1
|
Staiano AE, Button AM, Baker A, Beyl R, Conn AM, Lima A, Lindros J, Newton RL, Stein RI, Welch RR, Cook S, Wilfley DE. A pragmatic trial of a family-centered approach to childhood obesity treatment: Rationale and study design. Contemp Clin Trials 2024; 138:107459. [PMID: 38278478 PMCID: PMC10922779 DOI: 10.1016/j.cct.2024.107459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Family-based behavioral treatment (FBT) is an effective intensive health behavior and lifestyle treatment for obesity reduction in children and adolescents, but families have limited access. The purpose of this randomized, pragmatic, comparative effectiveness trial was to examine changes in child relative weight in a 12-month, enhanced standard of care (eSOC) intervention combined with FBT (eSOC+FBT) vs. eSOC alone. METHODS Children aged 6 to 15 years with obesity, and their primary caregiver, were recruited from primary care clinics. Families were randomized 1:1 to eSOC, a staged approach led by the primary care provider that gradually intensified dependent on a child's response to care and aligns with the American Medical Association guidelines, or the eSOC+FBT arm, which included regular meetings with a health coach for healthy eating, physical activity, positive parenting strategies, and managing social and environmental cues. Both treatments align with the 2023 American Academy of Pediatrics clinical practice guidelines. Assessments occurred at baseline, midpoint (month 6), end-of-intervention (month 12), and follow-up (month 18). Primary outcome was change from baseline to 12 months in child percent overweight (percentage above the median body mass index in the general US population normalized for age and sex). Secondary outcomes were parent weight, child psychosocial factors, heterogeneity of treatment effects, and cardiometabolic risk factors. Exploratory outcomes assessed reach, effectiveness, adoption, implementation, and maintenance. CONCLUSION This pragmatic trial will generate evidence for the comparative effectiveness of implementing two guidelines-based approaches in primary care for obesity reduction in children and adolescents. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03843424.
Collapse
Affiliation(s)
- Amanda E Staiano
- Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America.
| | - Alyssa M Button
- Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America
| | - Alison Baker
- American Academy of Pediatrics, 345 Park Blvd., Itasca, IL 60143, United States of America
| | - Robbie Beyl
- Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America
| | - Anne-Marie Conn
- University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY 14642, United States of America
| | - Angela Lima
- Washington University School of Medicine, 660 S. Euclid Ave., Mail Stop 8134-29-2100, St. Louis, MO 63110, United States of America
| | - Jeanne Lindros
- American Academy of Pediatrics, 345 Park Blvd., Itasca, IL 60143, United States of America
| | - Robert L Newton
- Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America
| | - Richard I Stein
- Washington University School of Medicine, 660 S. Euclid Ave., Mail Stop 8134-29-2100, St. Louis, MO 63110, United States of America
| | - R Robinson Welch
- Washington University School of Medicine, 660 S. Euclid Ave., Mail Stop 8134-29-2100, St. Louis, MO 63110, United States of America
| | - Stephen Cook
- University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY 14642, United States of America
| | - Denise E Wilfley
- Washington University School of Medicine, 660 S. Euclid Ave., Mail Stop 8134-29-2100, St. Louis, MO 63110, United States of America
| |
Collapse
|
2
|
Deshpande SN, Simkin DR. Complementary and Integrative Approaches to Sleep Disorders in Children. Child Adolesc Psychiatr Clin N Am 2023; 32:243-272. [PMID: 37147039 DOI: 10.1016/j.chc.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Sleep problems are very common in children and adolescents. Chronic insomnia is the leading cause of sleep disorders in children and adolescents. Adjunctive interventions that address low ferritin levels and vitamin D3 deficiency are helpful in children and adolescents. The addition of l-5-hydroxytryptophan, gabadone, l-theanine, Ashwagandha, omega 3 fatty acids, probiotics in bipolar disorder, and children with colic, meditation, and changing from a high-fat diet to a Mediterranean diet are also helpful adjunctive interventions. Actigraphy data should be collected in future sleep studies because subjective data may not indicate the true effect of the intervention.
Collapse
Affiliation(s)
- Swapna N Deshpande
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University, 5310 East 31st Street, Tulsa, OK 74135, USA.
| | - Deborah R Simkin
- Department of Psychiatry, Emory University School of Medicine, 8955 Highway 98 West, Suite 204, Miramar Beach, FL 32550, USA
| |
Collapse
|
3
|
Golovaty I, Ritchie ND, Tuomilehto J, Mohan V, Ali MK, Gregg EW, Bergman M, Moin T. Two decades of diabetes prevention efforts: A call to innovate and revitalize our approach to lifestyle change. Diabetes Res Clin Pract 2023; 198:110195. [PMID: 36470316 PMCID: PMC10079599 DOI: 10.1016/j.diabres.2022.110195] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/07/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
The impact of global diabetes prevention efforts has been modest despite the promise of landmark diabetes prevention trials nearly twenty years ago. While national and regional initiatives show potential, challenges remain to adapt large-scale strategies in the real-world that fits individuals and their communities. Additionally, the sedentary lifestyle changes during the COVID-19 pandemic and guidelines that now call for earlier screening (e.g., US Preventative Task Force) will increase the pool of eligible adults worldwide. Thus, a more adaptable, person-centered approach that expands the current toolkit is urgently needed to innovate and revitalize our approach to diabetes prevention. This review identifies key priorities to optimize the population-level delivery of diabetes prevention based on a consensus-based evaluation of the current evidence among experts in global translational programs; key priorities identified include (1) participant eligibility, (2) intervention intensity, (3) delivery components, (4) behavioral economics, (5) technology, and (6) the role of pharmacotherapy. We offer a conceptual framework for a broader, person-centered approach to better address an individual's risk, readiness, barriers, and digital competency.
Collapse
Affiliation(s)
- Ilya Golovaty
- Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA; General Medicine Service, VA Puget Sound Health Care System, Seattle, WA, USA.
| | - Natalie D Ritchie
- Office of Research, Denver Health and Hospital Authority, Denver, CO. Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. University of Colorado College of Nursing, Aurora, CO, USA
| | - Jaakko Tuomilehto
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland; Saudi Diabetes Research Group, King Abdulaziz University Jeddah, Saudi Arabia; Department of International Health, National School of Public Health, Instituto de Salud Carlos III. Madrid, Spain
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation & Chairman, Dr. Mohan's Diabetes Specialties Centre, Chennai, India
| | - Mohammed K Ali
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, USA; Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Edward W Gregg
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Michael Bergman
- Division of Endocrinology and Metabolism, Department of Medicine and of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Tannaz Moin
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA; VA Greater Los Angeles Health System and HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, Los Angeles, CA, USA
| |
Collapse
|
4
|
Deshpande SN, Simkin DR. Complementary and Integrative Approaches to Prevention and Treatment of Child and Adolescent Obesity. Child Adolesc Psychiatr Clin N Am 2023; 32:395-419. [PMID: 37147044 DOI: 10.1016/j.chc.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Childhood obesity is a significant global challenge with increasing prevalence. It is associated with long-term health risks. Interventions especially early on can be effective in the prevention and reducing the impact on health in children. In children, dysbiosis and inflammation are associated with obesity. Studies demonstrate that intensive lifestyle interventions in form of parent education, motivational interviewing to improve diet and exercise as well as mindfulness, and sleep improvement can help alleviate the risk. The article outlines the current research describing complementary and integrative approaches to the prevention and treatment of obesity in children.
Collapse
Affiliation(s)
- Swapna N Deshpande
- Department of Psychiatry, Oklahoma State University, 5310 E 31st St, Tulsa, OK 74135, USA.
| | - Deborah R Simkin
- Department of Psychiatry, Emory University School of Medicine, 4641 Gulfstarr Dr., Suite 106, Destin, FL 32541, USA
| |
Collapse
|
5
|
Zhong X, Xu X, Liu M, Wang P, He L, Christopher O, Zhang S, Lin Y, Huang Y, Xiong Z, Zhuang X, Liao X. Effect of intensive lifestyle intervention on the association between weight variability and major adverse cardiovascular events in overweight or obese adults with type 2 diabetes mellitus. J Diabetes Investig 2023; 14:441-451. [PMID: 36597380 PMCID: PMC9951560 DOI: 10.1111/jdi.13964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 11/10/2022] [Accepted: 12/05/2022] [Indexed: 01/05/2023] Open
Abstract
AIMS/INTRODUCTION Weight variability is associated with cardiovascular outcomes in diabetic patients. However, whether the guideline-recommended intensive lifestyle intervention (ILI) will affect this association in overweight or obese adults with diabetes is not well established. MATERIALS AND METHODS In 3,859 participants from the Action for Health in Diabetes (Look AHEAD) trial, the associations of 4 year weight variability measured by variability independent of the mean (VIM) with major adverse cardiovascular event (MACE) and secondary outcomes in ILI and diabetes support & education (DSE) arm were evaluated. RESULTS During a median follow-up of 9.6 years, 255 (12.9%) participants in the ILI arm and 247 (13.2%) participants in the DSE arm developed MACE. Participants with the highest quartile of weight variability (VIM Q4) experienced a 2.23-fold higher risk of MACE compared with the lowest quartile (VIM Q1) in the DSE arm (hazard ratio [HR] 2.23; 95% CI 1.51-3.30). Compared with the lowest weight variability (VIM Q1), participants with the highest weight variability (VIM Q4) were associated with higher risks of secondary cardiovascular composite outcome (HR 1.88; 95% CI 1.20-2.95), all-cause mortality (HR 3.19; 95% CI 1.75-5.82), and myocardial infarction (HR 1.95; 95% CI 1.12-3.37) in the DSE arm. CONCLUSIONS Among the overweight or obese individuals with type 2 diabetes mellitus, rising weight variability was independently associated with increased MACE risks in the DSE arm. Therefore, a guideline-recommended ILI strategy for weight loss should be adopted to improve cardiovascular outcomes without worrying about the effect of weight fluctuations.
Collapse
Affiliation(s)
- Xiangbin Zhong
- Department of CardiologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina,NHC Key Laboratory of Assisted CirculationSun Yat‐Sen UniversityGuangzhouChina
| | - Xingfeng Xu
- Department of CardiologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina,NHC Key Laboratory of Assisted CirculationSun Yat‐Sen UniversityGuangzhouChina
| | - Menghui Liu
- Department of CardiologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina,NHC Key Laboratory of Assisted CirculationSun Yat‐Sen UniversityGuangzhouChina
| | - Peng Wang
- Department of CardiologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina,NHC Key Laboratory of Assisted CirculationSun Yat‐Sen UniversityGuangzhouChina
| | - Lixiang He
- Department of CardiologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina,NHC Key Laboratory of Assisted CirculationSun Yat‐Sen UniversityGuangzhouChina
| | - Odong Christopher
- Department of CardiologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina,NHC Key Laboratory of Assisted CirculationSun Yat‐Sen UniversityGuangzhouChina
| | - Shaozhao Zhang
- Department of CardiologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina,NHC Key Laboratory of Assisted CirculationSun Yat‐Sen UniversityGuangzhouChina
| | - Yifen Lin
- Department of CardiologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina,NHC Key Laboratory of Assisted CirculationSun Yat‐Sen UniversityGuangzhouChina
| | - Yiquan Huang
- Department of CardiologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina,NHC Key Laboratory of Assisted CirculationSun Yat‐Sen UniversityGuangzhouChina
| | - Zhenyu Xiong
- Department of CardiologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina,NHC Key Laboratory of Assisted CirculationSun Yat‐Sen UniversityGuangzhouChina
| | - Xiaodong Zhuang
- Department of CardiologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina,NHC Key Laboratory of Assisted CirculationSun Yat‐Sen UniversityGuangzhouChina
| | - Xinxue Liao
- Department of CardiologyThe First Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina,NHC Key Laboratory of Assisted CirculationSun Yat‐Sen UniversityGuangzhouChina
| |
Collapse
|
6
|
Espeland MA, Justice JN, Bahnson J, Evans JK, Munshi M, Hayden KM, Simpson FR, Johnson KC, Johnston C, Kritchevsky SR. Eight-Year Changes in Multimorbidity and Frailty in Adults With Type 2 Diabetes Mellitus: Associations With Cognitive and Physical Function and Mortality. J Gerontol A Biol Sci Med Sci 2022; 77:1691-1698. [PMID: 34788804 PMCID: PMC9373968 DOI: 10.1093/gerona/glab342] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Indices of multimorbidity and deficit accumulation (ie, frailty indices) have been proposed as markers of biological aging. If true, changes in these indices over time should predict downstream changes in cognition and physical function, and mortality. METHODS We examined associations that 8-year changes in (i) a multimorbidity index comprised of 9 chronic diseases and (ii) a frailty index (FI) based on deficit accumulation in functional, behavioral, and clinical characteristics had with subsequent measures of cognitive and physical function over 10 years. We drew data from 3 842 participants in the Action for Health in Diabetes clinical trial. They were aged 45-76 years at baseline and at risk for accelerated biological aging due to overweight/obesity and type 2 diabetes mellitus. RESULTS A total of 1 501 (39%) of the cohort had 8-year increases of 1 among the 9 diseases tracked in the multimorbidity index and 868 (23%) had increases of ≥2. Those with greatest increases in multimorbidity tended to be older individuals, males, and non-Hispanic Whites. Greater FI increases tended to occur among individuals who were older, non-Hispanic White, heavier, and who had more baseline morbidities. Changes in multimorbidity and FI were moderately correlated (r = 0.26; p < .001). Increases in both multimorbidity and FI were associated with subsequently poorer composite cognitive function and 400-m walk speed and increased risk for death (all p < .001). CONCLUSIONS Accelerated biological aging, as captured by multimorbidity and frailty indices, predicts subsequent reduced function and mortality. Whether intensive lifestyle interventions generally targeting multimorbidity and FI reduce risks for downstream outcomes remains to be seen. Clinical Trials Registration Number: NCT00017953.
Collapse
Affiliation(s)
- Mark A Espeland
- Sticht Center for Healthy Aging and Alzheimer’s Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jamie Nicole Justice
- Sticht Center for Healthy Aging and Alzheimer’s Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Judy Bahnson
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Joni K Evans
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Medha Munshi
- Joslin Geriatric Diabetes Program, Joslin Diabetes Center, Boston, Massachusetts, USA
| | - Kathleen M Hayden
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Felicia R Simpson
- Department of Mathematics, Winston-Salem State University, Winston-Salem, North Carolina, USA
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Craig Johnston
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA
| | - Stephen R Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer’s Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| |
Collapse
|
7
|
Liu M, Huang R, Xu L, Zhang S, Zhong X, Chen X, Lin Y, Xiong Z, Wang L, Liao X, Zhuang X. Cardiovascular effects of intensive lifestyle intervention in adults with overweight/obesity and type 2 diabetes according to body weight time in range. EClinicalMedicine 2022; 49:101451. [PMID: 35747188 PMCID: PMC9156984 DOI: 10.1016/j.eclinm.2022.101451] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND We aimed to assess whether the cardiovascular effects of intensive lifestyle intervention (ILI) vary for those who can maintain the lower body weight after weight loss through ILI. METHODS In the secondary analysis of the Look AHEAD trial, we identified the status of weight loss for the participants in the ILI arm based on body weight time in range (TIR). These participants were allocated to three groups according to body weight TIR: 0% (n = 727), >0% to 50% (n = 656), and >50% to 100% (n = 811). For each group, cardiovascular outcomes were compared with matched participants receiving diabetes support & education (DSE) using 1:1 propensity score matching and Cox regression. FINDINGS During a median of 9·5 years of follow-up, participants with TIR of >50% to 100% can effectively maintain their body weight after weight loss through ILI; participants with TIR of 0% or >0% to 50% do not achieve or maintain weight loss. Compared with the corresponding matched participants in the DSE arm, participants with TIR of >50% to 100% in the ILI arm had a 45% lower risk of the primary outcome (HR 0·55, 95% CI 0·40-0·76), and no significant effects were found on the risk of the primary outcome in participants with TIR of 0% (HR 1·12, 95% CI 0·86-1·46) or >0% to 50% (HR 1·14, 95% CI 0·85-1·52). INTERPRETATION In adults with overweight/obesity and type 2 diabetes, ILI might help in lowering the risk of cardiovascular events when the lower body weight is maintained after weight loss. FUNDING None.
Collapse
Affiliation(s)
- Menghui Liu
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China
| | - Rihua Huang
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shaozhao Zhang
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China
| | - Xiangbin Zhong
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China
| | - Xiaohong Chen
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yifen Lin
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China
| | - Zhenyu Xiong
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China
| | - Lichun Wang
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China
| | - Xinxue Liao
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China
| | - Xiaodong Zhuang
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
8
|
Simpson FR, Carmichael O, Hayden KM, Hugenschmidt CE, McCaffery JM, Yasar S, Pajewski NM, Espeland MA. Does the impact of intensive lifestyle intervention on cognitive function vary depending baseline level of frailty? An ancillary study to the Action for Health in Diabetes (Look AHEAD) Trial. J Diabetes Complications 2021; 35:107909. [PMID: 33745805 PMCID: PMC8046723 DOI: 10.1016/j.jdiacomp.2021.107909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/28/2021] [Accepted: 03/08/2021] [Indexed: 11/27/2022]
Abstract
AIMS To assess whether there is an opportune window when intensive lifestyle intervention (ILI) benefits cognitive function. METHODS Standardized cognitive assessments were collected following ≥8 years of either ILI or a control condition of diabetes support and education (DSE) in 3708 individuals, ages 45-76 years at enrollment, with type 2 diabetes and overweight or obesity. Frailty index (FI) scores were used to group individuals at baseline into tertiles according to their age-related health status. Linear models were used to describe intervention adherence and cognitive function, with interaction terms to examine the consistency of relationships among tertiles. RESULTS Worse baseline FI scores were associated with poorer subsequent performance in tests of attention, processing speed, and executive function. No differences in any measure of cognitive function were observed between intervention groups within any FI tertile (all p > 0.10). Among individuals with worse baseline FI scores, weight gain was associated with poorer global cognitive function among participants assigned to DSE. There was no association between weight changes and cognitive function among participants assigned to ILI. CONCLUSIONS Among adults with type 2 diabetes and overweight/obesity, we found no evidence that there is a window of opportunity based on FI when ILI benefits cognitive function.
Collapse
Affiliation(s)
- Felicia R Simpson
- Department of Mathematics, Winston-Salem State University, 601 S. Martin Luther King Jr. Drive, Winston-Salem, NC 27110, United States of America
| | - Owen Carmichael
- Institute for Dementia Research and Prevention, Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States of America
| | - Kathleen M Hayden
- Department of Social Sciences and Health Policy, Wake Forest University, Winston-Salem, NC 27101, United States of America
| | - Christina E Hugenschmidt
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, One Medical Center Blvd, Winston-Salem, NC 27101, United States of America
| | - Jeanne M McCaffery
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, United States of America
| | - Sevil Yasar
- Departrment of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21224, United States of America
| | - Nicholas M Pajewski
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, One Medical Center Blvd, Winston-Salem, NC 27101, United States of America
| | - Mark A Espeland
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, One Medical Center Blvd, Winston-Salem, NC 27101, United States of America; Department of Biostatistics and Data Science, Wake Forest School of Medicine, One Medical Center Blvd, Winston-Salem, NC 27101, United States of America.
| |
Collapse
|
9
|
Nimitphong H, Sungkanuparph S, Areevut C, Saetung S, Jerawatana R, Hathaidechadusadee A, Somwang S, Tongchom W, Saibuathong N, Sakmanarit J, Pichitchaipitak O, Phuphuakrat A, Reutrakul S. Effects of an intensive lifestyle intervention and the role of sleep in people living with HIV and prediabetes: a pilot and feasibility study. BMC Res Notes 2021; 14:145. [PMID: 33865450 PMCID: PMC8052817 DOI: 10.1186/s13104-021-05558-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 04/08/2021] [Indexed: 01/21/2023] Open
Abstract
Objectives Prediabetes is prevalent in people living with HIV (PLWH). Insufficient and irregular sleep are linked to abnormal glucose metabolism. This study aimed to investigate the differences in sleep characteristics between PLWH with and without prediabetes, determine the acceptability/feasibility and effects of a pilot six-month intensive lifestyle intervention (ILI) program on glucose metabolism in those with prediabetes, and determine how sleep modulates these effects. Results Thirty-nine PLWH (20 normoglycemia and 19 prediabetes) participated. There were no differences in sleep characteristics between individuals with normoglycemia and prediabetes. Next, thirteen individuals with prediabetes completed a six-month ILI program. The ILI program resulted in significant body weight reduction at 6 months (63.5 ± 13.9 to 61.9 ± 14.0 kg, p = 0.012), which was maintained at 12 months (p < 0.001). Waist circumferences were significantly decreased at 12 months (85.4 ± 11.7 to 82.9 ± 12.7 cm, p = 0.014). An increase in sleep variability was significantly associated with an increase in 2-h plasma glucose, independent of changes in BMI (b = 0.603), and physical activity (b = 0.774). This pilot study suggested that ILI in PLWH with prediabetes is feasible and effective in improving metabolic control, with its effects possibly modulated by sleep variability. These findings should be confirmed in a larger study to reduce diabetes risk in this population. Trail registration: ClinicalTrial.gov, NCT03545217 (date of registration: May 22, 2018)
Collapse
Affiliation(s)
- Hataikarn Nimitphong
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. .,Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand.
| | - Somnuek Sungkanuparph
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Samut Prakan, Thailand
| | - Chatvara Areevut
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sunee Saetung
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ratanaporn Jerawatana
- Nursing Department, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Amornrat Hathaidechadusadee
- Division of Nutrition and Dietetics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Supaporn Somwang
- Division of Nutrition and Dietetics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wanabhorn Tongchom
- Nutrition Science Group, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nampeth Saibuathong
- Nursing Department, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jandanee Sakmanarit
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Orawan Pichitchaipitak
- Nursing Department, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Angsana Phuphuakrat
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sirimon Reutrakul
- Division of Endocrinology, Diabetes and Metabolism, University of Illinois At Chicago, Chicago, IL, USA
| |
Collapse
|
10
|
Li N, Liu J, Zhang C, Liu G, Leng J, Wang L, Li W, Yu Z, Hu G, Chan JCN, Yang X. Effects of lifestyle intervention during pregnancy on postpartum diabetes among Chinese women with gestational diabetes. Diabetologia 2021; 64:255-258. [PMID: 33064181 DOI: 10.1007/s00125-020-05308-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 09/16/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Ninghua Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jinnan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Cuiping Zhang
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - Gongshu Liu
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - Junhong Leng
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - Leishen Wang
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - Weiqin Li
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - Zhijie Yu
- Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
| | - Gang Hu
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Juliana C N Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xilin Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
- Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China.
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.
| |
Collapse
|
11
|
Langan A, Bader A, Goedkoop S, Cummings S, Tsikitas M, Nogueira I, Campoverde Reyes KJ, Stanford FC. A longitudinal study to investigate the effects of a 12-week comprehensive lifestyle weight management program on body weight and quality of life. Clin Nutr ESPEN 2020; 40:125-132. [PMID: 33183525 DOI: 10.1016/j.clnesp.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 09/18/2020] [Accepted: 10/05/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND & AIMS The majority of Americans now have overweight or obesity. With limited resources to treat all patients, group programs are emerging as an efficient method for dissemination of evidence-based lifestyle information. The objective of this study was to evaluate change in body weight, biochemical parameters, and quality of life among individuals after completion of a 12-week comprehensive group weight management program at an obesity medicine clinic. METHODS 204 patients were recruited for the study after enrolling in the Healthy Habits for Life program at the Massachusetts General Hospital Weight Center in Boston and Danvers, MA. Prior to the program, patients met individually with a dietitian and baseline data was collected. Primary outcome measures collected were weight and BMI change over the course of the program. Secondary measures collected included biochemical parameters and quality of life. Weekly group visits consisted of primary outcome collection and 1.5 h of instruction on various lifestyle- and nutrition-related topics. Secondary outcome measures were reassessed at an individual visit with the dietitian after the program concluded. RESULTS 142 participants were adherent to the protocol (attended 9 out of 12 classes). On average, patients lost 6.4 kg (14.1 lbs.), representing a percent total body weight loss of over 5%. Average BMI decrease was significant at 5.35 ± 4.61%. Improvements were seen in physical function, self-esteem, and sexual life; total QOL scores also improved by a significant 5.79% on average. There were also significant improvements in total cholesterol, triglycerides, and HbA1c. CONCLUSIONS The Healthy Habits for Life group program was an effective treatment for obesity and related health concerns, including overall quality of life. Group programs of this style may be a more efficient was to disseminate evidence-based lifestyle information and affect change for patients with overweight or obesity.
Collapse
Affiliation(s)
- Annette Langan
- MGH Weight Center, Massachusetts General Hospital, 50 Staniford St #430, Boston, MA, 02114, USA
| | - Abeer Bader
- MGH Weight Center, Massachusetts General Hospital, 50 Staniford St #430, Boston, MA, 02114, USA.
| | - Sonja Goedkoop
- MGH Weight Center, Massachusetts General Hospital, 50 Staniford St #430, Boston, MA, 02114, USA
| | - Susan Cummings
- MGH Weight Center, Massachusetts General Hospital, 50 Staniford St #430, Boston, MA, 02114, USA
| | - Marianne Tsikitas
- MGH Weight Center, Massachusetts General Hospital, 50 Staniford St #430, Boston, MA, 02114, USA
| | - Isadora Nogueira
- MGH Weight Center, Massachusetts General Hospital, 50 Staniford St #430, Boston, MA, 02114, USA
| | - Karen J Campoverde Reyes
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, 101 Merrimac Street, Suite 615, Boston, MA, 02114, USA; Liver Research Center, Beth Israel Deaconess Medical Center, 110 Francis Street, Suite 4A, Boston, MA, 02215, USA
| | - Fatima Cody Stanford
- MGH Weight Center, Massachusetts General Hospital, 50 Staniford St #430, Boston, MA, 02114, USA; Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, 101 Merrimac Street, Suite 615, Boston, MA, 02114, USA; Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street #6C, Boston, MA, 02114, USA
| |
Collapse
|
12
|
Melchart D, Wühr E, Wifling K, Bachmeier BE. The TALENT II study: a randomized controlled trial assessing the impact of an individual health management (IHM) on stress reduction. BMC Public Health 2018; 18:823. [PMID: 29973165 PMCID: PMC6030744 DOI: 10.1186/s12889-018-5756-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/26/2018] [Indexed: 11/10/2022] Open
Abstract
Background Unfavorable lifestyle factors influence the risk of stress disorders. For risk reduction, lifestyle modifications, such as regular physical activity, balanced nutrition and competence in stress management, are a means of choice. The clinical study examines the efficacy of an intensive lifestyle intervention, named Individual Health Management (IHM), − with regard to a reduction of perceived stress. The study is supported by the major regional health insurance, which conducts, in cooperation with the Traditional Chinese Medicine (TCM) hospital, Bad Kötzting, a local model project offering insurants the IHM program as prevention measure against stress and related aftermath. Methods The study is a controlled, randomized, monocentric trial with a 12-months intervention phase. Feasible persons are checked according to inclusion and exclusion criteria and assigned to the intervention or control group. Randomization ratio is 1:1. (A) Participants of the intervention group receive the lifestyle program IHM, have access to a web-based health portal (www.viterio.de), and join 3 full-day and 10 two-hour training sessions during the first 3 months. During the remaining 9 months, 4 training sessions and a weekly monitoring are performed with remote assistance. Besides measurement of perceived stress, examinations include burnout symptoms, heart rate variability, laboratory and physical findings. Further patient reported outcomes are documented (e.g. well-being, life satisfaction, severity of mood state, sense of coherence, psycho-vegetative test, cardio-metabolic risk factors, hypertension and diabetes risk. (B) Participants in the control group have access to the intensive lifestyle intervention IHM after a waiting period of at least 6 months. Examinations are conducted at baseline, after 3 and 6 months and in the intervention group additionally after 9 and 12 months. The confirmatory analysis examines the differences between the two groups with regard to changes in perceived stress after 6 months compared to the initial value. Discussion In order to enhance adherence, avoid attrition and to insure data quality, different measures will be implemented in the study. Based on a blended learning concept including a web-based e-health tool named VITERIO®, the program promises to achieve sustainable effects in perceived stress. Trial registration German Clinical Trial Register Freiburg (DRKS): DRKS00013040 (date registered 2017–10-1). Electronic supplementary material The online version of this article (10.1186/s12889-018-5756-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Dieter Melchart
- Director of the Competence Center for Complementary Medicine and Naturopathy (CoCoNat), Klinikum rechts der Isar, Technische Universität München, D-80801, Munich, Germany. .,Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, CH-8091, Zurich, Switzerland.
| | - Erich Wühr
- Member of the faculty for Applied Health Care Science, Deggendorf Institute of Technology DIT, D-94469, Deggendorf, Germany
| | - Kristina Wifling
- Competence Center for Complementary Medicine and Naturopathy (CoCoNat), Klinikum rechts der Isar, Technische Universität München, D-80801, Munich, Germany
| | - Beatrice E Bachmeier
- Competence Center for Complementary Medicine and Naturopathy (CoCoNat), Klinikum rechts der Isar, Technische Universität München, D-80801, Munich, Germany.,Institute of Laboratory Medicine, University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
13
|
Mikhail DS, Jensen TB, Wade TW, Myers JF, Frank JM, Wieland M, Hensrud D, McMahon MM, Collazo-Clavell ML, Abu-Lebdeh H, Kennel KA, Hurley DL, Grothe K, Jensen MD. Methodology of a multispecialty outpatient Obesity Treatment Research Program. Contemp Clin Trials Commun 2018; 10:36-41. [PMID: 29696156 PMCID: PMC5898534 DOI: 10.1016/j.conctc.2018.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 02/21/2018] [Accepted: 03/08/2018] [Indexed: 01/19/2023] Open
Abstract
Despite the large number of U.S. adults who overweight or obese, few providers have ready access to comprehensive lifestyle interventions, the cornerstone of medical obesity management. Our goal was to establish a research infrastructure embedded in a comprehensive lifestyle intervention treatment for obesity. The Obesity Treatment Research Program (OTRP) is a multi-specialty project at Mayo Clinic in Rochester, Minnesota designed to provide a high intensity, year-long, comprehensive lifestyle obesity treatment. The program includes a nutritional intervention designed to reduce energy intake, a physical activity program and a cognitive behavioral approach to increase the likelihood of long-term adherence. The behavioral intervention template incorporated the Diabetes Prevention Program and the Look AHEAD trial materials. The OTRP is consistent with national recommendations for the management of overweight and obesity in adults, but with embedded features designed to identify patient characteristics that might help predict outcomes, assure long-term follow up and support various research initiatives. Our goal was to develop approaches to understand whether there are patient characteristics that predict treatment outcomes.
Collapse
Affiliation(s)
- Dalia S Mikhail
- Division of Endocrinology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Teresa B Jensen
- Department of Family Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Todd W Wade
- Department of Family Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Jane F Myers
- Department of Family Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Jennifer M Frank
- Department of Family Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Mark Wieland
- Division of Community Internal Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Don Hensrud
- Division of Endocrinology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - M Molly McMahon
- Division of Endocrinology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | | | - Haitham Abu-Lebdeh
- Division of Endocrinology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Kurt A Kennel
- Division of Endocrinology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Daniel L Hurley
- Division of Endocrinology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Karen Grothe
- Department of Psychiatry and Psychology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Michael D Jensen
- Division of Endocrinology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| |
Collapse
|
14
|
Katzmarzyk PT, Martin CK, Newton RL, Apolzan JW, Arnold CL, Davis TC, Denstel KD, Mire EF, Thethi TK, Brantley PJ, Johnson WD, Fonseca V, Gugel J, Kennedy KB, Lavie CJ, Price-Haywood EG, Sarpong DF, Springgate B. Promoting Successful Weight Loss in Primary Care in Louisiana (PROPEL): Rationale, design and baseline characteristics. Contemp Clin Trials 2018; 67:1-10. [PMID: 29408562 PMCID: PMC5965693 DOI: 10.1016/j.cct.2018.02.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 01/22/2018] [Accepted: 02/01/2018] [Indexed: 11/18/2022]
Abstract
Underserved and minority populations suffer from a disproportionately high prevalence of obesity and related comorbidities. Effective obesity treatment programs delivered in primary care that produce significant weight loss are currently lacking. The purpose of this trial is to test the effectiveness of a pragmatic, high intensity lifestyle-based obesity treatment program delivered within primary care among an underserved population. We hypothesize that, relative to patients who receive usual care, patients who receive a high-intensity, health literacy- and culturally-appropriate lifestyle intervention will have greater percent reductions in body weight over 24 months. Eighteen clinics (N = 803 patients) serving low income populations with a high proportion of African Americans in Louisiana were randomized to the intervention or usual car. Patients in the intervention participate in a high-intensity lifestyle program delivered by health coaches employed by an academic health center and embedded in the primary care clinics. The program consists of weekly (16 in-person/6 telephone) sessions in the first six months, followed by sessions held at least monthly for the remaining 18 months. Primary care practitioners in usual care receive information on weight management and the current Centers for Medicare and Medicaid Services reimbursement for obesity treatment. The primary outcome is percent weight loss at 24 months. Secondary outcomes include absolute 24-month changes in body weight, waist circumference, blood pressure, fasting glucose and lipids, health-related quality of life, and weight-related quality of life. The results will provide evidence on the effectiveness of implementing high-intensity lifestyle and obesity counseling in primary care settings among underserved populations. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT02561221.
Collapse
Affiliation(s)
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Robert L Newton
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - John W Apolzan
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Connie L Arnold
- Department of Medicine, Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA, United States
| | - Terry C Davis
- Department of Medicine, Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA, United States
| | - Kara D Denstel
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Emily F Mire
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Tina K Thethi
- Department of Medicine, Division of Endocrinology and Metabolism, Tulane University Health Sciences Center, School of Medicine, New Orleans, LA, United States; Southeast Louisiana Veterans Health Care System, United States
| | | | - William D Johnson
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Vivian Fonseca
- Department of Medicine, Division of Endocrinology and Metabolism, Tulane University Health Sciences Center, School of Medicine, New Orleans, LA, United States; Southeast Louisiana Veterans Health Care System, United States
| | - Jonathan Gugel
- Department of Medicine, Section of General Internal Medicine & Geriatrics, Tulane University Health Sciences Center, School of Medicine, New Orleans, LA, United States
| | - Kathleen B Kennedy
- College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, United States
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, LA, United States
| | - Eboni G Price-Haywood
- Ochsner Clinic Foundation, Center for Applied Health Services Research, New Orleans, LA, United States; Ochsner Clinical School, University of Queensland, New Orleans, LA, United States
| | - Daniel F Sarpong
- College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, United States
| | - Benjamin Springgate
- Department of Internal Medicine, Louisiana State University School of Medicine, New Orleans, LA, United States; Program in Health Policy and Systems Management, Louisiana State University School of Public Health, New Orleans, LA, United States
| |
Collapse
|
15
|
Marquis-Gravel G, Hayami D, Juneau M, Nigam A, Guilbeault V, Latour É, Gayda M. Intensive lifestyle intervention including high-intensity interval training program improves insulin resistance and fasting plasma glucose in obese patients. Prev Med Rep 2015; 2:314-8. [PMID: 26844086 PMCID: PMC4721397 DOI: 10.1016/j.pmedr.2015.04.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Objectives To analyze the effects of a long-term intensive lifestyle intervention including high-intensity interval training (HIIT) and Mediterranean diet (MedD) counseling on glycemic control parameters, insulin resistance and β-cell function in obese subjects. Methods The glycemic control parameters (fasting plasma glucose, glycated hemoglobin), insulin resistance, and β-cell function of 72 obese subjects (54 women; mean age = 53 ± 9 years) were assessed at baseline and upon completion of a 9-month intensive lifestyle intervention program conducted at the cardiovascular prevention and rehabilitation center of the Montreal Heart Institute, from 2009 to 2012. The program included 2–3 weekly supervised exercise training sessions (HIIT and resistance exercise), combined to MedD counseling. Results Fasting plasma glucose (FPG) (mmol/L) (before: 5.5 ± 0.9; after: 5.2 ± 0.6; P < 0.0001), fasting insulin (pmol/L) (before: 98 ± 57; after: 82 ± 43; P = 0.003), and insulin resistance, as assessed by the HOMA-IR score (before: 3.6 ± 2.5; after: 2.8 ± 1.6; P = 0.0008) significantly improved, but not HbA1c (%) (before: 5.72 ± 0.55; after: 5.69 ± 0.39; P = 0.448), nor β-cell function (HOMA-β, %) (before: 149 ± 78; after: 144 ± 75; P = 0.58). Conclusion Following a 9-month intensive lifestyle intervention combining HIIT and MedD counseling, obese subjects experienced significant improvements of FPG and insulin resistance. This is the first study to expose the effects of a long-term program combining HIIT and MedD on glycemic control parameters among obese subjects. High-intensity interval training and Mediterranean diet improves glycemic parameters in obese subjects. Patients with insulin resistance benefit the most from this program. This is the first study to confirm these long-term benefits with such a program.
Collapse
Affiliation(s)
- Guillaume Marquis-Gravel
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Quebec, Canada; Department of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Douglas Hayami
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Quebec, Canada; Research Center, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada; Department of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Quebec, Canada; Research Center, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada; Department of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Quebec, Canada; Research Center, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada; Department of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Valérie Guilbeault
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Quebec, Canada
| | - Élise Latour
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Quebec, Canada
| | - Mathieu Gayda
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Quebec, Canada; Research Center, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada; Department of Medicine, University of Montreal, Montreal, Quebec, Canada
| |
Collapse
|