Lifestyle Interventions For Treatment Research Articles

Effectiveness of lifestyle interventions for treatment of overweight/obesity among children in China: A systematic review and meta-analysis.

Pediatric obesity has become a global public health problem. China has the largest population of obese children in the world. It is important to develop effective interventions to control child obesity. This systematic review summarizes proof from randomized controlled trials to assess the efficacy of lifestyle intervention to reduce BMI and metabolic risk factors for overweight/obese Chinese children. We searched studies from five databases (PubMed, MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and CNKI). Research that meets the following requirements was included: randomized controlled trials, participants are overweight/obese Chinese children aged <18 years old, and the effectiveness of lifestyle interventions is evaluated. Eight randomized controlled trials were included. A significant difference was found between the intervention group and the control group for the BMI changes (mean difference = -1.49; 95% CI: -2.20 to -0.77; p < 0.001). Subgroup analyses consistently demonstrated that effects of lifestyle interventions on BMI change including multiple-component interventions (mean difference = -2.03 kg/m2; 95% CI: -3.62 to -0.43; p < 0.001) were stronger than those only with physical activities or health education; effects of lifestyle interventions on BMI change were also strengthened if duration of intervention last for more than 1 year (mean difference = -3.03 kg/m2; 95% CI: -4.00 to -2.06; p = 0.01) or with age during 12-18 years old (mean difference = -1.90 kg/m2; 95% CI: -3.37 to -0.43; p < 0.001). Lifestyle interventions are effective in reducing BMI in Chinese children with overweight/obesity, and the effectiveness is more profound when the lifestyle intervention includes multiple components, lasts longer than one year, and/or is conducted among teens. These findings provide an important evidence base for developing and implementing potentially effective lifestyle interventions for the treatment of overweight/obesity among Chinese children.

Eating, sleeping and moving recommendations in clinical practice guidelines for paediatric depression: umbrella review.

Current first-line treatments for paediatric depression demonstrate mild-to-moderate effectiveness. This has spurred a growing body of literature on lifestyle recommendations pertaining to nutrition, sleep and exercise for treating paediatric depression. Paediatric depression clinical practice guidelines (CPGs) were reviewed for quality and to catalogue recommendations on nutrition, sleep and exercise made by higher-quality CPGs. Searches were conducted in Medline, EMBASE, PsycINFO, Web of Science and CINAHL, and grey literature CPGs databases for relevant CPGs. Eligible CPGs with a minimum or high-quality level, as determined by the Appraisal of Guidelines for Research and Evaluation, Second Edition instrument, were included if they were (a) paediatric; (b) CPGs, practice parameter or consensus or expert committee recommendations; (c) for depression; (d) the latest version and (e) lifestyle recommendations for nutrition, sleep or exercise. Key information extracted included author(s), language, year of publication, country, the institutional body issuing the CPG, target disorder, age group, lifestyle recommendation and the methods used to determine CPG lifestyle recommendations. Ten paediatric CPGs for depression with a minimum or high-quality level contained recommendations on nutrition, sleep or exercise. Lifestyle recommendations were predominately qualitative, with quantitative details only outlined in two CPGs for exercise. Most recommendations were brief general statements, with 50% lacking supporting evidence from the literature. Interest in lifestyle interventions for treatment in child and youth depression is growing. However, current CPG lifestyle recommendations for nutrition, sleep or exercise are based on expert opinion rather than clinical trials.

503-P: Intensive Lifestyle Interventions for Treatment towards Remission of Type 2 Diabetes: A Case Series

Background: Lifestyle interventions, including very low-calorie diets and liquid meal replacements, have been shown to achieve blood glucose improvements or remission. However, intensive lifestyle intervention using solid foods without calorie restriction has not been studied. Objective: The objective of this study is to describe changes in blood glucose, medication use and diabetes status among 50 patients who were prescribed intensive lifestyle changes to treat type 2 diabetes (T2D). Methods: Physicians were recruited by the American College of Lifestyle Medicine to submit case histories of patients who achieved blood glucose improvements and/or remission in QuestionPro, an online survey platform. Results: A total of 12 physicians reported on 50 patients, including 1 physician who reported on 37 patients. Mean (SD) age of patients was 66.4 (12.8) years (range 20-84), and 64% of patients were male. Primary lifestyle interventions included a whole food, plant-based diet (n=43), coaching program (n=3), ADA diet (n=2), whole food diet (n=1) and calorie restricted diet &amp;lt;1800kcal (n=1). No liquid meal replacements or other calorie restrictions were reported. Mean biometrics (SD) for time periods pre-intervention; 3-6 months post-; and most recent follow-up were: HbA1c 7.6 (1.5); 5.7 (0.3); 5.8 (0.4), fasting glucose 150.1 (53.4); 101.0 (30.8) ;105.2 (25.0), BMI 34.9 (14.4); 30.0 (6.0); 28.6 (5.2). A majority of patients were taking diabetes medications prior to interventions. At 3-6 months post intervention, a total of n=20 patients were not taking diabetes medications and of these, n=10 achieved either HbA1c&amp;lt;5.7 % or FSG&amp;lt;100 mg/dL. At most recent follow-up, n=21 were not taking diabetes medications and of these, n=9 achieved both HbA1c&amp;lt;5.7% and FSG&amp;lt;100 mg/dL, with n=1 for at least 12 months. Conclusion: Patients can improve blood glucose and may achieve remission of T2D using a whole food, plant-based dietary pattern, without liquid meal replacements. Disclosure M. Karlsen: None. G. Panigrahi: None. J. Kelly: None.

Contributions of a high-fat diet to Alzheimer's disease-related decline: A longitudinal behavioural and structural neuroimaging study in mouse models.

Obesity is recognized as a significant risk factor for Alzheimer's disease (AD). Studies have supported that obesity accelerates AD-related pathophysiology and memory impairment in mouse models of AD. However, the nature of the brain structure-behaviour relationship mediating this acceleration remains unclear. In this manuscript we evaluated the impact of adolescent obesity on the brain morphology of the triple transgenic mouse model of AD (3xTg) and a non-transgenic control model of the same background strain (B6129s) using longitudinally acquired structural magnetic resonance imaging (MRI). At 8 weeks of age, animals were placed on a high-fat diet (HFD) or an ingredient-equivalent control diet (CD). Structural images were acquired at 8, 16, and 24 weeks. At 25 weeks, animals underwent the novel object recognition (NOR) task and the Morris water maze (MWM) to assess short-term non-associative memory and spatial memory, respectively. All analyses were carried out across four groups: B6129s-CD and -HFD and 3xTg-CD and -HFD. Neuroanatomical changes in MRI-derived brain morphology were assessed using volumetric and deformation-based analyses. HFD-induced obesity during adolescence exacerbated brain volume alterations by adult life in the 3xTg mouse model in comparison to control-fed mice and mediated volumetric alterations of select brain regions, such as the hippocampus. Further, HFD-induced obesity aggravated memory in all mice, lowering certain memory measures of B6129s control mice to the level of 3xTg mice maintained on a CD. Moreover, decline in the volumetric trajectories of hippocampal regions for all mice were associated with the degree of spatial memory impairments on the MWM. Our results suggest that obesity may interact with the brain changes associated with AD-related pathology in the 3xTg mouse model to aggravate brain atrophy and memory impairments and similarly impair brain structural integrity and memory capacity of non-transgenic mice. Further insight into this process may have significant implications in the development of lifestyle interventions for treatment of AD.

Complementary medicine, self-help, and lifestyle interventions for Obsessive Compulsive Disorder (OCD) and the OCD spectrum: A systematic review

In Obsessive Compulsive Disorder (OCD) current standard pharmacotherapies may be of limited efficacy. Non-conventional interventions such as Complementary and Alternative Medicine (CAM), self-help techniques, and lifestyle interventions are commonly used by sufferers of OCD, however to date no systematic review of this specific area exists. We conducted a systematic review of studies using CAM, self-help, and lifestyle interventions for treatment of OCD and trichotillomania (TTM). PubMed, PsycINFO, China Academic Journals Full-text Database, The Cochrane Library and CINAHL were searched (up to Jan 11th 2011), for controlled clinical trials using non-conventional interventions for OCD. A quality analysis using a purpose-designed scale and an estimation of effect sizes (Cohen's d) where data was available, were also calculated. The literature search revealed 14 studies that met inclusion criteria. Methodological quality of nutraceutical studies (nutrients and herbal medicines) were rated as high (mean 8.6/10), whereas mind-body or self-help studies were poorer (mean 6.1/10). In OCD, tentative evidentiary support from methodologically weak studies was found for mindfulness meditation (d=0.63), electroacupuncture (d=1.16), and kundalini yoga (d=1.61). Better designed studies using the nutrient glycine (d=1.10), and traditional herbal medicines milk thistle (insufficient data for calculating d) and borage (d=1.67) also revealed positive results. A rigorous study showed that N-acetylcysteine (d=1.31) was effective in TTM, while self-help technique "movement decoupling" also demonstrated efficacy (d=0.94). Mixed evidence was found for myo-inositol (mean d=0.98). Controlled studies suggest that St John's wort, EPA, and meridian-tapping are ineffective in treating OCD. While several studies were positive, these were un-replicated and commonly used small samples. This precludes firm confidence in the strength of clinical effect. Preliminary evidence however is encouraging, and more rigorous research of some of the more hypothesis-based interventions in the treatment of OCD and TTM may be indicated.