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Gatzemeier J, Wilkinson LL, Price MJ, Lee MD. Self-identified strategies to manage intake of tempting foods: cross-sectional and prospective associations with BMI and snack intake. Public Health Nutr 2024; 27:e107. [PMID: 38504524 PMCID: PMC11036431 DOI: 10.1017/s1368980024000697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 02/28/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVES Individuals often use self-directed strategies to manage intake of tempting foods, but what these strategies are and whether they are effective is not well understood. This study assessed the frequency of use and subjective effectiveness of self-directed strategies in relation to BMI and snack intake. DESIGN A cross-sectional and prospective study with three time points (T1: baseline, T2: 3 months and T3: 3 years). At T1, demographics, frequency of use and subjective effectiveness of forty-one identified strategies were assessed. At T2 and T3, current weight was reported, and at T2 frequency of snack intake was also recorded. SETTING Online study in the UK. PARTICIPANTS Data from 368 participants (Mage = 34·41 years; MBMI = 25·06 kg/m2) were used for analysis at T1, n = 170 (46·20 % of the total sample) at T2 and n = 51 (13·59 %) at T3. RESULTS Two strategy factors were identified via principal axis factoring: (1) diet, exercise, reduction of temptations, and cognitive strategies, and (2) planning, preparation and eating style. For strategy 1, frequency of use, but not subjective effectiveness, was positively related to BMI at T1. Subjective effectiveness predicted an increase in BMI from T1 and T2 to T3. No relationship to snack intake was found. For strategy 2, frequency of use was negatively related to BMI at T1. Neither frequency of use nor subjective effectiveness were related to changes in BMI over time, but subjective effectiveness was negatively correlated with unhealthy snack intake. CONCLUSION Self-directed strategies to reduce the intake of tempting foods are not consistently related to BMI or snack intake.
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Affiliation(s)
| | | | - Menna J Price
- School of Psychology, Swansea University,
SA2 8PPSwansea, UK
| | - Michelle D Lee
- School of Psychology, Swansea University,
SA2 8PPSwansea, UK
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2
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Zhang Y, Duan Y, Long T, Wu Y, Huang J, Zhang Y, Li M. The specially designed nudging tableware promotes healthy food choices: Evidence from a randomized crossover trial in normal-weight young adults. Physiol Behav 2024; 273:114412. [PMID: 37981095 DOI: 10.1016/j.physbeh.2023.114412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/13/2023] [Accepted: 11/16/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE To evaluate the effects of the specially designed nudging tableware, including a plate and bowl, on individual food choices in normal-weight young adults and preliminarily explore its mechanisms. We hypothesized that the toolset could increase the choice of vegetables and decrease that of rice. METHODS A randomized, single-blind, two-period crossover trial was carried out among 40 normal-weight university students in China. All subjects completed two buffets separated by an interval of one week, wearing the eye tracker. Vegetable choice, evaluated through the proportion of vegetables, was the primary outcome, and the weight of vegetables and rice were the secondary outcomes. The mechanisms of the decision-making process were preliminarily explored through eye tracking. RESULTS The usage of the nudging tableware significantly increased the proportion of vegetables and decreased the amount of rice taken (P<0.05), while insignificantly increased the weight of vegetables (P = 0.079). Eye tracking shows that the nudging plate significantly prolonged the food-choosing process and fixation duration on vegetables (P<0.05), and the latter was positively correlated to the increased quantity of vegetables while using the nudging plate (r = 0.493, P<0.01). CONCLUSION The specially designed nudging tableware might be an effective and practical tool to promote the choice of less rice and more vegetables. Mechanisms behind this change might include automatic and unconscious processes with the inconspicuously smaller capacity of the bowl and larger portion size of the vegetable segment, and increased attention triggered by the vegetable patterns and larger green underpainting.
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Affiliation(s)
- Yiyun Zhang
- Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; School of Nursing, Peking University, Peking University Health Science Center, 38 Huayuan Road, Haidian District, Beijing 100191, China; A Joanna Briggs Institute Affiliated Group, Peking University Health Science Centre for Evidence-Based Nursing, Beijing, China
| | - Yachen Duan
- Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; School of Nursing, Peking University, Peking University Health Science Center, 38 Huayuan Road, Haidian District, Beijing 100191, China; A Joanna Briggs Institute Affiliated Group, Peking University Health Science Centre for Evidence-Based Nursing, Beijing, China
| | - Tianxue Long
- Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; School of Nursing, Peking University, Peking University Health Science Center, 38 Huayuan Road, Haidian District, Beijing 100191, China; A Joanna Briggs Institute Affiliated Group, Peking University Health Science Centre for Evidence-Based Nursing, Beijing, China
| | - Yi Wu
- Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; School of Nursing, Peking University, Peking University Health Science Center, 38 Huayuan Road, Haidian District, Beijing 100191, China; A Joanna Briggs Institute Affiliated Group, Peking University Health Science Centre for Evidence-Based Nursing, Beijing, China
| | - Jing Huang
- Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; School of Nursing, Peking University, Peking University Health Science Center, 38 Huayuan Road, Haidian District, Beijing 100191, China; A Joanna Briggs Institute Affiliated Group, Peking University Health Science Centre for Evidence-Based Nursing, Beijing, China
| | - Yating Zhang
- Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; School of Nursing, Peking University, Peking University Health Science Center, 38 Huayuan Road, Haidian District, Beijing 100191, China; A Joanna Briggs Institute Affiliated Group, Peking University Health Science Centre for Evidence-Based Nursing, Beijing, China
| | - Mingzi Li
- Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; School of Nursing, Peking University, Peking University Health Science Center, 38 Huayuan Road, Haidian District, Beijing 100191, China; A Joanna Briggs Institute Affiliated Group, Peking University Health Science Centre for Evidence-Based Nursing, Beijing, China.
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Spreckley M, de Lange J, Seidell JC, Halberstadt J. Patient insights into the experience of trying to achieve weight-loss and future expectations upon commencement of a primary care-led weight management intervention: A qualitative, baseline exploration. PLoS One 2022; 17:e0270426. [PMID: 35767563 PMCID: PMC9242434 DOI: 10.1371/journal.pone.0270426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 06/09/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction The long-term effects of interventions aiming to achieve substantial, sustainable weight loss maintenance have been disappointing. Most people regain their lost weight over time but some seem to be able to maintain their weight loss. We are following the experiences of patients over time prospectively. This study forms the baseline to provide insights into patient experiences prior to entering a primary care-led weight management intervention and their expectations going forward. Materials and methods We recruited 21 adult male and female patients of varying ethnicity with a BMI between 27.7kg/m2 and 48.4kg/m2 from a cohort of patients entering a primary care-led weight management intervention. Patients were offered video and audio interview options during the COVID-19 lockdown. In total, twenty chose the audio option, while one chose the video option. The interview format was semi-structured with room for individual exploration. Discussion We found that participants experienced feeling unable to control their weight and encountered a multitude of internal and external barriers to weight management. Some had supportive environments, while others experienced discouraging external influences. Though personal characteristics varied, motivations, goals and expected benefits were similar across this cohort. Most participants had previously experienced transient successful weight-loss attempts with varying approaches. COVID-19 was experienced as an opportunity or barrier for change. Conclusion This study illustrates the importance of gaining comprehensive insights into the diverse experiences patients encounter when trying to achieve weight loss. Personalized support taking into account individual experiences and circumstances may enhance long-term treatment outcomes. Future research into the complexities of weight management based on individual accounts can aid in the creation of improved treatment protocols.
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Affiliation(s)
- Marie Spreckley
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- * E-mail:
| | - Judith de Lange
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Jacob C. Seidell
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Jutka Halberstadt
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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Spreckley M, Seidell J, Halberstadt J. Perspectives into the experience of successful, substantial long-term weight-loss maintenance: a systematic review. Int J Qual Stud Health Well-being 2021; 16:1862481. [PMID: 33455563 PMCID: PMC7833027 DOI: 10.1080/17482631.2020.1862481] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Purpose: In light of the increasing prevalence of overweight and obesity, understanding the experiences, strategies and challenges encountered when trying to achieve substantial, sustainable weight loss is an important area to investigate. We systematically evaluated qualitative studies focusing on the accounts of individuals who have achieved sustained weight loss to create a comprehensive picture of the experience of sustainable weight loss. Methods: Included studies were peer-reviewed studies that qualitatively assessed the views and experiences of adults who previously had or currently have overweight or obesity who successfully lost weight and who subsequently maintained or regained weight. The evidence was systematically synthesized, which enabled the formulation of clear themes and recommendations. Results: The 15 chosen studies included the accounts of 294 individuals. We found that continuous monitoring and goal setting, driven by sustained motivation and encouraging experiences, while resisting ever present challenges and enduring discouraging experience encapsulates the experience of sustained, substantial weight loss. Conclusions: This review aims to provide a comprehensive understanding of the experiences, strategies and challenges encountered when trying to achieve substantial, sustained weight loss. Additional research taking into account findings from this review and others of its kind will enhance the formulation of treatment protocols.
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Affiliation(s)
- Marie Spreckley
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam , Amsterdam, Netherlands
| | - Jaap Seidell
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam , Amsterdam, Netherlands
| | - Jutka Halberstadt
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam , Amsterdam, Netherlands
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Iłowiecka K, Glibowski P, Skrzypek M, Styk W. The Long-Term Dietitian and Psychological Support of Obese Patients Who Have Reduced Their Weight Allows Them to Maintain the Effects. Nutrients 2021; 13:nu13062020. [PMID: 34208363 PMCID: PMC8231289 DOI: 10.3390/nu13062020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 12/25/2022] Open
Abstract
The role of post-therapeutic support after weight loss in obesity treatment is not fully understood. Therefore, weight maintenance after a successful weight loss intervention is not very common, especially in obese individuals. This randomized controlled study was conducted to explore the efficacy of following dietary and psychological support in a group of 36 obese individuals. Participants (22 women, 14 men aged 35.58 ± 9.85 years, BMI 35.04 ± 3.80 kg/m2) who completed a 12-month weight loss phase (balanced energy-restricted diet) were randomly allocated to receive 18-month support (SG) or no additional care (CG). The support phase included some elements of Ten Top Tips (TTT), cognitive behavioral therapy (CBT), motivational interviewing (MI) in combination with nutritional education and assessment of the level of physical activity. The primary outcome was the maintenance of anthropometric parameters at an 18-month follow-up. The secondary outcomes included evaluation of biochemical parameters and single nucleotide polymorphisms (SNPs) in genes connected with obesity. A comparison of SG vs. CG after a 30-month period of the study revealed significant differences in weight changes (−3.83 ± 6.09 vs. 2.48 ± 6.24 kg), Body Mass Index (−1.27 ± 2.02 vs. 0.72 ± 2.12 kg/m2), visceral adipose tissue (−0.58 ± 0.63 vs. 0.45 ± 0.74 L), and waist circumference (−4.83 ± 4.05 vs. 1.83 ± 5.97 cm). Analysis of SNPs (rs9939609 FTO, rs987237 TFAP2B, and rs894160 PLIN1) provided further insight into the potential modulating effect of certain genotypes on weight loss and maintenance and extended the knowledge of the potential benefits of personalized medicine. Post-therapeutical support in current clinical practice may increase the chances of long-term weight loss maintenance in obesity treatment even in patients with a genetic predisposition to excessive weight.
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Affiliation(s)
- Katarzyna Iłowiecka
- Department of Biotechnology, Microbiology and Human Nutrition, University of Life Sciences in Lublin, 20-704 Lublin, Poland;
| | - Paweł Glibowski
- Department of Biotechnology, Microbiology and Human Nutrition, University of Life Sciences in Lublin, 20-704 Lublin, Poland;
- Correspondence: ; Tel.: +48-(81)-462-33-49
| | - Michał Skrzypek
- Department of Clinical Dietetics, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Wojciech Styk
- Institute of Psychology, The John Paul II Catholic University of Lublin, 20-950 Lublin, Poland;
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Roslim NA, Ahmad A, Mansor M, Aung MMT, Hamzah F, Lua PL. The feasibility and acceptability of hypnotherapy among overweight and obese individuals in a Malaysia's public university. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 18:561-568. [PMID: 33794082 DOI: 10.1515/jcim-2020-0177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/02/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The global epidemic of overweight and obesity presents a major challenge in the health status of the society. Their prevalence is at an alarming rate worldwide due to poor compliance with conventional treatment and high rates of relapse, thus increasing demand for an effective and safe alternative approach such as hypnotherapy. This study aimed to evaluate the feasibility and acceptability of hypnotherapy for weight loss and to compare these among selected socio-demographics. METHODS A cross-sectional study was conducted among 30 students and staff of a public university in Terengganu, Malaysia using convenience sampling. Data analysis was carried out using SPSS 23.0. RESULTS Among the respondents (age = 26.17 ± 8.23 years; female = 66.7%; students = 63.3%), 40.0% were overweight and 60.0% were obese. Results indicated excellent feasibility as determined by participants' satisfaction towards the clarity of hypnotherapist's voice (93.3%), the suitability of content (86.7%) and time spent for the session (90.0%). Good overall acceptability (>60.0%) was also reported regarding hypnotherapist professionalism, the environment and perceived usefulness of hypnotherapy. Obese individuals were significantly more satisfied towards the hypnotherapist environment than overweight respondents (p=0.015). Additionally, no adverse effects were reported after the intervention. CONCLUSIONS This evidence signalled that hypnotherapy is a promising alternative tool in assisting overweight and obese individuals to lose weight. Extensive research is needed to substantiate its role in weight management programs for its full benefits.
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Affiliation(s)
- Nurul Afiedia Roslim
- Faculty of Pharmacy, Universiti Sultan Zainal Abidin (UniSZA), Besut, Terengganu, Malaysia
| | - Aryati Ahmad
- Faculty of Health Science, Universiti Sultan Zainal Abidin (UniSZA), Kuala Nerus, Terengganu, Malaysia
| | - Mardiana Mansor
- Faculty of Medicine, Universiti Sultan Zainal Abidin (UniSZA), Kuala Terengganu, Terengganu, Malaysia
| | - Myat Moe Thwe Aung
- Faculty of Medicine, Universiti Sultan Zainal Abidin (UniSZA), Kuala Terengganu, Terengganu, Malaysia
| | - Farrahdilla Hamzah
- Faculty of Medicine, Universiti Sultan Zainal Abidin (UniSZA), Kuala Terengganu, Terengganu, Malaysia
| | - Pei Lin Lua
- Faculty of Pharmacy, Universiti Sultan Zainal Abidin (UniSZA), Besut, Terengganu, Malaysia
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Determinants favoring weight regain after weight-loss therapy among postmenopausal women. Sci Rep 2020; 10:17713. [PMID: 33077809 PMCID: PMC7572409 DOI: 10.1038/s41598-020-74302-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 09/28/2020] [Indexed: 11/18/2022] Open
Abstract
Little is known about the factors affecting body weight-loss maintenance among postmenopausal women. We thus performed an analysis to identify some sociodemographic, physiological, and behavioral predictors of weight regain in a targeted subpopulation of women who had lost weight 1 year earlier. We also measured how eating behaviors and habits as well as physical activity pattern differ among successful and unsuccessful weight-loss maintainers over the trial. Sixty-four postmenopausal women were followed up for a year after dieting, and the successful and unsuccessful maintainers were identified. The regainers had regained an average of 4.9 kg of their lost body weight, while the maintainers had regained only 1.5 kg. Regainers had fewer years of education and lower initial body weight loss than maintainers. They also showed poor dietary adherence during dieting, and had unhealthy patterns of eating involving the avoidance of breakfast and a lower intake of nuts, seeds, and pulses, and a higher intake of sweets, biscuits, cakes, and pastries over time (excluding the dieting period). All the significant sociodemographic, physiological and behavioral variables differentiating regainers and maintainers before and after dieting were then examined as independent variables in a logistic regression model. The model showed that less weight reduction during dieting, higher disinhibition scores after dieting, and avoidance of breakfast before dieting were significant predictors of body weight regain in postmenopausal women. From a practical point of view, early identification of postmenopausal women who are at risk of regaining lost weight can allow health professionals to create behavioral and dietary supports to help prevent this. A regular schedule of follow-ups over at least the first year should be considered for them—including psychological and dietary intervention, if necessary. Since this sample study included only postmenopausal women, our findings are not generalizable to other populations.
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Jorge R, Santos I, Teixeira VH, Teixeira PJ. Does diet strictness level during weekends and holiday periods influence 1-year follow-up weight loss maintenance? Evidence from the Portuguese Weight Control Registry. Nutr J 2019; 18:3. [PMID: 30634981 PMCID: PMC6330473 DOI: 10.1186/s12937-019-0430-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 01/06/2019] [Indexed: 11/10/2022] Open
Abstract
There is not much evidence about how diet strictness during weekends and holidays influence long-term weight loss maintenance. Our aim was to examine how dieting more or less strictly during weekends and holidays (vs. weekdays and non-holiday periods) influence weight loss maintenance.Participants (n = 108) from the Portuguese Weight Control Registry indicated whether they had a more or less strict diet regimen during weekends compared to weekdays. A similar question about holiday and non-holiday period' diet regimen was answered. Weight and height were measured at baseline and 1y follow-up. A 3% maximum weight variation defined participants as "non-regainers".General level on dieting strictness on weekends vs. weekdays (r = - 0.28, p < 0.01) and holidays vs. non-holidays (r = - 0.33, p < 0.001) predicted 1y weight change.Participants who reported being less strict on weekends (OR = 0.34, 95% CI: 0.15-0.81) were more likely to be non-regainers when compared with the ones who reported being more strict on weekends. Non-significant results were found during holidays (OR = 0.47, 95% CI: 0.20-1.09).Adopting a less strict diet regimen during weekends, when compared to weekdays, was a behavioral strategy associated with long-term weight management in our sample.
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Affiliation(s)
- Rui Jorge
- Self-Regulation in Physical Activity, Nutrition and Obesity Research Group (PANO-SR), Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-687, Cruz Quebrada, Portugal.,Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Quinta da Granja, 2829-511, Monte de Caparica, Portugal.,Faculty of Nutrition and Food Sciences (FCNA), University of Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal
| | - Inês Santos
- Self-Regulation in Physical Activity, Nutrition and Obesity Research Group (PANO-SR), Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-687, Cruz Quebrada, Portugal.
| | - Vitor Hugo Teixeira
- Faculty of Nutrition and Food Sciences (FCNA), University of Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal.,Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
| | - Pedro Jorge Teixeira
- Self-Regulation in Physical Activity, Nutrition and Obesity Research Group (PANO-SR), Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-687, Cruz Quebrada, Portugal
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Sandercock V, Andrade J. Evaluation of Worksite Wellness Nutrition and Physical Activity Programs and Their Subsequent Impact on Participants' Body Composition. J Obes 2018; 2018:1035871. [PMID: 30631593 PMCID: PMC6304910 DOI: 10.1155/2018/1035871] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/17/2018] [Accepted: 11/05/2018] [Indexed: 12/14/2022] Open
Abstract
Background Adult obesity is globally recognized as a public health concern. As adults spend most of their weekdays at work, worksite wellness programs may include topics of nutrition education and physical activity to improve an employee's body composition. However, results are inconsistent with the impact they have on employees' body composition. Objective The purpose of this systematic review was to evaluate worksite wellness nutrition and physical activity programs and their subsequent impact on participants' body composition. Methods Extraction of articles was completed through 4 databases: PubMed, CINAHL, SCOPUS, and PsycINFO using keywords such as "nutrition and physical activity interventions/programs" and "weight." A 9-point inclusion criterion was established. Evaluation of the articles was assessed using the Academy of Nutrition and Dietetics Evidence-Based Manual. Results A total of 962 articles were identified. Twenty-three met the inclusion criterion. Seventeen studies resulted in a change in body composition (e.g., decreased BMI (kg/m2), waist circumference, and body fat percentage), and six studies did not show any changes. Programs that had professionals frequently interact with participants, regardless if the interactions were done daily, weekly, or monthly, led to a change in body composition. Additionally, programs that incorporated a motivation theory and provided content relevant to participants' needs resulted in a change in body composition. Conclusion Evidence supports that future worksite wellness programs that are designed using a motivational theory and content that is created relevant to participants' needs and that has frequent interactions with participants may result in a change in body composition.
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Affiliation(s)
- Victoria Sandercock
- School of Family and Consumer Sciences, Eastern Illinois University, Charleston 61920, USA
| | - Jeanette Andrade
- Food Science and Human Nutrition, University of Florida, Gainesville, FL 32611, USA
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LeBlanc ES, Patnode CD, Webber EM, Redmond N, Rushkin M, O'Connor EA. Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2018; 320:1172-1191. [PMID: 30326501 DOI: 10.1001/jama.2018.7777] [Citation(s) in RCA: 267] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Overweight and obesity have been associated with adverse health effects. OBJECTIVE To systematically review evidence on benefits and harms of behavioral and pharmacotherapy weight loss and weight loss maintenance interventions in adults to inform the US Preventive Services Task Force. DATA SOURCES MEDLINE, PubMed Publisher-Supplied Records, PsycINFO, and the Cochrane Central Register of Controlled Trials for studies published through June 6, 2017; ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials through August 2017; and ongoing surveillance in targeted publications through March 23, 2018. Studies from previous reviews were reevaluated for inclusion. STUDY SELECTION Randomized clinical trials (RCTs) focusing on weight loss or weight loss maintenance in adults. DATA EXTRACTION AND SYNTHESIS Data were abstracted by one reviewer and confirmed by another. Random-effects meta-analyses were conducted for weight loss outcomes in behavior-based interventions. MAIN OUTCOMES AND MEASURES Health outcomes, weight loss or weight loss maintenance, reduction in obesity-related conditions, and adverse events. RESULTS A total of 122 RCTs (N = 62 533) and 2 observational studies (N = 209 993) were identified. Compared with controls, participants in behavior-based interventions had greater mean weight loss at 12 to 18 months (-2.39 kg [95% CI, -2.86 to -1.93]; 67 studies [n = 22065]) and less weight regain (-1.59 kg [95% CI, -2.38 to -0.79]; 8 studies [n = 1408]). Studies of medication-based weight loss and maintenance interventions also reported greater weight loss or less weight regain in intervention compared with placebo groups at 12 to 18 months (range, -0.6 to -5.8 kg; no meta-analysis). Participants with prediabetes in weight loss interventions had a lower risk of developing diabetes compared with controls (relative risk, 0.67 [95% CI, 0.51 to 0.89]). There was no evidence of other benefits, but most health outcomes such as mortality, cardiovascular disease, and cancer were infrequently reported. Small improvements in quality of life in some medication trials were noted but were of unclear clinical significance. There was no evidence of harm such as cardiovascular disease from behavior-based interventions; higher rates of adverse events were associated with higher dropout rates in medication groups than in placebo groups. CONCLUSIONS AND RELEVANCE Behavior-based weight loss interventions with or without weight loss medications were associated with more weight loss and a lower risk of developing diabetes than control conditions. Weight loss medications, but not behavior-based interventions, were associated with higher rates of harms. Long-term weight and health outcomes data, as well as data on important subgroups, were limited.
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Affiliation(s)
- Erin S LeBlanc
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Carrie D Patnode
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Elizabeth M Webber
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Nadia Redmond
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Megan Rushkin
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Elizabeth A O'Connor
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
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