Lifestyle Change Interventions Research Articles

An expert consensus on the most effective components of integrated motivational interviewing and cognitive behavioural therapy for lifestyle behaviour change: protocol for an online modified Delphi study

IntroductionBehaviour change interventions are advocated as a key approach to manage behavioural risk factors such as insufficient physical activity, poor diet and smoking. Integrated motivational interviewing and cognitive behavioural therapy...

Impact of a post-lifestyle modification program in circulating angiopoietin-like proteins in Arab adolescents

This study investigated the differences and associations between serum levels of angiopoietin-like (ANGPTL)3, ANGPTL4, and ANGPTL8 in Saudi adolescents with varying levels of obesity and glycemia before and after undergoing a 12-month lifestyle change intervention. A total of 218 Saudi adolescents (45 normal, 77 overweight, and 96 obese) (mean age = 15.1 ± 1.5 years; mean BMI = 35.1 ± 6.6 kg/m2) were included. Anthropometrics were measured at baseline and follow-up. Overnight-fasting serum samples were also collected at baseline and after 12 months of intervention for routine analysis of fasting glucose, glycated hemoglobin (HbA1c) and lipid profile. Serum levels of insulin and ANGPTLs were assessed using commercial assays. At baseline, obese children had a higher ANGPTL8 level [0.7 ng/ml (0.4–1.3), p = 0.03]. In children with prediabetes (defined as those with HbA1c > 5.7), ANGPTL8 levels and HbA1c were significantly lower post-intervention [0.2 (0.1–0.8), p = 0.002; 5.5 ± 1.1), p < 0.001, respectively]. Follow-up lipid profile and insulin levels were significantly higher in all participants with prediabetes and obesity (p-values < 0.05). ANGPTL8 levels of those who achieved 5 % weight loss (N = 25) showed no difference after follow-up (p = 0.59). In conclusion, following a 12-month lifestyle modification program, decreased levels of circulating ANGPTL8 were observed in adolescents with obesity and prediabetes. Consequently, the degree of insulin resistance may be improved by reducing reduced ANGPTL8 levels.

The blood pressure postpartum (BP2) RCT: Testing utility of structured follow-up and lifestyle behaviour change interventions in the first 12 months following hypertensive pregnancy

The blood pressure postpartum (BP2) RCT: Testing utility of structured follow-up and lifestyle behaviour change interventions in the first 12 months following hypertensive pregnancy

Weight Loss in Short-Term Interventions for Physical Activity and Nutrition Among Adults With Overweight or Obesity: A Systematic Review and Meta-Analysis.

Reaching, enrolling, and retaining participants in lengthy lifestyle change interventions for weight loss is a major challenge. The objective of our meta-analysis was to investigate whether lifestyle interventions addressing nutrition and physical activity lasting 6 months or less are effective for weight loss. We searched for peer-reviewed studies on lifestyle change interventions of 6 months or less published from 2012 through 2023. Studies were screened based on inclusion criteria, including randomized controlled trials (RCTs) for adults with overweight or obesity. We used a random-effects model to pool the mean difference in weight loss between intervention and control groups. We also performed subgroup analyses by intervention length and control type. Fourteen RCTs were identified and included in our review. Half had interventions lasting less than 13 weeks, and half lasted from 13 to 26 weeks. Seven were delivered remotely, 4 were delivered in person, and 3 used combined methods. The pooled mean difference in weight change was -2.59 kg (95% CI, -3.47 to -1.72). The pooled mean difference measured at the end of the intervention was -2.70 kg (95% CI, -3.69 to -1.71) among interventions lasting less than 13 weeks and -2.40 kg (95% CI, -4.44 to -0.37) among interventions of 13 to 26 weeks. Short-term multicomponent interventions involving physical activity and nutrition can achieve weight loss for adults with overweight or obesity. Offering short-term interventions as alternatives to long-term ones may reach people who otherwise would be unwilling or unable to enroll in or complete longer programs.

Epicardial Adipose Tissue: A Precise Biomarker for Cardiovascular Risk, Metabolic Diseases, and Target for Therapeutic Interventions.

Epicardial adipose tissue (EAT) is located between the heart muscle and visceral pericardium, where it has direct contact with coronary blood vessels. Elevated thickness of this tissue can induce local inflammation affecting the myocardium and the underlying coronary arteries, contributing to various cardiovascular diseases such as coronary artery disease, atrial fibrillation, or heart failure with preserved ejection fraction. Recent studies have identified EAT thickness as a simple and reliable biomarker for certain cardiovascular outcomes. Examples include the presence of atherosclerosis, incident cardiovascular disease (CVD) in individuals with type 2 diabetes mellitus (T2DM), and the prevalence of atrial fibrillation. Furthermore, EAT measurements can help to identify patients with a higher risk of developing metabolic syndrome. Since the EAT thickness can be easily measured using echocardiography, such examinations could serve as a useful and cost-effective preventive tool for assessing cardiovascular health. This review also summarizes therapeutical interventions aimed at reducing EAT. Reducing EAT thickness has been shown to be possible through pharmacological, surgical, or lifestyle-change interventions. Pharmaceutical therapies, including thiazolidinediones, glucagon-like peptide 1-receptor agonists, sodium-glucose cotransporter 2 inhibitors, dipeptidyl peptidase-4 inhibitors, and statins, have been shown to influence EAT thickness. Additionally, EAT thickness can also be managed more invasively through bariatric surgery, or noninvasively through lifestyle changes to diet and exercise routines.

Improving mental health in black men through a 24-week community-based lifestyle change intervention: the black impact program

BackgroundPoor mental health is a leading cause of morbidity and mortality among Black men in the United States. Efforts to improve mental health among Black men have been hampered by a lack of access and utilization of mental health services. Physical activity and social networks have been shown to improve mental health. Thus, we examined the effect of a community team-based physical activity, health education and social needs intervention among Black men on mental health over 24 weeks.MethodsBlack adult males (n = 74) from a large Midwestern city participated in Black Impact, a 24-week community-based lifestyle change program adapted from the Diabetes Prevention Program and American Heart Association’s (AHA) Check, Change, Control Blood Pressure Self-Management Program, which incorporates AHA’s Life’s Simple 7 (LS7) framework. Measures of mental health including the Center for Epidemiological Studies Depression Scale (CES-D), Patient Health Questionnaire 2-question depression screener (PHQ-2), and Perceived Stress Scale-10 (PSS-10) were completed at baseline, 12 and 24 weeks. The change in mental health scores from baseline to 12 and 24 weeks were evaluated using linear mixed-effects models adjusting for age, education, and income. The change in cardiovascular health scores, defined as objective metrics of LS7 (LS5 [blood pressure, total cholesterol, fasting glucose, body mass index and smoking]), by baseline mental health were evaluated using linear mixed-effects models with an interaction term (time*baseline mental health variable) and a random intercept for each participant.ResultsAmong 71 Black men (mean age 51, 85% employed) at 24 weeks, CES-D scores decreased from 10.54 to 7.90 (-2.64, 95%CI:-4.74, -0.55), PHQ-2 decreased from 1.04 to 0.63 (-0.41, 95%CI: -0.75, -0.07), and PSS-10 decreased from 14.62 to 12.91 (-1.71, 95%CI: -3.53, 0.12). A 1-unit higher CES-D at baseline was associated with less improvement in LS5 scores by -0.04 (95%CI: -0.076, -0.005) and − 0.032 (95%CI:-0.067, 0.003) units at week 12 and 24, respectively, with similar findings for PSS.ConclusionsThe Black Impact community-based lifestyle program has the potential to reduce depressive symptoms and stress in Black men. There is a dire need for larger, randomized studies to test the impact of Black Impact on mental health in Black men to advance health equity.Trial RegistrationRetrospectively Registered, ClinicalTrials.gov Identifier: NCT04787978.

Characterization and efficacy of lifestyle behavior change interventions among adult rural cancer survivors: a systematic review.

Little is known about the intersection between age and rurality as characteristics that impact lifestyle behavior change for cancer survivors. This review aims to summarize the current literature on lifestyle behavior change interventions conducted among rural survivors of cancer, with an emphasis on older survivors. A systematic search of five databases identified randomized controlled trials and controlled clinical trials that targeted diet, physical activity, alcohol consumption, or tobacco use change in adult cancer survivors living in rural areas of the world. Eight studies met the inclusion criteria. Most studies were conducted in either Australia or the USA, included survivors at least 6weeks post-treatment, and half included only breast cancer survivors, while the other four included a mix of cancer types. All but one had a physical activity component. No articles addressed changes in alcohol or tobacco behavior. Seven (87.5%) had a fully remote or hybrid delivery model. Most of the physical activity interventions showed significant changes in physical activity outcomes, while the dietary interventions showed changes of clinical but not statistical significance. Few studies have been conducted to implement and evaluate the effectiveness of lifestyle behavior change interventions among older rural survivors of cancer. Future research should evaluate the acceptability and relevancy of adapted, evidence-based intervention with this population. Effective diet and physical activity interventions exist, albeit limited in terms of effective lifestyle behavior change intervention tailored to older, rural survivors of cancer, particularly in relation to alcohol and tobacco behaviors.

The Effectiveness of Lifestyle Changes in Glycemic Control among Pregnant Women with Gestational Diabetes Mellitus.

Background and Objectives: Gestational diabetes mellitus (GDM) is a type of diabetes that develops during pregnancy and affects approximately 10% of pregnant women worldwide. Understanding the impact of lifestyle changes on glycemic control in GDM is important for improving maternal and fetal outcomes and reducing the risk of diabetes in both the mother and child. The aim of this study is to evaluate the effectiveness as well as the factors affecting glycemic control by lifestyle changes in pregnant women with GDM. Materials and Methods: A descriptive cross-sectional study was conducted at three hospitals in the Thai Binh Province from June 2021 to May 2022. All pregnant women at 24-28 weeks of gestation, aged 18 years or older, were enrolled. GDM was diagnosed according to the guidelines of the International Association of the Diabetes and Pregnancy Study Groups. Lifestyle changes including diet and physical exercise were carried out for two weeks. The main outcome measured was successful glycemic control according to the 2018 ADA Recommendations for the Management and Treatment of GDM. Results: 1035 women were included and 20.2% diagnosed with GDM. After two weeks of lifestyle change intervention, 82.6% of the pregnant women with GDM had successful glycemic control. Pregnant women aged under 35 years had a 3.2 times higher rate of gestational glycemic control than those older than 35 (aOR = 3.22, p-value = 0.004). Women with a pre-pregnancy BMI of less than 25 had a higher rate of gestational glycemic control than those with a BMI of over 25 (aOR = 10.84, p-value < 0.001). Compared to women who had all three diagnostic criteria for gestational diabetes, those with two diagnostic criteria and one criterion were 3.8 times and 3 times more likely to have successful blood sugar control (aOR = 3.78, p-value = 0.01 and aOR = 3.03, p-value = 0.03, respectively). Conclusion: Lifestyle changes can be an effective measure for achieving glycemic control in women with GDM. Healthcare providers should consider individualized treatment plans based on the specific needs of each patient.

A study on the relationship between stress-associated lifestyles disorders and essential preventive therapy among women entrepreneurs

Stress is one of the critical factors nowadays affecting almost all people globally. Our study aims to find the association between stress among women entrepreneurs and their metabolic health issues caused by various hormonal imbalances. The study correlated with major female health issues such as polycystic ovarian syndrome, obesity, hyperprolactinemia, infertility, bone health, and trending lifestyle-changing interventions: diet, homeopathic, hormonal treatments, etc. A total of 60 women participants within the age group from 30 to 45 years were included in the study at Kolkata and surrounding areas considering participants’ hectic lifestyles, food and exercise habits, medicines, etc. The semi-structured online survey was done through email using the particular questionnaire based on biochemical test reports, seven-day diet and activities records, and medicine consumption cum hormonal intake irrespective of the participant. Pearson Chi-square test, Likelihood Ratio, Symmetric Measures applied for statistical analysis using SPSS-22. The results showed that the two types of stress were found in 30 participants in each category with asymptotic significance (2-sided) .392 and .403, respectively, while Chi-square significance is approximately .05. So, there is no statistical significance between the relationship of participants’ age, all types of concerning diseases, and practicing therapies. The study found that many participants were not following diet despite knowledge of health benefits. The study concluded that stress can be directly or indirectly related to metabolic syndrome but not always cause hormonal imbalances. However, the participants should go with a proper diet and exercise rather than practicing a fad diet or so-called crash diets.

EHealth in obesity care

Obesity in adults is a growing health concern. Although effective, current treatment options have not been able to overcome the various factors that contribute toward rising obesity rates. eHealth might hold the capacity to improve the effectiveness, delivery and flexibility of some of these treatments. Here, we show that eHealth lifestyle change interventions delivered through smartphones (mHealth) can facilitate significant weight loss, making mHealth an attractive adjunct to clinical obesity care. However, evidence is currently limited to short-term effects, and is also lacking with regards to effectiveness based on socioeconomic status and ethnic group. This raises concerns around the potential and inadvertent widening of obesity prevalence disparities between groups as mHealth lifestyle change interventions are increasingly used in obesity care. Thus, we also describe opportunities to address these concerns and gaps in evidence.

Impact of Lifestyle Change Intervention on Tuberculosis Treatment Outcome in Tuberculosis Patients with Diabetes Mellitus Comorbidity in South West Nigeria

It is well documented in the literature that there is poor treatment outcome in patients with Tuberculosis and Diabetes (TBDM) comorbidity due to the observed interference of drugs for Tuberculosis (TB) treatment on anti-diabetic drugs and elevated glucose level reduces the efficacy of anti- tuberculosis drugs leading to poor TB treatment outcome, and that insulin therapy is not affected by this drug interaction. Importantly, access to Insulin is a challenge due to its prohibitive out-of-pocket cost. The only alternative sustainable treatment for TBDM patients in resource-limited communities is lifestyle-based intervention. This study evaluated the impact of lifestyle intervention on TB treatment outcomes in patients with TBDM comorbidity. This study is a quasi-experimental intervention involving two cohorts of 25 TBDM patients each, as control and experimental cohorts. Their enrolment was from Tuberculosis patients from health facilities in Lagos and Oyo states. The questionnaires were administered before the commencement of the Intervention and at 8 weeks. The sputum Acid Fast Bacillus (AFB) was checked, and chest x-ray (CXR) done before Intervention and Sputum AFB at 8 weeks. The Control group showed no difference in the means of the sputum AFB 95%CI: 0.12(- 0.12 – 0.36; p&gt;0.05), which was an indication of poor treatment outcome. The difference in the means of the sputum AFB in the intervention group was statistically significant 95%CI: -0.8(-0.9 - -0.6; p&lt;0.05). The intervention with educational and behavioral lifestyle modifications significantly improved the outcome of treatment of TB in TBDM comorbidity. Keywords: Behavioral change, Tuberculosis, Diabetes, comorbidity, Treatment outcome.

Electronic Monitoring Of Mom’s Schedule (eMOMSTM): Recruitment of pregnant populations with elevated BMI in a feasibility randomized controlled trial

Underrepresentation of pregnant populations in randomized controlled trials of lifestyle change interventions is concerning due to high attrition and providers’ limited clinical time. The purpose of this evaluative study was to assess intervention uptake of pregnant individuals enrolled in a three-arm feasibility randomized controlled trial, electronic Monitoring Of Mom’s Schedule (eMOMSTM), examining lifestyle changes and lactation support alone, and in combination. Measures included: (1) participation and completion rates, and characteristics of intervention completers versus other eligible participants; and (2) provider experiences with screening and enrolling pregnant participants. Pregnant people with a pre-pregnancy body mass index ≥ 25 and < 35 kg/m2 were enrolled into the eMOMSTM trial between September 2019 - December 2020. Of the 44 consented participants, 35 were randomized, at a participation rate of 35%, and 26 completed the intervention, resulting in a completion rate of 74%. Intervention completers were slightly older and entered the study earlier in pregnancy compared to non-completers. Completers were more likely to be first-time mothers, resided in urban areas, had higher educational attainment, and were slightly more racially and ethnically diverse. A majority of providers reported willingness to participate, believed the study aligned with their organization’s mission, and were satisfied with using iPads for screening. Lessons learned to guide recruitment success include use of: (1) designated research staff in combination with physician support; and (2) user-friendly technology to help mitigate time burden on physicians and their staff. Future work should focus on successful strategies to recruit/retain pregnant populations in clinical trials.

A blended model to support brief interventions in primary care: A qualitative study of usability and acceptability of HealthEir in community pharmacy.

Brief interventions for lifestyle behaviour change are effective health promotion interventions. Primary care settings, including pharmacies, are the most frequently visited healthcare facilities and are well placed to provide brief health interventions. However, despite the evidence-based and policy guidance, barriers to brief interventions have limited their implementation. This study aimed to explore the usability and acceptability of HealthEir, a blended model with digital, print, and communication elements designed to support the delivery of brief health-promoting interventions in pharmacy practice. Usability tests using a think aloud protocol and set tasks (to assess usability) and semi-structured interviews (to assess acceptability) were conducted with fifteen patients and twelve pharmacists. Usability data were analysed deductively using Nielsen's five quality components of usability as a framework. Acceptability data were analysed using inductive thematic analysis. All participants found HealthEir straightforward to use and completed the required tasks without assistance. A small number of patient and pharmacist participants identified opportunity for improvement of the digital element. Acceptability was also high, with individual comments from participants identifying opportunity for improvements to HealthEir, and two patients identifying privacy or safety concerns. The majority of comments regarding acceptability reflected wider social and cultural challenges such as perceptions of the roles of pharmacists and pharmacies and the low priority of preventative health interventions. HealthEir has been demonstrated to be a usable and acceptable support that has the potential to overcome barriers to delivery of brief interventions in pharmacies. Usability and acceptability testing identified minor changes that may further improve its design prior to piloting and implementation.

Exploring the potential of mobile health interventions to address behavioural risk factors for the prevention of non-communicable diseases in Asian populations: a qualitative study

BackgroundChanging lifestyle patterns over the last decades have seen growing numbers of people in Asia affected by non-communicable diseases and common mental health disorders, including diabetes, cancer, and/or depression. Interventions targeting healthy lifestyle behaviours through mobile technologies, including new approaches such as chatbots, may be an effective, low-cost approach to prevent these conditions. To ensure uptake and engagement with mobile health interventions, however, it is essential to understand the end-users’ perspectives on using such interventions. The aim of this study was to explore perceptions, barriers, and facilitators to the use of mobile health interventions for lifestyle behaviour change in Singapore.MethodsSix virtual focus group discussions were conducted with a total of 34 participants (mean ± SD; aged 45 ± 3.6 years; 64.7% females). Focus group recordings were transcribed verbatim and analysed using an inductive thematic analysis approach, followed by deductive mapping according to perceptions, barriers, facilitators, mixed factors, or strategies.ResultsFive themes were identified: (i) holistic wellbeing is central to healthy living (i.e., the importance of both physical and mental health); (ii) encouraging uptake of a mobile health intervention is influenced by factors such as incentives and government backing; (iii) trying out a mobile health intervention is one thing, sticking to it long term is another and there are key factors, such as personalisation and ease of use that influence sustained engagement with mobile health interventions; (iv) perceptions of chatbots as a tool to support healthy lifestyle behaviour are influenced by previous negative experiences with chatbots, which might hamper uptake; and (v) sharing health-related data is OK, but with conditions such as clarity on who will have access to the data, how it will be stored, and for what purpose it will be used.ConclusionsFindings highlight several factors that are relevant for the development and implementation of mobile health interventions in Singapore and other Asian countries. Recommendations include: (i) targeting holistic wellbeing, (ii) tailoring content to address environment-specific barriers, (iii) partnering with government and/or local (non-profit) institutions in the development and/or promotion of mobile health interventions, (iv) managing expectations regarding the use of incentives, and (iv) identifying potential alternatives or complementary approaches to the use of chatbots, particularly for mental health.

Obstructive Sleep Apnoea (OSA) as a potentially modifiable risk factor for Mild Cognitive Impairment (MCI): A role for old age psychology?

It is estimated that just under a third of people with mild cognitive impairment (MCI) also have obstructive sleep apnoea (OSA; a form of sleep disordered breathing distinguished by repeated upper airway collapse during sleep), and disordered sleep is a potential risk factor for dementia. In this paper, we consider the potential role for the old age psychologist in (1) identifying OSA for onward referral and treatment, (2) assessing neurocognitive profiles in people with comorbid OSA and cognitive decline, (3) providing behavioural interventions to improve OSA treatment adherence, and (4) providing health psychology (lifestyle change) interventions relevant to both MCI and OSA.

Abstract A011: Lifestyle behavior change interventions among adult rural cancer survivors: A systematic review

Abstract Introduction: Though lifestyle behavior, such as dietary pattern or physical activity, has been shown to improve symptoms related to cancer treatment and secondary comorbidities (i.e., pain, fatigue, poor functionality), adherence to health-promoting behavioral interventions is low, particularly among older, rural-dwelling survivors of cancer. Shifting population dynamics in cancer survivorship regarding both aging and rurality indicate that it is crucial to understand the health needs of this older, lower resourced population if acceptable and effective lifestyle interventions are to be developed and implemented. This review aimed to summarize lifestyle behavior change interventions conducted among rural survivors of cancer, with an emphasis on older survivors. Methods: A systematic search of five databases (i.e., PubMed, CINAHL, CENTRAL, EMBASE, PsycINFO) identified randomized controlled trials and controlled clinical trials which targeted diet and/or physical activity change in adult cancer survivors living in rural areas. The conduct and reporting of this review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The protocol for this review was registered with PROSPERO International Prospective Register of Systematic Reviews (CRD42021282313). Articles were screened for eligibility by two independent reviewers and data were extracted using an a priori developed form. Results: Eight studies met the inclusion criteria. Average participant age was 59.9 years (range: 29-90 years). While three studies (37%) reported a mean sample age of 65 years or greater, none identified a priori inclusion criteria encompassing both older age and rurality. Most studies were conducted in Australia (n=4) or the United States (n=3), focused on breast cancer survivors (n=4), and included survivors at least 6-weeks post-treatment (n=5). Six (75%) had a fully remote or hybrid delivery model. Results from the three interventions which enrolled a mean study sample of 65 years or greater indicated that lower percentages of older, rural-dwelling participants met study goals related to fruit, vegetable, and saturated fat intake than younger and/or urban survivors. Older, rural-dwelling survivors reported greater improvements in physical function and physical activity post-intervention than older, urban-dwelling participants. Conclusions: Few studies have been conducted to evaluate the efficacy of lifestyle behavior change intervention among rural-dwelling survivors of cancer. None have been designed for older survivors living in rural areas, despite lower adherence to lifestyle behavior recommendations for survivors. There is a need to identify feasible and effective approaches to influence clinically meaningful behavior change for this population. Future research should evaluate the acceptability and relevancy of adapted, evidence-based intervention with older, rural-dwelling survivors of cancer. Citation Format: Samantha J. Werts, Rogelio Robles-Morales, Jennifer W. Bea, Cynthia A. Thomson. Lifestyle behavior change interventions among adult rural cancer survivors: A systematic review [abstract]. In: Proceedings of the AACR Special Conference: Aging and Cancer; 2022 Nov 17-20; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2022;83(2 Suppl_1):Abstract nr A011.

The ancients knew it already: how Stoic philosophy explains the link between mindfulness, emotion regulation and pro-environmental behaviours (Los antiguos ya lo sabían: cómo explica la filosofía estoica el vínculo entre mindfulness, regulación emocional y la conducta proambiental)

ABSTRACT A growing body of research suggests that there might be a strong link between (1) a specific way of applying a non-judgemental and present-centred attention to what seems to be an outer reality, known as mindfulness, (2) using emotion-regulation strategies (such as, for example, cognitive reappraisal) and (3) adopting a more sustainable lifestyle, implying a self-aware caring for the natural environment and the resources therein. The relationship between these factors, which we call here ‘the triple link’, has been supported by recent empirical data, from independent studies, using different approaches, across various disciplines. We present in this article a philosophical explanation of this relationship, based on the Ancient Stoic School of Philosophy, which can also be found in other ancient Western and Eastern philosophies. These reflections open a different perspective on the urgent issues of lifestyle change and behavioural interventions needed to cope with the potential environmental catastrophe, a perspective that reaches out of psychology and includes the metaphysical dimension in the understanding of people–environment relations.

Treatment of Men with Erectile Dysfunction through Lifestyle Modification Using a Digital Application - A Pilot Study

Introduction: Erectile dysfunction affects up to 30% of men in industrialized nations. Although the disease is more common in older age, men in their 30s and 40s are also affected. Despite the quantity and the important socio-psycho-pathogenic significance of erectile dysfunction, it is still treated almost exclusively by the administration of phosphodiesterase 5 inhibitors. Objective: To evaluate the effectiveness and acceptability of a digital lifestyle change intervention for men with erectile dysfunction. Material and Methods: In this pilot study, 20 patients with erectile dysfunction were encouraged to make lifestyle changes using a digital application. Results: We were able to show that the use of a digital application is very effective in supporting the lifestyle change efforts of patients with erectile dysfunction. Conclusion: Digital applications could offer valuable assistance in extending the purely symptomatic therapeutic approach (PDE5I) of men suffering from erectile dysfunction, to include the important component of lifestyle change in order to address the long-term implications of this complex condition

The Survival of Patients with Triple Negative Breast Cancer Undergoing Chemotherapy Along with Lifestyle Change Interventions

Background: The survival of patients with triple-negative breast cancer subtype undergoing chemotherapy along with weight management, physical activity, and diet was examined. In addition, the relationship between the Overall Survival (OS) of patients with expression P53 and Ki 67 was investigated. Methods: The study was conducted on 110 patients admitted to oncology clinics between October 2009 and July 2018. The patients underwent five chemotherapy cycles, including Docetaxel, Epirubicin, and Cyclophosphamide once every 21 days followed by two cycles of Epirubicin, Cyclophosphamide, and 5-Fluorouracil. The patients also received guidelines for physical exercise, diet, and lifestyle change. Results: The median and mean follow-ups were 52.3 and 45.6 months respectively. Eight patients were metastatic and 103 were under adjuvant therapy, 13 of whom had relapses. The median relapse-free survival and mean OS were 44.4 months and 49.2 months respectively. OS for P53-negative patients was 64.2 months, eight patients relapsed in the P53-positive group, and two relapsed in the P53-negative group. Survival was more favorable in the negative group (P=0.021). The mean DFS in the P53- negative group was 96.1% and 76.3% in the P53-positive group, suggesting a more favorable status in the P53-negative group. Out of 110 patients, 20 died and 90 are still alive. Conclusion: Combining physical exercise, diet, and lifestyle change with chemotherapy increases the chance of a better response to treatment and a reduction in the rate of relapse during the first three years. The survival rate was better in p53-negative patients.

Medically tailored meals for food insecurity and type 2 diabetes: Protocol for the Food as Medicine for Diabetes (FAME-D) trial

BackgroundFood insecurity is associated with worse glycemic management for individuals with type 2 diabetes mellitus (T2DM), but whether medically tailored meals (MTM), a food insecurity intervention, can improve glycemic management is unclear. ObjectiveTo describe the protocol for a trial assessing whether an MTM plus lifestyle intervention improves hemoglobin A1c (HbA1c) and participant-reported outcomes, relative to a food subsidy (money that can be spent on foods participants choose), for adults with both T2DM and food insecurity. MethodsThe Food as Medicine for Diabetes (FAME-D) randomized clinical trial (goal n = 200) is a pragmatic trial with an active comparator. Participants, who will have T2DM and report food insecurity, will be randomly assigned to a 6-month MTM plus telephone-delivered lifestyle change intervention, or a 6-month food subsidy ($40/month). The primary outcome is HbA1c at 6 months. Secondary outcomes include HbA1c at 12 months to assess whether the intervention effect (if any) is sustained, along with weight, food insecurity, diabetes distress, and health-related quality of life. Qualitative analyses of semi-structured interviews will help understand why, how, and under what circumstances the intervention achieved its observed results. ConclusionResults from FAME-D will help inform clinical management of food insecurity when it co-occurs with T2DM. Further, results may be useful as healthcare payors are considering coverage for MTM interventions.ClinicalTrials.gov: NCT04828785