Journal Article•
Lifestyle intervention in the treatment of severe obesity
TL;DR: After 15 weeks of intensive lifestyle intervention, there were significant improvements in aerobic fitness and metabolic risk parameters, and the observed weight loss was equivalent to that obtained by surgical treatment.
Abstract: INTRODUCTION The prevalence of overweight and obesity is escalating globally, and in Denmark more than 10% of the population are now severely overweight. The aim of this study was to estimate the short-term health effects of 15 weeks of intensive lifestyle intervention composed of physical activity, dietary changes and personal development in severely obese subjects of both sexes. MATERIALS AND METHODS The 27 subjects were weighed weekly. Fat percentage, abdominal circumference, maximum oxygen uptake, heart rate, oral glucose tolerance and blood lipids were measured at baseline and in week 15. The intensive lifestyle intervention was completed under supervision at a stay at Ebeltoft Kurcenter, and the goal was a weight loss of approximately 1% per week. RESULTS At baseline, the participants' average body mass index (BMI: kg/m2) was 44 +- 1; the BMI was reduced by 11% after the stay (p<0.001). Body weight was reduced by 14 +- 4 kg (p<0.001), corresponding to 76% of the desired weight loss. The subjects' fat mass was reduced by 4% (p<0.001), and their maximal oxygen uptake was enhanced by 25% (p<0.001). Concerning the blood lipids, total cholesterol was reduced by 8% (p = 0.03); there was no significant change in LDL level and a reduction of 15% (p<0.05) in HDL level. After the intervention, oral glucose tolerance was significantly improved (p<0.001). CONCLUSION After 15 weeks of intensive lifestyle intervention, there were significant improvements in aerobic fitness and metabolic risk parameters, and the observed weight loss was equivalent to that obtained by surgical treatment. Decisive in the choice of obesity treatment will continue to be the extent of success in permanent weight loss.
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TL;DR: It is concluded that PA was associated with change in body weight and CRF; however, there was a trend towards a gender specific effect between severely obese men and women.
Abstract: We aimed to examine the relationship between physical activity (PA) and change in body weight and cardiorespiratory fitness (CRF) in severely obese men and women Thirty-five subjects (10 men, body mass index 4 3 2 ± 5 1 kg/m 2) who participated in a 10-month lifestyle treatment programme were included The PA duration correlated only with weight change for men ( 𝑟 = − 0 6 9 , 𝑃 = 0 2 7 versus 𝑟 = − 0 1 9 , 𝑃 = 3 7 2 for women) Conversely, the PA intensity correlated only with CRF for women ( 𝑟 = 0 6 1 , 𝑃 = 0 0 3 versus 𝑟 = 0 3 9 , 𝑃 = 3 4 0 for men) PA explained 558 and 56% of weight change for men and women, respectively, whereas the corresponding explained variances for CRF were 156 and 367% We conclude that PA was associated with change in body weight and CRF; however, there was a trend towards a gender specific effect between severely obese men and women
30 citations
Cites background or result from "Lifestyle intervention in the treat..."
...As studies consistently show an especially large risk reduction with an increase in CRF beyond some minimal threshold [26, 37], any increase would be beneficial to health for most severely obese subjects, whose CRF is generally low [17, 18, 38, 39]....
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...This change parallels other study results for both severely obese and less obese subjects undergoing lifestyle interventions incorporating PA [17, 18, 36]....
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01 Jan 2010
TL;DR: Analizar rasgos y trastornos de personalidad mas comunes en personas con obesidad, evaluar signos, sintomas, and trastors psicopatologicos mas frecuentemente asociados al exceso de peso as mentioned in this paper.
Abstract: analizar los rasgos y trastornos de personalidad mas comunes en personas
con obesidad. Ademas, evaluar los signos, sintomas y trastornos psicopatologicos mas
frecuentemente asociados al exceso de peso.
12 citations
Journal Article•
TL;DR: NetHR is a practical, valid and non-invasive method to prescribe physical activity, taking in account individual characteristics (HR at rest combined with NetHR) in middle-aged to older adults.
Abstract: This study had a twofold purpose: i) to develop a regression equation to estimate metabolic equivalent (MET) in walk/run by heart rate increment above rest (NetHR), and; ii) to determine NetHR thresholds for light, moderate, and vigorous physical activity (PA), from middle aged to elderly. Sample 1 (prediction sample) comprised 39 subjects (19 male and 20 female), with 58.2 ± 11.0 years old. Sample 2 (validation sample) comprised 40 subjects (18 male and 22 female) with 63.3 ± 7.0 years old. Each participant did the following activities in sequence, a 15min rest period in supine position, walk at 3km/h, walk at 4.5km/h, and walk at 6km/h, for 6 min at each walk velocity interval. The oxygen up-take (VO2) and heart rate (HR) were continuously and simultaneously assessed. A hierarchical linear model was used to analyze the relationship between metabolic equivalent (MET) and NetHR. The regression equation for MET prediction was: MET = 1.265780 + 0.109479 NetHR. The NetHR thresholds (upper limit) for light, moderate and vigorous PA were 16 and 35 and 70 bpm, respectively. NetHR is a practical, valid and non-invasive method to prescribe physical activity, taking in account individual characteristics (HR at rest combined with NetHR) in middle-aged to older adults.
11 citations
Cites background from "Lifestyle intervention in the treat..."
...Received: 29 July 2009 / Accepted: 07 October 2009 / Published (online): 01 December 2009...
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...There are epidemiological and clinical evidences that physical activity (PA) can contribute to the prevention and rehabilitation of several chronic diseases, such as cardiovascular disease (Adamu et al., 2006), diabetes (Fodor and Adamo, 2001) and obesity (Pedersen et al., 2006)....
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TL;DR: It is concluded that the current laboratory-based evidence for PA and health is to be replicated yet in real-world settings and that rigorous and clinically relevant naturalistic research is required.
Abstract: Sedentary lifestyle is associated with cardiovascular and metabolic diseases. A compelling body of evidence demonstrates the amelioration and prevention of such conditions with increased levels of physical activity (PA). Despite this evidence, many public health initiatives aimed at increasing PA have failed to demonstrate clinically relevant effects on public health. It has been hypothesized that the highly controlled environments in which PA and health research is conducted limits its replicability in real-world community settings. This review aimed to evaluate the effectiveness of community fitness center-based interventions on inactivity-related diseases in adults. Data from 11 investigations highlighted 3 factors: 1) a lack of community-based PA studies, 2) a lack of clinically relevant data, and 3) further reliance on self-report and rudimentary measurements. It is concluded that the current laboratory-based evidence for PA and health is to be replicated yet in real-world settings and that rigorous and clinically relevant naturalistic research is required.
10 citations
Cites background from "Lifestyle intervention in the treat..."
...Articles also were excluded if they were not in English (22,33) or if the target cohort was children (35)....
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Dissertation•
01 May 2014
TL;DR: Real world interventions do not appear to be as effective in promoting health as laboratory research suggests should be the case, and on that basis, more real world research is warranted.
Abstract: Widespread physical inactivity and resultant increases in cardiovascular and metabolic disease is a serious public health concern in the developed World. Unsurprisingly, the vast majority of research evidence suggests that physical activity is an effective intervention in addressing this state of affairs. An apparently strong case exists for the widespread clinical prescription of physical activity (PA). The application of PA in both preventative and remedial health is often termed ‘exercise is medicine’.
Whilst on the basis of a large volume of laboratory data there is some consensus regarding the optimal delivery of health related PA, there is an apparent discrepancy between data emanating from laboratory and/or clinical studies and those emanating from real world interventions. In short, real world interventions do not appear to be as effective in promoting health as laboratory research suggests should be the case. This situation is compounded by a relative paucity of peer reviewed research studies reporting real world PA research, and furthermore by even less clinically relevant data. On this basis, a clear picture of the degree of translation from laboratory to the field is not yet possible. It is however not unreasonable to argue that the setting of the vast majority of research studies investigating the exercise is medicine hypothesis - that is laboratories, hospitals and clinics – might theoretically limit the translation of these findings to real world public health settings, and on that basis, more real world research is warranted.
In Chapters 1 and 2 of this thesis the above arguments are developed into a case for a large scale ecologically valid translational study to investigate the effects of exercise on clinically relevant health variables. Chapter 3 presents the results of a pilot study that assessed the comparative effectiveness of structured PA (STRUC), unstructured PA (FREE), and PA counselling (PAC), among sedentary individuals in a community fitness centre setting. Significant improvements were observed in cardiovascular risk factors in all three groups, with no significant between-group differences.
Chapters 4, 5 and 6 report data from a large scale, ecologically valid, longitudinal (48 week), multi-centre (n=26) investigation comparing the three interventions above with a measurement only condition. Participants were 1146 previously sedentary individuals. The ecological validity of the exercise is medicine hypothesis was tested from a clinical (Chapter 4) and behavioural (Chapter 5) perspective. Survey data pertaining to factors influencing the effectiveness of the interventions are explored in Chapter 6.
Data suggest that the baseline health status of participants mediated effects over time, with participants most at risk of cardiovascular disease experiencing clinically significant improvements in health (e.g. VO2max: STRUC High -7.52% vs Low 32.03% (P=0.005), FREE High -4% vs Low 24.31% (P=0.023), PAC High -8.19 vs Low 35.8% (P=0.007), COM High -5.22% vs Low 8.17% (P=0.663). These effects differed by condition. Improvements in body composition and VO2max following STRUC are consistent with previous laboratory findings. However, behavioural data indicate a stark contrast between retention rates observed in the current study and those reported elsewhere in laboratory studies (STRUC 34%, FREE 34%, PAC 29%, COM 31%). Post intervention survey data suggest that engaging with previously sedentary and/or low fitness participants within a fitness facility is challenging, and that as a consequence necessary levels of communication and motivation can be difficult to maintain.
Overall data highlight several factors that differ between laboratory research and real world practice. These collectively potentially reduce the ecological validity of the exercise is medicine hypothesis. It is suggested that more real world research is warranted to better identify factors that might both mediate and moderate the relationship between physical activity and health.
6 citations
Cites background from "Lifestyle intervention in the treat..."
...Papers were also excluded if not in English [86, 87] or if the target cohort were children [88]....
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