Effect Of Weight Loss Intervention Research Articles

Weight Loss Interventions for Hispanic Women in the United States: A Systematic Review.

Background Obesity rates in Hispanic women residing in the United States (U.S.) are disproportionately high, increasing the risk of obesity-related disease and mortality. The effectiveness of interventions targeting weight loss in this population remains largely unknown. Purpose The purpose of this review was to systematically evaluate the evidence related to the effectiveness of weight loss interventions conducted among U.S. Hispanic women and provide guidance for future research. Methods Bibliographic databases (n = 10, from each database's inception to July 2, 2019) were searched using the PRISMA guidelines for systematic reviews. Randomized controlled trials (RCTs) and quasi-experimental studies with weight change outcomes were included. Results were described in a narrative synthesis. Results 5,423 articles were assessed for eligibility based on inclusion criteria; 15 studies were included in the final review. Nine trials were RCTs and six were quasi-experimental studies; all but six were pilot studies. Most studies recruited overweight or obese women with no existing medical conditions and did not follow participants beyond the intervention. All trials were delivered in-person. Intervention strategies and content and weight change outcomes were highly variable. Conclusions RCTs with statistically powered sample sizes are needed to robustly test the effects of weight loss interventions in this population.

The effectiveness of weight-loss lifestyle interventions for improving fertility in women and men with overweight or obesity and infertility: A systematic review update of evidence from randomized controlled trials.

Being overweight or obese can have a negative impact on fertility outcomes. This systematic review updates randomized controlled trial (RCT) findings on the effectiveness of weight loss interventions in reducing weight and improving reproductive outcomes of women and men with overweight or obesity and infertility. Eligible studies, published since the last review, were identified by searching databases from March 20, 2016 until March 31, 2020. RCTs involving any type of lifestyle intervention were considered. Eight RCTs were identified and aggregated with seven RCTs included in our previous review. Meta-analyses revealed that women randomized to a combined diet and exercise intervention were more likely to become pregnant, risk ratio (RR) = 1.87 (95% CI 1.20, 2.93) and achieve a live birth RR = 2.20 (95% CI 1.23, 3.94), compared to women in control groups who received no or minimal intervention. This pattern was not replicated in trials where control groups received immediate access to assisted reproductive technology (ART). No eligible randomized trials involving men were identified. Data were largely obtained from small scale studies. Better designed, adequately powered, robust randomized trials are needed to better understand the effect of weight loss interventions on reproductive outcomes in both women and men.

Weight Management Strategies for the Patient with Diabetes.

Obesity is associated with an increased risk for type 2 diabetes, and weight loss in adults with obesity and type 2 diabetes may be indicated to reduce health risk and improve diabetes control. It is important to understand the effectiveness of weight loss interventions for the prevention and treatment of type 2 diabetes. Lifestyle interventions for weight loss show effectiveness for prevention of type 2 diabetes. Weight loss in patients with type 2 diabetes can decrease cardiometabolic risk and improve diabetes control. However, diabetes remission with lifestyle approaches is limited and to achieve this medical approaches such as bariatric surgery that result in greater magnitudes of weight loss may be necessary. Dissemination of lifestyle interventions for weight loss, along with other medical approaches such as bariatric surgery when indicated, are needed to reduce the health burden of type 2 diabetes in patients with obesity.

Effectiveness of a Family-Centered Pediatric Weight Management Program Integrated in Primary Care.

The evidence supporting the effectiveness of weight loss interventions with low to medium intensity is limited. To measure the effectiveness of a family-based weight management intervention in pediatric primary care to reduce body weight in children. Electronic medical record data of pediatric patients in Kaiser Permanente Orange County, California, who were enrolled in weight management between April 2014 and December 2018 (family-based behavior-changing weight management [FB-WMG], n = 162) and compared with a control group (CG) of patients who were referred but did not enroll (Ref-CG, n = 203) and an area-matched CG also matched by sex, age, zip code, and body mass index (BMI) (Area-CG, n = 287). BMI was measured at the first visit (or index date) and after 6 months. Children enrolled in the FB-WMG had 5 (interquartile range = 3-6) sessions over the first 6 months of the program. Most FB-WMG patients (69.1%) reduced or maintained BMI over 6 months, compared with 45.8% of Ref-CG (p < 0.001) and 57.8% of Area-CG (p = 0.02). In girls 3 to 12 years of age, 75% of participants reduced or maintained BMI, compared with 42% of Ref-CG (p < 0.001) and 59.8% of Area-CG (p = 0.07). On average, the difference in BMI change over the 6-month follow-up period was -0.85 kg/m² (95% confidence interval = -1.25 to -0.46 kg/m²) compared with Ref-CG and -0.28 kg/m² (95% confidence interval = -0.63 to 0.08 kg/m²) and Area-CG. Low- to moderate-intensity family-based weight management intervention in primary care can be successful after only 6 months compared with a referred control group.

Effectiveness of a Family-Centered Pediatric Weight Management Program Integrated in Primary Care

The evidence supporting the effectiveness of weight loss interventions with low to medium intensity is limited. To measure the effectiveness of a family-based weight management intervention in pediatric primary care to reduce body weight in children. Electronic medical record data of pediatric patients in Kaiser Permanente Orange County, California, who were enrolled in weight management between April 2014 and December 2018 (family-based behavior-changing weight management [FB-WMG], n = 162) and compared with a control group (CG) of patients who were referred but did not enroll (Ref-CG, n = 203) and an area-matched CG also matched by sex, age, zip code, and body mass index (BMI) (Area-CG, n = 287). BMI was measured at the first visit (or index date) and after 6 months. Children enrolled in the FB-WMG had 5 (interquartile range = 3-6) sessions over the first 6 months of the program. Most FB-WMG patients (69.1%) reduced or maintained BMI over 6 months, compared with 45.8% of Ref-CG (p < 0.001) and 57.8% of Area-CG (p = 0.02). In girls 3 to 12 years of age, 75% of participants reduced or maintained BMI, compared with 42% of Ref-CG (p < 0.001) and 59.8% of Area-CG (p = 0.07). On average, the difference in BMI change over the 6-month follow-up period was -0.85 kg/m² (95% confidence interval = -1.25 to -0.46 kg/m²) compared with Ref-CG and -0.28 kg/m² (95% confidence interval = -0.63 to 0.08 kg/m²) and Area-CG. Low- to moderate-intensity family-based weight management intervention in primary care can be successful after only 6 months compared with a referred control group.

Effect of bariatric surgery on plasma levels of oxidised phospholipids, biomarkers of oxidised LDL and lipoprotein(a)

BackgroundObesity is associated with adverse cardiovascular outcomes and this is improved following bariatric surgery. Oxidised phospholipids (OxPL) are thought to reflect the pro-inflammatory effects of lipoprotein(a) [Lp(a)], and both are independent predictors of cardiovascular disease. ObjectiveOur study sought to determine the impact of bariatric surgery on OxPL, biomarkers of oxidised LDL (OxLDL) and Lp(a). MethodsThis is a prospective, observational study of 59 patients with severe obesity undergoing bariatric surgery. Blood samples were obtained prior to surgery and at 6 and 12 months after. Sixteen patients attending the tertiary medical weight management clinic at the same centre were also recruited for comparison. Lipid and metabolic blood parameters, OxLDL, OxPL on apolipoprotein B-100 (OxPL-apoB), IgG and IgM autoantibodies to MDA-LDL, IgG and IgM apoB-immune complexes and Lp(a) were measured. ResultsReduction in body mass index (BMI) was significant following bariatric surgery, from median 48 kg/m2 at baseline to 37 kg/m2 at 6 months and 33 kg/m2 at 12 months. OxPL-apoB levels decreased significantly at 12 months following surgery [5.0 (3.2–7.4) to 3.8 (3.0–5.5) nM, p = 0.001], while contrastingly, Lp(a) increased significantly [10.2 (3.8–31.9) to 16.9 (4.9–38.6) mg/dl, p = 0.002]. There were significant post-surgical decreases in IgG and IgM biomarkers, particularly at 12 months, while OxLDL remained unchanged. ConclusionsBariatric surgery results in a significant increase in Lp(a) but reductions in OxPL-apoB and other biomarkers of oxidised lipoproteins, suggesting increased synthetic capacity and reduced oxidative stress. These biomarkers might be clinically useful to monitor physiological effects of weight loss interventions.

Effects of weight reduction on the breast cancer-related lymphedema: A systematic review and meta-analysis

BackgroundObesity has long been considered a risk factor for breast cancer–related lymphedema (BCRL), but the benefits of weight reduction in managing BCRL have not been clearly established. ObjectiveTo evaluate the beneficial effects of weight loss interventions (WLIs) on the reduction and prevention of BCRL. MethodsWe conducted a systematic review and meta-analysis by searching the PubMed, Scopus, and Embase databases from their earliest record to October 1st, 2019. We included randomized and non-randomized controlled trials involving adult patients with a history of breast cancer, that compared WLI groups with no-WLI groups, and provided quantitative measurements of lymphedema. ResultsInitial literature search yielded 461 nonduplicate records. After exclusion based on title, abstract, and full-text review, four randomized controlled trials involving 460 participants were included for quantitative analysis. Our meta-analysis revealed a significant between-group mean difference (MD) regarding the volume of affected arm (MD = 244.7 mL, 95% confidence interval [CI]: 145.3–344.0) and volume of unaffected arm (MD = 234.5 mL, 95% CI: 146.9–322.1). However, a nonsignificant between-group MD of −0.07% (95% CI: 1.22–1.08) was observed regarding the interlimb volume difference at the end of the WLIs. ConclusionsIn patients with BCRL, WLIs are associated with decreased volume of the affected and unaffected arms but not with decreased severity of BCRL measured by interlimb difference in arm volume.

Impact of weight loss interventions on patient-reported outcomes in overweight and obese adults with type 2 diabetes: a systematic review.

Previous reviews explored weight loss-induced metabolic changes in overweight and obese adults with type 2 diabetes (T2D) but did not report on the impact on patient-reported outcomes (PROs). This systematic review investigated the effect of weight loss interventions on weight loss and PROs in overweight and obese adults with T2D. We searched three electronic databases from inception to March 2018 for randomised controlled trials (RCTs) of weight loss interventions in overweight and obese (according to BMI) adults aged ≥ 18years reporting changes in PROs from baseline to at least one follow-up assessment during or post-intervention. One reviewer screened abstracts, performed data extraction, and conducted the narrative synthesis, with 25% cross-checking by a second reviewer. We extracted data relating to sample characteristics, intervention and comparison conditions, weight loss, and change in PROs. We identified 540 papers of which 23 met eligibility reporting on 19 RCTs. Four types of interventions (diet, surgery, pharmacological, and multi-component lifestyle interventions) significantly reduced weight. Weight loss was consistently associated with improvements in sexual and physical function across all intervention types, with diet and multi-component lifestyle interventions producing more substantial improvements than surgical or pharmacological interventions. Findings for other PROs, such as HRQOL and depressive symptoms, were inconsistent across studies and intervention types. The four weight loss interventions can be prescribed to engender weight loss in overweight and obese adults with T2D, with multi-component lifestyle interventions generating substantial improvements in physical and sexual function, perhaps due to the potency of exercise in improving PROs.

Association of overweight and obesity with obstructive sleep apnoea: A systematic review and meta-analysis

BackgroundResearch evidence suggests a close relationship between overweight and obesity with obstructive sleep apnoea (OSA); however, the extent of this relationship among different population groups is relatively unknown. The aim of this paper was to conduct a systematic review and meta-analysis to determine the magnitude of association of overweight and obesity with OSA in different population groups. MethodsWe searched five electronic databases (Medline, Embase, Cochrane Library, CBM and CNKI) from inception to December 2017 for comparative epidemiological studies assessing the relation between overweight and obesity with OSA. Studies were included if they reported OSA by polysomnography and overweight/obesity by body mass index. Two authors independently screened titles and abstracts, selected studies and extracted data. Study quality was assessed using the Newcastle-Ottawa Scale. Random effects meta-analysis was used to estimate pooled effect sizes with 95% confidence intervals (CI). Heterogeneity was examined using Cochrane's Q statistic and I2 test and explored using subgroup analyses for adults and children, adjusting for potential confounders. Publication bias was assessed using a funnel plot. ResultsTwelve case-control studies encompassing a total of 3214 participants (Obese group n = 773, Non-Obese group n = 315; OSA group n = 1742, Non-OSA group n = 384) were analyzed. Results showed that increased body mass index was associated with higher risk of OSA in the adult group. The Obese group was associated with increased risk of apnoea-hypopnoea index (AHI) compared to the Non-Obese group and the differences were statistically significant in both children (Mean Difference = 12.29; 95% CI 8.46–16.11; P < 0.00001) and adults (Mean Difference = 12.11; 95% CI 4.35–19.85; P = 0.002). ConclusionsThese findings suggest that overweight and obesity are important risk factors for OSA in both adults and children. Future studies are required to determine the effects of weight loss interventions in the development of obesity-related OSA.

Weight loss interventions for Hispanic women in the USA: a protocol for a systematic review

BackgroundIn the U.S., Hispanic women experience a disproportionate rate of obesity and obesity-related chronic diseases. At the same time, Hispanic women remain considerably underrepresented in behavioral weight loss interventions. The purpose of this review is to systematically evaluate the evidence related to the effectiveness of weight loss interventions among Hispanic women in the U.S. This review will identify elements of successful weight loss interventions as well as areas for future research.Methods/DesignThe following databases will be searched to identify all relevant articles (from inception onwards): PubMed, Embase, Scopus, Web of Science (Science Citation Index and Social Sciences Citation Index), PsycINFO, CINAHL, Chicano Database, SPORTDiscus, CAB s, and Google Scholar. We will include randomized controlled trials and quasi-experimental studies of adult women (> 18 years) from Hispanic/Latino background living in the United States. Eligible interventions will target weight-related behaviors (including diet, physical activity, behavior modification and/or their combinations). The review’s primary outcome will be weight change (expressed as change in lbs/kg or body mass index (BMI) (kg/m2)). Three reviewers will independently screen and select data and two will extract data. The methodological quality (or risk of bias) of individual studies will be appraised using the Effective Public Health Practice Project Quality Assessment Tool. A narrative synthesis will describe quality and content of the evidence.DiscussionThe aim of this systematic review is to critically examine existing weight loss interventions for Hispanic women in the U.S. and provide quality evidence for the effectiveness of these interventions on weight loss. Further, this review seeks to identify characteristics of effective interventions and suggest future directions for research efforts targeting weight loss in this population. This review will inform the development of future weight loss interventions for this population.Systematic review registrationPROSPERO CRD42019119094

Effectiveness of Weight Loss Interventions on Nonalcoholic Fatty Liver Disease

As there is no licensed pharmacologic therapy for the treatment of nonalcoholic fatty liver disease (NAFLD), clinical guidelines recommend counseling

Effects of Weight-Loss Interventions on Short-Chain Fatty Acid Concentrations in Blood and Feces of Adults: A Systematic Review

Short-chain fatty acids (SCFAs, mainly acetate, propionate, and butyrate), which are primarily derived from the gut microbiome, may exert anti-inflammatory and immunomodulatory effects, and regulate energy homeostasis. It has been suggested that weight loss may affect SCFA metabolism, but a systematic review of intervention studies is lacking. We aimed to systematically assess the effects of dietary, physical activity-based, and surgical weight-loss interventions among overweight [body mass index (BMI) 25-29.9kg/m2)] or obese (BMI ≥30kg/m2) adults (≥18 y) on concentrations of acetate, propionate, butyrate, and total SCFAs in blood, urine, or feces. We conducted a systematic literature search in PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to April 30, 2018 for randomized and nonrandomized weight-loss trials among overweight or obese adults, in which the concentrations of individual and total SCFAs were assessed. A total of 9 studies consisting of 2 randomized parallel-arm trials, 4 crossover trials, and 3 nonrandomized clinical or surgical trials were included. In the majority of studies, changes in fecal SCFA concentrations were assessed, whereas changes in serum SCFAs were reported from 1 trial. Individual and total SCFA concentrations either remained unchanged or decreased significantly following weight loss. Three of the dietary interventions that resulted in decreased SCFA concentrations were low (≤5% of energy) in total carbohydrates. Most of the studies had a high risk of bias. Decreases in SCFA concentrations may accompany weight loss induced by bariatric surgery or dietary restriction among overweight or obese adults, particularly when carbohydrate intake is reduced. However, findings were inconsistent and based on studies with high to unclear risk of bias, and small sample sizes. Because measurements of fecal SCFAs may not be ideal due to limited sample standardization, well-powered trials with repeated blood measurements of SCFAs are required. This review was registered at PROSPERO as CRD42018088716.

A systematic review and meta-analysis of the effectiveness of meal replacements for weight loss.

SummaryMeal replacements (MR) are generally not recommended in clinical guidelines for the management of obesity. The aim of this review is to provide an up‐to‐date systematic evaluation of the effect of weight loss interventions incorporating MR compared with alternative interventions on weight change at 1 year in adults with overweight or obesity. Six electronic databases were searched from inception to the end of August 2018 for randomized controlled trials comparing the effect of MR with interventions that did not include MR on weight at 1 year. We excluded studies using diets providing <3347 kJ/(800 kcal)/day and those which used total diet replacement (TDR) from this review. Risk of bias was assessed using the Cochrane risk of bias tool. Twenty‐three studies with 7884 adult participants were included. Six out of 23 studies were judged at low risk of bias across all domains, and 5/23 studies were judged at high risk of bias in at least one domain. Studies with similar intervention and comparators were grouped into five comparisons for analysis. Mean weight change at 1 year favoured the MR group relative to the control group in each comparison. In those comparisons where we conducted meta‐analysis, in people assigned to a diet incorporating MR, mean difference was −1.44 kg (−2.48 to −0.39 kg; I 2 = 38%) compared with alternative kinds of diets. In those assigned to a MR diet along with support, mean difference was −2.22 kg (−3.99 to −0.45, I 2 = 81%) compared with other diets with support and −3.87 kg (−7.34 to −0.40; I 2 = 60%) compared with other kinds of diet without support. In those assigned a MR diet with an enhanced level of support, mean difference was −6.13 kg (−7.35 to −4.91, I 2 = 19%) compared with alternative diets and regular support. Programmes incorporating meal replacements led to greater weight loss at 1 year than comparator weight loss programmes and should be considered as a valid option for management of overweight and obesity in community and health care settings.

Meta-analysis of the influence of lifestyle changes for preoperative weight loss on surgical outcomes.

The aim was to investigate whether preoperative weight loss results in improved clinical outcomes in surgical patients with clinically significant obesity. This was a systematic review and aggregate data meta-analysis of RCTs and cohort studies. PubMed, MEDLINE, Embase and CINAHL Plus databases were searched from inception to February 2018. Eligibility criteria were: studies assessing the effect of weight loss interventions (low-energy diets with or without an exercise component) on clinical outcomes in patients undergoing any surgical procedure. Data on 30-day or all-cause in-hospital mortality were extracted and synthesized in meta-analyses. Postoperative thromboembolic complications, duration of surgery, infection and duration of hospital stay were also assessed. A total of 6060 patients in four RCTs and 12 cohort studies, all from European and North American centres, were identified. Most were in the field of bariatric surgery and all had some methodological limitations. The pooled effect estimate suggested that preoperative weight loss programmes were effective, leading to significant weight reduction compared with controls: mean difference -7·42 (95 per cent c.i. -10·09 to -4·74) kg (P < 0·001). Preoperative weight loss interventions were not associated with a reduction in perioperative mortality (odds ratio 1·41, 95 per cent c.i. 0·24 to 8·40; I2 = 0 per cent, P = 0·66) but the event rate was low. The weight loss groups had shorter hospital stay (by 27 per cent). No differences were found for morbidity. This limited preoperative weight loss has advantages but may not alter the postoperative morbidity or mortality risk.

Energy balance and gastrointestinal cancer: risk, interventions, outcomes and mechanisms.

Obesity increases the risk of multiple gastrointestinal cancers and worsens disease outcomes. Conversely, strong inverse associations have emerged between physical activity and colon cancer and possibly other gastrointestinal malignancies. The effect of weight loss interventions - such as modifications of diet and/or physical activity or bariatric surgery - remains unclear in patients who are obese and have gastrointestinal cancer, although large clinical trials are underway. Human intervention studies have already shed light on potential mechanisms underlying the energy balance-cancer relationship, with preclinical models supporting emerging pathway effects. Central to interventions that reduce obesity or increase physical activity are pluripotent cancer-preventive effects (including reduced systemic and adipose tissue inflammation and angiogenesis, altered adipokine levels and improved insulin resistance) that directly interface with the hallmarks of cancer. Other mechanisms, such as DNA repair, oxidative stress and telomere length, immune function, effects on cancer stem cells and the microbiome, could also contribute to energy balance effects on gastrointestinal cancers. Although some mechanisms are well understood (for instance, systemic effects on inflammation and insulin signalling), other areas remain unclear. The current state of knowledge supports the need to better integrate mechanistic approaches with preclinical and human studies to develop effective, personalized diet and exercise interventions to reduce the burden of obesity on gastrointestinal cancer.

Effectiveness of Interventions for Weight Loss for People With Serious Mental Illness: A Systematic Review and Meta-Analysis.

We examined the effectiveness of weight loss interventions in community-based settings for people with serious mental illness (SMI). Four databases were searched for randomized controlled trials published in 2008 or later that met the criteria for the research question and used weight loss as an outcome measure. Data were extracted, and weight loss was analyzed using a meta-analysis. Similarities and differences in interventions were analyzed qualitatively. Seventeen studies and a total of 1,874 participants with various diagnoses of SMI were included in the meta-analysis. The various lifestyle-focused interventions had a significant effect on weight loss with an overall effect size of -0.308 (p < .001). Community-based interventions for people with SMI are effective for weight loss. Occupational therapists can be involved in the provision of weight loss interventions and in the development and study of intervention components that are most effective.

Effects of weight loss intervention on body composition and blood pressure among overweight and obese women: findings from the MyBFF@home study

BackgroundObesity is related to the increased incidence of hypertension and in healthy individuals, blood pressure changes with age and body mass. The aims of this paper were to evaluate the effectiveness of the weight loss intervention on body composition and blood pressure, and to evaluate the relationship between these factors among housewives in the MyBFF@home study.MethodsMyBFF@home intervention was a quasi-experimental study which involved 328 overweight and obese housewives aged 18–59 years old (Control group: 159, Intervention group: 169). Data of the control and intervention group (pre and post intervention who completed the body composition and blood pressure measurements were analysed. Body compositions were measured using the Body Impedance Analyser (InBody 720) and blood pressure (Systolic and Diastolic) was taken using the blood pressure monitoring device (Omron HEM 907) at baseline, 6 month and 12 month. Data analyses (Pearson’s correlation test and ANOVA) were performed and analysed using SPSS Statistics for Windows, version 22.0.ResultsVisceral fat area, fat mass and body fat percentage, were all significantly decreased in the intervention group compared to the control group after 6 month intervention (p < 0.05). Systolic blood pressure was reduced significantly by − 6.81 mmHg (95% CI: -9.72,-3.90; p < 0.01) in the intervention and by − 7.95 mmHg (95% CI: -11.69,-4.20; p < 0.01) in the control group after 6 month intervention. Diastolic blood pressure was significantly correlated with BMI (r = 0.19), waist circumference (r = 0.23), body fat mass (r = 0.22), body fat percentage (r = 0.18) visceral fat area (r = 0.22) and skeletal muscle mass (r = 0.14) with p < 0.05. At 12-month follow-up, no significant changes of blood pressure were detected in both groups.ConclusionThere were significant changes in the body fat and systolic blood pressure over 6 month among the participants in the intervention group compared to the control group. However, both groups were unable to sustain the positive changes in the body fats during the maintenance phase. There was a relationship between the body composition and blood pressure during the weight loss intervention and weight loss maintenance phase. Participation among obese housewives in a community-based intervention programme led to the improvements in blood pressure and body composition.

A New Deep Learning-Based Food Recognition System for Dietary Assessment on An Edge Computing Service Infrastructure

Literature has indicated that accurate dietary assessment is very important for assessing the effectiveness of weight loss interventions. However, most of the existing dietary assessment methods rely on memory. With the help of pervasive mobile devices and rich cloud services, it is now possible to develop new computer-aided food recognition system for accurate dietary assessment. However, enabling this future Internet of Things-based dietary assessment imposes several fundamental challenges on algorithm development and system design. In this paper, we set to address these issues from the following two aspects: (1) to develop novel deep learning-based visual food recognition algorithms to achieve the best-in-class recognition accuracy; (2) to design a food recognition system employing edge computing-based service computing paradigm to overcome some inherent problems of traditional mobile cloud computing paradigm, such as unacceptable system latency and low battery life of mobile devices. We have conducted extensive experiments with real-world data. Our results have shown that the proposed system achieved three objectives: (1) outperforming existing work in terms of food recognition accuracy; (2) reducing response time that is equivalent to the minimum of the existing approaches; and (3) lowering energy consumption which is close to the minimum of the state-of-the-art.

Effects of weight loss interventions for adults who are obese on mortality, cardiovascular disease, and cancer: systematic review and meta-analysis

Objective To assess whether weight loss interventions for adults with obesity affect all cause, cardiovascular, and cancer mortality, cardiovascular disease, cancer, and body weight.Design Systematic review and meta-analysis of randomised...

Efficacy of amultidisciplinary pulmonary rehabilitation outpatient program on exacerbations in overweight and obese patients with asthma.

Even though many studies have investigated the effectiveness of weight loss interventions, the efficacy of pulmonary rehabilitation (PR) has not yet been proven in obese patients with asthma. The aims of this study were to investigate the efficacy of PR on asthma exacerbations in the first year after PR and to evaluate the efficacy of PR in exercise capacity, quality of life, psychosocial symptoms and control of asthma in overweight patients. The exercise capacity, health-related quality of life scores, psychosocial symptoms, asthma control test (ACT) data, number of emergency admissions and hospitalizations of 35overweight patients with asthma who completed a1-year multidisciplinary PR program were recorded and analyzed. Of the participants 30 were female, the mean age was 45± 9years, 13 (37%) patients were overweight and 22 (63%) were obese. The average number of emergency admissions (from 1.2± 1.1 to 0.3± 0.8) and hospitalizations (from 0.6± 0.9 to 0.0± 0.1) decreased significantly 1 year after PR (both p<0.001). After PR, statistically significant improvements in exercise capacity as measured by the incremental shuttle walking test (ISWT) from 281± 104m to 339± 95m (p< 0.001), the endurance shuttle walking test (ESWT) from 13.3± 7.4min to 17.5± 4.5min (p= 0.005), quality of life measured by the St. George's respiratory questionnaire (SGRQ total from 64± 14 to 28± 10, p< 0.001), dyspnea sensation with the Medical Research Council (MRC) scale (from 2.6± 0.6 to 2.1± 0.4, p<0.001) and hospital anxiety depression scores (HADS, anxiety score from 9.9± 1.6 to 7.1± 2.1, depression score from 9.4± 1.9 to 7.2± 2.3, both p< 0.001) were found. A reduction in body mass index (BMI) was found in obese patients only, but the fat-free mass index (FFMI) improved in both overweight and obese patients (from 19.00± 1.90 to 19.45± 2.04, p= 0.01). The mean ACT score increased significantly (from 18 to 21points, p< 0.001). The number of patients with poorly controlled asthma decreased from 21 (60%) to 10 (28%). This study showed that comprehensive multidisciplinary PR was associated with adecreased number of emergency admissions and hospitalizations for asthma exacerbations in 1 year, and improvements of dyspnea sensation, quality of life, exercise capacity, and psychosocial status in overweight and obese patients.