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Hosseinpour-Niazi S, Niknam M, Amiri P, Mirmiran P, Einy E, Izadi N, Gaeini Z, Azizi F. The association between ultra-processed food consumption and health-related quality of life differs across lifestyle and socioeconomic strata. BMC Public Health 2024; 24:1955. [PMID: 39039502 PMCID: PMC11265477 DOI: 10.1186/s12889-024-19351-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/03/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND In this prospective study, we aimed to examine the association between ultra-processed foods and health-related quality of life (HRQoL) and to evaluate the effect of lifestyle and socioeconomic factors on this association. METHODS This study included 1766 adults (aged 18 to 78, 54.3% women), who took part in the Tehran Lipid and Glucose study. The Short-Form 12-Item Health Survey version 2 was used to determine HRQoL, which includes the physical component summary (PCS) and mental component summary (MCS) scores. Ultra-processed food consumption was assessed using a validated semi-quantitative food frequency questionnaire. Lifestyle (physical activity and smoking status) and socioeconomic factors (education level and employment status) were also determined. General linear models (GLM) were applied to estimate the mean (95% confidence interval) for MCS and PCS scores across the ultra-processed foods tertiles. Additionally, the effect of lifestyle and socioeconomic factors on the relationship between ultra-processed foods and HRQoL was examined using GLM. RESULTS The median consumption of ultra-processed foods was 11.9% (IQR: 8.2 to 16.8) of total energy intake. There was a significant inverse association between ultra-processed foods consumption and PCS, but not MCS, after adjustment for confounding factors. Significant interactions were observed between ultra-processed food consumption, sex, and occupation on PCS score (all P values < 0.001). The interaction test tended to be significant for smoking status, education levels, and physical activity levels. As ultra-processed food consumption increased, the PCS score significantly decreased in women (P = 0.043), low physical active subjects (P = 0.014), smokers (P = 0.015), and lower-educated individuals (P = 0.022). Non-employed individuals with higher ultra-processed food intake showed a decline in their PCS and MCS scores. While there was no significant difference in MCS score among different strata of lifestyle and socioeconomic status across tertiles of ultra-processed foods. CONCLUSIONS Higher intake of ultra-processed foods was associated with poorer physical health, particularly among women, those with unhealthy lifestyles, and low socioeconomic conditions.
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Affiliation(s)
- Somayeh Hosseinpour-Niazi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran.
| | - Mahdieh Niknam
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran.
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elaheh Einy
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Neda Izadi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran
| | - Zahra Gaeini
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Grey E, Griffin T, Jolly K, Pallan M, Parretti H, Retzer A, Gillison F. Extended brief interventions for weight management and obesity prevention in children: A rapid evidence review. Obes Rev 2023; 24:e13633. [PMID: 37604189 DOI: 10.1111/obr.13633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 07/25/2023] [Accepted: 07/30/2023] [Indexed: 08/23/2023]
Abstract
Uptake of child weight management (CWM) support is typically low, and services are not available in all areas. Extended brief interventions (EBIs) have been proposed as an affordable way to provide enhanced support, at a level between one-off brief advice and intensive CWM programs. This rapid systematic review sought to synthesize evidence on the efficacy of EBIs for weight management and obesity prevention in children (2-18 years). Embase and Web of Science were searched from January 2012 to January 2022. Nineteen studies, reporting on 17 separate EBIs, were included. The quality of studies was variable, and the EBIs were heterogeneous. The majority of EBIs (n = 14) were based on motivational interviewing. Five of the included studies reported significant improvements in parent or child determinants of health behavior change. However, robust measures of behavioral determinants were rarely used. No studies reported significant positive effects on child weight. No clear patterns in outcomes were identified. There is currently insufficient evidence for EBIs to be adopted as part of CWM services. To improve the evidence base, EBIs that are currently being implemented by local health services, should be evaluated to establish the most effective content, how it should be delivered, and by whom.
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Affiliation(s)
- Elisabeth Grey
- NIHR Applied Research Collaboration West, Bristol Medical School, University of Bristol, Bristol, UK
- Department for Health, University of Bath, Bath, UK
| | | | - Kate Jolly
- Institute of Applied Health Research and NIHR Applied Research Collaboration West Midlands, University of Birmingham, Birmingham, UK
| | - Miranda Pallan
- Institute of Applied Health Research and NIHR Applied Research Collaboration West Midlands, University of Birmingham, Birmingham, UK
| | - Helen Parretti
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Ameeta Retzer
- Institute of Applied Health Research and NIHR Applied Research Collaboration West Midlands, University of Birmingham, Birmingham, UK
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Lutaud R, Mitilian E, Forte J, Gentile G, Reynaud R, Truffet C, Bellanger T. Motivational interviewing for the management of child and adolescent obesity: a systematic literature review. BJGP Open 2023; 7:BJGPO.2022.0145. [PMID: 37402547 PMCID: PMC11176675 DOI: 10.3399/bjgpo.2022.0145] [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: 10/03/2022] [Revised: 03/17/2023] [Accepted: 05/02/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Among children or adolescents with obesity, 40-70.5% will remain obese as adults according to their paediatric body mass index (BMI). The recommended management involves changes in their nutritional habits (diet, physical activity, and sedentary lifestyle). Motivational interviewing (MI), a patient-centred consultation, has proven its worth in many fields where acting on behaviours is essential. AIM To investigate the use and outcomes of MI in the management of children and adolescents who are overweight and obese. DESIGN & SETTING A systematic review evaluated MI in the management of children and adolescents who are overweight and obese. METHOD PubMed, Web of Science, Cochrane Library, and CISMeF were searched between January 2022 and March 2022 for following terms: 'motivational interviewing', 'overweight or obesity', 'children or adolescent' to identify randomised controlled trials (RCTs). Inclusion criteria were interventions involving MI in children or adolescents who were commonly (polygenically) overweight or obese. Exclusion criteria were: studies before 1991; and articles not written in English or French. The first stage of the selection process was carried out by reading the titles and abstracts. A second stage was carried out by reading the complete studies. A secondary inclusion of articles was carried out following the reading of bibliographic references, mainly from systematic reviews and meta-analyses. The data were summarised in synthetic tables based on the Population, Intervention, Comparison, Outcomes, and Study (PICOS) tool. RESULTS From 444 articles the review identified 26 RCTs. Statistically significant results were found for all criteria (anthropometric and behavourial) in both children and adolescents. Quality of life and depression scores were also improved. Parental presence in the interview appeared to be essential for children, whereas for adolescents, the supportive involvement of parents outside of the interviews seemed more appropriate. The frequency and duration of the interventions played a major role in obtaining results, as did the number of people involved, and the diversity of the places where they are taken care of. CONCLUSION MI seems promising for children and adolescents with overweight or obesity, within the framework of a comprehensive, multiprofessional, family management, carried out over a long period with regular consultations.
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Affiliation(s)
- Romain Lutaud
- Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Université, France
- CNRS, EFS, ADES, Aix-Marseille Université, Marseille, France
| | - Eva Mitilian
- Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Université, France
| | - Jenny Forte
- Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Université, France
| | - Gaetan Gentile
- Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Université, France
- Aix Marseille Université, Institut des Neurosciences des Systèmes, INSERM, France
| | - Rachel Reynaud
- Aix Marseille Université, Faculté des Sciences Médicales et Paramédicales, Service de Pediatrie Multidisciplinaire CHU Timone Enfants, APHM, France
| | - Camille Truffet
- Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Université, France
| | - Thibault Bellanger
- Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Université, France
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He L, Basar E, Wiers RW, Antheunis ML, Krahmer E. Can chatbots help to motivate smoking cessation? A study on the effectiveness of motivational interviewing on engagement and therapeutic alliance. BMC Public Health 2022; 22:726. [PMID: 35413887 PMCID: PMC9003955 DOI: 10.1186/s12889-022-13115-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/25/2022] [Indexed: 12/30/2022] Open
Abstract
Background Cigarette smoking poses a major threat to public health. While cessation support provided by healthcare professionals is effective, its use remains low. Chatbots have the potential to serve as a useful addition. The objective of this study is to explore the possibility of using a motivational interviewing style chatbot to enhance engagement, therapeutic alliance, and perceived empathy in the context of smoking cessation. Methods A preregistered web-based experiment was conducted in which smokers (n = 153) were randomly assigned to either the motivational interviewing (MI)-style chatbot condition (n = 78) or the neutral chatbot condition (n = 75) and interacted with the chatbot in two sessions. In the assessment session, typical intake questions in smoking cessation interventions were administered by the chatbot, such as smoking history, nicotine dependence level, and intention to quit. In the feedback session, the chatbot provided personalized normative feedback and discussed with participants potential reasons to quit. Engagement with the chatbot, therapeutic alliance, and perceived empathy were the primary outcomes and were assessed after both sessions. Secondary outcomes were motivation to quit and perceived communication competence and were assessed after the two sessions. Results No significant effects of the experimental manipulation (MI-style or neutral chatbot) were found on engagement, therapeutic alliance, or perceived empathy. A significant increase in therapeutic alliance over two sessions emerged in both conditions, with participants reporting significantly increased motivation to quit. The chatbot was perceived as highly competent, and communication competence was positively associated with engagement, therapeutic alliance, and perceived empathy. Conclusion The results of this preregistered study suggest that talking with a chatbot about smoking cessation can help to motivate smokers to quit and that the effect of conversation has the potential to build up over time. We did not find support for an extra motivating effect of the MI-style chatbot, for which we discuss possible reasons. These findings highlight the promise of using chatbots to motivate smoking cessation. Implications for future research are discussed.
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Affiliation(s)
- Linwei He
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, the Netherlands.
| | - Erkan Basar
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT)-Lab, Department of Psychology, and Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - Marjolijn L Antheunis
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, the Netherlands
| | - Emiel Krahmer
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, the Netherlands
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Woo S, Park KH. Motivating Children and Adolescents in Obesity Treatment. J Obes Metab Syndr 2020; 29:260-269. [PMID: 32843587 PMCID: PMC7789025 DOI: 10.7570/jomes20026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/10/2020] [Accepted: 04/26/2020] [Indexed: 12/21/2022] Open
Abstract
Enhancing motivation is a crucial issue in pediatric obesity interventions, as behavioral changes related to food intake and physical exercise are difficult to carry out with an insufficient level of motivation. In the treatment setting, low motivation towards change may lead to early termination or inadequate treatment outcomes. This paper reviews widely-used models of motivation, including the transtheoretical model of change, self-determination theory, and motivational interviewing (MI). We introduce useful strategies based on each theoretical model to enhance motivation, such as an importance and confidence scale and a decisional balance technique. A review of recent MI interventions in children and adolescents is presented to discuss the efficacy of MI-based interventions and considerations for applying MI in pediatric obesity.
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Affiliation(s)
- Sarah Woo
- Major in Biomedical Science, Department of Medical Sciences, Hallym University College of Medicine, Chuncheon, Korea
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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Impact of intervention on nutritional status, consumption of processed foods, and quality of life of adolescents with excess weight. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2020. [DOI: 10.1016/j.jpedp.2019.05.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Impact of intervention on nutritional status, consumption of processed foods, and quality of life of adolescents with excess weight. J Pediatr (Rio J) 2020; 96:621-629. [PMID: 31376386 PMCID: PMC9432027 DOI: 10.1016/j.jped.2019.05.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/02/2019] [Accepted: 05/06/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To evaluate the impact of a nutritional intervention on nutritional status, ultra-processed food consumption, and quality of life of adolescents with excess weight. METHODS Experimental study with adolescent students with excess weight, divided into two groups, an intervention group and a control group. The nutritional intervention lasted six months, with an educational and motivational approach. Nutritional status (waist circumference and body mass index), quality of life, and ultra-processed food consumption were evaluated before and after the period. RESULTS Sixty-two adolescents with overweight or obesity participated in the study, 37 in the intervention group and 25 in the control group, aged 13.2±1.5 years in intervention group, and 13.0±1.8 years in control group, both of which had a higher female participation. There were changes in the body mass index (intervention group Δ: -0.81±2.28, control group Δ: -0.64±1.28) and in the waist circumference for intervention group (Δ:-3.31±5.47). For the pre- and post-ultra-processed food consumption, there was a significant reduction in the consumption of soft drinks in the intervention group (Δ: -0.07 [-0.27 to 0.00]), instant noodles (Δ: -0.03 [-0.07 to 0.00]), and sandwich cookies (Δ: -0.06 [-0.26 to 0.00]). The quality of life increased in the intervention group and decreased in the control group, with no intra- (p=0.162) or intergroup statistical relevance in the pre- (p=0.426) and post- (0.249) intervention period, with a reduction in the emotional domain score, with a significant variation in the intervention group (pre and post; Δ: -19.0±40.6). CONCLUSION There was a decrease in body mass index and waist circumference (central obesity being more often related to insulin resistance), reduction of ultra-processed food consumption (soft drinks, sandwich cookies, and instant noodles), and a tendency toward quality of life improvement (however, there was a decrease in the domains of emotional and school quality of life).
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