1
|
Bays HE. Why does type 2 diabetes mellitus impair weight reduction in patients with obesity? A review. OBESITY PILLARS (ONLINE) 2023; 7:100076. [PMID: 37990681 PMCID: PMC10661899 DOI: 10.1016/j.obpill.2023.100076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 11/23/2023]
Abstract
Background A common adiposopathic complication of obesity is type 2 diabetes mellitus. Healthful weight reduction in patients with obesity can improve glucose metabolism and potentially promote remission of type 2 diabetes mellitus. However, weight-reduction in patients with increased adiposity is impaired among patients with type 2 diabetes mellitus compared to patients without diabetes mellitus. Methods Data for this review were derived from PubMed and applicable websites. Results Among patients with increased body fat, the mechanisms underlying impaired weight reduction for those with type 2 diabetes mellitus are multifactorial, and include energy conservation (i.e., improved glucose control and reduced glucosuria), hyperinsulinemia (commonly found in many patients with type 2 diabetes mellitus), potential use of obesogenic anti-diabetes medications, and contributions from multiple body systems. Other factors include increased age, sex, genetic/epigenetic predisposition, and obesogenic environments. Conclusions Even though type 2 diabetes mellitus impairs weight reduction among patients with increased adiposity, clinically meaningful weight reduction improves glucose metabolism and can sometimes promote diabetes remission. An illustrative approach to mitigate impaired weight reduction due to type 2 diabetes mellitus is choosing anti-diabetes medications that increase insulin sensitivity and promote weight loss and deprioritize use of anti-diabetes medications that increase insulin exposure and promote weight gain.
Collapse
Affiliation(s)
- Harold Edward Bays
- Diplomate of American Board of Medicine, Medical Director / President, Louisville Metabolic and Atherosclerosis Research Center, Clinical Associate Professor, University of Louisville School of Medicine, 3288 Illinois Avenue, Louisville, KY, 40213, USA
| |
Collapse
|
2
|
Paloma T, Claudia CR, Naise R, Patricia B, Clevio F, Marcel Q, Pedro B, Abelardo A, Adriana B. Evaluation of nutritional status and adherence to dietary monitoring among patients with human T-cell leukemia virus type 1 infection. Clin Nutr ESPEN 2022; 52:198-207. [PMID: 36513454 DOI: 10.1016/j.clnesp.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 08/26/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND & AIMS The nutritional status of people infected with Human T-Cell Leukemia Virus type 1 (HTLV-1) is rarely studied. Malnutrition affects the immune system, but the consequences of this remain unknown in HTLV-1 infection. This study aimed to analyze the nutritional status, food intake, and ability to adhere to dietary counseling in people with symptomatic HTLV-1 infection. METHODS This was a longitudinal, prospective, observational study in which the nutritional status of people with symptomatic HTLV-1 was monitored between June 2016 and August 2019 at a referral center. At the baseline (day 0) and last stage (day 90) anthropometric, bioimpedance, and dietary assessments were performed. RESULTS In total, 71 participants with symptomatic HTLV-1 infection were enrolled, the majority (43, 60.6%) of whom were female. The mean age was 59.2 (±11.1) years. Participants were often overweight or obese (40, 56.3%) had a BMI above 25 kg/m2. The average consumption of recommended fibers and liquids was positively associated with percent lean body mass (%LM). Most participants who were overweight (36.6%) or obese (19.70%) and their nutritional status and eating behavior did not change during the follow-up period. Dietary counseling was unable to promote a change in the monotony of the existing eating habits. Participants with good adherence to nutritional guidelines had higher dietary diversity scores. CONCLUSION A high proportion of participants were overweight or obese. Adherence to dietary counseling was low, and its success was limited in improving dietary diversity/nutritional status. Loss to follow-up was a limitation of this study.
Collapse
Affiliation(s)
- Torres Paloma
- Nutrition Service, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil.
| | - Cople-Rodrigues Claudia
- Nutrition Institute, State University of Rio de Janeiro, Rua São Francisco Xavier 524, 12th Floor, Rio de Janeiro, RJ 20550-900, Brazil
| | - Rocha Naise
- Nutrition Service, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Brito Patricia
- Nutrition Service, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Fonseca Clevio
- COVID-19 Hospital Center to Combat Pandemic, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Quintana Marcel
- Clinical Research Platform, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Brasil Pedro
- Research Laboratory on Immunization and Health Surveillance, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Araújo Abelardo
- Clinical Research Laboratory in Neuroinfections, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Bacelo Adriana
- Nutrition Service, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| |
Collapse
|
3
|
Calandra JM, Shofer FS, Chao AM, Swanson RL. Nutrition Education, Understanding, and Counseling Practices Among Physiatrists: A Survey Study. Cureus 2022; 14:e28756. [PMID: 36211094 PMCID: PMC9531699 DOI: 10.7759/cureus.28756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 11/05/2022] Open
|
4
|
Betts AC, Ochoa C, Hamilton R, Sikka S, Froehlich-Grobe K. Barriers and Facilitators to Lifestyle Intervention Engagement and Weight Loss in People Living With Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2021; 27:135-148. [PMID: 33814891 PMCID: PMC7983639 DOI: 10.46292/sci20-00025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Individuals living with spinal cord injury (SCI) have a high prevalence of obesity and unique barriers to healthy lifestyle. Objective: To examine barriers and facilitators to engagement and weight loss among SCI participants enrolled in the Group Lifestyle Balance Adapted for individuals with Impaired Mobility (GLB-AIM), a 12-month intensive lifestyle intervention. Methods: SCI participants (N = 31) enrolled in a wait-list, randomized controlled trial where all participants received intervention between August 2015 and February 2017. Analyses of pooled data occurred in 2020 to examine cross-sectional and prospective associations of hypothesized barriers and facilitators with (1) intervention engagement, comprised of attendance and self-monitoring, and (2) percent weight change from baseline to 12 months. We performed multivariable linear regression on variables associated with outcomes at p < .05 in bivariate analyses and controlled for intervention group. Results: Participants were middle-aged (mean age, 48.26 ± 11.01 years), equally male (50%) and female, White (80.7%), and unemployed (65.6%). In participants who completed baseline surveys (n = 30), dietary self-efficacy explained 26% of variance in engagement (p < .01); among the 12-month study completers (n = 22, 71.0%), relationship issues explained 23% of variance in engagement (p < .01). Money problems, health issues unrelated to SCI, lack of motivation, and experimental group explained 57% of variance in weight loss (p for model < .01), with lack of motivation uniquely explaining 24% of variance (p < .01). Conclusion: Improving engagement and weight loss for persons with SCI in the GLBAIM program may be achieved by addressing lack of motivation, relationship issues, and nutrition self-efficacy.
Collapse
Affiliation(s)
- Andrea C. Betts
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, Dallas, Texas
| | - Christa Ochoa
- Baylor Scott & White Institute for Rehabilitation, Dallas, Texas
| | - Rita Hamilton
- Baylor Scott & White Institute for Rehabilitation, Dallas, Texas
| | - Seema Sikka
- Baylor Scott & White Institute for Rehabilitation, Dallas, Texas
| | | |
Collapse
|
5
|
Collins RA, Baker B, Coyle DH, Rollo ME, Burrows TL. Dietary Assessment Methods in Military and Veteran Populations: A Scoping Review. Nutrients 2020; 12:E769. [PMID: 32183380 PMCID: PMC7146105 DOI: 10.3390/nu12030769] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/06/2020] [Accepted: 03/10/2020] [Indexed: 12/20/2022] Open
Abstract
Optimal dietary intake is important for the health and physical performance of military personnel. For military veterans, the complex nature of transition into civilian life and sub-optimal dietary intake is a leading contributor to the increased burden of disease. A scoping review was undertaken to determine what is known about the assessment and reporting of dietary intakes within both military and veteran populations. In addition, this review determines if studies reporting on the dietary intake of military personnel or veterans include comparisons with dietary guidelines. Six databases were searched to identify papers published from the database inception to April 2019. Observational and intervention studies were searched to identify if they assessed and reported whole dietary intake data, reported data exclusively for a military or veteran population, and included only healthy populations. A total of 89 studies were included. The majority of studies used one dietary assessment method (n = 76, 85%) with fewer using multiple methods (n = 13, 15%). The most frequent methodology used was food frequency questionnaires (FFQ) (n = 40, 45%) followed by 24-hour recalls (n = 8, 9%) and food records (n = 8, 9%). The main dietary outcomes reported were macronutrients: carbohydrate, protein, fat, and alcohol (n = 66, 74%) with total energy intake reported in n = 59 (66%). Fifty four (61%) studies reported a comparison with country-specific dietary guidelines and 14 (16%) reported a comparison with the country-specific military guidelines. In conclusion, dietary intake in military settings is most commonly assessed via FFQs and 24-hour recalls. Dietary intake reporting is mainly focused around intakes of energy and macronutrients. Most studies compare against dietary guidelines, however, comparison to specific military dietary guidelines is minimal.
Collapse
Affiliation(s)
- Rebecca A. Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia; (R.A.C.); (M.E.R.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia
| | - Bradley Baker
- Food and Nutrition, Land Division, Defence Science and Technology Group, Scottsdale 7260, Australia;
| | - Daisy H. Coyle
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia; (R.A.C.); (M.E.R.)
- The George Institute for Global Health, University of New South Wales, Sydney 2042, Australia
| | - Megan E. Rollo
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia; (R.A.C.); (M.E.R.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia
| | - Tracy L. Burrows
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia; (R.A.C.); (M.E.R.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia
| |
Collapse
|
6
|
Holla JFM, van den Akker LE, Dadema T, de Groot S, Tieland M, Weijs PJM, Deutekom M. Determinants of dietary behaviour in wheelchair users with spinal cord injury or lower limb amputation: Perspectives of rehabilitation professionals and wheelchair users. PLoS One 2020; 15:e0228465. [PMID: 32004359 PMCID: PMC6993975 DOI: 10.1371/journal.pone.0228465] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/16/2020] [Indexed: 02/06/2023] Open
Abstract
Objective This study aims to identify determinants of dietary behaviour in wheelchair users with spinal cord injury or lower limb amputation, from the perspectives of both wheelchair users and rehabilitation professionals. The findings should contribute to the field of health promotion programs for wheelchair users. Methods Five focus groups were held with wheelchair users (n = 25), and two with rehabilitation professionals (n = 11). A thematic approach was used for data analysis in which the determinants were categorized using an integrated International Classification of Functioning, Disability and Health and Attitude, Social influence and self-Efficacy model. Results Reported personal factors influencing dietary behaviour in wheelchair users were knowledge, boredom, fatigue, stage of life, habits, appetite, self-control, multiple lifestyle problems, intrinsic motivation, goal setting, monitoring, risk perception, positive experiences, suffering, action planning, health condition, function impairments, attitude and self-efficacy. Reported environmental factors influencing dietary behaviour in wheelchair users were unadjusted kitchens, monitoring difficulties, eating out, costs, unfavourable food supply, nutrition education/counselling, access to simple healthy recipes, eating together, cooking for others, and awareness and support of family and friends. Conclusions Important modifiable determinants of dietary behaviour in wheelchair users that might be influenced in lifestyle interventions are knowledge, fatigue, habits, self-control, intrinsic motivation, risk perception, attitude and self-efficacy. It is recommended to involve relatives, since they appear to significantly influence dietary behaviour.
Collapse
Affiliation(s)
- Jasmijn F. M. Holla
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, The Netherlands
- Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, The Netherlands
| | - Lizanne E. van den Akker
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, The Netherlands
| | - Tessa Dadema
- Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Sonja de Groot
- Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, The Netherlands
- University Medical Centre Groningen, Centre for Human Movement Sciences, University of Groningen, Groningen, The Netherlands
| | - Michael Tieland
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Peter J. M. Weijs
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Department of Nutrition and Dietetics, Amsterdam University Medical Centres, VU University, Amsterdam, The Netherlands
| | - Marije Deutekom
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, The Netherlands
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- * E-mail:
| | | |
Collapse
|
7
|
Littman AJ, Haselkorn JK, Arterburn DE, Boyko EJ. Pilot randomized trial of a telephone-delivered physical activity and weight management intervention for individuals with lower extremity amputation. Disabil Health J 2018; 12:43-50. [PMID: 30115584 DOI: 10.1016/j.dhjo.2018.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 06/27/2018] [Accepted: 08/02/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Obesity and inactivity are common and burdensome for people with lower extremity amputation (LEA). The extent to which home-based physical activity/weight management programs are effective and safe for people with LEA is unknown. Translating effective interventions for understudied disability groups is needed. OBJECTIVE To test the feasibility, acceptability, and safety of a weight management and physical activity intervention and obtain preliminary efficacy estimates for changes in weight, body composition, and physical functioning. METHODS Eligibility criteria included: LEA ≥1 year prior, 18-69 years of age, overweight or obese and living in the Seattle area. The intervention arm received self-monitoring tools (e.g., pedometer, scale) and written materials, a single exercise counseling home visit by a physical therapist, and up to 11 telephone calls from a health coach over 20 weeks that involved motivational interviewing to set specific, attainable, and measurable goals. The self-directed control group received the same tools and materials but no home visit or coaching calls. RESULTS Nineteen individuals consented to participate, 15 were randomized (mean age = 56, 73% male, 80% transtibial amputation) and 11 completed 20-week follow-up assessments. The intervention was acceptable and safe. Coached participants had greater decreases in waist circumference (mean difference between groups over 20 weeks, baseline values carried forward: -4.3 cm, 95% CI -8.2, -0.4, p = 0.03) and fat mass (-2.1 kg, 95% CI -3.8, -0.4, p = 0.02). CONCLUSIONS The home-based intervention was promising in terms of efficacy, safety and acceptability. Inclusion of multiple trial centers and increased use of technology may facilitate recruitment and retention.
Collapse
Affiliation(s)
- Alyson J Littman
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States; Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research and Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States; Department of Epidemiology, University of Washington, Seattle, WA, United States.
| | - Jodie K Haselkorn
- Department of Epidemiology, University of Washington, Seattle, WA, United States; Multiple Sclerosis Center of Excellence West, VA Puget Sound Health Care System, United States; Department of Rehabilitation, University of Washington, Seattle, WA, United States.
| | - David E Arterburn
- Kaiser Permanente Washington Research Institute, Kaiser Permanente Washington, Seattle, WA, United States; Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, United States.
| | - Edward J Boyko
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, United States; Department of Epidemiology, University of Washington, Seattle, WA, United States; Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, United States.
| |
Collapse
|