How to Maintain a Healthy Body Weight

2006 ◽  
Vol 76 (4) ◽  
pp. 208-215 ◽  
Author(s):  
Astrup
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Body Weight ◽  
Glycemic Index ◽  
Dairy Products ◽  
Weight Control ◽  
Healthy Body Weight ◽  
Healthy Body

The epidemic of both obesity and type 2 diabetes is due to environmental factors, but the individuals developing the conditions possess a strong genetic predisposition. Observational surveys and intervention studies have shown that excess body fatness is the major environmental cause of type 2 diabetes, and that even a minor weight loss can prevent its development in high-risk subjects. Maintenance of a healthy body weight in susceptible individuals requires 45–60 minutes physical activity daily, a fat-reduced diet with plenty of fruit, vegetables, whole grain, and lean meat and dairy products, and moderate consumption of calorie containing beverages. The use of table values to predict the glycemic index of meals is of little – if any – value, and the role of a low-glycemic index diet for body weight control is controversial. The replacement of starchy carbohydrates with protein from lean meat and lean dairy products enhances satiety, and facilitate weight control. It is possible that dairy calcium also promotes weight loss, although the mechanism of action remains unclear. A weight loss of 5–10% can be induced in almost all obese patients providing treatment is offered by a professional team consisting of a physician and dieticians or nurses trained to focus on weight loss and maintenance. Whereas increasing daily physical activity and regular exercise does not significantly effect the rate of weight loss in the induction phase, it plays an important role in the weight maintenance phase due to an impact on daily energy expenditure and also to a direct enhancement of insulin sensitivity.

A Randomized controlled trial of SMS Intervention in Inner Mongolia with Type 2 Diabetes (Preprint)

2018 ◽  
Author(s):  
Xue Mei Wang ◽  
Dan Liu ◽  
Mao Lin Du ◽  
Rui Qi Hao ◽  
Hui Qiu Zheng ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Weight Control ◽  
Controlled Trial ◽  
Average Score ◽  
Randomized Controlled ◽  
Sms Intervention ◽  
Better Than

BACKGROUND Nonadherence to self-management is common among patients with type 2 diabetes (T2D) and often leads to severe complications. Short messages service (SMS) technology provides a practical medium for delivering content to address patients’ barriers to adherence. OBJECTIVE The aim of this study was to design a series of SMS intervention templates, and to evaluate the feasibility of the SMS through a short message quality evaluation questionnaire and to explore the intervention effect. METHODS 1. The SMS evaluation was assessed through the 10-point scale SMS Quality Assessment Questionnaire. 2. A randomized controlled trial was conducted. The patients in SMS intervention were randomly divided into intervention group (IG) and control group (CG), which received evaluated messages education and regular education, respectively. The intervention was divided into four phases, a telephone interview was conducted to evaluate the effectiveness of the intervention after each phase. The main outcome were changes in blood glucose and blood pressure (BP) and their control rates, and secondary outcomes were changes in diet, physical activity, weight control and other health-related behaviors. RESULTS 1. SMS design: 42 SMS text messages were designed to promote healthy behaviors in different stages of behavior change, covering four key domains: healthy knowledge, diet, physical activity, living habits and weight control. 2. SMS evaluation: The average score for healthy knowledge, diet, physical activity, living habits, weight control were 8.0 (SD 0.7), 8.5 (SD 0.6), 7.9 (SD 1.0), 8.0 (SD 0.7), and 8.4 (SD 0.9), respectively. 3. SMS intervention: A total of 146 people completed the four-phase intervention, including 72 in the CG and 74 in the IG. At the end of the intervention period, in the IG, the decrease in fasting blood glucose (FBG, mean 1.5mg/l [SD 3.0] vs 0.4 mg/l [SD 2.8], P=0.011), postprandial blood glucose (PBG, mean 5.8mg/l [SD 5.1] vs 4.2 mg/l [SD 4.7], P=0.028), systolic blood pressure (SBP, mean 9.1mmHg [SD 15.8] vs 2.2mmHg [SD 13.3], P=0.025), FBG control rate (45.9% vs 31.0%, P=0.046) and PBG control rate (57.8% vs 33.7%, P=0.002) were better than the CG. In self-behavior management, the changes of the weight control, diet and physical activity in the IG were better than those in the CG, and the average score of the IG was greater than that of the CG (1.1 vs [-0.3] ), P0.001). CONCLUSIONS The overall quality of SMS content is higher to meet the needs of patients; Diet, physical activity and weight control message need to be focused on push. SMS interventions contribute to the management of blood glucose and BP, and help to promote a series of healthy-related behaviors.

scholarly journals Effects of Cotadutide on Metabolic and Hepatic Parameters in Adults with Overweight or Obesity and Type 2 Diabetes Mellitus: A 54-Week Randomized Phase 2b Study

2021 ◽  
Author(s):  
Rajaa Nahra ◽  
Tao Wang ◽  
Kishore M. Gadde ◽  
Jan Oscarsson ◽  
Michael Stumvoll ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Body Weight ◽  
Ad Hoc ◽  
Open Label ◽  
Double Blind ◽  
Glucagon Receptor ◽  
Nonalcoholic Fatty Liver ◽  
Design And Methods

<a><b>Objective: </b></a>Cotadutide, a <a>dual GLP-1 and glucagon receptor agonist</a>, is under development for nonalcoholic steatohepatitis (NASH) and type 2 diabetes. The effects of cotadutide on hepatic and metabolic parameters were evaluated in participants with overweight/obesity and type 2 diabetes. <p><b>Research Design and Methods:</b> In this phase 2b study, 834 adults with BMI ≥25kg/m<sup>2</sup> and type 2 diabetes inadequately controlled with metformin (glycated hemoglobin A1c [HbA1c] of 7.0%─10.5% [53─91 mmol/mol]) were randomized to double-blind cotadutide 100µg (n=100), 200µg (n=256), or 300µg (n=256), placebo (n=110), or open-label liraglutide 1.8mg (n=110), all administered subcutaneously (NCT03235050). Coprimary endpoints were changes in HbA1c and body weight at week 14.<b> </b>The originally randomized interventions were continued to week 54.<b> </b>Liver damage biomarkers and liver fibrosis algorithms were assessed.</p> <p><b>Results</b>: Cotadutide significantly decreased HbA1c and body weight at weeks 14 and 54 versus placebo (all <i>P</i><0.001). Improvements in lipid profile, aspartate aminotransferase and alanine aminotransferase levels, <a>PRO-C3 level, fibrosis-4 index</a>, and <a>nonalcoholic fatty liver disease fibrosis score</a> were observed with cotadutide 300µg versus placebo, but not with liraglutide. Weight loss with cotadutide 200µg was similar to liraglutide 1.8mg, and greater with cotadutide 300µg versus liraglutide 1.8mg. <a>The most common adverse events with cotadutide (nausea, 35%; vomiting, 17%) decreased over time. </a></p> <p><b>Conclusions: </b>Cotadutide treatment for 54 weeks improved glycemic control and weight loss in participants with overweight/obesity and type 2 diabetes. Ad hoc analyses demonstrated improvements in hepatic parameters and support further evaluation of cotadutide in NASH. </p>

Abstract 11616: Effect of a Lifestyle Weight Loss Intervention on Visceral Fat and Glycemic Control Among Individuals With and Without Type 2 Diabetes

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Soohyun Nam ◽  
Soohyun Nam ◽  
Devon A Dobrosielski ◽  
Kerry J Stewart
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Body Weight ◽  
Glycemic Control ◽  
Aerobic Fitness ◽  
Visceral Fat ◽  
Subcutaneous Fat ◽  
Moderate Intensity ◽  
Weight Loss Diet

Background: Though a high amount of visceral fat is associated with insulin resistance, which can lead to type 2 diabetes (T2D) and cardiovascular diseases (CVDs), less is known about whether lifestyle modification (weight loss diet and exercise) induced changes in visceral fat are associated with improvements in glycemia. Methods: We randomized 77 individuals aged 35-65 years with T2D or pre-diabetes to 6-months of weight loss diet (D); or D combined with supervised moderate-intensity exercise training (D+E). Study measures were total abdominal, visceral and subcutaneous fat volumes by magnetic resonance imaging, aerobic fitness expressed as VO 2 peak during treadmill testing, body mass index (BMI), and HbA1c levels from blood samples. Results: Of 77 subjects (mean age, 54.8±7.8 years; mean BMI, 34.5 ± 4.7 kg/m 2 , women, 77.9%; Whites-65%, Blacks-34%, Asians-1%), n=37 had T2D and n=40 had pre-diabetes. At 6 months, both D and D+E groups improved from baseline (p<0.05 for all) but did not differ in their changes for body weight (D: -6.04 ± 4.54 kg; D+E: -6.68 ± 4.48 kg, p= 0.61 for the group differences in change), abdominal total fat (D: -101.93 ± 68.67 cm 2 ; D+E:-104.16 ± 72.37 cm 2 , p= 0.92), visceral fat (D:-25.53 ± 39.44 cm 2 ; D+E:,-23.24 ± 35.62 cm 2 , p=0.85), HbA1c (D:0.04 ± 0.46%; D+E:0.03 ± 0.63%, p=0.96), and VO 2 peak (D: 2.26 ± 3.92 ml/kg/min ; D+E:3.71 ± 2.65 ml/kg/min, p=0.11). In a multivariate analysis, adjusting for baseline visceral fat, T2D status, body weight loss and increases in aerobic fitness, a reduction in HbA1c (β=-0.49, p =0.007) was associated with a reduction in visceral fat (R 2 =0.34, p=0.02). Conclusion: The key finding was that diet or diet plus exercise-mediated reductions in visceral fat was associated with reduced HbA1c among individuals with T2D or pre-diabetes. These data contribute to growing body of evidence of the benefits of reducing abdominal obesity, in this case, resulting in better glycemic control in T2D and pre-diabetes.

scholarly journals Low and reduced carbohydrate diets: challenges and opportunities for type 2 diabetes management and prevention

2020 ◽  
Vol 79 (4) ◽  
pp. 498-513 ◽  
Author(s):  
Chaitong Churuangsuk ◽  
Michael E. J. Lean ◽  
Emilie Combet
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Weight Control ◽  
Diabetes Management ◽  
Food Selection ◽  
Food Sources ◽  
Micronutrient Deficiencies ◽  
Clinical Endpoints

Low-carbohydrate diets (LCD) have been promoted for weight control and type 2 diabetes (T2D) management, based on an emerging body of evidence, including meta-analyses with an indication of publication bias. Proposed definitions vary between 50 and 130 g/d, or <10 and <40 % of energy from carbohydrate, with no consensus on LCD compositional criteria. LCD are usually followed with limited consideration for other macronutrients in the overall diet composition, introducing variance in the constituent foods and in metabolic responses. For weight management, extensive evidence supports LCD as a valid weight loss treatment, up to 1–2 years. Solely lowering carbohydrate intake does not, in the medium/long term, reduce HbA1c for T2D prevention or treatment, as many mechanisms interplay. Under controlled feeding conditions, LCD are not physiologically or clinically superior to diets with higher carbohydrates for weight-loss, fat loss, energy expenditure or glycaemic outcomes; indeed, all metabolic improvements require weight loss. Long-term evidence also links the LCD pattern to increased CVD risks and mortality. LCD can lead to micronutrient deficiencies and increased LDL-cholesterol, depending on food selection to replace carbohydrates. Evidence is limited but promising regarding food choices/sources to replace high-carbohydrate foods that may alleviate the negative effects of LCD, demanding further insight into the dietary practice of medium to long term LCD followers. Long-term, high-quality studies of LCD with different food sources (animal and/or plant origins) are needed, aiming for clinical endpoints (T2D incidence and remission, cardiovascular events, mortality). Ensuring micronutrient adequacy by food selection or supplementation should be considered for people who wish to pursue long-term LCD.

Is there a metabolic rationale to support a weight loss programme to prevent diabetes?

2003 ◽  
Vol 3 (1_suppl) ◽  
pp. S12-S17
Author(s):  
Mike Lean
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Body Weight ◽  
Ideal Body Weight ◽  
Gastric Surgery ◽  
Necrosis Factor Alpha ◽  
Weight Loss Programme ◽  
Intervention Trials ◽  
Prevention Of Diabetes

It is well established that the incidences of type 2 diabetes and impaired glucose tolerance are very low at ideal body weight (body mass index [BMI] 21—22 kg/m2) but increases with increasing body fat and BMI. Adipose tissue is an active endocrine organ which secretes many hormones involved in the regulation of body weight and appetite, including leptin and tumour necrosis factor-alpha, which are related to diabetes development. Weight loss is an important goal within the overall management of diabetes, and recent intervention trials have established that the benefits of weight loss may extend to the prevention of diabetes itself. Weight loss associated with diet and exercise in the DPP and the FDPS, by the anti-obesity drug orlistat in the XENDOS trial, and by gastric surgery in the SOS study all significantly reduced the incidence of diabetes compared with controls. The prevention or reversal of obesity is therefore an increasingly important therapeutic target in the prevention of type 2 diabetes.

scholarly journals Frequency of self-monitoring of blood glucose in relation to weight loss and A1C during intensive multidisciplinary weight management in patients with type 2 diabetes and obesity

2019 ◽  
Vol 7 (1) ◽  
pp. e000659 ◽  
Author(s):  
Shaheen Tomah ◽  
Noor Mahmoud ◽  
Adham Mottalib ◽  
David M Pober ◽  
Mhd Wael Tasabehji ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Body Weight ◽  
Blood Glucose ◽  
Weight Management ◽  
Average Frequency ◽  
Baseline Body Mass Index ◽  
Self Monitoring ◽  
Median Change

ObjectiveWe evaluated the relationship between frequency of self-monitoring of blood glucose (SMBG) and body weight, A1C, and cardiovascular risk factors in patients with type 2 diabetes (T2D) and obesity enrolled in a 12-week intensive multidisciplinary weight management (IMWM) program.Research design and methodsWe conducted a retrospective analysis of 42 patients who electronically uploaded their SMBG data over 12 weeks of an IMWM program and divided them into tertiles based on their average frequency of SMBG per day. Mean (range) SMBG frequencies were 2.3 (1.1–2.9) times/day, 3.4 (3–3.9) times/day, and 5 (4–7.7) times/day in the lowest, middle, and highest tertiles, respectively. Anthropometric and metabolic parameters were measured at baseline and after 12 weeks of intervention.ResultsParticipants in the highest tertile achieved a median change (IQR) in body weight of −10.4 kg (−7.6 to −14.4 kg) compared with −8.3 kg (−5.2 to −12.2 kg), and −6.9 kg (−4.2 to −8.9 kg) in the middle and lowest tertiles, respectively (p=0.018 for trend). Participants in the highest tertile had a median change (IQR) in A1C of −1.25% (−0.6 to −3.1%) compared with −0.8% (−0.3% to −2%) and −0.5% (−0.2% to −1.2%) in the middle and lowest tertiles, respectively (p=0.048 for trend). The association between change in body weight and SMBG frequency remained significant after adjusting for age, sex, baseline body mass index, diabetes duration, and use of insulin therapy.ConclusionsIncreased frequency of SMBG during IMWM is associated with significantly better weight loss and improvement of A1C in patients with T2D and obesity. These findings may suggest future clinical recommendations aimed at increasing SMBG frequency to achieve the most favorable outcomes.

scholarly journals Effect of a long-term intensive lifestyle intervention on prevalence of cognitive impairment

Neurology ◽  
2017 ◽  
Vol 88 (21) ◽  
pp. 2026-2035 ◽  
Author(s):  
Mark A. Espeland ◽  
José A. Luchsinger ◽  
Laura D. Baker ◽  
Rebecca Neiberg ◽  
Steven E. Kahn ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Lifestyle Intervention ◽  
Cognitive Test ◽  
Intervention Effect ◽  
Intensive Lifestyle Intervention

Objective:To assess whether an average of 10 years of lifestyle intervention designed to reduce weight and increase physical activity lowers the prevalence of cognitive impairment among adults at increased risk due to type 2 diabetes and obesity or overweight.Methods:Central adjudication of mild cognitive impairment and probable dementia was based on standardized cognitive test battery scores administered to 3,802 individuals who had been randomly assigned, with equal probability, to either the lifestyle intervention or the diabetes support and education control. When scores fell below a prespecified threshold, functional information was obtained through proxy interview.Results:Compared with control, the intensive lifestyle intervention induced and maintained marked differences in weight loss and self-reported physical activity throughout follow-up. At an average (range) of 11.4 (9.5–13.5) years after enrollment, when participants' mean age was 69.6 (54.9–87.2) years, the prevalence of mild cognitive impairment and probable dementia was 6.4% and 1.8%, respectively, in the intervention group, compared with 6.6% and 1.8%, respectively, in the control group (p = 0.93). The lack of an intervention effect on the prevalence of cognitive impairment was consistent among individuals grouped by cardiovascular disease history, diabetes duration, sex, and APOE ε4 allele status (all p ≥ 0.50). However, there was evidence (p = 0.03) that the intervention effect ranged from benefit to harm across participants ordered from lowest to highest baseline BMI.Conclusions:Ten years of behavioral weight loss intervention did not result in an overall difference in the prevalence of cognitive impairment among overweight or obese adults with type 2 diabetes.Clinicaltrials.gov identifier:NCT00017953 (Action for Health in Diabetes).Level of evidence:This study provides Class II evidence that for overweight adults with type 2 diabetes, a lifestyle intervention designed to reduce weight and increase physical activity does not lower the risk of cognitive impairment.

scholarly journals PDB8 Weight Loss of ≥3% of Body Weight After Initiating New Anti-Diabetic Therapy is Associated With Glycemic Control at 6 Months in Patients With Type 2 Diabetes

2012 ◽  
Vol 15 (7) ◽  
pp. A494
Author(s):  
C. Mcadam-marx ◽  
B.K. Bellows ◽  
G.D. Wygant ◽  
J. Mukherjee ◽  
S. Unni ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Body Weight ◽  
Glycemic Control
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