25. Multiple Imputation for Nonresponse in Surveys. By D. B. Rubin. ISBN 0 471 08705 X. Wiley, Chichester, 1987. 258 pp. £30.25.

Multiple Imputation for Nonresponse in Surveys

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.

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

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Applied Missing Data Analysis

Background Despite the popularity of the low-carbohydrate, high-protein, high-fat (Atkins) diet, no randomized, controlled trials have evaluated its efficacy. Methods We conducted a one-year, multicenter, controlled trial involving 63 obese men and women who were randomly assigned to either a low-carbohydrate, high-protein, high-fat diet or a low-calorie, high-carbohydrate, low-fat (conventional) diet. Professional contact was minimal to replicate the approach used by most dieters. Results Subjects on the low-carbohydrate diet had lost more weight than subjects on the conventional diet at 3 months (mean [±SD], –6.8±5.0 vs. –2.7±3.7 percent of body weight; P=0.001) and 6 months (–7.0±6.5 vs. –3.2±5.6 percent of body weight, P=0.02), but the difference at 12 months was not significant (–4.4±6.7 vs. –2.5±6.3 percent of body weight, P=0.26). After three months, no significant differences were found between the groups in total or low-density lipoprotein cholesterol concentrations. The increase in high-density ...

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A randomized trial of a low-carbohydrate diet for obesity.

Metabolic syndrome is defined by a constellation of interconnected physiological, biochemical, clinical, and metabolic factors that directly increases the risk of cardiovascular disease, type 2 diabetes mellitus, and all cause mortality. Insulin resistance, visceral adiposity, atherogenic dyslipidemia, endothelial dysfunction, genetic susceptibility, elevated blood pressure, hypercoagulable state, and chronic stress are the several factors which constitute the syndrome. Chronic inflammation is known to be associated with visceral obesity and insulin resistance which is characterized by production of abnormal adipocytokines such as tumor necrosis factor α , interleukin-1 (IL-1), IL-6, leptin, and adiponectin. The interaction between components of the clinical phenotype of the syndrome with its biological phenotype (insulin resistance, dyslipidemia, etc.) contributes to the development of a proinflammatory state and further a chronic, subclinical vascular inflammation which modulates and results in atherosclerotic processes. Lifestyle modification remains the initial intervention of choice for such population. Modern lifestyle modification therapy combines specific recommendations on diet and exercise with behavioural strategies. Pharmacological treatment should be considered for those whose risk factors are not adequately reduced with lifestyle changes. This review provides summary of literature related to the syndrome's definition, epidemiology, underlying pathogenesis, and treatment approaches of each of the risk factors comprising metabolic syndrome.

/pdf/a-comprehensive-review-on-metabolic-syndrome-4f6j4v6qts.pdf

A Comprehensive Review on Metabolic Syndrome

https://www.drexel.edu/~/media/Files/psychology/labs/innovation/Behavioral%20Treatment%20for%20Obesity.ashx

Behavioral Treatment of Obesity

https://www.drexel.edu/~/media/Files/psychology/labs/lowelab/Lowe%20%20Butryn%202007.ashx

Hedonic hunger: a new dimension of appetite?

Objective: The objectives were to investigate the characteristics associated with frequent self-weighing and the relationship between self-weighing and weight loss maintenance.

Research Methods and Procedures: Participants (n = 3003) were members of the National Weight Control Registry (NWCR) who had lost ≥30 lbs, kept it off for ≥1 year, and had been administered the self-weighing frequency assessment used for this study at baseline (i.e., entry to the NWCR). Of these, 82% also completed the one-year follow-up assessment.

Results: At baseline, 36.2% of participants reported weighing themselves at least once per day, and more frequent weighing was associated with lower BMI and higher scores on disinhibition and cognitive restraint, although both scores remained within normal ranges. Weight gain at 1-year follow-up was significantly greater for participants whose self-weighing frequency decreased between baseline and one year (4.0 ± 6.3 kg) compared with those whose frequency increased (1.1 ± 6.5 kg) or remained the same (1.8 ± 5.3 kg). Participants who decreased their frequency of self-weighing were more likely to report increases in their percentage of caloric intake from fat and in disinhibition, and decreases in cognitive restraint. However, change in self-weighing frequency was independently associated with weight change.

Discussion: Consistent self-weighing may help individuals maintain their successful weight loss by allowing them to catch weight gains before they escalate and make behavior changes to prevent additional weight gain. While change in self-weighing frequency is a marker for changes in other parameters of weight control, decreasing self-weighing frequency is also independently associated with greater weight gain.

/pdf/consistent-self-monitoring-of-weight-a-key-component-of-2pdxlppwea.pdf

Consistent Self‐monitoring of Weight: A Key Component of Successful Weight Loss Maintenance

A comprehensive program of lifestyle modification induces loss of ∼10% of initial weight in 16 to 26 weeks, as revealed by a review of recent randomized controlled trials, including the Diabetes Prevention Program. Long-term weight control is facilitated by continued patient-therapist contact, whether provided in person or by telephone, mail, or e-mail. High levels of physical activity and the consumption of low-calorie, portion-controlled meals, including liquid meal replacements, can also help maintain weight loss. Additional studies are needed of the effects of macronutrient content (e.g., low-fat vs. low-carbohydrate diets) on long-term changes in weight and health. Research also is needed on effective methods of providing comprehensive weight loss control to the millions of Americans who need it.

https://onlinelibrary.wiley.com/doi/pdf/10.1038/oby.2004.282

Meghan L. Butryn

Papers

Behavioral Treatment of Obesity

Hedonic hunger: a new dimension of appetite?

Behavioral Treatment of Obesity

Consistent Self‐monitoring of Weight: A Key Component of Successful Weight Loss Maintenance

Efficacy of Lifestyle Modification for Long-Term Weight Control