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Efficacy of interventions aimed at reducing explicit and implicit weight bias in healthcare students: A systematic review and meta-analysis. 旨在减少医学生显性和隐性体重偏差的干预措施的效果:系统回顾和荟萃分析。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-08 DOI: 10.1111/obr.13847
Ravisha S Jayawickrama, Briony Hill, Moira O'Connor, Stuart W Flint, Erik Hemmingsson, Lucy R Ellis, Yaxing Du, Blake J Lawrence

We conducted a systematic review and meta-analysis to determine the efficacy of interventions aimed at reducing weight bias in healthcare students, and to explore factors that may impact intervention success. A systematic review and random-effects meta-analyses were conducted by including studies that examined the efficacy of weight bias reduction interventions for healthcare students. Of the 3463 journal articles and dissertations screened, 67 studies (within 64 records) met inclusion criteria, with 35 studies included in the meta-analyses (explicit = 35, implicit [and explicit] = 10) and 32 studies included in the narrative synthesis (explicit = 34, implicit [and explicit] = 3). Weight bias interventions had a small but positive impact, g = -0.31 (95% CI = -0.43 to -0.19, p < 0.001), in reducing students' explicit weight bias but there was no intervention effect on implicit weight bias, g = -0.12 (95% CI = -0.26 to 0.02, p = 0.105). There was considerable heterogeneity in the pooled effect for explicit bias (I2 = 74.28, Q = 132.21, df = 34, p < 0.001). All subgroup comparisons were not significant (p > 0.05) and were unable to explain the observed heterogeneity. Narrative synthesis supported meta-analytic findings. The small but significant reduction of explicit weight bias encourages the continued testing of interventions, irrespective of variation in individual intervention components. Contrarily, reductions in implicit weight bias may only be possible from a large societal shift in negative beliefs and attitudes held towards people living in larger bodies.

我们进行了一项系统综述和荟萃分析,以确定旨在减少医学生体重偏差的干预措施的效果,并探讨可能影响干预成功的因素。我们通过系统综述和随机效应荟萃分析,收录了针对医学生的减轻体重偏差干预效果的研究。在筛选出的 3463 篇期刊论文和学位论文中,有 67 项研究(64 条记录内)符合纳入标准,其中 35 项研究被纳入荟萃分析(显性 = 35,隐性[和显性] = 10),32 项研究被纳入叙述性综合(显性 = 34,隐性[和显性] = 3)。体重偏差干预的影响较小,但具有积极意义,g = -0.31 (95% CI = -0.43 to -0.19, p 2 = 74.28, Q = 132.21, df = 34, p 0.05),无法解释观察到的异质性。叙述性综述支持荟萃分析结果。显性体重偏差的减少幅度虽小,但意义重大,这鼓励人们继续对干预措施进行测试,而不管干预措施的各个组成部分是否存在差异。与此相反,内隐体重偏差的减少只有在社会对体重较大者的负面信念和态度发生巨大转变时才有可能实现。
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引用次数: 0
Bariatric surgeries and cardiac structure and function: Systematic review and network meta-analysis. 减肥手术与心脏结构和功能:系统回顾和网络荟萃分析。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-08 DOI: 10.1111/obr.13843
Xiao-Qian Zhang, Ke-Ning Chen, Zu-Xuan Zhang, Nian-Rong Zhang, Fang-Jie-Yi Zheng, Biao Zhou, Hua Meng, Zhi-Xin Zhang, Wen-Quan Niu

Background: Obesity, a global health problem, is causally implicated in the development of cardiovascular disease. Bariatric surgeries are effective treatment options for obesity; however, the effectiveness of different bariatric surgeries on cardiac structure and function is not fully understood. We undertook a systematic review and network meta-analysis to comprehensively assess this effectiveness.

Data source: PubMed, Web of Science, and EMBASE were searched from their inception until November 11, 2023. Studies that compared bariatric surgeries vis-à-vis non-surgical treatment, placebo, and other bariatric surgeries, as well as reported changes in left ventricular mass or its index (LVM or LVMI) or left ventricular ejection fraction (LVEF), were summarized.

Results: Total 19 studies (17 cohort studies and 2 randomized controlled trials) and 2012 adults were meta-analyzed. Patients receiving gastric bypass had appreciably lowered LVM (weighted mean difference [WMD]: -43.86 g, 95% confidence interval [CI] -61.09 to -26.63, p < 0.01) and LVMI (standardized mean difference: -0.67, 95% CI -1.03 to -0.32, p < 0.01) compared with other bariatric surgeries. No significant improvement in LVEF was noted across all surgeries. The drop in body mass index was most pronounced for biliopancreatic diversion with duodenal switch (WMD -16.33 kg/m2, 95% CI -21.60 to -11.05, p < 0.01).

Conclusions: Our findings of this network meta-analysis indicated that gastric bypass proved best for the improvement in cardiac structure, and there was no obvious improvement in cardiac function for all bariatric surgeries. Further studies are required to better understand the differing effectiveness of bariatric surgeries on cardiac structure and function and the underlying molecular mechanisms.

背景:肥胖症是一个全球性的健康问题,与心血管疾病的发生有着因果关系。减肥手术是治疗肥胖症的有效方法;然而,不同减肥手术对心脏结构和功能的效果尚不完全清楚。我们进行了一项系统综述和网络荟萃分析,以全面评估这种有效性:我们对 PubMed、Web of Science 和 EMBASE 进行了检索,检索时间从开始到 2023 年 11 月 11 日。对减肥手术与非手术治疗、安慰剂和其他减肥手术进行比较的研究,以及报告左心室质量或其指数(LVM 或 LVMI)或左心室射血分数(LVEF)变化的研究进行了汇总:共对 19 项研究(17 项队列研究和 2 项随机对照试验)和 2012 名成人进行了荟萃分析。接受胃旁路手术的患者LVM明显降低(加权平均差[WMD]:-43.86 g,95%置信区间[CI]-61.09至-26.63,P 2,95%CI-21.60至-11.05,P 结论:我们的这项网络荟萃分析结果表明,接受胃旁路手术的患者LVM明显降低:我们的网络荟萃分析结果表明,胃旁路手术对心脏结构的改善效果最好,而所有减肥手术对心脏功能的改善效果都不明显。要更好地了解减肥手术对心脏结构和功能的不同效果及其潜在的分子机制,还需要进一步的研究。
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引用次数: 0
Dietary calcium intake in relation to metabolic syndrome in adults: A systematic review and dose-response meta-analysis of epidemiological studies with GRADE assessment. 膳食钙摄入量与成人代谢综合征的关系:通过 GRADE 评估对流行病学研究进行系统回顾和剂量反应荟萃分析。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-08 DOI: 10.1111/obr.13850
Roxana Nematbakhsh, Parisa Rouhani, Parvane Saneei

Numerous studies have examined the relationship of calcium intake and metabolic syndrome (MetS) in adults in previous decades; but the results were inconsistent across different societies. This systematic review and dose-response meta-analysis assessed the relation between calcium consumption and MetS in adults. We did a systematic search of all articles published up to July 2023 in Scopus, PubMed/Medline, ISI Web of Science electronic databases, and Google Scholar. Observational studies investigated the association between dietary calcium (Ca) intake and MetS in adults were eligible to be included. For computing the estimates, a random effects model was applied. Combining 24 effect size from 17 investigations (15 cross-sectional and two cohort studies) with 74,720 participants and 18,200 cases showed that highest versus lowest level of dietary Ca intake was related to 23% significant decreased odds of MetS (OR = 0.77; 95% CI: 0.66, 0.89). Linear dose-response analysis of estimates from 12 investigations showed that each 100 mg/day increment in dietary Ca intake was associated with 3% marginally significant decreased odds in MetS (OR = 0.97; 95%CI: 0.93, 1.01). In nonlinear dose-response analysis of 12 studies with 67,896 participants, a significant association between dietary calcium intake and MetS was found (Pnonlinearity <0.001); such that 500 mg/day dietary calcium intake was related to maximum decrease in odds of MetS. According to this meta-analysis, the likelihood of MetS was significantly lower in adults with higher level of dietary calcium intake. Further large-scale prospective cohort investigations are needed to obtain stronger and more accurate results.

在过去的几十年中,有许多研究探讨了成人钙摄入量与代谢综合征(MetS)之间的关系;但不同社会的研究结果并不一致。本系统综述和剂量反应荟萃分析评估了成人钙摄入量与代谢综合征之间的关系。我们对 Scopus、PubMed/Medline、ISI Web of Science 电子数据库和 Google Scholar 中截至 2023 年 7 月发表的所有文章进行了系统检索。研究成人膳食钙(Ca)摄入量与 MetS 之间关系的观察性研究均符合纳入条件。在计算估计值时,采用了随机效应模型。将来自 17 项调查(15 项横断面研究和 2 项队列研究)、74,720 名参与者和 18,200 个病例的 24 个效应大小合并显示,膳食钙摄入量最高与最低水平相比,MetS 发生几率显著降低 23% (OR = 0.77; 95% CI: 0.66, 0.89)。对 12 项调查的估计值进行的线性剂量反应分析表明,膳食中钙的摄入量每增加 100 毫克/天,MetS 的几率就会略微降低 3%(OR = 0.97;95%CI:0.93, 1.01)。在对 12 项研究的 67,896 名参与者进行的非线性剂量反应分析中,发现膳食钙摄入量与 MetS 之间存在显著关联(Pnonlinearity)。
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引用次数: 0
Metabolomics: Implication in cardiovascular research and diseases 代谢组学:对心血管研究和疾病的影响。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-06 DOI: 10.1111/obr.13825
Amir Ajoolabady, Domenico Pratico, Warwick B. Dunn, Gregory Y. H. Lip, Jun Ren

Cellular metabolism influences all aspects of cellular function and is crucial for overall organismal health. Metabolic disorders related to cardiovascular health can lead to cardiovascular diseases (CVDs). Moreover, associated comorbidities may also damage cardiovascular metabolism, exacerbating CVD and perpetuating a vicious cycle. Given the prominent role of metabolic alterations in CVD, metabolomics has emerged as an imperative technique enabling a comprehensive assessment of metabolites and metabolic architecture within the body. Metabolite profile and metabolic pathways help to deepen and broaden our understanding of complex genomic landscape and pathophysiology of CVD. Here in this review, we aim to overview the experimental and clinical applications of metabolomics in pathogenesis, diagnosis, prognosis, and management of various CVD plus future perspectives and limitations.

细胞代谢影响着细胞功能的方方面面,对整个机体的健康至关重要。与心血管健康有关的代谢紊乱可导致心血管疾病(CVD)。此外,相关的并发症也会损害心血管代谢,加剧心血管疾病,使恶性循环持续下去。鉴于代谢改变在心血管疾病中的突出作用,代谢组学已成为一项必要的技术,可对体内代谢物和代谢结构进行全面评估。代谢物图谱和代谢途径有助于加深和拓宽我们对心血管疾病复杂基因组图谱和病理生理学的理解。在这篇综述中,我们旨在概述代谢组学在各种心血管疾病的发病机制、诊断、预后和管理方面的实验和临床应用,以及未来的前景和局限性。
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引用次数: 0
Potential pathways to the onset and development of eating disorders in people with overweight and obesity: A scoping review. 超重和肥胖症患者饮食失调症发病和发展的潜在途径:范围综述。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-04 DOI: 10.1111/obr.13840
Rabia Khalid, Natalie B Lister, Susan J Paxton, Sarah Maguire, Sol Libesman, Anna L Seidler, Kelly Cooper, Fiona Quigley, Jacqlyn Yourell, Louise A Baur, Hiba Jebeile

Objective: To describe pathways to eating disorder (ED) development that have been evaluated in people with overweight and obesity.

Methods: Four databases were searched to identify studies testing ED development models in adolescents (10-19 years) or adults (>19 years) with overweight and obesity. Explanatory variables were thematically grouped into constructs to describe pathways to each ED outcome.

Results: Of 2226 studies screened, 46 (10 adolescent; 36 adult) were included. Study samples were predominantly female, ranging from 22 to 2236 participants and mean age 12.3 to 56.0 years. In total, 207 explanatory variables were grouped into 18 constructs to summarize 107 pathways that were identified. The most common ED outcome was binge eating (n = 24 studies), followed by global ED psychopathology (n = 10 studies). Across pathways to ED development, negative affect was the most proposed construct, followed by preoccupation with weight/shape and weight stigma.

Conclusion: Pathways to ED development in people with overweight and obesity are complex and may include more than 18 different explanatory factors of which negative affect, preoccupation with weight/shape, and weight stigma are the most common. More research on adolescents, males, and the spectrum of ED in diverse populations is required for early identification and intervention.

目的描述对超重和肥胖症患者饮食失调(ED)发展途径的评估:对四个数据库进行了检索,以确定对超重和肥胖青少年(10-19 岁)或成年人(19 岁以上)饮食失调发展模式进行测试的研究。对解释性变量进行了主题分组,以描述每种 ED 结果的形成途径:在筛选出的 2226 项研究中,有 46 项(10 项青少年研究;36 项成人研究)被纳入其中。研究样本以女性为主,参与者人数从 22 人到 2236 人不等,平均年龄为 12.3 岁到 56.0 岁。共有 207 个解释性变量被归类为 18 个结构,总结出 107 条路径。最常见的 ED 结果是暴饮暴食(24 项研究),其次是整体 ED 精神病理学(10 项研究)。在所有导致 ED 的发展途径中,消极情绪是提出最多的结构,其次是对体重/体形的关注和体重耻辱感:结论:超重和肥胖症患者发生肥胖症的途径非常复杂,可能包括超过 18 种不同的解释因素,其中负性情绪、对体重/体形的关注和体重耻辱感是最常见的因素。需要对青少年、男性和不同人群的 ED 范围进行更多研究,以便及早识别和干预。
{"title":"Potential pathways to the onset and development of eating disorders in people with overweight and obesity: A scoping review.","authors":"Rabia Khalid, Natalie B Lister, Susan J Paxton, Sarah Maguire, Sol Libesman, Anna L Seidler, Kelly Cooper, Fiona Quigley, Jacqlyn Yourell, Louise A Baur, Hiba Jebeile","doi":"10.1111/obr.13840","DOIUrl":"https://doi.org/10.1111/obr.13840","url":null,"abstract":"<p><strong>Objective: </strong>To describe pathways to eating disorder (ED) development that have been evaluated in people with overweight and obesity.</p><p><strong>Methods: </strong>Four databases were searched to identify studies testing ED development models in adolescents (10-19 years) or adults (>19 years) with overweight and obesity. Explanatory variables were thematically grouped into constructs to describe pathways to each ED outcome.</p><p><strong>Results: </strong>Of 2226 studies screened, 46 (10 adolescent; 36 adult) were included. Study samples were predominantly female, ranging from 22 to 2236 participants and mean age 12.3 to 56.0 years. In total, 207 explanatory variables were grouped into 18 constructs to summarize 107 pathways that were identified. The most common ED outcome was binge eating (n = 24 studies), followed by global ED psychopathology (n = 10 studies). Across pathways to ED development, negative affect was the most proposed construct, followed by preoccupation with weight/shape and weight stigma.</p><p><strong>Conclusion: </strong>Pathways to ED development in people with overweight and obesity are complex and may include more than 18 different explanatory factors of which negative affect, preoccupation with weight/shape, and weight stigma are the most common. More research on adolescents, males, and the spectrum of ED in diverse populations is required for early identification and intervention.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e13840"},"PeriodicalIF":8.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142374769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Investigating discrepancies in findings between rigorous randomized trials and meta-analyses evaluating pregnancy interventions to limit gestational weight gain 调查评估限制妊娠体重增加的孕期干预措施的严格随机试验和荟萃分析结果之间的差异。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-03 DOI: 10.1111/obr.13826
Jodie M. Dodd, Andrea R. Deussen, Amanda J. Poprzeczny, Laura J. Slade, Megan Mitchell, Jennie Louise

Introduction

Robust randomized trials consistently demonstrate little impact from diet and physical activity interventions on gestational weight gain (GWG) and clinical outcomes, although meta-analyses report some benefit. Our aim was to evaluate the effect of trial quality on treatment effect estimates and review conclusions.

Methods

We conducted a systematic review of dietary and/or physical activity interventions for pregnant women with a body mass index ≥18.5 kg/m2. We assessed studies for risk of bias and methodological features impacting reliability. Outcomes included GWG; gestational diabetes mellitus (GDM); pre-eclampsia; caesarean birth; and birth weight measures. For each outcome, a sequence of meta-analyses was performed based on intervention group and level of potential bias in the effect estimate.

Results

We identified 128 eligible studies. The most robust estimate from a combined diet and physical activity behavioral intervention, with only studies at negligible risk of bias, was a difference in GWG of 1.10 kg (95% CI −1.62 to −0.58; 17,755 women). There was no evidence of an effect on any clinical outcomes.

Conclusions

Our findings highlight discrepancies produced by the indiscriminate inclusion of studies with methodological flaws in previous systematic reviews. Regular weighing of pregnant women is futile in the absence of clinical benefit.

导言:尽管荟萃分析表明饮食和体育锻炼干预对妊娠体重增加(GWG)和临床结果的影响很小,但可靠的随机试验始终证明了这一点。我们的目的是评估试验质量对治疗效果估计值和综述结论的影响:我们对体重指数≥18.5 kg/m2的孕妇的饮食和/或体力活动干预进行了系统性回顾。我们评估了研究的偏倚风险和影响可靠性的方法特征。结果包括妊娠体重指数(GWG)、妊娠糖尿病(GDM)、先兆子痫、剖腹产和出生体重测量。对于每项结果,我们都根据干预组和效应估计的潜在偏倚程度进行了一系列荟萃分析:我们确定了 128 项符合条件的研究。在只有偏倚风险可忽略不计的研究中,综合饮食和体育锻炼行为干预得出的最可靠的估计值是,GWG 的差异为 1.10 千克(95% CI -1.62 至 -0.58;17755 名女性)。没有证据表明对任何临床结果产生了影响:我们的研究结果凸显了以往系统性综述中不加区分地纳入有方法缺陷的研究而产生的差异。在没有临床益处的情况下,对孕妇进行定期称重是徒劳的。
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引用次数: 0
Development and clinical application of bioelectrical impedance analysis method for body composition assessment. 用于人体成分评估的生物电阻抗分析方法的开发和临床应用。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-30 DOI: 10.1111/obr.13844
Jang Won Son, Byoung-Duck Han, Jonathan P Bennett, Steve Heymsfield, Soo Lim

Obesity, which is characterized by excessive body fat, increases the risk of chronic diseases, such as type 2 diabetes, cardiovascular diseases, and certain cancers. Sarcopenia, a decline in muscle mass, is also associated with many chronic disorders and is therefore a major concern in aging populations. Body composition analysis is important in the evaluation of obesity and sarcopenia because it provides information about the distribution of body fat and muscle mass. It is also useful for monitoring nutritional status, disease severity, and the effectiveness of interventions, such as exercise, diet, and drugs, and thus helps assess overall health and longevity. Computed tomography, magnetic resonance imaging, and dual-energy X-ray absorptiometry are commonly used for this purpose. However, they have limitations, such as high cost, long measurement time, and radiation exposure. Instead, bioelectrical impedance analysis (BIA), which was introduced several decades ago and has undergone significant technological advancements, can be used. It is easily accessible, affordable, and importantly, poses no radiation risk, making it suitable for use in hospitals, fitness centers, and even at home. Herein, we review the recent technological developments and clinical applications of BIA to provide an updated understanding of BIA technology and its strengths and limitations.

肥胖症的特点是身体脂肪过多,会增加罹患慢性疾病的风险,如 2 型糖尿病、心血管疾病和某些癌症。肌肉减少症(肌肉质量下降)也与许多慢性疾病有关,因此是老龄人口的一个主要问题。身体成分分析对评估肥胖症和肌肉疏松症非常重要,因为它能提供有关身体脂肪和肌肉质量分布的信息。它还有助于监测营养状况、疾病严重程度以及运动、饮食和药物等干预措施的效果,从而帮助评估整体健康和寿命。计算机断层扫描、磁共振成像和双能 X 射线吸收测量法通常用于此目的。然而,这些方法存在成本高、测量时间长、辐射大等局限性。取而代之的是生物电阻抗分析法(BIA),该方法早在几十年前就已问世,并取得了重大技术进步。生物电阻抗分析法易于使用,价格低廉,更重要的是没有辐射风险,因此适合在医院、健身中心甚至家中使用。在此,我们回顾了 BIA 的最新技术发展和临床应用,以提供对 BIA 技术及其优势和局限性的最新了解。
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引用次数: 0
Primary care practitioner and patient perspectives on care following bariatric surgery: A meta-synthesis of qualitative research 初级保健医生和患者对减肥手术后护理的看法:定性研究的元综合。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-19 DOI: 10.1111/obr.13829
Sally Badorrek, Janet Franklin, Kate A. McBride, Laura Conway, Kathryn Williams

Primary care is central to ongoing health care following bariatric surgery and patients indicate a preference for receiving follow-up support by their primary care practitioner (PCP). This meta-synthesis investigates the perspectives of both PCPs and patients in post-bariatric surgery care provided by PCPs. The aim was to synthesize themes from qualitative research to recommend improvements in post-bariatric surgery clinical care in primary care settings. Systematic searches of Scopus, Medline, EMBASE, PsycINFO, the Cochrane Library, and Google Scholar resulted in the inclusion of eight papers in the meta-synthesis. Papers were critiqued using the Critical Appraisal Skills Program (CASP) and thematically coded in Quirkos Cloud. Seven themes were reached by author consensus including stigma and judgment; clinician barriers and facilitators; patient-related support needs; communication considerations; patient context or determinants; health care setting; and adapting to life after surgery. PCPs reported barriers including poor communication and guidance from bariatric surgery centers, limited knowledge and training in bariatric patient care, and patients who may have unrealistic outcomes and poor health literacy. Patients seek comprehensive care from their PCP, however, barriers hindering the provision of this care include adverse surgical outcomes, a poor relationship with their PCP, and limited and short-term follow-up care from the PCP. Insights from this meta-synthesis offer actionable recommendations for PCPs and bariatric surgery centers to enhance patient care immediately.

初级保健是减肥手术后持续保健的核心,患者表示更愿意接受初级保健医生(PCP)提供的后续支持。本综述调查了初级保健医生和患者对初级保健医生提供的减肥手术后护理的看法。其目的是综合定性研究的主题,为基层医疗机构的减肥术后临床护理提出改进建议。通过对 Scopus、Medline、EMBASE、PsycINFO、Cochrane Library 和 Google Scholar 进行系统检索,最终有 8 篇论文被纳入元综合研究。我们使用批判性评估技能程序(CASP)对论文进行了点评,并在 Quirkos Cloud 中进行了主题编码。通过作者共识达成了七个主题,包括污名化和评判;临床医生的障碍和促进因素;患者相关的支持需求;沟通考虑因素;患者背景或决定因素;医疗环境;以及适应术后生活。初级保健医生报告的障碍包括:来自减肥手术中心的沟通和指导不畅、减肥患者护理方面的知识和培训有限,以及患者可能有不切实际的结果和健康知识贫乏。患者寻求初级保健医生的全面护理,然而,妨碍提供这种护理的障碍包括不良的手术结果、与初级保健医生的关系不佳以及初级保健医生提供的有限和短期的后续护理。本荟萃综述为初级保健医生和减肥手术中心提供了可行的建议,以便立即加强对患者的护理。
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引用次数: 0
The impact of behavioral weight management interventions on eating behavior traits in children with overweight or obesity: Systematic review and meta-analysis. 行为体重管理干预对超重或肥胖儿童饮食行为特征的影响:系统回顾与荟萃分析。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-19 DOI: 10.1111/obr.13839
Patricia Eustachio Colombo, Milindu Wickramarachchi, Aiswarya Lakshmi, Laura Kudlek, Amy Ahern, Struan Tait, Natasha Reid, Rebecca A Jones, Andrea D Smith

Introduction: Behavioral weight management interventions (BWMIs) are an evidence-based strategy for addressing childhood obesity. Targeting eating behavior traits (EBTs; individual tendencies determining food intake/occasions) could play a pivotal role in improving the effectiveness of these behavioral interventions. The present study describes a systematic review and meta-analysis of the impact of BWMIs on eating behavior traits in children with overweight or obesity.

Methods: Seven databases were searched, and eligible studies included randomized controlled trials reporting EBT outcomes following BWMIs delivered to children with overweight or obesity (<18 years of age). Random effects meta-analyses were conducted to compare EBT outcomes for intervention and control groups. Synthesis without meta-analysis (SWiM) was applied for EBTs where meta-analysis was not feasible.

Results: The review identified eight trials characterizing the impact of BWMIs on 15 EBTs. Meta-analyses of data from three trials at intervention completion and post-intervention (average of 28 weeks [±8]) revealed positive short-term increases in dietary restraint (SMD random effect 0.42 [95% CI 0.13, 0.70]). However, these effects were not sustained at follow-up. Improvements in emotional eating, external eating, food responsiveness, and enjoyment of food were shown in studies which could not be pooled quantitatively.

Conclusion: BWMIs in children living with overweight/obesity are beneficial for the improvement of some EBTs at intervention completion including dietary restraint, emotional eating, external eating, food responsiveness, and enjoyment of food. However, this remains a relatively unexplored area and more research is needed to strengthen understanding of the multifaceted impact of child BWMIs on a comprehensive range of EBTs.

导言:行为体重管理干预(BWMIs)是解决儿童肥胖问题的一种循证策略。针对饮食行为特征(EBTs;决定食物摄入量/发生率的个人倾向)的干预措施可在提高这些行为干预措施的有效性方面发挥关键作用。本研究对 BWMIs 对超重或肥胖儿童饮食行为特征的影响进行了系统回顾和荟萃分析:方法:研究人员检索了七个数据库,符合条件的研究包括随机对照试验,这些试验报告了向超重或肥胖儿童提供 BWMIs 后的 EBT 结果(结果:审查发现了 8 项试验,这些试验描述了 BWMI 对 15 项 EBTs 的影响。对三项试验在干预完成时和干预后(平均 28 周 [±8])的数据进行的元分析表明,饮食限制在短期内得到了积极的改善(SMD 随机效应 0.42 [95% CI 0.13, 0.70])。然而,这些效果在随访中并未持续。在情绪化饮食、外食、对食物的反应能力和对食物的喜爱程度方面有所改善的研究无法进行定量汇总:结论:对超重/肥胖儿童进行 BWMIs 有益于在干预结束时改善某些 EBT,包括饮食节制、情绪化进食、外食、对食物的反应能力和对食物的喜爱程度。然而,这仍然是一个相对尚未探索的领域,需要更多的研究来加强了解儿童 BWMI 对一系列 EBT 的多方面影响。
{"title":"The impact of behavioral weight management interventions on eating behavior traits in children with overweight or obesity: Systematic review and meta-analysis.","authors":"Patricia Eustachio Colombo, Milindu Wickramarachchi, Aiswarya Lakshmi, Laura Kudlek, Amy Ahern, Struan Tait, Natasha Reid, Rebecca A Jones, Andrea D Smith","doi":"10.1111/obr.13839","DOIUrl":"https://doi.org/10.1111/obr.13839","url":null,"abstract":"<p><strong>Introduction: </strong>Behavioral weight management interventions (BWMIs) are an evidence-based strategy for addressing childhood obesity. Targeting eating behavior traits (EBTs; individual tendencies determining food intake/occasions) could play a pivotal role in improving the effectiveness of these behavioral interventions. The present study describes a systematic review and meta-analysis of the impact of BWMIs on eating behavior traits in children with overweight or obesity.</p><p><strong>Methods: </strong>Seven databases were searched, and eligible studies included randomized controlled trials reporting EBT outcomes following BWMIs delivered to children with overweight or obesity (<18 years of age). Random effects meta-analyses were conducted to compare EBT outcomes for intervention and control groups. Synthesis without meta-analysis (SWiM) was applied for EBTs where meta-analysis was not feasible.</p><p><strong>Results: </strong>The review identified eight trials characterizing the impact of BWMIs on 15 EBTs. Meta-analyses of data from three trials at intervention completion and post-intervention (average of 28 weeks [±8]) revealed positive short-term increases in dietary restraint (SMD random effect 0.42 [95% CI 0.13, 0.70]). However, these effects were not sustained at follow-up. Improvements in emotional eating, external eating, food responsiveness, and enjoyment of food were shown in studies which could not be pooled quantitatively.</p><p><strong>Conclusion: </strong>BWMIs in children living with overweight/obesity are beneficial for the improvement of some EBTs at intervention completion including dietary restraint, emotional eating, external eating, food responsiveness, and enjoyment of food. However, this remains a relatively unexplored area and more research is needed to strengthen understanding of the multifaceted impact of child BWMIs on a comprehensive range of EBTs.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e13839"},"PeriodicalIF":8.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Higher fiber higher carbohydrate diets better than lower carbohydrate lower fiber diets for diabetes management: Rapid review with meta-analyses. 高纤维、高碳水化合物饮食比低碳水化合物、低纤维饮食更有利于糖尿病的控制:快速回顾与荟萃分析。
IF 8.9 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-19 DOI: 10.1111/obr.13837
Andrew N Reynolds,Jessica Lang,Amanda Brand,Jim Mann
BACKGROUNDSome dietary recommendations continue to recommend carbohydrate restriction as a cornerstone of dietary advice for people with diabetes.PURPOSEWe compared the cardiometabolic effects of diets higher in both fiber and carbohydrate with lower carbohydrate lower fiber diets in type 1 or type 2 diabetes.DATA SOURCESMEDLINE, Embase, and the Cochrane Database of Systematic Reviews up to June 24, 2024, with additional hand searching.STUDY SELECTIONRandomized controlled trials in which both dietary fiber and carbohydrate amount had been modified were identified from source evidence syntheses on carbohydrate amount in people with diabetes.DATA EXTRACTIONTwo reviewers independently.DATA SYNTHESISTen eligible trials including 499 participants with diabetes (98% with T2) were identified from the potentially eligible 828 trials included in existing evidence syntheses. Pooled findings indicate that higher fiber higher carbohydrate diets reduced HbA1c (mean difference [MD] -0.50% [95% confidence interval -0.99 to -0.02]), fasting insulin (MD -0.99 μIU/mL [-1.83 to -0.15]), total cholesterol (MD -0.16 mmol/L [-0.27 to -0.05]) and low-density lipoprotein cholesterol (MD -0.16 mmol/L (-0.31 to -0.01) when compared with lower carbohydrate lower fiber diets. Trials with larger differences in fiber and carbohydrate intakes between interventions reported greater reductions. Certainty of evidence for these outcomes was moderate or high, with most outcomes downgraded due to heterogeneity unexplained by any single variable.LIMITATIONSOur predefined scope excluded trials with co-interventions such as energy restriction, which may have provided addition information.CONCLUSIONSFindings indicate the greater importance of promoting dietary fiber intakes, and the relative unimportance of carbohydrate amount in recommendations for people with diabetes.
背景一些膳食建议继续推荐限制碳水化合物,将其作为糖尿病患者膳食建议的基石。目的我们比较了纤维和碳水化合物含量均较高的膳食与碳水化合物含量较低的膳食对 1 型或 2 型糖尿病患者心脏代谢的影响。从有关糖尿病患者碳水化合物摄入量的证据综述中筛选出膳食纤维和碳水化合物摄入量均有所改变的随机对照试验。汇总结果表明,高纤维、高碳水化合物饮食可降低 HbA1c(平均差 [MD] -0.50% [95% 置信区间 -0.99 至 -0.02])、空腹胰岛素(MD -0.99 μIU/mL [-1.与低碳水化合物、低纤维膳食相比,空腹胰岛素(MD -0.99 μIU/mL [-1.83 to -0.15])、总胆固醇(MD -0.16 mmol/L [-0.27 to -0.05])和低密度脂蛋白胆固醇(MD -0.16 mmol/L (-0.31 to -0.01))。干预措施之间纤维和碳水化合物摄入量差异较大的试验报告了更大的降幅。结论研究结果表明,提高膳食纤维摄入量更为重要,而碳水化合物的摄入量在糖尿病患者的建议中相对不重要。
{"title":"Higher fiber higher carbohydrate diets better than lower carbohydrate lower fiber diets for diabetes management: Rapid review with meta-analyses.","authors":"Andrew N Reynolds,Jessica Lang,Amanda Brand,Jim Mann","doi":"10.1111/obr.13837","DOIUrl":"https://doi.org/10.1111/obr.13837","url":null,"abstract":"BACKGROUNDSome dietary recommendations continue to recommend carbohydrate restriction as a cornerstone of dietary advice for people with diabetes.PURPOSEWe compared the cardiometabolic effects of diets higher in both fiber and carbohydrate with lower carbohydrate lower fiber diets in type 1 or type 2 diabetes.DATA SOURCESMEDLINE, Embase, and the Cochrane Database of Systematic Reviews up to June 24, 2024, with additional hand searching.STUDY SELECTIONRandomized controlled trials in which both dietary fiber and carbohydrate amount had been modified were identified from source evidence syntheses on carbohydrate amount in people with diabetes.DATA EXTRACTIONTwo reviewers independently.DATA SYNTHESISTen eligible trials including 499 participants with diabetes (98% with T2) were identified from the potentially eligible 828 trials included in existing evidence syntheses. Pooled findings indicate that higher fiber higher carbohydrate diets reduced HbA1c (mean difference [MD] -0.50% [95% confidence interval -0.99 to -0.02]), fasting insulin (MD -0.99 μIU/mL [-1.83 to -0.15]), total cholesterol (MD -0.16 mmol/L [-0.27 to -0.05]) and low-density lipoprotein cholesterol (MD -0.16 mmol/L (-0.31 to -0.01) when compared with lower carbohydrate lower fiber diets. Trials with larger differences in fiber and carbohydrate intakes between interventions reported greater reductions. Certainty of evidence for these outcomes was moderate or high, with most outcomes downgraded due to heterogeneity unexplained by any single variable.LIMITATIONSOur predefined scope excluded trials with co-interventions such as energy restriction, which may have provided addition information.CONCLUSIONSFindings indicate the greater importance of promoting dietary fiber intakes, and the relative unimportance of carbohydrate amount in recommendations for people with diabetes.","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"55 1","pages":"e13837"},"PeriodicalIF":8.9,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Obesity Reviews
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