SUN-546 18-Day Lifestyle Program Improves Metabolic Equivalent Measures, BMI, and Exercise Capacity Among Overweight and Obese Adults

Abstract Introduction Various kinds of diets, workout programs, exist to lower one’s Body Mass Index (BMI), increase strength, and endurance. Metabolic Equivalent Measures (METS) is often used to measure exercise intensity1. A simple 18-day lifestyle program may be effective in raising METS, lowering BMI, and building endurance among overweight and obese adults. Methods Participants took part in an 18-day residential lifestyle program that encouraged daily outdoor exercise. Those with a BMI greater than 24.9kg/m2 were selected for this study. BMI, METS, and miles walked per day were measured at baseline and 14 days into the program. METS was measured using the Bruce Protocol while participants reported miles walked per day. Participants were given a walking goal of 5 miles per day. Participants ate 2 vegeterian meals a day that were low in sugar and fat but high in fiber. The program also encouraged moderate sunlight exposure, adequate water intake, sleep hygiene, and temperance. The program incorporated spiritual activities such as corporate prayer, spiritual contemplation, and hymn singing. A patient-doctor relationship was established and participants were consistently monitored. Results A total of n=627 participants were used in this study. METS increased from a baseline mean of 7.61 kcal/kg/hour to a final mean of 9.19 kcal/kg/hour. This is an increase of 1.58 kcal/kg/hour, ±1.26, with t(626)=-25.35 and p<0.001. BMI decreased from a baseline mean of 32.49 kg/m2 to a final mean of 31.39 kg/m2. This is a decrease of 1.094 kg/m2, ± 2.22, with t(626)=39.22 and p<0.001. Miles walked per day (MPD) increased from a baseline mean of 0.86 MPD to a final mean of 4.04 MPD. This is an increase of 3.18 MPD, ±2.01, with t(626)=-33.36 and p<0.001. Conclusion The program significantly improved METS, BMI, and physical endurance among the participants. This suggests that simple lifestyle changes are effective even among overweight and obese adults and should be encouraged by health professionals. Longitudinal studies are needed to examine these lifestyle effects outside of this program.

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Differences in exercise capacity and health-related quality of life according to the body mass index in patients with COPD

Pulmonology ◽

10.1016/j.pulmoe.2021.07.002 ◽

2021 ◽

Author(s):

Jhonatan Betancourt-Peña ◽

Juan Carlos Ávila-Valencia ◽

Diana Milena Diaz-Vidal ◽

Vicente Benavides-Córdoba

Keyword(s):

Quality Of Life ◽

Body Mass Index ◽

Exercise Capacity ◽

Body Mass ◽

The Body ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Long-term body mass index changes in overweight and obese adults and the risk of heart failure, cardiovascular disease and mortality: a cohort study of over 260,000 adults in the UK

BMC Public Health ◽

10.1186/s12889-021-10606-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Barbara Iyen ◽

Stephen Weng ◽

Yana Vinogradova ◽

Ralph K. Akyea ◽

Nadeem Qureshi ◽

...

Keyword(s):

Heart Failure ◽

Cardiovascular Disease ◽

Body Mass Index ◽

Cohort Study ◽

Body Mass ◽

World Health ◽

Obese Adults ◽

Bmi Trajectories ◽

The Impact

Abstract Background Although obesity is a well-recognised risk factor for cardiovascular disease (CVD), the impact of long-term body mass index (BMI) changes in overweight or obese adults, on the risk of heart failure, CVD and mortality has not been quantified. Methods This population-based cohort study used routine UK primary care electronic health data linked to secondary care and death-registry records. We identified adults who were overweight or obese, free from CVD and who had repeated BMI measures. Using group-based trajectory modelling, we examined the BMI trajectories of these individuals and then determined incidence rates of CVD, heart failure and mortality associated with the different trajectories. Cox-proportional hazards regression determined hazards ratios for incident outcomes. Results 264,230 individuals (mean age 49.5 years (SD 12.7) and mean BMI 33.8 kg/m2 (SD 6.1)) were followed-up for a median duration of 10.9 years. Four BMI trajectories were identified, corresponding at baseline, with World Health Organisation BMI classifications for overweight, class-1, class-2 and class-3 obesity respectively. In all four groups, there was a small, stable upwards trajectory in BMI (mean BMI increase of 1.06 kg/m2 (± 3.8)). Compared with overweight individuals, class-3 obese individuals had hazards ratios (HR) of 3.26 (95% CI 2.98–3.57) for heart failure, HR of 2.72 (2.58–2.87) for all-cause mortality and HR of 3.31 (2.84–3.86) for CVD-related mortality, after adjusting for baseline demographic and cardiovascular risk factors. Conclusion The majority of adults who are overweight or obese retain their degree of overweight or obesity over the long term. Individuals with stable severe obesity experience the worst heart failure, CVD and mortality outcomes. These findings highlight the high cardiovascular toll exacted by continuing failure to tackle obesity.

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Lifestyle Changes and Body Mass Index during COVID-19 Pandemic Lockdown: An Italian Online-Survey

Nutrients ◽

10.3390/nu13041117 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1117

Author(s):

Silvia Maffoni ◽

Silvia Brazzo ◽

Rachele De Giuseppe ◽

Ginevra Biino ◽

Ilaria Vietti ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Online Survey ◽

Negative Impact ◽

Phase 1 ◽

Adult Population ◽

Lifestyle Changes ◽

Eating Behaviours ◽

Public Health Services ◽

Activity Frequency

Background. COVID-19 pandemic has imposed a period of contingency measures, including total or partial lockdowns all over the world leading to several changes in lifestyle/eating behaviours. This retrospective cohort study aimed at investigating Italian adult population lifestyle changes during COVID-19 pandemic “Phase 1” lockdown (8 March–4 May 2020) and discriminate between positive and negative changes and BMI (body mass index) variations (ΔBMI). Methods. A multiple-choice web-form survey was used to collect retrospective data regarding lifestyle/eating behaviours during “Phase 1” in the Italian adult population. According to changes in lifestyle/eating behaviours, the sample was divided into three classes of changes: “negative change”, “no change”, “positive change”. For each class, correlations with ΔBMI were investigated. Results. Data were collected from 1304 subjects (973F/331M). Mean ΔBMI differed significantly (p < 0.001) between classes, and was significantly related to water intake, alcohol consumption, physical activity, frequency of “craving or snacking between meals”, dessert/sweets consumption at lunch. Conclusions. During “Phase 1”, many people faced several negative changes in lifestyle/eating behaviours with potential negative impact on health. These findings highlight that pandemic exacerbates nutritional issues and most efforts need to be done to provide nutrition counselling and public health services to support general population needs.

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Regional muscle-adipose distribution is different in patients with heart failure with preserved or reduced ejection fraction

European Heart Journal ◽

10.1093/ehjci/ehaa946.1075 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

H Ishikawa ◽

Y Izumiya ◽

A Shibata ◽

T Yoshida ◽

H Hayashi ◽

...

Keyword(s):

Heart Failure ◽

Body Mass Index ◽

Adipose Tissue ◽

Ejection Fraction ◽

Exercise Capacity ◽

Exercise Tolerance ◽

The Other ◽

Reduced Ejection Fraction ◽

Significant Difference ◽

Regional Muscle

Abstract Background Epicardial adipose tissue (EAT) has been recognized to contribute inflammatory activity and atherosclerosis. On the other hand, it has been reported that the volume of EAT is lower in non-ischemic heart failure (HF) patients than healthy individuals. However, the difference in regional muscle-adipose distribution including EAT between HF with preserved ejection fraction (HFpEF) and HF reduced ejection fraction (HFrEF) has not been investigated. In addition, we investigated whether distribution of body composition contributed to exercise capacity. Methods The study included 105 non-ischemic HF patients diagnosed by cardiac catheterization between September 2017 and November 2019. Epicardial, abdominal and thigh muscle and adipose tissue volume were measured by computed tomography (CT), and exercise tolerance was evaluated by symptom-limited cardiopulmonary exercise test. Results Patients were divided into 2 groups according to the left ventricular ejection fraction, ≥40% as HFpEF (n=28) or <40% as HFrEF (n=77). There was no significant difference comorbidity, including hypertension, dyslipidemia, chronic kidney disease, and body mass index. Plasma B-type natriuretic peptide level was significantly higher in HFrEF than HFpEF group (146.2 vs 393.2 pg/ml, p<0.01), whereas, high-sensitive troponin T level was not different between two groups. Although there was no significant difference in BMI between two groups, the volume of EAT was significantly higher in HFpEF than HFrEF group (81.8 vs 136.4 ml, p=0.01). On the other hand, HFpEF had more thigh adipose tissue compared with HFrEF group (54.6 vs 42.1 ml, p=0.03). There were negative correlations between EAT volume and parameters of exercise capacity such as anaerobic threshold (r=−0.42, p<0.01) and peak VO2 (r=−0.32, p<0.01). Muscle volume itself does not corelate with these parameters. Conclusion In patient with nonischemic HF, the pattern of regional adipose distribution may have important role in pathologically. HFpEF and HFrEF has different pattern despite similar body mass index. These differences may be related to impaired exercise tolerance in these 2 different types of HF. Correlation between EAT and AT, peak VO2 Funding Acknowledgement Type of funding source: None

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Disfunção diafragmática e mortalidade em pacientes portadores de DPOC

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132009001200003 ◽

2009 ◽

Vol 35 (12) ◽

pp. 1174-1181 ◽

Cited By ~ 14

Author(s):

Wellington Pereira dos Santos Yamaguti ◽

Elaine Paulin ◽

João Marcos Salge ◽

Maria Cristina Chammas ◽

Alberto Cukier ◽

...

Keyword(s):

Body Mass Index ◽

Airway Obstruction ◽

Exercise Capacity ◽

Body Mass ◽

Indice Bode

OBJETIVO: Verificar se indivíduos portadores de DPOC com disfunção diafragmática apresentam maior risco de mortalidade quando comparados àqueles sem disfunção diafragmática. MÉTODOS: Foi avaliada a função pulmonar, a mobilidade diafragmática, a qualidade de vida e o índice conhecido como Body mass index, airway Obstruction, Dyspnea, and Exercise capacity (BODE) em 42 pacientes portadores de DPOC. Os pacientes foram alocados em dois grupos de acordo com a gravidade do acometimento da mobilidade do diafragma: grupo de baixa mobilidade (BM; mobilidade < 33,99 mm) e grupo de alta mobilidade (AM; mobilidade > 34,00 mm). O índice BODE e a qualidade de vida foram quantificados nos dois grupos. Todos os pacientes foram acompanhados prospectivamente por um período de até 48 meses a fim de identificarmos o número de óbitos decorrentes de complicações respiratórias devido a DPOC. RESULTADOS: Dos 42 pacientes avaliados, 20 foram classificados no grupo BM, e 22 foram alocados no grupo AM. Não houve diferenças significativas quanto à faixa etária, hiperinsuflação pulmonar e fatores relacionados à qualidade de vida entre os grupos. Entretanto, o grupo BM apresentou maior pontuação no índice BODE em relação ao grupo AM (p = 0,01). O acompanhamento dos pacientes ao longo de 48 meses permitiu identificar quatro óbitos na população estudada, sendo todos os casos no grupo BM (15,79%; p = 0,02). CONCLUSÕES: Esses resultados sugerem que pacientes portadores de DPOC com disfunção diafragmática, caracterizada por uma baixa mobilidade do diafragma, apresentam maior risco de mortalidade quando comparados àqueles sem disfunção diafragmática.

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Impaired endothelium-dependent vasodilation in overweight and obese adult humans is not limited to muscarinic receptor agonists

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.01281.2007 ◽

2008 ◽

Vol 294 (4) ◽

pp. H1685-H1692 ◽

Cited By ~ 39

Author(s):

Gary P. Van Guilder ◽

Brian L. Stauffer ◽

Jared J. Greiner ◽

Christopher A. DeSouza

Keyword(s):

Body Mass Index ◽

Substance P ◽

Sodium Nitroprusside ◽

Muscarinic Receptor ◽

Body Mass ◽

Area Under The Curve ◽

Normal Weight ◽

Obese Adults ◽

Single Class ◽

Receptor Agonists

Muscarinic receptor agonists have primarily been used to characterize endothelium-dependent vasodilator dysfunction with overweight/obesity. Reliance on a single class of agonist, however, yields limited, and potentially misleading, information regarding endothelial vasodilator capacity. The aims of this study were to determine 1) whether the overweight/obesity-related reduction in endothelium-dependent vasodilation extends beyond muscarinic receptor agonists and 2) whether the contribution of nitric oxide (NO) to endothelium-dependent vasodilation is reduced in overweight/obese adults. Eighty-six middle-aged and older adults were studied: 42 normal-weight (54 ± 1 yr, 21 men and 21 women, body mass index = 23.4 ± 0.3 kg/m2) and 44 overweight/obese (54 ± 1 yr, 28 men and 16 women, body mass index = 30.3 ± 0.6 kg/m2) subjects. Forearm blood flow (FBF) responses to intra-arterial infusions of acetylcholine in the absence and presence of the endothelial NO synthase inhibitor NG-monomethyl-l-arginine, methacholine, bradykinin, substance P, isoproterenol, and sodium nitroprusside were measured by strain-gauge plethysmography. FBF responses to each endothelial agonist were significantly blunted in the overweight/obese adults. Total FBF (area under the curve) to acetylcholine (50 ± 5 vs. 79 ± 4 ml/100 ml tissue), methacholine (55 ± 4 vs. 86 ± 5 ml/100 ml tissue), bradykinin (62 ± 5 vs. 85 ± 4 ml/100 ml tissue), substance P (37 ± 4 vs. 57 ± 5 ml/100 ml tissue), and isoproterenol (62 ± 4 vs. 82 ± 6 ml/100 ml tissue) were 30%-40% lower in the overweight/obese than normal-weight adults. NG-monomethyl-l-arginine significantly reduced the FBF response to acetylcholine to the same extent in both groups. There were no differences between the groups in the FBF responses to sodium nitroprusside. These results indicate that agonist-stimulated endothelium-dependent vasodilation is universally impaired with overweight/obesity. Moreover, this impairment appears to be independent of NO.

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Role of ventilatory response to exercise in determining exercise capacity in COPD

Journal of Applied Physiology ◽

10.1152/jappl.1995.79.6.1870 ◽

1995 ◽

Vol 79 (6) ◽

pp. 1870-1877 ◽

Cited By ~ 19

Author(s):

O. Bauerle ◽

M. Younes

Keyword(s):

Body Mass Index ◽

Oxygen Consumption ◽

Exercise Capacity ◽

Body Mass ◽

Ventilatory Response ◽

Inspiratory Flow ◽

Peak Oxygen Consumption ◽

Chronic Obstructive ◽

Inspiratory Capacity ◽

Response To Exercise

The progression of chronic obstructive pulmonary disease (COPD) is generally associated with decreased exercise capacity. Differences in forced expired volume in 1 s (FEV1) among patients account for only a fraction of the variability in maximal oxygen consumption (VO2max). We hypothesized that variability in ventilatory response to exercise and in inspiratory mechanics and body mass index contributes importantly to variability in VO2max in this disease. We analyzed the files of 53 patients with established diagnosis of COPD who underwent a recent symptom-limited exercise test. We used inspiratory capacity and maximum inspiratory flow as measures of variability in inspiratory mechanics. The minute ventilation (VE) at the subject's VO2max was divided by the predicted in a normal subject at the same VO2 to obtain a ratio (VE,max/VE,pred). The ventilatory response during exercise provided the best correlation with peak VO2 (r = 0.62). FEV1 and inspiratory capacity also correlated with peak oxygen consumption but not as well as the ventilatory response (r = 0.49 and r = 0.46, respectively). Maximum inspiratory flow and body mass index showed only weak positive correlations (r = 0.23, not significant). The stepwise analysis generated the following equation: VO2max (%predicted) = (77.26 x VE,pred/VE,max) + [0.45 x FEV1 (%predicted)] - 23.66; r = 0.76, P < 0.001. We conclude that variability in the ventilatory response during exercise is one of the main determinants of variability in exercise capacity in COPD patients.

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Effect of Body Mass Index on Exercise Capacity in Patients With Hypertrophic Cardiomyopathy

The American Journal of Cardiology ◽

10.1016/j.amjcard.2017.09.026 ◽

2018 ◽

Vol 121 (1) ◽

pp. 100-106 ◽

Cited By ~ 7

Author(s):

Carolyn M. Larsen ◽

Caroline A. Ball ◽

Virginia B. Hebl ◽

Kevin C. Ong ◽

Konstantinos C. Siontis ◽

...

Keyword(s):

Body Mass Index ◽

Hypertrophic Cardiomyopathy ◽

Exercise Capacity ◽

Body Mass

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Relationship Between Weekly Patterns of Caloric Intake and Reported Weight Loss Outcomes: Retrospective Cohort Study (Preprint)

10.2196/preprints.8320 ◽

2017 ◽

Author(s):

Christine Hill ◽

Brian W Weir ◽

Laura W Fuentes ◽

Alicia Garcia-Alvarez ◽

Danya P Anouti ◽

...

Keyword(s):

Body Mass Index ◽

Weight Loss ◽

Linear Regression ◽

Mobile Phone ◽

Body Mass ◽

Caloric Intake ◽

Body Mass Index Category ◽

Obese Adults ◽

Weight Loss Outcomes ◽

The Relationship

BACKGROUND Although millions of overweight and obese adults use mobile phone apps for weight loss, little is known about the predictors of success. OBJECTIVE The objective of this study was to understand the relationship between weight loss outcomes and weekly patterns of caloric intake among overweight and obese adults using a mobile phone app for weight loss. METHODS We examined the relationship between weekly patterns of caloric intake and weight loss outcomes among adults who began using a weight loss app in January 2016 and continued consistent use for at least 5 months (N=7007). Unadjusted and adjusted linear regression analyses were used to evaluate the predictors of percentage of bodyweight lost for women and men separately, including age, body mass index category, weight loss plan, and difference in daily calories consumed on weekend days (Saturday and Sunday) versus Monday. RESULTS In adjusted linear regression, percentage of bodyweight lost was significantly associated with age (for women), body mass index (for men), weight loss plan, and differences in daily caloric intake on Mondays versus weekend days. Compared with women consuming at least 500 calories more on weekend days than on Mondays, those who consumed 50 to 250 calories more on weekend days or those with balanced consumption (±50 calories) lost 1.64% more and 1.82% more bodyweight, respectively. Women consuming 250 to 500 calories or more than 500 calories more on Mondays than on weekend days lost 1.35% more and 3.58% more bodyweight, respectively. Compared with men consuming at least 500 calories more on weekend days than on Mondays, those consuming 250 to 500 calories or more than 500 calories more on Mondays than on weekend days lost 2.27% and 3.42% less bodyweight, respectively. CONCLUSIONS Consistent caloric intake on weekend days and Mondays or consuming slightly fewer calories per day on Mondays versus weekend days was associated with more successful weight loss. CLINICALTRIAL ClinicalTrials.gov NCT03136692; https://clinicaltrials.gov/ct2/show/NCT03136692 (Archived by WebCite at http://www.webcitation.org/6y9JvHya4)

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