1
|
Fernández-Ruiz VE, Ramos-Morcillo AJ, Solé-Agustí M, Paniagua-Urbano JA, Armero-Barranco D. Effectiveness of an Interdisciplinary Program Performed on Obese People Regarding Nutritional Habits and Metabolic Comorbidity: A Randomized Controlled Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17010336. [PMID: 31947784 PMCID: PMC6981546 DOI: 10.3390/ijerph17010336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 12/23/2019] [Accepted: 01/01/2020] [Indexed: 12/25/2022]
Abstract
Obesity is an important public health problem. The combined use of different therapies performed by an interdisciplinary group can improve the management of this health issue. The main goal of this research is to determine the effectiveness of a multidisciplinary program based on healthy eating, exercise, cognitive-behavioral therapy, and health education in improving metabolic comorbidity, Body Mass Index (BMI), and nutritional habits among obese adults, at short (12 months) and long term (24 months). A randomized controlled clinical trial was conducted at a community care center between February 2014 and February 2016. A random sampling was done (299), total population (3262). A sample of 74 subjects diagnosed with obesity (experimental group, n = 37 and control group, n = 37) was conducted. Inclusion criteria: obese people (BMI: >30 kg/m2) with metabolic comorbidity and bad nutritional habits. Exclusion criteria: other comorbidities. A 12-month interdisciplinary program (with pre-test, 12 months and 24 months of follow-up) was applied. Intervention is based on healthy eating, exercise, and cognitive behavioral therapy. The intervention had a positive effect on nutritional habits (F2;144 = 115.305; p < 0.001). The experimental group increased fruit and vegetable intake (F2;144 = 39.604, p < 0.001), as well as fortified foods (F2;144 = 10,076, p < 0.001) and reduced fats, oils, and sweets F2;144 = 24,086, p < 0.001). In the experimental group, a BMI reduction of 2.6 to 24 months was observed. At follow-up, no participant had inadequate nutritional habits, compared to 35.1% of the control group (χ22 = 33,398; p < 0.001). There was also a positive response of metabolic comorbidities in the intervention group. The interdisciplinary program improved all participants’ metabolic parameters, BMI, and nutritional habits while maintaining the long-term effects (24 months).
Collapse
Affiliation(s)
| | | | | | | | - David Armero-Barranco
- Department of Nursing, Faculty of Nursing, University of Murcia, 30100 Espinardo, Spain;
| |
Collapse
|
2
|
Baillot A, Romain AJ, Boisvert-Vigneault K, Audet M, Baillargeon JP, Dionne IJ, Valiquette L, Chakra CNA, Avignon A, Langlois MF. Effects of lifestyle interventions that include a physical activity component in class II and III obese individuals: a systematic review and meta-analysis. PLoS One 2015; 10:e0119017. [PMID: 25830342 PMCID: PMC4382170 DOI: 10.1371/journal.pone.0119017] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 01/08/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND In class II and III obese individuals, lifestyle intervention is the first step to achieve weight loss and treat obesity-related comorbidities before considering bariatric surgery. A systematic review, meta-analysis, and meta-regression were performed to assess the impact of lifestyle interventions incorporating a physical activity (PA) component on health outcomes of class II and III obese individuals. METHODS An electronic search was conducted in 4 databases (Medline, Scopus, CINAHL and Sportdiscus). Two independent investigators selected original studies assessing the impact of lifestyle interventions with PA components on anthropometric parameters, cardiometabolic risk factors (fat mass, blood pressure, lipid and glucose metabolism), behaviour modification (PA and nutritional changes), and quality of life in adults with body mass index (BMI) ≥ 35 kg/m2. Estimates were pooled using a random-effect model (DerSimonian and Laird method). Heterogeneity between studies was assessed by the Cochran's chi-square test and quantified through an estimation of the I². RESULTS Of the 3,170 identified articles, 56 met our eligibility criteria, with a large majority of uncontrolled studies (80%). The meta-analysis based on uncontrolled studies showed significant heterogeneity among all included studies. The pooled mean difference in weight loss was 8.9 kg (95% CI, 10.2-7.7; p < 0.01) and 2.8 kg/m² in BMI loss (95% CI, 3.4-2.2; p < 0.01). Long-term interventions produced superior weight loss (11.3 kg) compared to short-term (7.2 kg) and intermediate-term (8.0 kg) interventions. A significant global effect of lifestyle intervention on fat mass, waist circumference, blood pressure, total cholesterol, LDL-C, triglycerides and fasting insulin was found (p<0.01), without significant effect on HDL-C and fasting blood glucose. CONCLUSIONS Lifestyle interventions incorporating a PA component can improve weight and various cardiometabolic risk factors in class II and III obese individuals. However, further high quality trials are needed to confirm this evidence, especially beyond weight loss.
Collapse
Affiliation(s)
- Aurélie Baillot
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Ahmed J. Romain
- Unit of Nutrition and Diabetes, Department of Endocrinology-Nutrition and Diabetes, University Hospital of Montpellier, Montpellier, France
| | - Katherine Boisvert-Vigneault
- Research Centre on Aging, Health and Social Services Centre, Institute of Geriatrics, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Faculty of Physical Education and Sports, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Mélisa Audet
- Research Centre on Aging, Health and Social Services Centre, Institute of Geriatrics, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Faculty of Physical Education and Sports, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jean Patrice Baillargeon
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Isabelle J. Dionne
- Research Centre on Aging, Health and Social Services Centre, Institute of Geriatrics, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Faculty of Physical Education and Sports, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Louis Valiquette
- Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Quebec, Canada
| | - Claire Nour Abou Chakra
- Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Quebec, Canada
| | - Antoine Avignon
- Unit of Nutrition and Diabetes, Department of Endocrinology-Nutrition and Diabetes, University Hospital of Montpellier, Montpellier, France
- INSERM U1046, Physiology and experimental medicine of heart and muscles, University of Montpellier, Montpellier, France
| | - Marie-France Langlois
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| |
Collapse
|
3
|
Clini EM, Lugli D, Prato F, Crisafulli E. Long-term Weight Loss and Maintenance in Morbidly Obese Individuals with Obstructive Sleep Apnea. Am J Respir Crit Care Med 2009; 180:190-1; author reply 191. [DOI: 10.1164/ajrccm.180.2.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Enrico M. Clini
- University of Modena-Reggio Emilia and Villa Pineta Rehabilitation Hospital
Pavullo, n/f (modern), Italy
| | - Daniela Lugli
- University of Modena-Reggio Emilia and Villa Pineta Rehabilitation Hospital
Pavullo, n/f (modern), Italy
| | - Francesco Prato
- University of Modena-Reggio Emilia and Villa Pineta Rehabilitation Hospital
Pavullo, n/f (modern), Italy
| | - Ernesto Crisafulli
- University of Modena-Reggio Emilia and Villa Pineta Rehabilitation Hospital
Pavullo, n/f (modern), Italy
| |
Collapse
|