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Wong EML, Leung DYP, Wang Q, Leung AYM, Cheung ASP. The effect of a lifestyle intervention program using a mobile application versus the effect of a program using a booklet for adults with metabolic syndrome: A three-arm randomized controlled trial. J Nurs Scholarsh 2023; 55:936-948. [PMID: 36896916 DOI: 10.1111/jnu.12883] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 02/01/2023] [Accepted: 02/14/2023] [Indexed: 03/11/2023]
Abstract
PURPOSE The research aimed to examine the effect of a lifestyle intervention program using mobile application versus booklet for adults with metabolic syndrome in Hong Kong. The outcomes comprised body weight (primary outcome), exercise amount, improvement of cardiometabolic risk factors, cardiovascular endurance, perceived stress scale, and exercise self-efficacy. DESIGN A three-arm randomized controlled trial namely App group, Booklet group, and control group was adopted. METHODS Two hundred sixty-four adults with metabolic syndrome were recruited from community centers from 2019 to December 2021. Inclusion criteria are those adults with metabolic syndrome, able to use a smart phone. All participants received a 30-min health talk. App group additionally received a mobile application, while Booklet group received a booklet, and the control group received a placebo booklet. Data were collected at baseline, Weeks 4, 12, and 24. SPSS and generalized estimating equations (GEE) model were employed for data analysis. FINDINGS Attrition rates were minimal, ranged from 2.65% to 6.44%. Both app and booklet group showed significant improvement in outcomes (exercise amount, waist circumference) when compared to control group. However, statistically significant and superior results were observed in app group, including body weight, exercise amount, waist circumference, body mass index, and systolic blood pressure when compared to booklet group. CONCLUSION The lifestyle intervention supported with app was found to be superior to the booklet support for reducing body weight and maintaining exercise. CLINICAL RELEVANCE The lifestyle intervention program using mobile application support could be used widely for adults with metabolic syndrome in the community. Suggest nurses may incorporate this program in their health promotion strategies focusing on a healthy lifestyle to reduce the risk of progression to metabolic syndrome.
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Affiliation(s)
| | | | - Qun Wang
- School of Nursing, Shenzhen University, Shenzhen, China
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2
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Otsuka Y, Nakagami T. Poor Eating Behaviors Related to the Progression of Prediabetes in a Japanese Population: An Open Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11864. [PMID: 36231160 PMCID: PMC9565240 DOI: 10.3390/ijerph191911864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to examine lifestyle factors associated with the change in glucose categories among individuals without diabetes. We analyzed cohort data of medical check-ups at baseline between April 2008 and December 2012. The primary and secondary outcomes were the change in glucose categories from normoglycemia (glycated hemoglobin (HbA1c) < 5.7% and fasting plasma glucose (FPG) < 5.6 mmol/L) to prediabetes (HbA1c 5.7-6.4% or FPG 5.6-6.9 mmol/L) and from prediabetes to normoglycemia. During a mean follow-up of 2.4 years, 7083 of 57,018 individuals with normoglycemia developed prediabetes, whereas 4629 of 9926 individuals with prediabetes returned to normoglycemia. Factors associated with progression to prediabetes were baseline BMI (hazard ratio [95% confidence interval]: 1.08 [1.07-1.09]), change in BMI during follow-up (1.05 [1.03-1.07]), late dinner/snacking (1.16 [1.10-1.22]), skipping breakfast (1.12 [1.06-1.18]), and heavy alcohol consumption (1.33 [1.24-1.42]). Factors associated with return to normoglycemia from prediabetes were baseline BMI (0.94 [0.93-0.95]) and change in BMI during follow-up (0.95 [0.93-0.97]). In conclusion, poor eating behaviors, such as skipping breakfast, late dinner/snacking, and heavy alcohol consumption, were associated with the progression from normoglycemia to prediabetes.
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Affiliation(s)
- Yuichiro Otsuka
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Tomoko Nakagami
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo 162-8666, Japan
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3
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Yuan SQ, Liu YM, Liang W, Li FF, Zeng Y, Liu YY, Huang SZ, He QY, Quach B, Jiao J, Baker JS, Yang YD. Association Between Eating Speed and Metabolic Syndrome: A Systematic Review and Meta-Analysis. Front Nutr 2021; 8:700936. [PMID: 34746200 PMCID: PMC8564065 DOI: 10.3389/fnut.2021.700936] [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: 06/17/2021] [Accepted: 09/14/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This review aimed to systematically summarize and meta-analyze the association between eating speed and metabolic syndrome (MetS). Methods: Following the Preferred Reporting Items for Systematic Reviews, and Meta Analyses (PRISMA) guidelines, four electronic databases (PubMed, Web of Science, MEDLINE, and EMBASE) were searched until March 2021 to identify eligible articles based on a series of inclusion and exclusion criteria. Heterogeneity was examined using I 2 statistics. Using random-effects models, the pooled odds ratios (ORs), and 95% CIs were calculated to evaluate the association between eating speed with MetS and its components, including central obesity, blood pressure (BP), high-density lipoprotein cholesterol (HDL), triglyceride (TG), and fasting plasma glucose (FPG). Results: Of the 8,500 original hits generated by the systematic search, 29 eligible studies with moderate-to-high quality were included, involving 465,155 subjects. The meta-analysis revealed that eating faster was significantly associated with higher risks of MetS (OR = 1.54, 95% CI: 1.27-1.86), central obesity (OR = 1.54, 95% CI: 1.37-1.73), elevated BP (OR = 1.26, 95% CI: 1.13-1.40), low HDL (OR = 1.23, 95% CI: 1.15-1.31), elevated TG (OR = 1.29, 95% CI: 1.18-1.42), and elevated FPG (OR = 1.16, 95% CI: 1.06-1.27) compared to eating slowly. Conclusions: The results of the review indicated that eating speed was significantly associated with MetS and its components. Interventions related to decreasing eating speed may be beneficial for the management of MetS. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021242213, identifier: CRD42021242213.
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Affiliation(s)
- Shu-Qian Yuan
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Ying-Ming Liu
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Wei Liang
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China.,Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Fei-Fei Li
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China.,Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Yuan Zeng
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Yin-Yue Liu
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Shu-Zhen Huang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Quan-Yuan He
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Binh Quach
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Jiao Jiao
- Dr. Stephen Hui Research Centre for Physical Recreation and Wellness, Hong Kong Baptist University, Hong Kong, China
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China.,Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Yi-de Yang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
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4
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Wong EML, Leung DYP, Tam HL, Wang Q, Yeung KW, Leung AYM. The Effect of a Lifestyle Intervention Program Using a Mobile Application for Adults with Metabolic Syndrome, versus the Effect of a Program Using a Booklet: A Pilot Randomized Controlled Trial. Clin Interv Aging 2021; 16:633-644. [PMID: 33888981 PMCID: PMC8057802 DOI: 10.2147/cia.s303920] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/27/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to examine the preliminary effect, feasibility, and acceptability of a lifestyle intervention program using a mobile application (app) versus the effect of a program using a booklet for adults with metabolic syndrome (MetS). Patients and Methods This trial was conducted in two community centers of Hong Kong. Participants were included if they were adults with MetS, aged over 50, and able to use a smartphone. Eligible subjects were randomly assigned to either the app group or booklet group. Those in the booklet group received a health talk and a booklet, whereas those in the app group received a health talk and a MetS app to support their exercise maintenance and health records for 3 months. Both groups received similar educational content related to healthcare for MetS clients. Data were collected at baseline (T1) and at 1- (T2) and 3-month (T3) intervals. Outcomes were body weight (primary outcome), total amount of exercise, blood pressure, and lipid concentrations. Data were analyzed using the generalized estimating equation models. Feasibility and acceptability were assessed in process evaluation. Results Ninety-eight individuals were screened for eligibility and 77 were randomized into the app group (n = 38) or booklet group (n = 39). The attrition rate at T3 was 11.690%. The app group showed a significant reduction in body weight (β = −1.069, p = 0.012) and body mass index (β = −0.371, p = 0.026), a greater amount of exercise (β = 8.454, p = 0.032), and improved exercise self-efficacy (β = 10.62, p = 0.001) within 3 months. There were no significant differences between groups for other outcomes. The participants appreciated the proposed intervention of the programme. Conclusion The MetS app may be incorporated in the health promotion programme to support exercise maintenance and a healthy lifestyle in the community.
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Affiliation(s)
- Eliza Mi Ling Wong
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, SAR, People's Republic of China
| | - Doris Y P Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, SAR, People's Republic of China
| | - Hon Lon Tam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, SAR, People's Republic of China
| | - Qun Wang
- School of Nursing, Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Kai Wang Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, SAR, People's Republic of China
| | - Angela Y M Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, SAR, People's Republic of China
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5
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Doke M, Komagamine Y, Kanazawa M, Iwaki M, Suzuki H, Miyazaki Y, Mizuno T, Okayasu K, Minakuchi S. Effect of dental intervention on improvements in metabolic syndrome patients: a randomized controlled clinical trial. BMC Oral Health 2021; 21:4. [PMID: 33407371 PMCID: PMC7788763 DOI: 10.1186/s12903-020-01373-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/14/2020] [Indexed: 01/22/2023] Open
Abstract
Background Metabolic syndrome (MetS), caused by the accumulation of visceral fat, is considered a major cause of cardiovascular disease. This randomized controlled trial aimed to clarify the effect of dental intervention, including prosthodontics and/or periodontal treatment, combined with dietary and exercise guidance on MetS. Methods In total, 112 patients who met the Japanese waist circumference criteria of MetS were recruited. The intervention group (ITG) received dental intervention along with dietary and exercise guidance, while the control group (CTG) received dietary and exercise guidance alone. Three outcome measurements were obtained before intervention (BL), 1 month after intervention (1M), and 3 months after intervention (3M). Results Body water rate (p = 0.043) was significantly higher in ITG than in CTG at 1M. Simultaneously, fasting blood sugar level (p = 0.098) tended to be lower in ITG than in CTG. Lean mass (p = 0.037) and muscle mass (p = 0.035) were significantly higher and body weight (p = 0.044) significantly lower in ITG than in CTG at 3M. Body mass index (p = 0.052) tended to be lower in ITG than in CTG. Conclusions Dental intervention combined with lifestyle guidance may improve anthropometric status and reduce the risk of MetS. Trial registration University Hospital Medical Information Network Center Unique UMIN000022753. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000026176.
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Affiliation(s)
- Midori Doke
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, Japan
| | - Yuriko Komagamine
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, Japan.
| | - Manabu Kanazawa
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, Japan
| | - Maiko Iwaki
- General Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Suzuki
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuya Mizuno
- Department of Health Science and Physical Education, College of Liberal Arts and Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kaori Okayasu
- Yokohama City Minato Red Cross Hospital Medical Center for Allergic and Immune Diseases, Yokohama, Japan
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, Japan
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6
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Ekuni D, Furuta M, Kimura T, Toyama N, Fukuhara D, Uchida Y, Sawada N, Morita M. Association between intensive health guidance focusing on eating quickly and metabolic syndrome in Japanese middle-aged citizens. Eat Weight Disord 2020; 25:91-98. [PMID: 29882038 DOI: 10.1007/s40519-018-0522-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/15/2018] [Indexed: 01/06/2023] Open
Abstract
PURPOSE The purpose of this intervention study was to investigate whether intensive health guidance focusing on eating quickly can prevent metabolic syndrome (MetS) more effectively than standard routine guidance in Japanese citizens living in rural areas. METHODS This controlled, non-randomized, intervention study analyzed 141 participants with MetS at baseline. Participants in the intervention group received health guidance focusing on eating quickly and standard health guidance about MetS in accordance with the guidelines of the Ministry of Health, Labour and Welfare in Japan, whereas participants in the control group received only standard health guidance about MetS. The primary study outcome was the prevalence of MetS at a 1-year follow-up. RESULTS At 1-year follow-up, the prevalence of MetS in the intervention group was significantly lower than that in the control group (p = 0.003). The decreases in body weight, body mass index, waist circumference and triglycerides from baseline to 1 year were significantly greater in the intervention group than in the control group (p < 0.05). CONCLUSION Intensive health guidance focusing on eating quickly is more effective for improving MetS than standard Japanese health guidance alone. LEVEL OF EVIDENCE Level II, Evidence obtained from well-designed controlled trials without randomization. TRIAL REGISTRY NAME, REGISTRATION IDENTIFICATION NUMBER, AND URL FOR THE REGISTRY: UMIN, UMIN000030600, http://www.umin.ac.jp/ctr/index-j.htm.
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Affiliation(s)
- Daisuke Ekuni
- Departments of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan. .,Advanced Research Center for Oral and Craniofacial Sciences, Okayama University Dental School, Okayama, Japan.
| | - Michiko Furuta
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | | | - Naoki Toyama
- Departments of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Daiki Fukuhara
- Departments of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Yoko Uchida
- Departments of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Nanami Sawada
- Departments of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Manabu Morita
- Departments of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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7
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Ozaki I, Watai I, Nishijima M, Saito N. Randomized controlled trial of Web-based weight-loss intervention with human support for male workers under 40. J Occup Health 2019; 61:110-120. [PMID: 30698339 PMCID: PMC6499366 DOI: 10.1002/1348-9585.12037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 11/20/2018] [Indexed: 01/21/2023] Open
Abstract
Objectives Human support can boost weight reduction in Internet‐based weight‐loss intervention. However, the most effective way to combine human support and the Internet for weight loss is unclear. This study aimed to examine the effects of two weight‐loss programs for male workers aged 18‐39 that combined different intensities of human support with website support compared to a delayed‐intervention group (control group; CG), in a randomized controlled trial. Methods Seventy‐one participants with overweight or obesity were allocated to one of three 12‐week treatment programs. The Standard Support Group (SSG) was provided support via website and two face‐to‐face group guidance sessions, at the beginning and at the end of the program along with monthly general emails throughout the program. The Enhanced Support Group (ESG) received four remote support sessions based on Supportive Accountability (SA) in addition to the SSG. The CG was provided the same program as SSG after the other two groups had completed the program. The primary outcome was body weight reduction. Results ESG participants reduced their weight significantly more than SSG and CG participants (P = 0.038, P < 0.001, respectively), and SSG participants reduced their weight significantly more than CG participants (P = 0.033). Conclusions The additional remote human support provided to the participants in the ESG was beneficial for weight loss in male workers. The low‐intensity program provided to the SSG was also effective. Further studies with more participants in diverse settings and with participants who are less interested in their health and weight management are needed.
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Affiliation(s)
- Itsuko Ozaki
- School of Nursing, Nagoya City University, Nagoya, Japan.,Department of Nursing, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Izumi Watai
- Department of Nursing, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Mariko Nishijima
- Department of Nursing, Graduate School of Medicine, Ehime University, Toon, Japan
| | - Nozomu Saito
- Department of Nursing, Graduate School of Medicine, Ehime University, Toon, Japan
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Matsuzaki K, Taniguchi S, Inoue K, Kawamura T. Effectiveness of a healthcare retreat for male employees with cardiovascular risk factors. Prev Med Rep 2019; 13:170-174. [PMID: 30619665 PMCID: PMC6313817 DOI: 10.1016/j.pmedr.2018.12.005] [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: 09/10/2018] [Revised: 12/03/2018] [Accepted: 12/15/2018] [Indexed: 12/30/2022] Open
Abstract
Lifestyle modification is the primary treatment strategy for obesity, hypertension, dyslipidemia, and hyperglycemia. Recently, the Japanese government designed a healthcare retreat program for persons with cardiovascular risk factors. However, the structure and effectiveness of this program has not been fully discussed. Employees of a company group with obesity and one or more other cardiovascular risk factors were enrolled in the study. The participants in the three-day retreat program were compared with those receiving a brochure-based advice for their subsequent changes in the annual health check-up data using the propensity score matching method. Among the 415 eligible employees, 220 underwent the intensive program and 195 received a brochure-based advice. In the propensity score-matched subjects, reduction in body weight (2.7 kg vs. 0.99 kg, p < 0.01), waist circumference (3.5 cm vs. 1.5 cm, p < 0.01), and non-HDL cholesterol (8.8 mg/dl vs. 1.3 mg/dl, p = 0.05) were significantly greater in the intensive care group one year later. The superiority of the intensive program, however, was gradually attenuted for subsequent two years later. This healthcare retreat with counseling and training program would improve body weight and waist circumference for one to two subsequent years. Lifestyle modification is the primary treatment strategy for cardiovascular disease. Based on the trans-theoretical model, healthcare retreat program was established. Mean 2.7 kg reduction in body weight after 1 year in healthcare retreat group Our healthcare retreat program may supersede conventional approach.
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Affiliation(s)
- Keiichi Matsuzaki
- Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501, Japan
| | - Shotaro Taniguchi
- Laboratory and Vascular Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan.,Miyazaki Prefectural Health Foundation, 1-1-2, Kirishima, Miyazaki City, Miyazaki 880-0032, Japan
| | - Kana Inoue
- Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501, Japan
| | - Takashi Kawamura
- Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501, Japan
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Kitakata H, Kohno T, Kohsaka S, Fujino J, Nakano N, Fukuoka R, Yuasa S, Maekawa Y, Fukuda K. Patient confidence regarding secondary lifestyle modification and knowledge of 'heart attack' symptoms following percutaneous revascularisation in Japan: a cross-sectional study. BMJ Open 2018; 8:e019119. [PMID: 29549203 PMCID: PMC5857652 DOI: 10.1136/bmjopen-2017-019119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess patient perspectives on secondary lifestyle modification and knowledge of 'heart attack' after percutaneous coronary intervention (PCI) for coronary artery disease (CAD). DESIGN Observational cross-sectional study. SETTING A single university-based hospital centre in Japan. PARTICIPANTS In total, 236 consecutive patients with CAD who underwent PCI completed a questionnaire (age, 67.4±10.1 years; women, 14.8%; elective PCI, 75.4%). The survey questionnaire included questions related to confidence levels about (1) lifestyle modification at the time of discharge and (2) appropriate recognition of heart attack symptoms and reactions to these symptoms on a four-point Likert scale (1=not confident to 4=completely confident). PRIMARY OUTCOME MEASURE The primary outcome assessed was the patients' confidence level regarding lifestyle modification and the recognition of heart attack symptoms. RESULTS Overall, patients had a high level of confidence (confident or completely confident,>75%) about smoking cessation, alcohol restriction and medication adherence. However, they had a relatively low level of confidence (<50%) about the maintenance of blood pressure control, healthy diet, body weight and routine exercise (≥3 times/week). After adjustment, male sex (OR 3.61, 95% CI 1.11 to 11.8) and lower educational level (OR 3.25; 95% CI 1.70 to 6.23) were identified as factors associated with lower confidence levels. In terms of confidence in the recognition of heart attack, almost all respondents answered 'yes' to the item 'I should go to the hospital as soon as possible when I have a heart attack'; however, only 28% of the responders were confident in their ability to distinguish between heart attack symptoms and other conditions. CONCLUSIONS There were substantial disparities in the confidence levels associated with lifestyle modification and recognition/response to heart attack. These gaps need to be studied further and disseminated to improve cardiovascular care.
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Affiliation(s)
- Hiroki Kitakata
- Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Kohno
- Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shun Kohsaka
- Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Junko Fujino
- Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Naomi Nakano
- Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ryoma Fukuoka
- Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shinsuke Yuasa
- Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yuichiro Maekawa
- Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Keiichi Fukuda
- Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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10
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Medical Nutrition Therapy and Weight Loss Questions for the Evidence Analysis Library Prevention of Type 2 Diabetes Project: Systematic Reviews. J Acad Nutr Diet 2017; 117:1578-1611. [DOI: 10.1016/j.jand.2017.06.361] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 06/20/2017] [Indexed: 01/03/2023]
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11
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The effects of a lifestyle intervention program on physical outcomes, depression, and quality of life in adults with metabolic syndrome: A randomized clinical trial. Int J Cardiol 2017; 230:461-467. [DOI: 10.1016/j.ijcard.2016.12.084] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 11/25/2016] [Accepted: 12/16/2016] [Indexed: 01/22/2023]
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12
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Lokin JLC, Hengeveld PJ, Conijn AP, Nieuwkerk PT, Koelemay MJW. Disease understanding in patients with intermittent claudication: A qualitative study. JOURNAL OF VASCULAR NURSING 2017; 33:112-8. [PMID: 26298615 DOI: 10.1016/j.jvn.2015.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 02/04/2015] [Accepted: 02/04/2015] [Indexed: 11/16/2022]
Abstract
The aim of our qualitative study was to investigate the understanding of patients with intermittent claudication (IC) regarding the etiology and atherosclerotic nature of their disease. Patients were recruited from participants of the SUPER study, a randomized trial comparing angioplasty and supervised exercise therapy for alleviation of IC owing to an iliac artery obstruction. Patients were submitted to explorative, semistructured, in-depth interviews that were fully transcribed, coded, and categorized. We interviewed 19 patients. The majority of respondents (79%) recognized smoking as a major risk factor contributing to the etiology of IC. However, nearly one-half (47%) underestimated the effects of unhealthy dietary and exercise patterns. In contrast, a substantial number of respondents (42%) overestimated the contribution of genetics to the etiology of their disease. Most respondents (79%) were unaware of the fact that IC implies systemic atherosclerosis.This study shows that the patients' interpretation of the etiology and nature of IC was mostly incorrect. Therefore, we suggest that health care providers enhance counseling about etiologic factors and the systemic nature of IC to optimize outcomes of lifestyle adjustments.
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Affiliation(s)
- Joost L C Lokin
- Department of Vascular Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Paul J Hengeveld
- Department of Vascular Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Anne P Conijn
- Department of Vascular Surgery, Academic Medical Center, Amsterdam, The Netherlands.
| | - Pythia T Nieuwkerk
- Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands
| | - Mark J W Koelemay
- Department of Vascular Surgery, Academic Medical Center, Amsterdam, The Netherlands
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13
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Iwahashi H, Imagawa A. Type 2 diabetes mellitus prevention strategy: Target and goal in Japanese men. J Diabetes Investig 2016; 7:283-5. [PMID: 27330711 PMCID: PMC4847879 DOI: 10.1111/jdi.12481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 01/06/2016] [Accepted: 01/06/2016] [Indexed: 12/01/2022] Open
Affiliation(s)
- Hiromi Iwahashi
- Department of Diabetes Care Medicine and Graduate School of Medicine Osaka University Suita Osaka Japan
| | - Akihisa Imagawa
- Department of Metabolic Medicine Graduate School of Medicine Osaka University Suita Osaka Japan
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Satoh T, Nemoto Y, Utumi T, Munakata M. Physical Therapy for Metabolic Syndrome Prevention in Workers: Novel Role of Physical Therapist. Nihon Eiseigaku Zasshi 2016; 71:119-25. [PMID: 27246150 DOI: 10.1265/jjh.71.119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In Japan, physical therapists have usually been involved in physical therapy for patients with functional disorders associated with cerebrovascular or orthopedic diseases in hospitals. With the aging of Japanese society, the number of diseased people will progressively increase; thus, it is important to pay much more attention to disease prevention. In this regard, physical therapists are expected to play a new role in the field of preventive medicine. Metabolic syndrome or central obesity with multiple cardiometabolic risks is associated with a high risk of type 2 diabetes or cardiovascular diseases and is now a central target for early detection and intervention for disease prevention. The incidence of metabolic syndrome increases with age, and men showed a higher incidence of metabolic syndrome than women in all generations. We have been involved in the guidance of workers with metabolic syndrome for a long time, and we conducted a multicenter study to establish effective guidance for these worker. In this paper, we will use our evidence to discuss the role of physical therapists in providing guidance for preventing metabolic syndrome. We are now conducting worksite supporting exercise intervention for workers who were resistant to conventional lifestyle guidance. In addition, the unique role of physical therapists in this new trial will be introduced.
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Affiliation(s)
- Tomonori Satoh
- Research Center for the Promotion of Health and Employment Support, Tohoku Rosai Hospital
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15
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Replication in physiotherapy: useful or reinventing the wheel? J Physiother 2015; 61:169-71. [PMID: 26303365 DOI: 10.1016/j.jphys.2015.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 07/28/2015] [Indexed: 11/22/2022] Open
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16
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Lifestyle modification for metabolic syndrome: a systematic review. Am J Med 2014; 127:1242.e1-10. [PMID: 25004456 DOI: 10.1016/j.amjmed.2014.06.035] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 06/07/2014] [Accepted: 06/09/2014] [Indexed: 01/07/2023]
Abstract
BACKGROUND All 5 components of metabolic syndrome have been shown to improve with lifestyle and diet modification. New strategies for achieving adherence to meaningful lifestyle change are needed to optimize atherosclerotic cardiovascular risk reduction. We performed a systematic literature review, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework (PRISMA), investigating optimal methods for achieving lifestyle change in metabolic syndrome. METHODS We submitted standardized search terms to the PubMed Central, CINAHL, Web of Science, and Ovid databases. Within those results, we selected randomized controlled trials (RCTs) presenting unique methods of achieving lifestyle change in patients with one or more components of the metabolic syndrome. Data extraction using the population, intervention, comparator, outcome, and risk of bias framework (PICO) was used to compare the following endpoints: prevalence of metabolic syndrome, prevalence of individual metabolic syndrome components, mean number of metabolic syndrome components, and amount of weight loss achieved. RESULTS Twenty-eight RCTs (6372 patients) were included. Eight RCTs demonstrated improvement in metabolic syndrome risk factors after 1 year. Team-based, interactive approaches with high-frequency contact with patients who are motivated made the largest and most lasting impact. Technology was found to be a useful tool in achieving lifestyle change, but ineffective when compared with personal contact. CONCLUSION Patient motivation leading to improved lifestyle adherence is a key factor in achieving reduction in metabolic syndrome components. These elements can be enhanced via frequent encounters with the health care system. Use of technologies such as mobile and Internet-based communication can increase the effectiveness of lifestyle change in metabolic syndrome, but should not replace personal contact as the cornerstone of therapy. Our ability to derive quantitative conclusions is limited by inconsistent outcome measures across studies, low power and homogeneity of individual studies, largely motivated study populations, short follow-up periods, loss to follow-up, and lack of or incomplete blinding.
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Mastellos N, Gunn LH, Felix LM, Car J, Majeed A. Transtheoretical model stages of change for dietary and physical exercise modification in weight loss management for overweight and obese adults. Cochrane Database Syst Rev 2014:CD008066. [PMID: 24500864 PMCID: PMC10088065 DOI: 10.1002/14651858.cd008066.pub3] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Obesity is a global public health threat. The transtheoretical stages of change (TTM SOC) model has long been considered a useful interventional approach in lifestyle modification programmes, but its effectiveness in producing sustainable weight loss in overweight and obese individuals has been found to vary considerably. OBJECTIVES To assess the effectiveness of dietary intervention or physical activity interventions, or both, and other interventions based on the transtheoretical model (TTM) stages of change (SOC) to produce sustainable (one year and longer) weight loss in overweight and obese adults. SEARCH METHODS Studies were obtained from searches of multiple electronic bibliographic databases. We searched The Cochrane Library, MEDLINE, EMBASE and PsycINFO. The date of the last search, for all databases, was 17 December 2013. SELECTION CRITERIA Trials were included if they fulfilled the criteria of randomised controlled clinical trials (RCTs) using the TTM SOC as a model, that is a theoretical framework or guideline in designing lifestyle modification strategies, mainly dietary and physical activity interventions, versus a comparison intervention of usual care; one of the outcome measures of the study was weight loss, measured as change in weight or body mass index (BMI); participants were overweight or obese adults only; and the intervention was delivered by healthcare professionals or trained lay people at the hospital and community level, including at home. DATA COLLECTION AND ANALYSIS Two review authors independently extracted the data, assessed studies for risk of bias and evaluated overall study quality according to GRADE (Grading of Recommendations Assessment, Development and Evaluation). We resolved disagreements by discussion or consultation with a third party. A narrative, descriptive analysis was conducted for the systematic review. MAIN RESULTS A total of three studies met the inclusion criteria, allocating 2971 participants to the intervention and control groups. The total number of participants randomised to the intervention groups was 1467, whilst 1504 were randomised to the control groups. The length of intervention was 9, 12 and 24 months in the different trials. The use of TTM SOC in combination with diet or physical activity, or both, and other interventions in the included studies produced inconclusive evidence that TTM SOC interventions led to sustained weight loss (the mean difference between intervention and control groups varied from 2.1 kg to 0.2 kg at 24 months; 2971 participants; 3 trials; low quality evidence). Following application of TTM SOC there were improvements in physical activity and dietary habits, such as increased exercise duration and frequency, reduced dietary fat intake and increased fruit and vegetable consumption (very low quality evidence). Weight gain was reported as an adverse event in one of the included trials. None of the trials reported health-related quality of life, morbidity, or economic costs as outcomes. The small number of studies and their variable methodological quality limit the applicability of the findings to clinical practice. The main limitations include inadequate reporting of outcomes and the methods for allocation, randomisation and blinding; extensive use of self-reported measures to estimate the effects of interventions on a number of outcomes, including weight loss, dietary consumption and physical activity levels; and insufficient assessment of sustainability due to lack of post-intervention assessments. AUTHORS' CONCLUSIONS The evidence to support the use of TTM SOC in weight loss interventions is limited by risk of bias and imprecision, not allowing firm conclusions to be drawn. When combined with diet or physical activity, or both, and other interventions we found very low quality evidence that it might lead to better dietary and physical activity habits. This systematic review highlights the need for well-designed RCTs that apply the principles of the TTM SOC appropriately to produce conclusive evidence about the effect of TTM SOC lifestyle interventions on weight loss and other health outcomes.
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Affiliation(s)
- Nikolaos Mastellos
- Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, St Dunstans Road, London, Hammersmith, UK, W6 8RP
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Gin H, Demeaux JL, Grelaud A, Grolleau A, Droz-Perroteau C, Robinson P, Lassalle R, Abouelfath A, Boisseau M, Toussaint C, Moore N. Observation of the long-term effects of lifestyle intervention during balneotherapy in metabolic syndrome. Therapie 2013; 68:163-7. [PMID: 23886461 DOI: 10.2515/therapie/2013025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 01/29/2013] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Estimate the effect of lifestyle adjustment activities in patients with metabolic syndrome treated by prescribed balneotherapy. METHODS Observational pilot cohort study with 12-month follow-up after multidimensional lifestyle training (physical, dietary, educational) during 3-week standard stay in the spa town of Eugénie-les-Bains. RESULTS Of 145 eligible patients, 97 were included; 63 were followed and analysable. At inclusion all had ≥3 National cholesterol education program-Adult treatment panel III (NCEP-ATPIII) criteria defining metabolic syndrome, 76.2% were female, mean age was 61.2 years. At the end of follow-up (median:10.4 months, Inter-Quartile Range: [6.7;11.4]), 48 of these 63 patients (76.2%) no longer had metabolic syndrome (95%CI [65.7;86.7]). These 48 patients without metabolic syndrome at the end of follow-up represented 49.5% of the 97 included (95%CI [39.5;59.4]). CONCLUSIONS Future studies of lifestyle interventions taking advantage of the spa environment can be expected to find least one third of patients free of metabolic syndrome at the end of 12-month follow-up in the intervention group.
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Affiliation(s)
- Henri Gin
- Université de Bordeaux, Bordeaux, France
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A strategy for obesity control: repetition is the key. Hypertens Res 2011; 34:548. [DOI: 10.1038/hr.2011.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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