Pub Date : 2024-06-10eCollection Date: 2024-06-01DOI: 10.1002/osp4.763
Meifang Chen, Jiaqi Liu
Increasing evidence has reported the anti-obesity effects of traditional Chinese medicines (TCMs) and their potential advantages in weight loss, such as fewer side effects and lower costs compared to the current recommended treatments like Western medicines. Previous review studies have examined the effects of a few commonly used TCM therapies such as acupuncture and herbal medicines on weight loss. This network meta-analysis (NMA) study aims to review and rank the effects of currently available TCMs on weight loss and to compare the effects of TCMs with different intervention durations. Eligible Randomized controlled trials (RCTs) conducted among Chinese adults with overweight or obesity were searched on electronic databases (PubMed, Embase, CNKI, WanFang, VIP, and SinoMed) up to 1 March 2023. Pairwise meta-analysis was performed to examine the pooled effects of TCMs on weight loss, and NMA was conducted to rank different types of TCMs. Subgroup analysis stratified by intervention duration was performed. Forty-six RCTs were eligible for inclusion in the review. The results showed that TCMs, especially when the treatment duration was ≤6 months, were more effective in both body weight and Body Mass Index (BMI) reduction than non-pharmacological interventions and placebo/no treatment. Acupotomy was ranked as the most effective TCM treatment in reducing both body weight and BMI. Traditional Chinese medicines have promising potential for weight loss and could be included in future clinical guidance as a standalone or supplementary treatment for obesity. Future studies need to further investigate under-researched TCMs, examine the long-term effects and safety of TCMs in obesity treatment, and validate the findings from this study among other ethnic populations.
{"title":"Effects of traditional Chinese medicines on weight management among adults with overweight or obesity: A systematic review and network meta-analysis.","authors":"Meifang Chen, Jiaqi Liu","doi":"10.1002/osp4.763","DOIUrl":"10.1002/osp4.763","url":null,"abstract":"<p><p>Increasing evidence has reported the anti-obesity effects of traditional Chinese medicines (TCMs) and their potential advantages in weight loss, such as fewer side effects and lower costs compared to the current recommended treatments like Western medicines. Previous review studies have examined the effects of a few commonly used TCM therapies such as acupuncture and herbal medicines on weight loss. This network meta-analysis (NMA) study aims to review and rank the effects of currently available TCMs on weight loss and to compare the effects of TCMs with different intervention durations. Eligible Randomized controlled trials (RCTs) conducted among Chinese adults with overweight or obesity were searched on electronic databases (PubMed, Embase, CNKI, WanFang, VIP, and SinoMed) up to 1 March 2023. Pairwise meta-analysis was performed to examine the pooled effects of TCMs on weight loss, and NMA was conducted to rank different types of TCMs. Subgroup analysis stratified by intervention duration was performed. Forty-six RCTs were eligible for inclusion in the review. The results showed that TCMs, especially when the treatment duration was ≤6 months, were more effective in both body weight and Body Mass Index (BMI) reduction than non-pharmacological interventions and placebo/no treatment. Acupotomy was ranked as the most effective TCM treatment in reducing both body weight and BMI. Traditional Chinese medicines have promising potential for weight loss and could be included in future clinical guidance as a standalone or supplementary treatment for obesity. Future studies need to further investigate under-researched TCMs, examine the long-term effects and safety of TCMs in obesity treatment, and validate the findings from this study among other ethnic populations.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and objective: The relationship between sleep duration and obesity has been the focus of numerous investigations. This systematic review and meta-analysis of prospective cohort studies aimed to assess the relationship between sleep duration, abdominal obesity, and body composition.
Methods: PubMed, Scopus, and Web of Science were searched until February 2024. Cohort studies that assessed the relationship between sleep duration at night and central obesity measures or body composition indices in adults were included. The quality of studies was assessed using the Newcastle-Ottawa scale. Random-effects meta-analysis was conducted on studies that reported risk ratio (RR) and 95% confidence intervals (CIs).
Results: Eighteen studies were eligible to be included. Eleven out of the 18 studies were not included in the analysis as 10 studies did not report RR, and in one study, the definition of short and normal sleep duration was different from others. The results of the meta-analysis indicated that short sleep duration was significantly associated with abdominal obesity (RR = 1.08; 95% CI: 1.04-1.12; I2 = 49.1%, n = 7), but long sleep duration was not (RR = 1.02; 95% CI: 0.83-1.24; I2 = 98.2%, n = 6).
Conclusions: Short sleep duration was associated with a slightly higher risk of central obesity, while long sleep duration was not.
{"title":"Short sleep duration is associated with higher risk of central obesity in adults: A systematic review and meta-analysis of prospective cohort studies.","authors":"Ali Kohanmoo, Masoumeh Akhlaghi, Najmeh Sasani, Fatemeh Nouripour, Caterina Lombardo, Asma Kazemi","doi":"10.1002/osp4.772","DOIUrl":"10.1002/osp4.772","url":null,"abstract":"<p><strong>Background and objective: </strong>The relationship between sleep duration and obesity has been the focus of numerous investigations. This systematic review and meta-analysis of prospective cohort studies aimed to assess the relationship between sleep duration, abdominal obesity, and body composition.</p><p><strong>Methods: </strong>PubMed, Scopus, and Web of Science were searched until February 2024. Cohort studies that assessed the relationship between sleep duration at night and central obesity measures or body composition indices in adults were included. The quality of studies was assessed using the Newcastle-Ottawa scale. Random-effects meta-analysis was conducted on studies that reported risk ratio (RR) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Eighteen studies were eligible to be included. Eleven out of the 18 studies were not included in the analysis as 10 studies did not report RR, and in one study, the definition of short and normal sleep duration was different from others. The results of the meta-analysis indicated that short sleep duration was significantly associated with abdominal obesity (RR = 1.08; 95% CI: 1.04-1.12; <i>I</i> <sup>2</sup> = 49.1%, n = 7), but long sleep duration was not (RR = 1.02; 95% CI: 0.83-1.24; <i>I</i> <sup>2</sup> = 98.2%, n = 6).</p><p><strong>Conclusions: </strong>Short sleep duration was associated with a slightly higher risk of central obesity, while long sleep duration was not.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kimberly A. Gudzune, G. Jerome, Stacy Goldsholl, A. Dalcin, Joseph Gennusa, Tyler Fink, Christina T. Yuan, Kristal L. Brown, Eva Minahan, Nae-Yuh Wang, Gail L. Daumit
Abstract Background Obesity is a leading cause of preventable death among individuals with serious mental illness (SMI). A prior randomized controlled trial demonstrated the efficacy of a lifestyle style intervention tailored to this population; however, such interventions need to be adapted and tested for real‐world settings. Aims This study evaluated implementation interventions to support community mental health program staff to deliver an evidence‐based lifestyle intervention to clients with obesity and SMI. Materials & Methods In this cluster‐randomized pilot trial, the standard arm combined multimodal training with organizational strategy meetings and the enhanced arm included all standard strategies plus performance coaching. Staff‐coaches delivered a 6‐month group‐based lifestyle intervention to clients with SMI. Primary outcomes were changes in staff knowledge, self‐efficacy, and fidelity scores for lifestyle intervention delivery. Linear mixed‐effects modeling was used to analyze outcomes, addressing within‐site clustering and within‐participant longitudinal correlation of outcomes. Results Three sites were in the standard arm (7 staff‐coaches); 5 sites in the enhanced arm (11 staff‐coaches). All sites delivered all 26 modules of the lifestyle intervention. Staff‐coaches highly rated the training strategy's acceptability, feasibility and appropriateness. Overall, mean knowledge score significantly increased pre‐post by 5.5 (95% CI: 3.9, 7.1) and self‐efficacy was unchanged; neither significantly differed between arms. Fidelity ratings remained stable over time and did not differ between arms. Clients with SMI achieved a mean 6‐month weight loss of 3.8 kg (95% CI: 1.6, 6.1). Conclusions Mental health staff delivering a lifestyle intervention was feasible using multicomponent implementation interventions, and preliminary results show weight reduction among clients with SMI. The addition of performance coaching did not significantly change outcomes. Future studies are needed to definitively determine the effect on client health outcomes.
{"title":"Implementing an evidence‐based behavioral weight‐loss program in community mental health centers: A randomized pilot study","authors":"Kimberly A. Gudzune, G. Jerome, Stacy Goldsholl, A. Dalcin, Joseph Gennusa, Tyler Fink, Christina T. Yuan, Kristal L. Brown, Eva Minahan, Nae-Yuh Wang, Gail L. Daumit","doi":"10.1002/osp4.760","DOIUrl":"https://doi.org/10.1002/osp4.760","url":null,"abstract":"Abstract Background Obesity is a leading cause of preventable death among individuals with serious mental illness (SMI). A prior randomized controlled trial demonstrated the efficacy of a lifestyle style intervention tailored to this population; however, such interventions need to be adapted and tested for real‐world settings. Aims This study evaluated implementation interventions to support community mental health program staff to deliver an evidence‐based lifestyle intervention to clients with obesity and SMI. Materials & Methods In this cluster‐randomized pilot trial, the standard arm combined multimodal training with organizational strategy meetings and the enhanced arm included all standard strategies plus performance coaching. Staff‐coaches delivered a 6‐month group‐based lifestyle intervention to clients with SMI. Primary outcomes were changes in staff knowledge, self‐efficacy, and fidelity scores for lifestyle intervention delivery. Linear mixed‐effects modeling was used to analyze outcomes, addressing within‐site clustering and within‐participant longitudinal correlation of outcomes. Results Three sites were in the standard arm (7 staff‐coaches); 5 sites in the enhanced arm (11 staff‐coaches). All sites delivered all 26 modules of the lifestyle intervention. Staff‐coaches highly rated the training strategy's acceptability, feasibility and appropriateness. Overall, mean knowledge score significantly increased pre‐post by 5.5 (95% CI: 3.9, 7.1) and self‐efficacy was unchanged; neither significantly differed between arms. Fidelity ratings remained stable over time and did not differ between arms. Clients with SMI achieved a mean 6‐month weight loss of 3.8 kg (95% CI: 1.6, 6.1). Conclusions Mental health staff delivering a lifestyle intervention was feasible using multicomponent implementation interventions, and preliminary results show weight reduction among clients with SMI. The addition of performance coaching did not significantly change outcomes. Future studies are needed to definitively determine the effect on client health outcomes.","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140971392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Hasan Maleki, Sara Abdizadeh Javazm, S. Dastghaib, Anahita Panji, Mohammad Hojjati Far, Hajar Mahmoodi, M. Siri, S. M. Shafiee
Abstract Background Lipotoxicity, caused by adipocyte triglyceride over‐accumulation, contributes to obesity‐related comorbidities such as hypertension, type 2 diabetes, coronary heart disease, respiratory dysfunction, and osteoarthritis. This study focuses on determining how sirtuin‐1 (SIRT‐1) mediates quercetin's (QCT) effect on 3T3‐L1 adipocytes. Key aspects of this study include preventing adipogenesis, inducing lipolysis, and stimulating adipocyte apoptosis. Methods 3T3‐L1 adipocytes underwent treatment with varying QCT doses, lipopolysaccharide (LPS), and the SIRT‐1 inhibitor EX‐527, followed by 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyl‐2H‐tetrazolium bromide [MTT] assay for cell viability assessment. Furthermore, quantitative real‐time polymerase chain reaction measured mRNA expression levels of adipogenesis markers (fatty acid synthase [FASN] and peroxisome proliferator‐activated receptor gamma [PPARγ]), lipolysis markers (adipose triglyceride lipase [ATGL] and hormone‐sensitive lipase [HSL]), and apoptosis markers (B‐cell lymphoma2 [Bcl‐2], Bcl‐2 Associated ‐X‐protein [BAX] and Caspase‐3). Results The data showed that LPS + QCT significantly reduced cell viability in a dose‐ and time‐dependent manner, unaffected by LPS + QCT + EX‐527. Treatment with LPS + QCT did not affect FASN and PPARγ expression but significantly increased ATGL and HSL mRNA expression compared with LPS alone. Interestingly, EX‐527 reversed the effects of LPS + QCT on lipogenesis and lipolysis markers completely. QCT enhanced apoptosis in a SIRT‐1 independent pattern. Conclusion The data suggest that QCT suppresses adipogenesis while increasing lipolysis via SIRT‐1. However, QCT's effects on apoptosis appear to be independent of SIRT‐1. These findings provide further evidence for QCT's effects on adipocytes, particularly its interaction with SIRT‐1.
{"title":"The effect of quercetin on adipogenesis, lipolysis, and apoptosis in 3T3‐L1 adipocytes: The role of SIRT1 pathways","authors":"Mohammad Hasan Maleki, Sara Abdizadeh Javazm, S. Dastghaib, Anahita Panji, Mohammad Hojjati Far, Hajar Mahmoodi, M. Siri, S. M. Shafiee","doi":"10.1002/osp4.752","DOIUrl":"https://doi.org/10.1002/osp4.752","url":null,"abstract":"Abstract Background Lipotoxicity, caused by adipocyte triglyceride over‐accumulation, contributes to obesity‐related comorbidities such as hypertension, type 2 diabetes, coronary heart disease, respiratory dysfunction, and osteoarthritis. This study focuses on determining how sirtuin‐1 (SIRT‐1) mediates quercetin's (QCT) effect on 3T3‐L1 adipocytes. Key aspects of this study include preventing adipogenesis, inducing lipolysis, and stimulating adipocyte apoptosis. Methods 3T3‐L1 adipocytes underwent treatment with varying QCT doses, lipopolysaccharide (LPS), and the SIRT‐1 inhibitor EX‐527, followed by 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyl‐2H‐tetrazolium bromide [MTT] assay for cell viability assessment. Furthermore, quantitative real‐time polymerase chain reaction measured mRNA expression levels of adipogenesis markers (fatty acid synthase [FASN] and peroxisome proliferator‐activated receptor gamma [PPARγ]), lipolysis markers (adipose triglyceride lipase [ATGL] and hormone‐sensitive lipase [HSL]), and apoptosis markers (B‐cell lymphoma2 [Bcl‐2], Bcl‐2 Associated ‐X‐protein [BAX] and Caspase‐3). Results The data showed that LPS + QCT significantly reduced cell viability in a dose‐ and time‐dependent manner, unaffected by LPS + QCT + EX‐527. Treatment with LPS + QCT did not affect FASN and PPARγ expression but significantly increased ATGL and HSL mRNA expression compared with LPS alone. Interestingly, EX‐527 reversed the effects of LPS + QCT on lipogenesis and lipolysis markers completely. QCT enhanced apoptosis in a SIRT‐1 independent pattern. Conclusion The data suggest that QCT suppresses adipogenesis while increasing lipolysis via SIRT‐1. However, QCT's effects on apoptosis appear to be independent of SIRT‐1. These findings provide further evidence for QCT's effects on adipocytes, particularly its interaction with SIRT‐1.","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140756406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Warhurst, E. Georgousopoulou, Farah Sethna, Hsin‐Chia Huang
Abstract Objective Obstructive sleep apnea (OSA) affects maternal and neonatal health during pregnancy. This study aimed to identify characteristics and comorbidities associated with sleep clinic referral in high‐risk pregnancies with Body Mass Index (BMI) ≥35 kg/m2. Method Retrospective cohort study for individuals in a high‐risk pregnancy clinic at a tertiary Australian hospital from 1 January to 31 December 2020 with BMI≥35 kg/m2. The primary outcome measure was sleep clinic referral. Exposure data included multiple comorbidities and formal tools (Epworth Sleepiness Scale and STOP‐BANG). Multivariable analysis was used to identify factors associated with referral. Descriptive data on barriers to diagnosis and treatment were collected. Results Of 161 pregnant individuals, 38.5% were screened using formal tools and 13.7% were referred to sleep clinic. Having STOP‐BANG performed was associated with sleep clinic referral (Odds Ratio: 18.04, 95% Confidence Interval:4.5–71.7, p < 0.001). No clinical characteristics were associated with the likelihood of performing STOP‐BANG. The COVID‐19 pandemic was a treatment barrier for three individuals. Conclusions Current screening practices identify pregnant individuals with the highest pre‐test probability of having OSA. Future research should evaluate real‐world strategies to improve identification and management in this high‐risk population.
{"title":"Referral practices and treatment of obstructive sleep apnea in pregnancies with obesity","authors":"S. Warhurst, E. Georgousopoulou, Farah Sethna, Hsin‐Chia Huang","doi":"10.1002/osp4.754","DOIUrl":"https://doi.org/10.1002/osp4.754","url":null,"abstract":"Abstract Objective Obstructive sleep apnea (OSA) affects maternal and neonatal health during pregnancy. This study aimed to identify characteristics and comorbidities associated with sleep clinic referral in high‐risk pregnancies with Body Mass Index (BMI) ≥35 kg/m2. Method Retrospective cohort study for individuals in a high‐risk pregnancy clinic at a tertiary Australian hospital from 1 January to 31 December 2020 with BMI≥35 kg/m2. The primary outcome measure was sleep clinic referral. Exposure data included multiple comorbidities and formal tools (Epworth Sleepiness Scale and STOP‐BANG). Multivariable analysis was used to identify factors associated with referral. Descriptive data on barriers to diagnosis and treatment were collected. Results Of 161 pregnant individuals, 38.5% were screened using formal tools and 13.7% were referred to sleep clinic. Having STOP‐BANG performed was associated with sleep clinic referral (Odds Ratio: 18.04, 95% Confidence Interval:4.5–71.7, p < 0.001). No clinical characteristics were associated with the likelihood of performing STOP‐BANG. The COVID‐19 pandemic was a treatment barrier for three individuals. Conclusions Current screening practices identify pregnant individuals with the highest pre‐test probability of having OSA. Future research should evaluate real‐world strategies to improve identification and management in this high‐risk population.","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140787936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Gorczyca, R. Washburn, L. Ptomey, M. Mayo, R. Krebill, Debra K Sullivan, Cheryl A Gibson, Sarah Stolte, Joseph E. Donnelly
Abstract Introduction Rural living adults have higher rates of obesity compared with their urban counterparts and less access to weight management programs. Previous research studies have demonstrated clinically relevant weight loss in rural living adults who complete weight management programs delivered by university affiliated interventionists. However, this approach limits the potential reach, adoption, implementation, and maintenance of weight management programs for rural residents. Weight management delivered through rural health clinics by non‐physician clinic associated staff, for example, nurses, registered dieticians, allied health professionals, etc. has the potential to improve access to weight management for rural living adults. This trial compared the effectiveness of a 6‐month multicomponent weight management intervention for rural living adults delivered using group phone calls (GP), individual phone calls (IP) or an enhanced usual care control (EUC) by rural clinic associated staff trained by our research team. Methods Rural living adults with overweight/obesity (n = 187, age ∼ 50 years 82% female, body mass index ∼35 kg/m2) were randomized (2:2:1) to 1 of 3 intervention arms: GP, which included weekly ∼ 45 min sessions with 7–14 participants (n = 71), IP, which included weekly ∼ 15 min individual sessions (n = 80), or EUC, which included one‐45 min in‐person session at baseline. Results Weight loss at 6 months was clinically relevant, that is, ≥5% in the GP (−11.4 kg, 11.7%) and the IP arms (−9.1 kg, 9.2%) but not in the EUC arm (−2.6%, −2.5% kg). Specifically, 6 month weight loss was significantly greater in the IP versus EUC arms (−6.5 kg. p ≤ 0.025) but did not differ between the GP and IP arms (−2.4 kg, p > 0.025). The per participant cost per kg. weight loss for implementing the intervention was $93 and $60 for the IP and GP arms, respectively. Conclusions Weight management delivered by interventionists associated with rural health clinics using both group and IP calls results in clinically relevant 6 months weight loss in rural dwelling adults with overweight/obesity with the group format offering the most cost‐effective strategy. Clinical trial registration: ClinicalTrials.gov (NCT02932748).
{"title":"Weight management in rural health clinics: Results from the randomized midwest diet and exercise trial","authors":"A. Gorczyca, R. Washburn, L. Ptomey, M. Mayo, R. Krebill, Debra K Sullivan, Cheryl A Gibson, Sarah Stolte, Joseph E. Donnelly","doi":"10.1002/osp4.753","DOIUrl":"https://doi.org/10.1002/osp4.753","url":null,"abstract":"Abstract Introduction Rural living adults have higher rates of obesity compared with their urban counterparts and less access to weight management programs. Previous research studies have demonstrated clinically relevant weight loss in rural living adults who complete weight management programs delivered by university affiliated interventionists. However, this approach limits the potential reach, adoption, implementation, and maintenance of weight management programs for rural residents. Weight management delivered through rural health clinics by non‐physician clinic associated staff, for example, nurses, registered dieticians, allied health professionals, etc. has the potential to improve access to weight management for rural living adults. This trial compared the effectiveness of a 6‐month multicomponent weight management intervention for rural living adults delivered using group phone calls (GP), individual phone calls (IP) or an enhanced usual care control (EUC) by rural clinic associated staff trained by our research team. Methods Rural living adults with overweight/obesity (n = 187, age ∼ 50 years 82% female, body mass index ∼35 kg/m2) were randomized (2:2:1) to 1 of 3 intervention arms: GP, which included weekly ∼ 45 min sessions with 7–14 participants (n = 71), IP, which included weekly ∼ 15 min individual sessions (n = 80), or EUC, which included one‐45 min in‐person session at baseline. Results Weight loss at 6 months was clinically relevant, that is, ≥5% in the GP (−11.4 kg, 11.7%) and the IP arms (−9.1 kg, 9.2%) but not in the EUC arm (−2.6%, −2.5% kg). Specifically, 6 month weight loss was significantly greater in the IP versus EUC arms (−6.5 kg. p ≤ 0.025) but did not differ between the GP and IP arms (−2.4 kg, p > 0.025). The per participant cost per kg. weight loss for implementing the intervention was $93 and $60 for the IP and GP arms, respectively. Conclusions Weight management delivered by interventionists associated with rural health clinics using both group and IP calls results in clinically relevant 6 months weight loss in rural dwelling adults with overweight/obesity with the group format offering the most cost‐effective strategy. Clinical trial registration: ClinicalTrials.gov (NCT02932748).","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140793512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kacey Chae, Jashalynn German, Karla Kendrick, Sean Tackett, Paul O'Rourke, Kimberly A Gudzune, Marci Laudenslager
Objective: Despite the rising prevalence of people living with obesity, physicians are providing suboptimal care to these individuals, which may be a consequence of inadequate education in weight management and negative attitudes toward people living with obesity. Internal Medicine (IM) residency is an ideal setting to address physicians' attitudes toward people living with obesity. However, there is a paucity of recent literature on this topic. This study sought to assess the current attitudes of IM residents toward obesity as a disease, people living with obesity, and obesity treatment.
Methods: A cross-sectional survey was conducted in 2020 across two IM programs assessing residents' attitudes toward obesity as a disease, people living with obesity, and obesity treatment.
Results: Among 42 residents who participated in the survey, 64% were women; 31 percent were Post Graduate Year 1, 31% PGY-2, and 38% PGY-3. Mean attitude scores were high on statements regarding obesity as a chronic disease [4.7 (SD 0.4)] and its association with serious medical conditions [4.9 (SD 0.3)]. Residents had overall positive attitudes toward people living with obesity. In contrast, residents felt negatively regarding their level of success in helping patients lose weight [2.0 (SD 0.7)].
Conclusions: While residents recognized obesity as a chronic disease and had positive attitudes toward people living with obesity, their low ratings regarding weight management success suggest that targeted educational efforts are needed to increase obesity treatment self-efficacy.
{"title":"What are Internal medicine residents' attitudes toward obesity as a disease, people living with obesity, and obesity treatment?","authors":"Kacey Chae, Jashalynn German, Karla Kendrick, Sean Tackett, Paul O'Rourke, Kimberly A Gudzune, Marci Laudenslager","doi":"10.1002/osp4.748","DOIUrl":"10.1002/osp4.748","url":null,"abstract":"<p><strong>Objective: </strong>Despite the rising prevalence of people living with obesity, physicians are providing suboptimal care to these individuals, which may be a consequence of inadequate education in weight management and negative attitudes toward people living with obesity. Internal Medicine (IM) residency is an ideal setting to address physicians' attitudes toward people living with obesity. However, there is a paucity of recent literature on this topic. This study sought to assess the current attitudes of IM residents toward obesity as a disease, people living with obesity, and obesity treatment.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted in 2020 across two IM programs assessing residents' attitudes toward obesity as a disease, people living with obesity, and obesity treatment.</p><p><strong>Results: </strong>Among 42 residents who participated in the survey, 64% were women; 31 percent were Post Graduate Year 1, 31% PGY-2, and 38% PGY-3. Mean attitude scores were high on statements regarding obesity as a chronic disease [4.7 (SD 0.4)] and its association with serious medical conditions [4.9 (SD 0.3)]. Residents had overall positive attitudes toward people living with obesity. In contrast, residents felt negatively regarding their level of success in helping patients lose weight [2.0 (SD 0.7)].</p><p><strong>Conclusions: </strong>While residents recognized obesity as a chronic disease and had positive attitudes toward people living with obesity, their low ratings regarding weight management success suggest that targeted educational efforts are needed to increase obesity treatment self-efficacy.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kathryn M. Taylor, Michael P. Castellani, P. Bartlett, Tyler E. Oliver, Holly L. McClung
Abstract Objective The U.S. Army uses sex‐specific circumference‐based prediction equations to estimate percent body fat (%BF) to evaluate adherence to body composition standards. The equations are periodically evaluated to ensure that they continue to accurately assess %BF in a diverse population. The objective of this study was to develop and validate alternative field expedient equations that may improve upon the current Army Regulation (AR) body fat (%BF) equations. Methods Body size and composition were evaluated in a representatively sampled cohort of 1904 active‐duty Soldiers (1261 Males, 643 Females), using dual‐energy X‐ray absorptiometry (%BFDXA), and circumferences obtained with 3D imaging and manual measurements. Sex stratified linear prediction equations for %BF were constructed using internal cross validation with %BFDXA as the criterion measure. Prediction equations were evaluated for accuracy and precision using root mean squared error, bias, and intraclass correlations. Equations were externally validated in a convenient sample of 1073 Soldiers. Results Three new equations were developed using one to three circumference sites. The predictive values of waist, abdomen, hip circumference, weight and height were evaluated. Changing from a 3‐site model to a 1‐site model had minimal impact on measurements of model accuracy and performance. Male‐specific equations demonstrated larger gains in accuracy, whereas female‐specific equations resulted in minor improvements in accuracy compared to existing AR equations. Equations performed similarly in the second external validation cohort. Conclusions The equations developed improved upon the current AR equation while demonstrating robust and consistent results within an external population. The 1‐site waist circumference‐based equation utilized the abdominal measurement, which aligns with associated obesity related health outcomes. This could be used to identify individuals at risk for negative health outcomes for earlier intervention.
{"title":"Development and cross‐validation of a circumference‐based predictive equation to estimate body fat in an active population","authors":"Kathryn M. Taylor, Michael P. Castellani, P. Bartlett, Tyler E. Oliver, Holly L. McClung","doi":"10.1002/osp4.747","DOIUrl":"https://doi.org/10.1002/osp4.747","url":null,"abstract":"Abstract Objective The U.S. Army uses sex‐specific circumference‐based prediction equations to estimate percent body fat (%BF) to evaluate adherence to body composition standards. The equations are periodically evaluated to ensure that they continue to accurately assess %BF in a diverse population. The objective of this study was to develop and validate alternative field expedient equations that may improve upon the current Army Regulation (AR) body fat (%BF) equations. Methods Body size and composition were evaluated in a representatively sampled cohort of 1904 active‐duty Soldiers (1261 Males, 643 Females), using dual‐energy X‐ray absorptiometry (%BFDXA), and circumferences obtained with 3D imaging and manual measurements. Sex stratified linear prediction equations for %BF were constructed using internal cross validation with %BFDXA as the criterion measure. Prediction equations were evaluated for accuracy and precision using root mean squared error, bias, and intraclass correlations. Equations were externally validated in a convenient sample of 1073 Soldiers. Results Three new equations were developed using one to three circumference sites. The predictive values of waist, abdomen, hip circumference, weight and height were evaluated. Changing from a 3‐site model to a 1‐site model had minimal impact on measurements of model accuracy and performance. Male‐specific equations demonstrated larger gains in accuracy, whereas female‐specific equations resulted in minor improvements in accuracy compared to existing AR equations. Equations performed similarly in the second external validation cohort. Conclusions The equations developed improved upon the current AR equation while demonstrating robust and consistent results within an external population. The 1‐site waist circumference‐based equation utilized the abdominal measurement, which aligns with associated obesity related health outcomes. This could be used to identify individuals at risk for negative health outcomes for earlier intervention.","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140779316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mary E. Davis, Catherine Blake, Grainne O'Donoghue
Abstract Background Improvements in cardiorespiratory fitness (CRF) have been shown to largely attenuate the negative health risks associated with obesity. To date, literature on women with obesity has focused upon the evaluation of aerobic‐based exercise interventions. Hence, there is a need to evaluate resistance and combined interventions with this cohort. Objective This study aimed to evaluate the feasibility and efficacy of three exercise modalities in women with obesity for improving CRF, strength, body composition and other health outcomes. Methods Sixty‐seven women with obesity were randomly assigned to the control (CON) or one of three exercise groups (aerobic [AE], resistance [RE], COM). Exercise groups were trained x3 times/week for 12 weeks (up to 150‐min/week). Feasibility outcomes included adherence, attendance, recruitment and retention rates and adverse events. Secondary outcomes were CRF (predicted VO2 max), body composition (body weight [BW], waist circumference [WC], body fat percentage [%BF], fat mass [FM] and lean mass) and strength (5RM bench press, leg dynamometry, grip strength) and self‐reported measures of physical activity, mood, sleep, pain and quality of life. Results Findings support the feasibility of all three exercise modalities in terms of adherence, attendance, and retention. Interventions with a resistance component (COM and RE) were associated with the greatest improvements across the broad range of health outcomes measured. Combined was the most promising for body composition outcomes including body mass index (Effect size [ES] = 0.79, p = 0.04), BW (ES = 0.75, p = 0.05), %BF (ES = 0.77, p = 0.04), FM (ES = 0.83, p = 0.03) and WC (ES = 0.90, p = 0.02), physical activity (i.e., moderate physical activity [ES = 0.69, p = 0.07), mood (ES = 0.83, p = 0.03) and sleep (ES = 0.78, p = 0.04). Resistance was most promising for CRF (ES = 1.47, p = 0.002), strength (i.e., bench press [ES = 2.88, p=<0.001]) and pain (i.e., pain severity [ES = 0.40, p = 0.31]). Conclusions For health outcomes, these results indicate the importance of including a resistance component when prescribing exercise for women with obesity to achieve meaningful improvements. CLINICAL TRIAL REGISTRATION ISRCTN13517067
{"title":"Comparison of time‐matched aerobic, resistance or combined exercise training in women living with obesity: The EXOFFIT study","authors":"Mary E. Davis, Catherine Blake, Grainne O'Donoghue","doi":"10.1002/osp4.749","DOIUrl":"https://doi.org/10.1002/osp4.749","url":null,"abstract":"Abstract Background Improvements in cardiorespiratory fitness (CRF) have been shown to largely attenuate the negative health risks associated with obesity. To date, literature on women with obesity has focused upon the evaluation of aerobic‐based exercise interventions. Hence, there is a need to evaluate resistance and combined interventions with this cohort. Objective This study aimed to evaluate the feasibility and efficacy of three exercise modalities in women with obesity for improving CRF, strength, body composition and other health outcomes. Methods Sixty‐seven women with obesity were randomly assigned to the control (CON) or one of three exercise groups (aerobic [AE], resistance [RE], COM). Exercise groups were trained x3 times/week for 12 weeks (up to 150‐min/week). Feasibility outcomes included adherence, attendance, recruitment and retention rates and adverse events. Secondary outcomes were CRF (predicted VO2 max), body composition (body weight [BW], waist circumference [WC], body fat percentage [%BF], fat mass [FM] and lean mass) and strength (5RM bench press, leg dynamometry, grip strength) and self‐reported measures of physical activity, mood, sleep, pain and quality of life. Results Findings support the feasibility of all three exercise modalities in terms of adherence, attendance, and retention. Interventions with a resistance component (COM and RE) were associated with the greatest improvements across the broad range of health outcomes measured. Combined was the most promising for body composition outcomes including body mass index (Effect size [ES] = 0.79, p = 0.04), BW (ES = 0.75, p = 0.05), %BF (ES = 0.77, p = 0.04), FM (ES = 0.83, p = 0.03) and WC (ES = 0.90, p = 0.02), physical activity (i.e., moderate physical activity [ES = 0.69, p = 0.07), mood (ES = 0.83, p = 0.03) and sleep (ES = 0.78, p = 0.04). Resistance was most promising for CRF (ES = 1.47, p = 0.002), strength (i.e., bench press [ES = 2.88, p=<0.001]) and pain (i.e., pain severity [ES = 0.40, p = 0.31]). Conclusions For health outcomes, these results indicate the importance of including a resistance component when prescribing exercise for women with obesity to achieve meaningful improvements. CLINICAL TRIAL REGISTRATION ISRCTN13517067","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140776977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julianne G. Clina, Holly R Wyatt, James O Hill, Christine C. Ferguson, Hui-Ju Young, James H. Rimmer
Abstract Background People with physical disabilities (PWD) have a higher prevalence of obesity than populations without disability, but most evidence‐based weight loss programs have not included this population. The State of Slim (SOS) program is an evidence‐based weight loss program that has demonstrated success in producing weight loss in populations without disability, but it has not been adapted for or evaluated in PWD. Methods The SOS program was systematically adapted using the evidence‐informed Guidelines, Recommendations, and Adaptations Including Disability (GRAIDs) framework. A total of 35 participants enrolled in the State of Slim Everybody program. The program was offered entirely online. Body weight, attendance, and food log completion were also tracked weekly. The program length was 16.5 h and included weekly group instruction, with optional one‐on‐one sessions provided upon request. Following completion, participants completed post‐evaluation surveys on overall satisfaction with the program. The primary outcomes were program effectiveness (i.e., body weight), usability, and feasibility. Results Thirty‐two out of 35 participants completed the program, representing a retention rate of 91.4%. Average weight loss was 10.9% (9.9 ± 0.7 kg (t (31) = −13.3, p =< 0.0001)). On a 1 (dissatisfied/completely useless) to 5 (very satisfied/completely helpful) Likert scale, the average score for overall program satisfaction was 4.8 ± 0.1 and program helpfulness 4.6 ± 0.1. Conclusion The State of Slim Everybody program demonstrated significant weight loss and good usability and feasibility in PWD. Existing adaptation frameworks can be used to create inclusive health promotion programs for adults with physical disabilities.
{"title":"Pilot evaluation of a behavioral weight loss program for adults with physical disabilities: State of Slim Everybody usability and feasibility","authors":"Julianne G. Clina, Holly R Wyatt, James O Hill, Christine C. Ferguson, Hui-Ju Young, James H. Rimmer","doi":"10.1002/osp4.750","DOIUrl":"https://doi.org/10.1002/osp4.750","url":null,"abstract":"Abstract Background People with physical disabilities (PWD) have a higher prevalence of obesity than populations without disability, but most evidence‐based weight loss programs have not included this population. The State of Slim (SOS) program is an evidence‐based weight loss program that has demonstrated success in producing weight loss in populations without disability, but it has not been adapted for or evaluated in PWD. Methods The SOS program was systematically adapted using the evidence‐informed Guidelines, Recommendations, and Adaptations Including Disability (GRAIDs) framework. A total of 35 participants enrolled in the State of Slim Everybody program. The program was offered entirely online. Body weight, attendance, and food log completion were also tracked weekly. The program length was 16.5 h and included weekly group instruction, with optional one‐on‐one sessions provided upon request. Following completion, participants completed post‐evaluation surveys on overall satisfaction with the program. The primary outcomes were program effectiveness (i.e., body weight), usability, and feasibility. Results Thirty‐two out of 35 participants completed the program, representing a retention rate of 91.4%. Average weight loss was 10.9% (9.9 ± 0.7 kg (t (31) = −13.3, p =< 0.0001)). On a 1 (dissatisfied/completely useless) to 5 (very satisfied/completely helpful) Likert scale, the average score for overall program satisfaction was 4.8 ± 0.1 and program helpfulness 4.6 ± 0.1. Conclusion The State of Slim Everybody program demonstrated significant weight loss and good usability and feasibility in PWD. Existing adaptation frameworks can be used to create inclusive health promotion programs for adults with physical disabilities.","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140773074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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