Sustainable Lifestyle Changes Research Articles

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

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.

Health care professionals’ experiences and perceptions of health promotion through the health dialogue intervention in the scania region, Sweden: a qualitative interview study

BackgroundCardiovascular disease and type 2 diabetes are among the largest public health challenges in Sweden. Research indicates that a healthy lifestyle can prevent most cases. The health dialogue is an evidence-based public health programme for primary care with positive results in several regions of Sweden. This study aimed to describe health care professionals’ experiences and perceptions of health promotion through the health dialogue intervention during the pilot phase in the Scania region of Sweden.MethodsThe study consists of 12 individual interviews with health care professionals educated in the health dialogue method, implementing the intervention in Scania. Qualitative content analysis with an inductive approach was used.ResultsThe analysis resulted in 10 sub-categories and the four main categories: A more health-promoting mindset would benefit primary care; Empower individuals; Facilitate sustainable lifestyle changes; Challenges, tools and support for the implementation of the health dialogue. One overarching theme emerged: “Health dialogue, a potential start of a paradigm shift in Swedish primary care”.ConclusionsConclusions imply that the health dialogue is a well-structured method with tools to make health promotion and primary prevention an integrated part of primary care. A respectful and motivating approach during the health dialogue is recommended. It is important to have an ongoing discussion about the approach among the health care professionals. Incorporating the Health Belief Model in the health care professionals’ education in the method could increase the focus on self-efficacy during counselling, which could favour the participants’ change process.

Fresh Start: A Comprehensive Pilot Produce Prescription Program to Improve Food Literacy and Glycemic Control in Rural, Uninsured Patients

Produce prescription (PRx) programs improve access to fresh fruits and vegetables. However, many programs lack culinary focused nutrition education or behavioral support to promote sustainable lifestyle changes. The pilot Fresh Start PRx (FSPRx) program was a 20-week PRx program. The purpose of this study was to examine the impact of the FSPRx program on food literacy, lifestyle behaviors, and health outcomes (e.g., glycemic control) with rural, uninsured patients with type-2 diabetes. Adult patients (n = 56) diagnosed with type-2 diabetes enrolled in the pilot FSPRx program. The FSPRx program consisted of telephone-based health coaching, group educational sessions, and a PRx. Patients completed diet quality, food literacy, and physical activity questionnaires and had blood drawn for hemoglobin A1C (HbA1C) pre- and post-intervention. Twenty-seven patients had a significant improvement in both fruit and vegetable consumption. Nineteen patients had an increase in total food literacy scores, budgeting skills, meal planning and prepping, nutrition resourcefulness, and physical activity confidence after the intervention. Patients had an average HbA1C decline of .79% (n = 27, P = .01, t = 2.49). This pilot suggests comprehensive PRx programming that integrates culinary and food literacy focused education and behavioral support may be effective in improving patients' diet quality, knowledge, skills, self-efficacy, and health.

Public Health Collaboration Conference

The PHC's mission is to ‘empower, inspire and educate people that most chronic diseases can be prevented and reversed by maintaining good metabolic health through sustainable lifestyle changes’. George Winter reports from its latest gathering in Sheffield

Chronic Stress-Related Osteosarcopenic Obesity: A Common Modern Syndrome Requiring Sustained Lifestyle Changes and Stress Management

Through several pathological mechanisms, chronic stress contributes to the development of “osteosarcopenic obesity”, a clinical syndrome that includes impairments in the structure and function of a patient’s bones, skeletal muscles, and adipose tissue. This syndrome, which could be alternatively called “chronic stress and inflammation syndrome”, has its genesis in early life and, by the age of 50–60 years, affects up to two-thirds of Western populations. Chronic psycho-socioeconomic stress and lifestyle factors, such as a sedentary life, poor quality nutrition, irregular daily schedules, and inadequate sleep, which all act on a genetic and epigenetic predisposition background, play essential pathogenic roles in the development of this widespread syndrome. Key pathogenic mediators are those of the stress system and inflammatory reaction. Lifestyle changes, in combination with stress management, can prevent, arrest, or reverse this debilitating syndrome.

Conceptualizing demand-side technological and social innovations in modeling pathways to carbon neutrality

Achieving mid-century carbon neutrality goals requires drastic energy and carbon dioxide (CO2) emissions reductions that can be enabled by transformative demand-side technological and social innovations. These innovations can significantly reduce energy demand and related emissions to achieve global low energy demand (LED) pathways that rely less on uncertain CO2 removal technologies to meet climate targets. Many existing decarbonization pathway studies focus more on supply-side innovations with less attention on LED innovations, and those that do often have limited focus on industry, freight transport, and broader cross-sector strategies. In this perspective, we apply the “avoid-shift-improve” framework to assess the technical potential and deployment feasibility (in terms of adoption, implementation and response) barriers of demand-side innovations. We observed that smart, integrated building systems improve energy performance, with further reductions possible through design, occupant behavior changes, and social interactive programs. Improved design processes, higher quality products, and circular economy strategies can reduce material demand and associated industrial energy use. Shared mobility systems face uncertain net energy impacts, but smart freight and logistics, and aviation to rail shift can be deployed quickly. Sustainable food, fashion and lifestyle changes are needed beyond technological transformations. Our work illuminates potential impacts and factors that affect realization of the technical potential of individual LED innovations to support their inclusion in future global and national LED scenarios and climate policy development. Additional research is needed to ensure successful integration of LED innovations into a broader mix of climate actions to provide greater flexibility, speed, and lower costs for decarbonization.

Effect of visual presentation of atherosclerotic carotid plaque on adherence to secondary preventive therapy using mHealth technologies (PreventiPlaque app): Study protocol for a randomized controlled trial

BackgroundCardiovascular disease is the major cause of death worldwide. Although knowledge regarding diagnosing and treating cardiovascular disease has increased dramatically, secondary prevention remains insufficiently implemented due to failure among affected individuals to adhere to guideline recommendations. This has continued to lead to high morbidity and mortality rates. Involving patients in their healthcare and facilitating their active roles in their chronic disease management is an opportunity to meet the needs of the increasing number of cardiovascular patients. However, simple recall of advice regarding a more preventive lifestyle does not affect sustainable behavioral lifestyle changes. We investigate the effect of plaque visualization combined with low-threshold daily lifestyle tasks using the smartphone app PreventiPlaque to evaluate change in cardiovascular risk profile. Methodsand study design: This randomized, controlled clinical trial includes 240 participants with ultrasound evidence of atherosclerotic plaque in one or both carotid arteries, defined as focal thickening of the vessel wall measuring 50% more than the regular vessel wall. A criterion for participation is access to a smartphone suitable for app usage. The participants are randomly assigned to an intervention or a control group. While both groups receive the standard of care, the intervention group has additional access to the PreventiPlaque app during the 12-month follow-up. The app includes daily tasks that promote a healthier lifestyle in the areas of smoking cessation, medication adherence, physical activity, and diet. The impact of plaque visualization and app use on the change in cardiovascular risk profile is assessed by SCORE2. Feasibility and effectiveness of the PreventiPlaque app are evaluated using standardized and validated measures for patient feedback. Ethics and disseminationThis clinical trial is approved by the ethics committee of the University of Duisburg-Essen (Germany). Study results will be disseminated at conferences and in peer-reviewed journals. Information regarding the PreventiPlaque app is available via print media, social media channels, and on the authors’ websites.

Mindful Eating Healthy Nutrition Group Visit for Adult Metabolic Syndrome, Feasibility Acceptability for Patients.

Context: Metabolic syndrome, includes elevated fasting glucose, high triglycerides, hypertension, low HDL & abdominal obesity, affects 35% of adults in the United States. People with metabolic syndrome are at high risk for diabetes and cardiovascular disease and have higher all-cause mortality. Usual treatment for metabolic syndrome is weight loss through diet and exercise. Evidence supports the use of mindfulness as a strategy for effective weight management. Objective: Are group visits for mindful eating and healthy nutrition education feasible and acceptable across different primary care settings for patients, staff and clinicians? Study design: Pilot/feasibility study. Setting: Needham Wellesley Family Medicine PC, a physician-owned family medicine practice in Wellesley, MA. Population Studied: 15 patients 18+ years with obesity/overweight and metabolic syndrome or diabetes, cardiovascular disease, hypertension. actively enrolled at site, able to consent, understand procedures, Exclusions: lack cognitive capacity, unable/unwilling to consent or complete study. Intervention: Group visits with mindfulness, mindful eating, healthy nutrition for adults with metabolic syndrome and related conditions. Curriculum: evidence-based principles of mindfulness, mindful eating, healthy nutrition, and activity to improve patient management of metabolic syndrome and related conditions. The curriculum seeks to foster sustainable lifestyle change related to eating behaviors, nutrition choices, activity, self-efficacy, stress-management, and goal setting. Physician, mindfulness teacher and patients meet for 13 weekly group visits during 3 months. Outcome measures: patient surveys at T0, weeks 5 and 10. measure mindfulness, mindful eating, nutrition practices. Survey questions and semi-structured interviews after the sessions ended. We collected feasibility data for scheduling, staffing, recruiting patients, and for patients acquiring skills and knowledge; and acceptability to patients; Results: Patients report: increased fruits, vegetables, salads, fish; decreased simple carbohydrates; and (5=better) eating healthier 4.5/5, achieve goals for lifestyle change 4.2/5; mindful eating was helpful 4.7/5; positive reinforcement from shared experiences, request more direct teaching, and more time to share with others. Conclusions: Mindful eating healthy nutrition group visits are feasible. Patients report acceptability for group visits, healthier eating & lifestyle change.

Community Preventive Health Education Intervention for Pediatric Iron-Deficiency Anemia in Rural Southeast Nigeria.

Iron-deficiency anemia (IDA) is a global cause of morbidity in children under five, particularly in sub-Saharan Africa. In southeast Nigeria, poor dietary intake and caregiver knowledge about childhood anemia are observed; however, there is no consensus on how to best prevent it. This study seeks to test the effectiveness of caregiver education on improving anemia knowledge and dietary prevention strategies and promoting sustainable lifestyle changes to reduce the prevalence of childhood IDA. A questionnaire was administered to the primary caregivers of 41 patients under age five with anemia in southeast Nigeria regarding socioeconomic status (SES), diet diversity, and risk factors for anemia. Caregivers were administered a preeducation questionnaire, poster education on anemia and iron-rich foods, and a posteducation questionnaire. All patients underwent a medical exam to confirm a diagnosis of anemia or anemia-related conditions. Ninety-five percent of patients had moderate diet diversity, but there was no correlation between diet diversity and SES. Barriers to healthier diets were associated with SES. Preeducation scores were not associated with caregivers' education levels; however, posteducation scores were significantly higher in university-educated than technical-trained caregivers. Caregiver-reported self-efficacy increased after the education program. Caregivers' SES was associated with financial and knowledge barriers to a healthier diet but not diet diversity, suggesting that nutritional education could benefit all SES groups. Overall, the education program increased caregivers' anemia knowledge across educational levels. A community-based health education program could improve caregivers' anemia knowledge and self-efficacy in applying this information and potentially reduce this area's pediatric IDA.

Psychosocial Mediators of Web-Based Interventions for Promoting a Healthy Lifestyle Among Chinese College Students: Secondary Analysis of a Randomized Controlled Trial.

BackgroundWeb-based multiple health behavior change (MHBC) interventions have demonstrated effectiveness in promoting physical activity (PA) and fruit and vegetable consumption (FVC) among Chinese college students. However, there is limited research examining their effects on promoting a healthy lifestyle (ie, adhering to both PA and FVC behavioral recommendations) among Chinese college students. In addition, the salient psychosocial mediators of successful MHBC interventions need to be researched.ObjectiveThis study aims to examine the effectiveness of a previous 8-week web-based MHBC program for promoting a healthy lifestyle and enhancing the psychosocial determinants (intention, self-efficacy, planning, and social support) of behavior change among Chinese college students. Furthermore, the study aims to identify whether changes in these psychosocial determinants mediate intervention effectiveness on the immediate and sustained lifestyle changes.MethodsThis was a secondary analysis for a 3-arm randomized controlled trial. Chinese college students (N=552) were randomly assigned to 1 of 3 groups: a PA-first group (4-week PA intervention followed by 4-week FVC intervention), an FVC-first group (4-week FVC intervention followed by 4-week PA intervention), and a placebo control group. The intervention content was designed based on the health action process approach model. Data for analyses were collected at baseline (T0), postintervention assessment (T1), and 12-week follow-up assessment (T2).ResultsAt baseline, 13.9% (77/552) of the participants maintained a healthy lifestyle. After 8 weeks, more (200/552, 36.2%) participants achieved a healthy lifestyle. PA-first and FVC-first groups were, respectively, 3.24 times and 5 times more likely to adopt a healthy lifestyle than the control group at T1. After 12 weeks, 35.5% (196/552) of the participants adopted a healthy lifestyle. Intervention groups were approximately 2.99 times (PA first) and 4.07 times (FVC first) more likely to adopt a healthy lifestyle than the control group at T2. Intervention effects favored both intervention groups in self-efficacy and planning for PA and in intention and planning for FVC compared with the control condition. In addition, changes in PA self-efficacy and FVC intention mediated intervention effectiveness on the immediate lifestyle change after 8 weeks. Changes in FVC intention were identified as a salient mediator for facilitating sustained lifestyle change after 12 weeks.ConclusionsThis study provides empirical evidence for the effectiveness of an 8-week theory- and web-based MHBC intervention program on promoting a healthy lifestyle, self-efficacy and planning for PA, and intention and planning for FVC among Chinese college students. These research findings add new knowledge to the underlying psychosocial mechanisms of successful MHBC interventions. Overall, this study has considerable implications for future web-based MHBC research and practice in terms of addressing PA self-efficacy and FVC intention and helping students to adopt and maintain a healthy lifestyle independently of whether PA or FVC is addressed first.Trial RegistrationClinicalTrials.gov NCT03627949; https://clinicaltrials.gov/ct2/show/NCT03627949