Healthy Lifestyle Program Research Articles

Metabolic syndrome amongst adults in Jordan: prevalence, trend, and its association with socio-demographic characteristics

BackgroundMultiple epidemiological studies were conducted amongst a variety of ethnic groups and showed discrepancies in the prevalence of metabolic syndrome (MeS) and its individual components. This study aimed to determine the prevalence of MeS in Jordan using both the Adult Treatment Panel Guidelines (ATP III) and the International Diabetes Federation (IDF) criteria. The study also aimed to assess the changes in the prevalence of MeS over time and determine its association with sociodemographic variables.MethodsData from the 2017 Cardiovascular Disease Risk Factors Survey were used for this study. Socio-demographic and clinical data were collected using a structured questionnaire. Blood samples were taken for biochemical measurements. Furthermore, anthropometric characteristics were measured by the same team of trained field researchers. A sample of 4,056 individuals aged between 18 and 90 years was included in this study. The findings from the 2017 survey were compared with the findings of a 2009 survey that adopted the same methods and procedures.ResultsAccording to the IDF criteria, the crude prevalence of Metabolic syndrome was 48.2% (52.9% among men and 46.2% among women; p < 0.001). Using the ATP III criteria, the prevalence was 44.1% (51.4% among men and 41% among women, p < 0.001). The age-standardized prevalence rate of metabolic syndrome was 44% (95% CI 42.7, 45.4) and 39.9% (95% CI 39.6, 41.2), according to both the IDF definition and ATP III criteria, respectively. The Kappa measure of agreement showed excellent agreement between the two definitions (k = 81.9%, p < 0.001). Of all participants, 41.7% met both the IDF and ATP III diagnostic criteria, 6.6% met the IDF criteria only, and 2.5% met the ATP III criteria only. The age-standardized prevalence rate of metabolic syndrome was significantly higher in 2017 (45.7% in men and 44.5% in women) than that in 2009 survey (34.6% in men and 39.8% in women). Gender, age, occupation, region, and marital status were significantly associated with metabolic syndrome.ConclusionsThe prevalence of metabolic syndrome in Jordan is considerably high and it is increasing. Healthy lifestyle programs encouraging appropriate dietary habits and physical activity are strongly recommended in Jordan.

Abstract 15269: Baseline Relationships of Walking, Physical Activity Habits and Self-perceived Recovery After Stroke in People Engaged in a Healthy Lifestyle Program

Introduction: Recovery of walking is an important goal for people after stroke and is linked with acquiring secondary conditions deleterious to health. Our purpose was to assess the baseline relationships between walking performance, physical activity habits and self-perceived recovery after stroke in people engaged in a healthy lifestyle program. Hypothesis: We hypothesized that walking performance would be strongly related to self-reported stroke recovery and physical activity habits. Methods: Community dwelling adults at least 12 months post-stroke with a body mass index (BMI) of 25 or greater were recruited to participate in a healthy lifestyle program adapted for people with stroke. Baseline measures of walking performance [10-meter walk test (10MWT); 6-minute walk test (6MWT)] and self-reported outcomes [Self-Report Habits Index (SRHI); Stroke Impact Scale (SIS)] were correlated. Results: Adults (34 male, 31 female; 64.6% scored as having some disability on the Modified Rankin Scale) aged 57.9±12.8 years with a BMI of 33.0±5.9 and median of 3 years post-stroke participated. 10MWT walking speed was 1.0±0.4m/s and 6MWT distance walked was 343.3±132.3m. SRHI physical activity scores of 4.6±1.7 (above average habit formation; scale = 1 - 7) and SIS subscales ADL/IADL and mobility normed scores of -0.1±0.7 and -1.3±0.8 respectively, and perceived recovery of 70.9±16.9% were reported. The 10MWT was significantly and moderately correlated with SIS ADL/IADL (r=0.48; p&lt;0.001) and mobility (r=0.41; p&lt;0.001), but weakly with SIS perceived recovery (r=0.34; p&lt;0.01) and SRHI physical activity (r=-0.32; p&lt;0.01). The 6MWT was significantly and moderately correlated with SIS ADL/IADL (r=0.48; p&lt;0.001) and mobility (r=0.47; p&lt;0.001), but weakly with SIS perceived recovery (r=0.33; p&lt;0.01) and SRHI physical activity (r=-0.33; p&lt;0.01). Conclusions: Walking performance among our participants post-stroke was consistent with community dwelling adults, but only somewhat related to their perception of recovery of function and mobility. Additional factors beyond perceived recovery likely contribute to walking abilities post-stroke.

BERLATIH DIRI DENGAN POLA HIDUP SEHAT SEJAK DINI

This healthy lifestyle training activity is intended for students around the Perumahan Polda-Bhayangkara Buper Distrik Heram Kota Jayapura Propinsi Papua. Healthy lifestyle training activities are intended for students because they are easier to train a healthy lifestyle from an early age. By knowing healthy behavior from an early age, the trainees will be easier to do it from the beginning so that the formation of healthy behaviors is more easily achieved. The focus of this activity is focused on healthy lifestyle material through eating, drinking, hand washing and bathing. There were twenty school children around this housing complex who participated in this activity. This activity is carried out for three days. Material about health, especially the benefits of hand washing, healthy food, healthy drinks and the benefits of regular and clean baths. Also carried out in this activity is practice and guidance on how to wash your hands properly with cleansing soap. Healthy eating and drinking activities are also carried out along with a menu of bolu cakes, green beans, pudding and milk. At the end of the training there were tools for brushing teeth, toothpaste, notebooks and stationery for them. Through this healthy lifestyle training program the participants gained insight into doing a healthy lifestyle, practiced some healthy behaviors and got a tooth brushing tool. The hope is that by practicing some of these healthy behaviors during the training, these can be continued in daily life with the support of various parties, especially in their family.Keywords: Healthy lifestyle, training, students, Jayapura, Papua

Challenges of making healthy lifestyle changes for families in Aotearoa/New Zealand.

The objective of the current study was to identify challenges of making and sustaining healthy lifestyle changes for families with children/adolescents affected by obesity, who were referred to a multicomponent healthy lifestyle assessment and intervention programme in Aotearoa/New Zealand (NZ). Secondary qualitative analysis of semi-structured interviews. Taranaki region of Aotearoa/NZ. Thirty-eight interviews with parents/caregivers (n 42) of children/adolescents who had previously been referred to a family-focused multidisciplinary programme for childhood obesity intervention, who identified challenges of making healthy lifestyle changes. Participants had varying levels of engagement, including those who declined contact after their referral. Participant-identified challenges included financial cost, impact of the food environment, time pressures, stress, maintaining consistency across households, independence in adolescence, concern for mental health and frustration when not seeing changes in weight status. Participants recognised a range of factors that contributed towards their ability to make and sustain change, including factors at the wider socio-environmental level beyond their immediate control. Even with the support of a multidisciplinary healthy lifestyle programme, participants found it difficult to make sustained changes within an obesogenic environment. Healthy lifestyle intervention programmes and families' abilities to make and sustain changes require alignment of prevention efforts, focusing on policy changes to improve the food environment and eliminate structural inequities.

Development and Usability Evaluation of a Healthy Lifestyle Coaching Chatbot Using a Habit Formation Model.

ObjectivesIt is crucial to find ways to fit regular exercise into the daily lives of office workers. Non-exercise activity thermogenesis has been introduced as an effective form of daily exercise. This study aimed to develop a healthy lifestyle coaching program for office workers, to be delivered using a messenger application.MethodsThe interface was developed using KakaoTalk and Plus Friend. Performance feedback was developed using the IBM Watson conversation program. Twenty office workers used the application for three weeks. Afterward, a survey was conducted to assess the usability of and participants’ satisfaction with the application.ResultsThe application delivered customized push alarms, provided information related to habit formation, allowed for one-on-one chats, and delivered rewards. The satisfaction measurement results for the application showed that extrinsic reward factors contributed the most to the performance of the activity, followed by reminders and intrinsic rewards. Regarding the usability test, the perceived usefulness of the Healthy Lifestyle Coaching Chatbot was highest, followed by the usage intent and the perceived ease of use.ConclusionsThis study found that coaching programs using chatbots can improve the effectiveness of performing simple, repetitive exercises.

Improving health-related quality of life and adherence to health-promoting behaviors among coronary artery bypass graft patients: a non-randomized controlled trial study.

This study aimed to determine the impact of a healthy lifestyle empowerment program on health-related quality of life and adherence to health-promoting behaviors in coronary artery bypass graft patients. This non-randomized controlled trial was conducted in 2019 on 97 coronary artery bypass graft patients in Iran. Participants were selected by culturally pragmatic and non-randomized method and assigned to healthy lifestyle empowerment program group (HLEPG) (n = 49) and conventional education group (CEG) (n = 48). Data were collected by the 12-item short-form health survey (SF-12) and health-promoting lifestyle profile II (HPLP2), which were administered at baseline and three-month follow-up. The healthy lifestyle empowerment program and conventional education as two interventions were performed for HLEPG and CEG, respectively. Data analysis was performed using the paired t-test, independent t-test, analysis of covariance and linear mixed method at the 0.05 significance level. In the follow-up, both groups showed a significant increase in the mean score of health-related quality of life (p ≤ 0.001) but this increase was visibly greater in the HLEPG (from 23.47 ± 7.48 to 35.60 ± 5.95) than in the CEG (from 22.93 ± 5.93 to 27.6 ± 4.90). The healthy lifestyle empowerment program also significantly increased the mean score of adherence to health-promoting behaviors in the HLEPG (p ≤ 0.001), whereas no such change was observed in the CEG. The results of the linear mixed model showed that the follow-up scores health-related quality of life and adherence to health-promoting behaviors of the HLEPG were 27.26 and 7.56 units significantly greater than the CEG after HLEP, respectively (p < 0.001). Considering the results of this study, health care providers are recommended to devise and implement healthy lifestyle empowerment programs to improve the health-related quality of life of coronary artery bypass surgery patients. Registered at Iranian Registry of Clinical Trials (IRCT20171213037860N1).

Students’ Reflections on an Experiential Learning Rotation With the Peer-Education About Weight Steadiness Club Program

Overview. Experiential learning has become a common pedagogical approach to provide university students an opportunity to apply classroom-acquired knowledge and skills in real-world settings. Evaluation of such experiences from a student perspective is needed to improve experiential learning opportunities offered in higher education settings. Purpose. The purpose of this qualitative study was to evaluate the experience of 13 university students who rotated with a healthy lifestyle program for middle schoolers. Method. The Peer-education About Weight Steadiness Club program was implemented by peer or adult educators, as a healthy lifestyle after-school intervention. Trainees participated in a learning rotation with the program for 16 weeks and were exposed to research coordination and implementation of the nutrition and healthy lifestyles program. After finishing their rotation, trainees completed a structured elicitation interview conducted by a faculty member and a graduate assistant. The 11-question individual elicitation interview, ranging from 16 to 40 minutes, queried trainees on elements of the learning experience. A grounded theory approach was used to guide data coding and analyses, which led to formulation of themes. Results. Forty codes were assigned to segments of the interview responses, which were then coalesced to formulate six themes and 16 subthemes. Identified themes include (1) program context, (2) roles and responsibilities of trainees, (3) professional development of trainees, (4) overall program implementation, (5) factors influencing implementation, and (6) health and behavioral outcomes. Conclusions. Student trainees gained program content knowledge, acquired skills transferable to their careers, valued this learning experience, and planned to apply lessons learned.

Barriers and facilitators in implementing a pilot, pragmatic, telemedicine-delivered healthy lifestyle program for obesity management in a rural, academic obesity clinic

PurposeFew evidence-based strategies are specifically tailored for disparity populations such as rural adults. Two-way video-conferencing using telemedicine can potentially surmount geographic barriers that impede participation in high-intensity treatment programs offering frequent visits to clinic facilities. We aimed to understand barriers and facilitators of implementing a telemedicine-delivered tertiary-care, rural academic weight-loss program for the management of obesity.MethodsA single-arm study of a 16-week, weight-loss pilot evaluated barriers and facilitators to program participation and exploratory measures of program adoption and staff confidence in implementation and intervention delivery. A program was delivered using video-conferencing within an existing clinical infrastructure. Elements of Consolidated Framework for Implementation Research (CFIR) provided a basis for assessing intervention characteristics, inner and outer settings, and individual characteristics using surveys and semi-structured interviews. We evaluated elements of the RE-AIM model (reach, adoption) to assess staff barriers to success for future scalability.FindingsThere were 27 patients and 8 staff completing measures. Using CFIR, the intervention was valuable from a patient participant standpoint; staff equally had positive feelings about using telemedicine as useful for patient care. The RE-AIM framework demonstrated limited reach but willingness to adopt was above average. A significant barrier limiting sustainability was physical space for intervention delivery and privacy and dedicated resources for staff. Scheduling stressors were also a challenge in its implementation.ConclusionsThe need to engage staff, enhance organizational culture, and increase reach are major factors for rural health obesity clinics to enhance sustainability of using telemedicine for the management of obesity.Trial registrationClinicaltrials.gov NCT03309787. Registered on 16 October 2017.

Results of the 3 Pillars Study (3PS), a relationship-based programme targeting parent-child interactions, healthy lifestyle behaviours, and the home environment in parents of preschool-aged children: A pilot randomised controlled trial.

BackgroundEarly childhood is a critical period for the development of obesity, with new approaches to prevent obesity in this age group needed. We designed and piloted the 3 Pillars Study (3PS), a healthy lifestyle programme informed by attachment theory for parents of preschool-aged children.MethodsA 2-arm, randomised controlled pilot study was conducted to assess the effectiveness of 3PS, a 6-week programme involving a half-day workshop plus 6-week access to a study website. The programme was designed to promote routines around healthy lifestyle behaviours, including sleep, limited screen use, and family meals, within the context of positive, reciprocal parent-child interactions. Parents (n = 54) of children aged 2–4 years who regularly exceeded screen use recommendations (≥1 hour per day), were randomised to the 3PS programme (n = 27) or a wait-list control group (n = 27). Child screen time at 6 weeks was the primary endpoint. Frequency of family meals, parent feeding practices, diet quality, sleep, Child Routine Inventory (to assess predictability of commonly occurring routines), and household chaos were also assessed. Study data were collected online at baseline, 6 weeks, and 12 weeks via REDCap.ResultsNo group differences were observed for changes from baseline in screen time (primary endpoint), feeding behaviour scores, Child Routine Inventory scores, or total night time sleep duration at 6 and 12 weeks, although all measures improved in the hypothesised direction in the 3PS group. Compared with controls, the intervention group demonstrated significant improvements from baseline in household chaos scores (i.e. a reduction in chaos) and a number of measures of sleep outcomes, indicating improved sleep continuity. The programme was highly acceptable to parents.Conclusions and recommendationsA relational approach appears promising as a novel way to promote healthy lifestyle behaviours associated with the prevention of childhood obesity in children aged 2–4 years. A larger study is warranted.

Determining barriers and facilitators to engagement for families in a family-based, multicomponent healthy lifestyles intervention for children and adolescents: a qualitative study

ObjectivesRecruitment and retention in child and adolescent healthy lifestyle intervention services for childhood obesity is challenging, and inequalities across social groups are persistent. This study aimed to understand the barriers...

Workplace nutrition habits in Slovenian small and middle sized enterprises

Abstract Background Premature death, chronic diseases, productivity loss and other social and economic concerns can be influenced by healthy lifestyle workplace promotion programs, including healthy nutrition habits. In Slovenia a project called &amp;gt;&amp;gt;STAR-VITAL-healthy ageing at workplace &amp;lt;&amp;lt; has been going on since September 2017. Methods The survey results are based on an analysis of 805 respondents from 20 different small and middle sized enterprises in Slovenia. The survey was carried out via both a paper questionnaire and an online survey during the period from June 2019 to February 2020. The screening questionnaire was completed before interventions. We estimated the average score for the eight questions concerning nutritional habits. Results Nutritional habits are the following: 62% respondents eat three or more meals a day, 64% respondents eat vegetables each day, 59,8% respondents eat fruits each day, 31,9% respondents eat fish or see fruits at least once a week, 45,7% respondents eat whole wheats at least once a week, 54,1% respondents eat red meat not more than twice a week, 62,1% respondents eat fried food not more than three times a month and 79,1% respondents drink sweet drinks less than three times a week. The results on question &amp;gt;&amp;gt;What is the most common form of meal you eat while at work? &amp;lt;&amp;lt; are the following: purchase meal at restaurant 45,3%, bring from home 32,7%, delivery/carry out 6,2%, do not eat 5,2%, other 4,7%, employer cafeteria 3,9% and vending machine 1,2%. Conclusions The results of our survey show that a significant percentage of the workers in Slovenia still has unhealthy nutritional habits. Assessment of nutritional habits before workplace promotion program interventions allow us to compare which combinations of interventions are the most effective. The results will indicate the strength and weakness of each intervention and how it could be improved. Key messages The population is growing old and chronic diseases increases, which is part of the bad nutritional habits. Healthy lifestile promotion is needed to improve quality of life. The workplace health promoting programs have been shown to be an efficient way of improving workerś health. Implementing promotional program of nutritional habits are proper for Slvenian enterprises.

Validation of a health promotion leadership self-efficacy measure in Jewish and Palestinian women

Abstract Background Health promotion (HP) leadership training is necessary to optimize health promotion in all sectors of society, and as in all interventions, there is a need for a measure to assess the effectiveness of leadership training and leadership self-efficacy. The current study aims to validate a 13-item self-report scale for use in health promotion leadership programs. The scale, in Hebrew and Arabic versions, assesses health-promotion leadership skills and self-efficacy (HPLSES). Methods Data for the Hebrew scale were collected as part of a leadership training program for women in Jerusalem and Beer Sheva workplaces (n = 38). The Arabic scale was administered as part of a healthy lifestyle and leadership training program conducted in community centers in East Jerusalem (n = 155). Data for both scales were collected at baseline and 6 months post-intervention. Validation of scales included a panel of experts to assess content validity, Cronbach's alpha to assess internal validity, and structural equation modeling (SEM) to assess construct validity. A specific model was designed to test predictive validity for both communities. Results Content validity was confirmed by a panel of experts. Preliminary correlation analysis between the instrument items showed high correlations for both time periods, which suggested difficulties in building distinct dimensions. Preliminary confirmatory models using exploratory/confirmatory models for the13 items showed reasonable loadings (Loading&amp;gt;0.65). We obtained acceptable goodness-of-fit to the empirical data (Cronbach's alpha=0.90). Conclusions This scale demonstrated acceptable content, internal and construct validity for addressing leadership self-efficacy. It can be used in the evaluation of HP leadership training. Caution is advised in generalizing the results for the Jewish sample given the small sample size. Key messages This scale has been validated as a measure for assessing leadership self-efficacy. The scale can be used in evaluation of health promotion leadership trainings for the same population.

Physical Activity and Physical Competence in Overweight and Obese Children: An Intervention Study.

With the current obesity epidemic and the decline of fitness among school-aged children, the importance of obesity interventions to promote physical activity and healthy habits has become indisputable. The purpose of this study was to assess the efficacy of a school-based multicomponent intervention in increasing physical activity (PA) levels, actual physical abilities, and perceived physical abilities in clinical and nonclinical samples of overweight/obese boys and girls aged 10–12 years. The clinical intervention group (n = 35) participated in a 7-month after-school program in addition to curricular physical education lessons, while the nonclinical control group (n = 29) received usual curricular lessons. Measures included levels of PA and fitness and individual’s perceptions of physical ability. After treatment, the intervention group showed improved PA levels, perceived physical ability, and throwing and jumping task performances compared to the control group. Results indicate that a multicomponent program can improve levels of PA, fitness, and perceived competence of overweight participants. Findings highlight the importance of a comprehensive healthy lifestyle program that includes physical, psychosocial, and behavioral factors and suggest practical implications for educators, trainers, and teachers in identifying best practices targeting childhood obesity.

THE PUBLIC AWARENESS OF OVERWEIGHT AND OBESITY AS A RISK FACTOR FOR CARDIOVASCULAR DISEASES

The cardiovascular pathology is a leading condition in the structure of clinical cases associated with overweight and obesity: more than two-thirds of cardiovascular mortality cases: annually, four million deaths worldwide are associated with a high body mass index (BMI). The awareness among the unorganized population aged from 20 to 82 years in the total number of 280 people was assessed. During the study it was found that overweight and obesity are quite common both among women (20.71 and 16.78%) and men (33.22% and 11.79%, respectively). Among the examined patients, an elevated blood pressure and various changes of the electrocardiogram were detected, of which left ventricular hypertrophy was observed in 57%, which is not only a compensatory reaction, but one of the most important independent factors for the cardiovascular risk. All respondents were offered to attend the Health Promotion School providing the educational program for prevention and correction of the main risk factors for obesity and heart diseases. The principle objective of this program was a change of lifestyle with a primary focus on patients with CVD, increased e physical activity and change of the quality of the diet rather than restricting its caloric value. The second survey was conducted in 6 months and the findings are as follows: BMI was corrected among overweight and obese female patients (14.22 and 13.57%), as well as among male patients (23.21% and 7.5%, respectively), thereby reducing the risk for cardiovascular diseases. The public awareness regarding the risk factors for cardiovascular diseases is considered to be low. Maintaining a healthy lifestyle, rational nutrition and educational program activities are the measures for management of overweight and obese patients resulting in reduction of the risk for cardiovascular diseases.

Exploring Black Girls' Recommendations for Healthy Lifestyle Interventions to Address Obesity.

Objective This mixed-methods study investigated Black girls' (N = 15) definitions of health and reports on socio-ecological factors that influenced health attitudes, beliefs, and behaviors. Participants were surveyed about their emotional health, body image, experiences of discrimination, and eating patterns. Methods Directed content analysis was used to identify themes, categories, and capture the depth of information conveyed. The study also used the Nominal Group Technique to elicit recommendations about intervention content, structure, and facilitation of a healthy lifestyle program targeting Black girls. Participants represented various ethnic backgrounds, ranged in age from 14 to 17 years (M = 16), and were in the ninth and 10th grades. Participants also represented a specific sample of Black adolescent girls who are medically categorized as obese. Results Findings indicated that Black girls use an intersectional (race-gender) lens to frame their definitions of health and inform health-related behaviors. Recommendations for obesity interventions targeting Black girls include leveraging time during school to deliver services, intentional selection of program facilitators to include race-gender similarities, and professionals trained to work with adolescents. Additionally, considerations for provider-patient interactions include the use of nonstigmatizing language and direct communication. Conclusion Findings serve to address the paucity of culturally responsive interventions targeting Black girls' health. Implications include enhancement of program retention and sustained engagement to facilitate effective treatment outcomes and address the disparity in the prevalence of obesity. In doing so, there is a potential to reduce health disparities associated with increased weight as Black girls' transition into adulthood.

Willingness to pay for a telemedicine-delivered healthy lifestyle programme

Introduction Effective weight-management interventions require frequent interactions with specialised multidisciplinary teams of medical, nutritional and behavioural experts to enact behavioural change. However, barriers that exist in rural areas, such as transportation and a lack of specialised services, can prevent patients from receiving quality care. Methods We recruited patients from the Dartmouth-Hitchcock Weight & Wellness Center into a single-arm, non-randomised study of a remotely delivered 16-week evidence-based healthy lifestyle programme. Every 4 weeks, participants completed surveys that included their willingness to pay for services like those experienced in the intervention. A two-item Willingness-to-Pay survey was administered to participants asking about their willingness to trade their face-to-face visits for videoconference visits based on commute and copay. Results Overall, those with a travel duration of 31–45 min had a greater willingness to trade in-person visits for telehealth than any other group. Participants who had a travel duration less than 15 min, 16–30 min and 46–60 min experienced a positive trend in willingness to have telehealth visits until Week 8, where there was a general negative trend in willingness to trade in-person visits for virtual. Participants believed that telemedicine was useful and helpful. Conclusions In rural areas where patients travel 30–45 min a telemedicine-delivered, intensive weight-loss intervention may be a well-received and cost-effective way for both patients and the clinical care team to connect.

Increased dairy product consumption as part of a diet and exercise weight management program improves body composition in adolescent females with overweight and obesity-A randomized controlled trial.

Exercise can improve body composition in adolescents and adults with overweight/obesity. Consumption of dairy foods, as part of a healthy lifestyle program, can also promote favourable body composition changes in adults with overweight/obesity. However, the few studies examining these combined effects on body composition in adolescents are inconclusive. To determine whether increased dairy product consumption, as part of a lifestyle modification program featuring exercise training and dietary guidance promotes favourable body composition changes in adolescent females with overweight/obesity. Fifty-four participants (age: 14.8 ± 2.2y; BMI percentile: 95th ± 6) assigned to three groups completed the study. There were two experimental groups: recommended dairy (RDa; n = 24) and low dairy (LDa; n = 22), and a no-intervention control group (Con; n = 8). RDa and LDa participated in a 12-week, eucaloric, lifestyle modification intervention consisting of mixed-mode exercise (3x/week), and nutritional counselling. RDa was provided 4 servings/day of dairy foods, while LDa and Con maintained habitually low intakes (0-2 servings/day). Body weight/composition, waist/hip circumference, cardiovascular fitness and food intake were assessed at weeks 0 and 12. Weight did not significantly change in any group. RDa significantly decreased fat mass (FM) and increased lean mass (LM) more than LDa and Con (FM: -1.3 ± 2.1 kg, -1.1 ± 2.0 kg, 0.8 ± 1.8 kg; LM: 1.5 ± 1.9 kg, 0.7 ± 1.6 kg, 0.5 ± 1.4 kg, respectively). LDa also significantly decreased FM and increased LM more than Con (P < .005; all interactions). The inclusion of dairy foods in the diet of adolescent females with overweight/obesity, as part of a diet and exercise intervention, favourably improves body composition in the absence of weight loss.

Primary Outcomes of a Healthy Lifestyle Interventions for Latino Families

Latinos, especially children, are disproportionately affected by obesity. Sanos y Fuertes is a community-based, participatory research project that created a culturally resonant, bilingual, healthy lifestyle intervention for Latinos in California. Results of the program for families are presented. Methods: The sample consisted of 390 Latino families with at least one 2 to 8-year-old child. Confidential, self-report, paper-and-pencil surveys and objective anthropometrics were assessed. Paired sample t-tests evaluated changes between baseline-to-follow-up assessments. Results: A significant decrease was observed in children’s percent body fat, but not in adults. Improvements were found in adult knowledge, frequency of food label use and serving MyPlate portions. Adult frequency of breakfast, fruit, and vegetable intake increased, while frequency of sugary beverage intake decreased. Concomitant increases in parent-reported frequencies of children’s intake of breakfast, fruits, and vegetables were observed along with a less frequent intake of sugary beverage. Conclusion: Sanos y Fuertes is a promising, short-term healthy lifestyle education program which may lower obesity risk among Latino families. Replication in a randomized controlled trial is needed to establish its effectiveness among diverse Latino populations.

The Prevalence of Metabolic Syndrome in Iranian Firefighters

Background: Metabolic syndrome (MetS) is closely related to the risk of cardiovascular disease (CVD), particularly in stressful occupations. Firefighting is a hazardous profession and is associated with high metabolic risk. However, limited studies on firefighters are available. Objectives: This study aimed to determine the prevalence of MetS among firefighters in Zahedan city, Iran. Methods: This cross-sectional study was performed on 140 firefighters (age range, 16 - 55 years) employed at the fire department in Zahedan city, southeast Iran. Anthropometric characteristics and metabolic risk parameters, including blood pressure (BP), fasting blood sugar (FBS), and lipid profile were measured, and the prevalence of metabolic syndrome was assessed based on National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Results: MetS was presented in 47 (33.6%) of the firefighters. Among the metabolic risk factors, abdominal obesity (87.1%), low-high density lipoprotein (HDL-C) (62.1%), and hypertriglyceridemia (61.4%) were more prevalent. Moreover, a significant increasing trend was found with increasing age and work experience (both, P = 0.05). However, no significant differences were found for the remaining metabolic risk factors. Conclusions: The findings showed that about one-third of the firefighters had MetS. Age, abdominal obesity, and dyslipidemia were independent risk factors for MS in the firefighters. Thus, efforts should be undertaken to implement healthy lifestyle promotion programs for firefighters.

Efficacy of Three Low-Intensity, Internet-Based Psychological Interventions for the Treatment of Depression in Primary Care: Randomized Controlled Trial.

BackgroundPrimary care is a major access point for the initial treatment of depression, but the management of these patients is far from optimal. The lack of time in primary care is one of the major difficulties for the delivery of evidence-based psychotherapy. During the last decade, research has focused on the development of brief psychotherapy and cost-effective internet-based interventions mostly based on cognitive behavioral therapy (CBT). Very little research has focused on alternative methods of treatment for depression using CBT. Thus, there is a need for research into other therapeutic approaches.ObjectiveThis study aimed to assess the effectiveness of 3 low-intensity, internet-based psychological interventions (healthy lifestyle psychoeducational program [HLP], focused program on positive affect promotion [PAPP], and brief intervention based on mindfulness [MP]) compared with a control condition (improved treatment as usual [iTAU]).MethodsA multicenter, 4-arm, parallel randomized controlled trial was conducted between March 2015 and March 2016, with a follow-up of 12 months. In total, 221 adults with mild or moderate major depression were recruited in primary care settings from 3 Spanish regions. Patients were randomly distributed to iTAU (n=57), HLP (n=54), PAPP (n=56), and MP (n=54). All patients received iTAU from their general practitioners. The main outcome was the Spanish version of the Patient Health Questionnaire-9 (PHQ-9) from pretreatment (time 1) to posttreatment (time 2) and up to 6 (time 3) and 12 (time 4) months’ follow-up. Secondary outcomes included the visual analog scale of the EuroQol, the Short-Form Health Survey (SF-12), the Positive and Negative Affect Schedule (PANAS), and the Pemberton Happiness Index (PHI). We conducted regression models to estimate outcome differences along study stages.ResultsA moderate decrease was detected in PHQ-9 scores from HLP (β=–3.05; P=.01) and MP (β=–3.00; P=.01) compared with iTAU at posttreatment. There were significant differences between all intervention groups and iTAU in physical SF-12 scores at 6 months after treatment. Regarding well-being, MP and PAPP reported better PHI results than iTAU at 6 months post treatment. PAPP intervention significantly decreased PANAS negative affect scores compared with iTAU 12 months after treatment.ConclusionsThe low-intensity, internet-based psychological interventions (HLP and MP) for the treatment of depression in primary care are more effective than iTAU at posttreatment. Moreover, all low-intensity psychological interventions are also effective in improving medium- and long-term quality of life. PAPP is effective for improving health-related quality of life, negative affect, and well-being in patients with depression. Nevertheless, it is important to examine possible reasons that could be implicated for PAPP not being effective in reducing depressive symptomatology; in addition, more research is still needed to assess the cost-effectiveness analysis of these interventions.Trial RegistrationISRCTN Registry ISRCTN82388279; http://www.isrctn.com/ISRCTN82388279International Registered Report Identifier (IRRID)RR2-10.1186/s12888-015-0475-0