Abstract
Purpose The purpose of this paper is to examine the effect of the intensive lifestyle modification program on weight and metabolic syndrome risk reduction in rural obese women who have no underlying non-communicable diseases in Thailand. Design/methodology/approach A randomized controlled trial was conducted. In total, 60 healthy obese women aged 30-50 years were recruited and randomly assigned to either the intervention (n=30) or control (n=30) group after health screening. Tailored nutritional counseling, health education and exercise training were included in the lifestyle modification program. Behavioral modification techniques were also incorporated. The intervention was conducted weekly for the first eight weeks, then biweekly until week 16. Findings The student’s t-test was used to compare mean difference between groups. The total weight loss in the intervention group (n=29) was significantly higher, 7.6±2.9 kg, compared with the control group (n=30) who lost 0.7±1.4 kg (p<0.001). The intervention group lost weight 10.2 percent from baseline which was significantly higher than that in the control group (p<0.001). Systolic and diastolic blood pressures, fasting blood sugar, and waist circumference were significantly improved. Triglyceride levels slightly improved while high density lipoprotein cholesterol was slightly lowered. The intervention group showed a statistical reduction in abnormal components of metabolic syndrome compared with the control group, with the relative risk=0.24, 95% confidence interval=0.072-0.791, and p=0.018. Originality/value Compatibility of the program activities conducted by a health professional who had achieved healthy weight loss and accepted as a role model was a key to achieving effective weight loss and metabolic syndrome risk reduction in obese women in rural areas. The program should be integrated into the conventional practice of health care centers.
Highlights
Obesity is a global public health problem[1]
Excess visceral fat often found in obesity is associated with metabolic syndrome, type 2 diabetes mellitus, hypertension, coronary artery disease, and stroke[6, 7]
The participants had an average age of about 42.68 years (SD 1⁄4 5.24, max/min of age 1⁄4 30/50), average body mass index (BMI) 32.37 kg/m2 (SD 1⁄4 3.81), mostly farmers with literacy levels at an elementary level, and relatively low income
Summary
Obesity is a global public health problem[1]. In Thailand, the prevalence of obesity has been increasing at an alarming rate in all life stages[2]. Behavior modification programs combined with health education based on a health belief model[13] can enhance practical lifestyle modification skills compatible with individual contexts for managing weight[14] because individuals might make decision to change positively once individuals perceive their risk and severity of the risk threatening their life. They are likely to act when they perceive that their changes gain more benefits and are able to do it[13]. Any behavioral modification intended to result in weight loss should be compatible with the individual’s practical aspects of their lifestyle and contexts over the long-term
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