Component Of Weight Management Research Articles

Pre-pandemic physical activity as a predictor of infection and mortality associated with COVID-19: Evidence from the National Health Insurance Service.

During the coronavirus disease 2019 (COVID-19) pandemic, many populations have experienced reduced physical activity (PA) levels, weight gain, and increased anxiety and depression. However, according to a previous study, engaging in PA has a positive effect on damages caused by COVID-19. Therefore, this study aimed to investigate the association between PA and COVID-19 using the National Health Insurance Sharing Service Database in South Korea. Logistic regression analysis was used to analyze the association of PA with COVID-19 and mortality. The analysis was adjusted for body mass index, sex, age, insurance type, comorbidity, and region of residence at baseline. Disability and lifestyle (weight, smoking, and drinking status) were adjusted consecutively. The results indicated that engaging in insufficient PA as per the WHO guidelines predicts a higher risk of COVID-19 when controlling for personal characteristics, comorbidity, lifestyle, disability, and mortality. This study revealed the need to engage in PA and manage weight to reduce the risk of infection and mortality associated with COVID-19. Because engaging in PA is an important component of weight management and can help restore physical and mental health after the COVID-19 pandemic, it should be emphasized as a pillar of recovery after COVID-19.

1435-P: Identifying the Continuing Educational Needs of U.S. Physicians in Managing Patients with T2DM and Obesity

Most people with type 2 diabetes (T2D) also have obesity and the prevalence of both continues to increase. This study sought to understand approaches of endocrinologists (ENDOs) and primary care physicians (PCPs) in managing patients with both T2D and obesity to identify areas where physicians may benefit from continued education. A patient case-based survey assessing approaches to managing patients with T2D and obesity was fielded in October 2021, with responses from US-practicing ENDOs (n=181) and PCPs (n=350) . Survey questions included free response, multiple choice, and rating scales. Descriptive analysis was performed. When presented with a patient with poorly controlled T2D, obesity, and other clinical concerns (eg, elevated blood pressure (BP) , hyperlipidemia, and cigarette use) , improving HbA1c was among the top three goals in 93% of physicians, while BP control was a top goal for just over half and weight loss was a top goal for only 45%. In another patient presenting with T2D and unchanged BMI of 37 kg/m2, despite 6 months of lifestyle intervention, 9% of ENDOs and 15% of PCPs would continue current weight management without change. If the patient’s BMI been higher at 47 kg/m2, both ENDOs and PCPs were more likely to begin a weight loss medication and PCPs were more likely to defer management to a specialist. Most physicians (63%) agreed that effectively managing T2D leads to weight loss and 83% agreed that GLP-1 receptor agonists are effective for obesity. However, only half of ENDOs and 29% of PCPs have a certain percentage of body weight loss goal when managing obesity in patients with T2D. Further, 19% of ENDOs and 30% of PCPs reported that they trial diet, exercise, and behavioral modifications for 6 months or longer. Results show physicians may benefit from continuing education focused on the importance of addressing weight in combination with glycemic control for patients with T2D and obesity, and the benefits of pharmacotherapy as a component of weight management. Disclosure W.Cerenzia: None. S.Stacy: None. S.Wiley: None.

Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative.

Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative.

Discussing Weight Management With Type 2 Diabetes Patients in Primary Care Using the Small Talk Big Difference Intervention: Protocol for a Randomized Controlled Trial.

BackgroundGuidelines for the management of type 2 diabetes universally recommend that adults with type 2 diabetes and obesity be offered individualized interventions to encourage weight loss. Yet despite the existing recommendations, provision of weight management services is currently patchy around the United Kingdom and where services are available, high attrition rates are often reported. In addition, individuals often fail to take up services, that is, after discussion with a general practitioner or practice nurse, individuals are referred to the service but do not attend for an appointment. Qualitative research has identified that the initial discussion raising the issue of weight, motivating the patient, and referring to services is crucial to a successful outcome from weight management.ObjectiveOur aim was to evaluate the effectiveness of an Internet-based training program and practice implementation toolkit with or without face-to-face training for primary care staff. The primary outcome is the change in referral rate of patients with type 2 diabetes to National Health Service adult weight management programs, 3 months pre- and postintervention.MethodsWe used the Behavior Change Wheel to develop an intervention for staff in primary care consisting of a 1-hour Internet-based eLearning package covering the links between obesity, type 2 diabetes, and the benefits of weight management, the treatment of diabetes in patients with obesity, specific training in raising the issue of weight, local services and referral pathways, overview of weight management components/ evidence base, and the role of the referrer. The package also includes a patient pamphlet, a discussion tool, a practice implementation checklist, and an optional 2.5-hour face-to-face training session. We have randomly assigned 100 practices in a 1:1 ratio to either have immediate access to all the resources or have access delayed for 4 months. An intention-to-treat statistical analysis will be performed.ResultsRecruitment to the study is now complete. We will finalize follow-up in 2018 and publish in early 2019.ConclusionsThis protocol describes the development and randomized evaluation of the effectiveness of an intervention to improve referral and uptake rates of weight management programs for adults with type 2 diabetes. At a time when many new dietary and pharmacological weight management interventions are showing large clinical benefits for people with type 2 diabetes, it is vital that primary care practitioners are willing, skilled, and able to discuss weight and make appropriate referrals to services.Trial RegistrationClinicalTrials.gov NCT03360058; https://clinicaltrials.gov/ct2/show/NCT03360058 (Archived by WebCite at http://www.webcitation.org/74HI8ULfn)International Registered Report Identifier (IRRID)DERR1-10.2196/12162

Evaluating Online Continuing Professional Development Regarding Weight Management for Pregnancy Using the New World Kirkpatrick Model.

Clinical practice guidelines advocate the importance of continuing professional development (CPD) that supports health professionals (HPs) to discuss the sensitive topic of maternal weight management with women. However, there is a lack of accredited CPD related to this important area of preconception and antenatal care. Therefore, aims were to evaluate HPs' reactions to accredited online CPD regarding weight management for pregnancy and their knowledge, attitudes, confidence, and commitment to provide women with advice after completing the course. A mixed-methods evaluation was based on the New World Kirkpatrick Model (NWKM). Accredited online CPD was developed by experts in maternal nutrition and weight management. Participants completed a questionnaire before (n = 136) and after (n = 65) the weight management components of the course. McNemar and Wilcoxon signed-rank tests were used to evaluate paired data (n = 36) (p < .05). Deductive content analyses explored free-text responses (n = 65). Participants' reactions to the online CPD were encouraging, facilitating increases in perceptions of the importance of weight management for pregnancy and confidence to provide advice. Quantitative measures assessed no change in participants' knowledge; however, qualitative analyses revealed an increase in participants' knowledge of communication strategies that they intend to apply in practice. The NWKM facilitated an evaluation of HPs' encouraging reactions to online CPD and the affective constructs of education including attitudes, confidence, and commitment to provide advice. Online CPD should be developed with collaboration between universities/professional associations and health care providers, so that evaluation of organizational change and clinical outcomes is possible.

The influence of front‐of‐pack nutrition information on consumers’ portion size perceptions

Issue addressed Portion size guidance strategies have been suggested as an important component of weight management; therefore, the Health Star Rating (HSR) front-of-pack labels could influence consumers' portion-size decisions. However, this has not been investigated to date. This study aims to evaluate whether presenting energy content information and HSRs influences portion size self-selection of specific foods and meals. Methods Adults were randomly assigned to one of three experimental groups in this randomised controlled experiment. Each participant was given either a kJ/100g food label or a HSR label, or was given no information on nutrient composition. They were then asked to serve themselves an adequate portion of breakfast cereal (Kellogg's Nutri-Grain), fruit salad and chocolate, plus a three-component meal (chicken, fries and mixed vegetables). Portion serves and meal weights were compared between each experimental group using ANOVA and the discretionary foods were also compared with the Australian Guide to Healthy Eating (AGHE). Results Neither the kilojoule nor HSR information influenced the self-served portion size of foods or meal components. Mean self-served portion size of the discretionary foods were significantly greater than the standard serving sizes as specified in the AGHE. Conclusion Although food labels have the potential to assist consumers in making product choices, this study indicates that presenting nutrition information does not affect portion size decisions in young adults. So what? Strategies that assist consumers to choose appropriate portion sizes should be developed as a weight management tool.

A Review of Primary Care-Based Childhood Obesity Prevention and Treatment Interventions.

Effective obesity prevention and treatment interventions targeting children and their families are needed to help curb the obesity epidemic. Pediatric primary care is a promising setting for these interventions, and a growing number of studies are set in this context. This review aims to identify randomized controlled trials of pediatric primary care-based obesity interventions. A literature search of 3 databases retrieved 2947 publications, of which 2899 publications were excluded after abstract (n=2722) and full-text review (n=177). Forty-eight publications, representing 31 studies, were included in the review. Eight studies demonstrated a significant intervention effect on child weight outcomes (e.g., BMI z-score, weight-for-length percentile). Effective interventions were mainly treatment interventions, and tended to focus on multiple behaviors, contain weight management components, and include monitoring of weight-related behaviors (e.g., dietary intake, physical activity, or sedentary behaviors). Overall, results demonstrate modest support for the efficacy of obesity treatment interventions set in primary care.

Improving Body Image in Our Patients: A Key Component of Weight Management

Improving Body Image in Our Patients: A Key Component of Weight Management

Physical activity and cancer survivorship.

There has been an increase in the cancer survivor population in the United States over the past several decades primarily due to improvements in early detection of first malignancies and effective treatment modalities. A wealth of evidence has demonstrated that regular physical activity is associated with a lower risk of death, all-cause mortality, cancer recurrence, and several chronic diseases, including type 2 diabetes and cardiovascular disease, common comorbid conditions in people who have survived cancer. Physical activity also is a central component of weight management. This review summarizes the current physical activity recommendations and the evidence linking physical activity to improvements in weight management, physiological effects, and psychological health outcomes for cancer survivors. The available literature suggests physical activity is safe and is positively associated with weight management, cardiorespiratory fitness, muscular strength and endurance, quality of life, fatigue, and other psychosocial factors in cancer survivors. Yet relationships related to specific cancer diagnoses, treatments, and underlying cardiometabolic mechanisms associated with survival have not been thoroughly examined in randomized controlled trials. Furthermore, factors that influence adherence to physical activity behaviors must be identified to develop effective exercise programs. The use of objective measures of physical activity and the standardization of reporting outcome measures within intervention trials are needed to complement this effort. Healthcare providers should consider individual differences among cancer survivors and tailor physical activity programs to meet the individual needs of the patient to assist in the adoption and maintenance of a physically active lifestyle.

Parental perspectives regarding primary-care weight-management strategies for school-age children.

To identify parental perspectives regarding weight-management strategies for school-age children, focus groups were conducted of parents of overweight and obese (body mass index ≥ 85th percentile) 6-12-year-old children recruited from primary-care clinics. Questions focused on the role of the primary-care provider, effective components of weight-management strategies and feasibility of specific dietary strategies. Focus groups were recorded, transcribed and analysed using margin coding and grounded theory. Six focus groups were held. The mean age (in years) for parents was 32, and for children, eight; 44% of participants were Latino, 33%, African-American and 23%, white. Parents' recommendations on the primary-care provider's role in weight management included monitoring weight, providing guidance regarding health risks and lifestyle changes, consistent follow-up and using discretion during weight discussions. Weight-management components identified as key included emphasising healthy lifestyles and enjoyment, small changes to routines and parental role modelling. Parents prefer guidance regarding healthy dietary practices rather than specific weight-loss diets, but identified principles that could enhance the acceptability of these diets. For dietary guidance to be feasible, parents recommended easy-to-follow instructions and emphasising servings over counting calories. Effective weight-management strategies identified by parents include primary-care provider engagement in weight management, simple instructions regarding healthy lifestyle changes, parental involvement and deemphasising specific weight-loss diets. These findings may prove useful in developing primary-care weight-management strategies for children that maximise parental acceptance.

Physical Activity: A Key for the Preclusion of Obesity in Children

Childhood obesity is the one of the serious problem globally which keeps on increasing with high rate. Physical activity plays an important role in handling the childhood obesity. Physical activity has long been considered an integral component of weight management, but exercise alone is a reasonably ineffective means for reducing fat percentage. Physical activity along with healthy nutrition boosts the process of fat percentage discount and also helpful in monitoring the hypothalamus part of brain which plays an important role in regulating the food intake. Data suggested that anthropometry is a key component of nutritional status assessment in children especially body mass index, which is quite effective and reliable. Without engaging the children’s in physical activity leads to increased chances of obesity, cardiovascular diseases, cancer and diabetes in future and that fastenings the attention of fitness personal and policy makers. Hence, parents and policymakers have to plan accordingly to make their child healthy and fit. This article reviews the available literature regarding the role of physical activity and nutrition in the prevention and handling of childhood obesity along with various anthropometric assessment methods.

Key Principles in Internet-Based Weight Management Systems

To provide a review of weight management components as a means for developing suggested guidelines for online program development or selection. Forty-two published studies associated with Internet programs were reviewed. Studies included online weight management components: tailored feedback, social support, self-monitoring, and interactive components. Five key principles associated with Internet-based weight management programming are presented: (1) recreate the human experience, (2) personalize to the individual, (3) create a dynamic experience, (4) provide a supportive environment, and (5) build upon sound theory. Key principles can guide in the development or selection of online weight management programs.

Literacy, Numeracy, and Portion-Size Estimation Skills

Portion-size estimation is an important component of weight management. Literacy and numeracy skills may be important for accurate portion-size estimation. It was hypothesized that low literacy and numeracy would be associated with decreased accuracy in portion estimation. A cross-sectional study of primary care patients was performed from July 2006 to August 2007; analyses were performed from January 2008 to October 2008. Literacy and numeracy were assessed with validated measures (the Rapid Estimate of Adult Literacy in Medicine and the Wide Range Achievement Test, third edition). For three solid-food items and one liquid item, participants were asked to serve both a single serving and a specified weight or volume amount representing a single serving. Portion-size estimation was considered accurate if it fell within +/-25% of a single standard serving. Of 164 participants, 71% were women, 64% were white, and mean (SD) BMI was 30.6 (8.3) kg/m(2). While 91% reported completing high school, 24% had <9th-grade literacy skills and 67% had <9th-grade numeracy skills. When all items were combined, 65% of participants were accurate when asked to serve a single serving, and 62% were accurate when asked to serve a specified amount. In unadjusted analyses, both literacy and numeracy were associated with inaccurate estimation. In multivariate analyses, only lower literacy was associated with inaccuracy in serving a single serving (OR=2.54; 95% CI=1.11, 5.81). In this study, many participants had poor portion-size estimation skills. Lower literacy skills were associated with less accuracy when participants were asked to serve a single serving. Opportunities may exist to improve portion-size estimation by addressing literacy.

Appropriate Physical Activity Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults

Overweight and obesity affects more than 66% of the adult population and is associated with a variety of chronic diseases. Weight reduction reduces health risks associated with chronic diseases and is therefore encouraged by major health agencies. Guidelines of the National Heart, Lung, and Blood Institute (NHLBI) encourage a 10% reduction in weight, although considerable literature indicates reduction in health risk with 3% to 5% reduction in weight. Physical activity (PA) is recommended as a component of weight management for prevention of weight gain, for weight loss, and for prevention of weight regain after weight loss. In 2001, the American College of Sports Medicine (ACSM) published a Position Stand that recommended a minimum of 150 min wk(-1) of moderate-intensity PA for overweight and obese adults to improve health; however, 200-300 min wk(-1) was recommended for long-term weight loss. More recent evidence has supported this recommendation and has indicated more PA may be necessary to prevent weight regain after weight loss. To this end, we have reexamined the evidence from 1999 to determine whether there is a level at which PA is effective for prevention of weight gain, for weight loss, and prevention of weight regain. Evidence supports moderate-intensity PA between 150 and 250 min wk(-1) to be effective to prevent weight gain. Moderate-intensity PA between 150 and 250 min wk(-1) will provide only modest weight loss. Greater amounts of PA (>250 min wk(-1)) have been associated with clinically significant weight loss. Moderate-intensity PA between 150 and 250 min wk(-1) will improve weight loss in studies that use moderate diet restriction but not severe diet restriction. Cross-sectional and prospective studies indicate that after weight loss, weight maintenance is improved with PA >250 min wk(-1). However, no evidence from well-designed randomized controlled trials exists to judge the effectiveness of PA for prevention of weight regain after weight loss. Resistance training does not enhance weight loss but may increase fat-free mass and increase loss of fat mass and is associated with reductions in health risk. Existing evidence indicates that endurance PA or resistance training without weight loss improves health risk. There is inadequate evidence to determine whether PA prevents or attenuates detrimental changes in chronic disease risk during weight gain.

Physical Activity Preferences and Perceived Barriers to Activity Among Persons With Severe Mental Illness in the United Kingdom

This study assessed physical activity interests among psychiatric patients. A cross-sectional survey of 120 psychiatric patients in the United Kingdom assessed preferences for physical activity, perceived barriers to activity, and other psychosocial factors related to exercise levels. Compared with the general population, respondents were less active. Respondents reported very little confidence in their ability to exercise when feeling sad or stressed, and they reported low levels of social support toward exercising. Approximately half the respondents or more expressed a belief in the health benefits of exercise, enjoyment of exercise, and a desire to be more active. Walking was the most popular activity, and fatigue and illness were the most common barriers to activity. Equal numbers preferred individual and group activities. A majority agreed that they would exercise more if they talked with an exercise instructor or were advised by their doctor. Physical activity interventions for the psychiatric population need to bridge the gap between high interest and low uptake through, for example, professional support and enhancing self-efficacy by combating barriers and tailoring to preferences.

RETRACTED: Obesity and physical activity: A review

Obesity has become a problem of epidemic proportions in the U.S., with nearly two thirds of American adults being either overweight or obese. Current data suggest that this trend remains on the rise and threatens many of the gains that have been made in the prevention and treatment of heart disease. Exercise has long been considered an integral component of weight management, but available evidence suggests that exercise alone is a relatively inefficient means for losing weight. In contrast, regular exercise appears crucial in the prevention of weight gain and successful maintenance of weight loss, and in the fostering of cardiovascular health. This article reviews the available literature regarding the role of exercise in the prevention and treatment of obesity and evaluates the adequacy of current national guidelines.

ESTIMATION OF RESTING ENERGY EXPENDITURE IN PERSON WITH SPINAL CORD INJURY

Proper nutrition is an important component of weight management, rehabilitation, and healing of decubitus ulcers in persons with spinal cord injury (SCI). Frequently, decisions regarding the caloric requirement of the person with SCI are based on an estimation of resting energy expenditure (REE) using empirically derived equations for the able-bodied, i.e., Harris Benedict, Long. The dietician's primary objective is to accomplish an optimal balance between the person's nutritional needs and their caloric intake. PURPOSE: Develop and validate a new equation to estimate REE in persons with SCI and to determine if existing equations provide adequate precision for this population. METHODS: Subjects were randomly assigned to either a prediction (PRE, n = 24) or validation (VAL, n = 16) group. All subjects completed a resting energy study after a 12 hr fast. Stepwise regression analysis was performed on PRE group data to derive a new population specific equation (VAREE) to estimate REE. The VAREE was compared (ANOVA) with measured REE (REEMeas); and two equations currently in use clinically namely, Harris Benedict (HB) and Long (kcal/kg). RESULTS: Differences in demographic characteristics (age, height, weight, REEMeas) between the PRE and VAL groups were not significant. The resulting equation from the PRE group was VAREE (kcal) = 413.317+11.447(AL)+13.162(Wt)−0.672(MSI). Where AL is anatomical level of injury, Wt is body weight in kg and MSI is months since injury. The equation accounted for 69% of the variance in the PRE group. When compared in the VAL group the REEMeas, HB and new equation were not different from each other, whereas the Long equation significantly (P < 0.05) over estimated REE. CONCLUSION: Although the new equation performed well in the validation group work continues to improve on the current model. Department of Veterans Affairs, Rehabilitation Research and Development Service

Obesity in the elderly.

In developed countries, there is a general increase in body weight and body mass index (BMI) with age, until approximately 60 years of age, when body weight and BMI begin to decline. The proportion of intra-abdominal fat, which is related to increased morbidity and mortality, progressively increases with age. There is also a progressive decline in energy intake and daily total energy expenditure (165 kcal/decade in men and 103 kcal/decade in women in developed countries), which is primarily due to a decrease in physical activity, and to a lesser extent, a decrease in basal metabolic rate. The decrease in physical activity is more pronounced in those with chronic disabilities and diseases. The BMI-mortality curves have been reported to move upward (greater overall mortality), become flatter (less effect of BMI on mortality), and in some cases shift to the right (minimum mortality occurs at a higher BMI), for a variety of possible reasons. Weight loss in the elderly has been reported to increase, decrease, or not alter mortality, but the studies are confounded by numerous methodological problems. It has been argued that there may be little benefit in encouraging weight loss in extreme old age (short life expectancy), especially when there are no obesity-related complications or biochemical risk factors and when strong resistance and distress arise from changes in lifelong habits of eating and exercise. In contrast, weight loss in the elderly can reduce morbidity from arthritis, diabetes and other conditions, reduce cardiovascular risk factors, and improve well-being. BMI also predicts morbidity in those without disease. Furthermore, increased physical activity in the elderly, which is an important component of weight management, can produce beneficial effects on muscle strength, endurance, and well-being.