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Results for “Weight Reduction Programs”

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At least 469 records · Page 26Linked to original sources

PubMed2005

Incidence of type 2 diabetes in the randomized multiple risk factor intervention trial.

BACKGROUND: Weight loss and increased physical exercise reduce the risk for diabetes in people with impaired glucose tolerance. Randomized trial evidence on the effect of these interventions on people without impaired glucose tolerance is lacking. OBJECTIVE: To examine the influence of a comprehensive intervention program on the risk for developing diabetes in men without impaired glucose tolerance and in a post hoc subgroup analysis by baseline cigarette smoking status. DESIGN: Randomized, controlled trial. SETTING: 22 clinical centers for the Multiple Risk Factor Intervention Trial (MRFIT). PARTICIPANTS: 12,866 men age 35 to 57 years at risk for cardiovascular disease were randomly assigned to either a special intervention or usual care group and followed for 6 to 7 years; this report focuses on 11,827 men without diabetes or impaired glucose tolerance at entry for whom follow-up glucose measurements were available. MEASUREMENTS: Cardiovascular disease risk factors, fasting blood glucose levels, and diabetes medication history were assessed before randomization and annually. INTERVENTION: Men in the special intervention group were counseled to change diet (reduce saturated fat, cholesterol, and calorie intake), to stop smoking, and to increase physical activity. Blood pressure was treated more intensively in the special intervention group than in the usual care group. RESULTS: 11.5% of the special intervention group and 10.8% of the usual care group developed diabetes over 6 years of follow-up (hazard ratio, 1.08 [95% CI, 0.96 to 1.20]). The special intervention-usual care hazard ratio for diabetes was 1.26 (CI, 1.10 to 1.45) among smokers (63%) and 0.82 (CI, 0.68 to 0.98) among nonsmokers (37%). These estimates differed significantly (P = 0.0003). Weight gain after smoking cessation and the use of antihypertensive drugs may have counterbalanced the beneficial effect of the lifestyle intervention for the special intervention group smokers, while the lifestyle intervention was beneficial among nonsmokers. LIMITATIONS: Principal findings are based on a post hoc subgroup analysis. CONCLUSIONS: In nonsmokers, an intervention program that included nutrition counseling to produce reductions in weight, serum cholesterol, and (along with antihypertensive medication) blood pressure reduced the risk for diabetes.

Adult↗

PubMedDate not supplied

Three-year follow-up of Pawtucket Heart Health's community-based weight loss programs.

PURPOSE: The purpose of the study was to evaluate the effectiveness of a community-based weight loss program. DESIGN: A questionnaire was administered by telephone to subjects one to three years following participation in a weight loss program. SETTING: The study took place in Pawtucket, Rhode Island. The Pawtucket Heart Health Program is part of this setting. SUBJECTS: A stratified sample of 400 subjects was randomly selected from 2,186 people who participated in weight loss programs between 1985 and 1987. A total of 285 subjects completed the questionnaire; 229 subjects provided sufficient information to be included in the study. INTERVENTION: The subjects participated in community-based and worksite-based weight loss programs. MEASURES: Self-reported heights and weights before and after intervention and demographic data were collected. Desirable body weight and Garrow's health risk classifications were calculated. RESULTS: Overall, there was a 3.2% reduction in body weight between time of entrance into weight loss programs and time of interview. Eighty percent of the participants lost weight in the program; mean weight loss was 11 pounds. At time of follow-up interview one to three years later, 65% of subjects weighed less than at entrance into the community programs; on average, subjects weighed six pounds less. Sixty-nine percent of the sample was above 20% desirable body weight at entrance and 26% of this group lost enough weight to lower their health risk category. CONCLUSIONS: Weight loss in this community-based program compares favorably with those reported by more intense and expensive clinic-bound programs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2004

Conditional cash transfers are associated with a small reduction in the rate of weight gain of preschool children in northeast Brazil.

Programs providing cash transfers to poor families, conditioned upon uptake of preventive health services, are common in Latin America. Because of the consistent association between undernutrition and poverty, and the role of health services in providing growth promotion, these programs are supposed to improve children's growth. The impact of such a program was assessed in 4 municipalities in northeast Brazil by comparing 1387 children under 7 y of age from program beneficiary households with 502 matched nonbeneficiaries who were selected to receive the program but who subsequently were excluded as a result of quasi-random administrative errors. Anthropometric status was assessed 6 mo after benefits began to be distributed, and beneficiary children were 0.13 Z-scores lighter (weight-for-age) than excluded children, after adjusting for confounders (P = 0.024). The children's growth trajectories were reconstructed by copying up to 10 recorded weights from their Ministry of Health growth monitoring cards and by relating each weight to the child's age, gender, and duration of receipt of the program benefit in a random effects regression model. Totals of 472 beneficiary and 158 excluded children under 3 y of age were included in this analysis. Each additional month of exposure to the program was associated with a rate of weight gain 31 g lower than that observed in excluded children of the same age (P < 0.001). This failure to respond positively to the program may have been due to a perception that benefits would be discontinued if the child started to grow well. Nutrition programs should guard against giving the impression that poor growth will be rewarded.

Brazil↗

PubMed1999

Access to TV contingent on physical activity: effects on reducing TV-viewing and body-weight.

One child was recruited for a study assessing the effectiveness of a device aimed at reducing excessive television viewing and increasing exercising. The device was comprised of a control box which attaches to the electrical cord of a television set, and two sensors which attached to the wheel and corresponding wheel rim of a stationary bicycle. The child in this study was watching an excessive amount of TV (averaging over 4 hours per day), and she had a weight problem. An ABAB design was used in the study. After collecting baseline data, the child was required to ride a bicycle for 60 minutes to watch 60 minutes of TV, and this program successfully reduced TV viewing. Reductions in TV viewing and weight loss were found at a follow-up.

Body Weight↗

PubMed2006

Telerehabilitation in spinal cord injury persons: a novel approach.

The care of a spinal cord injury (SCI) person constitutes a great challenge for the provider: SCI persons are mobility impaired, and they are prone to develop multiple comorbidities such as diabetes mellitus, hypertension, obesity, bladder infections, wounds, and depression. Furthermore, disease manifestations can be misleading depending on the level of injury. The utilization of telemedicine to monitor patients and deliver care has opened a new horizon for SCI persons. Several telehealth programs are now in use to monitor pressure ulcers and postdischarge rehabilitation in SCI persons. To answer the need for a more comprehensive approach to the multifaceted manifestation of SCI at the James J. Peters VAMC, we have started a customized telerehabilitation program. The program monitors the most common comorbidities of SCI, it is instrumental in the reintegration of the SCI person in the community, it offers individualized in-home rehabilitation programs, it addresses safety issues, and it offers counseling, weight reduction, and maintenance plans. A team of SCI specialists-including an internist, a registered nurse, a physical therapist, a nutritionist, a psychologist, and a recreational therapist-are available for weekly meetings with the patients. The programs are tailored to the patients' needs and agreed upon by both parties. Both messaging devices and video monitors are utilized. An interdisciplinary template is used to record assessments and plans. Preliminary results are encouraging; coordination of the team and relative poor technology are some of the obstacles we have identified. Further evaluation is necessary to determine cost effectiveness.

Home Care Services↗

PubMed1995

Improvement of left ventricular morphology and function in obese subjects following a diet and exercise program.

The aim of this work was to compare left ventricular performance during weight reduction induced by either physical training and diet or diet alone. Forty-three moderately obese subjects received a hypocaloric diet of 800 kcal/d for 4 weeks; 22 of them were also subjected to an exercise program. By means of echocardiography, left ventricular dimensions and systolic time intervals were determined. Heart rate and blood pressure were measured at rest and during exercise. The addition of physical training resulted in a more favourable change in weight loss (-8.3 vs -6.3 kg), heart rate (-14 vs -7 bpm), systolic (-17 vs -8 mm Hg), and diastolic (-11 vs -6 mm Hg) blood pressure. Left ventricular mass (LVM) was diminished more pronounced by combined therapy (-10.0%) as compared to diet alone (-4.7%). Changes in LVM were correlated with weight loss but not with alterations in heart rate and blood pressure. Fractional shortening and mean circumferential fiber shortening velocity did not improve significantly whereas the ratio of preejection period/left ventricular ejection time (PEPi/LVETi) was shortened in the diet and diet plus exercise group by -10.7 and -17.9%, respectively. It was concluded that exercise training in combination with a hypocaloric diet reduces left ventricular dimensions, LVM and PEPi/LVETi more distinctly than diet alone.

Adult↗

PubMed1986

Metabolic aspects of exercise and weight reduction.

Current knowledge about the thermic effects of exercise in lean and obese subjects and the relationships between exercise and food intake, resting metabolic rate, and dietary-induced thermogenesis were reviewed. Studies of the effects of carbohydrate restriction during low calorie diets on the capacity to perform physical exercise and of the effects of weight reduction with or without the addition of physical training on the metabolic abnormalities of non-insulin-dependent diabetes mellitus are also described. The metabolic efficiency of physical work is normal in obesity, total energy expenditure is increased because of increased body mass, and increased energy expenditure is not necessarily matched by a compensatory increase in caloric intake. Thus, increased physical activity can be expected to result in negative energy balance in obese subjects. It is not clear whether exercise increases resting metabolic rate, but there is considerable evidence that exercise may potentiate the thermic effect of food in lean subjects and that this response may be blunted in the obese. The capacity to perform moderate-intensity exercise during carbohydrate-restricted, low calorie diets is maintained after a period of adaptation, but the capacity for high-intensity exercise (greater than 70% VO2max) is decreased unless adequate carbohydrate is provided to maintain muscle glycogen stores. The major effect of the addition of a program of physical training to dietary restriction and weight reduction in the treatment of non-insulin-dependent diabetes mellitus is an increase in peripheral sensitivity to insulin, primarily due to increased non-oxidative glucose disposal in muscle tissue.

Animals↗

PubMed1992

The effect of weight loss on change in waist-to-hip ratio in patients with type II diabetes.

This study sought to determine whether weight loss would alter body fat distribution in obese men and women with type II diabetes. Subjects were 60 women and 33 men who participated in a year-long weight loss program. Weight losses of women and men, respectively, averaged 13.4 kg and 16.8 kg at six months and 11.2 kg and 13.1 kg at one year. WHR decreased significantly in both genders: for women, WHR decreased from 0.95 at baseline to 0.93 at six months and 0.94 at one year; for men WHR decreased from 0.99 at baseline to 0.96 at six months and 0.96 at one year. Subjects with greater upper body obesity at baseline did not lose more weight than subjects with less upper body obesity, but they did have greater reductions in WHR at six months in both genders and at one year in men. The magnitude of WHR reduction was strongly related to the amount of weight lost in men, but was not related to weight loss in women. Improvements in fasting glucose, fasting insulin, and HbA1 were significantly related to weight loss, but not to reductions in WHR. Thus, participation in a weight loss program had beneficial effects on body fat distribution in patients with type II diabetes, but these changes in WHR were not independently associated with improvements in glycemic control.

Adipose Tissue↗

PubMed1984

The psychology and physiology of obesity: implications for screening and treatment.

This article examines the psychological and physiological concomitants of obesity and presents practical methods for working with obese patients. Three areas of physiology are covered: fat cell theory, set point theory, and dietary obesity. The social and emotional consequences of obesity are discussed, as are the psychological stages experienced by both patients and professionals during a typical course of weight reduction. Screening is a most important aspect of a program. There are several methods for determining which patients will profit from treatment. Recent advances in treatment include a focus on physical activity, improvements in behavior modification, and the development of aggressive methods for promoting weight loss in moderately and morbidly overweight persons. Finally, social support is discussed, because the social context in which a program is administered may be more important than the nature of the program itself.

Animals↗

PubMed1996

Significance of physical activity for prevention and control of hypertension.

The beneficial effect of habitual physical exercise, and physical fitness, on blood pressure has been reported in the past. However, the reported fall in blood pressure, associated with physical exercise, could be related to at least one confounding factor. That is, the independent effect of weight loss caused by physical exercise, on blood pressure. Exercise results in loss of body fat, a redistribution of fat stores, and weight loss. All of these are associated with a concomitant reduction in blood pressure. It is not clear whether the reduction in blood pressure is caused independently by a decrease in caloric intake alone, or an increase in physical activity, or the combination of the two. This is particularly true in the case of primary prevention of hypertension in the community where an effective and acceptable strategy for life-style modification has to be developed; a strategy which must be based on valid scientific evidence. The Trial of Hypertension Prevention (TOHP), a large scale randomized clinical trial, was designed to test the hypothesis on the efficacy of weight loss (induced by a combination of reductions in caloric intake and increased physical exercise) on primary prevention of hypertension. Eligible participants were randomized into either the weight loss group, or the control group. The exercise component of the weight loss program included mild exercise, 3-4 days a week for 35-40 minutes at an intensity of 40-45% of heart rate reserve. The dietary component included a reduction in caloric intake to less than 1200 KCal per day. After 18 months, the difference in weight loss between the two groups was 3.9 Kg in favor of the dietary modification and exercise (P < 0.01). This was accompanied with a significant reduction in blood pressure (P < 0.01). Weight loss was a significant predictor for blood pressure change over time (P < 0.001). These findings confirm the efficacy of maintaining an ideal body weight, by a program which combines physical exercise and reduction in caloric intake, on primary prevention of hypertension in the community.

Clinical Trials as Topic↗

PubMed1994

Effects of aerobic conditioning at intensities corresponding to lactate threshold plus reduced energy intake in college-age females.

The effects of a 15-wk aerobic conditioning (4.2 +/- 1.3 d/wk) plus energy restriction (25 kcal/kg/d diet) program on anthropometric and physiologic attributes were studied in 16 obese women between the ages of 18 and 24. The women were divided into either an experimental (E, n = 10) group or a control (C, n = 6) group. The exercise + diet (E) group demonstrated significant reductions in body weight, both absolute and relative body fat, Katsura index, and serum triglycerides, and increases in oxygen uptake relative to lactate threshold (LT), maximal oxygen uptake, and the ratio of high-density lipoprotein cholesterol to total cholesterol. In the C group, none of the variables measured in this study remained unchanged. Thus the benefits of weight reduction without any change in fat free weight following the program were pronounced in the female university-age group that we studied. In conclusion, the highly structured aerobic conditioning at intensities corresponding to LT together with a proper dietary regimen is considered optimal with respect to favorable changes in various anthropometric and physiologic attributes. The feasibility of treating obese individuals with manifestation of medical and/or psychological problems in a school setting should be a significant matter in future research.

Adolescent↗

PubMedDate not supplied

Cardiovascular risk reductions associated with aggressive lifestyle modification and cardiac rehabilitation.

BACKGROUND: Patients who have been treated for coronary heart disease can enroll in traditional cardiac rehabilitation, the Ornish Program, or no rehabilitation at all. No study has compared the impact of each on cardiovascular disease risk (CVD) factors. METHODS: The current study compared CVD risk changes in post coronary artery bypass graft or percutaneous coronary intervention procedure patients who participated in the Ornish Heart Disease Reversing Program, a traditional cardiac rehabilitation, and a control group that received no formal cardiac risk-reduction program. This was a longitudinal, observational study of 84 patients receiving CVD standard of care who elected to participate in 1 of the 3 study groups. Assessments of CVD risk factors and anginal severity were obtained at baseline, 3 months, and 6 months. RESULTS: Ornish program participants had significantly greater reductions in anginal frequency, body weight, body mass index, systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, glucose, dietary fat, and increases in complex carbohydrates than were documented in the rehabilitation or control groups. The control group experienced the greatest reduction in anginal pain severity, but also had significantly higher systolic blood pressure, total cholesterol, and low-density lipoprotein cholesterol. CONCLUSIONS: These findings suggest that CVD patients who choose to participate in the Ornish program can experience greater improvements in CVD risks than patients who choose to participate in traditional cardiac rehabilitation or no formal program.

Angioplasty, Balloon, Coronary↗

PubMed2005

Impact of weight loss on cortisol secretion in obese men with and without metabolic syndrome features.

BACKGROUND AND AIM: Disturbances in cortisol metabolism have been associated with obesity and metabolic syndrome development. The aim of this study was to evaluate the effect of weight loss induced by an energy-restricted diet on postprandial cortisol secretion in obese men with and without metabolic syndrome features. METHODS AND RESULTS: Twelve obese men (BMI: 32.5-36.2 kg/m2), six without and six with at least three markers of metabolic syndrome, and six lean men (BMI: 22.2-24.9 kg/m2) participated. Plasma cortisol was measured at fasting and at 30 min intervals for 3h after standard breakfast intake. Obese volunteers repeated those measurements after weight loss induced by a 10-week hypocaloric balanced diet. Fasting (p = 0.002) and postprandial (p = 0.014) cortisol secretions in obese men were statistically lower than in lean subjects. The slimming program produced a -0.9 kg per week mean weight reduction with no differences between both groups (p = 0.297). After weight loss, postprandial cortisol secretion increased in volunteers with (p = 0.028) and without metabolic syndrome manifestations (p = 0.043), as compared to baseline, achieving values near to those of controls. Cortisol levels negatively correlated with body weight (r = -0.61; p < 0.001). CONCLUSIONS: Therefore, the effect of weight loss on cortisol metabolism appeared to be mediated by changes in body weight, which were apparently not affected by the occurrence of metabolic syndrome features.

Adult↗

PubMed2004

Dietary supplements for body-weight reduction: a systematic review.

BACKGROUND: Compliance with conventional weight-management programs is notoriously poor, and a plethora of over-the-counter slimming aids are sold with claims of effectiveness. OBJECTIVE: The objective of the study was to assess the evidence from rigorous clinical trials, systematic reviews, and meta-analyses on the effectiveness of dietary supplements in reducing body weight. DESIGN: The study was a systematic review. Literature searches were conducted on Medline, Embase, Amed, Cinahl, and the Cochrane Library until March 2003. Hand searches of medical journals, the authors' own files, and bibliographies of identified articles were conducted. There were no restrictions regarding the language of publication. The screening of studies, selection, validation, data extraction, and the assessment of methodologic quality were performed independently by the 2 reviewers. To be included, trials were required to be randomized and double-blind. Systematic reviews and meta-analyses of dietary supplements were included if they were based on the results of randomized, double-blind trials. RESULTS: Five systematic reviews and meta-analyses and 25 additional trials were included and reviewed. Data on the following dietary supplements were identified: chitosan, chromium picolinate, Ephedra sinica, Garcinia cambogia, glucomannan, guar gum, hydroxy-methylbutyrate, plantago psyllium, pyruvate, yerba maté, and yohimbe. The reviewed studies provide some encouraging data but no evidence beyond a reasonable doubt that any specific dietary supplement is effective for reducing body weight. The only exceptions are E. sinica- and ephedrine-containing supplements, which have been associated with an increased risk of adverse events. CONCLUSIONS: The evidence for most dietary supplements as aids in reducing body weight is not convincing. None of the reviewed dietary supplements can be recommended for over-the-counter use.

Complementary Therapies↗

PubMed1993

[The effect of aerobic exercise training on internal body fat in obese women].

A group of 11 obese women (from 13% of ideal weight and higher) volunteered to participate in a study designed to reduce weight in a 92-day program of aerobic exercise. Before and after the weight reduction period, body fat indices were measured by deuterium oxide (D2O) dilution and by skinfold anthropometry. Changes in internal body fat and subcutaneous fat were calculated. Mean weight loss was 3.6 +/- 1.2 kg, and internal body fat and subcutaneous fat were 1.8 +/- 1.3 kg (21.2%) and 3.0 +/- 0.9 kg (16.0%), respectively. Highly significant correlation were obtained between changes in internal body fat and total body fat (r = 0.856, p < 0.001). However, changes in internal body fat were not significantly associated with changes in waist to hip ratio (WHR). In the present study, we found that changes in total body fat were significantly related to changes in internal body fat during treatment of obesity with aerobic exercise. However, changes in internal body fat were not valid estimates of changes in body fat distribution in relation to changes in WHR.

Adipose Tissue↗

PubMed1995

Perceptions of childhood obesity of undergraduate students in physical education.

A sample (N = 200) of undergraduate students in physical education from 12 universities in a midwestern state was sent the 1990 Price questionnaire; 178 responded (89%). 96% of the respondents indicated that normal weight is very important in children, 88% agreed that physical education teachers should play major roles in treating childhood obesity. 92% believed their college courses prepared them to administer exercise programs to help children reduce weight, and 70% supported school-based weight-reduction strategies. Over-all, the students seemed to want to help eliminate childhood obesity and indicated they should become significantly involved in school programs designed to achieve this goal.

Adult↗

PubMed2001

Health at any size: the size-acceptance nondiet movement.

A controversial new approach to obesity treatment has emerged during the last two decades in response to traditional programs that do not result in sustained reductions in weight. Goals of the size-acceptance nondiet movement include improving self-image, normalizing eating behavior, and increasing physical activity independent of body weight. This commentary presents the basic tenets and early voices in the movement, reviews government weight recommendations, and suggests strategies for the size-sensitive physician.

Body Image↗

PubMed1983

Body size estimation and locus of control in obese adolescent boys undergoing weight reduction.

Body size estimation (BSE) and locus of control (LOC) were studied in 18 obese adolescent boys undergoing weight reduction. The subjects attended a seven-week summer camp which offered both increased activity and a 1200 kcal (5023 kJ)/d diet, resulting in an average weight loss of 29.2 +/- 6.3 lb (13.3 +/- 2.9 kg) and a decrease in body fat from 39.0 percent +/- 0.6 percent to 27.5 percent +/- 4.3 percent. Fatness was correlated with poor physical performance [1.5 mile (2.4 km) runs]. Weight reduction and decreased body fat resulted in an improved running time. BSE was assessed using self photographs distorted by an anamorphic lens. While subjects could correctly estimate their body size prior to weight reduction, after weight reduction they significantly underestimated body size. This finding contrasts with adults with juvenile-onset obesity who overestimate body size after weight reduction. LOC (measured by Nowicki-Strickland LOC Inventory) changed in the direction of internality after weight reduction. The use of exercise with the weight loss program may thus improve feelings of control and prevent overestimation of body size.

Adolescent↗