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Mehta NH, Huey SL, Kuriyan R, Peña-Rosas JP, Finkelstein JL, Kashyap S, Mehta S. Potential Mechanisms of Precision Nutrition-Based Interventions for Managing Obesity. Adv Nutr 2024; 15:100186. [PMID: 38316343 PMCID: PMC10914563 DOI: 10.1016/j.advnut.2024.100186] [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: 09/20/2023] [Revised: 01/17/2024] [Accepted: 02/01/2024] [Indexed: 02/07/2024] Open
Abstract
Precision nutrition (PN) considers multiple individual-level and environmental characteristics or variables to better inform dietary strategies and interventions for optimizing health, including managing obesity and metabolic disorders. Here, we review the evidence on potential mechanisms-including ones to identify individuals most likely to respond-that can be leveraged in the development of PN interventions addressing obesity. We conducted a review of the literature and included laboratory, animal, and human studies evaluating biochemical and genetic data, completed and ongoing clinical trials, and public programs in this review. Our analysis describes the potential mechanisms related to 6 domains including genetic predisposition, circadian rhythms, physical activity and sedentary behavior, metabolomics, the gut microbiome, and behavioral and socioeconomic characteristics, i.e., the factors that can be leveraged to design PN-based interventions to prevent and treat obesity-related outcomes such as weight loss or metabolic health as laid out by the NIH 2030 Strategic Plan for Nutrition Research. For example, single nucleotide polymorphisms can modify responses to certain dietary interventions, and epigenetic modulation of obesity risk via physical activity patterns and macronutrient intake have also been demonstrated. Additionally, we identified limitations including questions of equitable implementation across a limited number of clinical trials. These include the limited ability of current PN interventions to address systemic influences such as supply chains and food distribution, healthcare systems, racial or cultural inequities, and economic disparities, particularly when designing and implementing PN interventions in low- and middle-income communities. PN has the potential to help manage obesity by addressing intra- and inter-individual variation as well as context, as opposed to "one-size fits all" approaches though there is limited clinical trial evidence to date.
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Affiliation(s)
- Neel H Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - Samantha L Huey
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States; Center for Precision Nutrition and Health, Cornell University, Ithaca, NY, United States
| | - Rebecca Kuriyan
- Division of Nutrition, St. John's Research Institute, Bengaluru, Karnataka, India
| | - Juan Pablo Peña-Rosas
- Global Initiatives, The Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland
| | - Julia L Finkelstein
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States; Center for Precision Nutrition and Health, Cornell University, Ithaca, NY, United States; Division of Nutrition, St. John's Research Institute, Bengaluru, Karnataka, India
| | - Sangeeta Kashyap
- Division of Endocrinology, Diabetes and Metabolism, Weill Cornell Medicine New York Presbyterian, New York, NY, United States
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States; Center for Precision Nutrition and Health, Cornell University, Ithaca, NY, United States; Division of Medical Informatics, St. John's Research Institute, Bengaluru, Karnataka, India.
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Schiano E, Iannuzzo F, Stornaiuolo M, Guerra F, Tenore GC, Novellino E. Gengricin ®: A Nutraceutical Formulation for Appetite Control and Therapeutic Weight Management in Adults Who Are Overweight/Obese. Int J Mol Sci 2024; 25:2596. [PMID: 38473841 DOI: 10.3390/ijms25052596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
In the field of nutritional science and metabolic disorders, there is a growing interest in natural bitter compounds capable of interacting with bitter taste receptors (TAS2Rs) useful for obesity management and satiety control. This study aimed to evaluate the effect of a nutraceutical formulation containing a combination of molecules appropriately designed to simultaneously target and stimulate these receptors. Specifically, the effect on CCK release exerted by a multi-component nutraceutical formulation (Cinchona bark, Chicory, and Gentian roots in a 1:1:1 ratio, named Gengricin®) was investigated in a CaCo-2 cell line, in comparison with Cinchona alone. In addition, these nutraceutical formulations were tested through a 3-month randomized controlled trial (RCT) conducted in subjects who were overweight-obese following a hypocaloric diet. Interestingly, the Gengricin® group exhibited a significant greater weight loss and improvement in body composition than the Placebo and Cinchona groups, indicating its effectiveness in promoting weight regulation. Additionally, the Gengricin® group reported higher satiety levels and a significant increase in serum CCK levels, suggesting a physiological basis for the observed effects on appetite control. Overall, these findings highlight the potential of natural nutraceutical strategies based on the combination of bitter compounds in modulating gut hormone release for effective appetite control and weight management.
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Affiliation(s)
- Elisabetta Schiano
- Inventia Biotech-Healthcare Food Research Center s.r.l., Strada Statale Sannitica KM 20.700, 81020 Caserta, Italy
| | - Fortuna Iannuzzo
- Department of Pharmacy, University of Chieti-Pescara G. D'Annunzio, 66100 Chieti, Italy
| | - Mariano Stornaiuolo
- Department of Pharmacy, University of Naples Federico II, Via Domenico Montesano 59, 80131 Naples, Italy
| | - Fabrizia Guerra
- NGN Healthcare-New Generation Nutraceuticals s.r.l., Torrette Via Nazionale 207, 83013 Mercogliano, Italy
| | - Gian Carlo Tenore
- Department of Pharmacy, University of Naples Federico II, Via Domenico Montesano 59, 80131 Naples, Italy
| | - Ettore Novellino
- Inventia Biotech-Healthcare Food Research Center s.r.l., Strada Statale Sannitica KM 20.700, 81020 Caserta, Italy
- Department of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, Italy
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Timkova V, Minarikova D, Fabryova L, Buckova J, Minarik P, Katreniakova Z, Nagyova I. Facilitators and barriers to behavior change in overweight and obesity management using the COM-B model. Front Psychol 2024; 15:1280071. [PMID: 38455118 PMCID: PMC10919221 DOI: 10.3389/fpsyg.2024.1280071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 02/05/2024] [Indexed: 03/09/2024] Open
Abstract
Introduction Increasing overweight and obesity rates represent one of the global public health challenges. COM-B is a theoretical model used to identify areas to target to achieve behavior change. It identifies three factors that are needed for any behavior to occur: capability, opportunity, and motivation. We aimed to assess the potential facilitators and barriers to behavior change in weight management using the COM-B. Methods The study included 139 people with overweight and obesity (mean age 48.81 ± 14.49 years; 64.5% female; body mass index 32.64 ± 6.51 kg/m2; waist-to-height ratio 0.62 ± 0.10) from primary care settings. All participants completed the Brief Measure of Behavior Change (COM-B), the General Self-Efficacy Scale (GSE), the Rosenberg Self-esteem Scale (RSE), and the Overall Evaluation of Health (OEH). Multiple linear regression was performed to analyse the data. Results The associations between sociodemographic and clinical variables and COM-B domains attenuated or were no longer significant when psychological resources were added to the regression models. Self-efficacy was identified as a stronger facilitator of health behavior change (p < 0.001) when compared to self-esteem (p < 0.05). No associations between automatic motivation and psychological resources were identified, however. Automatic motivation was found to be associated with higher age, being in a relationship, and better health. Discussion Behavioral interventions for weight management should specifically target different components of COM-B. Self-efficacy and self-esteem may play a significant role in individual capabilities, opportunities, and reflective motivation and should be included in tailored public health interventions. Health programs targeting younger and single people, and people with chronic conditions may help to promote sustainable behavior change.
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Affiliation(s)
- Vladimira Timkova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef (PJ) Safarik University in Kosice, Kosice, Slovakia
| | - Daniela Minarikova
- Department of Organisation and Management of Pharmacy, Faculty of Pharmacy, Comenius University in Bratislava, Bratislava, Slovakia
| | - Lubomira Fabryova
- Biomedical Research Centre of the Slovak Academy of Sciences, Bratislava, Slovakia
- Institute for Prevention and Intervention, St. Elisabeth University of Health and Social Work, Bratislava, Slovakia
- Faculty of Nursing and Medical Professional Studies, Slovak Health University, Bratislava, Slovakia
| | - Jana Buckova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef (PJ) Safarik University in Kosice, Kosice, Slovakia
| | - Peter Minarik
- Biomedical Research Centre of the Slovak Academy of Sciences, Bratislava, Slovakia
- Institute for Prevention and Intervention, St. Elisabeth University of Health and Social Work, Bratislava, Slovakia
| | - Zuzana Katreniakova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef (PJ) Safarik University in Kosice, Kosice, Slovakia
| | - Iveta Nagyova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef (PJ) Safarik University in Kosice, Kosice, Slovakia
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Williams PA, Rotunda W, Porterfield D, Skeete RA, Smith AD, Proia KK. Implementation of Session Zero as a Recruitment Strategy in the National Diabetes Prevention Program's Lifestyle Change Program. Sci Diabetes Self Manag Care 2024; 50:74-86. [PMID: 38158815 PMCID: PMC10995983 DOI: 10.1177/26350106231215767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
PURPOSE The purpose of the study was to understand the extent to which organizations offering the Centers for Disease Control and Prevention's (CDC) National Diabetes Prevention Program (National DPP) lifestyle change program implement session zero (a pre-enrollment session designed to recruit, engage, and enroll participants in programs), the stated purpose(s) for offering session zero, the content of session zero, and best practices for using session zero for recruitment. METHODS Researchers conducted a survey of all organizations offering the National DPP lifestyle change program that were registered with the CDC's Diabetes Prevention Recognition Program and their affiliated delivery locations. RESULTS Most (79.5%) delivery locations reported implementing session zero; of these, most used session zero as a recruitment strategy (81.1%) and orientation session (72.8%), whereas few (17.7%) used session zero solely to complete participant enrollment paperwork. Most (60.7%) delivery locations that implement session zero offer all their sessions at the same location, offer one session per upcoming participant cohort (66.7%), and use a consistent agenda (83.0%). Out of a list of activities informed by behavior change theory, the most common was offering an opportunity to enroll in the year-long lifestyle change program at the end of session zero (71.1%). CONCLUSIONS Most National DPP delivery locations implement session zero as a recruitment and orientation session. Most delivery locations reported including some activities informed by behavior change theory, but delivery locations could offer more theoretically informed activities during their session zero. The findings provide practice-based considerations for implementing session zero for recruitment into lifestyle change programs.
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Affiliation(s)
| | - Wendi Rotunda
- RTI International, Research Triangle Park, North Carolina
| | | | | | - Akimi D Smith
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Krista K Proia
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Muscogiuri G. The timing of energy intake. Proc Nutr Soc 2024; 83:28-34. [PMID: 37955116 DOI: 10.1017/s0029665123003725] [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] [Indexed: 11/14/2023]
Abstract
The aim of the paper is to review the current evidence on the impact of 'the timing of energy intake' on the risk of developing obesity and obesity-related metabolic diseases. The prevalence of obesity is currently increasing worldwide thus becoming a severe health burden for most countries. Indeed, obesity represents a risk factor for several non-communicable diseases such as cancer, type 2 diabetes, dyslipidaemia, CVD and overall mortality. In order to treat obesity, several pharmacological approaches have been developed and are indicated for subjects with obesity with a BMI ≥ 30 kg/m2 or ≥ 27 kg/m2 and obesity-related comorbidities. For severe obesity (BMI ≥ 40 kg/m2), bariatric surgery represents a promising approach. The most common bariatric surgical procedures are represented by the Roux-en-Y gastric bypass, laparoscopic adjustable band, laparoscopic gastric sleeve and biliopancreatic diversion with duodenal switch. Both anti-obesity pharmacological and surgical treatments require change in lifestyle. When a nutritional plan is established, attention is usually paid to macronutrient composition and energy intake, while 'the time of food' is not taken into account. Chronotype, which is the attitude of a subject to carry out most of their daily activities in the first (morning chronotype) or second half (evening chronotype) of the day, has been reported to have a role in the pathogenesis of obesity and obesity-related cardiometabolic diseases as well as eating speed. Thus, adopting a physiological timing of energy intake could be an additional strategy to potentiate the current anti-obesity approaches.
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Affiliation(s)
- Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia e Andrologia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, Naples 80131, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O.), Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia e Andrologia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, Naples 80131, Italy
- Cattedra Unesco 'Educazione alla Salute e Allo Sviluppo Sostenibile', Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, Naples 80131, Italy
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Di Fusco SA, Mocini E, Gulizia MM, Gabrielli D, Grimaldi M, Oliva F, Colivicchi F. ANMCO (Italian Association of Hospital Cardiologists) scientific statement: obesity in adults-an approach for cardiologists. Eat Weight Disord 2024; 29:1. [PMID: 38168872 PMCID: PMC10761446 DOI: 10.1007/s40519-023-01630-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
Obesity is a complex, chronic disease requiring a multidisciplinary approach to its management. In clinical practice, body mass index and waist-related measurements can be used for obesity screening. The estimated prevalence of obesity among adults worldwide is 12%. With the expected further increase in overall obesity prevalence, clinicians will increasingly be managing patients with obesity. Energy balance is regulated by a complex neurohumoral system that involves the central nervous system and circulating mediators, among which leptin is the most studied. The functioning of these systems is influenced by both genetic and environmental factors. Obesity generally occurs when a genetically predisposed individual lives in an obesogenic environment for a long period. Cardiologists are deeply involved in evaluating patients with obesity. Cardiovascular risk profile is one of the most important items to be quantified to understand the health risk due to obesity and the clinical benefit that a single patient can obtain with weight loss. At the individual level, appropriate patient involvement, the detection of potential obesity causes, and a multidisciplinary approach are tools that can improve clinical outcomes. In the near future, we will probably have new pharmacological tools at our disposal that will facilitate achieving and maintaining weight loss. However, pharmacological treatment alone cannot cure such a complex disease. The aim of this paper is to summarize some key points of this field, such as obesity definition and measurement tools, its epidemiology, the main mechanisms underlying energy homeostasis, health consequences of obesity with a focus on cardiovascular diseases and the obesity paradox.Level of evidence V: report of expert committees.
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Affiliation(s)
- Stefania Angela Di Fusco
- Emergency Department, Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University, 00161, Rome, Italy.
| | | | - Domenico Gabrielli
- Cardio-Thoracic-Vascular Department, San Camillo-Forlanini Hospital, Rome, Italy
- Heart Care Foundation, Florence, Italy
| | - Massimo Grimaldi
- Department of Cardiology, General Regional Hospital "F. Miulli", Acquaviva delle Fonti, 70021, Bari, Italy
| | - Fabrizio Oliva
- De Gasperis Cardio Center, Niguarda Hospital, 20162, Milan, Italy
| | - Furio Colivicchi
- Emergency Department, Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
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Alejandro AL, Leo WWC, Bruce M. Opportunities to Improve Awareness of Antimicrobial Resistance Through Social Marketing: A Systematic Review of Interventions Targeting Parents and Children. HEALTH COMMUNICATION 2023; 38:3376-3392. [PMID: 36437539 DOI: 10.1080/10410236.2022.2149132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Lack of knowledge from parents concerning the appropriate use of antimicrobials leads to poor treatment choices and mismanagement of antimicrobials for their children. Social marketing (SM) strategies have the potential to help parents access useful information on the appropriate use of antimicrobials. Still, its application in interventions targeting antimicrobial/antibiotic resistance awareness is minimal. This study explores the use of SM in antimicrobial/antibiotic awareness campaigns (AACs) to identify opportunities for SM approaches in developing future communication interventions targeting parents and children. We conduct a systematic review of interventions targeting parents and children between 2000 and 2022. Articles meeting the selection criteria were assessed against social marketing benchmark criteria (SMBC). We identified 6978 original records, 16 of which were included in the final review. None of the articles explicitly identified SM as part of their interventions. Twelve interventions (75%) included 1 to 4 (out of 8) benchmark criteria, while four (25%) had 5-8 benchmarks in their interventions. Of the interventions with less than four benchmark criteria, six studies (50%) reported a positive effect direction outcome, and six studies (50%) reported negative/no change direction on the outcome of interests. Meanwhile, all interventions with five or more SMBC resulted in a positive effect direction in their outcomes. In this review, the use of SM has shown promising results, indicating opportunities for future antimicrobial resistance (AMR) interventions that incorporate social marketing benchmark criteria to improve intervention outcomes.
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Affiliation(s)
- Aaron Lapuz Alejandro
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University
- Department of Nursing, Fiona Stanley Hospital
| | | | - Mieghan Bruce
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University
- School of Veterinary Medicine, Murdoch University
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Wu Y, Zeng Y, Ren Y, Yu J, Zhang Q, Xiao X. Insights into RNA N6-methyladenosine in Glucose and Lipid Metabolic Diseases and Their Therapeutic Strategies. Endocrinology 2023; 165:bqad170. [PMID: 37950364 DOI: 10.1210/endocr/bqad170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 11/12/2023]
Abstract
The incidence of glucose and lipid metabolism diseases, including type 2 diabetes, obesity, metabolic syndrome, and nonalcoholic fatty liver disease, is rising, which places an enormous burden on people around the world. However, the mechanism behind these disorders remains incompletely understood. N6-methyladenosine (m6A) is 1 type of posttranscriptional RNA modification, and research has shown that it plays a crucial role in several metabolic diseases. m6A methylation is reversibly and dynamically regulated by methyltransferases (writers), demethylases (erasers), and m6A binding proteins (readers). Dysregulation of RNA m6A modification is related to different metabolic processes. Targeting RNA m6A methylation is a potential treatment strategy for these chronic metabolic diseases. This review discusses studies on RNA m6A modification in metabolic diseases and existing therapeutic drugs, with the aim of providing a concise perspective on its potential applications in managing metabolic disorders.
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Affiliation(s)
- Yifan Wu
- Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Yuan Zeng
- Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Yaolin Ren
- Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Jie Yu
- Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Qian Zhang
- Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xinhua Xiao
- Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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Cox JS, Searle A, Thornton G, Hamilton-Shield JP, Hinton EC. Integrating COM-B and the person-based approach to develop an ACT based therapy programme to raise self-determination in adolescents with obesity. BMC Health Serv Res 2023; 23:1158. [PMID: 37884913 PMCID: PMC10601199 DOI: 10.1186/s12913-023-09930-6] [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: 05/25/2022] [Accepted: 08/16/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND This paper details the development of the Adolescent Intrinsic Motivation 'AIM2Change' intervention to support weight-management in young people previously unable to make changes whilst attending a tier 3 weight management service for children and young people. AIM2Change is an acceptance and commitment therapy based intervention that will be delivered one-to-one online over a seven-week period. METHODS To develop this intervention, we have triangulated results from a qualitative research study, patient and public involvement groups (PPI) and a COM-B (capability, opportunity, motivation, behaviour) analysis, in a method informed by the person-based approach. RESULTS The integrated development approach yielded a broad range of perspectives and facilitated the creation of a tailored intervention to meet the needs of the patient group whist remaining pragmatic and deliverable. CONCLUSIONS The next steps for this intervention will be in-depth co-development of the therapy sessions with service users, before implementing a proof of concept trial.
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Affiliation(s)
- Jennifer S. Cox
- National Institute for Health Research Bristol Biomedical Research Centre Diet and Physical Activity Theme, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, BS8 1TU UK
| | - Aidan Searle
- National Institute for Health Research Bristol Biomedical Research Centre Diet and Physical Activity Theme, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, BS8 1TU UK
| | - Gail Thornton
- Ms Gail Thornton, Patient & Public Involvement Representative, Bristol, UK
| | - Julian P. Hamilton-Shield
- National Institute for Health Research Bristol Biomedical Research Centre Diet and Physical Activity Theme, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, BS8 1TU UK
| | - Elanor C. Hinton
- National Institute for Health Research Bristol Biomedical Research Centre Diet and Physical Activity Theme, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, BS8 1TU UK
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Compañ-Gabucio LM, Mancheño-Bañón D, Torres-Collado L, Vioque J, García-de-la-Hera M. Cognitive Behavioural Therapies for Weight-Loss in Adults: A Scoping Review Protocol. Healthcare (Basel) 2023; 11:2473. [PMID: 37761670 PMCID: PMC10531440 DOI: 10.3390/healthcare11182473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/20/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Obesity and being overweight are very important public health issues due to their increasing prevalence worldwide. Third-wave cognitive behavioural therapies (3wCBT) have emerged in the last few years to promote weight loss. However, the scientific evidence identifying the most commonly used 3wCBT in weight-loss interventions in adults is still needed. The objective of this scoping review will be to identify the most widely researched 3wCBT used to facilitate weight loss in an adult population who are overweight and obese, according to the published scientific literature. The search will be carried out independently by two authors in PubMed (MEDLINE), Scopus, EMBASE, Web of Science, and PsycINFO, using search equations that contain keywords related to our search question: (1) population: adult and elderly population, (2) intervention: terms related to 3wCBT, and (3) results: weight loss or weight management. The data extraction will be performed following the indications of the Cochrane manual, and the results will be presented in three tables. The 3wCBTs have shown promising results for weight loss, but it is not yet known which of them is the most widely used to achieve weight loss in the adult population. Thus, the results of this scoping review could guide professionals in the psychological treatment of obesity and being overweight.
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Affiliation(s)
- Laura María Compañ-Gabucio
- Unidad de Epidemiología de la Nutrición (EPINUT), Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550 Alicante, Spain; (L.M.C.-G.); (D.M.-B.); (J.V.); (M.G.-d.-l.-H.)
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034 Madrid, Spain
| | - Diana Mancheño-Bañón
- Unidad de Epidemiología de la Nutrición (EPINUT), Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550 Alicante, Spain; (L.M.C.-G.); (D.M.-B.); (J.V.); (M.G.-d.-l.-H.)
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
| | - Laura Torres-Collado
- Unidad de Epidemiología de la Nutrición (EPINUT), Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550 Alicante, Spain; (L.M.C.-G.); (D.M.-B.); (J.V.); (M.G.-d.-l.-H.)
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034 Madrid, Spain
| | - Jesús Vioque
- Unidad de Epidemiología de la Nutrición (EPINUT), Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550 Alicante, Spain; (L.M.C.-G.); (D.M.-B.); (J.V.); (M.G.-d.-l.-H.)
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034 Madrid, Spain
| | - Manuela García-de-la-Hera
- Unidad de Epidemiología de la Nutrición (EPINUT), Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550 Alicante, Spain; (L.M.C.-G.); (D.M.-B.); (J.V.); (M.G.-d.-l.-H.)
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034 Madrid, Spain
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Woo S, Jung S, Lim H, Kim Y, Park KH. Exploring the Effect of the Dynamics of Behavioral Phenotypes on Health Outcomes in an mHealth Intervention for Childhood Obesity: Longitudinal Observational Study. J Med Internet Res 2023; 25:e45407. [PMID: 37590040 PMCID: PMC10472181 DOI: 10.2196/45407] [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: 12/29/2022] [Revised: 05/14/2023] [Accepted: 06/30/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Advancements in mobile health technologies and machine learning approaches have expanded the framework of behavioral phenotypes in obesity treatment to explore the dynamics of temporal changes. OBJECTIVE This study aimed to investigate the dynamics of behavioral changes during obesity intervention and identify behavioral phenotypes associated with weight change using a hybrid machine learning approach. METHODS In total, 88 children and adolescents (ages 8-16 years; 62/88, 71% male) with age- and sex-specific BMI ≥85th percentile participated in the study. Behavioral phenotypes were identified using a hybrid 2-stage procedure based on the temporal dynamics of adherence to the 5 behavioral goals during the intervention. Functional principal component analysis was used to determine behavioral phenotypes by extracting principal component factors from the functional data of each participant. Elastic net regression was used to investigate the association between behavioral phenotypes and weight change. RESULTS Functional principal component analysis identified 2 distinctive behavioral phenotypes, which were named the high or low adherence level and late or early behavior change. The first phenotype explained 47% to 69% of each factor, whereas the second phenotype explained 11% to 17% of the total behavioral dynamics. High or low adherence level was associated with weight change for adherence to screen time (β=-.0766, 95% CI -.1245 to -.0312), fruit and vegetable intake (β=.1770, 95% CI .0642-.2561), exercise (β=-.0711, 95% CI -.0892 to -.0363), drinking water (β=-.0203, 95% CI -.0218 to -.0123), and sleep duration. Late or early behavioral changes were significantly associated with weight loss for changes in screen time (β=.0440, 95% CI .0186-.0550), fruit and vegetable intake (β=-.1177, 95% CI -.1441 to -.0680), and sleep duration (β=-.0991, 95% CI -.1254 to -.0597). CONCLUSIONS Overall level of adherence, or the high or low adherence level, and a gradual improvement or deterioration in health-related behaviors, or the late or early behavior change, were differently associated with weight loss for distinctive obesity-related lifestyle behaviors. A large proportion of health-related behaviors remained stable throughout the intervention, which indicates that health care professionals should closely monitor changes made during the early stages of the intervention. TRIAL REGISTRATION Clinical Research Information Science KCT0004137; https://tinyurl.com/ytxr83ay.
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Affiliation(s)
- Sarah Woo
- Department of Medical Sciences, College of Medicine, Hallym University, Chuncheon-si, Republic of Korea
| | - Sunho Jung
- School of Management, Kyung Hee University, Seoul, Republic of Korea
| | - Hyunjung Lim
- Department of Medical Nutrition, Kyung Hee University, Yongin-si, Republic of Korea
| | - YoonMyung Kim
- University College, Yonsei University International Campus, Incheon, Republic of Korea
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang-si, Gyeonggi-do, Republic of Korea
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12
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Encantado J, Marques MM, Gouveia MJ, Santos I, Sánchez-Oliva D, O'Driscoll R, Turicchi J, Larsen SC, Horgan G, Teixeira PJ, Stubbs RJ, Heitmann BL, Palmeira AL. Testing motivational and self-regulatory mechanisms of action on device-measured physical activity in the context of a weight loss maintenance digital intervention: A secondary analysis of the NoHoW trial. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 64:102314. [PMID: 37665806 DOI: 10.1016/j.psychsport.2022.102314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 10/10/2022] [Accepted: 10/10/2022] [Indexed: 09/06/2023]
Abstract
BACKGROUND To date, few digital behavior change interventions for weight loss maintenance focusing on long-term physical activity promotion have used a sound intervention design grounded on a logic model underpinned by behavior change theories. The current study is a secondary analysis of the weight loss maintenance NoHoW trial and investigated putative mediators of device-measured long-term physical activity levels (six to 12 months) in the context of a digital intervention. METHODS A subsample of 766 participants (Age = 46.2 ± 11.4 years; 69.1% female; original NoHoW sample: 1627 participants) completed all questionnaires on motivational and self-regulatory variables and had all device-measured physical activity data available for zero, six and 12 months. We examined the direct and indirect effects of Virtual Care Climate on post intervention changes in moderate-to-vigorous physical activity and number of steps (six to 12 months) through changes in the theory-driven motivational and self-regulatory mechanisms of action during the intervention period (zero to six months), as conceptualized in the logic model. RESULTS Model 1 tested the mediation processes on Steps and presented a poor fit to the data. Model 2 tested mediation processes on moderate-to-vigorous physical activity and presented poor fit to the data. Simplified models were also tested considering the autonomous motivation and the controlled motivation variables independently. These changes yielded good results and both models presented very good fit to the data for both outcome variables. Percentage of explained variance was negligible for all models. No direct or indirect effects were found from Virtual Care Climate to long term change in outcomes. Indirect effects occurred only between the sequential paths of the theory-driven mediators. CONCLUSION This was one of the first attempts to test a serial mediation model considering psychological mechanisms of change and device-measured physical activity in a 12-month longitudinal trial. The model explained a small proportion of variance in post intervention changes in physical activity. We found different pathways of influence on theory-driven motivational and self-regulatory mechanisms but limited evidence that these constructs impacted on actual behavior change. New approaches to test these relationships are needed. Challenges and several alternatives are discussed. TRIAL REGISTRATION ISRCTN Registry, ISRCTN88405328. Registered December 16, 2016, https://www.isrctn.com/ISRCTN88405328.
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Affiliation(s)
- Jorge Encantado
- Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Lisbon, Portugal; Applied Psychology Research Center Capabilities & Inclusion (APPsyCI), ISPA, Instituto Universitário, Lisbon, Portugal.
| | - Marta M Marques
- Trinity Centre for Practice and Healthcare Innovation & ADAPT Centre, Trinity College Dublin, Dublin, Ireland; Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Maria João Gouveia
- Applied Psychology Research Center Capabilities & Inclusion (APPsyCI), ISPA, Instituto Universitário, Lisbon, Portugal
| | - Inês Santos
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Lisbon, Portugal; Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | | | - Ruairi O'Driscoll
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Jake Turicchi
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Sofus C Larsen
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Denmark
| | - Graham Horgan
- Biomathematics & Statistics Scotland (James Hutton Institute), Aberdeen, United Kingdom
| | - Pedro J Teixeira
- Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Lisbon, Portugal
| | - R James Stubbs
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Berit Lilienthal Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Denmark; The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Sydney, Australia; Section for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - António L Palmeira
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Lisbon, Portugal
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Masood Z, Khan Y, Hashmi MR, Ali Asghar A. Patients with obesity face greater barrier to health care management than patients with normal body mass index: growing evidence. Fam Pract 2022:cmac131. [PMID: 36409279 DOI: 10.1093/fampra/cmac131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Zainab Masood
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Yalnaz Khan
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Adam Ali Asghar
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
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14
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Iłowiecka K, Glibowski P, Libera J, Koch W. Changes in Novel Anthropometric Indices of Abdominal Obesity during Weight Loss with Selected Obesity-Associated Single-Nucleotide Polymorphisms: A Small One-Year Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11837. [PMID: 36142109 PMCID: PMC9517315 DOI: 10.3390/ijerph191811837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
Whether BMI and the competing waist circumference (WC)-based anthropometric indices are associated with obesity-related single-nucleotide polymorphisms (SNPs) is as yet unknown. The current study aimed to evaluate the anthropometric indices (fat mass index, body shape index, visceral adiposity index, relative fat mass, body roundness index, and conicity index) during a weight loss intervention in 36 obese individuals. Blood biochemical parameters (total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides) and three SNPs (FTO rs9939609, TFAP2B rs987237, and PLIN1 rs894160) were assessed in 22 women and 14 men (35.58 ± 9.85 years, BMI 35.04 ± 3.80 kg/m2) who completed a 12-month balanced energy-restricted diet weight loss program. Body composition was assessed via bioelectrical impedance (SECA mBCA515). At the end of the weight loss intervention, all anthropometric indices were significantly reduced (p < 0.05). For the SNP FTO rs9939609, the higher risk allele (A) was characteristic of 88.9% of the study group, in which 10 participants (27.8%) were homozygous. We found a similar distribution of alleles in TFAP2B and PLIN1. Heterozygous genotypes in FTO rs9939609 and TFAP2B rs987237 were predisposed to significant reductions in WC-based novel anthropometric indices during weight loss. The influence of PLIN1 rs894160 polymorphisms on the changes in the analyzed indices during weight loss has not been documented in the present study.
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Affiliation(s)
- Katarzyna Iłowiecka
- Department of Food and Nutrition, Medical University of Lublin, 4a Chodźki Str., 20-093 Lublin, Poland
| | - Paweł Glibowski
- Department of Biotechnology, Microbiology and Human Nutrition, University of Life Science in Lublin, 8 Skromna Str., 20-704 Lublin, Poland
| | - Justyna Libera
- Division of Engineering and Cereals Technology, Department of Plant Food Technology and Gastronomy, University of Life Sciences, 8 Skromna Str., 20-704 Lublin, Poland
| | - Wojciech Koch
- Department of Food and Nutrition, Medical University of Lublin, 4a Chodźki Str., 20-093 Lublin, Poland
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Barber TM, Kabisch S, Randeva HS, Pfeiffer AFH, Weickert MO. Implications of Resveratrol in Obesity and Insulin Resistance: A State-of-the-Art Review. Nutrients 2022; 14:nu14142870. [PMID: 35889827 PMCID: PMC9320680 DOI: 10.3390/nu14142870] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Resveratrol is a polyphenol chemical that naturally occurs in many plant-based dietary products, most notably, red wine. Discovered in 1939, widespread interest in the potential health benefits of resveratrol emerged in the 1970s in response to epidemiological data on the cardioprotective effects of wine. Objective: To explore the background of resveratrol (including its origins, stability, and metabolism), the metabolic effects of resveratrol and its mechanisms of action, and a potential future role of dietary resveratrol in the lifestyle management of obesity. Data sources: We performed a narrative review, based on relevant articles written in English from a Pubmed search, using the following search terms: “resveratrol”, “obesity”, “Diabetes Mellitus”, and “insulin sensitivity”. Results: Following its ingestion, resveratrol undergoes extensive metabolism. This includes conjugation (with sulfate and glucuronate) within enterocytes, hydrolyzation and reduction within the gut through the action of the microbiota (with the formation of metabolites such as dihydroresveratrol), and enterohepatic circulation via the bile. Ex vivo studies on adipose tissue reveal that resveratrol inhibits adipogenesis and prevents the accumulation of triglycerides through effects on the expression of Peroxisome Proliferator-activated Receptor γ (PPARγ) and sirtuin 1, respectively. Furthermore, resveratrol induces anti-inflammatory effects, supported by data from animal-based studies. Limited data from human-based studies reveal that resveratrol improves insulin sensitivity and fasting glucose levels in patients with Type 2 Diabetes Mellitus and may improve inflammatory status in human obesity. Although numerous mechanisms may underlie the metabolic benefits of resveratrol, evidence supports a role in its interaction with the gut microbiota and modulation of protein targets, including sirtuins and proteins related to nitric oxide, insulin, and nuclear hormone receptors (such as PPARγ). Conclusions: Despite much interest, there remain important unanswered questions regarding its optimal dosage (and how this may differ between and within individuals), and possible benefits within the general population, including the potential for weight-loss and improved metabolic function. Future studies should properly address these important questions before we can advocate the widespread adoption of dietary resveratrol supplementation.
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Affiliation(s)
- Thomas M. Barber
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; (T.M.B.); (H.S.R.)
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - Stefan Kabisch
- Department of Endocrinology and Metabolic Medicine, Campus Benjamin Franklin, Charité University Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; (S.K.); (A.F.H.P.)
| | - Harpal S. Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; (T.M.B.); (H.S.R.)
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - Andreas F. H. Pfeiffer
- Department of Endocrinology and Metabolic Medicine, Campus Benjamin Franklin, Charité University Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; (S.K.); (A.F.H.P.)
- Deutsches Zentrum für Diabetesforschung e.V., Geschäftsstelle am Helmholtz-Zentrum München, Ingolstädter Landstraße, 85764 Neuherberg, Germany
| | - Martin O. Weickert
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; (T.M.B.); (H.S.R.)
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
- Centre for Sport, Exercise and Life Sciences, Faculty of Health & Life Sciences, Coventry University, Coventry CV1 2TU, UK
- Correspondence:
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16
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Hayotte M, Gioda J, d'Arripe-Longueville F. Effects and Acceptability of Technology-Based Physical Activity Interventions in Bariatric Surgery: a Scoping Review. Obes Surg 2022; 32:2445-2456. [PMID: 35501637 DOI: 10.1007/s11695-022-06049-1] [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: 09/07/2021] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 11/28/2022]
Abstract
The aim of this scoping review is to highlight current trends in the emerging field of technology-based physical activity interventions (TbPAI) in pre- and post-bariatric surgery. Original articles published between 2000 and 2020 on eHealth, bariatric surgery, and physical activity were identified through electronic searches of eight databases. Screening, data extraction, and charting were performed independently by two authors and disagreements were resolved by consensus. Nine full-text articles were included in this review. The studies reported that the physical activity outcomes had improved and the interventions were positively perceived by the target population. We highlight some consistent findings, as well as knowledge gaps, and suggest how future studies could be improved.
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17
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Ma LJ, Hou XD, Qin XY, He RJ, Yu HN, Hu Q, Guan XQ, Jia SN, Hou J, Lei T, Ge GB. Discovery of human pancreatic lipase inhibitors from root of Rhodiola Crenulata via integrating bioactivity-guided fractionation, chemical profiling and biochemical assay. J Pharm Anal 2022; 12:683-691. [PMID: 36105167 PMCID: PMC9463489 DOI: 10.1016/j.jpha.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 03/20/2022] [Accepted: 04/02/2022] [Indexed: 12/03/2022] Open
Abstract
Although herbal medicines (HMs) are widely used in the prevention and treatment of obesity and obesity-associated disorders, the key constituents exhibiting anti-obesity activity and their molecular mechanisms are poorly understood. Recently, we assessed the inhibitory potentials of several HMs against human pancreatic lipase (hPL, a key therapeutic target for human obesity), among which the root-extract of Rhodiola crenulata (ERC) showed the most potent anti-hPL activity. In this study, we adopted an integrated strategy, involving bioactivity-guided fractionation techniques, chemical profiling, and biochemical assays, to identify the key anti-hPL constituents in ERC. Nine ERC fractions (retention time = 12.5–35 min), obtained using reverse-phase liquid chromatography, showed strong anti-hPL activity, while the major constituents in these bioactive fractions were subsequently identified using liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-Q-TOF-MS/MS). Among the identified ERC constituents, 1,2,3,4,6-penta-O-galloyl-β-d-glucopyranose (PGG) and catechin gallate (CG) showed the most potent anti-hPL activity, with pIC50 values of 7.59 ± 0.03 and 7.68 ± 0.23, respectively. Further investigations revealed that PGG and CG potently inhibited hPL in a non-competitive manner, with inhibition constant (Ki) values of 0.012 and 0.082 μM, respectively. Collectively, our integrative analyses enabled us to efficiently identify and characterize the key anti-obesity constituents in ERC, as well as to elucidate their anti-hPL mechanisms. These findings provide convincing evidence in support of the anti-obesity and lipid-lowering properties of ERC. The root-extract of Rhodiola crenulata (ERC) potently inhibits hPL. The hPL inhibitors in ERC were characterized using an integrated panel of assays. Six constituents in ERC were identified as hPL inhibitors. PGG and CG are potent non-competitive hPL inhibitors (Ki < 0.1 μM). The binding modes of PGG and CG were examined based on docking simulations.
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Affiliation(s)
- Li-Juan Ma
- Shanghai Frontiers Science Center of TCM Chemical Biology, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
- Department of Endocrinology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200062, China
| | - Xu-Dong Hou
- Shanghai Frontiers Science Center of TCM Chemical Biology, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
- Department of Endocrinology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200062, China
- College of Basic Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Xiao-Ya Qin
- Shanghai Frontiers Science Center of TCM Chemical Biology, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Rong-Jing He
- Shanghai Frontiers Science Center of TCM Chemical Biology, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Hao-Nan Yu
- Shanghai Frontiers Science Center of TCM Chemical Biology, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Qing Hu
- Shanghai Frontiers Science Center of TCM Chemical Biology, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Xiao-Qing Guan
- Shanghai Frontiers Science Center of TCM Chemical Biology, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Shou-Ning Jia
- Qinghai Hospital of Traditional Chinese Medicine, Xining, 810099, China
| | - Jie Hou
- College of Basic Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Tao Lei
- Department of Endocrinology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200062, China
- Corresponding author.
| | - Guang-Bo Ge
- Shanghai Frontiers Science Center of TCM Chemical Biology, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
- Corresponding author.
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18
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de Sousa D, Fogel A, Azevedo J, Padrão P. The Effectiveness of Web-Based Interventions to Promote Health Behaviour Change in Adolescents: A Systematic Review. Nutrients 2022; 14:nu14061258. [PMID: 35334915 PMCID: PMC8954163 DOI: 10.3390/nu14061258] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 11/16/2022] Open
Abstract
Although web-based interventions are attractive to researchers and users, the evidence about their effectiveness in the promotion of health behaviour change is still limited. Our aim was to review the effectiveness of web-based interventions used in health behavioural change in adolescents regarding physical activity, eating habits, tobacco and alcohol use, sexual behaviour, and quality of sleep. Studies published from 2016 till the search was run (May-to-June 2021) were included if they were experimental or quasi-experimental studies, pre-post-test studies, clinical trials, or randomized controlled trials evaluating the effectiveness of web-based intervention in promoting behaviour change in adolescents regarding those health behaviours. The risk of bias assessment was performed by using the Effective Public Health Practice Project (EPHPP)-Quality Assessment Tool for Quantitative Studies. Fourteen studies were included. Most were in a school setting, non-probabilistic and relatively small samples. All had a short length of follow-up and were theory driven. Thirteen showed significant positive findings to support web-based interventions' effectiveness in promoting health behaviour change among adolescents but were classified as low evidence quality. Although this review shows that web-based interventions may contribute to health behaviour change among adolescents, these findings rely on low-quality evidence, so it is urgent to test these interventions in larger controlled trials with long-term maintenance.
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Affiliation(s)
- Daniela de Sousa
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal; (D.d.S.); (A.F.); (J.A.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
| | - Adriana Fogel
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal; (D.d.S.); (A.F.); (J.A.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
| | - José Azevedo
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal; (D.d.S.); (A.F.); (J.A.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Faculdade de Letras, Universidade do Porto, 4150-564 Porto, Portugal
| | - Patrícia Padrão
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal; (D.d.S.); (A.F.); (J.A.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
- Correspondence: ; Tel.: +351-22-5074320
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Obesity-Related Brain Cholinergic System Impairment in High-Fat-Diet-Fed Rats. Nutrients 2022; 14:nu14061243. [PMID: 35334899 PMCID: PMC8948807 DOI: 10.3390/nu14061243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 12/11/2022] Open
Abstract
A link between obesity and cerebral health is receiving growing recognition. Here, we investigate in the frontal cortex and hippocampus the potential involvement of cholinergic markers in brain alterations previously reported in rats with obesity induced by diet (DIO) after long-term exposure (17 weeks) to a high-fat diet (HFD) in comparison with animals fed with a standard diet (CHOW). The obesity developed after 5 weeks of HFD. Bodyweight, systolic blood pressure, glycemia, and insulin levels were increased in DIO rats compared to the CHOW group. Measurements of malondialdehyde (MDA) provided lipid peroxidation in HFD-fed rats. Western blot and immunohistochemical techniques were performed. Our results showed a higher expression of choline acetyltransferase (ChAT) and vesicular acetylcholine transporter (VAChT) in obese rats but not the VAChT expression in the frontal cortex after 17 weeks of HFD. Furthermore, the acetylcholinesterase (AChE) enzyme was downregulated in HFD both in the frontal cortex and hippocampus. In the brain regions analyzed, it was reported a modulation of certain cholinergic receptors expressed pre- and post-synaptically (alpha7 nicotinic receptor and muscarinic receptor subtype 1). Collectively, these findings point out precise changes of cholinergic markers that can be targeted to prevent cerebral injuries related to obesity.
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Julia Tong T, Mohammadnezhad M, Salem Alqahtani N, Salusalu M. Perception of students on factors contributing to overweight and obesity among high school students in Kiribati: A qualitative study. PLoS One 2022; 17:e0260900. [PMID: 35051216 PMCID: PMC8775294 DOI: 10.1371/journal.pone.0260900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/18/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Overweight and obesity among high school students is a growing distress not only to the individual wellbeing of a person but also to the productivity of communities and economic expense of both developed and developing nations. This study aimed to determine factors contributing to overweight and obesity among high school students in Kiribati through the perception of students. METHODS This qualitative study was conducted in four (4) randomly selected senior high schools on South Tarawa, Kiribati from August to November, 2020. A purposive sampling was used to select thirty-two (32) students enrolled into form levels 4-7. A semi-structured open-ended questionnaire was used for data collection using face-to-face in-depth interviews. Data was transcribed and analyzed using thematic analysis method. RESULTS This research revealed that the participants were 21 (65.6%) were females and 11 (34.4%) males from form levels four with 9 (28.1%) participants, five with 9 (28.1%) participants, and form seven with 14 (43.8%) participants. Five themes identified including determinants and prevention of overweight and obesity, education and health system factors, stigma, and being fat comes with high risk. These themes collectively elaborate on the essentials of overweight and obesity that are obtained from perspectives of students. CONCLUSION A strong cultural belief and practice has caused misperception of overweight and obesity among students with knowledge-behavior gap recognized as the main reason behind the failure in lifestyle changes among adolescents. Strengthen healthy behavioral lifestyle, improve awareness, and support feasible preventative strategies is recommended to all students.
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Affiliation(s)
- Tanebu Julia Tong
- Department of Public Health, Ministry of Health and Medical Services, South Tarawa, Kiribati
| | | | | | - Mosese Salusalu
- School of Public Health and Primary Care, Fiji National University, Suva, Fiji
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21
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Fu E, Neubert SW, Chang A, Smith JD, Graham AK. Characterizing behavior change techniques used in the self-management of binge eating and weight: Applying a user-centered design approach. Eat Behav 2022; 44:101591. [PMID: 34920208 PMCID: PMC8885842 DOI: 10.1016/j.eatbeh.2021.101591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/15/2021] [Accepted: 11/30/2021] [Indexed: 01/03/2023]
Abstract
User-centered design methods aim to increase intervention engagement by focusing on consumers' needs and preferences. We conducted a needs assessment (the first step in user-centered design) via a digital diary study to understand how individuals with recurrent binge eating (≥12 episodes in 3 months) and obesity (BMI ≥30 kg/m2) manage these problems in their day-to-day lives and the approaches they use to change their behavior. Specifically, we applied the Behavior Change Technique (BCT)-Taxonomy to characterize which standardized BCTs individuals use to change binge eating and health-related behaviors and their motivations to use them, to inform the design of a mobile intervention. We analyzed qualitative data from 22 adults (64% female, 32% White) who submitted 176 diary entries. For each entry, we coded the BCTs used, motivation for use, and whether the BCT(s) were perceived as beneficial for behavior change. Across participants, investigators identified 50 of the 93 standardized BCTs (54%). Each participant used an average of 12 (SD = 4) BCTs, most commonly Behavior Substitution (72.3%), Distraction (68.2%), Goal Setting (Behavior) (63.6%), Action Planning (59.1%) and Adding Objects to the Environment (59.1%). More BCTs were coded as beneficial (49%) versus detrimental (24%) or neutral (27%). Techniques were most commonly motivated by preventing binge eating (95.5%), losing weight (95.5%), reducing unhealthy food choices (90.9%), or managing stress (59.1%). Results help inform how interventions could be designed to support consumers in changing binge eating and weight-related behaviors, although such designs would need to be tested for their impact on engagement and outcomes.
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Affiliation(s)
- Emily Fu
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Sarah W Neubert
- Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States of America
| | - Angela Chang
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States of America
| | - J D Smith
- Department of Population Health Sciences, University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, United States of America
| | - Andrea K Graham
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States of America.
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22
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Encantado J, Marques MM, Palmeira AL, Sebire SJ, Teixeira PJ, Stubbs RJ, Heitmann BL, Gouveia MJ. Development and cross-cultural validation of the Goal Content for Weight Maintenance Scale (GCWMS). Eat Weight Disord 2021; 26:2737-2748. [PMID: 33646516 DOI: 10.1007/s40519-021-01148-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 02/04/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Long-term weight management requires sustained engagement with energy-balance-related behaviours. According to self-determination theory, behaviour goals can support or undermine motivation depending on the quality of their content (i.e., extrinsic and intrinsic motivation). This study aimed to develop and validate the goal content for weight loss maintenance scale (GCWMS). METHODS The GCWMS was administered to 1511 participants who had achieved clinically significant weight losses and were taking part in a large weight loss maintenance study: the NoHoW Trial (ISRCTN88405328). The scale derived from two well-established questionnaires regarding exercise goals. Construct validity was examined for 4 theory-driven domains: Health Management, Challenge, Image, and Social Recognition. Split-sample confirmatory factor analysis was conducted to test the factorial validity and multi-group measurement invariance (configural, metric, scalar, and residual invariance). The reliability estimates were also assessed, and discriminant validity was evaluated using 2 conceptually related questionnaires. RESULTS The first analysis showed a poor fit of the original factorial structure. Subsequent investigation with a new specified model indicated close fit to the data after removal of 3 items χ2(58) = 599.982; p < .001; χ2/df = 10.345; CFI = 0.940; GFI = 0.941; SRMR = 0.063; RMSEA = 0.079 (LL = 0.073; UL = .084). Good internal consistency was achieved in all subscales (α > .775), convergent and divergent validity were verified through associations with other theoretical related constructs. Findings from multi-group invariance test demonstrated that the specified model of GCWMS achieved full measurement invariance for gender but did not support residual invariance across countries. CONCLUSION Findings support the hypothesised four-dimension structure of the GCWMS, confirming reliability and multi-group invariance in factor structure. Analysis also supports valid group means comparisons on latent factors at gender and at cross-cultural level. Ways to improve the quality of the scale are discussed. LEVEL OF EVIDENCE Level V, cross-sectional descriptive.
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Affiliation(s)
- Jorge Encantado
- Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal.
- Applied Psychology Research Center Capabilities & Inclusion (APPsyCI), ISPA - Instituto Universitário, Lisboa, Portugal.
| | - Marta M Marques
- Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal.
- Trinity College Dublin, ADAPT Centre & Trinity Centre for Practice and Healthcare Innovation, College Green, Dublin, Ireland.
| | - António L Palmeira
- Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Lisboa, Portugal
| | - Simon J Sebire
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Pedro J Teixeira
- Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - R James Stubbs
- Faculty of Medicine and Health, School of Psychology, University of Leeds, Leeds, UK
| | - Berit L Heitmann
- Research Unit for Dietary Studies at The Parker Institute Bispebjerg and Frederiksberg Hospital, Part of the Copenhagen University Hospital-The Capital Region, Copenhagen, Denmark
- Section for General Medicine, The Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Maria J Gouveia
- Applied Psychology Research Center Capabilities & Inclusion (APPsyCI), ISPA - Instituto Universitário, Lisboa, Portugal
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23
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Interventions Targeting Bottle and Formula Feeding in the Prevention and Treatment of Early Childhood Caries, Overweight and Obesity: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312304. [PMID: 34886023 PMCID: PMC8656950 DOI: 10.3390/ijerph182312304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 11/21/2022]
Abstract
Overweight, obesity and early childhood caries (ECC) are preventable conditions affecting infants and young children, with increased prevalence in those formula-fed. Previous research has focused on distinct outcomes for oral health and healthy weight gain. However, the aetiology may be linked through overlapping obesogenic and cariogenic feeding behaviours, such as increased sugar exposure through bottle propping and overfeeding. Best-practice bottle feeding and transition to cup use may concurrently reduce overweight, obesity and ECC. This integrative review aimed to identify interventions supporting best-practice formula feeding or bottle cessation and examine the intervention effects on feeding, oral health and weight outcomes. The reviewers searched nine databases and found 27 studies that met the predetermined inclusion criteria. Eighteen studies focused on populations vulnerable to ECC or unhealthy weight gain. All studies focused on carer education; however, only 10 studies utilised behaviour change techniques or theories addressing antecedents to obesogenic or cariogenic behaviours. The outcomes varied: 16 studies reported mixed outcomes, and eight reported worsened post-intervention outcomes. While some studies reported improvements, these were not maintained long-term. Many study designs were at risk of bias. Effective intervention strategies for preventing ECC and child obesity require the holistic use of interdisciplinary approaches, consumer co-design and the use of behavioural change theory.
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Kolay E, Bykowska-Derda A, Abdulsamad S, Kaluzna M, Samarzewska K, Ruchala M, Czlapka-Matyasik M. Self-Reported Eating Speed Is Associated with Indicators of Obesity in Adults: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2021; 9:healthcare9111559. [PMID: 34828605 PMCID: PMC8619990 DOI: 10.3390/healthcare9111559] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/23/2021] [Accepted: 10/29/2021] [Indexed: 02/07/2023] Open
Abstract
Eating speed (ES) as a dietary behaviour has become a widely discussed factor for weight management and obesity. This study analysed the relationship between ES and anthropometric indicators of obesity, including BMI and waist circumference (WC) in adults. A search conducted of PubMed, Web of Science, Science Direct and Scopus found six longitudinal studies and fifteen cross-sectional studies published for further analysis. A quality assessment was performed with the MINORS checklist. Eight studies were included in the meta-analysis and almost all reviewed studies showed that ES was associated with BMI, and non-fast eaters had significantly lower BMI than fast eaters. Therefore, it was assumed that slowing down the ES may be an effective strategy for weight management and lowering obesity risk. There was also an association between WC and ES. Assessment of eating speed can be included in nutrition surveys to analyse obesity risk. More broadly, research is also needed to establish a validated and standardised methodology to determine eating speed. Further research needs to examine the links between eating speed, obesity, ethnicity, sex, food culture and chronic diseases.
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Affiliation(s)
- Ezgi Kolay
- Department of Human Nutrition and Dietetics, Poznan University of Life Sciences, 31 Wojska Polskiego St., 60-624 Poznan, Poland; (E.K.); (A.B.-D.); (S.A.)
| | - Aleksandra Bykowska-Derda
- Department of Human Nutrition and Dietetics, Poznan University of Life Sciences, 31 Wojska Polskiego St., 60-624 Poznan, Poland; (E.K.); (A.B.-D.); (S.A.)
| | - Safa Abdulsamad
- Department of Human Nutrition and Dietetics, Poznan University of Life Sciences, 31 Wojska Polskiego St., 60-624 Poznan, Poland; (E.K.); (A.B.-D.); (S.A.)
| | - Malgorzata Kaluzna
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego St., 60-355 Poznan, Poland; (M.K.); (M.R.)
| | - Karolina Samarzewska
- Department of Clinical Auxiology and Pediatric Nursing, Poznan University of Medical Sciences, 27/33 Szpitalna, 60-572 Poznan, Poland;
| | - Marek Ruchala
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego St., 60-355 Poznan, Poland; (M.K.); (M.R.)
| | - Magdalena Czlapka-Matyasik
- Department of Human Nutrition and Dietetics, Poznan University of Life Sciences, 31 Wojska Polskiego St., 60-624 Poznan, Poland; (E.K.); (A.B.-D.); (S.A.)
- Correspondence: ; Tel.: +48-61-846-62-04
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25
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Liew TM, Lee CS. Examining the Utility of Social Media in COVID-19 Vaccination: Unsupervised Learning of 672,133 Twitter Posts. JMIR Public Health Surveill 2021; 7:e29789. [PMID: 34583316 PMCID: PMC8568045 DOI: 10.2196/29789] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/01/2021] [Accepted: 09/18/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Although COVID-19 vaccines have recently become available, efforts in global mass vaccination can be hampered by the widespread issue of vaccine hesitancy. OBJECTIVE The aim of this study was to use social media data to capture close-to-real-time public perspectives and sentiments regarding COVID-19 vaccines, with the intention to understand the key issues that have captured public attention, as well as the barriers and facilitators to successful COVID-19 vaccination. METHODS Twitter was searched for tweets related to "COVID-19" and "vaccine" over an 11-week period after November 18, 2020, following a press release regarding the first effective vaccine. An unsupervised machine learning approach (ie, structural topic modeling) was used to identify topics from tweets, with each topic further grouped into themes using manually conducted thematic analysis as well as guided by the theoretical framework of the COM-B (capability, opportunity, and motivation components of behavior) model. Sentiment analysis of the tweets was also performed using the rule-based machine learning model VADER (Valence Aware Dictionary and Sentiment Reasoner). RESULTS Tweets related to COVID-19 vaccines were posted by individuals around the world (N=672,133). Six overarching themes were identified: (1) emotional reactions related to COVID-19 vaccines (19.3%), (2) public concerns related to COVID-19 vaccines (19.6%), (3) discussions about news items related to COVID-19 vaccines (13.3%), (4) public health communications about COVID-19 vaccines (10.3%), (5) discussions about approaches to COVID-19 vaccination drives (17.1%), and (6) discussions about the distribution of COVID-19 vaccines (20.3%). Tweets with negative sentiments largely fell within the themes of emotional reactions and public concerns related to COVID-19 vaccines. Tweets related to facilitators of vaccination showed temporal variations over time, while tweets related to barriers remained largely constant throughout the study period. CONCLUSIONS The findings from this study may facilitate the formulation of comprehensive strategies to improve COVID-19 vaccine uptake; they highlight the key processes that require attention in the planning of COVID-19 vaccination and provide feedback on evolving barriers and facilitators in ongoing vaccination drives to allow for further policy tweaks. The findings also illustrate three key roles of social media in COVID-19 vaccination, as follows: surveillance and monitoring, a communication platform, and evaluation of government responses.
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Affiliation(s)
- Tau Ming Liew
- Department of Psychiatry, Singapore General Hospital, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Cia Sin Lee
- SingHealth Polyclinics, Singapore, Singapore
- Family Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
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26
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Olateju IV, Ogwu D, Owolabi MO, Azode U, Osula F, Okeke R, Akabalu I. Role of Behavioral Interventions in the Management of Obesity. Cureus 2021; 13:e18080. [PMID: 34671541 PMCID: PMC8522530 DOI: 10.7759/cureus.18080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2021] [Indexed: 12/05/2022] Open
Abstract
Overweight and obesity are the leading lifestyle-related causes of clinical and public health concerns. Health behavior change is central in obesity management. This review provides the various behavioral interventions in the management of obesity. Behavior modification is a structured method for improving lifestyle habits such as exercise, diet, and other practices that might influence behavior. This review article was based on current and older literature on behavioral approaches to target overweight/obesity. Articles about the various interventions to reduce obesity, particularly behavior interventions, were searched and explored. All the articles found to reveal behavior modification techniques, including goal-setting, self-monitoring, stimulus control, cognitive restructuring, stress management, problem-solving, and social support and information were obtained by reading the full text of the articles. The articles which did not provide any information regarding behavior interventions to reduce obesity were excluded from the review. This review discussed practical ways to incorporate behavior interventions in the management of obesity. The benefits and effectiveness of behavioral interventions on achieving and maintaining weight loss are also discussed. Patients using behavioral modification strategies to make these changes are more likely to succeed in long-term weight maintenance.
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Affiliation(s)
| | - Dolly Ogwu
- Psychiatry, University of Benin, Benin, NGA
| | | | - Ugonna Azode
- Clinical Research, Walden University, Minneapolis, USA.,Informatics, University of Wisconsin School of Medicine and Public Health, Madison, USA.,Physical Therapy, University of Ghana Legon, Accra, GHA.,Medicine and Surgery, Avalon University School of Medicine, Williemstaad, CUW
| | - Felicity Osula
- Internal Medicine, The University of Chicago Medicine, Chicago, USA
| | - Richard Okeke
- Internal Medicine, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, UKR
| | - Ijeoma Akabalu
- Medicine, Caribbean Medical University School of Medicine, Willemstad, CUW
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27
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Berry R, Kassavou A, Sutton S. Does self-monitoring diet and physical activity behaviors using digital technology support adults with obesity or overweight to lose weight? A systematic literature review with meta-analysis. Obes Rev 2021; 22:e13306. [PMID: 34192411 DOI: 10.1111/obr.13306] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 01/30/2023]
Abstract
Establish whether digital self-monitoring of diet and physical activity is effective at supporting weight loss, increasing physical activity and improving eating behavior in adults with obesity or overweight, and determine the intervention components that might explain variations in its effectiveness. A systematic search of MEDLINE, Embase, PsycINFO, Web of Science, Scopus, Cinahl, and CENTRAL identified 4068 studies, of which 12 randomized controlled trials were eligible and included in the review. A random-effect meta-analysis evaluated intervention effectiveness and subgroup analyses tested for effective intervention content. Twelve studies were included in the review and meta-analysis. Digital self-monitoring of both diet and physical activity had a statistically significant effect at supporting weight loss (mean difference [MD] = -2.87 [95% CI -3.78, -1.96], P < 0.001, I2 = 69%), improving moderate physical activity (standardized mean difference [SMD] = 0.44 [95% CI 0.26, 0.62], P < 0.001, I2 = 0%), and reducing calorie intake (MD = -181.71 [95% CI -304.72, -58.70], P < 0.01, I2 = 0%). Tailored interventions were significantly more effective than nontailored interventions (x2 = 12.92, P < 0.001). Digital self-monitoring of physical activity and diet is an effective intervention to support weight loss in adults with obesity or overweight. This effect is significantly associated with tailored advice. Future studies should use rigorous designs to explore intervention effectiveness to support weight loss as an adjunct to weight management services.
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Affiliation(s)
- Rhiannon Berry
- Department of Public Health and Primary Care, Cambridge University, Cambridge, UK
| | - Aikaterini Kassavou
- Department of Public Health and Primary Care, Cambridge University, Cambridge, UK
| | - Stephen Sutton
- Department of Public Health and Primary Care, Cambridge University, Cambridge, UK
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28
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Briggs T, Quick V, Hallman WK. Feature Availability Comparison in Free and Paid Versions of Popular Smartphone Weight Management Applications. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:732-741. [PMID: 34315678 DOI: 10.1016/j.jneb.2021.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Characterize capabilities of nutrition applications (apps) for weight management and associations between features, ratings, and app installations. DESIGN Calorie tracking apps with weight management as a primary outcome were selected from the Apple App Store and Google Play Store using keywords "diet" and "weight loss." METHODS Reviewers assessed free and upgraded versions of nutrition apps (n = 15) for features within 4 categories: (1) dietary intake, (2) anthropometrics, (3) physical activity, and (4) behavior change strategies. OUTCOME MEASURES Presence of specific app features, app ratings, and app installations. ANALYSIS Descriptive statistics of free and paid app versions. Spearman rank-order correlations were used to determine associations between feature inclusion, app ratings, and installations. RESULTS The apps had the greatest number of features in the dietary intake category. Additional dietary intake features were those most likely obtained through a subscription purchase. Behavior change content was absent from most apps. The macronutrient adjustment feature was strongly associated with average app ratings (rs = 0.74; P < 0.002) and with subscription costs (rs = 0.60; P < 0.019). CONCLUSIONS AND IMPLICATIONS This study found most nutrition apps possess an abundance of features dedicated to dietary intake, anthropometric, and physical activity tracking while also being notably devoid of behavior change content features.
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Affiliation(s)
- Telema Briggs
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ.
| | - Virginia Quick
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ
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29
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Kummer AG, Davis-Ajami ML, Arce B, Hartlieb K, Dickinson S, Golzarri-Arroyo L, Olcott CO, Faith M, Jayawardene WP. 'eatNplay' - a rurally-tailored, family-based, telehealth intervention for childhood obesity: Protocol for a mixed-methods randomized newsletter controlled pilot study. Contemp Clin Trials 2021; 109:106542. [PMID: 34403780 DOI: 10.1016/j.cct.2021.106542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/16/2021] [Accepted: 08/11/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Childhood obesity disproportionately affects rural communities where access to pediatric weight control services is limited. Telehealth may facilitate access to these services. OBJECTIVE This paper describes the rationale, curriculum, and methodology for conducting a randomized controlled pilot trial of a rural, family-based, telehealth intervention that aims to improve weight-related behaviors among children, compared to monthly newsletters. METHODS A mixed-methods randomized design will randomly assign 44 rural families with one or more children aged 5 to 11 years identified as overweight or obese to an intervention or newsletter control group. The intervention group will attend 'eatNplay' group videoconferencing telehealth sessions, conducted weekly by a registered nurse and a motivational interviewing expert, to discuss diet, exercise, sleep, and peer group influences. The control group will receive newsletters covering these topics. Outcome measures at baseline, 12, and 26 weeks will assess 1) participant engagement and satisfaction with 'eatNplay'; 2) child's BMI, dietary behavior, physical activity, and sleep behavior; and 3) parent/guardians' self-reported beliefs, behaviors, attitudes, perceived stress, and perceived quality of life. Analyses will employ 1) thematic analysis of semi-structured parent/guardian interviews after follow-up to help refine the intervention (e.g., curriculum), and 2) linear mixed models to compare outcomes between groups pre- and post-intervention and reduce bias from unobserved variables. Results of this pilot study could refine methodology for conducting telehealth studies, acceptability of healthcare provider-involved recruitment, interdisciplinary team approach, and addressing childhood obesity in rural communities through telehealth.
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Affiliation(s)
- Allisandra G Kummer
- School of Public Health, Department of Epidemiology and Biostatistics, Indiana University Bloomington, 1025 E. 7th Street #111, Bloomington, IN 47405, USA.
| | - Mary Lynn Davis-Ajami
- Indiana University School of Nursing, Indiana University-Purdue University Indianapolis, 600 Barnhill Dr. Indianapolis, IN 46202, USA.
| | - Britney Arce
- School of Nursing, Indiana University Bloomington, 2631 E. Discovery Parkway, Bloomington, IN 47405, USA.
| | - Kathryn Hartlieb
- Humanities, Health and Society, Florida International University College of Medicine, 11200 SW 8th Street, Miami, FL 33136, USA
| | - Stephanie Dickinson
- School of Public Health, Department of Epidemiology and Biostatistics, Indiana University Bloomington, 1025 E. 7th Street #111, Bloomington, IN 47405, USA.
| | - Lilian Golzarri-Arroyo
- School of Public Health, Department of Epidemiology and Biostatistics, Indiana University Bloomington, 1025 E. 7th Street #111, Bloomington, IN 47405, USA.
| | - Courtney O Olcott
- Institute for Research on Addictive Behavior, School of Public Health, Indiana University Bloomington, 1033 E. 3rd Street, Bloomington, IN 47405, USA.
| | - Myles Faith
- Graduate School of Education, Department of Counseling, School & Educational Psychology, University at Buffalo-State University of New York, 409 Baldy Hall, Buffalo, NY 14260, USA.
| | - Wasantha P Jayawardene
- Institute for Research on Addictive Behavior, School of Public Health, Indiana University Bloomington, 1033 E. 3rd Street, Bloomington, IN 47405, USA.
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30
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Hayotte M, Iannelli A, Nègre V, Pradier C, Thérouanne P, Fuch A, Diagana O, Garbarino JM, Vuillemin A, Colson SS, Chevalier N, d'Arripe-Longueville F. Effects of technology-based physical activity interventions for women after bariatric surgery: study protocol for a three-arm randomised controlled trial. BMJ Open 2021; 11:e046184. [PMID: 34330855 PMCID: PMC8327817 DOI: 10.1136/bmjopen-2020-046184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION A recent meta-analysis provided proof of efficacy for mobile technology to increase physical activity or weight loss in the short term. Videoconferencing may also be effective, especially as it reduces the barriers related to face-to-face physical activity interventions. Both technologies seem particularly interesting for bariatric surgery management, but their long-term effects on physical activity maintenance are unknown. Moreover, the mechanisms underlying their effectiveness, such as technology acceptability and motivational processes, have not been examined.The objectives of this study are to determine the effects of two technology-based (mobile technology and videoconferencing) physical activity programmes after bariatric surgery compared with standard care and to assess the contribution of acceptability and motivational mechanisms in explaining these effects on physical activity, physiological measures and health indicators. METHODS AND ANALYSIS One hundred and twenty young women who have undergone bariatric surgery in the last 3-6 months will be included. The volunteers will be randomly assigned to one of three arms: CONTROL (standard care), ACTI-MOBIL (mobile technology) or ACTI-VISIO (videoconferencing). The primary outcome is the distance travelled during a 6 min walk test relativised according to Capadaglio's theoretical distance. Secondary outcomes are behavioural measures of physical activity, physiological measures, health indicators, technology acceptability and motivational concepts. Data will be collected at baseline (T0), 3 months (T3) and 6 months (T6). The technology groups will receive a physical activity programme for 12 weeks (between T0 and T3). A mixed model approach will be used to analyse the change in outcomes over time for each group. ETHICS AND DISSEMINATION This study protocol was reviewed and approved by the French East 1 Protection of Persons Ethics Committee (number: 2020.A00172-37) and the French National Commission for Information Technology and Civil Liberties (number: UCA-R20-034). The results will be disseminated through conference presentations and peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT04478331.
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Affiliation(s)
- Meggy Hayotte
- Laboratoire Motricité Humaine Expertise Sport Santé (LAMHESS), Université Côte d'Azur, Nice, France
| | - Antonio Iannelli
- Centre Spécialisé Obésité PACA Est, Centre Hospitalier Universitaire de Nice Pole Digestif Addictologie Reanimation chirurgicale Endocrinologie, Nice, France
| | - Véronique Nègre
- Centre Spécialisé Obésité PACA Est, Centre Hospitalier Universitaire de Nice Pole Digestif Addictologie Reanimation chirurgicale Endocrinologie, Nice, France
| | - Christian Pradier
- Département de Santé Publique, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Pierre Thérouanne
- Laboratoire d'Anthropologie et de Psychologie Cliniques, Cognitives et Sociales (LAPCOS), Université Côte d'Azur, Nice, France
| | - Alain Fuch
- Association Azur Sport Santé, Nice, France
| | | | - Jean-Marie Garbarino
- Laboratoire Motricité Humaine Expertise Sport Santé (LAMHESS), Université Côte d'Azur, Nice, France
| | - Anne Vuillemin
- Laboratoire Motricité Humaine Expertise Sport Santé (LAMHESS), Université Côte d'Azur, Nice, France
| | - Serge S Colson
- Laboratoire Motricité Humaine Expertise Sport Santé (LAMHESS), Université Côte d'Azur, Nice, France
| | - Nicolas Chevalier
- Centre Spécialisé Obésité PACA Est, Centre Hospitalier Universitaire de Nice Pole Digestif Addictologie Reanimation chirurgicale Endocrinologie, Nice, France
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Fenton S, Burrows TL, Collins CE, Rayward AT, Murawski B, Duncan MJ. Efficacy of a Multi-Component m-Health Diet, Physical Activity, and Sleep Intervention on Dietary Intake in Adults with Overweight and Obesity: A Randomised Controlled Trial. Nutrients 2021; 13:nu13072468. [PMID: 34371975 PMCID: PMC8308779 DOI: 10.3390/nu13072468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 12/14/2022] Open
Abstract
This three-arm randomised controlled trial evaluated whether (1) a multi-component weight loss intervention targeting diet, physical activity (PA), and sleep was effective at improving dietary intake over six months and 12 months, compared with a control, and (2) the enhanced diet, PA, and sleep intervention was more effective at improving dietary intake than the traditional diet and PA intervention. A total of 116 adults (70% female, 44.5 years, BMI 31.7 kg/m2) were randomised to either traditional diet and PA intervention; enhanced diet, PA, and sleep intervention; or wait-list control. To examine between-group differences, intervention groups were pooled and compared with the control. Then, the two intervention groups were compared. At six months, the pooled intervention group consumed 1011 fewer kilojoules/day (95% CI −1922, −101), less sodium (−313.2 mg/day; 95% CI −591.3, −35.0), and higher %EI from fruit (+2.1%EI; 95% CI 0.1, 4.1) than the controls. There were no differences in intake between the enhanced and traditional groups at six months. At 12 months, the pooled intervention and control groups reported no significant differences. However, compared to the traditional group, the enhanced reported higher %EI from nutrient-dense foods (+7.4%EI; 95% CI 1.3, 13.5) and protein (+2.4%EI; 95% CI 0.1, 4.6), and reduced %EI from fried/takeaway foods (−3.6%EI; 95% CI −6.5, −0.7), baked sweet products (−2.0%EI; 95% CI −3.6, −0.4), and packaged snacks (−1.1%EI; 95% CI −2.2, −0.3). This weight loss intervention reduced total energy and sodium intakes as well as increased fruit intake in adults at six months. The enhanced intervention group reported improved dietary intake relative to the traditional group at 12 months.
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Affiliation(s)
- Sasha Fenton
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (T.L.B.); (C.E.C.); (A.T.R.); (B.M.)
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Tracy L. Burrows
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (T.L.B.); (C.E.C.); (A.T.R.); (B.M.)
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Clare E. Collins
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (T.L.B.); (C.E.C.); (A.T.R.); (B.M.)
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Anna T. Rayward
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (T.L.B.); (C.E.C.); (A.T.R.); (B.M.)
- School of Education, College of Human and Social Futures, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Beatrice Murawski
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (T.L.B.); (C.E.C.); (A.T.R.); (B.M.)
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Mitch J. Duncan
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (T.L.B.); (C.E.C.); (A.T.R.); (B.M.)
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Correspondence:
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De Bacquer D, Astin F, Kotseva K, Pogosova N, De Smedt D, De Backer G, Rydén L, Wood D, Jennings C. Poor adherence to lifestyle recommendations in patients with coronary heart disease: results from the EUROASPIRE surveys. Eur J Prev Cardiol 2021; 29:383-395. [PMID: 34293121 DOI: 10.1093/eurjpc/zwab115] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/25/2021] [Accepted: 06/10/2021] [Indexed: 11/14/2022]
Abstract
AIMS Despite the high use of cardioprotective medications, the risk factor control in patients with coronary heart disease (CHD) is still inadequate. Guidelines identify healthy lifestyles as equally important in secondary prevention as pharmacotherapy. Here, we describe reasons for poor lifestyle adherence from the patient's perspective. METHODS AND RESULTS In the EUROASPIRE IV and V surveys, 16 259 CHD patients were examined and interviewed during a study visit ≥6 months after hospital discharge. Data gathering was fully standardized. The Brief Illness Perception questionnaire was completed by a subsample of 2379 patients. Half of those who were smoking prior to hospital admission, were still smoking; 37% of current smokers had not attempted to quit and 51% was not considering to do so. The prevalence of obesity was 38%. Half of obese patients tried to lose weight in the past month and 61% considered weight loss in the following month. In relation to physical activity, 40% was on target with half of patients trying to do more everyday activities. Less than half had the intention to engage in planned exercise. Only 29% of all patients was at goal for all three lifestyle factors. The number of adverse lifestyles was strongly related to the way patients perceive their illness as threatening. Lifestyle modifications were more successful in those having participated in a cardiac rehabilitation and prevention programme. Patients indicated lack of self-confidence as the main barrier to change their unhealthy behaviour. CONCLUSION Modern secondary prevention programmes should target behavioural change in all patients with adverse lifestyles.
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Affiliation(s)
- Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University, C. Heymanslaan 10-6K3, entrance 42, B-9000 Ghent, Belgium
| | - Felicity Astin
- Centre for Applied Research in Health, University of Huddersfield and Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, UK
| | - Kornelia Kotseva
- National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland.,Imperial College Healthcare NHS Trust, London, UK
| | - Nana Pogosova
- National Medical Research Centre of Cardiology, Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Delphine De Smedt
- Department of Public Health and Primary Care, Ghent University, C. Heymanslaan 10-6K3, entrance 42, B-9000 Ghent, Belgium
| | - Guy De Backer
- Department of Public Health and Primary Care, Ghent University, C. Heymanslaan 10-6K3, entrance 42, B-9000 Ghent, Belgium
| | - Lars Rydén
- Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - David Wood
- National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland.,National Heart and Lung Institute, Imperial College London, London, UK
| | - Catriona Jennings
- National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland.,Imperial College Healthcare NHS Trust, London, UK
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Acceptability of technology-based physical activity intervention profiles and their motivational factors in obesity care: a latent profile transition analysis. Int J Obes (Lond) 2021; 45:1488-1498. [PMID: 33893384 DOI: 10.1038/s41366-021-00813-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 03/16/2021] [Accepted: 04/09/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES This study aimed to: (a) identify the acceptability profiles for three technology-based physical activity interventions (TbPAI) in obesity treatment (active video games, mobile applications, telehealth), (b) examine the issues of consistency or change in these profiles for the same individual across technologies, and (c) determine whether acceptability profiles are related to motivational factors. METHODS Three hundred and twelve women (Mage = 30.7, SD = 7.1 years; MBMI = 34.5, SD = 7.8 kg/m²) using obesity services were recruited for this cross-sectional survey. They completed an online survey including sociodemographic data and measures related to physical activity: level, stage of change, motivation, and general causality orientations. The women read descriptions of the three technologies and rated their acceptability. We used a latent profile transition analysis (LPTA) approach. RESULTS A 2-class model (high and low acceptability) best described the profiles for each technology. Intra-individual analysis revealed that the profiles exhibited both changes and stability across TbPAI. Women with high scores on impersonal orientation were more likely to be in the high acceptability telehealth profile, whereas those reporting high scores on control orientation were more likely to be in the high acceptability active video games profile. Women with high scores on control orientation and low scores on impersonal orientation were more likely to be in the high acceptability mobile applications profile. CONCLUSIONS Results showed that the causality orientations were factors related to the TbPAI acceptability profiles, suggesting that clinicians should consider these psychological characteristics in TbPAI counseling.
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Moitra P, Verma P, Madan J. Development and validation of a questionnaire measuring knowledge, attitudes, and practices (KAP) to healthy eating and activity patterns in school children (HEAPS). Nutr Health 2021; 27:199-209. [PMID: 33522877 DOI: 10.1177/0260106020982356] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Development of culturally appropriate and psychometrically sound instruments that measure knowledge and health behaviors of children will help to inform appropriate interventions. AIM To develop and test the validity and reliability of a questionnaire measuring knowledge, attitudes, and practices to healthy eating and activity patterns in school children in India. METHODS Review of literature, focus-group discussions, and theoretical constructs of the Health Belief Model guided the development of an item pool. Face and content validity were assessed by children and a panel of experts and the item content validity, item difficulty, and discrimination indices were calculated. Construct validity was determined using the principal axis method of exploratory factor analysis among a cross-sectional sample of children (n=252). Internal consistency (Cronbach α values >0.7) and test-retest reliability (intraclass correlation coefficient values >0.75) were estimated. RESULTS Item content validity index for clarity and relevance were satisfactory (>0.80) and internal consistency for knowledge (Kuder-Richardson 20 = 0.832), attitude (Cronbach's α = 0.912), and practice items (Cronbach's α = 0.769) were good. Four factors (children's eating habits, family dietary practices, and consumption of healthy and unhealthy foods) and two factors (moderate to vigorous activities and sedentary activities) explained 67.7% and 48.2% of the total variance in practice items. Intraclass correlation coefficient estimates ranged from good to excellent (0.72-0.99). CONCLUSIONS The results of the validity and reliability of the 84-item knowledge, attitudes, and practices to healthy eating and activity patterns in schoolchildren questionnaire were promising. The detailed description of the methodology employed may prove useful to researchers conducting similar studies in children.
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Affiliation(s)
- Panchali Moitra
- Department of Food, Nutrition & Dietetics, 210967Sir Vithaldas Thackersey College of Home Science (Autonomous), Shreemati Nathibai Damodar Thackersey Women's University, Mumbai, India
| | - Preeti Verma
- Department of Special Education, Associate Dean, Interdisciplinary Studies, 29551Shreemati Nathibai Damodar Thackersey Women's University, Mumbai, India
| | - Jagmeet Madan
- Department of Food, Nutrition & Dietetics, 210967Sir Vithaldas Thackersey College of Home Science (Autonomous), Shreemati Nathibai Damodar Thackersey Women's University, Mumbai, India
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Bartosiewicz A, Łuszczki E, Nagórska M, Oleksy Ł, Stolarczyk A, Dereń K. Risk Factors of Metabolic Syndrome among Polish Nurses. Metabolites 2021; 11:metabo11050267. [PMID: 33922860 PMCID: PMC8145067 DOI: 10.3390/metabo11050267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/13/2021] [Accepted: 04/21/2021] [Indexed: 02/08/2023] Open
Abstract
The metabolic syndrome, also known as syndrome X or the insulin resistance, is defined by the World Health Organization as a pathologic condition characterized by abdominal obesity, insulin resistance, hypertension, and hyperlipidemia. Both all over the world and in Poland, there is a shortage of nurses; most of those employed are in the pre-retirement age. However, the requirements in this profession and the patient’s right to care at the highest level remain unchanged and do not take into account the poor condition or age of working nurses, so special attention should be paid to the state of health in this professional group. There is an emphasis on the importance of the adopted attitude toward health and the resulting behaviors, such as regular weight control, following dietary recommendations, regular physical activity and participation in preventive examinations. The aim of the study was to assess the frequency of the occurrence of the metabolic syndrome, its individual components and determining the factors influencing its development in Polish nurses. The research conducted among the nurses in question included DXA (Dual Energy X-ray Absorptiometry) measurements, assessment of glucose concentration, lipid profile, blood pressure and a questionnaire survey. Almost half of the surveyed nurses have metabolic syndrome, which significantly increases the risk of developing cardiovascular diseases or diabetes. After multivariate analysis, it was found that being overweight and obesity were significant factors influenced the MS (metabolic syndrome) occurrence among Polish nurses. Being overweight increases the chances of MS occurrence 8.58 times in relation to BMI (Body Mass Index) <25, obesity increases the chances of MS occurrence 8.085 times in relation to BMI <25, and obesity class II/III increases the chances of MS occurrence 16.505 times in relation to BMI <25. Preventive and supportive measures for this professional group are needed.
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Affiliation(s)
- Anna Bartosiewicz
- Institute of Health Sciences, Medical College of Rzeszów University, 35-959 Rzeszów, Poland; (E.Ł.); (K.D.)
- Correspondence: ; Tel.: +48-17-851-6811
| | - Edyta Łuszczki
- Institute of Health Sciences, Medical College of Rzeszów University, 35-959 Rzeszów, Poland; (E.Ł.); (K.D.)
| | - Małgorzata Nagórska
- Institute of Medical Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland;
| | - Łukasz Oleksy
- Orthopaedic and Rehabilitation Department, Medical University of Warsaw, 02-091 Warsaw, Poland; (Ł.O.); (A.S.)
| | - Artur Stolarczyk
- Orthopaedic and Rehabilitation Department, Medical University of Warsaw, 02-091 Warsaw, Poland; (Ł.O.); (A.S.)
| | - Katarzyna Dereń
- Institute of Health Sciences, Medical College of Rzeszów University, 35-959 Rzeszów, Poland; (E.Ł.); (K.D.)
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Brown MC, Haste A, Araújo-Soares V, Skinner R, Sharp L. Identifying and exploring the self-management strategies used by childhood cancer survivors. J Cancer Surviv 2021; 15:344-357. [PMID: 33156449 PMCID: PMC7966631 DOI: 10.1007/s11764-020-00935-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 09/05/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE Childhood cancer survivors (CCSs) are at increased risk of chronic health problems. Effective self-management could help CCSs cope with the challenges that accompany survivorship and reduce their risk of developing further health problems. There is little evidence about the extent to which CCSs engage with self-management and the specific strategies they use. This study aimed to identify and explore the strategies that CCSs use to manage the consequences of cancer. METHODS Twenty-four CCSs were recruited via follow-up clinics. Participants completed a semi-structured interview which was audio-recorded and transcribed. Directed content analysis was used to identify self-reported self-management strategies and categorise them into main self-management types. RESULTS CCSs reported 118 specific self-management strategies which fell under 20 main self-management strategy types. All CCSs reported using several main self-management strategy types and specific self-management strategies. Main strategy types used by all CCSs were "adopting a healthy lifestyle", "self-motivating", "using support", "reasoned decision-making" and "creating a healthy environment". The most common specific self-management strategies were "receiving family support" (n = 20) and "attending follow-up and screening appointments" (n = 20). CONCLUSIONS This is the first study which has enabled CCSs to self-report the numerous strategies they employ to look after their health and well-being, contributing to a more comprehensive picture of self-management in CCSs. IMPLICATIONS FOR CANCER SURVIVORS These findings may increase healthcare professionals' awareness of the many ways in which CCSs manage their health and is a valuable first step in the development of a supported self-management intervention for CCSs in follow-up care.
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Affiliation(s)
- Morven C Brown
- Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, NE1 4LP,, Newcastle upon Tyne, UK.
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK.
| | - Anna Haste
- Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, NE1 4LP,, Newcastle upon Tyne, UK
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, NE1 4LP,, Newcastle upon Tyne, UK
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
| | - Roderick Skinner
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, NE1 4LP,, Newcastle upon Tyne, UK
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
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Hayotte M, Nègre V, Gray L, Sadoul JL, d'Arripe-Longueville F. The transtheoretical model (TTM) to gain insight into young women's long-term physical activity after bariatric surgery: a qualitative study. Obes Surg 2021; 30:595-602. [PMID: 31654341 DOI: 10.1007/s11695-019-04220-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Over the long term, people who have undergone bariatric surgery (BS) remain overly sedentary with inadequate physical activity (PA). The purpose of this study was to apply the transtheoretical model (TTM) to (1) explore in-depth how PA is experienced years after BS and (2) identify the barriers to and facilitators of PA involved at each stage of change (SOC). METHODS Seventeen women with a mean age of 32.5 ± 3.3 years and a percentage of total weight loss of 29.6 ± 12.4 were interviewed at a mean of 9.4 ± 3.6 years after BS. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. RESULTS The distribution of barriers to and facilitators of PA differed with the SOC. In progressing from the precontemplation and contemplation stages to the preparation stage, the women experienced changes in their decisional balance, supported by processes of self-reevaluation and environmental reevaluation. In shifting from preparation to the action and maintenance stages, they experienced intrinsic motivation and self-liberation processes. The relapse stage was associated with a decrease in self-efficacy to cope with life constraints. CONCLUSIONS This study presents an in-depth theory-based exploration of the dynamics of long-term engagement in PA after BS in young women, with clinical implications for providing them with better guidance toward a more physically active lifestyle.
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Affiliation(s)
| | - Véronique Nègre
- Centre Spécialisé Obésité PACA Est, Pôle DARE, Centre Hospitalier Universitaire de Nice membre de l'Université Côte d'Azur, Nice, France
| | - Laura Gray
- Université Côte d'Azur, LAMHESS, Nice, France
| | - Jean-Louis Sadoul
- Centre Spécialisé Obésité PACA Est, Pôle DARE, Centre Hospitalier Universitaire de Nice membre de l'Université Côte d'Azur, Nice, France
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Willmott T, Rundle-Thiele S. Are we speaking the same language? Call for action to improve theory application and reporting in behaviour change research. BMC Public Health 2021; 21:479. [PMID: 33691658 PMCID: PMC7944470 DOI: 10.1186/s12889-021-10541-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 03/03/2021] [Indexed: 12/14/2022] Open
Abstract
Inconsistencies are evident in definitions and interpretations of theory, application of theory, and reporting of theory use within the behaviour change field impeding cumulative knowledge advancement. Standardised frameworks and methods are needed to support the definition, application, and reporting of theory, and to assist researchers in understanding how theory should be applied to build cumulative knowledge over time. Progress is being made with the development of ontologies, taxonomies, methods for mapping interventions, and coding schemes; however, consolidation is needed to improve levels and quality of theory use, and to facilitate the translation of theory-driven research in practice. This paper discusses the importance of rigorous theory application and reporting in health-related behaviour change research and outlines the need for a standardised framework that supports both researchers and practitioners in designing, implementing, and evaluating theory-driven interventions in a concrete and consistent manner. To this end, several recommendations are provided to facilitate the development of a standardised framework that supports theory application and reporting in the behaviour change field. Concrete and consistent theory application and reporting will permit critical appraisal within and across studies, thereby advancing cumulative knowledge of behaviour change over time.
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Affiliation(s)
- Taylor Willmott
- Social Marketing @ Griffith, Griffith University, 170 Kessels Road, Nathan, QLD 4111 Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, Griffith University, 170 Kessels Road, Nathan, QLD 4111 Australia
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Ghosh A, Sharma K. Screening and brief intervention for substance use disorders in times of COVID-19: potential opportunities, adaptations, and challenges. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:154-159. [PMID: 33481639 DOI: 10.1080/00952990.2020.1865996] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The ongoing pandemic has led to a sudden disruption of routine treatment services. Consequently, the already existing treatment gap for substance use disorders is likely to widen. There is an opportunity to expand the scope of Screening and Brief Intervention (SBI) to meet this unprecedented challenge. Its brevity, flexibility, and generalizability have positioned SBI to deal with additional systemic, structural, and attitudinal barriers that pertain to the pandemic. The standard content of SBI could be modified to adapt to the current context. SBI could also be used as a vehicle to render strategies for infection risk minimization. In this Perspective, we anticipate the challenges of expanding and implementing SBI in the present circumstances and present potential solutions. SBI, with adaptations, could bridge the augmented treatment gap for substance use disorders during COVID-19.
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Affiliation(s)
- Abhishek Ghosh
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Kshitiz Sharma
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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Moraes ADS, Padovani RDC, La Scala Teixeira CV, Cuesta MGS, Gil SDS, de Paula B, Dos Santos GM, Gonçalves RT, Dâmaso AR, Oyama LM, Gomes RJ, Caranti DA. Cognitive Behavioral Approach to Treat Obesity: A Randomized Clinical Trial. Front Nutr 2021; 8:611217. [PMID: 33681273 PMCID: PMC7929974 DOI: 10.3389/fnut.2021.611217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/08/2021] [Indexed: 11/13/2022] Open
Abstract
Our aim was to analyze and compare the effects of three different long-term treatments on anthropometric profiles, eating behaviors, anxiety and depression levels, and quality of life of groups of adults with obesity. Methods: The 43 participants in the study were randomly assigned to one of three groups: the education and health group (EH, n = 12), which received lectures on health topics; the physical exercise group (PE, n = 13), which underwent physical training; and the interdisciplinary therapy plus cognitive behavioral therapy (IT + CBT) (n = 18) group, which received physical training, nutritional advice, and physical and psychological therapy. Results: Total quality of life increased significantly in the EH group (△ = 2.00); in the PE group, body weight significantly decreased (△ = -1.42) and the physical domain of quality of life improved (△ = 1.05). However, the most significant changes were seen in the IT + CBT group, in which the anthropometric profile improved; there were an increase in quality of life in all domains (physical, psychological, social, and environmental), an improvement in eating behaviors [Dutch Eating Behavior Questionnaire (DEBQ), total △ = -8.39], and a reduction in depression [Beck Depression Inventory (BDI), △ = -10.13). Conclusion: The IT + CBT program was more effective than the PE and EH programs. Clinical Trial Registration Number: NCT02573688.
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Affiliation(s)
- Amanda Dos Santos Moraes
- Post Graduate Program of Interdisciplinary Health Sciences, Federal University of São Paulo, São Paulo, Brazil.,Obesity Study Group (GEO), Post-Graduate Program of Nutrition, Federal University of São Paulo, São Paulo, Brazil
| | - Ricardo da Costa Padovani
- Post Graduate Program of Interdisciplinary Health Sciences, Federal University of São Paulo, São Paulo, Brazil.,Obesity Study Group (GEO), Post-Graduate Program of Nutrition, Federal University of São Paulo, São Paulo, Brazil.,Health, Education and Society Department, Federal University of São Paulo, São Paulo, Brazil
| | - Cauê Vazquez La Scala Teixeira
- Post Graduate Program of Interdisciplinary Health Sciences, Federal University of São Paulo, São Paulo, Brazil.,Obesity Study Group (GEO), Post-Graduate Program of Nutrition, Federal University of São Paulo, São Paulo, Brazil
| | - Maria Gabriela Soria Cuesta
- Post Graduate Program of Interdisciplinary Health Sciences, Federal University of São Paulo, São Paulo, Brazil.,Obesity Study Group (GEO), Post-Graduate Program of Nutrition, Federal University of São Paulo, São Paulo, Brazil.,Post Graduate Program of Food, Nutrition, Federal University of São Paulo, São Paulo, Brazil
| | - Silvandro Dos Santos Gil
- Post Graduate Program of Interdisciplinary Health Sciences, Federal University of São Paulo, São Paulo, Brazil.,Obesity Study Group (GEO), Post-Graduate Program of Nutrition, Federal University of São Paulo, São Paulo, Brazil
| | - Bárbara de Paula
- Obesity Study Group (GEO), Post-Graduate Program of Nutrition, Federal University of São Paulo, São Paulo, Brazil.,Graduate Program of Interdisciplinary Health Sciences, Federal University of São Paulo, São Paulo, Brazil
| | - Gilberto Monteiro Dos Santos
- Obesity Study Group (GEO), Post-Graduate Program of Nutrition, Federal University of São Paulo, São Paulo, Brazil
| | | | - Ana Raimunda Dâmaso
- Obesity Study Group (GEO), Post-Graduate Program of Nutrition, Federal University of São Paulo, São Paulo, Brazil
| | - Lila Missae Oyama
- Obesity Study Group (GEO), Post-Graduate Program of Nutrition, Federal University of São Paulo, São Paulo, Brazil.,Post Graduate Program of Food, Nutrition, Federal University of São Paulo, São Paulo, Brazil
| | - Ricardo José Gomes
- Post Graduate Program of Interdisciplinary Health Sciences, Federal University of São Paulo, São Paulo, Brazil.,Obesity Study Group (GEO), Post-Graduate Program of Nutrition, Federal University of São Paulo, São Paulo, Brazil.,Biosciences Department, Federal University of São Paulo, São Paulo, Brazil
| | - Danielle Arisa Caranti
- Post Graduate Program of Interdisciplinary Health Sciences, Federal University of São Paulo, São Paulo, Brazil.,Obesity Study Group (GEO), Post-Graduate Program of Nutrition, Federal University of São Paulo, São Paulo, Brazil.,Health, Education and Society Department, Federal University of São Paulo, São Paulo, Brazil.,Biosciences Department, Federal University of São Paulo, São Paulo, Brazil
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Mansoor S, Jain P, Hassan N, Farooq U, Mirza MA, Pandith AA, Iqbal Z. Role of Genetic and Dietary Implications in the Pathogenesis of Global Obesity. FOOD REVIEWS INTERNATIONAL 2021. [DOI: 10.1080/87559129.2021.1874409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Sheikh Mansoor
- Division of Biochemistry, Faculty of Basic Sciences, SKUAST, Jammu, India
| | - Pooja Jain
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Nazia Hassan
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Uzma Farooq
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Mohd. Aamir Mirza
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Arshad A Pandith
- Advanced Centre for Human Genetics, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, J&K, India
| | - Zeenat Iqbal
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
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Sporrel K, Nibbeling N, Wang S, Ettema D, Simons M. Unraveling Mobile Health Exercise Interventions for Adults: Scoping Review on the Implementations and Designs of Persuasive Strategies. JMIR Mhealth Uhealth 2021; 9:e16282. [PMID: 33459598 PMCID: PMC7850911 DOI: 10.2196/16282] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 02/03/2020] [Accepted: 03/23/2020] [Indexed: 12/22/2022] Open
Abstract
Background It is unclear why some physical activity (PA) mobile health (mHealth) interventions successfully promote PA whereas others do not. One possible explanation is the variety in PA mHealth interventions—not only do interventions differ in the selection of persuasive strategies but also the design and implementation of persuasive strategies can vary. However, limited studies have examined the different designs and technical implementations of strategies or explored if they indeed influenced the effectiveness of the intervention. Objective This scoping review sets out to explore the different technical implementations and design characteristics of common and likely most effective persuasive strategies, namely, goal setting, monitoring, reminders, rewards, sharing, and social comparison. Furthermore, this review aims to explore whether previous mHealth studies examined the influence of the different design characteristics and technical operationalizations of common persuasive strategies on the effectiveness of the intervention to persuade the user to engage in PA. Methods An unsystematic snowball and gray literature search was performed to identify the literature that evaluated the persuasive strategies in experimental trials (eg, randomized controlled trial, pre-post test). Studies were included if they targeted adults, if they were (partly) delivered by a mobile system, if they reported PA outcomes, if they used an experimental trial, and when they specifically compared the effect of different designs or implementations of persuasive strategies. The study methods, implementations, and designs of persuasive strategies, and the study results were systematically extracted from the literature by the reviewers. Results A total of 29 experimental trials were identified. We found a heterogeneity in how the strategies are being implemented and designed. Moreover, the findings indicated that the implementation and design of the strategy has an influence on the effectiveness of the PA intervention. For instance, the effectiveness of rewarding was shown to vary between types of rewards; rewarding goal achievement seems to be more effective than rewarding each step taken. Furthermore, studies comparing different ways of goal setting suggested that assigning a goal to users might appear to be more effective than letting the user set their own goal, similar to using adaptively tailored goals as opposed to static generic goals. This study further demonstrates that only a few studies have examined the influence of different technical implementations on PA behavior. Conclusions The different implementations and designs of persuasive strategies in mHealth interventions should be critically considered when developing such interventions and before drawing conclusions on the effectiveness of the strategy as a whole. Future efforts are needed to examine which implementations and designs are most effective to improve the translation of theory-based persuasive strategies into practical delivery forms.
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Affiliation(s)
- Karlijn Sporrel
- Faculty of Geosciences, Utrecht University, Utrecht, Netherlands
| | - Nicky Nibbeling
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Shihan Wang
- Institute of Informatics, University of Amsterdam, Amsterdam, Netherlands.,Department of Information and Computing Sciences, Utrecht University, Utrecht, Netherlands
| | - Dick Ettema
- Faculty of Geosciences, Utrecht University, Utrecht, Netherlands
| | - Monique Simons
- Social Sciences, Consumption and Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
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Nifina N, Krishnan A. Association of bowel and tear suppression with coronary artery disease: A case control study. J Ayurveda Integr Med 2021; 12:80-86. [PMID: 33446378 PMCID: PMC8039329 DOI: 10.1016/j.jaim.2020.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 11/25/2022] Open
Abstract
Background Coronary Artery disease (CAD) accounts for one-third or more of all deaths in individuals over 35 years of age. In Ayurveda, umbrella term Hrdroga encompasses the concept of CAD. Vegadharana, suppression of natural urges is a lifestyle error that has been denoted as a potential risk factor of Hrdroga, but there is a lacuna of convincing research works. Objective The present study is designed to assess and evaluate the association of Purisavegadharana, Baspavegadharana (bowel, tear suppression) with CAD. Materials and methods Study followed case-control design; Cases (110) were patients aged above 18 years of either sex, diagnosed with CAD in a duration less than or equal to 10 years, attending outpatient department (OPD) of an Allopathy and Ayurveda hospital. The controls (110) included hospital controls from same hospitals. Exposure status was assessed through Case Record Form (CRF), Bowel suppression and Tear suppression assessment Questionnaires, interview with patients and scrutiny of past medical records. Odds ratios and chi-square tests were computed. Receiver Operating Characteristic (ROC) curves of logistic regression models fitted were generated and optimal cut-off points for bowel and tear suppression scores were derived through Youden index. Results Tear suppression and bowel suppression showed odds ratio of 4.47 and 2.30 respectively. Other commendable predisposing factors were age above 60 years, family history of disease and use of medication. Highest odds ratio from logistic regression was for palpitation (8.67) and followed by tobacco use (6.23). Conclusion Study indicated high association of bowel and tear suppression with CAD along with other predisposing factors, prominent of which were palpitation and use of tobacco use.
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Affiliation(s)
- N Nifina
- Department of Swasthavritta, VPSV Ayurveda College Kottakkal, Kerala, India
| | - Anupama Krishnan
- Department of Swasthavritta, VPSV Ayurveda College Kottakkal, Kerala, India.
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Jessen-Winge C, Ilvig PM, Fritz H, Brandt CJ, Lee K, Christensen JR. What a weight loss programme should contain if people with obesity were asked - a qualitative analysis within the DO:IT study. BMC Public Health 2021; 21:28. [PMID: 33407271 PMCID: PMC7789717 DOI: 10.1186/s12889-020-09850-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 11/05/2020] [Indexed: 12/31/2022] Open
Abstract
Background Currently 1.9 billion adults worldwide are estimated to be overweight or obese. In Denmark the municipalities hold the responsibility to deliver weight loss programmes to overweight and obese citizens. There is a tendency to assume that weight loss programmes that show positive effects in specialized hospital settings are directly transferrable to municipal settings. However, municipality-based weight loss programmes have not produced clinically significant reductions in body weight. One reason for this may be that much research evidence regarding obesity programming neglects the perspectives of people with obesity. The first step in developing a weight loss programme designed for municipal settings is to understand what people with obesity want and need from a programme. The aim of this study was to examine what people with obesity find important in a weight loss programme for weight loss and weight maintenance. Methods We used a qualitative, explorative, descriptive design with individual interviews. We included men and women age 17 and older with a BMI ≥ 25 kg/m2. Participants were recruited from the wait lists of 13 municipality programmes and through Facebook posts. Data were analyzed using content analysis. Results Thirty-four participants with overweight or obesity were individually interviewed (ages between 19 and 74). Findings suggest that weight loss programmes should; a) support participants in structuring days; b) consider the use of replacement activities to reduce cognitive and emotional burden; c) aide individuals to increase self-efficacy and; d) include family and friends as well as health professionals and peers in the weight loss process. Diet and exercise, while important, should be balanced with other meaningful activities in everyday life. Conclusion Participants in this study wished to balance weight loss related activities with overall everyday life as well as finding the believe in their ability to lose weight in social relations.
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Affiliation(s)
- Christina Jessen-Winge
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psycomotore therapy, University College Copenhagen, Sigurdsgade 26, 2200, Copenhagen, Denmark. .,Department of Public Health, University of Southern Denmark, JB Winsløwsvej 9A, 5000, Odense C, Denmark.
| | - Pia Maria Ilvig
- Department of Public Health, University of Southern Denmark, JB Winsløwsvej 9A, 5000, Odense C, Denmark
| | - Heather Fritz
- Department of Health Care sciences, Occupational Therapy Program, Wayne State University, 259 Mack Ave, Detroit, MI, 48201, USA
| | - Carl J Brandt
- Department of Public Health, University of Southern Denmark, JB Winsløwsvej 9A, 5000, Odense C, Denmark
| | - Kim Lee
- Department of Public Health, University of Southern Denmark, JB Winsløwsvej 9A, 5000, Odense C, Denmark.,Department of Occupational Therapy, University College South, Degnevej 16, 6705, Esbjerg, Denmark
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Culliford A, Bradbury J. A cross-sectional survey of the readiness of consumers to adopt an environmentally sustainable diet. Nutr J 2020; 19:138. [PMID: 33298065 PMCID: PMC7727219 DOI: 10.1186/s12937-020-00644-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 11/11/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The current food system is responsible for significant environmental damage therefore, encouraging consumers to adopt an environmentally sustainable diet is a key public health challenge. Dietary guidelines have been developed that outline recommendations for purchasing and consuming food in an environmentally sustainable manner, but they have not yet been incorporated in UK national dietary guidelines. METHODS Via an online survey of UK adults, we evaluated consumers' perceptions of the environmental benefit of various sustainable diet recommendations, their readiness to adopt these behaviours using the stage of change construct of the Transtheoretical Model, the factors that influenced their food choices, and their current consumption of plant- and animal-based sources of protein. Additionally, we investigated how demographic characteristics and food choice motives were associated with perceived environmental benefit of and readiness to adopt these sustainable diet recommendations. RESULTS The survey was completed by 442 participants (66% female, 80% aged 25-54 years, 85% with higher education). The majority of participants considered the recommendations to 'reduce consumption of air-freighted foods' (79%), 'reduce food waste' (75%), and 'buy locally grown produce' (78%) to have a high environmental benefit, whereas a smaller proportion of participants perceived 'prioritise plant-based proteins' (42%) and 'choose organic produce' (27%) to have a high environmental benefit. Differences in perceptions and readiness to adopt sustainable dietary behaviours were observed between demographic groups, with women significantly more likely than men to be in action/maintenance (A/M) stages of change for prioritising plant proteins (OR 0.54), and younger participants more likely to be in pre-contemplation/contemplation (PC/C) stages of change for 'choose organic produce' (OR 2.03) and 'choose sustainable fish' (OR 2.45). Health, cost, environmental sustainability and taste were the most commonly reported food choice motives. Reporting environmental sustainability as a food choice motive was associated with readiness to adopt sustainable diet recommendations. CONCLUSIONS We found that consumers in the UK are engaged with some aspects of sustainable diets but remain resistant to others. The results of this study indicate that acceptable dietary guidelines could be developed to address environmental sustainability. Several behaviours were identified that consumers were willing to adopt, but there were barriers preventing them, highlighting that policy action is required to enable behaviour change to occur. Differences between demographic groups highlight potential targets for future campaigns promoting sustainable diets.
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Affiliation(s)
- Amy Culliford
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK
| | - Jane Bradbury
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK
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Asbjørnsen RA, Wentzel J, Smedsrød ML, Hjelmesæth J, Clark MM, Solberg Nes L, Van Gemert-Pijnen JEWC. Identifying Persuasive Design Principles and Behavior Change Techniques Supporting End User Values and Needs in eHealth Interventions for Long-Term Weight Loss Maintenance: Qualitative Study. J Med Internet Res 2020; 22:e22598. [PMID: 33252347 PMCID: PMC7735908 DOI: 10.2196/22598] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/23/2020] [Accepted: 09/15/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND An increasing number of eHealth interventions aim to support healthy behaviors that facilitate weight loss. However, there is limited evidence of the effectiveness of the interventions and little focus on weight loss maintenance. Knowledge about end user values and needs is essential to create meaningful and effective eHealth interventions, and to identify persuasive system design (PSD) principles and behavior change techniques (BCTs) that may contribute to the behavior change required for successful long-term weight loss maintenance. OBJECTIVE This study aimed to provide insight into the design of eHealth interventions supporting behavior change for long-term weight maintenance. The study sought to identify the values and needs of people with obesity aiming to maintain weight after weight loss, and to identify PSD principles, BCTs, and design requirements that potentially enable an eHealth intervention to meet end user values and needs. METHODS This study presents the concept of integrating PSD principles and BCTs into the design process of eHealth interventions to meet user values and needs. In this study, individual interviews and focus groups were conducted with people with obesity (n=23) and other key stakeholders (n=27) to explore end user values and needs related to weight loss maintenance. Design thinking methods were applied during the focus group sessions to identify design elements and to explore how eHealth solutions can support the needs to achieve sustainable weight loss maintenance. The PSD model and behavior change taxonomy by Michie were used to identify PSD principles and BCT clusters to meet end user values and needs. RESULTS A total of 8 key end user values were identified, reflecting user needs for weight loss maintenance support: self-management, personalized care, autonomy, feel supported, positive self-image, motivation, happiness, and health. Goals and planning, feedback and monitoring, repetition and substitution, shaping knowledge, social support, identity, and self-belief were some of the BCT clusters identified to address these concepts, together with PSD principles such as personalization, tailoring, self-monitoring, praise, and suggestions. CONCLUSIONS The process of translating end user values and needs into design elements or features of eHealth technologies is an important part of the design process. To our knowledge, this is the first study to explore how PSD principles and BCTs can be integrated when designing eHealth self-management interventions for long-term weight loss maintenance. End users and other key stakeholders highlighted important factors to be considered in the design of eHealth interventions supporting sustained behavior change. The PSD principles and BCTs identified provide insights and suggestions about design elements and features to include for supporting weight loss maintenance. The findings indicate that a combination of BCTs and PSD principles may be needed in evidence-based eHealth interventions to stimulate motivation and adherence to support healthy behaviors and sustained weight loss maintenance. TRIAL REGISTRATION ClinicalTrials.gov NCT04537988; https://clinicaltrials.gov/ct2/show/NCT04537988.
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Affiliation(s)
- Rikke Aune Asbjørnsen
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands.,Research and Innovation Department, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Jobke Wentzel
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands.,Research Group IT Innovations in Health Care, Windesheim University of Applied Sciences, Zwolle, Netherlands
| | | | - Jøran Hjelmesæth
- Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Matthew M Clark
- Department of Psychiatry & Psychology, Mayo Clinic, College of Medicine & Science, Rochester, MN, United States
| | - Lise Solberg Nes
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Department of Psychiatry & Psychology, Mayo Clinic, College of Medicine & Science, Rochester, MN, United States.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Julia E W C Van Gemert-Pijnen
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands.,University Medical Center Groningen, Groningen, Netherlands.,University of Waterloo, Waterloo, ON, Canada
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Kushner RF. What COVID-19 is Teaching Us About Counseling for Weight Management. Obesity (Silver Spring) 2020; 28:2036-2037. [PMID: 32762123 PMCID: PMC7436471 DOI: 10.1002/oby.22988] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/16/2020] [Accepted: 07/26/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Robert F. Kushner
- Department of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
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The Health Benefits of Dietary Fibre. Nutrients 2020; 12:nu12103209. [PMID: 33096647 PMCID: PMC7589116 DOI: 10.3390/nu12103209] [Citation(s) in RCA: 223] [Impact Index Per Article: 55.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/11/2020] [Accepted: 10/14/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Dietary fibre consists of non-digestible forms of carbohydrate, usually as polysaccharides that originate from plant-based foods. Over recent decades, our diet within Westernised societies has changed radically from that of our hominid ancestors, with implications for our co-evolved gut microbiota. This includes increased ingestion of ultra-processed foods that are typically impoverished of dietary fibre, and associated reduction in the intake of fibre-replete plant-based foods. Over recent decades, there has been a transformation in our understanding of the health benefits of dietary fibre. Objective: To explore the current medical literature on the health benefits of dietary fibre, with a focus on overall metabolic health. Data Sources: We performed a narrative review, based on relevant articles written in English from a PubMed search, using the terms ‘dietary fibre and metabolic health’. Results: In the Western world, our diets are impoverished of fibre. Dietary fibre intake associates with overall metabolic health (through key pathways that include insulin sensitivity) and a variety of other pathologies that include cardiovascular disease, colonic health, gut motility and risk for colorectal carcinoma. Dietary fibre intake also correlates with mortality. The gut microflora functions as an important mediator of the beneficial effects of dietary fibre, including the regulation of appetite, metabolic processes and chronic inflammatory pathways. Conclusions: Multiple factors contribute to our fibre-impoverished modern diet. Given the plethora of scientific evidence that corroborate the multiple and varied health benefits of dietary fibre, and the risks associated with a diet that lacks fibre, the optimization of fibre within our diets represents an important public health strategy to improve both metabolic and overall health. If implemented successfully, this strategy would likely result in substantial future health benefits for the population.
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The effectiveness of nutrition education programmes on improving dietary intake in athletes: a systematic review. Br J Nutr 2020; 125:1359-1373. [DOI: 10.1017/s0007114520003694] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractNutrition education programmes for athletes aim to enhance nutrition knowledge and more importantly support positive dietary change to enhance performance, health and well-being. This systematic review assessed changes in the dietary intakes of athletes in response to nutrition education programmes. A search was conducted which included studies providing quantitative dietary intake assessment of athletes of any calibre aged between 12 and 65 years in response to a nutrition education programme. Standardised differences (effect sizes) were calculated (when possible) for each dietary parameter. The search yielded 6285 papers with twenty-two studies (974 participants (71·9 % female)) eligible for inclusion. Studies described athletes competing at high school (n 3) through to college level or higher (n 19). Study designs were either single arm with an intervention-only group (twelve studies; n 241) or double arm including an intervention and control group (ten studies; n 689). No control groups received an alternative or ‘sham’ intervention. Face-to-face lectures (9/22) and individual nutrition counselling (6/22) were the most common education interventions. Non-weighed, 3-d diet records (10/22) were the most frequently utilised dietary assessment method. Although 14/22 studies (n 5 single and n 9 double) reported significant change in at least one nutrition parameter, dietary changes were inconsistent. Poor study quality and heterogeneity of methods prohibit firm conclusions regarding overall intervention success or superior types of educational modalities. Of note, carbohydrate intakes ‘post-intervention’ when assessed often failed to meet recommended guidelines (12/17 studies). Given the substantial investment made in nutrition education interventions with athletes, there is a need for well-designed and rigorous research to inform future best practice.
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Importance of Self-Efficacy in Eating Behavior and Physical Activity Change of Overweight and Non-Overweight Adolescent Girls Participating in Healthy Me: A Lifestyle Intervention with Mobile Technology. Nutrients 2020; 12:nu12072128. [PMID: 32709005 PMCID: PMC7400873 DOI: 10.3390/nu12072128] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/11/2020] [Accepted: 07/15/2020] [Indexed: 02/08/2023] Open
Abstract
Very little is known about how multicomponent interventions directed to entire populations work in selected groups of adolescents. The aim was to evaluate the effectiveness of the Healthy Me one-year program on changes in healthy eating and physical activity among overweight and non-overweight female students. Randomization involved the allocation of full, partial or null intervention. The randomized field trial was implemented in 48 secondary schools (clusters) all over Poland among 1198 15-year-old girls. In this study, a sample of N = 1111 girls who participated in each evaluation study was analyzed. Using multimedia technologies, efforts were made to improve health behaviors and increase self-efficacy. The main outcome was a health behavior index (HBI), built on the basis of six nutritional indicators and one related to physical activity. HBI was analyzed before and immediately after intervention and at three months' follow-up, and the HBI change was modeled. Statistical analysis included nonparametric tests and generalized linear models with two-way interactions. Comparing the first and third surveys, in the overweight girls, the HBI index improved by 0.348 (SD = 3.17), while in the non-overweight girls it had worsened. After adjusting for other factors, a significant interaction between body weight status and level of self-efficacy as predictors of HBI changes was confirmed. The program turned out to be more beneficial for overweight girls.
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