 adults. Results: The weighted proportion of past-year weight loss attempts increased from 35.2% in 2005 to 41.3% in 2021. The proportion of past-year weight loss attempts increased for individuals with nonobese body mass index (BMIs) (<25 kg/m2), decreased for males with obese BMIs (≥25 kg/m2), and did not change for females with obese BMIs. A multivariate-adjusted model showed that the proportion of weight loss attempts decreased for males and increased for females over the 16-year period [odds ratio (OR) (95% confidence interval): males, 0.993 (0.988-0.998); females, 1.013 (1.009-1.017)]. The OR of weight loss attempts was higher for females, younger individuals, and those with higher economic status, higher BMIs, self-perceived larger body shapes, self-rated better health, and chronic diseases. These characteristics decreased the odds of individuals with obese BMIs making no weight loss attempts. Conclusions: The proportion of past-year weight loss attempts increased over the 16-year period among all participants, but a declining trend was observed for those with obesity. In addition to BMI, socioeconomic factors, subjective perceptions of body shape, and health-related factors were related to weight loss attempts.
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Affiliation(s)
- Kayoung Lee
- Department of Family Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Republic of Korea
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Kuk JL, Daniels SB, Ardern CI, Pooni R. Changes in the prevalence of U.S. adults using diet, exercise, pharmaceuticals and diet products for weight loss over time: Analysis of NHANES 1999-2018. PLoS One 2023; 18:e0292810. [PMID: 37847708 PMCID: PMC10581481 DOI: 10.1371/journal.pone.0292810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/28/2023] [Indexed: 10/19/2023] Open
Abstract
To examine changes in the use of diet, exercise, and pharmacological/diet product weight loss (WL) practices over time, and differences in these trends by sex and obesity status, data from the National Health and Examination Survey (NHANES Continuous 1999-2018) was used. The prevalence of diet, exercise and use of WL drugs and products over time were examined in men and women with and without obesity in a series of cross-sectional nationally representative samples (n = 43,020). Women and those with obesity were more likely to engage in WL practices over the past year, with an increased prevalence of WL efforts over time (38.4 to 43.2%). Amongst those who engaged in WL attempts, diet-related WL was most common (87-93%), followed by exercise-related WL (47-68%), whereas use of WL drugs and products was the least common (5-21%). There were modest differences in the prevalence of diet or exercise WL over time, with some differences by sex and obesity status. Most notable was the increase in the prevalence of exercise WL practices in women with obesity, with no differences among men or women without obesity. When examining specific types of diets, there were more clear differences in the adoption of diets over time, with the use of more traditional calorie/portion/fat restriction diets becoming less prevalent, and sugar/carbohydrate restriction becoming more prevalent over time (P<0.005). Changes over time in the use of diets were, were however, similar in men and women with and without obesity. Use of pharmacotherapy/diet products tended to decline in prevalence over time but was consistently highest in women with obesity. Thus, there are differences in the types of WL strategies individuals have employed over time, with variations in their popularity of use by sex and obesity status. However, the pattern of changes over time were quite similar in men and women with and without obesity.
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Affiliation(s)
- Jennifer L. Kuk
- School of Kinesiology and Health Sciences, York University, Toronto, ON, Canada
| | - Simone B. Daniels
- School of Kinesiology and Health Sciences, York University, Toronto, ON, Canada
| | - Chris I. Ardern
- School of Kinesiology and Health Sciences, York University, Toronto, ON, Canada
| | - Rubin Pooni
- School of Kinesiology and Health Sciences, York University, Toronto, ON, Canada
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Pélissier L, Bagot S, Miles-Chan JL, Pereira B, Boirie Y, Duclos M, Dulloo A, Isacco L, Thivel D. Is dieting a risk for higher weight gain in normal-weight individual? A systematic review and meta-analysis. Br J Nutr 2023; 130:1190-1212. [PMID: 36645258 DOI: 10.1017/s0007114523000132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
While there is an increasing prevalence of dieting in the overall population, weight loss (WL) practices could be a risk factor for weight gain (WG) in normal-weight (NW) individuals. The aim of the present work was to systematically review all the studies implicating diet restriction and body weight (BW) evolution in NW people. The literature search was registered in PROSPERO (CRD42021281442) and was performed in three databases from April 2021 to June 2022 for articles involving healthy NW adults. From a total of 1487 records initially identified, eighteen were selected in the systematic review. Of the eight dieting interventional studies, only one found a higher BW after weight recovery, but 75 % of them highlighted metabolic adaptations in response to WL favouring weight regain and persisting during/after BW recovery. Eight of the ten observational studies showed a relationship between dieting and major later WG, while the meta-analysis of observational studies results indicated that 'dieters' have a higher BW than 'non-dieters'. However, considering the high methodological heterogeneity and the publication bias of the studies, this result should be taken with caution. Moreover, the term 'diet' was poorly described, and we observed a large heterogeneity of the methods used to assess dieting status. Present results suggest that dieting could be a major risk factor for WG in the long term in NW individuals. There is, however, a real need for prospective randomised controlled studies, specifically assessing the relationship between WL induced by diet and subsequent weight in this population.
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Affiliation(s)
- Léna Pélissier
- Clermont Auvergne University, UPR 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), CRNH Auvergne, Clermont-Ferrand, France
| | - Sarah Bagot
- Clermont Auvergne University, UPR 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), CRNH Auvergne, Clermont-Ferrand, France
| | - Jennifer Lynn Miles-Chan
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Bruno Pereira
- Unit of Biostatistics (DRCI), Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Yves Boirie
- Department of Human Nutrition, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France
| | - Martine Duclos
- Observatoire National de l'Activité Physique et de la Sédentarité (ONAPS), Faculty of Medicine, Clermont Auvergne University, Clermont-Ferrand, France
- University Hospital (CHU) Clermont-Ferrand, Hospital G. Montpied, Department of Sport Medicine and Functional Explorations, Clermont-Ferrand, France
- International Research Chair Health in Motion, Clermont Auvergne University Foundation, Clermont-Ferrand, France
| | - Abdul Dulloo
- Department of Endocrinology, Metabolism and Cardiovascular System, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Laurie Isacco
- Clermont Auvergne University, UPR 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), CRNH Auvergne, Clermont-Ferrand, France
| | - David Thivel
- Clermont Auvergne University, UPR 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), CRNH Auvergne, Clermont-Ferrand, France
- Observatoire National de l'Activité Physique et de la Sédentarité (ONAPS), Faculty of Medicine, Clermont Auvergne University, Clermont-Ferrand, France
- International Research Chair Health in Motion, Clermont Auvergne University Foundation, Clermont-Ferrand, France
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Fekih-Romdhane F, Azzi V, Malaeb D, Sarray El Dine A, Obeid S, Hallit S. Psychometric properties of an Arabic translation of the body appreciation scale (BAS-2) and its short forms (BAS-2SF) in a community sample of Lebanese adults. J Eat Disord 2023; 11:160. [PMID: 37723503 PMCID: PMC10506330 DOI: 10.1186/s40337-023-00885-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/09/2023] [Indexed: 09/20/2023] Open
Abstract
OBJECTIVES The present study sought to examine the factor structure, reliability, validity and gender invariance of the Arabic Body Appreciation Scale (BAS-2), and its two short forms (the 3-item and 2-item BAS-2SF) among community Lebanese Arabic-speaking adults. METHODS We carried-out an online cross-sectional survey. The 10-item BAS-2, the functionality appreciation scale and the Eating Attitudes Test-26 were completed by 826 Lebanese community adults (57.9% females, aged 25.42 ± 8.44 years). RESULTS The Arabic 10-item, 3-item and 2-item BAS-2 converged on a one-factor solution, and demonstrated high internal consistency (McDonald's ω value of .92, .88, and .86 respectively). All indices suggested that configural, metric, and scalar invariance was supported across gender. The 3-item and 2-item BAS-2SF were highly correlated with the original BAS-2 (r > 0.9). Higher 10-item, 3-item and 2-item BAS-2 scores correlated significantly and strongly with more positive eating attitudes and greater functionality appreciation, and higher 10-item BAS-2 scores correlated positively and weakly with BMI, supporting convergent validity. CONCLUSION The present work contributes to the literature by providing a psychometrically sound Arabic-translation of the BAS-2 and short-forms, benefitting both researchers and clinicians.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, 2010 Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Vanessa Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Abir Sarray El Dine
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Beirut, Lebanon
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Psychology Department, College of Humanities, Effat University, Jeddah, Saudi Arabia
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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Sooriyaarachchi P, Jayawardena R, Pavey T, King NA. A qualitative exploration of the experiences of shift workers participated in a low-calorie meal replacement dietary intervention. BMJ Open 2023; 13:e072012. [PMID: 37709328 PMCID: PMC10503395 DOI: 10.1136/bmjopen-2023-072012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/31/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES Shift work is associated with various health challenges, including obesity and metabolic disturbances. To address these concerns, a randomised controlled clinical trial was conducted to evaluate the efficacy of a low-calorie meal replacement (MR) dietary intervention for dinner among shift workers with obesity. This study focuses on the qualitative aspects of this intervention, aiming to explore the experiences and perceptions of shift workers who participated in the trial. DESIGN Following the completion of the intervention, semi-structured face-to-face or telephone interviews were conducted with a purposive sample of trial participants. Data analysis was inductive, thematic using NVivo V.10 software. SETTING The intervention was conducted among shift workers with obesity in a private hospital in Sri Lanka and resulted in a modest decrease in weight. PARTICIPANTS Using purposeful maximum variation sampling, we recruited eight healthcare shift workers who took part in a weight loss intervention. RESULTS All participants expressed satisfaction with the MR meal for dinner, highlighting its positive impact on their well-being. Despite initial difficulties, strong determination and motivation by results supported adherence. Some participants suggested that the MR could be improved with sweeter taste and more flavour options. Few reported mild bloating at the beginning, but no serious side effects were noted. Participants felt lighter in their bodies due to weight loss. The method's simplicity was the most frequently reported benefit, making it feasible even during busy night shifts. Overall, participants highly recommended the intervention to others in need. CONCLUSION Participants experienced weight loss by replacing their dinner with the MR. This study offers valuable insights for tailoring future workplace-based dietary interventions for this vulnerable population. TRIAL REGISTRATION NUMBER ACTRN12622000231741.
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Affiliation(s)
- Piumika Sooriyaarachchi
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Ranil Jayawardena
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo, Sri Lanka
| | - Toby Pavey
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Neil A King
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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Ikram A, Khalid W, Saeed F, Arshad MS, Afzaal M, Arshad MU. Senna: As immunity boosting herb against Covid-19 and several other diseases. J Herb Med 2023; 37:100626. [PMID: 36644449 PMCID: PMC9830937 DOI: 10.1016/j.hermed.2023.100626] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 11/16/2020] [Accepted: 01/09/2023] [Indexed: 01/11/2023]
Abstract
Introduction A novel coronavirus outbreak in China (SARS-CoV-2) which began in December 2019, was proven major threat to global health. However, several results from clinical practices indicate that herbal medicine plays an important role in the prevention of COVID-19, which brings new hope for its treatment. The objective of this study is to check the effectivity of senna (Senna alexandrina Mill.) as an immunity-boosting herb against Covid-19 and several other diseases. Method The literature search was carried out using scientific databases comprising of Scopus, Science Direct, PubMed, Cochrane Library, Science Hub and Google Scholar, up to May 2020, using the following keywords: "senna", "senna makki", "Senna alexandrina", "senna nutrition value", "senna medicinal effect", "vitamins in senna", "mineral in senna", "bioactive compounds in senna", "laxiary components in senna", "senna against diseases", "senna enhance immunity", "covid_19″, "covid_19 symptoms". The authors also obtained data from primary and secondary sources as well. Result The results of different studies showed that senna was composed of a wide range of immunity-enhancing bioactive components like antioxidants, vitamins, minerals and laxatives. These bioactive components are effective against COVID-19 and other diseases. Conclusion Senna has medicinal and nutritional effects on the human body and has a key role in boosting immunity to prevent COVID-19 symptoms. Important nutritional components of senna include antioxidants, phytochemicals, vitamins and minerals that aids in reducing the risk of various diseases and also enhances the immune system.
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Leonard KS, de Brito JN, Larouche ML, Rydell SA, Mitchell NR, Pereira MA, Buman MP. Effect of Weight Goals on Sitting and Moving During a Worksite Sedentary Time Reduction Intervention. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022; 7:e000210. [PMID: 36213514 PMCID: PMC9534174 DOI: 10.1249/tjx.0000000000000210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Introduction/Purpose Although many US adults report trying to lose weight, little research has examined weight loss goals as a motivator for reducing workplace sitting and increasing physical activity. This exploratory analysis examined weight goals and the association with changes in workplace sitting, physical activity, and weight. Methods Employees (N = 605) were drawn from worksites participating in Stand and Move at Work. Worksites (N = 24) were randomized to a multilevel behavioral intervention with (STAND+) or without (MOVE+) sit-stand workstations for 12 months; MOVE+ worksites received sit-stand workstations from 12 to 24 months. At each assessment (baseline and 3, 12, and 24 months), participants were weighed and wore activPAL monitors. Participants self-reported baseline weight goals and were categorized into the "Lose Weight Goal" (LWG) group if they reported trying to lose weight or into the "Other Weight Goal" (OWG) group if they did not. Results Generalized linear mixed models revealed that within STAND+, LWG and OWG had similar sitting time through 12 months. However, LWG sat significantly more than OWG at 24 months. Within MOVE+, sitting time decreased after introduction of sit-stand workstations for LWG and OWG, although LWG sat more than OWG. Change in physical activity was minimal and weight remained stable in all groups. Conclusions Patterns of change in workplace sitting were more favorable in OWG relative to LWG, even in the absence of notable weight change. Expectations of weight loss might be detrimental for reductions in workplace sitting. Interventionists may want to emphasize non-weight health benefits of reducing workplace sitting.
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Affiliation(s)
- Krista S. Leonard
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Junia N. de Brito
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Sarah A. Rydell
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Mark A. Pereira
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Matthew P. Buman
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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O'Connor RM, Kenny PJ. Utility of 'substance use disorder' as a heuristic for understanding overeating and obesity. Prog Neuropsychopharmacol Biol Psychiatry 2022; 118:110580. [PMID: 35636576 DOI: 10.1016/j.pnpbp.2022.110580] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/24/2022] [Accepted: 05/24/2022] [Indexed: 02/07/2023]
Abstract
Rates of obesity and obesity-associated diseases have increased dramatically in countries with developed economies. Substance use disorders (SUDs) are characterized by the persistent use of the substance despite negative consequences. It has been hypothesized that overconsumption of palatable energy dense food can elicit SUD-like maladaptive behaviors that contribute to persistent caloric intake beyond homeostatic need even in the face of negative consequences. Palatable food and drugs of abuse act on many of the same motivation-related circuits in the brain, and can induce, at least superficially, similar molecular, cellular, and physiological adaptations on these circuits. As such, applying knowledge about the neurobiological mechanisms of SUDs may serve as useful heuristic to better understand the persistent overconsumption of palatable food that contributes to obesity. However, many important differences exist between the actions of drugs of abuse and palatable food in the brain. This warrants caution when attributing weight gain and obesity to the manifestation of a putative SUD-related behavioral disorder. Here, we describe similarities and differences between compulsive drug use in SUDs and overconsumption in obesity and consider the merit of the concept of "food addiction".
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Affiliation(s)
- Richard M O'Connor
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, United States of America
| | - Paul J Kenny
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, United States of America.
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Shah N, Perkovic V, Kotwal S. Impact of SGLT2 inhibitors on the kidney in people with type 2 diabetes and severely increased albuminuria. Expert Rev Clin Pharmacol 2022; 15:827-842. [PMID: 35912871 DOI: 10.1080/17512433.2022.2108402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Diabetes is the most common cause of end stage kidney disease. Therapies such as sodium-glucose co-transporter-2 inhibitors have been identified over the last decade as effective oral hypoglycemic agents that also confer additional cardio and kidney protection. Knowledge of their mechanism of action and impact on patients with diabetes and albuminuria is vital in galvanizing prescriber confidence and increasing clinical uptake. AREAS COVERED This manuscript discusses the pathophysiology of diabetic kidney disease, patho-physiological mechanisms for sodium-glucose co-transporter-2 inhibitors, and their impact on patients with Type 2 diabetes mellitus and albuminuric kidney disease. EXPERT OPINION Sodium-glucose co-transporter-2 inhibitors reduce albuminuria with consequent benefits on cardiovascular and kidney outcomes in patients with diabetes and severe albuminuria. Whilst they have been incorporated into guidelines, the uptake of these agents into clinical practice has been slow. Increasing the uptake of these agents into clinical practice is necessary to improve outcomes for the large number of patients with diabetic kidney disease globally.
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Affiliation(s)
- Nasir Shah
- Faculty of Medicine, UNSW, Kensington, Sydney Australia 2052
| | - Vlado Perkovic
- Faculty of Medicine, UNSW, Kensington, Sydney Australia 2052.,The George Institute for Global Health, UNSW, 1 King Street, Newtown, Sydney, Australia 2042
| | - Sradha Kotwal
- The George Institute for Global Health, UNSW, 1 King Street, Newtown, Sydney, Australia 2042.,Prince of Wales Hospital, High Street, Sydney, Australia, 2031
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12
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Targeting skeletal muscle mitochondrial health in obesity. Clin Sci (Lond) 2022; 136:1081-1110. [PMID: 35892309 PMCID: PMC9334731 DOI: 10.1042/cs20210506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/26/2022] [Accepted: 07/05/2022] [Indexed: 11/21/2022]
Abstract
Metabolic demands of skeletal muscle are substantial and are characterized normally as highly flexible and with a large dynamic range. Skeletal muscle composition (e.g., fiber type and mitochondrial content) and metabolism (e.g., capacity to switch between fatty acid and glucose substrates) are altered in obesity, with some changes proceeding and some following the development of the disease. Nonetheless, there are marked interindividual differences in skeletal muscle composition and metabolism in obesity, some of which have been associated with obesity risk and weight loss capacity. In this review, we discuss related molecular mechanisms and how current and novel treatment strategies may enhance weight loss capacity, particularly in diet-resistant obesity.
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Atchison A, Zickgraf HF. Orthorexia nervosa and eating disorder behaviors: A systematic review of the literature. Appetite 2022; 177:106134. [PMID: 35750289 DOI: 10.1016/j.appet.2022.106134] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 05/13/2022] [Accepted: 06/08/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Orthorexia nervosa (ON) involves obsessive thoughts about healthy eating and distress related to this obsession. There is still dispute over whether ON should be considered on the obsessive-compulsive spectrum, the eating disorder (ED) spectrum, or as its own disorder. Based on current research, orthorexic behaviors seem to be closely related to eating disorder behaviors. However, given the range of instruments used to measure ED and ON, and the lack of consistency in the specific ED domains explored, a review of the current literature is warranted. OBJECTIVE The objective of this study was to review the literature relating ON and ED symptoms in an effort to understand the nature of their relationship, and to identify ED symptom domains most closely related to ON. METHODS A search was conducted on PubMed, Science Direct, and Web of Science using the term "orthorexia" and at least one of the following: "anorexia nervosa," "bulimia nervosa," "eating disorder," "arfid," "restrictive," "body image," "weight concern," "shape concern." After exclusion criteria were applied, 42 articles were included in the review. RESULTS The results indicated that ON is consistently related to both trait and disordered restrictive eating symptoms of anorexia nervosa, and weight control motivations for food choice. However, ON was less consistently related to binge-spectrum eating disorder symptoms, emotional eating, uncontrolled eating, or body dissatisfaction/shape and weight concerns. CONCLUSION The finding that ON symptoms are related to restraint and weight loss efforts, but not to body dissatisfaction or dysregulated eating suggests that ON may represent a distinct ED.
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Affiliation(s)
- Anna Atchison
- University of South Alabama, Department of Psychology, Mobile, AL, 36688, USA.
| | - Hana F Zickgraf
- University of South Alabama, Department of Psychology, Mobile, AL, 36688, USA
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Singh R, Rathore SS, Khan H, Karale S, Chawla Y, Iqbal K, Bhurwal A, Tekin A, Jain N, Mehra I, Anand S, Reddy S, Sharma N, Sidhu GS, Panagopoulos A, Pattan V, Kashyap R, Bansal V. Association of Obesity With COVID-19 Severity and Mortality: An Updated Systemic Review, Meta-Analysis, and Meta-Regression. Front Endocrinol (Lausanne) 2022; 13:780872. [PMID: 35721716 PMCID: PMC9205425 DOI: 10.3389/fendo.2022.780872] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/10/2022] [Indexed: 12/11/2022] Open
Abstract
Background Obesity affects the course of critical illnesses. We aimed to estimate the association of obesity with the severity and mortality in coronavirus disease 2019 (COVID-19) patients. Data Sources A systematic search was conducted from the inception of the COVID-19 pandemic through to 13 October 2021, on databases including Medline (PubMed), Embase, Science Web, and Cochrane Central Controlled Trials Registry. Preprint servers such as BioRxiv, MedRxiv, ChemRxiv, and SSRN were also scanned. Study Selection and Data Extraction Full-length articles focusing on the association of obesity and outcome in COVID-19 patients were included. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used for study selection and data extraction. Our Population of interest were COVID-19 positive patients, obesity is our Intervention/Exposure point, Comparators are Non-obese vs obese patients The chief outcome of the study was the severity of the confirmed COVID-19 positive hospitalized patients in terms of admission to the intensive care unit (ICU) or the requirement of invasive mechanical ventilation/intubation with obesity. All-cause mortality in COVID-19 positive hospitalized patients with obesity was the secondary outcome of the study. Results In total, 3,140,413 patients from 167 studies were included in the study. Obesity was associated with an increased risk of severe disease (RR=1.52, 95% CI 1.41-1.63, p<0.001, I2 = 97%). Similarly, high mortality was observed in obese patients (RR=1.09, 95% CI 1.02-1.16, p=0.006, I2 = 97%). In multivariate meta-regression on severity, the covariate of the female gender, pulmonary disease, diabetes, older age, cardiovascular diseases, and hypertension was found to be significant and explained R2 = 40% of the between-study heterogeneity for severity. The aforementioned covariates were found to be significant for mortality as well, and these covariates collectively explained R2 = 50% of the between-study variability for mortality. Conclusions Our findings suggest that obesity is significantly associated with increased severity and higher mortality among COVID-19 patients. Therefore, the inclusion of obesity or its surrogate body mass index in prognostic scores and improvement of guidelines for patient care management is recommended.
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Affiliation(s)
- Romil Singh
- Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA, United States
| | - Sawai Singh Rathore
- Department of Internal Medicine, Dr. Sampurnanand Medical College, Jodhpur, India
| | - Hira Khan
- Department of Neurology, Allegheny General Hospital, Pittsburgh, PA, United States
| | - Smruti Karale
- Department of Internal Medicine, Government Medical College-Kolhapur, Kolhapur, India
| | - Yogesh Chawla
- Department of Immunology, Mayo Clinic, Rochester, MN, United States
| | - Kinza Iqbal
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Abhishek Bhurwal
- Department of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, United States
| | - Aysun Tekin
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Rochester, MN, United States
| | - Nirpeksh Jain
- Department of Emergency Medicine, Marshfield Clinic, Marshfield, WI, United States
| | - Ishita Mehra
- Department of Internal Medicine, North Alabama Medical Center, Florence, AL, United States
| | - Sohini Anand
- Department of Internal Medicine, Patliputra Medical College and Hospital, Dhanbad, India
| | - Sanjana Reddy
- Department of Internal Medicine, Gandhi Medical College, Secunderabad, India
| | - Nikhil Sharma
- Department of Nephrology, Mayo Clinic, Rochester, MI, United States
| | - Guneet Singh Sidhu
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MI, United States
| | | | - Vishwanath Pattan
- Department of Medicine, Division of Endocrinology and Metabolism, State University of New York (SUNY) Upstate Medical University, Syracuse, NY, United States
| | - Rahul Kashyap
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Rochester, MN, United States
| | - Vikas Bansal
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MI, United States
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Association of sleep duration and sleep quality with overweight/obesity among adolescents of Bangladesh: a multilevel analysis. BMC Public Health 2022; 22:374. [PMID: 35189883 PMCID: PMC8862335 DOI: 10.1186/s12889-022-12774-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/02/2022] [Indexed: 11/25/2022] Open
Abstract
Background Sleep deprivation is widely recognized as a potential contributor to childhood obesity. However, few studies have addressed this issue in low-income settings. The aim of this study was to determine the association of both sleep duration and sleep quality with overweight/obesity among adolescents of Bangladesh. Methods A cross-sectional study was conducted in four randomly selected schools in Gazipur, Bangladesh, from May to August 2019. Using a self-administered semi-structured questionnaire, data on sleep duration and sleep quality were collected from 1,044 adolescents between 13 and 17 years of age. The body mass indices of the study participants were evaluated using their objectively-assessed anthropometric measurements (weight and height). Multilevel logistic regression was used for data analysis. Results The prevalence of underweight, overweight and obesity in adolescents in this study were 14.9, 18 and 7.1%, respectively. More than 15% of the students reported sleep disturbance and poor sleep quality. After adjusting for confounders, reduced (<7 h/day) total sleep duration (OR=1.73, 95% CI=1.21-2.47), weekend sleep duration (OR=1.46, 95% CI=1.00-2.12), and night sleep duration (OR=1.55, 95% CI=1.06-2.28) were found to be significantly associated with overweight or obesity in Bangladeshi adolescents. Similarly, significant positive associations were evident between short duration of total sleep (OR=0.33, 95% CI=0.20-0.54), weekday sleep (OR=0.55, 95% CI=0.35-0.84), weekend sleep (OR=0.53, 95% CI=0.31-0.89), and night sleep (OR=0.56, 95% CI=0.36-0.87), and underweight in study participants. Adolescents with short sleep duration were found less likely to be underweight and more likely to be overweight/obese. Conclusions Study findings denoted short sleep duration to be associated with overweight/obesity and underweight among adolescents of Bangladesh. Adequate sleep may therefore serve as an effective obesity prevention strategy in the growing stages. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12774-0.
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van Rongen S, Handgraaf M, Benoist M, de Vet E. The effect of personal relative deprivation on food choice: An experimental approach. PLoS One 2022; 17:e0261317. [PMID: 35025897 PMCID: PMC8758004 DOI: 10.1371/journal.pone.0261317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 12/01/2021] [Indexed: 11/18/2022] Open
Abstract
Growing evidence suggests that relative disadvantage is more relevant than absolute socioeconomic factors in explaining disparities in healthfulness of diet. In a series of pre-registered experiments, we tested whether personal relative deprivation (PRD), i.e. the sense that one is unfairly deprived of a deserved outcome relative to others, results in choosing more palatable, rewarding foods. Study 1 (N = 102) demonstrated the feasibility and effectiveness of a game for inducing real-time experiences of PRD. Study 2 (N = 287) showed no main effect of PRD condition on hypothetical food choices, but an interaction between chronic PRD and condition revealed that those in the PRD condition chose more rewarding foods when feeling chronically deprived. In Study 3 (N = 260) the hypothesized main effect was found on real, non-hypothetical food choices: those in the PRD condition chose more rewarding foods, controlling for sensitivity to palatable food. Our results provide preliminary indications that the experience of being relatively deprived, rather than the objective amount or resources, may result in a higher preference for high-caloric and palatable foods. It may be suggested that efforts to reduce societal disparities in healthfulness of diet may need to focus on perceptions of injustice beyond objective inequalities.
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Affiliation(s)
- Sofie van Rongen
- Consumption and Healthy Lifestyles Group, Wageningen University & Research, Wageningen, Gelderland, The Netherlands
- * E-mail:
| | - Michel Handgraaf
- Urban Economics Group, Wageningen University & Research, Wageningen, Gelderland, The Netherlands
| | - Maaike Benoist
- Human Nutrition and Health Group, Wageningen University & Research, Wageningen, Gelderland, The Netherlands
| | - Emely de Vet
- Consumption and Healthy Lifestyles Group, Wageningen University & Research, Wageningen, Gelderland, The Netherlands
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17
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Eom H, Lee D, Cho Y, Moon J. The association between meal regularity and weight loss among women in commercial weight loss programs. Nutr Res Pract 2022; 16:205-216. [PMID: 35392532 PMCID: PMC8971826 DOI: 10.4162/nrp.2022.16.2.205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/29/2021] [Accepted: 06/29/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND/OBJECTIVES While many obesity studies have pointed out the importance of meal regularity, few have conducted empirical analyses using data from food diaries. We examined the association between meal regularity (i.e., meal time regularity [MTR] and calorie intake regularity [CIR]) and weight loss. SUBJECTS/METHODS We collected food diary data from 637 women who had participated in commercial weight loss programs for 28–168 days (4–24 weeks). This study defined “meal regularity” in terms of two concepts: MTR and CIR. MTR refers to how regularly people eat their meals (i.e., at certain times each day), whereas CIR refers to how regularly people consume a certain amount of calories at each meal. We conducted multiple regression analyses. RESULTS MTR (model 1: β = −2,576.526, P < 0.001; model 2: β = −1511.447, P < 0.05; model 3: β = −1,721.428, P < 0.05) and CIR (model 1: β = −1,231.551, P < 0.01; model 2: β = −2,082.353, P < 0.001; model 3: β = −1,343.490, P < 0.01) turned out to be significant determinants of the amount of weight loss in breakfast, lunch, and dinner contexts. While meal regularity (i.e., MTR and CIR) was significantly associated with weight loss, daily calorie intake from meals was not significantly associated with the amount of weight loss (model 1: β = 0.13, P > 0.05; model 2: β = 0.11, P > 0.05; model 3: β = 0.14, P > 0.05). Subjects who consumed an equal amount of calories per meal throughout the day lost more weight than those who did not (model 4: β = −3,675.51, P < 0.001). CONCLUSIONS Eating each meal (i.e., breakfast, lunch, and dinner) at a certain time every day may increase weight loss success. Also, consuming the same amount of calories at each meal may help weight loss success.
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Affiliation(s)
- Haram Eom
- Department of Agricultural Economics & Rural Development, Seoul National University, Seoul 08826, Korea
| | - Dongmin Lee
- Department of Food Processing and Distribution, Gangneung-Wonju National University, Gangneung 25457, Korea
| | | | - Junghoon Moon
- Department of Agricultural Economics & Rural Development, Seoul National University, Seoul 08826, Korea
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van der Laan LN, Papies EK, Ly A, Smeets PAM. Examining the neural correlates of goal priming with the NeuroShop, a novel virtual reality fMRI paradigm. Appetite 2021; 170:105901. [PMID: 34968564 DOI: 10.1016/j.appet.2021.105901] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/05/2021] [Accepted: 12/23/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Health goal priming has been shown to stimulate healthy food choices by activating an individual's weight-control goal. The present study combined fMRI with a novel virtual reality food choice task to elucidate the underlying neural mechanisms of health goal priming. Previous research has suggested that the ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) play a role in the incorporation of health considerations into the food choice process. Responses may be more representative for those found in real life when assessed in an environment similar to the actual choice environment. Therefore, the first aim of the study was to explore if a novel virtual reality food choice task is sufficiently sensitive to detect basic valuation processes in food choice. The second aim was to examine whether increased activation in the dlPFC drives the effects of health goal priming. METHODS Fifty-six female participants performed an fMRI food choice task embedded in a virtual supermarket environment. They chose between perceived healthy and unhealthy products in a health prime, hedonic prime, and non-food control condition, while activation in brain areas involved in self-control and valuation (vmPFC, dlPFC) was assessed. RESULTS There were no differences in relative preference for perceived healthy products over unhealthy products between the conditions. There were also no main effects of prime condition on brain activation in the vmPFC and dPFC during food choice. Across conditions, activation in the vmPFC correlated with the tastiness of the chosen product during food choice. CONCLUSIONS Although the study does not provide support for health goal priming triggering neural self-control mechanisms, results did show that virtual reality has potential for a more realistic fMRI food choice paradigm.
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Affiliation(s)
- L N van der Laan
- University Medical Center Utrecht. Image Sciences Institute, the Netherlands.
| | - E K Papies
- University of Glasgow, School of Psychology and Neuroscience, UK
| | - A Ly
- University Medical Center Utrecht. Image Sciences Institute, the Netherlands
| | - P A M Smeets
- University Medical Center Utrecht. Image Sciences Institute, the Netherlands
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19
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A review of sex differences in the mechanisms and drivers of overeating. Front Neuroendocrinol 2021; 63:100941. [PMID: 34454955 DOI: 10.1016/j.yfrne.2021.100941] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/23/2021] [Accepted: 08/17/2021] [Indexed: 12/16/2022]
Abstract
Disordered eating is often associated with marked psychological and emotional distress, and severe adverse impact on quality of life. Several factors can influence eating behavior and drive food consumption in excess of energy requirements for homeostasis. It is well established that stress and negative affect contribute to the aetiology of eating disorders and weight gain, and there is substantial evidence suggesting sex differences in sub-clinical and clinical types of overeating. This review will examine how negative affect and stress shape eating behaviors, and how the relationship between the physiological, endocrine, and neural responses to stress and eating behaviors differs between men and women. We will examine several drivers of overeating and explore possible mechanisms underlying sex differences in eating behavior.
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20
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Cai Z, Yang Y, Zhang J. Obesity is associated with severe disease and mortality in patients with coronavirus disease 2019 (COVID-19): a meta-analysis. BMC Public Health 2021; 21:1505. [PMID: 34348687 PMCID: PMC8334342 DOI: 10.1186/s12889-021-11546-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 07/23/2021] [Indexed: 02/08/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has led to global research to predict those who are at greatest risk of developing severe disease and mortality. The aim of this meta-analysis was to determine the associations between obesity and the severity of and mortality due to COVID-19. Methods We searched the PubMed, EMBASE, Cochrane Library and Web of Science databases for studies evaluating the associations of obesity with COVID-19. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random- or fixed-effects models. Meta-regression analyses were conducted to estimate regression coefficients. Results Forty-six studies involving 625,153 patients were included. Compared with nonobese patients, obese patients had a significantly increased risk of infection. (OR 2.73, 95% CI 1.53–4.87; I2 = 96.8%), hospitalization (OR 1.72, 95% CI 1.55–1.92; I2 = 47.4%), clinically severe disease (OR 3.81, 95% CI 1.97–7.35; I2 = 57.4%), mechanical ventilation (OR 1.66, 95% CI 1.42–1.94; I2 = 41.3%), intensive care unit (ICU) admission (OR 2.25, 95% CI 1.55–3.27; I2 = 71.5%), and mortality (OR 1.61, 95% CI 1.29–2.01; I2 = 83.1%). Conclusion Patients with obesity may have a greater risk of infection, hospitalization, clinically severe disease, mechanical ventilation, ICU admission, and mortality due to COVID-19. Therefore, it is important to increase awareness of these associations with obesity in COVID-19 patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11546-6.
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Affiliation(s)
- Zixin Cai
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yan Yang
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Jingjing Zhang
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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21
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Association between weight cycling and risk of kidney cancer: a prospective cohort study and meta-analysis of observational studies. Cancer Causes Control 2021; 32:1029-1038. [PMID: 34089471 DOI: 10.1007/s10552-021-01455-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/29/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Weight cycling is common in populations. However, it is unclear whether frequency and magnitude of weight cycling is associated with kidney cancer risk, independent of body mass index (BMI). METHODS A prospective cohort study followed 85,562 participants from Health Professionals Follow-up Study and Nurses' Health Study (1992-2014). At baseline, participants reported frequency and magnitude of intentional weight loss in the past 4 years. Cox proportional hazard model was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). We also conducted a meta-analysis of all available observational studies including our two cohorts. RESULTS During 22 years of follow-up, we identified 441 kidney cancer cases. Compared with non-weight cyclers (no attempt of intentional weight loss), severe cyclers (≥ 3 times of intentional weight loss of ≥ 4.5 kg) were at increased kidney cancer risk after adjusting for BMI before weight cycling (pooled multivariable-adjusted HR, 1.78; 95% CI, 1.19, 2.66). Additional adjustment for attained BMI after weight cycling had minimal influence. There was a positive trend between weight cycling by frequency and magnitude and kidney cancer risk (P-trend = 0.01). Moreover, the observed positive association did not differ by subtypes of cyclers (e.g., adiposity status, weight-loss methods). In the meta-analysis, we found a strong positive association between weight cycling and kidney cancer risk (summary relative risk for weight cyclers vs. non-cyclers, 1.51; 95% CI, 1.16, 1.96; I2: 52.2%; 6 studies). CONCLUSION Frequent substantial weight cycling was associated with increased risk of kidney cancer, independent of BMI. Our study suggests that weight cycling may be an important risk factor for kidney cancer.
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22
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Kuk JL, Dehlehhosseinzadeh M, Kamran E, Wharton S. An analysis of weight loss efforts and expectations in a Canadian Cohort: A retrospective medical chart review. Clin Obes 2021; 11:e12449. [PMID: 33745235 DOI: 10.1111/cob.12449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 02/17/2021] [Accepted: 03/03/2021] [Indexed: 11/30/2022]
Abstract
The weight loss history and weight loss goals were examined in 4108 patients referred to a publicly funded evidence-based clinical weight management program using a retrospective chart review. The majority of patients were white females, aged of 50.1 ± 13.7 years and a BMI of 39.0 ± 7.5 kg/m2 . Pregnancy was the most common reason for weight gain in women (17.7%) and while the reasons in men are more varied (injury, stress and medication: all ~5%). Over 50% of patients cited no specific reason for their weight gain. Self-directed diet and exercise were the most commonly used self-reported weight loss methods. Women were more likely to report using medication and bariatric surgical weight loss methods than men (P < .05), and only 5% of women and 12.8% men report never having tried to lose weight in the past. Patients had an ideal weight loss goal of 28.9% to 34.4%, which was similar to the patient's lowest reported adult weight. Approximately 70% of patients enrolling at the clinic had previously lost at least 4.5 kg (10 lb) one or more times and 16.7% lost weight at least 5 times in their life, but patient weight at enrolment was similar to their highest adult reported weight. Thus, most patients referred to this clinical weight management program have previously attempted self-directed diet and exercise weight loss. Patients were close to their highest adult weight and had very large weight loss goals, similar to what is typically achieved only by surgical intervention, despite having already had several bouts of weight loss.
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Affiliation(s)
- Jennifer L Kuk
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | | | - Elham Kamran
- Weight Management Clinic, The Wharton Medical Clinic, Hamilton, Canada
| | - Sean Wharton
- School of Kinesiology and Health Science, York University, Toronto, Canada
- Weight Management Clinic, The Wharton Medical Clinic, Hamilton, Canada
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Stahr S, Chiang T, Bauer MA, Runnells GA, Rogers LJ, Vi Do H, Kadlubar SA, Joseph Su L. Low‑Level Environmental Heavy Metals are Associated with Obesity Among Postmenopausal Women in a Southern State. EXPOSURE AND HEALTH 2021; 13:269-280. [PMID: 34337191 PMCID: PMC8323941 DOI: 10.1007/s12403-020-00381-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Both arsenic and cadmium are reported to be toxic to humans. The use of saliva as a biomarker of low-level exposures to these elements has not been adequately explored, and the putative relationship between exposure and obesity is unclear. This cross-sectional study aims to investigate the relationship between salivary arsenic and cadmium concentrations and their association with obesity. Arsenic and cadmium concentrations were analyzed in human saliva samples by Inductively Coupled Plasma-Mass Spectrometry on 270 randomly selected women who participated in the Arkansas Rural Community Health Study. Multivariable logistic regression was performed to evaluate the association between heavy metal concentrations and obesity. Stratified logistic regression was performed based on menopausal status. Generalized linear models were used to evaluate weight gain velocity. Significant positive associations were observed in postmenopausal women for both arsenic (OR = 4.43, 95% CI 1.91-10.28) and cadmium (OR = 2.72, 95% CI 1.23-5.99) concentrations, as well as significant trends among tertiles (p < 0.01 and p = 0.01, respectively). No relationship with obesity was evident among premenopausal women for either metal. A dose-response relationship was observed between increasing weight gain velocity and increasing metal concentrations. At concentrations well below governmental and industrial standards for acute toxicity, significant associations between obesity and concentration of these heavy metals are evident. The rate at which individuals gain weight is affected by metal concentrations and may play a role in the rapid increase in weight in postmenopausal women. These results might explain, in part, the missing variability in the increasing obesity pandemic in certain population exposed to these environmental toxicants.
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Affiliation(s)
- Shelbie Stahr
- Interdisciplinary Biomedical Sciences, Department of Clinical and Translational Sciences, University of Arkansas Medical Sciences, 4301 W. Markham St. Slot #601, Little Rock, AR 72205, USA
| | - Tung‑chin Chiang
- Department of Environmental and Occupational Health, Fay W. Boozman College of Public Health, University of Arkansas Medical Sciences, 4301 West Markham, # 820, Little Rock, AR 72205, USA
| | - Michael A. Bauer
- Department of Biomedical Informatics, College of Medicine, University of Arkansas Medical Sciences, 4018 W Capitol Ave, Little Rock, AR 72205, USA
| | - Gail A. Runnells
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas Medical Sciences, 4301 W. Markham St. # 820, Little Rock, AR 72205, USA
| | - Lora J. Rogers
- COPH Department of Epidemiology Slot 721-21, Winthrop P. Rockefeller Cancer Institute, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4104 Outpatient Circle, Little Rock, AR 72205-7101, USA
| | - Huyen Vi Do
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas Medical Sciences, 4301 W. Markham St. # 820, Little Rock, AR 72205, USA
| | - Susan A. Kadlubar
- Department of Environmental and Occupational Health, Fay W. Boozman College of Public Health, University of Arkansas Medical Sciences, 4301 West Markham, # 820, Little Rock, AR 72205, USA
| | - L. Joseph Su
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas Medical Sciences, 4301 W. Markham St. # 820, Little Rock, AR 72205, USA
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Abstract
Restrained eating is a popular weight loss strategy for young women that tends to have limited effectiveness over extended periods of time. Although previous studies have explored and identified possible personality and behavior differences between successful and unsuccessful restrained eaters (REs), there has been a paucity of research on neurophysiological differences.Towards addressing this gap, we assessed brain resting state (Rs) differences in groups of unsuccessful REs (N = 39) and successful REs (N = 31). In line with hypotheses, unsuccessful REs displayed reduced regional homogeneity in brain regions involved in cognitive control (inferior parietal lobe) compared to successful REs. Regions involved in conflict monitoring (anterior cingulate cortex) were also observed to be comparatively less active in the unsuccessful RE group. Finally, based on analyses of independent components and seed-based functional connectivity, regions involved in conflict monitoring and cognitive control, especially those localized within the frontoparietal network, showed weaker connectivities among unsuccessful REs compared to their successful counterparts.These results underscore specific brain Rs differences between successful REs and unsuccessful REs in regions implicated in cognitive control and conflict monitoring.
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Dogbe W, Salazar-Ordóñez M, Gil JM. Disentangling the Drivers of Obesity: An Analytical Framework Based on Socioeconomic and Intrapersonal Factors. Front Nutr 2021; 8:585318. [PMID: 33791330 PMCID: PMC8006933 DOI: 10.3389/fnut.2021.585318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 02/08/2021] [Indexed: 11/21/2022] Open
Abstract
Obesity is increasing at exponential rates in developed economies despite the numerous policy interventions being implemented. The causes of obesity are multifactorial demanding a holistic review for targeted intervention. This study, therefore, provides a holistic overview of multiple factors affecting body weights i.e., socioeconomic and intrapersonal factors. We used data from a household and experimental survey carried out in Spain (Barcelona) in 2014. A non-linear path analysis was used considering the non-linear relationships that might exist between these factors and body weight. Results confirm non-linear relationships between some socioeconomic, intrapersonal factors and body weight. Among the intrapersonal factors, obesity is directly influenced by volitional control of obesity, attitude toward obese persons, holding a correct body image and body image dissatisfaction. Socioeconomic factors that have significant influence on obesity were age, education and gender. Risk attitudes do not correlate with obesity.
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Affiliation(s)
- Wisdom Dogbe
- Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Melania Salazar-Ordóñez
- Universidad de Córdoba, WEARE-Water, Environmental and Agricultural Resources Economics, Córdoba, Spain
| | - Jose M Gil
- Center for Agro-Food Economics and Development (CREDA-UPC-IRTA), University Polytechnic of Catalonia, Barcelona, Spain
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Ellis JM, Essayli JH, Zickgraf HF, Rossi J, Hlavka R, Carels RA, Whited MC. Comparing stigmatizing attitudes toward anorexia nervosa, binge-eating disorder, avoidant-restrictive food intake disorder, and subthreshold eating behaviors in college students. Eat Behav 2020; 39:101443. [PMID: 33142129 DOI: 10.1016/j.eatbeh.2020.101443] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 09/20/2020] [Accepted: 10/07/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The relative stigmatization of various eating disorders (ED) remains understudied, and there is no research examining stigma toward avoidant-restrictive food intake disorder (ARFID) or adult picky eating. The present study examined the relative stigmatization of various EDs and the subthreshold eating behaviors that are risk factors for their development, and the relation of gender differences to stigma. METHOD A sample of 1147 college students was recruited and completed the study online. Participants were randomized and presented with a vignette representing a clinical ED [anorexia nervosa (AN), binge-eating disorder (BED), ARFID] or a subthreshold eating presentation (restrained eating, emotional eating, picky eating). Participants completed measures of stigma and perceived psychopathology. A 6 (target eating behavior) × 2 (target gender) × 2 (participant gender) MANOVA and subsequent ANOVAs were employed. RESULTS Measures of stigma revealed significant main effects for eating presentation and participant gender. There were also significant interactions between eating presentation and participant gender. Men reported more stigmatizing views toward BED and AN compared to women. Overall, restraint was stigmatized less than the other targets, and AN received the greatest amount of stigma. Participants rated BED and AN as more pathological than all other targets, emotional eating and ARFID as more pathological than picky eating and restrained eating, and restrained eating as less pathological than all other targets. CONCLUSIONS Future research should explore how the severity of eating behavior influences perceptions and at what level behaviors such as restriction are recognized as disordered.
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Affiliation(s)
- Jordan M Ellis
- Department of Psychology, East Carolina University, United States of America; Wilford Hall Ambulatory Medical Center, Joint Base San Antonio - Lackland, United States of America.
| | - Jamal H Essayli
- Department of Pediatrics and Psychiatry & Behavioral Health, Penn State College of Medicine, United States of America
| | - Hana F Zickgraf
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, United States of America
| | - James Rossi
- Department of Psychology, East Carolina University, United States of America
| | - Reid Hlavka
- Department of Psychology, East Carolina University, United States of America
| | - Robert A Carels
- Department of Psychology, East Carolina University, United States of America
| | - Matt C Whited
- Department of Psychology, East Carolina University, United States of America
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27
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Stinson EJ, Piaggi P, Votruba SB, Venti C, Lovato‐Morales B, Engel S, Krakoff J, Gluck ME. Is Dietary Nonadherence Unique to Obesity and Weight Loss? Results From a Randomized Clinical Trial. Obesity (Silver Spring) 2020; 28:2020-2027. [PMID: 32808484 PMCID: PMC7644624 DOI: 10.1002/oby.23008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/07/2020] [Accepted: 08/12/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Weight stigma is associated with poor dietary adherence, yet adherence is essential for weight loss and maintenance. This study aimed to determine differences in dietary adherence and perceived hunger between lean individuals and two groups of individuals with obesity. METHODS In a 6-week outpatient dietary intervention (23 males; aged 48 [SD 14] years), lean participants (n = 23; BMI 23 [SD 2] kg/m2 ) received a weight-maintaining energy needs (WMEN) diet, and participants with obesity (BMI 36 [SD 7]) were randomized to either WMEN (n = 18) or a 35% calorie-reduced (CR) diet (n = 19). All food was provided, and multiple adherence and hunger ratings were assessed daily and weekly on an outpatient basis and in person at twice-weekly visits (e.g., 24-hour recall, diaries). RESULTS Weight decreased more in the group of CR individuals with obesity (β = -0.301 kg/wk, P = 0.02) compared with the group of lean individuals and the group of WMEN individuals with obesity. However, total percent adherence did not differ between groups (P = 0.60), and hunger scores did not change across groups over time (P = 0.08). CONCLUSIONS Results indicate that there are no differences in dietary adherence between lean individuals and individuals with obesity and adherence is not associated with adiposity or hunger. Thus, the belief that nonadherence (e.g., lack of willpower) is unique to obesity is untrue and may perpetuate weight bias and stigma.
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Affiliation(s)
- Emma J. Stinson
- Obesity and Diabetes Clinical Research SectionNational Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthPhoenixArizonaUSA
| | - Paolo Piaggi
- Obesity and Diabetes Clinical Research SectionNational Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthPhoenixArizonaUSA
| | - Susanne B. Votruba
- Obesity and Diabetes Clinical Research SectionNational Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthPhoenixArizonaUSA
| | - Colleen Venti
- Obesity and Diabetes Clinical Research SectionNational Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthPhoenixArizonaUSA
| | - Barbara Lovato‐Morales
- Obesity and Diabetes Clinical Research SectionNational Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthPhoenixArizonaUSA
| | | | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research SectionNational Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthPhoenixArizonaUSA
| | - Marci E. Gluck
- Obesity and Diabetes Clinical Research SectionNational Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthPhoenixArizonaUSA
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28
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Body Image Relates to Exercise-Induced Antinociception and Mood Changes in Young Adults: A Randomized Longitudinal Exercise Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186801. [PMID: 32961848 PMCID: PMC7558618 DOI: 10.3390/ijerph17186801] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/10/2020] [Accepted: 09/16/2020] [Indexed: 02/05/2023]
Abstract
Background: An important motivation for adolescents and young adults to engage in aerobic exercise (AE) is to improve fitness, body composition and physical appearance. These parameters have an impact on bodily perception as conceptualized by the 'body image' (BI) construct. AE is known to have positive effects on pain perception, mood, and body image (BI). However, no study has hitherto investigated their interrelationship within one study. Methods: Participants were randomly assigned to an intervention group (IG, n = 16, 6 months of AE) or a passive control group (CG, n = 10). Frankfurt Body-Concept Scales (FKKS), Positive and Negative Affect Scale (PANAS), State and Trait Anxiety Inventory, warmth and heat pain thresholds (WPT, HPT), pain tolerance, and graded exercise test data from baseline (T0) and the end of the intervention (T6) were analyzed using a paired t-test (p < 0.05). Results: A significant increase in the BI dimension 'physical efficacy' was identified from T0 to T6, which correlated positively with PANAS Positive Affect Scale and HPT. Conclusion: Data in young adults undergoing AE indicate that changes in the BI sub-category 'physical efficacy' are closely linked with changes in positive affect and antinociception. These novel findings suggest that BI plays a role in antinociception and positive affect.
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29
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Severe Metabolic Acidosis: A Case of Triple Hit with Ketogenic Diet, Vinegar, and Metformin in an Obese Patient. Case Rep Nephrol 2020; 2020:8861978. [PMID: 33014485 PMCID: PMC7512078 DOI: 10.1155/2020/8861978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 08/30/2020] [Accepted: 09/08/2020] [Indexed: 11/23/2022] Open
Abstract
Obesity is an epidemic with high burden of disease. It is directly proportional to increased risk of morbidity and mortality. Ketogenic diet and herbal supplements have recently gained popularity amongst patients struggling with weight loss. There are limited data available for most of these supplements contrary to the claims laid by the mainstream media. Due to lack of awareness, this patient population is at high risk of adverse effects. We present a case of severe acidosis secondary to ketogenic diet and acetic acid (vinegar) ingestion. The use of dietary acetic acid is usually well tolerated; however, in this case, the large quantities and presence of acute renal injury and metformin use may have worsened the acidosis. Severe ketosis in setting of ketogenic diets is a serious complication, which is infrequently reported in literature. Many of these diets and supplements may seem harmless, but as our case illustrates, when combined with other risk factors, patients can face serious adverse effects and even require hospitalization. It is imperative that such dietary practices are physician supervised to avoid complications. With the recent surge of over-the-counter weight loss supplements and ketogenic diets, physicians also need to engage in dietary discussion with patients when attempting to lose weight.
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30
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Dedrick A, Merten JW, Adams T, Wheeler M, Kassie T, King JL. A Content Analysis of Pinterest Belly Fat Loss Exercises: Unrealistic Expectations and Misinformation. AMERICAN JOURNAL OF HEALTH EDUCATION 2020. [DOI: 10.1080/19325037.2020.1795754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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31
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Clark CC, Chambers A, Fernandes JF, Musalek M, Podstawski R, Eyre EL, Duncan M. Individual vs. group-based strategies for weight loss and management in adults: Pen profile perceptions. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.obmed.2020.100225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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32
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Carr KD. Homeostatic regulation of reward via synaptic insertion of calcium-permeable AMPA receptors in nucleus accumbens. Physiol Behav 2020; 219:112850. [PMID: 32092445 PMCID: PMC7108974 DOI: 10.1016/j.physbeh.2020.112850] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/23/2020] [Accepted: 02/18/2020] [Indexed: 10/25/2022]
Abstract
The incentive effects of food and related cues are determined by stimulus properties and the internal state of the organism. Enhanced hedonic reactivity and incentive motivation in energy deficient subjects have been demonstrated in animal models and humans. Defining the neurobiological underpinnings of these state-based modulatory effects could illuminate fundamental mechanisms of adaptive behavior, as well as provide insight into maladaptive consequences of weight loss dieting and the relationship between disturbed eating behavior and substance abuse. This article summarizes research of our laboratory aimed at identifying neuroadaptations induced by chronic food restriction (FR) that increase the reward magnitude of drugs and associated cues. The main findings are that FR decreases basal dopamine (DA) transmission, upregulates signaling downstream of the D1 DA receptor (D1R), and triggers synaptic incorporation of calcium-permeable AMPA receptors (CP-AMPARs) in the nucleus accumbens (NAc). Selective antagonism of CP-AMPARs decreases excitatory postsynaptic currents in NAc medium spiny neurons of FR rats and blocks the enhanced rewarding effects of d-amphetamine and a D1R, but not a D2R, agonist. These results suggest that FR drives CP-AMPARs into the synaptic membrane of D1R-expressing MSNs, possibly as a homeostatic response to reward loss. FR subjects also display diminished aversion for contexts associated with LiCl treatment and centrally infused cocaine. An encompassing, though speculative, hypothesis is that NAc synaptic incorporation of CP-AMPARs in response to food scarcity and other forms of sustained reward loss adaptively increases incentive effects of reward stimuli and, at the same time, diminishes responsiveness to aversive stimuli that have potential to interfere with goal pursuit.
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Affiliation(s)
- Kenneth D Carr
- Departments of Psychiatry and Biochemistry and Molecular Pharmacology, New York University School of Medicine, 435 East 30th Street, New York, NY 10016, United States.
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33
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Heo M, Wylie-Rosett J. Being obese versus trying to lose weight: Relationship with physical inactivity and soda drinking among high school students. THE JOURNAL OF SCHOOL HEALTH 2020; 90:301-305. [PMID: 32020630 PMCID: PMC7413307 DOI: 10.1111/josh.12879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 02/14/2019] [Accepted: 05/10/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Among adolescents, physical inactivity and unhealthy dietary habits are associated with being obese. We know little about how those are associated with trying to lose weight. METHODS We analyzed the 2013 Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Surveillance data (N = 13,583) to examine how obesity and trying to lose weight are associated with: (1) <5 physically active days per week with ≥60 minutes physical activity; (2) playing with video computer games ≥3 hours per day on average; (3) no participation in any sports team in the past year; and (4) drinking soda ≥2 times per day. We applied survey logistic regression adjusting for age and Hispanic ethnicity, stratified by sex. RESULTS Both being obese (13.7%) and trying to lose weight (47.7%) are significantly associated with physical inactivity. Soda drinking was associated with being obese (odds ratio [OR] = 1.34, p = .003 for boys and OR = 1.36, p = .014 for girls); it was inversely associated trying to lose weight among girls (OR = 0.72, p < .001) but not among boys (OR = 1.13, p = .174). CONCLUSION Obesity was associated with physical inactivity and drinking soda in both sexes. Only girls appeared to avoid drinking soda as a strategy for losing weight. Trying to lose weight was associated with a higher likelihood of physically inactive behaviors both sexes. High schools need to develop collaborative strategies for reducing adolescent obesity and supporting students who are trying to lose weight that address physical inactivity and soda intake.
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Affiliation(s)
- Moonseong Heo
- Department of Public Health Sciences, Clemson University, 605 Grove Road Suite 205, Greenville, SC, 29605
| | - Judith Wylie-Rosett
- Division Head for Health Promotion and Nutrition Research, Department of Epidemiology and Population Health, 1307 Belfer Building, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461
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34
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Han L, You D, Zeng F, Feng X, Astell-Burt T, Duan S, Qi L. Trends in Self-perceived Weight Status, Weight Loss Attempts, and Weight Loss Strategies Among Adults in the United States, 1999-2016. JAMA Netw Open 2019; 2:e1915219. [PMID: 31722029 PMCID: PMC6902793 DOI: 10.1001/jamanetworkopen.2019.15219] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
IMPORTANCE The self-perception of weight and weight loss attempts might promote weight loss and maintenance. OBJECTIVE To examine trends in current measured body mass index (BMI) and weight, self-reported weight, self-perceived weight status, weight loss attempts, and weight loss strategies among adults in the United States. DESIGN, SETTING, AND PARTICIPANTS This national cross-sectional study used data from continuous National Health and Nutrition Examination Survey (NHANES) data sets (1999-2000 to 2015-2016). Participants were US residents older than 20 years. Data were analyzed from January 2018 to December 2018. MAIN OUTCOMES AND MEASURES Current measured BMI and weight, self-reported weight, self-perceived weight status, weight loss attempts, and applied weight loss strategies. Adjusted, self-reported, prior-year weight was calculated using correction equations that considered age, sex, race/ethnicity, and quartile of self-reported prior-year weight. RESULTS Data were collected from 48 026 participants (19 792 [41.2%] aged 40-64 years; 24 255 [50.5%] women; 21 725 [45.2%] white) through 9 surveys from 1999-2000 to 2015-2016. Increasing trends were observed in current measured BMI (difference, 1.20; 95% CI, 0.92-1.47; P for trend < .001), current measured weight (difference 2.77 kg; 95% CI, 1.92-3.61 kg; P for trend < .001), adjusted, self-reported, prior-year weight (difference, 2.36 kg; 95% CI, 1.52-3.21 kg; P for trend < .001), and the difference between measured and adjusted self-reported weight (difference 0.70 kg; 95% CI, 0.34-1.07 kg; P for trend < .001). During this period, the proportion of overall participants who had attempted to lose weight increased from 34.3% to 42.2% (difference, 8.0%; 95% CI, 4.1%-10.5%; P for trend < .001). The most commonly reported weight loss strategies with the most rapidly increasing prevalence during the study period were reduced food consumption (21.2%-31.9%; difference, 11.1%; 95% CI, 8.2%-13.3%; P for trend < .001), exercise (18.2%-31.5%; difference, 14.4%; 95% CI, 11.3%-16.9%; P for trend < .001), and frequent water intake (0.2%-26.3%; difference, 26.2%; 95% CI, 24.1%-29.0%; P for trend < .001). Between 2005-2006 and 2015-2016, increases were also observed for the reported consumption of more fruits, vegetables, and salads (0.1%-29.4%; difference, 30.3%; 95% CI, 28.1%-31.2%; P for trend < .001), changing eating habits (0.3%-20.5%; difference, 20.2%; 95% CI, 19.1%-22.3%; P for trend < .001), and the consumption of less sugar, candy, and sweets (0.2%-20.9%; difference, 21.7%; 95% CI, 19.3%-22.6%; P for trend < .001). CONCLUSIONS AND RELEVANCE In this cross-sectional study, our data indicated an increasing trend in the proportion of participants who attempted to lose weight and a parallel increasing trend in current measured BMI and weight among adults in the United States.
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Affiliation(s)
- Liyuan Han
- School of Medicine, Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, Ningbo University, Ningbo, Zhejiang Province, China
- School of Public Health and Tropical Medicine, Department of Epidemiology, Tulane University, New Orleans, Louisiana
| | - Dingyun You
- School of Public Health, Kunming Medical University, Kunming City, Yunnan Province, China
| | - Fangfang Zeng
- School of Medicine, Department of Epidemiology, Jinan University, Guangzhou, Guangdong Province, China
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab, School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- Menzies Centre for Health Policy, University of Sydney, Sydney, New South Wales, Australia
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab, School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- Menzies Centre for Health Policy, University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, Peking Union Medical College, The Chinese Academy of Medical Sciences, Beijing, China
| | - Shiwei Duan
- School of Medicine, Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, Ningbo University, Ningbo, Zhejiang Province, China
| | - Lu Qi
- School of Public Health and Tropical Medicine, Department of Epidemiology, Tulane University, New Orleans, Louisiana
- Clinical and Translational Epidemiology Unit, Division of Gastroenterology, Massachusetts General Hospital, Boston
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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Gastil J, Marriott R. How Communicating Misleading Information Dilutes Public Understanding of Weight Loss Mechanisms. HEALTH COMMUNICATION 2019; 34:1524-1532. [PMID: 30095286 DOI: 10.1080/10410236.2018.1504656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The biomedical literature describes clearly the direct mechanisms influencing weight gain, but broader public discourse on the subject is rife with misleading claims about the factors that cause people to gain or lose weight. We examine how such misleading claims can dilute accurate information to the point that people arrive at poor judgments about the direct causes of weight gain. We adapt the conventional experimental paradigm used in dilution research (Nisbett, Zukier, & Lemley, 1981) to measure the effect of different information levels of dilution. We use a pair of online survey experiments to distinguish the effects of receiving distractingly plausible information versus raw information overload. These experiments also probe the limits of the dilution effect by using a large national sample of participants who vary by their health information efficacy and other potential moderators. Results suggest that public confusion about weight loss may stem from a dilution effect, which remains constant across a wide range of subgroups one might otherwise expect to resist it.
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Affiliation(s)
- John Gastil
- Department of Communication Arts & Sciences, Pennsylvania State University
| | - Robert Marriott
- Department of Communication Arts & Sciences, Pennsylvania State University
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36
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Giudici KV, Baudry J, Méjean C, Lairon D, Bénard M, Hercberg S, Bellisle F, Kesse-Guyot E, Péneau S. Cognitive Restraint and History of Dieting Are Negatively Associated with Organic Food Consumption in a Large Population-Based Sample of Organic Food Consumers. Nutrients 2019; 11:E2468. [PMID: 31618887 PMCID: PMC6836016 DOI: 10.3390/nu11102468] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/07/2019] [Accepted: 10/09/2019] [Indexed: 01/06/2023] Open
Abstract
Organic food consumption has risen in many countries during the past decades, but individual motives leading to these choices remain unclear. This study aimed to evaluate the associations between cognitive restraint (CR), history of dieting and organic food intake. This cross-sectional analysis included 20,085 organic food consumers from the NutriNet-Santé cohort. CR (range score 1-4) was evaluated by the Three-Factor-Eating-Questionnaire and practice of dieting (never vs. past/current) was assessed by an ad hoc questionnaire. Frequencies of organic food intake overall and in 16 food groups were assessed by the Organic Food Frequency Questionnaire. Linear regression and analysis of covariance (ANCOVA) were performed to investigate the association between CR score, history of dieting and contribution of organic food intake to the total food intake. A lower overall contribution of organic options in the diet was observed in women with higher levels of CR (β = -3.61%, 95% CI: -4.32; -2.91 for 1 point of CR, p < 0.001) and with a history of dieting (31.1 ± 0.4% in past/current vs. 32.6 ± 0.3% in never dieters; p = 0.001). Consistent associations were observed in men with a history of dieting (26.4 ± 0.8% in past/current vs. 28.7 ± 0.4% in never dieters; p = 0.012). Overall, individuals-in particular women-with higher CR scores or with a history of dieting selected fewer organic food options. Our findings illustrate the complexity of potentially concurrent motives to food choices, in a context of increasing interest in organic food consumption.
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Affiliation(s)
- Kelly Virecoulon Giudici
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Julia Baudry
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Caroline Méjean
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
- INRA, UMR 1110, Marchés, organisations, institutions et stratégies d'acteurs (MOISA), F-34000 Montpellier, France.
| | - Denis Lairon
- Nutrition, obésité et risque thrombotique (NORT), Inserm, UMR S 1062, Aix Marseille Université, INRA 1260, F-13385 Marseille, France.
| | - Marc Bénard
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Serge Hercberg
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
- Santé Publique France, Unité de Surveillance et d'Épidémiologie Nutritionnelle (USEN), Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
- Département de Santé Publique, Hôpital Avicenne, F-93000 Bobigny, France.
| | - France Bellisle
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Emmanuelle Kesse-Guyot
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Sandrine Péneau
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologies et Biostatistiques, Inserm (U1153), INRA, CNAM, Université Paris 13, Sorbonne Paris Cité, F-93017 Bobigny, France.
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Masterson TD, Brand J, Lowe MR, Metcalf SA, Eisenberg IW, Emond JA, Gilbert-Diamond D, Marsch LA. Relationships Among Dietary Cognitive Restraint, Food Preferences, and Reaction Times. Front Psychol 2019; 10:2256. [PMID: 31649589 PMCID: PMC6794363 DOI: 10.3389/fpsyg.2019.02256] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 09/20/2019] [Indexed: 11/13/2022] Open
Abstract
Objective To assess the associations between dietary cognitive restraint, disinhibited eating, and how taste and health perceptions relate to food preference; and further, whether cognitive restraint and disinhibited eating are associated with food preference decision reaction time. Methods Five hundred and seventeen adults participated in the study. Dietary cognitive restraint and disinhibited eating were assessed using the shortened Three-Factor Eating Questionnaire (TFEQ-R18). Participants also completed a dietary decision-making task to examine their food-related decisions. Participants were presented with 50 food items and asked to rate them for health and for taste. Participants were then presented with a reference food item and comparison items one at a time and asked to indicate which of the two foods they would prefer to eat. Results Participants with higher levels of cognitive restraint were more sensitive to health perceptions whereas those with higher levels of disinhibited eating were more sensitive to taste perceptions when indicating food preference. Reaction time analysis corroborated these results. Being classified as high for cognitive restraint was associated with faster reaction times if the preferred food was rated as healthier than the referent food. Conversely, being classified as high for disinhibited eating was associated with faster reaction times if the preferred food was rated as tastier than the referent food. Conclusion The dietary decision-making task appears to capture distinct aspects of dietary restraint and disinhibition and may be useful in future studies to measure and/or alter levels of dietary restraint and disinhibition.
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Affiliation(s)
- Travis D Masterson
- Norris Cotton Cancer Center, Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States
| | - John Brand
- Norris Cotton Cancer Center, Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States
| | - Michael R Lowe
- Department of Psychology, Drexel University, Philadelphia, PA, United States
| | - Stephen A Metcalf
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
| | - Ian W Eisenberg
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Jennifer A Emond
- Department of Biomedical Data Sciences, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
| | - Diane Gilbert-Diamond
- Norris Cotton Cancer Center, Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
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“I will fast … tomorrow”: Intentions to restrict eating and actual restriction in daily life and their person-level predictors. Appetite 2019; 140:10-18. [DOI: 10.1016/j.appet.2019.04.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/01/2019] [Accepted: 04/26/2019] [Indexed: 12/25/2022]
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Liang B, Wang Y, Tsou MH. A "fitness" Theme May Mitigate Regional Prevalence of Overweight and Obesity: Evidence from Google Search and Tweets. JOURNAL OF HEALTH COMMUNICATION 2019; 24:683-692. [PMID: 31469057 DOI: 10.1080/10810730.2019.1657526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Taking ecological perspectives to overweight and obesity, the current study applies data mining approach to examine the association between information and social environments and regional prevalence of overweight and obesity. In particular, we focus on online search and social media data since the increasing popularity of location-based geo-targeting could be an influential source of regional differences in health information and social environment. In Study 1, we calculated the correlation between regional overweight and obesity rates with regional Google searches for a time period of 12 years (2004 to 2016). The findings showed that in regions with high overweight and obesity rates, people were looking for and obtaining information on weight-loss and diet;, but in regions with low overweight and obesity rates, people were looking for and obtaining information on fitness services and facilities. In Study 2, we analyzed and compared 4010 tweets from Houston, a city with a high overweight and obesity rate, and 3281 tweets from San Diego, a city with a low overweight and obesity rate. The tweets were collected from August 2015 to August of 2016. We analyzed the textual content of tweets by word frequency analysis and topic modeling. The findings suggest that San Diego has a social environment that focuses on fitness and combining exercising with dieting. In contrast, Houston's social environment emphasizes dieting. The implication of these findings is that health practitioners should push a paradigm shift to a stronger focus on "healthy life" (combining exercising and dieting) in regions with high overweight and obesity rates.
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Affiliation(s)
- Bo Liang
- Department of Business, Saint Vincent College, Latrobe, PA, USA
| | - Ye Wang
- Department of Communication Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Ming-Hsiang Tsou
- Department of Geography, San Diego State University, San Diego, CA, USA
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Sares-Jäske L, Knekt P, Männistö S, Lindfors O, Heliövaara M. Self-Report Dieters: Who Are They? Nutrients 2019; 11:nu11081789. [PMID: 31382439 PMCID: PMC6723801 DOI: 10.3390/nu11081789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 12/31/2022] Open
Abstract
Dieting attempts have become popular worldwide. Dieting, however, seems to have both positive and negative health-related consequences. So far, only a few studies have focused on the determinants of dieting in detail. This study explores the association between self-report dieting attempts and intentional weight loss (IWL) during the previous year and several demographic, lifestyle, health, and psychological factors in a cross-sectional study design using data from the representative Finnish Health 2000 Survey. The sample comprised 2147 men and 2378 women, aged 30–69. Information for potential determinants was assembled via health examinations, interviews, and questionnaires. Approximately 24% of the men and 39% of the women reported dieting attempts and 10% of the men and 15% of the women reported IWL. Dieting attempts were associated with younger age, education, BMI, formerly smoking, more favourable values in lifestyle variables, and unfavorable values in serum HDL and triglycerides, a worse sense of coherence, concerns about one’s appearance, and concerns about one’s health. Among men, diabetics and those sleeping ≤6 h a night more frequently reported dieting attempts and those with osteoarthritis reported IWL. Moreover, the gradient between BMI and dieting attempts was significantly stronger in men than in women. Men seem to attempt dieting when they have actual health-related reasons, while such reasons are not so strongly associated with dieting in women. These findings can be used for determining subpopulations with obesity and real weight-loss needs and, alternatively, subpopulations with normal weight unnecessarily attempting dieting.
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Affiliation(s)
- Laura Sares-Jäske
- Department of Public Health Solutions, National Institute for Health and Welfare, 00271 Helsinki, Finland.
- Department of Public Health, University of Helsinki, 00014 Helsinki, Finland.
| | - Paul Knekt
- Department of Public Health Solutions, National Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Satu Männistö
- Department of Public Health Solutions, National Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Olavi Lindfors
- Department of Public Health Solutions, National Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Markku Heliövaara
- Department of Public Health Solutions, National Institute for Health and Welfare, 00271 Helsinki, Finland
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Sarfan LD, Clerkin EM, Teachman BA, Smith AR. Do thoughts about dieting matter? Testing the relationship between thoughts about dieting, body shape concerns, and state self-esteem. J Behav Ther Exp Psychiatry 2019; 62:7-14. [PMID: 30149204 DOI: 10.1016/j.jbtep.2018.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 08/14/2018] [Accepted: 08/19/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Dieters are likely primed to think about their diet throughout the day (e.g., as they feel hungry). However, prior research has not tested whether and how thinking about dieting might have negative effects, like poor self-esteem and body shape concerns. METHODS We experimentally primed dieters' thoughts about their diets and tested whether: 1) dieting thoughts are related to poor state self-esteem through body shape concerns; and 2) dieting thoughts are related to body shape concerns through poor state self-esteem. Dieting participants (N = 225) were randomly assigned to complete a dieting or neutral prime. RESULTS Unexpectedly, there was a different pattern of results across male (n = 72) and female (n = 144) dieters. When accounting for body shape concerns, males primed to think about dieting (vs. neutral condition) reported greater state self-esteem. Further, the dieting prime indirectly led to lower body shape concerns through greater state global self-esteem. However, for females, the dieting prime indirectly led to poorer state self-esteem through its effects on body shape concerns. LIMITATIONS The sample was collected online and was predominantly female and Caucasian. Other limitations include self-report of dieting status and body mass index. CONCLUSIONS The findings suggest that for males, thoughts about dieting may actually be associated with greater state self-esteem, which may indirectly predict lower body shape concerns. In contrast, for females, when thoughts about dieting activate body shape concerns, poorer state self-esteem may follow. These results highlight important, potentially gender-specific relationships between thoughts about dieting, body shape concerns, and state self-esteem.
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Affiliation(s)
- Laurel D Sarfan
- Department of Psychology, Miami University, 90 N. Patterson Ave, Oxford, OH, 45224, USA.
| | - Elise M Clerkin
- Department of Psychology, Miami University, 90 N. Patterson Ave, Oxford, OH, 45224, USA
| | - Bethany A Teachman
- Department of Psychology, University of Virginia, 485 McCormick Road, Charlottesville, VA, 22903, USA
| | - April R Smith
- Department of Psychology, Miami University, 90 N. Patterson Ave, Oxford, OH, 45224, USA
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Alexander E, Tseng E, Durkin N, Jerome GJ, Dalcin A, Appel LJ, Clark JM, Gudzune KA. Long-term retention in an employer-based, commercial weight-loss programme. Clin Obes 2019; 9:e12284. [PMID: 30248246 DOI: 10.1111/cob.12284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/05/2018] [Accepted: 08/28/2018] [Indexed: 01/14/2023]
Abstract
The aim of this study is to examine factors associated with long-term retention in a commercial weight-loss programme. We conducted a retrospective analysis of an employer-based, commercial programme from 2013 to 2016. Our dependent variable was 'long-term retention', defined as continuously enrolled participants who actively engaged through coach calls at 6 and 12 months. Independent variables included baseline demographics, programme engagement and weight change. We conducted multivariate logistic regression analyses assessing for differences in long-term retention by several factors, adjusted for employer clustering. Overall, 68.3% were retained at 6% and 45.9% at 12 months. Greater number of coach calls and website logins during the first 3 months significantly increased the odds of long-term retention, while having chronic conditions significantly decreased the odds. Weight-loss success (≥5% loss at 6 months) was significantly associated with increased odds of retention (12-month: odds ratio [OR] 2.80, P < 0.001), while early weight-loss failure (≥0% weight change at 1 month) significantly decreased odds of retention (12-month: OR 0.66, P = 0.008). In an employer-based, commercial weight loss programme, greater early programme engagement was associated with long-term retention. Given these programmes' popularity and potential reach, our results could be used to develop and test strategies designed to improve retention in commercial weight-loss programmes.
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Affiliation(s)
- E Alexander
- Department of Health Policy and Management, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - E Tseng
- Division of General Internal Medicine, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - N Durkin
- The Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
| | - G J Jerome
- The Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
- Department of Kinesiology, Towson University, Towson, Maryland, USA
| | - A Dalcin
- Division of General Internal Medicine, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- The Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
| | - L J Appel
- Division of General Internal Medicine, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- The Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - J M Clark
- Division of General Internal Medicine, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- The Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - K A Gudzune
- Division of General Internal Medicine, Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- The Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA
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Chaitoff A, Swetlik C, Ituarte C, Pfoh E, Lee LL, Heinberg LJ, Rothberg MB. Associations Between Unhealthy Weight-Loss Strategies and Depressive Symptoms. Am J Prev Med 2019; 56:241-250. [PMID: 30661572 DOI: 10.1016/j.amepre.2018.09.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 09/03/2018] [Accepted: 09/04/2018] [Indexed: 12/29/2022]
Abstract
INTRODUCTION There appears to be a link between weight loss and improved mental health, but less is known about how using unhealthy weight-loss strategies impacts the odds of reporting depression. METHODS This study includes respondents from the National Health and Nutrition Examination Survey from 2005 to 2014 who attempted to lose weight over the past year. Analysis occurred in 2017. Multivariable logistic regression was used to describe associations between all weight-loss strategies, including those grouped as unhealthy (smoking, vomiting, laxatives, skipping meals, and using diet pills), and the adjusted odds of depression (Patient Health Questionnaire-9 score ≥10). The model was then stratified by BMI, sex, race, and antidepressant use to compare the effect of using at least one unhealthy weight-loss strategy and depression within certain populations. RESULTS The sample included 6,765 respondents (weighted n=59.2 million, 95% CI=55.5, 62.9 million). Of these respondents, 18.0% (n=1,270) reported using at least one unhealthy weight-loss strategy. In unadjusted analysis, unhealthy weight-loss strategies were generally associated with higher incidence and odds of reporting depression. In multivariable analysis, using at least one unhealthy weight-loss strategy was significantly associated with odds of reporting depression (AOR=1.47, 95% CI=1.14, 1.91, p<0.01). When the model was stratified, this effect was statistically significant among respondents with class I or II obsesity (AOR=2.20, 95% CI=1.56, 3.10, p<0.01); female respondents (AOR=1.46, 95% CI=1.06, 2.00, p=0.02); and respondents who did not use an antidepressant (AOR=1.57, 95% CI=1.14, 2.15, p=0.01). CONCLUSIONS Unhealthy weight-loss strategies are associated with increased odds of depression. This may inform screening practices and public health messaging.
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Affiliation(s)
- Alexander Chaitoff
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio.
| | - Carol Swetlik
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Catherine Ituarte
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Elizabeth Pfoh
- Center for Value-Based Care Research, Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Ling-Ling Lee
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Leslie J Heinberg
- Center for Behavioral Health, Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio
| | - Michael B Rothberg
- Center for Value-Based Care Research, Medicine Institute, Cleveland Clinic, Cleveland, Ohio
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Gatzemeier J, Price M, L Wilkinson L, Lee M. Understanding everyday strategies used to manage indulgent food consumption: A mixed-methods design. Appetite 2019; 136:70-79. [PMID: 30668967 DOI: 10.1016/j.appet.2019.01.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 11/30/2018] [Accepted: 01/09/2019] [Indexed: 12/22/2022]
Abstract
To maintain a healthy body weight or support weight loss efforts, dietary self-management must allow for the limitation of tempting high energy-dense foods. We were interested in people's implementation of day-to-day strategies in order to successfully manage their indulgent food and beverage consumption. Participants from the Swansea area, UK (N = 25; Mage = 37; 68% male) were divided into four focus groups. The average BMI was within the healthy range (23 kg/m2). Each group discussed the approaches that they used to manage their consumption of indulgent foods and drinks. Group discussions were then transcribed, thematically analysed and independently reviewed by a second researcher. In a follow-up phase, participants were asked to rate how often they used the identified strategies and to rate the perceived effectiveness of any that applied to them. The thematic analysis revealed four major themes: Exercise, Cognitive Strategies, Availability and Meal Formation. Variability in the frequency with which strategies were used and perceived as effective was evident. Notably, participants tended to use multiple strategies and even lean participants who did not identify themselves as 'dieters' none-the-less employed a variety of strategies to successfully manage their exposure to and consumption of tempting foods. The findings suggest that dietary advice could be improved by taking into account the strategies for managing indulgent food consumption that are frequently used by individuals, as well as those that are perceived as effective.
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Affiliation(s)
- Jennifer Gatzemeier
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, SA2 8PP, UK.
| | - Menna Price
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, SA2 8PP, UK.
| | - Laura L Wilkinson
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, SA2 8PP, UK.
| | - Michelle Lee
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, SA2 8PP, UK.
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Zickgraf HF, Ellis JM, Essayli JH. Disentangling orthorexia nervosa from healthy eating and other eating disorder symptoms: Relationships with clinical impairment, comorbidity, and self-reported food choices. Appetite 2018; 134:40-49. [PMID: 30543837 DOI: 10.1016/j.appet.2018.12.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 11/30/2018] [Accepted: 12/09/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Orthorexia nervosa (ON) is characterized by obsessions about eating healthily and rigid adherence to a perceived healthy diet. This study uses the Eating Habits Questionnaire to investigate the relationship of ON symptoms with self-reported food intake, eating-related impairment, obsessive compulsive disorder symptoms (OCD), gender, and BMI while controlling for other eating disordered symptoms. The aim of this study is to provide further evidence for the construct of ON as distinct from other forms of disordered eating. METHODS The sample consisted of 449 adults recruited on Amazon's Mechanical Turk. Self-reported symptoms of currently recognized eating disorders (anorexia and bulimia nervosa, AN/BN, avoidant/restrictive food intake disorder, ARFID) were statistically controlled in correlational analyses and MANCOVA exploring the relationship of ON domains to comorbidity, eating behavior, gender, and weight. RESULTS Confirmatory factor analysis supported a three-factor solution for the EHQ, with factors representing normative healthy eating behaviors ("behaviors"), positive feelings associated with healthy eating ("feelings"), and interference/problems from rigid healthy eating ("problems"). Overall ON symptoms were more strongly related to AN/BN than to ARFID. Of the subscales, only Problems was related to other eating disorder symptomatology. Controlling for other eating disorder symptoms, overall ON symptomatology was not related to clinical impairment from eating or OCD, although it was related to higher self-reported intake of fruits/vegetables and lower intake of discretionary foods. When other eating disordered symptoms and ON domains were statistically controlled, Problems was related to clinical eating impairment, OCD symptoms, and higher intake of both fruits/vegetables and discretionary foods. CONCLUSIONS The Problems scale of the EHQ appears to capture disordered eating symptomatology that is distinct from other eating disorders and from normative healthy eating behaviors, consistent with descriptions of ON.
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Affiliation(s)
- Hana F Zickgraf
- University of Chicago Pritzker School of Medicine, United States; Penn State College of Medicine, Penn State Health Milton S. Hershey Medical Center, United States.
| | | | - Jamal H Essayli
- Penn State College of Medicine, Penn State Health Milton S. Hershey Medical Center, United States
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Isacco L, Miles-Chan JL. Gender-specific considerations in physical activity, thermogenesis and fat oxidation: implications for obesity management. Obes Rev 2018; 19 Suppl 1:73-83. [PMID: 30511503 DOI: 10.1111/obr.12779] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/11/2018] [Indexed: 12/25/2022]
Abstract
With current 'one-size-fits-all' obesity prevention and management strategies proving largely ineffective, the focus has shifted towards a more tailored, individualized approach. However, investigation of the mechanisms underlying inter-individual variability in metabolic profile and response to intervention often yield conflicting results. Indeed, it is perhaps surprising that despite at least a century of recognition that sex hormones influence metabolism, firm conclusions regarding the effects of the menstrual cycle, hormonal contraception and menopause on many aspects of energy expenditure and substrate utilization remain to be drawn. In this review, we examine current evidence relating to gender-specific considerations in the promotion of physical activity, thermogenesis and fat oxidation for body-weight regulation, including the relationship between sex hormone status and non-exercise activity thermogenesis - an energy expenditure compartment that is often overlooked in favour of traditional exercise/sport physical activities yet presents a viable target in the search for effective weight management.
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Affiliation(s)
- L Isacco
- Research Unit EA3920 Prognostic Markers and Regulatory Factors of Cardiovascular Diseases and Exercise Performance Health Innovation Platform, University of Bourgogne Franche-Comté, Besançon, France
| | - J L Miles-Chan
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
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Alexander E, Tseng E, Durkin N, Jerome GJ, Dalcin A, Appel LJ, Clark JM, Gudzune KA. Factors associated with early dropout in an employer-based commercial weight-loss program. Obes Sci Pract 2018; 4:545-553. [PMID: 30574348 PMCID: PMC6298204 DOI: 10.1002/osp4.304] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/20/2018] [Accepted: 09/22/2018] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE Minimizing program dropout is essential for weight-loss success, but factors that influence dropout among commercial programs are unclear. This study's objective was to determine factors associated with early dropout in a commercial weight-loss program. METHODS A retrospective analysis of a remotely delivered, employer-based commercial program from 2013 to 2016 was conducted. The dependent variable was 'early dropout', defined as enrollees who disengaged from telephone coaching by month 2's end. Independent variables included demographics, program website engagement and early weight change. Multivariate logistic regression analyses were used to assess for differences in early dropout by several factors, adjusted for employer clustering. RESULTS Of the 5,274 participants, 26.8% dropped out early. Having ≥1 chronic condition (odds ratio [OR] 1.41, p < 0.001) and 'weight-loss failure' defined as ≥0% weight change at month 1's end (OR 1.86, p < 0.001) had significantly increased odds of early dropout. Increasing age by 10-year intervals (OR 0.90, p = 0.002) and 'meeting the website login goal' defined as ≥90 logins in 3 months (OR 0.13, p < 0.001) significantly decreased the odds of early dropout. CONCLUSIONS Presence of comorbidities, less online engagement and weight-loss failure were associated with early dropout in a commercial program. Strategies to prevent dropout among high-risk participants, such as increased support or program tailoring, should be developed and tested.
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Affiliation(s)
- E. Alexander
- Department of Health Policy and ManagementThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - E. Tseng
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins School of MedicineBaltimoreMDUSA
- The Welch Center for Prevention, Epidemiology, and Clinical ResearchBaltimoreMDUSA
| | - N. Durkin
- The Welch Center for Prevention, Epidemiology, and Clinical ResearchBaltimoreMDUSA
| | - G. J. Jerome
- The Welch Center for Prevention, Epidemiology, and Clinical ResearchBaltimoreMDUSA
- Department of KinesiologyTowson UniversityTowsonMDUSA
| | - A. Dalcin
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins School of MedicineBaltimoreMDUSA
- The Welch Center for Prevention, Epidemiology, and Clinical ResearchBaltimoreMDUSA
| | - L. J. Appel
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins School of MedicineBaltimoreMDUSA
- The Welch Center for Prevention, Epidemiology, and Clinical ResearchBaltimoreMDUSA
- Department of EpidemiologyThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - J. M. Clark
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins School of MedicineBaltimoreMDUSA
- The Welch Center for Prevention, Epidemiology, and Clinical ResearchBaltimoreMDUSA
- Department of EpidemiologyThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - K. A. Gudzune
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins School of MedicineBaltimoreMDUSA
- The Welch Center for Prevention, Epidemiology, and Clinical ResearchBaltimoreMDUSA
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Talepasand S, Golzari M. Attention Control in Presence of Food Cues in Restrained and Unrestrained Eaters. Noro Psikiyatr Ars 2018; 55:301-306. [PMID: 30622384 PMCID: PMC6300831 DOI: 10.5152/npa.2017.19323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 09/13/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION This research tries to study the relation between dietary restraint and attention control in females admitted to diet therapy clinics in Kerman County. METHODS Participants were all female subjects who had been admitted to diet therapy clinics in Kerman County. The sample size included 80 women between ages of 15 to 50 years. Participants were selected through convenience sampling. All participants were asked to fill out the Dutch Eating Behavior Questionnaire and respond to Stroop task software. RESULTS The restrained eaters' reaction time towards food stimuli was higher than that of unrestrained eaters. The reaction time in Stroop effect condition in restrained eaters was higher than that of unrestrained eaters. In restrained eaters, the reaction time in presence of food stimuli was higher than the condition in which non-food stimuli were presented. In presence of food stimuli, the reaction time in Stroop effect condition was higher than non-Stroop effect. Finally, it was determined that in non-Stroop conditions compared to Stroop conditions, strained eaters had a higher reaction time in presence of food stimuli than the condition in which non-food stimuli were presented. CONCLUSION These findings verify the role of attention bias in reaction to food stimuli in restrained eaters and they suggest that diet success relies on avoiding interactions related to food.
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Akehurst H, Pesantes MA, Cornejo SDP, Manrique K, Lazo-Porras M, Portocarrero J, Diez-Canseco F, Bernabe-Ortiz A, Trujillo AJ, Miranda JJ. A descriptive study of potential participant preferences for the design of an incentivised weight loss programme for people with type 2 diabetes mellitus attending a public hospital in Lima, Peru. Wellcome Open Res 2018; 3:53. [PMID: 30740534 PMCID: PMC6348435 DOI: 10.12688/wellcomeopenres.14552.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2018] [Indexed: 11/30/2022] Open
Abstract
Background: Weight loss is important for the control of type 2 diabetes mellitus but is difficult to achieve and sustain. Programmes employing financial incentives have been successful in areas such as smoking cessation. However, the optimum design for an incentivised programme for weight loss is undetermined, and may depend on social, cultural and demographic factors. Methods: An original questionnaire was designed whose items addressed respondent personal and health characteristics, and preferences for a hypothetical incentivised weight loss programme. One hundred people with type 2 diabetes mellitus were recruited to complete the questionnaire from the endocrinology clinic of a public hospital in Lima, Peru. A descriptive analysis of responses was performed. Results: Ninety-five percent of subjects who had previously attempted to lose weight had found this either 'difficult' or 'very difficult'. Eighty-five percent of subjects would participate in an incentivised weight loss programme. Median suggested incentive for 1 kg weight loss every 2 weeks over 9 months was PEN 100 (~USD $30). Cash was preferred by 70% as payment method. Only 56% of subjects would participate in a deposit-contract scheme, and the median suggested deposit amount was PEN 20 (~USD $6). Eighty percent of subjects would share the incentive with a helper, and family members were the most common choice of helper. Conclusions: The challenge of achieving and sustaining weight loss is confirmed in this setting. Direct cash payments of PEN 100 were generally preferred, with substantial scope for involving a co-participant with whom the incentive could be shared. Employing direct financial incentives in future weight loss programmes appears to be widely acceptable among people with type 2 diabetes mellitus.
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Affiliation(s)
- Harold Akehurst
- Great Western Hospitals NHS Trust, Swindon, UK
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - M. Amalia Pesantes
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Katty Manrique
- Department of Endocrinology, Hospital Nacional Arzobispo Loayza, Lima, Peru
| | - Maria Lazo-Porras
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- CONEVID Unidad de Conocimiento y Evidencia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jill Portocarrero
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Francisco Diez-Canseco
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Antonio J. Trujillo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - J. Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
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Kline CE, Burke LE, Sereika SM, Imes CC, Rockette-Wagner B, Mendez DD, Strollo PJ, Zheng Y, Rathbun SL, Chasens ER. Bidirectional Relationships Between Weight Change and Sleep Apnea in a Behavioral Weight Loss Intervention. Mayo Clin Proc 2018; 93:1290-1298. [PMID: 30082081 PMCID: PMC6129208 DOI: 10.1016/j.mayocp.2018.04.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/17/2018] [Accepted: 04/19/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To examine the bidirectional relationship between weight change and obstructive sleep apnea (OSA) in the context of a behavioral weight loss intervention. PATIENTS AND METHODS Adults who were overweight or obese (N=114) participated in a 12-month behavioral weight loss intervention from April 17, 2012, through February 9, 2015. The apnea-hypopnea index (AHI), a marker of the presence and severity of OSA, was assessed at baseline, 6 months, and 12 months. Linear mixed models evaluated the effect of weight change on the AHI and the effect of OSA (AHI ≥5) on subsequent weight loss. Secondary analyses evaluated the effect of OSA on intervention attendance, meeting daily calorie goals, and accelerometer-measured physical activity. RESULTS At baseline, 51.8% of the sample (n=59) had OSA. Adults who achieved at least 5% weight loss had an AHI reduction that was 2.1±0.9 (adjusted mean ± SE) events/h greater than those with less than 5% weight loss (P<.05). Adults with OSA lost a mean ± SE of 2.2%±0.9% less weight during the subsequent 6-month interval compared with those without OSA (P=.02). Those with OSA were less adherent to daily calorie goals (mean ± SE: 25.2%±3.3% vs 34.8%±3.4% of days; P=.006) and had a smaller increase in daily activity (mean ± SE: 378.3±353.7 vs 1060.1±377.8 steps/d; P<.05) over 12 months than those without OSA. CONCLUSION Behaviorally induced weight loss in overweight/obese adults was associated with significant AHI reduction. However, the presence of OSA was associated with blunted weight loss, potentially via reduced adherence to behaviors supporting weight loss. These results suggest that OSA screening before attempting weight loss may be helpful to identify who may benefit from additional behavioral counseling.
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Affiliation(s)
- Christopher E Kline
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA.
| | - Lora E Burke
- School of Nursin, University of Pittsburgh, Pittsburgh, PA; Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Susan M Sereika
- School of Nursin, University of Pittsburgh, Pittsburgh, PA; Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA; Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA
| | | | | | - Dara D Mendez
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Patrick J Strollo
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA; VA Pittsburgh Health System, Pittsburgh, PA
| | - Yaguang Zheng
- Connell School of Nursing, Boston College, Boston, MA
| | - Stephen L Rathbun
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA
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