Lifestyle Change Urged in New AHA Guidelines

In health education and promotion, “risk factors” for disease gathered from epidemiological research form the basis from which the majority of recommendations to individuals for lifestyle change are made. Unfortunately, many health practitioners are unaware that this type of research was never intended to be applied to individuals. The result is ongoing public confusion and anxiety concerning health recommendations and a loss of credibility for health professionals. This article: 1) briefly reviews the most commonly encountered limitations inherent in epidemiological research; 2) explores the problems and potential negative consequences of incorrectly applying epidemiological research in health education and promotion; and 3) makes recommendations to help health practitioners more skillfully interpret and incorporate into their work findings from epidemiological research.

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Randomized Trial for Weight Loss Using a Digital Therapeutic Application

Journal of Diabetes Science and Technology ◽

10.1177/19322968211000815 ◽

2021 ◽

pp. 193229682110008

Author(s):

Tryggvi Thorgeirsson ◽

Johanna E. Torfadottir ◽

Erlendur Egilsson ◽

Saemundur Oddsson ◽

Thrudur Gunnarsdottir ◽

...

Keyword(s):

Weight Loss ◽

Mobile Application ◽

Intervention Group ◽

Lifestyle Change ◽

Noncommunicable Diseases ◽

Control Group ◽

Intention To Treat ◽

Protocol Group ◽

Lifestyle Program ◽

Program Intervention

Background: Smartphones present a near-ubiquitous channel through which structured lifestyle change can reduce risk or progression of the most common noncommunicable diseases. We explored whether a digital structured lifestyle program enhances weight loss. Methods: We randomized overweight and obese participants attending a four-month lifestyle change program to either standard weekly coaching sessions (controls), or standard treatment supplemented with a digital therapeutic mobile application (intervention). Changes in body mass index after four months were the main outcome measure. Odds ratios of achieving 5% weight loss were estimated with unconditional logistic regression. Results: Of 234 eligible persons, 146 (62%) agreed to participate, were block-randomized, showed up for the baseline measures, and constituted the intention-to-treat (ITT) sample ( n = 95 intervention group, n = 51 control group). In the intervention group, 70 (74%) downloaded the mobile application and completed the program (intervention per-protocol). Significant weight loss and BMI reduction were observed for both the intention-to-treat intervention group ( P < 0.05, P = 0.01) and the per-protocol intervention group ( P < 0.0001, P < 0.0001). For the intervention per-protocol group, the odds ratio of achieving 5% weight loss, compared to not treated per-protocol, was 3.3 (95% CI 1.3-8.2), adjusting for age and weight at baseline.Attendance to weekly coaching sessions decreased by 18% during the program in the control group while it increased by 3% amongst the per-protocol group ( P = 0.004). Conclusions: These preliminary findings support the benefit of a digital therapeutic to enhance weight reduction and attendance in a structured lifestyle change program. Larger trials of longer duration are needed to confirm these findings.

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Indirect Health Effects of COVID-19: Unhealthy Lifestyle Behaviors during the Lockdown in the United Arab Emirates

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041964 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1964

Author(s):

Hadia Radwan ◽

Mahra Al Kitbi ◽

Hayder Hasan ◽

Marwa Al Hilali ◽

Nada Abbas ◽

...

Keyword(s):

Physical Activity ◽

United Arab Emirates ◽

Lifestyle Change ◽

Change Score ◽

Lifestyle Changes ◽

Lifestyle Behaviors ◽

Negative Consequences ◽

Unhealthy Lifestyle ◽

Cross Sectional ◽

Study Results

Background: Lockdown measures were implemented in many countries to limit the spread of the COVID-19 pandemic. However, such restrictions could precipitate unintended negative consequences on lifestyle behaviors. The main objective of this study was to investigate the prevalence and determinants of unhealthy behavior changes during the COVID-19 lockdown among residents of the United Arab Emirates (UAE). Methods: A cross-sectional web-based survey of adults residing in the UAE was carried out during lockdown (n = 2060). Using a multi-component questionnaire, the collected data included questions regarding the following lifestyle changes: Increased dietary intake, increased weight, decreased physical activity, decreased sleep, and increased smoking. An unhealthy lifestyle change score was calculated based on the number of unhealthy lifestyle changes each participant reported. In addition, sociodemographic and living conditions information was collected. Descriptive statistics as well as simple and multiple linear regression analyses were used to examine the prevalence and determinants of the unhealthy lifestyle changes considered in this study. Results: Among the unhealthy lifestyle changes examined, increased food intake was the most common (31.8%), followed by decreased physical activity (30%), increased weight (29.4%), decreased sleep (20.8%), and increased smoking (21%). In addition to identifying the correlates of each of the aforementioned lifestyle changes, the results of the multiple regression linear analyses revealed the following correlates for the overall unhealthy lifestyle change score: females (β = 0.32, CI: 0.22; 0.42), living in an apartment (β = 0.12, CI: 0.003; 0.23) and being overweight/obese (β = 0.24, CI: 0.15; 0.32) had higher scores, while older adults (>40 years) had lower scores (β = −0.23, CI: −0.34; −0.12). Conclusions: The COVID-19 lockdown has resulted in a high prevalence of unhealthy lifestyle behaviors and practices among UAE residents. The findings of this study provided the evidence base for officials to design interventions targeting high-risk groups and aiming to improve healthy lifestyle factors among residents during the pandemic.

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Choice of Intensive Lifestyle Change and/or Metformin after Shared Decision Making for Diabetes Prevention: Results from the Prediabetes Informed Decisions and Education (PRIDE) Study

Medical Decision Making ◽

10.1177/0272989x211001279 ◽

2021 ◽

pp. 0272989X2110012

Author(s):

Tannaz Moin ◽

Jacqueline M. Martin ◽

Carol M. Mangione ◽

Jonathan Grotts ◽

Norman Turk ◽

...

Keyword(s):

Decision Making ◽

Usual Care ◽

Shared Decision Making ◽

Diabetes Prevention ◽

Lifestyle Change ◽

Diabetes Incidence ◽

Shared Decision ◽

Informed Decisions ◽

Unit Increase ◽

Pride Study

Introduction While the Diabetes Prevention Program Study demonstrated that intensive lifestyle change and metformin both reduce type 2 diabetes incidence, there are little data on patient preferences in real-world, clinical settings. Methods The Prediabetes Informed Decisions and Education (PRIDE) study was a cluster-randomized trial of shared decision making (SDM) for diabetes prevention. In PRIDE, pharmacists engaged patients with prediabetes in SDM using a decision aid with information about both evidence-based options. We recorded which diabetes prevention option(s) participants chose after the SDM visit. We also evaluated logistic regression models examining predictors of choosing intensive lifestyle change ± metformin, compared to metformin or usual care, and predictors of choosing metformin ± intensive lifestyle change, compared to intensive lifestyle change or usual care. Results Among PRIDE participants ( n = 515), 55% chose intensive lifestyle change, 8.5% chose metformin, 15% chose both options, and 21.6% declined both options. Women (odds ratio [OR] = 1.60, P = 0.023) had higher odds than men of choosing intensive lifestyle change. Patients >60 years old (OR = 0.50, P = 0.028) had lower odds than patients <50 years old of choosing metformin. Participants with higher body mass index (BMI) had higher odds of choosing intensive lifestyle change (OR = 1.07 per BMI unit increase, P = 0.005) v. other options and choosing metformin (OR = 1.06 per BMI unit increase, P = 0.008) v. other options. Conclusions Patients with prediabetes are making choices for diabetes prevention that generally align with recommendations and expected benefits from the published literature. Our results are important for policy makers and clinicians, as well as program planners developing systemwide approaches for diabetes prevention.

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