Significant Improvements In Waist Circumference Research Articles

The effects of jujube (Ziziphus jujube) on metabolic and mental health outcomes in patients with metabolic syndrome: A randomized controlled trial

ObjectivesThe effects of jujube (Ziziphus jujube) consumption on metabolic and mental health outcomes in subjects diagnosed with metabolic syndrome (MetS) is unknown and remains to be examined. Hence, we carried out a parallel-group, randomized controlled trial to investigate this issue. MethodsEligible participants were randomly assigned to the intervention (n = 30) or the control (n = 30) groups to receive either jujube or a placebo for eight weeks. Subjects were provided with 30 g dried jujube powder or placebo and were asked to consume half of the powder at 10 a.m. and the rest at 4 p.m. Lipid profile, fasting blood glucose (FBG), waist circumference (WC), and blood pressure were evaluated as primary outcomes. Secondary outcomes collected were mental health measures (e.g., depression, anxiety, and stress). ResultsJujube consumption failed to decrease FBG, total cholesterol, low-density lipoprotein cholesterol, and blood pressure, as well as depression and anxiety scores (P > 0.05). However, the between-group comparison revealed a significant improvement in WC (− 3.98 vs. − 0.51, P = 0.01), triglyceride (TG) (− 24.96 vs. − 0.73, P = 0.03), and high-density lipoprotein cholesterol (HDL-C) (2.83 vs. 0.40, P = 0.01) in the jujube group compared to the placebo. In addition, compared to the control group, jujube consumption led to a significant improvement in the score of stress (− 5.80 vs. − 2.86, P = 0.01). ConclusionJujube consumption only had beneficial effects on WC, TG, and HDL-C in subjects with MetS. However, the current study has methodological weaknesses in blinding and herb purity/potency testing, which should be addressed in future studies.

A mandatory practice in type 2 diabetes mellitus to maintain quality of life

Nepalese owing to modern lifestyle and processed food are racially at an elevated risk of acquiring central obesity-related insulin resistance (IR) and thus Type 2 diabetes mellitus (T2DM) and Diabetic Kidney Disease (DKD). Low birth weight in utero and later becoming obese risks the development of T2DM. In a total of eighty-four newly diagnosed treatment-naive Nepalese T2DMs, incidence of IR, percentage beta-cell function (%BCF) and percentage insulin sensitivity (%IS) were determined using Homeostatic Model Assessment 2 (HOMA2-IR). Association of HOMA2-IR with albuminuria, kidney function, hs-CRP, fatty liver, fatty pancreas, several anthropometric and biochemical parameters were analyzed. Among the eighty-four T2DMs, fifty-four agreeing regular follow-ups were prescribed a low-carbohydrate diet (<130gm/day). At 6 months, their glycemic controls were monitored. From 84 newly diagnosed T2DMs, 56 (66.7%) were insulin resistant and 28(33.3%) insulin-sensitive on HOMA2-IR. There was a significant association of HOMA2-IR with albuminuria and declining kidney function (p=0.006 and 0.034 respectively) and most of them were at reversible stages. Waist circumference (WC), waist-hip ratio (WHR), lipid profile ratios, fatty liver and fatty pancreas were elucidated as potential markers for IR. The IS group (ISG) had significantly inadequate %BCF (p=0.001) but high %IS (p<0.001) has healthier WHR (p=0.001) and lipid profile ratios which are opposite to IR group (IRG). 13 ISG had raised hs-CRP and 15 normal and 21 IRG had normal hs-CRP and 35 raised. At 6 months, the IRG achieved significantly better postprandial glycemic goals (p=0.04) and significant improvement in WC and WHR (p=0.008 and 0.03 respectively) with a low-carbohydrate diet as compared to ISG. Severe insulin resistance and IR-associated DKD, fatty liver and fatty pancreas are highly prevalent from the time of diagnosis of T2DM in the Nepalese population. Thus inspecting for IR and its consequences mandatorily at diagnosis and applying precision therapies like adjustments in the quality and quantity of staple food carbohydrates significantly improves IR-related parameters and glycemia.

Efficacy of traditional Chinese exercises in improving anthropometric and biochemical indicators in overweight and obese subjects: A systematic review and meta-analysis.

The efficacy of traditional Chinese exercise (TCE)-based intervention in the improvement of anthropometric and biochemical indicators in overweight and obese patients is controversial. In this regard, the aim of this review was to summarize the evidence of TCE interventions to evaluate their effectiveness on the anthropometric and biochemical indicators of overweight and obese patients. Five databases were systematically searched for relevant articles published from inception to October 2022. Randomized controlled trials examining TCE intervention in overweight and obese patients The treatment effects were estimated using a random-effect meta-analysis model with standardized mean differences (Hedges' g). The categorical and continuous variables were used to conduct moderator analyses. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42022377632). Nine studies involving a total of 1297 participants were included in the final analysis. In the anthropometric indicators outcomes, the meta-analytic findings revealed large and significant improvements in body mass index (g = 1.44, 95% confidence interval [CI] = 1.27-1.61, P = .000, I2 = 99%), weight (g = 1.47, 95% CI = 1.25-1.68, P = .000, I2 = 95%), fat percentage (g = 1.22, 95% CI = 0.52-1.93, P = .000, I2 = 93%), and small and significant improvements in waist circumference (g = 0.38, 95% CI = 0.21-0.54, P = .000, I2 = 99%). In the biochemical indicators outcomes, the findings revealed large and significant improvements in low density lipoprotein (g = 2.08, 95% CI = 1.80-2.37, P = .000, I2 = 98%), moderate and significant improvements in triglyceride (g = 0.69, 95% CI = 0.56-0.81, P = .000, I2 = 96%), small and significant improvements in total cholesterol (g = 0.37, 95% CI = 0.19-0.54, P = .000, I2 = 77%), and high-density lipoprotein (g = -0.71, 95% CI = -0.86 to 0.57, P = .000, I2 = 99%). The moderator shows that the effects of TCE on anthropometric and biochemical indicators were moderated by frequency of exercise, exercise duration, and type of control group. TCE intervention is a beneficial non-pharmacological approach to improving anthropometric and biochemical indicators in overweight and obese subjects, especially in body mass index, weight, fat percentage, triglyceride, and low-density lipoprotein. The clinical relevance of our findings is pending more extensive trials and more rigorous study designs to strengthen the evidence.

The use of wearable technology in a comprehensive chronic pain management programme

Technology is increasingly used to promote physical activity and reduce sedentary behaviour in the general population, but the possibility of using it to support physical activity in chronic pain patients is still sparse. Physical activity is crucial for improving quality of life of chronic pain patients. However, long-term physical activity goals widely depend on pain perception, actual or anticipated pain exacerbation, and lack of confidence when doing physical activity. We aimed to determine whether wearable technology can improve management of chronic pain. Full protocol of this 8-week clinical trial is available in the Clinical Trials Registry (NCT 03837080). In short, chronic pain patients enrolled in the 4-week multidisciplinary chronic pain management programme wore fitness wristbands during the 4-week programme (0-4 weeks) and during the follow-up (4-8 weeks). Fitness wristbands measured physical activity and sleep patterns. Additionally, anthropometric measurements and psychological condition of patients (by using Pain Catastrophizing Scale and Depression, Anxiety and Stress Scale – 21 Items questionnaires) was measured. The number of steps and average time of activity per day increased, as well as deep sleep time per day but without reaching statistical significance. Significant improvements in waist circumference and waist-to-hip ratio and waist-to-height ratio with longer deep sleep time were found. No significant correlation was found between physical activity, sleep quality and psychological characteristics or catastrophizing. By wearing fitness wristbands, patients feel actively involved in their chronic pain management. In a clinical/research setting, wristbands provide better, continuous oversight of patient’s progress end enables tailoring of individualized strategies. However, the use of wristbands requires some level of IT knowledge, and sudden malfunctions of the wristband and/or the software can be expected. Additionally, some individual characteristics (i.e., demographics, psychosocial factors, lack of motivation) can also be obstacles to their use.

The use of wearable technology in a comprehensive chronic pain management programme

Technology is increasingly used to promote physical activity and reduce sedentary behaviour in the general population, but the possibility of using it to support physical activity in chronic pain patients is still sparse. Physical activity is crucial for improving quality of life of chronic pain patients. However, long-term physical activity goals widely depend on pain perception, actual or anticipated pain exacerbation, and lack of confidence when doing physical activity. We aimed to determine whether wearable technology can improve management of chronic pain. Full protocol of this 8-week clinical trial is available in the Clinical Trials Registry (NCT 03837080). In short, chronic pain patients enrolled in the 4-week multidisciplinary chronic pain management programme wore fitness wristbands during the 4-week programme (0-4 weeks) and during the follow-up (4-8 weeks). Fitness wristbands measured physical activity and sleep patterns. Additionally, anthropometric measurements and psychological condition of patients (by using Pain Catastrophizing Scale and Depression, Anxiety and Stress Scale – 21 Items questionnaires) was measured. The number of steps and average time of activity per day increased, as well as deep sleep time per day but without reaching statistical significance. Significant improvements in waist circumference and waist-to-hip ratio and waist-to-height ratio with longer deep sleep time were found. No significant correlation was found between physical activity, sleep quality and psychological characteristics or catastrophizing. By wearing fitness wristbands, patients feel actively involved in their chronic pain management. In a clinical/research setting, wristbands provide better, continuous oversight of patient’s progress end enables tailoring of individualized strategies. However, the use of wristbands requires some level of IT knowledge, and sudden malfunctions of the wristband and/or the software can be expected. Additionally, some individual characteristics (i.e., demographics, psychosocial factors, lack of motivation) can also be obstacles to their use.

A Web-Delivered, Clinician-Led Group Exercise Intervention for Older Adults With Type 2 Diabetes: Single-Arm Pre-Post Intervention.

BackgroundThe COVID-19 pandemic created unprecedented shifts in the way health programs and services are delivered. A national lockdown to prevent the spread of COVID-19 in Australia was introduced in March 2020. This lockdown included the closure of exercise clinics, fitness centers, and other community spaces, which, before the pandemic, were used to deliver Beat It. Beat It is an 8-week in-person, community-based, and clinician-led group exercise and education program for adults self-managing diabetes. To continue offering Beat It, it was adapted from an in-person program to a fully web-based supervised group exercise program for adults with type 2 diabetes (T2DM).ObjectiveThis study aims to assess whether the Beat It Online program produced comparable health outcomes to the Beat It in-person program in terms of improving physical fitness (muscular strength and power, aerobic endurance, balance, and flexibility) and waist circumference in older adults with T2DM.MethodsAustralians with T2DM who were aged ≥60 years were included. They were enrolled in Beat It Online, a twice-weekly supervised group exercise and education program conducted via videoconference over 8 weeks. Anthropometric measurements and physical fitness parameters were assessed at baseline and completion. The adaptations to Beat It are reported using the Model for Adaptation, Design, and Impact, including the type of changes (what, where, when, and for whom), the criteria for making those changes (why and how), and the intended and unintended outcomes. The intended outcomes were comparable functional fitness as well as physical and mental health improvements across demographics and socioeconomic status.ResultsA total of 171 adults (mean 71, SD 5.6 years; n=54, 31.6% male) with T2DM were included in the study, with 40.4% (n=69) residing in lower socioeconomic areas. On the completion of the 8-week program, significant improvements in waist circumference, aerobic capacity, muscular strength, flexibility, and balance were observed in both male and female participants (all P<.001). The Model for Adaptation, Design, and Impact reports on 9 clinical, practical, and technical aspects of Beat It that were adapted for web-based delivery.ConclusionsThis study found that Beat It Online was just as effective as the in-person program. This adapted program produced comparable health benefits across demographics and socioeconomic status. This study offers important findings for practitioners and policy makers seeking to maintain independence of older people with T2DM, reversing frailty and maximizing functional and physical fitness, while improving overall quality of life. Beat It Online offers a flexible and inclusive solution with significant physical and mental health benefits to individuals. Further evaluation of Beat It (both in-person and Online) adapted for culturally and linguistically diverse communities will provide greater insights into the efficacy of this promising program.

School-based high-intensity interval training programs in children and adolescents: A systematic review and meta-analysis.

1) To investigate the effectiveness of school-based high-intensity interval training (HIIT) interventions in promoting health outcomes of children and adolescents compared with either a control group or other exercise modality; and 2) to explore the intervention characteristics and process outcomes of published school-based HIIT interventions. We searched Medline, Embase, CINAHL, SPORTDiscus, and Web of Science from inception until 31 March 2021. Studies were eligible if 1) participants aged 5-17 years old; 2) a HIIT intervention within a school setting ≥ 2 weeks duration; 3) a control or comparative exercise group; 4) health-related, cognitive, physical activity, nutrition, or program evaluation outcomes; and 5) original research published in English. We conducted meta-analyses between HIIT and control groups for all outcomes with ≥ 4 studies and meta-regressions for all outcomes with ≥ 10 studies. We narratively synthesised results between HIIT and comparative exercise groups. Fifty-four papers met eligibility criteria, encompassing 42 unique studies (35 randomised controlled trials; 36 with a high risk of bias). Meta-analyses indicated significant improvements in waist circumference (mean difference (MD) = -2.5cm), body fat percentage (MD = -1.7%), body mass index (standardised mean difference (SMD) = -1.0), cardiorespiratory fitness (SMD = +1.0), resting heart rate (MD = -5bpm), homeostatic model assessment-insulin resistance (MD = -0.7), and low-density lipoprotein cholesterol (SMD = -0.9) for HIIT compared to the control group. Our narrative synthesis indicated mixed findings between HIIT and other comparative exercise groups. School-based HIIT is effective for improving several health outcomes. Future research should address the paucity of information on physical activity and nutrition outcomes and focus on the integration and long-term effectiveness of HIIT interventions within school settings. PROSPERO CRD42018117567.

Intermittent aerobic-resistance interval training versus continues aerobic training: Improvement in cardiac electrophysiologic and anthropometric measures in male patients post myocadiac infarction, a randomized control trial.

Exercise is a valuable intervention modality for patients post-myocardial infarction (MI). Aerobic and resistance training are both commonly used separately in cardiac rehabilitation. However, the effect of aerobic interval exercise combined with alternating sets of resistance training (super-circuit training, SCT) on cardiac electrophysiologic and anthropometric measures had not been thoroughly investigated. The primary objective of this study was to compare the effectiveness of moderate-intensity continuous-aerobic training (CAT) vs. SCT on cardiac electrical measures (resting electrocardiographic, ECG; a nd heart rate variability, HRV) in patients' post-MI presenting reduced left ventricular function. Second, to examine its effect on anthropometric measures. Twenty-nine men post-MI with reduced left ventricular function were assigned randomly to either 12 weeks of CAT (n = 15) or SCT (n = 14). CAT group performed moderate-intensity activity. SCT group performed high-intensity exercise, alternating between resistance and aerobic training. Differences between CAT and SCT groups were done using independent t-tests, paired t-tests and effect size (ES). Participants in both groups improved their HRV measures (increase in HFnu; p < 0.05; ES > 0.51) and ECG (reduction in QT-dispersion; p < 0.05; ES > 0.51). Only the SCT group had significant improvements in waist circumference (p < 0.05). Exercise improves cardiac electrical measures post-MI. However, in comparison to CAT, SCT may yield greater anthropometric changes. In order to have improvements in cardiac electrical stability, clinicians working with post-MI patients may use both CAT and SCT. However, SCT might result in greater improvements.

Similar Adaptations to 10 Weeks Concurrent Training on Metabolic Markers and Physical Performance in Young, Adult, and Older Adult Women.

It has been proposed that the combination of high-intensity aerobic exercises and resistance training (RT) known as concurrent training (CT) could improve metabolic syndrome (MetS) markers, and that the exercise mixture in CT could dampen muscle anaerobic pathways, a result known as the interference effect. However, there is scarce evidence on its effects in women across different ages. Therefore, we sought to determine the effects of a 10-week CT intervention on MetS markers and endurance performance in adult women and compared age-related differences between young, adult, and older participants. A total of 112 women with >1 MetS risk factors were included in the study. Participants were allocated to different groups according to the following cutoff age ranges: 20–29years (y), n = 25; 30–39y, n = 35; 40–49y, n = 43; and 50–59y, n = 53. Participants performed 10 weeks of CT, including resistance training (RT), involving six major muscle groups, and high-intensity interval training (HIIT) in a cycle ergometer. Anthropometric, cardiovascular, metabolic, and performance outcomes were assessed before and after the intervention. The CT induced significant improvements in waist circumference (WC) (20–29y: –2.5; 30–39y: –4.1; 40–49y: –4.2; 50–59y: –2.8 Δcm) and the distance achieved in the six-minute walking test (6Mwt) (20–29y: +47.6; 30–39y: +66.0; 40–49y: +43.0; 50–59y: +58.6 Δm) across all age groups, without significant differences between groups. In addition, a significant correlation was found between 6Mwt and WC, independent of age. In conclusion, our results showed that a 10-week CT intervention improved MetS risk factors in women, suggesting that the beneficial effects promoted by CT are independent of age and confirming CT as an effective, age-independent training regimen to improve metabolic health in women.

Community-Based Exercise and Lifestyle Program Improves Health Outcomes in Older Adults with Type 2 Diabetes

Background: The aim of this study was to assess the efficacy of Beat It—a community-based exercise and lifestyle intervention—in improving anthropometric and physical fitness outcomes in older adults with type 2 diabetes mellitus (T2DM). Methods: Australians with T2DM who were aged 60 years or older were included. These individuals were enrolled in Beat It, a twice-weekly supervised group exercise and education program conducted over 8 weeks. Anthropometric measurements and physical fitness parameters were assessed at baseline and completion. Physical fitness measures were then compared to validated criterion standards of fitness levels required by older adults to remain physically independent into later life. Results: A total of 588 individuals were included in the study. At baseline, a substantial proportion of the cohort had physical fitness measures that were below the standard for healthy independent living for their gender and age. Significant improvements in waist circumference and physical fitness were observed post program and resulted in an increase in the number of participants who met the standard for healthy independent living. Conclusions: Participation in Beat It improved important health outcomes in older adults with T2DM. A longer-term follow-up is needed to determine whether these positive changes were maintained beyond the delivery of the program.

Appointment Adherence to a City-Wide Cardiovascular Disease Prevention Program: Its Predictors and Outcomes.

This study identified predictors of appointment adherence and examined its impacts on improvements in metabolic risk factors in a free city-wide cardiovascular disease prevention program in Seoul, South Korea. Data of 8251 citizens with metabolic syndrome were used. Appointment adherers were defined as having 70% or higher adherence rates, that is, 3 or more visits. Of the 8251 citizens, 17.6% were appointment adherers. Appointment adherers were significantly more likely to be older, low-income earners, nonsmokers, and nonobese than appointment nonadherers. Moreover, appointment adherers, compared with nonadherers, showed significant improvements in waist circumference, systolic blood pressure, and high-density lipoprotein cholesterol, but not in fasting glucose and triglycerides. Designing strategies for increasing appointment adherence to a free city-wide cardiovascular disease prevention program is essential to improve health outcomes, especially targeting population groups with young age, high-income, current smoking, or obesity.

Effect Of A Personalized Community-based Exercise Program On Metabolic Syndrome Risk Factors

Community exercise programs have been used to increase physical activity and reduce cardiovascular risks. PURPOSE: To investigate the effectiveness of a personalized community-based exercise program based on intensities personalized to individual ventilatory thresholds (VT) on decreasing metabolic syndrome (MetS) risk factors. METHODS: One hundred and fifty inactive community members were physician referred to a 12-week community exercise program between June 2016 and May 2019. Participants were separated into two groups: non-exercise control (age: M= 45.612.5 yrs) and exercise intervention (age: M= 46.6, SD= 16.7 yrs) prescribed via VT1 and VT2, exercising three times week. VT1 and VT2 measures were obtained by performing treadmill talk tests. MetS risk factors, abdominal obesity as measured by waist circumference (WC), hypertriglyceridemia, low HDL-C, hypertension as measured by systolic blood pressure (SPB) and diastolic blood pressure (DBP), and fasting blood glucose (BG), were analyzed retrospectively using MetS z-score. Paired and independent sample t-tests were used to compare within-group changes from pre- to post-intervention and between-group changes for all primary outcome measures, respectively. Significance was set at α<0.05. RESULTS: The non-exercise group experienced unchanged WC, triglycerides, and BG and had a statistically significant worsening in HDL-C (M±SD)(pre: 50.7 ± 18.2, post: 49.4 ± 16.5), SBP (pre: 119.0 ± 11.0, post: 121.2 ± 9.6), DBP (pre: 79.4 ± 8.4, post: 81.4 ± 6.6), and MetS z-score (pre: -4.14 ± 4.01, post: -3.68± -4.07). In contrast, the personalized exercise group showed statistically significant improvement in WC (pre: 84.0 ± 14.2, post: 83.1± 12.9), triglycerides (pre: 110.8 ± 54.4, post: 104.5 ± 45.7), HDL-C (pre: 54.2 ± 17.9, post: 57.8 ± 15.9), SBP (pre: 122.6 ± 14.1, post: 117.4 ± 13.1), DBP (pre: 79.7 ± 9.7, post: 77.3 ± 7.7), BG (pre: 92.5 ± 8.6, post: 89.7 ± 7.0), and MetS z-score (pre: -3.52 ± 3.82, post: -4.12 ± 3.24). CONCULSION: These findings provide preliminary evidence that individualized programming can be implemented into community-based exercise programs to reduce MetS risk in previously inactive individuals.

A Mobile Health Intervention System for Women With Coronary Heart Disease: Usability Study.

BackgroundCoronary heart disease (CHD) is the leading cause of death and disability among American women. The prevalence of CHD is expected to increase by more than 40% by 2035. In 2015, the estimated cost of caring for patients with CHD was US $182 billion in the United States; hospitalizations accounted for more than half of the costs. Compared with men, women with CHD or those who have undergone coronary revascularization have up to 30% more rehospitalizations within 30 days and up to 1 year. Center-based cardiac rehabilitation is the gold standard of care after an acute coronary event, but few women attend these valuable programs. Effective home-based interventions for improving cardiovascular health among women with CHD are vital for addressing this gap in care.ObjectiveThe ubiquity of mobile phones has made mobile health (mHealth) behavioral interventions a viable option to improve healthy behaviors of both women and men with CHD. First, this study aimed to examine the usability of a prototypic mHealth intervention designed specifically for women with CHD (herein referred to as HerBeat). Second, we examined the influence of HerBeat on selected health behaviors (self-efficacy for diet, exercise, and managing chronic illness) and psychological (perceived stress and depressive symptoms) characteristics of the participants.MethodsUsing a single-group, pretest, posttest design, 10 women participated in the 12-week usability study. Participants were provided a smartphone and a smartwatch on which the HerBeat app was installed. Using a web portal dashboard, a health coach monitored participants’ ecological momentary assessment data, their behavioral data, and their heart rate and step count. Participants then completed a 12-week follow-up assessment.ResultsAll 10 women (age: mean 64.4 years, SD 6.3 years) completed the study. The usability and acceptability of HerBeat were good, with a mean system usability score of 83.60 (SD 16.3). The participants demonstrated statistically significant improvements in waist circumference (P=.048), weight (P=.02), and BMI (P=.01). Furthermore, depressive symptoms, measured with the Patient Health Questionnaire-9, significantly improved from baseline (P=.04).ConclusionsThe mHealth prototype was feasible and usable for women with CHD. Participants provided data that were useful for further development of HerBeat. The mHealth intervention is expected to help women with CHD self-manage their health behaviors. A randomized controlled trial is needed to further verify the findings.

Impact of a short-term synbiotic supplementation on metabolic syndrome and systemic inflammation in elderly patients: a randomized placebo-controlled clinical trial.

The connection between gut microbiota imbalance, inflammation and its role in the pathogenesis of metabolic syndrome (MetS) clustering factors has been increasingly recognized. However, data on the efficacy of probiotics supplementation on MetS components are few and almost lacking in the elderly. To address this issue, we conducted a randomized, double-blind, placebo-controlled, parallel-group, clinical study on a large sample of MetS elderly patients. After 14days of diet and physical activity standardization, 60 elderly patients were randomized to treatment with a synbiotic formula of Lactobacillus plantarum PBS067, Lactobacillus acidophilus PBS066 and Lactobacillus reuteri PBS072 with active prebiotics or placebo. Patients were evaluated anamnestically and by the execution of a physical examination and laboratory and haemodynamic analyses at the baseline and after 60days of treatment. At enrollment and at the end of the trial, all enrolled patients complete the EuroQol-5 Dimension (EQ-5D) questionnaire. Through the 2-month period of treatment, patients who received active treatment experienced a statistically significant improvement in waist circumference and in fasting plasma insulin, total cholesterol, high-density lipoprotein cholesterol, non-HDL-C, triglycerides (TG), low-density lipoprotein cholesterol, high-sensitivity C-reactive protein and tumor necrosis factor alpha serum levels, compared both to the baseline and the control group. Visceral adiposity index improvement in the synbiotic treatment group was significantly greater than in placebo group. Compared to baseline, treatment with synbiotics also significantly reduced mean arterial pressure and fasting plasma glucose. All treatment groups demonstrated a significant decrease in TG. TG reduction in the synbiotic group was significantly greater than in the control group. The EQ-5D VAS questionnaire significantly improved only in probiotics-treated subjects. Treatment with a synbiotic formula of L. plantarum PBS067, L. acidophilus PBS066 and L. reuteri PBS072 with active prebiotics decreased MetS syndrome prevalence, several cardiovascular risk factors and markers of insulin resistance in elderly patients.

Effects of Auricular Acupressure on Korean Children Who are Obese

PurposeThis study aimed to examine the effects of auricular acupresure on reducing obesity in children who are obese. Design and methodsThe study design was a randomized controlled trial design. Participants aged between 9 and 11 years were 65 children who are obese, divided into the experimental group (n = 31) and control group (n = 34). The sessions continued for 8 weeks. The participants in the experimental and control groups received auricular acupressure using ear pellets (seeds) on 5 acupoints known to be either effective in obesity treatment or ineffective. Outcome measures included body image score, children's depression inventory, Rosenberg self-esteem scale, and anthropometric indices (waist circumference, hip circumference, BMI, etc.). ResultsChildren in the experimental group showed significant improvement in waist circumference and hip circumference after 8 weeks compared with those in the control group (p < .001). But no statistically significant difference in body image score, depression score, or self-esteem score emerged before or after auricular acupressure in the experimental and control groups. ConclusionsAuricular acupressure using ear pellets for eight weeks was effective in decreasing waist and hip circumferences in children who are obese. Practice implicationsAuricular acupressure can be used as an intervention method for children to control obesity.

Effects of high intensity interval training among overweight individuals with psychotic disorders: A randomized controlled trial

Physical activity has been suggested to reduce the high prevalence of metabolic complications in individuals with psychosis. Although high intensity interval training (HIIT) is efficacious in other populations, it remains poorly studied in psychosis. MethodsRandomized controlled study comparing the effects of 6 months HIIT supervised program (30-minute treadmill sessions twice a week) to usual-care waiting-list control group. Anthropometric (primary outcome: waist circumference), body composition, blood profile, blood pressure, psychiatric symptoms and global functioning were measured at baseline and 6 months. ResultsSixty-six individuals with psychosis (62% men; 30.7 ± 7.2 years old; mean BMI: 32.7 ± 5.7 kg/m2) were randomly assigned to either HIIT (n = 38) or control group (n = 28). Mean attendance rate to HIIT sessions was 64%, although 50% dropped-out the intervention before the end. Few minor adverse events were reported. The intent to treat analysis showed no impact of HIIT on waist circumference (p = 0.25). However, in a post-hoc analysis among the compliant participants (>64% of prescribed sessions), significant improvements in waist circumference (−2.94, SE = 1.41, p = 0.04), negative symptoms (PANSS negative −3.7, SE = 1.39; p = 0.01), social (SOFAS +6.16, SE = 1.76, p = 0.001) and global functioning (GAF +5.38, SE = 2.28, p = 0.02) were observed. DiscussionHIIT seems to be safe and well accepted in overweight individuals with psychosis. Exercise compliance to HIIT is associated with improvements in waist circumference as well as negative symptoms and functioning. Interventions improving attendance are needed.

Feasibility and potential efficacy of commercial mHealth/eHealth tools for weight loss in African American breast cancer survivors: pilot randomized controlled trial.

Weight management after breast cancer (BC) treatment in African American (AA) women is crucial to reduce comorbid conditions and health disparities. We examined feasibility and potential efficacy of commercial eHealth/mHealth tools for weight management in AA BC survivors in New Jersey. Participants (N = 35) were randomized to an intervention (SparkPeople) plus activity tracker, Fitbit Charge (n = 18), or wait-list active control group (Fitbit only, n = 17). Anthropometric, behavioral, and quality of life (QOL) outcomes were collected at baseline, 3, 6, and 12 months. Differences in outcomes were assessed using intent-to-treat analysis. Retention was 97.1%. Both groups lost weight, with no significant differences between groups. At month 6, mean weight change was: intervention: -1.71 kg (SD 2.33; p = .006), 33.3% lost ≥3% of baseline weight; control: -2.54 kg (SD 4.00, p = .002), 23.5% lost ≥3% weight. Intervention participants achieved significant improvements in waist circumference (-3.56 cm, SD 4.70, p = .005), QOL (p = .030), and use of strategies for healthy eating (p = .025) and decreasing calories (p < .001). Number of days logged food per week was associated with decreases in waist circumference at 6 months (β -0.79, 95% CI, -1.49, -0.09, p = .030) and 12 months (β -2.16, 95% CI, -4.17, -0.15, p = .038). Weight loss was maintained at 12 months. This is the first study to demonstrate potential efficacy of commercial eHealth/mHealth tools for weight loss in AA BC survivors, without additional counseling from the research team. If effective, they may be convenient weight loss tools that can be easily and widely disseminated. Clinical Trials registration: ClinicalTrials.gov NCT02699983.

The effect of a 12-week exercise and lifestyle management programme on cardiac risk reduction: A pilot using a kaupapa Māori philosophy

Introduction: Cardiovascular disease remains the leading cause of premature death and disability for all New Zealanders. Māori, the Indigenous people of New Zealand, are disproportionately affected. The New Zealand Māori Health Strategy recognises that “health and wellbeing are influenced and affected by the ‘collective’ … and the importance of working with people in their social contexts, not just with their physical symptoms” (Ministry of Health, 2002, p. 1). In a Māori worldview, a holistic approach to health is innate. Objectives: This project piloted a kaupapa Māori approach within an existing 12-week clinical exercise and lifestyle management programme. The aims of the study were to determine the effectiveness of a kaupapa Māori 12-week exercise and lifestyle management programme on parameters of cardiac risk and quality of life. Methods: 12 Māori participants attended, 3 times per week over a 12-week period, for monitored, supervised, and individualised exercise. Participants performed a progressive aerobic-only programme for 6 weeks and then a combined aerobic and resistance training programme from weeks 7 through 12. Education sessions were chosen by participants. Results: There was a statistically significant improvement in waist circumference (–3.7 cm; p = .05), hip circumference (–4.6 cm; p = .03), systolic blood pressure (–22 mm Hg; p = .01), and HDL cholesterol (0.22 mmol/L; p = .01). In addition, physical (p = .05) and overall (p = .03) quality of life improved. Conclusion: A kaupapa Māori approach within a structured lifestyle management programme modifies cardiac risk parameters in Māori.

Can low BMI Chinese patients with type 2 diabetes benefit from laparoscopic Roux-en-Y gastric bypass surgery?

BackgroundThe efficacy of laparoscopic Roux-en-Y gastric bypass (LRYGB) in type 2 diabetes mellitus (T2D) is closely associated with the preoperative body mass index (BMI) of the patient. There is a lack of long-term and large sampling evidence on the efficacy of LRYGB in T2D patients with low BMI in China. ObjectivesThis retrospective study aimed to evaluate the efficacy of surgical treatment in a Chinese population with T2D (especially patients with BMI<27.5 kg/m2). SettingUniversity-affiliated hospital, China MethodsSeventy-eight patients with T2D were included in the study and evaluated before and after LRYGB surgery. No patients were lost to follow-up at any time points. ResultsThirty-eight T2D patients with BMI≥27.5 kg/m2 in group 1 (high BMI group) had significant improvements in waist circumference, blood glucose levels, homeostasis model assessment-insulin resistance index, and C-peptide levels after LRYGB (P<.05). Forty T2D patients with BMI<27.5 kg/m2 in group 2 (low BMI group, including 19 T2D patients with BMI<25 kg/m2) had significant improvements in waist circumference and waist-to-hip ratio after LRYGB (P< .05). ConclusionsLRYGB surgery may be beneficial in T2D patients with BMI<27.5 kg/m2 in China.

Community-based fortified dietary intervention improved health outcomes among low-income African-American women

Poor dietary exposure disproportionately affects African-Americans and contributes to the persistence of disparities in health outcomes. In this study, we hypothesized that fortified dietary intervention (FDI) will improve measured dietary and related health outcomes and will be acceptable among low-income African-American women living in Tampa, FL. These objectives were tested using a prospective experimental study using pretest and posttest design with a control group, using a community-based participatory research approach. The intervention (FDI) was designed by the community through structural modification of a preexisting, diet-based program by the addition of a physical and mental health component. Paired sample t tests were used to examine preintervention and postintervention changes in study outcomes. A total of 49 women participated in the study, 26 in the FDI group and 23 controls. Two weeks postintervention, there were significant improvements in waist circumference and health-related quality of life related to physical health (P< .0001), physical fitness subscores (P= .002), and nutritional subscores (P= .001) in the FDI group. Among overweight/obese women, improvement in health-related quality of life related to physical health, a significant decrease in depressive score, and a reduction in waist circumference were noted. In the control group, a decrease in waist circumference was observed. Implementation of the FDI through a community-based participatory research approach is feasible and effective among low-income African-American women in general and overweight/obese women in particular. Social reengineering of a nutritional intervention coupled with community-based approach will enhance health outcomes of low-income women.