Sustainable Lifestyle Changes Research Articles

Risk of developing Type 2 Diabetes Mellitus in a vulnerable community in northern Argentina

Introduction: Prevention of diabetes requires sustained lifestyle changes as well as identification of groups at higher risk. Objective: The aim of this research was to estimate the risk of diabetes in vulnerable subjects from a primary care center in northern Argentina, with no known glucose abnormalities, using the FINDRISC questionnaire, investigate the relationship between survey variables and the final score, and explore its association with metabolic risk factors and body composition. Methodology: This cross-sectional design included 498 patients without type 2 diabetes or known glycemic abnormalities. All subjects underwent a complete medical history and completed the FINDRISC questionnaire. Results: The predominant age group was 18-45 years old. Around 64% were physically active and 44% reported daily consumption of fruit and vegetables. Most of them had a BMI higher than 25 kg/m2. Regarding the risk of developing type 2 diabetes in the next 10 years, 24.3% were at low risk and the remaining fraction was distributed in slightly elevated, moderate, high and very high risk. All variables influenced the individuals' variance (p < 0.05). The hierarchical clustering and principal component analysis (PCA) revealed that elevated FINDRISC score was strongly associated with: age > 65 years, fasting blood glucose, BMI ? 30 kg/m2 and antihypertensives use. CONCLUTION: We found a high percentage of obesity and overweight, as well as a high risk of cardiometabolic disease and of developing T2D. In addition, in the population studied, the variables that compose the FINDRISC did not influence the highest score in the same way.

Positive impact of nutrition in the prevention of peripheral vascular disease and severe acute respiratory syndrome coronavirus 2: review.

Recent research has shown that there is a link between the trend of cardiovascular disease (CVD), chronic symptoms of SARS-CoV-2 (COVID-19), and medical nutrition therapy. Making positive changes to an individual's lifestyle can help to reduce the symptoms that follow exposure to CVD and COVID-19. Sustainable nutrition and lifestyle changes can positively impact an individual's health. Studies have considered the risk factors associated with the disease, medical history, the link between nutrition and peripheral vascular disease (PVD), symptom management, and the interrelationship between nutrition, COVID-19, and PVD. One study has demonstrated that Western Dietary intake can boost the innate immune system while suppressing humoral response, causing chronic inflammation and poor host defense against viruses. However, further investigation is needed to confirm. Patients with PVD and COVID-19 have experienced a reduction in side effects when prescribed a regimen of medical nutrition therapy, heart-healthy diets, and adequate physical activity before and after symptoms of both diseases appear. This approach has proven to be a protective factor during the combination of both illnesses. Our findings indicate that balanced diet and lifestyle are essential in supporting an optimal immune system that can reduce the risk of virus load in individuals at risk of infection and symptoms from COVID-19 and PVD.

The Role of Public Health in Preventing Obesity

Obesity has become a global public health crisis, affecting individuals across various demographics and leading to significant health and economic burdens. This paper investigates the role of public health interventions in preventing obesity, focusing on epidemiological trends, genetic and environmental factors, and community-based approaches. The review analyzes the intersection of genetics, appetite regulation, and the environment in obesity’s etiology while emphasizing the need for multidisciplinary, evidence-based, and community-driven interventions. Public health policies, including legislative measures, public awareness campaigns, and school-based programs, are crucial in combating obesity and promoting healthier lifestyles. Effective obesity prevention requires holistic, inclusive, and culturally sensitive strategies that engage communities, prioritize early intervention, and foster sustainable lifestyle changes. Keywords: Obesity prevention, public health, epidemiology, gene-environment interaction.

Digital therapeutics in hypertension: How to make sustainable lifestyle changes.

Various digital therapeutic products have been validated and approved since 2017. They have demonstrated efficacy and safety as a new therapeutic modality in various disorders or conditions. Hypertension is a common but serious condition that can be prevented or controlled with lifestyle changes and medicines. Although a digital therapeutic in hypertension is validated and approved in Japan, whether digital therapeutics (DTx) can significantly improve sustainable lifestyle changes is still a controversial topic. Most studies did not discuss the long-term gain challenges. In this review, the authors discuss the definition of DTx, and analyze the motivation, engagement and adherence challenges of DTx in hypertension. Some ongoing artificial intelligence (AI)-enabled or cognitive behavioral therapy (CBT)-based digital interventions and behavioral strategies for implementing sustainable lifestyle changes are identified and analyzed. With AI-enabled interventions and behavioral strategies, DTx might be one of the effective approaches to make sustainable lifestyle changes.

Preserving insulin function in diabetes: a case report

BackgroundThis case report explores the long-term dynamics of insulin secretion and glycemic control in two patients with diabetes mellitus type 2 over 20 years. The observations underscore the impact of lifestyle interventions, including weight loss and calorie restriction, on insulin secretion patterns and glucose levels during 75 g oral glucose tolerance tests. Additionally, the role of hemoglobin A1c fluctuations, influenced by various factors such as body weight, exercise, and pharmacological interventions, is investigated.Case presentationCase 1 involves a Japanese woman now in her late 70s who successfully maintained her hemoglobin A1c below 7% for over two decades through sustained weight loss and lifestyle changes. Despite a gradual decline in the homeostasis model assessment of β cell function, the patient exhibited remarkable preservation of insulin secretion patterns over the 20-year follow-up. In case 2, a Japanese woman, now in her early 70s, experienced an improvement in hemoglobin A1c to 6.3% after a period of calorie limitation due to a wrist fracture in 2018. This incident seemed to trigger a temporary rescue of pancreatic β cell function, emphasizing the dynamic nature of insulin secretion. Both cases highlight the potential for pancreatic β cell rescue and underscore the persistence of insulin secretion over the 20-year follow-up. Additionally, we have briefly discussed three additional cases with follow-ups ranging from 10 to 17 years, demonstrating similar trends in glucose and insulin ratios.ConclusionsLong-term lifestyle interventions, such as weight loss and calorie restriction, can preserve pancreatic β cell function and maintain glycemic control in type 2 diabetes patients over 20 years. Two patients showed stable or improved insulin secretion and favorable hemoglobin A1c levels, challenging the traditional view of irreversible β cell decline. The findings highlight the importance of personalized, nonpharmacological approaches, suggesting that sustained lifestyle changes can significantly impact diabetes management and potentially rescue β cell function.

Application of artificial intelligence technology in monitoring students' health: Preliminary results of Syiah Kuala Integrated Medical Monitoring (SKIMM).

Health promoting university is a holistic approach to health that uses higher education settings to create a learning environment that improves the health and well-being of the campus community in a sustainable manner. The utilization of technology such as artificial intelligence (AI) could be one of the main success factors in the implementation of health-promoting universities to increase the effectiveness and efficiency of all stages of activities carried out in health promotion and prevention efforts. Integrated monitoring with the utilization of AI in this program is conducted to evaluate the health status of the students. The Syiah Kuala Integrated Medical Monitoring (SKIMM) has three components of continuous health status evaluation: vital signs, nutritional status, and burnout status. Health status monitoring was conducted continuously for three months among medical students at the Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, Indonesia. This system uses the WhatsApp application as a platform to monitor health status. Student health monitoring in this program consists of two main activities: the health measurement phase and the health monitoring phase. The use of the SKIMM system to monitor students' vital signs, nutritional status and burnout status through the use of AI significantly raises students' awareness to conduct timely self-examination and enables sustainable healthy lifestyle behavior change. The adoption of AI technology allows for continuous health promotion to the entire academic community, including students in implementing the health promoting university.

Edukasi dan Promosi Kesehatan Diabetes Melitus Lingkungan XIX Kelurahan Tanjung Mulia Hilir Kecamatan Medan Deli

Education and health care for diabetes mellitus in Environment Objective: This implementation is to increase knowledge and health care about diabetes mellitus in Environment XIX, Tanjung Mulia Hilir Village, Medan Deli District. Health promotion for diabetes mellitus (DM) focuses on empowering individuals and communities to make sustainable lifestyle changes that prevent or delay the onset of type 2 diabetes and effectively manage existing diabetes to minimize complications. This method involves a multifaceted approach that includes: 1). Prevention, namely increasing awareness by educating the public about diabetes risk factors (such as obesity, lack of physical activity, unhealthy eating patterns, family history) and promoting healthy lifestyle choices. Encourage regular screening for early diagnosis, especially for those with risk factors. Promote healthy eating habits, regular physical activity, and maintaining a healthy weight. Expected Outcome: increasing public awareness of diabetes risk factors (such as obesity, lack of physical activity, unhealthy diet, family history) and promoting healthy lifestyle choices. As well as the existence of guidelines for healthy eating and physical activity. Mechanisms for solving problems and overcoming them.

Networked sustainable lifestyle activism: growth and limits of zero waste movement in urban China

ABSTRACT How do citizens express environmentalism and lead sustainable change in an authoritarian country like China, where contentious political civic actions have limited saliency? Can we re-imagine what forms of citizen action build ’environmental movement’ in this socio-political context? Based on 41 in-depth interviews and seven months of participant observations in China’s zero waste community, this article proposes networked sustainable lifestyle activism as an important form of environmental movement in China’s socio-political context. Drawing on lifestyle movement (Haenfler et al. 2012) and sustainable materialism (Schlosberg 2019) theories, I analyze the growth, characteristics, and limitations of the zero waste movement in China. It consists of sustainable lifestyle activism that adopts lifestyle change for broader sustainability, pursues anti-consumerism authentic identity and well-being as a site of change, and grows through social media and informal networks. Meanwhile, the movement goes beyond individual lifestyle change as networks of secondhand material flow and collective, non-contentious environmental actions. Difficulties to promote widespread, thorough sustainable lifestyle change and constrained political engagement are important factors that limit the movement’s effects. My research contributes to the literature on new environmental movements, theoretical discussion of environmental movements in China, and empirical understanding of civic environmental actions in this socio-political context.

FITNOURISH: Smart Nutrition Tracker for Fitness Enthusiasts

In today’s health-conscious society, individuals are increasingly recognizing the importance of nutrition in optimizing their overall health and wellness. However, the conventional approach to nutrition often fails to consider the unique needs and preferences of individuals, resulting in generic dietary recommendations that may not be effective or sustainable. The Personalized Nutrition Analyzer is a cutting-edge system designed to address this gap by providing tailored nutrition recommendations and meal planning services based on each user’s specific characteristics, dietary preferences, and health goals. By leveraging advanced technology and data analytics, this sophisticated system empowers individuals to make informed decisions about their dietary intake, ultimately contributing to improved health outcomes and enhanced well-being. The Personalized Nutrition Analyzer revolutionizes dietary guidance by offering tailored nutrition recommendations and meal planning services to individuals striving for optimal health and wellness. Through meticulous analysis of user input, dietary preferences, and health objectives, the system provides personalized meal plans, nutrient analyses, and insightful guidance to facilitate informed decision-making regarding dietary choices. In a world where health consciousness is paramount, traditional one-size-fits-all dietary approaches often overlook individual nuances, leading to suboptimal outcomes. However, the Personalized Nutrition Analyzer bridges this gap by leveraging sophisticated technology and data analytics to customize dietary strategies according to each user’s unique characteristics and goals. By empowering users with personalized insights and actionable recommendations, the system promotes sustainable lifestyle changes and fosters improved health outcomes

Implementation of a randomized mobile-technology lifestyle program in individuals with nonalcoholic fatty liver disease

Identifying effective, feasible, low-cost interventions that promote sustainable lifestyle changes in nonalcoholic fatty liver disease (NAFLD) is a key unmet need. The aim of this study was to assess predictors of lifestyle practice patterns of NAFLD patients and evaluate the implementation of a mobile technology-based intervention. We prospectively enrolled adults with NAFLD (diagnosed by imaging or biopsy). Individuals with additional liver diseases or decompensated cirrhosis were excluded. Patient were randomized to usual care or a FitBit based program for 6-months. We obtained anthropometrics, labs, vibration controlled transient elastography (VCTE), health-related quality of life (HRQOL), physical activity, diet and motivation to change data. 70 patients were enrolled, 33% with cirrhosis. Median age was 52.1 years, 47% males, 83% white, body mass index 32.3, liver stiffness 7.6 kPa, controlled attenuation parameter 319 db/m, and 50% had diabetes. Baseline HRQOL was 5.4/7 and independently negatively correlated with level of concern about their disease and positively with physical function. Younger age was independently associated with unhealthy diets whereas diabetes was independently associated with unhealthy diets and higher VCTE kPa. 6-month follow-up data available on 31 patients showed trends in improvement in weight. In a cohort of NAFLD patients, we identified independent correlates of lifestyle behaviors and HRQOL. Implementation of interventions that improve physical function may improve HRQOL in NAFLD. Younger patients and those with diabetes appeared to have the greatest need for dietary interventions. Structured mobile technology lifestyle interventions using Fitbit and personalized coaching showed promise but require further validation with a focus on sustainability of intervention and improvement in outcomes.

App-Based Lifestyle Intervention (PINK! Coach) in Breast Cancer Patients-A Real-World-Data Analysis.

Overweight and a lack of physical activity not only increase the risk of recurrence in breast cancer patients but also negatively impact overall and long-term survival, as well as quality of life. The results presented here are the first real-world data from the DiGA PINK! Coach examining the physical activity and BMI of app users. Based on the literature, an approximate weight gain of 10% over 6 months and a decrease in physical activity can be expected. The purpose of this study is to retrospectively investigate the effects of the PINK! Coach in a real-world setting on patients' BMI and physical activity level during acute therapies. such as chemotherapy (CHT) and antihormone therapy (AHT). The PINK! Coach app accompanies breast cancer patients during and after acute therapy to bring about a sustainable lifestyle change. The patients are encouraged to establish a healthy diet, become physically active, and make informed decisions. In this study, real-world data from the app were analyzed over 6 months from baseline to T1 (after 12 weeks) and T2 (after 24 weeks). The patients were under acute therapy or in follow-up care receiving either CHT or AHT. The analyzed data indicate that all patients were able to maintain a consistent BMI over 6 months independent of pre-defined subgroups such as AHT, CHT, or BMI subgroups. In the subgroup of patients undergoing AHT, overweight patients were even able to significantly reduce their BMI by 1-score-point over 6 months (p < 0.01). The subgroup of patients undergoing CHT also showed an significant overall reduction in BMI (p = 0.01). All patients were also able to significantly increase their daily step count as well as their physical activity minutes per day. After the first 12 weeks, 41.4% of patients experienced weight gain, 33.4% were able to maintain their weight, and 24.2% reduced their weight. The presented data provides intriguing insights into the users of the PINK! Coach app and the impact of this usage in regards to BMI and physical activity. At the current time, there are only a few effective concepts for encouraging all breast cancer patients to engage in moderate physical activity and reduce body weight. Often, these concepts apply to selected patient groups. The data presented here include all age groups, tumor stages, and therapies, providing an initial insight into a comprehensive approach. Data over an even longer period would be one way to better contextualize the results in current research.

Personalized Fitness and Diet Planner with Smartwatch Integration

This survey paper explores the intersection of technology and health by delving into the realm of personalized fitness and diet planning, with a focus on seamless integration with smartwatches. The paper reviews existing literature, methodologies, and advancements in the development of innovative solutions that leverage smartwatch capabilities to tailor fitness and dietary recommendations to individual needs. By examining the convergence of data analytics, artificial intelligence, and wearable technology, the survey sheds light on the potential benefits, challenges, and future prospects of adopting a personalized approach to health and wellness. The aim is to provide readers with a comprehensive overview of the current state-of-the-art, fostering a deeper understanding of how the integration of smartwatches into personalized health management systems can contribute to more effective and sustainable lifestyle changes. Key Words: NLU, NLP, SVM, BERT, API, BMI

MHealth app features that facilitate adolescent use for lifestyle management, and are endorsed by caregivers and health care providers.

Mobile health (mHealth) apps are becoming a promising tool to motivate sustainable lifestyle and behavior changes, including modifications to diet and exercise. However, most current mHealth apps do not have meaningful, and sustained user acceptance, particularly, among adolescents. They perceive mHealth apps designed for adults to be tedious and visually unexciting, which discourage adolescent usage. Researchers and adolescent mHealth app developers would benefit from a foundational understanding of which functions and features adolescents feel would most motivate app use. Capturing caregivers' and health care providers' inputs are also important as both groups play an integral role in adolescent health care decision-making. The purpose of the study is to explore and analyze mHealth app features identified by adolescents, caregivers, and health care providers that have the potential to inspire continued use, thereby resulting in sustained health behavior changes in adolescents. We used inductive thematic analysis of qualitative data obtained from semi-structured focus groups conducted via Zoom©. Important features of mHealth apps that encourage adoption and continued use were explored with 25 participants, including adolescents, their caregivers, and health care providers. Common features facilitating continual usage of mHealth apps that were identified as significant by participating adolescents, their caregivers and health care providers were: look and feel of the app, customization, educational information/recommendations, and integration with electronic health record. Features such as gamification and social interaction that are usually lacking in current adolescent mHealth apps were well recognized as meaningful for motivational purposes. The findings suggest that adolescents and caregivers identify an app as valuable when it is user-friendly and intuitive and appreciate features that are motivating and can engage users in positive behaviors. Health care providers prefer mHealth apps that are user-friendly and can be effectively integrated into the cycle of care, thereby enabling delivery of efficient and value-based health care. Thus, mHealth app designs that are informed by health care providers' clinical experience and needs, in combination with app features that are desired and supported by both adolescents and their caregivers, have the potential to motivate widespread adoption and long-term use, which could result in improved health behaviors and outcomes among adolescents.

Keep your brain healthy: development and evaluation of an e‐learning tool on dementia risk reduction

AbstractBackgroundMany people are unaware of the potential for dementia risk reduction, but state they would appreciate more information on this topic (1). Raising awareness is important as a first step towards behavior change (2). The knowledge that a set of lifestyle behaviors is beneficial for your cognitive health may also provide additional motivation (2).MethodAn online, free e‐learning on the topic of dementia risk reduction for the Dutch adult population will be developed (in co‐creation with Alzheimer Netherlands). It will cover the following topics: physical activity, healthy diet and alcohol consumption, cognitive activity, mental wellbeing including social wellbeing and sleep, cardiovascular health, and tips from lifestyle coaches and end‐users on how to make sustainable lifestyle changes. The content of the e‐learning will be delivered in stages, so that completion of the full course takes approximately seven weeks.ResultThe e‐learning’s effectiveness in terms of knowledge acquisition, evolution in motivation for health behavior and actual health behavior improvements will be assessed with validated questionnaires in a pre‐post study. Participants (minimum N = 300) will complete an online survey before starting the course, immediately thereafter and again three months later. User experiences and engagement with the e‐learning materials will also be evaluated.ConclusionAwareness of the potential for dementia risk reduction is currently lacking in the general population. An e‐learning is a low‐level means that can be used to increase knowledge and awareness, and could further easily be implemented as a stand‐alone tool or as part of current or future dementia risk reduction initiatives.

A Study on Lifestyle Pattern Associated with Diet, Physical activity, and Body Mass Index in a Case of GYM Goers

This study examines the lifestyle patterns related to diet, physical activity, and body mass index (BMI) among gym goers. the objective is to investigate the associations between these lifestyle factors and their impact on overall health and fitness outcomes in this population. A comprehensive analysis of dietary habits, physical activity routines, and BMI measurements was conducted among gym goers the study collected data from 100 member (males and females) through interview method and the using google forms and measurement the statistical analysis technique like t-test are used were applied to identify patterns between diet, physical activity, and Body Mass Index. These research findings have implications and programs tailored to the specific needs of gym goers, aiming to improve health outcomes and promote sustainable lifestyle changes in this population. With the goal of improving their health outcomes and facilitating long term lifestyle changes. Keywords: - Fitness community, Health-conscious individuals, Weight management and progress tracking, Workout routines, Exercise, Physical fitness, Nutrition and eating habits.

An Innovative Approach to Measure Mental Resilience and Wellbeing at the Individual and Societal Level Using the “Human Condition-4 – Satisfaction Index”

The concept of resilience is one aspect of mental health and coping mechanism that is paramount to understand the relationship between physical and mental health. However, in recent decades, there is a growing dissatisfaction among healthcare professionals with the traditional clinically driven resilience assessment tool. This is largely due to the fact that most resilience measures are unidimensional, with very long questionnaires and fails to address the complex underlying determinates of health. Resilience is a complex multidimensional construct with multiple interacting factors such as epigenetic, socio-economic, cultural, and environmental factors; all play critical roles in developing and modulating resilience in an integrated way. In recognition of that, this paper proposed an easy-to-use diagnostic resilience assessment tool that is person-centred and encompasses personal, community, and societal aspects of individual life. The four proposed domains for measuring resilience are (1) Control – self-determination, (2) Connectedness – social significance, (3) Cohesion – meaning and over-individual context, and (4) “Cherished” – identity and integrity. Furthermore, we propose a four-step guideline for the application of the proposed resilience assessment tool, which is applicable at the individual and societal levels. The overall aim is to support individuals and vulnerable populations by enhancing resilience and mitigating the untoward consequences. The assessment tool and the four-step guidelines can facilitate informed decision-making strategies that are feasible and support sustainable lifestyle changes and improve negatively correlated mental health indicators such as life and suffering, helplessness, social significance, identity, and meaning.

The Effectiveness of Integrating Psychotherapy Into Overweight/Obesity Interventions on Youth’s Weight Status and Depressive Symptoms: A Narrative Review

Introduction: Childhood obesity and youth depression are serious ongoing global crises of the 21st century. Many researchers have often attributed this to the well-established association between them. Consequently, psychotherapies are increasingly being integrated into interventions to improve weight status and depression outcomes for individuals with overweight and/or obesity (OW/OB). However, the effectiveness of these interventions has not yet been reviewed for youth with OW/OB. Such youth tend to be at a higher risk of developing comorbid depressive symptoms, which can likely persist into adulthood. Therefore, this narrative review explored the effectiveness of psychotherapy integrations within OW/OB interventions on youth’s weight statuses and their depressive symptoms contemporaneously. Methods: Medline, Embase, PsycInfo, PubMed, and Scopus were accessed. English peer-reviewed empirical articles, reviews, meta-analyses, clinical trials, and pilot studies from the last ten years and those that investigated the effectiveness of OW/OB interventions integrated with psychotherapy among youth (5-18 years) were included. Keywords related to diet, psychotherapy, OW/OB, youth, and depression were used. Non-peer-reviewed sources, reviews lacking sufficient transparency in their methodology, editorials, letters, study protocols, commentaries, preprints, and dissertations were excluded. Results: Four studies, including two pilot studies, were included. Overall, we found high heterogeneity in their intervention components and conditions, study designs, participants, and results. Among youth, all studies found no significant improvements in weight status as per the authors’ set significance thresholds. Mixed results were obtained for the effect on youth’s depressive symptoms. Discussion: There is an alarming lack of recent literature investigating the impact of integrated evidence-based psychotherapies within OW/OB interventions on youth’s weight statuses and depressive symptoms. It is important to investigate their effectiveness in equipping youth with OW/OB with skills to make sustained lifestyle changes and cope with weight discrimination and depressive symptoms. We attributed the weak success of these interventions to the lack of cultural adaptations and standardization of study types, intervention structures, components, and conditions. Conclusion: It is important for researchers to continue investigating the success of such interventions on youth with OW/OB’s physical and mental outcomes simultaneously. This will further inform the interdisciplinary approach needed to deliver appropriate care to these youth.

Feasibility of Health and Fitness Data Collection in Online Behavioral Intervention of Elderly

Abstract The global increase in life expectancy has led to a growing elderly population, which necessitates novel strategies to promote healthy ageing and maintain optimal quality of life. Lifestyle coaching has emerged as a promising intervention to address these challenges by offering tailored guidance and support for seniors to make sustainable lifestyle changes. This study investigates the feasibility of collecting health and fitness data reported by the elderly population participating in an online behavioural intervention. We recruited 60 community-dwelling elderly individuals between the ages of 55-80 (including both men and women) for a 14-week online intervention promoting healthy lifestyles using coaching principles. The main criteria for inclusion were a diagnosis of arterial hypertension with or without medication and/or overweight or obesity as defined by BMI. We collected health-related data (arterial blood pressure, weight, waist circumference, quality of life using EQ-5D-5L questionnaire) and fitness-related data (30-second chair test, 2-minute step test). All data were self-recorded by the participants and reported via an online system with the help of a health coach. Forty-seven participants were able to complete the entire 14-week intervention. The initial data set resulted in only 51% (24 out of 47) of the participants having reported the full dataset. We then used written and spoken reminders to notify participants to submit the collected data, which brought the percentage up to 70% (33 out of 47). The main obstacle in health and fitness-related data collection was the forgetfulness of participants to do the self-reported measurements and tests. Among other factors affecting the amount of collected data, we experienced a lack of understanding of the process of the fitness tests, as well as a low questionnaire completion ratio. Almost 80% of participants managed to report all of the health-related data which was also considered the least complicated to collect. Key messages • Elderly people with higher cardiovascular risk are able to self-report health and fitness data in online behavioral intervention but thorough guidance and reminders need to be applied. • Elderly people are willing to participate on the online lifestyle behavioural interventions.

SAT368 Severe Hyperandrogenism in a Young Woman with Elevated BMI: A Case Study of The Role of Weight Loss in The Management of PCOS

Abstract Disclosure: S. Rodriguez Ortega: None. I.R. Bass: None. Background: Increased adiposity enhances the phenotypic expression and severity of hyperandrogenism in women with Polycystic Ovarian Syndrome (PCOS). Weight loss has been associated with improved endocrine features in women with PCOS and elevated Body Mass Index (BMI). Bariatric surgery can be an effective means of significant weight loss and restoration of the hypothalamic pituitary axis. Case Presentation: A 21-year-old Hispanic nulligravid woman presented with history of oligomenorrhea, weight gain and hirsutism. Her symptoms started after menarche at 15 years old with irregular periods, hair growth on her face and neck, and rapid weight gain. She was evaluated by an endocrinologist and was found to have an elevated total testosterone level by LC/MS on several different occasions: 309ng/dl, 259ng/dl and 229 ng/dl, as well as elevated androstenedione 346 ng/dl (41-262ng/dl). She was treated with metformin and oral contraceptive pill for two years and then referred for second opinion. On our physical exam, she had a BMI of 44.60 kg/ m2, a deep voice, Ferriman Gallwey score of 12 and acanthosis nigricans. OCPs were held for three months for accurate testing and work up revealed total testosterone 164.7 ng/dl (10.0-55.0 ng/dl), sex hormone binding globulin 25.4 nmol/L (24.6-112.0 nmol/L), bioavailable testosterone 84.3ng/dL (51.4%), DHEAs 375 µg/dl (110-431.7 µg/dl), and androstenedione 264 ng/dl (41-262 ng/dl). Other causes of hyperandrogenism such as hyperprolactinemia, hypothyroidism and congenital adrenal hyperplasia were ruled out. MRI pituitary from outside facility was reviewed and was normal. MRI abdomen and pelvis with/without contrast was performed, which demonstrated normal adrenal glands and an 8.1 cm midline pelvic cyst, containing a 0.7 cm enhancing solid nodule. She was referred for surgery for concern for possible virilizing tumor. The cyst was surgically removed and intra-operative ovarian exploration and cytopathology from pelvic washing were negative. She was referred for bariatric surgery and underwent a sleeve gastrectomy. After 6 weeks, she lost 30lbs, BMI improved to 37.1 kg/ m2 and her menses resumed. Repeat labs showed improvement in her androgens: total testosterone 64.8ng/dl, SHBG 104nmol/L, androstenedione 127ng/dl. After 8 months, she lost 110lbs and has dramatic improvement in her hirsutism and clearance of her acanthosis nigricans. Conclusion: Sustained lifestyle changes and weight loss are a mainstay in the treatment of patients with PCOS and obesity. Bariatric surgery results in durable weight loss and restores the normal physiological balance of sex hormones and improves signs and symptoms of hyperandrogenism. Presentation Date: Saturday, June 17, 2023

Motivational communication skills to improve motivation and adherence in cardiovascular disease prevention: A narrative review.

Lifestyle optimization is one of the most essential components of cardiovascular disease prevention. Motivational counseling provided by health care professionals could promote lifestyle modification. The purpose of the review is to identify possible evidence-based psychological principles that may be applicable to motivational counseling in the prevention of cardiovascular disease. These motivational communication skills promote behavioral change, improved motivation and adherence to cardiovascular disease prevention. A personal collection of the relevant publications. The review identified and summarized the previous evidence of implementation intentions, mental contrasting, placebo effect and nocebo effects and identity-based regulations in behavior change interventions and proposed their potential application in cardiovascular disease prevention. However, it is challenging to provide real support in sustainable CVD-risk reduction and encourage patients to implement lifestyle changes, while avoiding being unnecessarily judgmental, disrespectful of autonomy, or engaging patients in burdensome efforts that have little or no effect on the long run. Motivational communication skills have a great potential for effectuating sustainable lifestyle changes that reduce CVD-related risks, but it is also surrounded by ethical issues that should be appropriately addressed in practice. It is key to realize that motivational communication is nothing like an algorithm that is likely to bring about sustainable lifestyle change, but a battery of interventions that requires specific expertise and long term joint efforts of patients and their team of caregivers.