A randomised controlled trial of a community-based healthy lifestyle program for overweight and obese adolescents: the Loozit? study protocol

Background  

There is a need to develop sustainable and clinically effective weight management interventions that are suitable for delivery in community settings where the vast majority of overweight and obese adolescents should be treated. This study aims to evaluate the effect of additional therapeutic contact as an adjunct to the Loozit^? group program – a community-based, lifestyle intervention for overweight and lower grade obesity in adolescents. The additional therapeutic contact is provided via telephone coaching and either mobile phone Short Message Service or electronic mail, or both.     

Comparative effectiveness of lifestyle interventions on cardiovascular risk factors among a Dutch overweight working population: A randomized controlled trial

Background  

Overweight (Body Mass Index [BMI] ≥ 25 kg/m²) and obesity (BMI≥ 30 kg/m²) are associated with increased cardiovascular risk, posing a considerable burden to public health. The main aim of this study was to investigate lifestyle intervention effects on cardiovascular risk factors in healthy overweight employees.     

Markers of metabolic syndrome in obese children before and after 1-year lifestyle intervention program

Purpose  

Excess weight may be related to the development of adverse cardiometabolic risk factors in children. The aim of this study was to evaluate the effect of a lifestyle intervention program (nutrition and exercise counseling) on anthropometric parameters and metabolic syndrome (MS) components in Portuguese overweight/obese children.     

Basal growth hormone concentration increased following a weight loss focused dietary intervention in older overweight and obese women

Objectives  

Growth and sex steroid hormones decrease with aging and obesity. The effect of dietary weight loss and exercise training lifestyle interventions was examined on hormones as well as determining their relationships with physical function in older obese and overweight adults.     

Development and evaluation of the lifestyle intervention “Obeldicks light” for overweight children and adolescents

Aim  

Specific interventions for overweight but not obese children have not been established yet. Therefore, we developed the methods, materials, and an evaluation protocol for a lifestyle intervention for overweight children based on an intervention for obese children.     

An effective lifestyle intervention in overweight children: one-year follow-up after the randomized controlled trial on "Obeldicks light"

Background & aims

Lifestyle interventions address primarily obese children, while interventions tailored to overweight but not obese children are scarce. The effectiveness of the lifestyle intervention “Obeldicks light” based on physical activity training, nutrition education, and behavior counseling for overweight children and their parents has been demonstrated by a randomized controlled trial. Here, we present the 12 months follow-up analysis of these children after end of intervention.

Methods

Degree of overweight (BMI and SDS-BMI), waist circumference, skinfold thickness, bioimpedance analyses (BIA), and blood pressure were determined in 76 overweight (BMI>90^th≤97^th percentile) children (mean age 11.8 ± 1.8years, 67% females, mean BMI 24.3 ± 1.9 kg/m²) participating in the evaluation study of “Obeldicks light” at onset of intervention (T0), end of 6 months intervention (T1), 6 months after end of intervention (T2) and 12 months after end of intervention (T3). Comparisons were performed on an intention-to-treat approach.

Results

The drop-out rate was 4% in the intervention period and additional 3% during follow-up. The children reduced significantly (p < 0.001) their SDS-BMI in the intervention period between T0 and T1 (−0.27 ± 0.23; p < 0.001). This SDS-BMI reduction remained stable at T2 (T0-T2:-0.26 ± 0.31; p < 0.001) and T3 (T0-T3:-0.26 ± 0.39; p < 0.001). SDS-BMI reductions were independent from age and gender. Body fat measured by skinfold thickness and BIA, waist circumference, and blood pressure decreased significantly in the intervention period and remained stable in the follow-up period as well.

Conclusions

The lifestyle intervention “Obeldicks light” was effective in reducing degree of overweight, fat mass, waist circumference, and blood pressure both at end of intervention and in a 12 months follow-up period.     

Effect of an individually tailored one-year energy balance programme on body weight,body composition and lifestyle in recent retirees: a cluster randomised controlled trial

Background  

The increased prevalence of overweight and obesity warrants preventive actions, particularly among people in transitional stages associated with lifestyle changes, such as occupational retirement. The purpose is to investigate the effect of a one year low-intensity computer-tailored energy balance programme among recent retirees on waist circumference, body weight and body composition, blood pressure, physical activity and dietary intake.     

Socio-Economic,Demographic and Lifestyle Determinants of Overweight and Obesity among Adults of Northeast India

Background

Overweight and obesity are the accumulation of high body adiposity, which can have detrimental health effects and contribute to the development of numerous preventable non-communicable diseases. This study aims to evaluate the effect of socio-economic, demographic and lifestyle factors on the prevalence of overweight and obesity among adults belonging to the Rengma-Naga population of North-east India.

Methods

This cross-sectional study was conducted among 826 Rengma-Naga individuals (males: 422; females: 404) aged 20–49 years from the Karbi Anglong District of Assam, using a two-stage stratified random sampling. The socio-economic, demographic and lifestyle variables were recorded using structured schedules. Height and weight were recorded and the Body Mass Index (BMI) was calculated using standard procedures and equation. The WHO (2000) cut-off points were utilized to assess the prevalence of overweight (BMI ≥23.00–24.99 kg/m²) and obesity (BMI ≥25.00 kg/m²). The data were analysed using ANOVA, chi-square analysis and binary logistic regression analysis using SPSS (version 17.0).

Results

The prevalence of overweight and obesity were 32.57% (males: 39.34%; females: 25.50%) and 10.77% (males: 9.95%; females: 11.63%), respectively. The binary logistic regression analysis showed that age groups (e.g., 40–49 years), education (≥9^th standard), part-time occupation and monthly income (≥Rs.10000) were significantly associated with overweight and obesity (p<0.05).

Conclusions

Age, education occupation and income appear to have higher associations with overweight and obesity among adults. Suitable healthcare strategies and intervention programmes are needed for combating such prevalence in population.     

Accelerometer profiles of physical activity and inactivity in normal weight,overweight, and obese U.S. men and women

Background  

The 2005-2006 National Health and Nutrition Examination Survey (NHANES) is used to describe an accelerometer-derived physical activity/inactivity profile in normal weight (BMI < 25 kg/m²), overweight (25 ≤ BMI < 30 kg/m²), and obese (BMI ≥ 30 kg/m²) U.S. adults.     

Promotion of couples' voluntary counselling and testing for HIV through influential networks in two African capital cities

Background

Changes in lifestyles and in the environment over the last decades are probably the most important cause of the overweight epidemic, but the findings are inconsistent among studies. The purpose of this study was to investigate the association of several socio-economic and lifestyle factors with overweight in Flemish adults, using BMI ≥ 25 kg/m², waist circumference (WC) ≥ 94 cm (men) or ≥ 80 cm (women) and the combination of BMI and WC for identifying overweight.

Methods

This cross-sectional epidemiological study was conducted by the Flemish Policy Research Centre Sport, Physical Activity and Health between October 2002 and February 2004 in 46 Flemish communities. A total of 4903 Flemish adults (2595 men and 2308 women), aged 18 to 75 years, from a population-based random sample were included in the analysis. Body weight, height and WC were measured, and socio-economic and lifestyle factors were reported by means of validated questionnaires.

Results

The results of the logistic regressions revealed that age is positively associated with overweight in both genders. Alcohol consumption is associated with overweight only in men. Men smoking in the past and watching TV >11 h/week have significantly higher OR's for overweight, while men who participate in health related sports >4 h/week have significantly lower OR's for overweight. In women, watching TV >9 h/week was positively associated with overweight. Women who are current smokers or participate in health related sports >2.5 h/week or with a higher educational level have significantly lower odds for overweight. Different results are observed between the first (BMI) and the second model (WC) in both genders. In men, the models differ for education and health related sports, while in women they differ for smoking status and leisure time physical activity.

Conclusion

The present study confirms the contention that overweight is a multifactorial problem. Age and TV viewing are positively associated with overweight, while educational level and health related sports are negatively related to overweight in both genders. In men, alcohol consumption and smoking in the past are also among the lifestyle factors associated with overweight. This study also indicates that BMI and WC do not have the same discriminative function regarding different lifestyle factors.     

A randomized trial of a lifestyle intervention in obese endometrial cancer survivors: quality of life outcomes and mediators of behavior change

Background  

To examine the effects of a 6 month lifestyle intervention on quality of life, depression, self-efficacy and eating behavior changes in overweight and obese endometrial cancer survivors.     

The impact of social deprivation on the response to a randomised controlled trial of a weight management intervention (BeWEL) for people at increased risk of colorectal cancer

Background

Although 45% of colorectal cancer (CRC) cases may be avoidable through appropriate lifestyle and weight management, health promotion interventions run the risk of widening health inequalities. The BeWEL randomised controlled trial assessed the impact of a diet and activity programme in overweight adults who were diagnosed with a colorectal adenoma, demonstrating a significantly greater weight loss at 12 months in intervention participants than in controls. The present study aimed to compare BeWEL intervention outcomes by participant deprivation status.

Methods

The intervention group of the BeWEL trial (n = 163) was classified by the Scottish Index of Multiple Deprivation (SIMD) quintiles into ‘more deprived’ (SIMD 1–2, n = 58) and ‘less deprived’ (SIMD 3–5, n = 105). Socio‐economic and lifestyle variables were compared at baseline to identify potential challenges to intervention adherence in the more deprived. Between group differences at 12 months in primary outcome (change in body weight) and secondary outcomes (cardiovascular risk factors, diet, physical activity, knowledge of CRC risk and psychosocial variables) were assessed by deprivation status.

Results

At baseline, education (P = 0.001), income (P < 0.001), spending on physical activity (P = 0.003) and success at previous weight loss attempts (P = 0.007) were significantly lower in the most deprived. At 12 months, no between group differences by deprivation status were detected for changes in primary and main secondary outcomes.

Conclusions

Despite potential barriers faced by the more deprived participants, primary and most secondary outcomes were comparable between groups, indicating that this intervention is unlikely to worsen health inequalities and is equally effective across socio‐economic groups.     

Prevalence of Obesity Among Male Adolescents in Arar Saudi Arabia: Future Risk of Cardiovascular Disease

Background:

Obesity in adolescence is crucial as it represents an important stage in human life. Dietary habits are greatly associated with lifestyle. Many reports suggested direct relationship between adolescent fatness and increased risk of cardiovascular diseases (CVD) which will be found in young adult population.

Aim:

Determine the prevalence of overweight and obesity among male adolescents in Arar city, Saudi Arabia (KSA). We estimated the future risk of developing cardiovascular diseases in this age‐group and its possible correlation to different lifestyles and dietary habits.

Results:

A total of 523 male students with a mean age of 16.7 ± 0.9 years participated in the current study in which 30.4% of those students were obese and 17.2% were overweight. A direct relationship was found between body weight and different dietary and lifestyle habits. The risk of CVD based on waist height ratio (WHtR) was found in 33.5% of participants (30.4% obese, 2.1% overweight and 1% normal weight); moreover, the risk of CVD was strongly related to different dietary and lifestyle habits.

Conclusion:

Overweight and obesity were high among adolescent male students in Arar, who became susceptible to the risk of CVD. Arar showed the highest rate of obesity all over KSA. Both obesity and risk of CVD were strongly related to bad dietary habits and lifestyle.     

Lifestyle and Overweight Among Japanese Adolescents: The Toyama Birth Cohort Study

Objective

To investigate the effects of lifestyle factors on overweight among Japanese adolescents.

Methods

We studied 5753 junior high school students (2842 boys and 2911 girls) aged 12 to 13 years. The students were residents of Toyama prefecture, Japan and completed a questionnaire about their height, weight, and lifestyle factors, in June and July 2002. Subjects with a body-mass index (BMI) higher than age- and sex-specific cut-off points were defined as obese. Parental overweight was defined as a BMI of 25 or higher. Logistic regression analysis was used to examine associations between lifestyle factors and overweight.

Results

Skipping breakfast, eating quickly, excessive eating, physical inactivity, and long hours of TV watching were positively and significantly associated with overweight in both sexes. There was a negative association between snacking and overweight in girls (P < 0.001); no such association was found in boys (P > 0.05). Nighttime snacking was negatively associated with overweight in boys and girls (P < 0.05). Extended video game playing (≥2 hours; OR = 2.00, P = 0.012) and short sleep duration (<7 hours; OR = 1.81, P = 0.004) were significantly associated with overweight in girls only. The respective risks of overweight that derived from the subjects’ fathers and mothers were 2.0 and 2.5 times, respectively, in boys and 1.9 and 3.0 times in girls.

Conclusions

Parental overweight, skipping breakfast, eating quickly, excessive eating, long hours of TV watching, long hours of video game playing, physical inactivity, and short sleep duration were associated with adolescent overweight. Furthermore, there were significant negative associations between adolescent overweight and snacking in girls and nighttime snacking in both sexes.Key words: overweight, lifestyle factors, adolescents, Japan, Toyama birth cohort study     

Dietary and other lifestyle characteristics of Cypriot school children: results from the nationwide CYKIDS study

Background  

Dietary and lifestyle behaviors at young ages have been associated with the development of various chronic diseases. Schools are regarded as an excellent setting for lifestyle modification; there is a lack, however, of published dietary data in Cypriot school children. Thus, the objective of this work was to describe lifestyle characteristics of a representative segment of Cypriot school children and provide implications for school health education.     

The association of self-esteem,depression and body satisfaction with obesity among Turkish adolescents

Background  

The purpose of this study was to determine the prevalence of overweight and obesity and to examine the effects of actual weight status, perceived weight status and body satisfaction on self-esteem and depression in a high school population in Turkey.     

Infancy and childhood growth and physical activity in adolescence: prospective birth cohort study from Brazil

Background

A poor understanding of the specific lifestyle behaviors that result in weight loss has hindered the development of effective interventions. The aim of this paper was to identify potential behavioral mediators of weight loss in the Healthy Dads, Healthy Kids (HDHK) intervention for overweight fathers.

Findings

The three-month intervention was evaluated in a randomized controlled trial and conducted in Newcastle, New South Wales, Australia. Baseline, three month (immediate post-intervention) and six month assessments were conducted. Recruitment and follow-up occurred between October 2008 and May 2009. The study sample included 53 overweight/obese men [mean ( SD) age=40.6( 97.1) years; body mass index (BMI)=33.2 (3.9) kgm^-2] and their primary school-aged children [n=71, 54% boys; age=8.2 (2.0) years] who were randomized to HDHK program or a wait-list control group. Physical activity (PA) was assessed using pedometers and dietary behaviors were measured using a validated food frequency questionnaire. The intervention resulted in significant weight loss (5.131.27kg, P<0.0001) and increased PA among fathers (2769750 steps/day, P<0.001) and their children (1486521 steps/day, P<0.01). Fathers PA mediated weight loss in the intervention (AB=2.31, 95% CI=4.63 to 0.67) and was responsible for 47% of the intervention effect. Changes in dietary behaviors were not statistically significant.

Conclusions

PA was an important mediator of weight loss in the HDHK intervention. Encouraging overweight fathers to be more active with their children appears to be a promising strategy for obesity treatment in men.     

Effectiveness and cost-effectiveness of lifestyle interventions on physical activity and eating habits in persons with severe mental disorders: A systematic review

Background  

There is a high prevalence of overweight and obesity in persons with severe mental disorders and this has serious implications on the short and long term health outcomes of these patients. The aim of this review was to evaluate the effectiveness of lifestyle interventions targeting physical activity and eating habits in persons with severe mental disorders. Special attention was given if any of the included studies in the review also examined the cost-effectiveness of these health promotion interventions.     

Effectiveness of a community-based intervention for weight loss on cardiometabolic risk factors among overweight and obese women in a low socio-economic urban community: findings of the MyBFF@home

Background

The effectiveness of lifestyle intervention for weight loss on cardiometabolic risk factors among overweight and obese individuals in the community setting remains inconclusive. This study aimed to evaluate the effect of a 6-month weight loss lifestyle intervention on cardiometabolic risk factors among overweight and obese women and the sustainability of the changes in those markers at 12-month follow-up, comparing an intervention group with a control group.

Methods

A total of 243 participants from MyBFF@home were included in this study. Fasting blood samples at baseline, 6- and 12-month were assessed for fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides. The effect of the intervention on cardiometabolic risk markers were investigated within and between study groups using t-test and general linear model (GLM) repeated measure ANOVA.

Results

Results from repeated measures ANOVA showed intervention effect only in TC where significant reduction was found in the intervention group (? 0.26 mmol/L [95% CI: – 0.47 to ? 0.06], p?<?0.01) compared to the control group (? 0.06 mmol/L [95% CI: – 0.28 to 0.17]) at 12 months. At 6 months, TC was reduced significantly in both groups but only intervention group retained the reduction in maintenance phase while, the level increased significantly in the control group (0.22 mmol/L [95% CI: 0.06 to 0.38]). This attributed to significant increase in TC/HDL-C ratio in the control group during maintenance phase (0.32 [95% CI: 0.15 to 0.50], p?<?0.001). The intervention group also showed trend of reduction in FPG at 6 months and further decreased during maintenance phase (??0.19 mmol/L [95% CI: – 0.32 to ? 0.06], p?<?0.01). At 6 months HDL-C was maintained in the intervention group but reduced significantly in the control group (??0.05 mmol/L [95% CI: – 0.10 to ? 0.01], p?<?0.05). No significant difference was detected in both markers when compared between groups.

Conclusions

In the context of low socio-economic communities, this study supports that weight loss related lifestyle modifications over a 6-month period could improve selected cardiometabolic risk factors, particularly fasting glucose, TC and HDL-C in overweight and obese women with favourable sustainability over a 12-month period.

     

The change in weight perception of weight status among the overweight: comparison of NHANES III (1988–1994) and 1999–2004 NHANES

Objectives  

This study seeks to determine whether perception of weight status among the overweight has changed with the increasing overweight/obesity prevalence.