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Caffieri A, Gómez‐Gómez I, Barquero‐Jimenez C, De‐Juan‐Iglesias P, Margherita G, Motrico E. Global prevalence of perinatal depression and anxiety during the COVID-19 pandemic: An umbrella review and meta-analytic synthesis. Acta Obstet Gynecol Scand 2024; 103:210-224. [PMID: 38113292 PMCID: PMC10823409 DOI: 10.1111/aogs.14740] [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: 06/27/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION The prevalence of depression and anxiety symptoms in pregnant and postpartum women during the COVID-19 pandemic was assessed by several systematic reviews (SRs) and meta-analyses which provided contrasting and different results. We aimed to summarize the evidence relating to the global prevalence of anxiety and depression among pregnant and postpartum women during the COVID-19 pandemic. MATERIAL AND METHODS An umbrella review of SRs and meta-analyses was performed. Searches were conducted in electronic databases up to April 2023. SRs and meta-analyses reporting the prevalence of perinatal anxiety and depression during the COVID-19 pandemic were selected for eligibility. Primary studies extracted from eligible meta-analyses were included in the quantitative synthesis. The research protocol was registered on PROSPERO (CRD42020173125). RESULTS A total of 25 SRs (198 primary studies) and 12 meta-analyses (129 primary studies) were included in the qualitative and quantitative synthesis, respectively. Studies involved data from five continents and 45 countries. The pooled prevalence of antenatal and postpartum depression was 29% (n = 55; 95% CI: 25%-33%) and 26% (n = 54; 95% CI: 23%-30%), respectively. In the case of anxiety, the pooled antenatal and postnatal prevalence was 31% (n = 44; 95% CI: 26%-37%; n = 16; 95% CI: 24%-39%). Differences emerged between continents, with Africa having the highest prevalence of perinatal depression and Oceania and Europe having the highest prevalence of antenatal and postnatal anxiety. The prevalence also varied depending on the assessment tools, especially for antenatal anxiety. A medium-high quality of the studies was observed. One SR assessed strength-of-evidence, reporting very low strength. CONCLUSIONS During the COVID-19 pandemic, depression and anxiety were common, affecting almost one in three perinatal women globally. A high heterogeneity and a risk of publication bias were found, partially due to the variety of assessment tools and cut-offs. The results may not be generalized to minorities. Studies on the prevalence of clinical diagnoses are needed. Based on our results it is not possible to firmly affirm that the COVID-19 pandemic was the main factor that directly increased perinatal depression and anxiety during the past few years. Future studies should study other factors' impact.
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Affiliation(s)
- Alessia Caffieri
- Department of Humanistic StudiesUniversity of Naples Federico IINaplesItaly
| | | | | | | | - Giorgia Margherita
- Department of Humanistic StudiesUniversity of Naples Federico IINaplesItaly
| | - Emma Motrico
- Department of PsychologyUniversidad Loyola AndalucíaSevilleSpain
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Shi W, Green H, Sikhosana N, Fernandez R. Effectiveness of Telehealth Cardiac Rehabilitation Programs on Health Outcomes of Patients With Coronary Heart Diseases: An Umbrella Review. J Cardiopulm Rehabil Prev 2024; 44:15-25. [PMID: 37335820 DOI: 10.1097/hcr.0000000000000807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
PURPOSE The aim of this study was to conduct an umbrella review summarizing the evidence from existing systematic reviews of telehealth cardiac rehabilitation (CR) on health outcomes of patients with coronary heart disease (CHD). REVIEW METHODS An umbrella review of systematic reviews was undertaken in accordance with the PRISMA and JBI guidelines. A systematic search was conducted in Medline, APA PsycINFO, Embase, CINAHL, Web of Science, Cochrane database of systematic reviews, JBI evidence synthesis, Epistemonikos, and PROSPERO, searching for systematic reviews published from 1990 to current and was limited to the language source of English and Chinese. Outcomes of interest were health behaviors and modifiable CHD risk factors, psychosocial outcomes, and other secondary outcomes. Study quality was appraised using the JBI checklist for systematic reviews. A narrative analysis was conducted, and meta-analysis results were synthesized. SUMMARY From 1301 identified reviews, 13 systematic reviews (10 meta-analyses) comprised 132 primary studies conducted in 28 countries. All the included reviews have high quality, with scores ranging 73-100%. Findings to the health outcomes remained inconclusive, except solid evidence was found in the significant improvement in physical activity (PA) levels and behaviors from telehealth interventions, exercise capacity from mobile health (m-health) only and web-based only interventions, and medication adherence from m-health interventions. Telehealth CR programs, work adjunct or in addition to traditional CR and standard care, are effective in improving health behaviors and modifiable CHD risk factors, particularly in PA. In addition, it does not increase the incidence in terms of mortality, adverse events, hospital readmission, and revascularization.
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Affiliation(s)
- Wendan Shi
- Centre for Research in Nursing and Health, St George Hospital, Kogarah, New South Wales, Australia (Ms Shi, Dr Green, Mr Sikhosana, and Dr Fernandez); Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, and Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia (Ms Shi); Faculty of Medicine and Health, University of Newcastle, Callaghan, New South Wales, Australia (Mr Sikhosana and Dr Fernandez); and School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, and Centre for Evidence based Initiatives in Health Care: A JBI Centre for Excellence, Wollongong, New South Wales, Australia (Dr Green)
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Wilson EJ, Abbott MJ, Norton AR. The impact of psychological treatment on intolerance of uncertainty in generalized anxiety disorder: A systematic review and meta-analysis. J Anxiety Disord 2023; 97:102729. [PMID: 37271039 DOI: 10.1016/j.janxdis.2023.102729] [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: 08/18/2022] [Revised: 04/03/2023] [Accepted: 05/18/2023] [Indexed: 06/06/2023]
Abstract
Research has demonstrated a strong link between intolerance of uncertainty and generalized anxiety disorder (GAD). The current systematic review and meta-analysis aimed to evaluate how effective evidence-based psychological treatments are at reducing intolerance of uncertainty for adults with GAD. An extensive literature search identified 26 eligible studies, with a total of 1199 participants with GAD. Psychological treatments (k = 32 treatment groups) yielded large significant within-group effect size from pre- to post-treatment and pre-treatment to follow-up for intolerance of uncertainty (g = 0.88; g = 1.05), as well as related symptoms including worry (g = 1.32; g = 1.45), anxiety (g = 0.94; g = 1.04) and depression (g = 0.96; g = 1.00). Psychological treatment also yielded a large significant between-group effect on intolerance of uncertainty (g = 1.35). Subgroups analysis found that CBT that directly targeted intolerance of uncertainty (CBT-IU) throughout treatment was significantly more effective than general CBT at reducing intolerance of uncertainty (p < 0.01) and worry (p < 0.01) from pre- to post treatment, however, this result was not maintained at follow-up. Meta-regression analyses supported this finding as increases in the amount of time spent directly targeting intolerance of uncertainty, significantly increased the effect size for both intolerance of uncertainty (z = 2.01, p < 0.01) and worry (z = 2.23, p < 0.01). Overall, these findings indicate that psychological treatments are effective at reducing IU, and related symptom measures of GAD.
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Affiliation(s)
- Emily J Wilson
- Graduate School of Health, University of Technology Sydney, Australia
| | - Maree J Abbott
- School of Psychology, The University of Sydney, Australia.
| | - Alice R Norton
- Graduate School of Health, University of Technology Sydney, Australia; School of Psychology, The University of Sydney, Australia
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Rivero-Mendoza D, Caldwell CL, Cooper H, Goldberg J, Lamothe M, Logan S, Smith EB, Torna E, Zeldman JA, Dahl WJ. Recommending ultra-processed oral nutrition supplements for unintentional weight loss: Are there risks? Nutr Clin Pract 2023; 38:88-101. [PMID: 36286334 PMCID: PMC10092420 DOI: 10.1002/ncp.10921] [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: 04/13/2022] [Revised: 09/01/2022] [Accepted: 09/24/2022] [Indexed: 01/11/2023] Open
Abstract
Oral nutrition supplements (ONS) are widely recommended for the management of unintentional weight loss in patient populations, long-term care residents, and community-dwelling older adults. Most marketed ONS are ultra-processed, with precision nutrition and aseptic composition, as well as convenience and availability, driving their selection. However, therapeutic effectiveness is mixed and the potential health risks of consuming ultra-processed ONS long-term in lieu of less-processed foods have received little attention. A diverse and balanced microbiota supporting immunity and wellness is maintained by a diet rich in plant-sourced foods. The implications of ultra-processed ONS displacing plant-sourced foods, and specifically the potential for undesirable impacts on the gut microbiota, require consideration. Most ONS are either devoid of fiber or are supplemented with isolated or purified fibers that may contribute to adverse gastrointestinal symptoms and appetite suppression. In contrast, the diversity of microbial-available, nondigestible carbohydrates, together with the array of phytochemicals found in plant-sourced foods, support microbial diversity and its resiliency. This review outlines the clinical dilemma of recommending commercial ultra-processed ONS vs nutritionally adequate (eg, high-energy/high-protein) foods and beverages that contribute to diet quality, maintenance of a diverse and stable gut microbiota composition, and support nutrition status and health. Ultra-processed ONS may fall short of expected health benefits, and overreliance may potentially contribute to the risk for patient and older adult populations because of the displacement of a variety of healthful foods.
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Affiliation(s)
- Daniela Rivero-Mendoza
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA
| | - Cecelia L Caldwell
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA.,Department of Food and Nutrition Services, Ascension Sacred Heart Pensacola Hospital, Pensacola, Florida, USA
| | - Hannah Cooper
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA.,MRM Nutrition, San Diego, California, USA
| | - Jessica Goldberg
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA.,Veritas Collaborative, Atlanta, Georgia, USA
| | - Meagan Lamothe
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA.,Department of Food and Nutrition Services, University of Florida Health Shands Hospital, Gainesville, Florida, USA
| | - Sarah Logan
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA.,Lake Nona Performance Club, Orlando, Florida, USA
| | - Elena B Smith
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA
| | - Elena Torna
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA
| | - Jamie A Zeldman
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA.,Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida, USA
| | - Wendy J Dahl
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA
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Neil-Sztramko SE, Teggart K, Moore C, Sherifali D, Fitzpatrick-Lewis D, Coletta G, Phillips SM, Newbold KB, Alvarez E, Kuspinar A, Kennedy CC, Santaguida PL, Ganann R. Community-based group physical activity and/or nutrition interventions to promote mobility in older adults: an umbrella review. BMC Geriatr 2022; 22:539. [PMID: 35768770 PMCID: PMC9241281 DOI: 10.1186/s12877-022-03170-9] [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: 07/16/2021] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity and a healthy diet are important in helping to maintain mobility with aging. This umbrella review aims to identify group-based physical activity and/or nutrition interventions for community-dwelling older adults that improve mobility-related outcomes. METHODS Five electronic databases (MEDLINE, Embase, CINAHL, Cochrane CENTRAL, Sociological Abstracts) were searched from inception to December 2021. Eligibility criteria included systematic reviews exploring the effectiveness of physical activity or structured exercise, alone or combined with nutrition interventions on mobility-related outcomes (aerobic capacity, physical function, balance, falls/safety, muscle strength, health-related quality of life/wellbeing). Interventions must have been delivered in a group setting to community-dwelling older adults aged 55+. Two reviewers independently performed eligibility screening, critical appraisal (using AMSTAR 2) and data extraction. The GRADE approach was used to reflect the certainty of evidence based on the size of the effect within each mobility-related outcome category. Older adult/provider research partners informed data synthesis and results presentation. RESULTS In total, 62 systematic reviews (1 high, 21 moderate, 40 low/critically low quality) were identified; 53 included physical activity only, and nine included both physical activity and nutritional supplements. No reviews included nutrition interventions alone. Combined aerobic/resistance, general physical activity, and mind-body exercise all improved physical function and balance (moderate-high certainty). Aerobic/resistance training improved aerobic capacity (high certainty). Resistance training and general physical activity improved muscle strength (moderate certainty). Aerobic/resistance training and general physical activity are likely to reduce falls among older adults (moderate certainty). There was no evidence of benefit for nutritional supplementation with physical activity. CONCLUSIONS Group-based physical activity interventions that combine aerobic and resistance, general PA and mind-body exercise can improve measures of mobility in community-dwelling older adults. We found no reviews focused on nutrition only, highlighting a gap in the literature.
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Affiliation(s)
- Sarah E Neil-Sztramko
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8S 4K1, Canada.
| | - Kylie Teggart
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Caroline Moore
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Diana Sherifali
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Donna Fitzpatrick-Lewis
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Giulia Coletta
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Stuart M Phillips
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - K Bruce Newbold
- School of Earth, Environment & Society, Faculty of Science, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Elizabeth Alvarez
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8S 4K1, Canada
| | - Ayse Kuspinar
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Courtney C Kennedy
- Department of Medicine, Division of Geriatrics, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Pasqualina L Santaguida
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8S 4K1, Canada
| | - Rebecca Ganann
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, L8S 4K1, Canada
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Interventions to Improve Child Physical Activity in the Early Childhood Education and Care Setting: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041963. [PMID: 35206152 PMCID: PMC8872396 DOI: 10.3390/ijerph19041963] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 02/04/2023]
Abstract
Early childhood education and care (ECEC) services are a key setting to support improvements in the physical activity of young children. This umbrella review gathered and synthesised systematic review evidence of the effectiveness of interventions in the ECEC setting on the physical activity levels of children aged 0-6. We also mapped the current evidence to the existing ECEC sector-specific physical activity practice recommendations. Five electronic databases were searched to identify systematic reviews that evaluated the impact of any ECEC-based interventions on the physical activity levels (e.g., moderate-to-vigorous physical activity, total physical activity) of children aged 0-6. One reviewer extracted data on intervention effectiveness and quality of the reviews, checked by a second reviewer. Ten reviews were included. Overall, the majority of the reviews found interventions delivered in ECEC improved child physical activity. Across reviews, the impact of six intervention strategies were identified, mapped to four (of eight) broad recommendations (i.e., providing opportunity, offering educator training, educators promoting the benefits of physical activity, creating a physical activity-promoting environment). The impact of the majority of recommendations, however, did not have systematic review evidence. Further investigation of the effectiveness of ECEC-based physical activity strategies is required to demonstrate support for the existing recommended practices.
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Fernandez R, Sikhosana N, Green H, Halcomb EJ, Middleton R, Alananzeh I, Trakis S, Moxham L. Anxiety and depression among healthcare workers during the COVID-19 pandemic: a systematic umbrella review of the global evidence. BMJ Open 2021; 11:e054528. [PMID: 34548373 PMCID: PMC8458002 DOI: 10.1136/bmjopen-2021-054528] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To summarise the evidence relating to the prevalence of anxiety and depression among healthcare workers (HCWs) during the COVID-19 pandemic. DESIGN An umbrella review of systematic reviews was undertaken using the Joanna Briggs Institute (JBI) methods. DATA SOURCES The Cochrane database of systematic reviews, JBI Evidence Synthesis, MEDLINE, Web of Science, PsycINFO, Embase and CINAHL were searched in March 2021 for reviews published in English. ELIGIBILITY CRITERIA Systematic reviews reporting the prevalence of anxiety and depression among HCWs during the COVID-19 pandemic. Two researchers screened each abstract and independently reviewed full text articles. Study quality was assessed using the JBI critical appraisal tool for systematic reviews, and the degree of overlap in primary studies was calculated. RESULTS Ten systematic reviews (100 unique studies), including 169 157 HCWs from 35 countries were included. The prevalence of anxiety among all HCWs ranged from 22.2% (95% CI 21.3% to 23.1%) to 33.0% (95% CI 31.9% to 34.1%). The prevalence of anxiety among physicians (n=5820) was reported to be between 17% and 19.8% and for nurses (n=14 938) between 22.8% and 27%. The prevalence of depression among all HCWs ranged from 17.9% (95% CI 17.1% to 18.8%) to 36% (95% CI 34.9% to 37.1%). The prevalence of depression among physicians (n=643) and nurses (n=8063) was reported to be 40.4% and 28%, respectively. CONCLUSIONS There is wide variation evident in the presence of anxiety and depression among HCWs. In particular, the prevalence of depression among physicians was high. Strategies to reduce the incidence of anxiety and depression are urgently required. PROSPERO REGISTRATION NUMBER CRD42021238960.
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Affiliation(s)
- Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- St George Hospital, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
- Centre for Evidence based Initiatives in Health Care: A JBI Centre of Excellence, University of Wollongong, Wollongong, New South Wales, Australia
| | - Nqobile Sikhosana
- St George Hospital, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
- Centre for Evidence based Initiatives in Health Care: A JBI Centre of Excellence, University of Wollongong, Wollongong, New South Wales, Australia
| | - Heidi Green
- St George Hospital, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
- Centre for Evidence based Initiatives in Health Care: A JBI Centre of Excellence, University of Wollongong, Wollongong, New South Wales, Australia
| | - Elizabeth J Halcomb
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- St George Hospital, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
- Illawarra Health and Medical Research Institute (IHMRI), Wollongong, New South Wales, Australia
| | - Rebekkah Middleton
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- St George Hospital, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
- Illawarra Health and Medical Research Institute (IHMRI), Wollongong, New South Wales, Australia
| | - Ibrahim Alananzeh
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Stamatia Trakis
- St George Hospital, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
| | - L Moxham
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- St George Hospital, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
- Centre for Evidence based Initiatives in Health Care: A JBI Centre of Excellence, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute (IHMRI), Wollongong, New South Wales, Australia
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Padilla CJ, Ferreyro FA, Arnold WD. Anthropometry as a readily accessible health assessment of older adults. Exp Gerontol 2021; 153:111464. [PMID: 34256113 DOI: 10.1016/j.exger.2021.111464] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 12/30/2022]
Abstract
Anthropometry (derived from the Greek Anthropos: human, and metron: measure) refers to the systematic collection, and measurement of the physical characteristics of the human body, primarily body weight, body size, and shape. Anthropometric values are closely related to genetic factors, environmental characteristics, social, and cultural conditions, lifestyle, functional status, and health. Anthropometric measurements can be used to assess risk of malnutrition, obesity, muscle wasting, increased fat mass, and maldistribution of adipose tissue. Potential modifiable factors include circumferences, skinfolds, and body weight. While are height, and the bone diameters are non-modifiable. Kinanthropometry is the study of size, shape, proportionality, composition, biological maturation, and body function, in order to understand the process of growth, exercise, sports performance, and nutrition. Aging of the population, which is associated with increased risk of chronic disease, and disability, is one of the most important demographic changes facing many countries. Anthropometric indicators are simple, portable, non-invasive, inexpensive, and easily applied measurements that can be readily applied in geriatric populations to guide preventative measures, and medical interventions in older adults.
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Affiliation(s)
- Carlos J Padilla
- Division of Neuromuscular Diseases, Department of Neurology, The Ohio State Wexner Medical Center, Columbus, OH, USA.
| | - Fernando A Ferreyro
- Division of Nutritional Science, Department of Health Science, Universidad de las Americas Puebla, Puebla, Mexico.
| | - W David Arnold
- Division of Neuromuscular Diseases, Department of Neurology, The Ohio State Wexner Medical Center, Columbus, OH, USA; Department of PM&R, The Ohio State Wexner Medical Center, Columbus, OH, USA; Department of Neuroscience, The Ohio State Wexner Medical Center, Columbus, OH, USA; Department of Physiology and Cell Biology, The Ohio State Wexner Medical Center, Columbus, OH, USA.
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Dedov II, Shestakova MV, Melnichenko GA, Mazurina NV, Andreeva EN, Bondarenko IZ, Gusova ZR, Dzgoeva FK, Eliseev MS, Ershova EV, Zhuravleva MV, Zakharchuk TA, Isakov VA, Klepikova MV, Komshilova KA, Krysanova VS, Nedogoda SV, Novikova AM, Ostroumova OD, Pereverzev AP, Rozhivanov RV, Romantsova TI, Ruyatkina LA, Salasyuk AS, Sasunova AN, Smetanina SA, Starodubova AV, Suplotova LA, Tkacheva ON, Troshina EA, Khamoshina MV, Chechelnitskaya SM, Shestakova EA, Sheremet’eva EV. INTERDISCIPLINARY CLINICAL PRACTICE GUIDELINES "MANAGEMENT OF OBESITY AND ITS COMORBIDITIES". OBESITY AND METABOLISM 2021; 18:5-99. [DOI: 10.14341/omet12714] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | - M. S. Eliseev
- Research Institute of Rheumatogy named after V.A. Nasonova
| | | | | | | | - V. A. Isakov
- Federal Research Center of Nutrition, Biotechnology and Food Safety
| | - M. V. Klepikova
- Russian Medical Academy of Continuous Professional Education
| | | | | | | | - A. M. Novikova
- Research Institute of Rheumatogy named after V.A. Nasonova
| | - O. D. Ostroumova
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry
| | - A. P. Pereverzev
- Russian National Research Medical University named after N.I. Pirogov
| | | | | | | | | | - A. N. Sasunova
- Federal Research Center of Nutrition, Biotechnology and Food Safety
| | | | | | | | - O. N. Tkacheva
- Russian National Research Medical University named after N.I. Pirogov
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Wolfenden L, Barnes C, Lane C, McCrabb S, Brown HM, Gerritsen S, Barquera S, Véjar LS, Munguía A, Yoong SL. Consolidating evidence on the effectiveness of interventions promoting fruit and vegetable consumption: an umbrella review. Int J Behav Nutr Phys Act 2021; 18:11. [PMID: 33430879 PMCID: PMC7798190 DOI: 10.1186/s12966-020-01046-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/27/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The overarching objective was to examine the effectiveness of intervention strategies to promote fruit and vegetable consumption. To do this, systematic review evidence regarding the effects of intervention strategies was synthesized; organized, where appropriate, by the setting in which the strategies were implemented. Additionally, we sought to describe gaps in the review of evidence; that is, where evidence regarding the effectiveness of recommended policy actions had not been systematically synthesised. METHODS We undertook a systematic search of electronic databases and the grey literature to identify systematic reviews describing the effects of any intervention strategy targeting fruit and/or vegetable intake in children or adults of any age. RESULTS The effects of 32 intervention strategies were synthesised from the 19 included reviews. The strategies were mapped across all three broad domains of the NOURISHING framework (i.e. food environment, food system and behaviour change communication), but covered just 14 of the framework's 65 sub-policy areas. There was evidence supporting the effectiveness of 19 of the 32 intervention strategies. The findings of the umbrella review suggest that intervention strategies implemented within schools, childcare services, homes, workplaces and primary care can be effective, as can eHealth strategies, mass media campaigns, household food production strategies and fiscal interventions. CONCLUSIONS A range of effective strategy options are available for policy makers and practitioners interested in improving fruit and/or vegetable intake. However, the effects of many strategies - particularly those targeting agricultural production practices, the supply chain and the broader food system - have not been reported in systematic reviews. Primary studies assessing the effects of these strategies, and the inclusion of such studies in systematic reviews, are needed to better inform national and international efforts to improve public health nutrition. TRIAL REGISTRATION The review protocol was deposited in a publicly available Open Science framework prior to execution of the search strategy. https://osf.io/unj7x/.
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Affiliation(s)
- Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Hunter New England Population Health, Locked Bag 10 Wallsend NSW, Newcastle, NSW, 2287, Australia.
- Corporación Actuemos, Santiago, Chile.
| | - Courtney Barnes
- School of Medicine and Public Health, The University of Newcastle, Hunter New England Population Health, Locked Bag 10 Wallsend NSW, Newcastle, NSW, 2287, Australia
| | - Cassandra Lane
- School of Medicine and Public Health, The University of Newcastle, Hunter New England Population Health, Locked Bag 10 Wallsend NSW, Newcastle, NSW, 2287, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, The University of Newcastle, Hunter New England Population Health, Locked Bag 10 Wallsend NSW, Newcastle, NSW, 2287, Australia
| | - Hannah M Brown
- School of Medicine and Public Health, The University of Newcastle, Hunter New England Population Health, Locked Bag 10 Wallsend NSW, Newcastle, NSW, 2287, Australia
| | - Sarah Gerritsen
- Corporación Actuemos, Santiago, Chile
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Simon Barquera
- Corporación Actuemos, Santiago, Chile
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Lesly Samara Véjar
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Ana Munguía
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Sze Lin Yoong
- Swinburne University of Technology, School of Health Sciences, Hawthorn, VIC, Australia
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Khalil H, Ellwood L, Lord H, Fernandez R. Pharmacological Treatment for Obesity in Adults: An Umbrella Review. Ann Pharmacother 2020; 54:691-705. [PMID: 31958967 DOI: 10.1177/1060028019898912] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objective: To synthesize the evidence from systematic reviews of clinical trials investigating the effectiveness of pharmacological therapies approved by the Australian Therapeutic Goods Administration and the US Food and Drug Administration for the management of obesity in adults. Data Sources: A 3-step literature search of the MEDLINE, EMBASE, CINAHL, and PubMed databases was conducted between March and May 2019. The key terms used were obesity, pharmacological therapy, antiobesity agent, antiobesity medication, weight loss, and systematic review. Study Selection and Data Extraction: Systematic reviews that evaluated the effectiveness of pharmacological therapies for the management of obesity in patients with a body mass index of or greater than 25 kg/m2. Data Synthesis: Nine systematic reviews involving three pharmacotherapies, liraglutide, orlistat, and naltrexone-bupropion were identified. The results indicate that the pharmacotherapies reduced weight when compared with placebo. Orlistat was effective in significantly reducing fasting blood glucose, HbA1c, total cholesterol, triglycerides, and systolic and diastolic blood pressure. All reviews discussed the presence or risk of gastrointestinal adverse effects including diarrhea, vomiting, and nausea related to orlistat and liraglutide. Relevance to Patient Care and Clinical Practice: This umbrella review compares the efficacy and safety of antiobesity medications for reducing weight and a discussion on their weight loss and metabolic control to guide clinicians when prescribing medications for obesity. Conclusions: All pharmacological therapies included in this review are superior to placebo in reducing weight. Clinicians should consider patient comorbidities and risk of adverse events when recommending medications for weight loss.
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Affiliation(s)
- Hanan Khalil
- La Trobe University, Melbourne, Victoria, Australia
| | - Laura Ellwood
- Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of Excellence, Wollongong, New South Wales, Australia.,St George Hospital, Kogarah, New South Wales, Australia
| | - Heidi Lord
- Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of Excellence, Wollongong, New South Wales, Australia.,St George Hospital, Kogarah, New South Wales, Australia
| | - Ritin Fernandez
- Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of Excellence, Wollongong, New South Wales, Australia.,St George Hospital, Kogarah, New South Wales, Australia.,University of Wollongong, Wollongong, New South Wales, Australia
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Abstract
The NOVA food categorisation recommends ‘avoiding processed foods (PF), especially ultra-processed foods (UPF)’ and selecting minimally PF to address obesity and chronic disease. However, NOVA categories are drawn using non-traditional views of food processing with additional criteria including a number of ingredients, added sugars, and additives. Comparison of NOVA's definition and categorisation of PF with codified and published ones shows limited congruence with respect to either definition or food placement into categories. While NOVA studies associate PF with decreased nutrient density, other classifications find nutrient-dense foods at all levels of processing. Analyses of food intake data using NOVA show UPF provide much added sugars. Since added sugars are one criterion for designation as UPF, such a proof demonstrates a tautology. Avoidance of foods deemed as UPF, such as wholegrain/enriched bread and cereals or flavoured milk, may not address obesity but could decrease intakes of folate, calcium and dietary fibre. Consumer understanding and implementation of NOVA have not been tested. Neither have outcomes been compared with vetted patterns, such as Dietary Approaches to Stop Hypertension, which base food selection on food groups and nutrient contribution. NOVA fails to demonstrate the criteria required for dietary guidance: understandability, affordability, workability and practicality. Consumers’ confusion about definitions and food categorisations, inadequate cooking and meal planning skills and scarcity of resources (time, money), may impede adoption and success of NOVA. Research documenting that NOVA can be implemented by consumers and has nutrition and health outcomes equal to vetted patterns is needed.
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