Normalization of haemostatic alterations in overweight children with weight loss due to lifestyle intervention

Therapy of choice in obese children and adolescents is lifestyle intervention based on nutrition education, behavioural treatment and exercise treatment. Its efficacy even after the end of intervention has been proven by several randomised-controlled trials and meta-analyses including a recent Cochrane review. However, randomised-controlled trials are likely to overestimate the effectiveness. Studies under normal day-to-day circumstances demonstrated only a very moderate effect on weight loss (<10% success rate 2 years after the onset of intervention). A reduction of >0·5 SDS-BMI (which means a stable weight over 1 year in growing children) is associated with an improvement of cardiovascular risk factors, while improvements of quality of life seem independent of the degree of weight loss. Younger children and less overweight children particularly profit from lifestyle interventions in contrast to extremely obese adolescents. Recent studies demonstrated that involving parents is crucial for success, suggesting that parents and children and not children alone should be the primary target of interventions. Failures in weight reduction are attributed not only to a lack of motivation but also to other aspects particular to the genetic background. The techniques, more than the contents, of an intervention influence the treatment outcome. Besides behavioural therapy, systemic and solution-focused treatments are important. Future longitudinal research should focus on the identification of which children and adolescents profit from which kind of intervention, in order to be able to tailor specific treatment approaches. Studies under normal day-to-day circumstances are necessary to prove the benefit of this kind of intervention.

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Examining physiological aspects of Kinect as a weight-loss mechanism for overweight children

PsycEXTRA Dataset ◽

10.1037/e590272013-001 ◽

2013 ◽

Author(s):

Jacquelyn A. Corvan ◽

Jackie Israel ◽

Kristen Jastrowski Mano

Keyword(s):

Weight Loss ◽

Overweight Children ◽

Loss Mechanism

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742-P: Magnitude of A1C Improvement in Relation to Weight Loss after Intensive Lifestyle Intervention in Real-World Diabetes Practice: Thirteen Years of Observation

Diabetes ◽

10.2337/db19-742-p ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 742-P

Author(s):

AHMED H. ELDIB ◽

SHAHEEN TOMAH ◽

ADHAM MOTTALIB ◽

SAHAR ASHRAFZADEH ◽

OSAMA HAMDY

Keyword(s):

Weight Loss ◽

Lifestyle Intervention ◽

Real World ◽

Intensive Lifestyle Intervention

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Faculty Opinions recommendation of Effect of Wearable Technology Combined With a Lifestyle Intervention on Long-term Weight Loss: The IDEA Randomized Clinical Trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726764681.793523664 ◽

2016 ◽

Author(s):

Marleen van Baak

Keyword(s):

Clinical Trial ◽

Weight Loss ◽

Randomized Clinical Trial ◽

Lifestyle Intervention ◽

Wearable Technology

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Bariatric Surgery vs Lifestyle Intervention for Diabetes Treatment: 5-Year Outcomes From a Randomized Trial

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa006 ◽

2020 ◽

Vol 105 (3) ◽

pp. 866-876 ◽

Cited By ~ 10

Author(s):

Anita P Courcoulas ◽

James W Gallagher ◽

Rebecca H Neiberg ◽

Emily B Eagleton ◽

James P DeLany ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Lifestyle Intervention ◽

Controlled Trial ◽

The United States ◽

Diabetes Remission ◽

University Of Pittsburgh ◽

Lifestyle Treatment ◽

Surgical Treatments ◽

The University

Abstract Context Questions remain about bariatric surgery for type 2 diabetes mellitus (T2DM) treatment. Objective Compare the remission of T2DM following surgical or nonsurgical treatments. Design, setting, and participants Randomized controlled trial at the University of Pittsburgh, in the United States. Five-year follow-up from February 2015 until June 2016. Interventions 61 participants with obesity and T2DM who were initially randomized to either bariatric surgical treatments (Roux-en-Y gastric bypass [RYGB] or laparoscopic adjustable gastric banding [LAGB]) or an intensive lifestyle weight loss intervention (LWLI) program for 1 year. Lower level lifestyle weight loss interventions (LLLIs) were then delivered for 4 years. Main Outcomes and Measures Diabetes remission assessed at 5 years. Results The mean age of the patients was 47 ± 6.6 years, 82% were women, and 21% African American. Mean hemoglobin A1c level 7.8% ± 1.9%, body mass index (BMI) 35.7 ± 3.1 kg/m2, and 26 participants (43%) had BMI < 35 kg/m2. Partial or complete T2DM remission was achieved by 30% (n = 6) of RYGB, 19% (n = 4) of LAGB, and no LWLI participants (P = .0208). At 5 years those in the RYGB group had the largest percentage of individuals (56%) not requiring any medications for T2DM compared with those in the LAGB (45%) and LWLI (0%) groups (P = .0065). Mean reductions in percent body weight at 5 years was the greatest after RYGB 25.2% ± 2.1%, followed by LAGB 12.7% ± 2.0% and lifestyle treatment 5.1% ± 2.5% (all pairwise P < .01). Conclusions Surgical treatments are more effective than lifestyle intervention alone for T2DM treatment.

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Return on Investment: Medical Savings of an Employer‐Sponsored Digital Intensive Lifestyle Intervention, Weight Loss

Obesity ◽

10.1002/oby.23117 ◽

2021 ◽

Vol 29 (4) ◽

pp. 654-661

Author(s):

Cecelia M. Horstman ◽

Donna H. Ryan ◽

Louis J. Aronne ◽

Caroline M. Apovian ◽

John P. Foreyt ◽

...

Keyword(s):

Weight Loss ◽

Lifestyle Intervention ◽

Return On Investment ◽

Intensive Lifestyle Intervention

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Abstract P073: Insufficient and Poor Sleep are Associated with Barriers to Healthy Eating and Lower Physical Activity: Baseline Characteristics of the EMPOWER Study

Circulation ◽

10.1161/circ.131.suppl_1.p073 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Christopher E Kline ◽

Patrick J Strollo ◽

Eileen R Chasens ◽

Bonny Rockette-Wagner ◽

Andrea Kriska ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Sleep Quality ◽

Lifestyle Intervention ◽

Body Fat ◽

Healthy Eating ◽

Perceived Barriers ◽

Poor Sleep ◽

Body Habitus ◽

Overweight Adults

Background: Sleep is emerging as an important factor that impacts dietary habits, physical activity, and metabolism. However, minimal attention is typically given to sleep in traditional lifestyle interventions. The purpose of these analyses was to examine baseline associations between sleep and physical activity and perceived barriers to healthy eating, which are two common lifestyle intervention targets, in a sample of apparently healthy adults enrolled in a behavioral weight loss intervention study. Methods: 150 overweight adults (51.1±10.2 y; 91% female; 79% Caucasian) participated in a 12-month lifestyle intervention that featured adaptive ecological momentary assessment. Sleep, physical activity, barriers to healthy eating and body habitus/composition were assessed prior to the intervention. Objective sleep was estimated with 7 days of wrist-worn actigraphy (Philips Actiwatch 2); sleep onset latency (SOL; the amount of time it takes to fall asleep after going to bed), sleep efficiency (SE; the percentage of time in bed that is spent asleep), and total sleep time (TST; total time spent asleep) served as the primary actigraphic sleep variables. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Physical activity was assessed with 7 days of waist-worn accelerometry (ActiGraph GT3x). Perceived barriers to healthy eating were assessed with the Barriers to Healthy Eating questionnaire. Body mass index (BMI) served as the measure of body habitus, and body fat was assessed with bioelectrical impedance. Results: Mean BMI and body fat for the sample were 34.0±4.6 kg/m2 and 43.7±5.5%, respectively. Mean TST was 6.6±0.8 h/night; approximately 23% of the sample averaged less than 6 hours of sleep. Mean SOL and SE for the sample were 15.3±16.2 min and 85.7±6.1%, respectively. Based on the PSQI, 52.0% of the sample had poor sleep quality. Following adjustment for age, sex, and race, longer SOL was associated with fewer steps/day (β=-.19, p=.02) and less time spent in moderate to vigorous physical activity (MVPA; β=-.16, p=.03), and lower SE was related to less MVPA (β=.15, p=.04). Shorter TST was associated with greater barriers to healthy eating (β=-.16, p=.05). Longer SOL was associated with higher BMI (β=.16, p=.05) and body fat % (β=.15, p=.03), and lower SE was related to higher body fat % (β=-.13, p=.06). Conclusions: Short sleep duration and sleep disturbance were highly prevalent in this sample of overweight adults. Significant associations were observed between sleep and measures of body habitus/composition and eating and physical activity habits. Efforts to improve sleep during a behavioral intervention for weight loss may reduce barriers to healthy eating and improve physical activity habits as well as weight loss outcomes.

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Abstract MP006: A Feasible and Effective Mobile Health Weight Loss Lifestyle Intervention for Filipinos With Type 2 Diabetes

Circulation ◽

10.1161/circ.135.suppl_1.mp006 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Melinda S Bender ◽

Bruce Cooper ◽

Shoshana Arai

Keyword(s):

Weight Loss ◽

Waist Circumference ◽

Lifestyle Intervention ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Retention Rate ◽

Intervention Group ◽

Step Counts ◽

Fasting Plasma ◽

Cardiometabolic Risks

Introduction: Filipino Americans have the highest prevalence of obesity and type 2 diabetes (T2D) compared to Asian American subgroups placing them at high risk for cardiometabolic disease. Effective interventions are needed to reduce these health disparities. Mobile health (mHealth) weight loss lifestyle interventions have been effective in reducing cardiometabolic risks, but are untested among Filipinos, particularly with T2D. As prolific users of digital technology, Filipinos are ideal candidates for mHealth lifestyle interventions. Therefore, we conducted the PilAm Go4Health intervention study - a culturally adapted weight loss lifestyle intervention using mobile technology to reduce cardiometabolic risks among Filipinos with T2D. Objective: To demonstrate intervention feasibility and potential efficacy. Hypothesis: 1) participant retention rate will be greater than 80%; 2) Compared to the control, intervention group will have significantly greater reduction in: % weight loss, waist circumference, fasting plasma glucose, and HbA1; and greater increase in step-counts. Methods: Two-arm (intervention +active control groups) RCT compared a 3-month intervention (Fitbit accelerometer +mHealth app/diary +Facebook group) and control (Fitbit accelerometer). N=45 overweight Filipino adults with T2D were recruited from Northern California communities. Between group differences from baseline to 3-months were analyzed using: 1) multilevel regression for within-person change in weight and step-counts using a nonparametric bias-corrected bootstrapped 95% CI for the multilevel models, and 2) T-tests, ANOVA for waist circumference, fasting plasma glucose, and HbA1c (significance =p<0.05, 2-sided). Cohen’s d was used for effect size analyses. Results: Randomized N=45 Filipinos (intervention =22 and control =23). Mean age was 58±10 years, 62% women, and retention rate=100%. There was significantly greater reduction in the intervention group compared to the control for: % weight (2.3% greater decrease, d=0.46); waist circumference (-2.68cm; d= 0.88); and fasting plasma glucose (-18.52mg/dl; d= -0.86). HbA1c group difference was not significant (-0.34%; p< 0.19). Step-counts significantly increased in the intervention group compared to control (3432 steps at endpoint; d=1.44). Conclusion: PilAm Go4Health intervention demonstrated excellent feasibility in recruitment and retention, and potential efficacy for reducing cardiometabolic risks in Filipinos with T2D. Results warrant further testing of this lifestyle intervention that may support translation to other at-risk diverse populations living with T2D.

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