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Results for “Weight Reduction Programs”

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PubMed1977

Plasma high-density lipoprotein cholesterol level. Influence of risk factor intervention.

Determinants of circulating high density lipoproteins (HDL) were sought in 301 men studied during a year of participation in a coronary prevention program. Mean plasma HDL-cholesterol concentration rose by 2.8 mg/dl (6%) in the group receiving multifactor intervention, but the change did not differ significantly from that in the comparison group. Larger changes in both directions were seen in many individuals. Multiple regression analysis of these changes indicates that increased plasma HDL levels occur when plasma triglyceride level is decreased, cigarette smoking is reduced, and habitual alcohol intake is increased. Increases in the concentration of HDL-cholesterol also tended to accompany adherence to the fat-controlled diet, reduction in LDL-cholesterol level, and loss of body weight. Conventional coronary prevention programs are unlikely to have an adverse influence on this new, risk-lowering factor.

Adult↗

PubMed1979

The massively obese hypertensive patient: an analysis of blood pressure response to weight reduction with supplemented fasting.

A 42.4% incidence of hypertension was seen in 783 massively obese patients admitted to a supplemented fasting program between February 1974 and November 1976. Chosen for this study were the 99 hypertensives who had not received any antihypertensive medication before admission. The blood pressure response after 1 week of inhospital fasting was compared with that at the end of a period of outpatient fasting. Reduction in blood pressure was noted in 85 patients by the end of the first week; by the end of the fasting period, 68 patients were normotensive. We conclude that the elevated blood pressure common in a high percentage of massively obese patients is primarily volume-dependent.

Blood Pressure↗

PubMed1994

Effects of intensive multiple risk factor reduction on coronary atherosclerosis and clinical cardiac events in men and women with coronary artery disease. The Stanford Coronary Risk Intervention Project (SCRIP).

BACKGROUND: Recent clinical trials have shown that modification of plasma lipoprotein concentrations can favorably alter progression of coronary atherosclerosis, but no data exist on the effects of a comprehensive program of risk reduction involving both changes in lifestyle and medications. This study tested the hypothesis that intensive multiple risk factor reduction over 4 years would significantly reduce the rate of progression of atherosclerosis in the coronary arteries of men and women compared with subjects randomly assigned to the usual care of their physician. METHODS AND RESULTS: Three hundred men (n = 259) and women (n = 41) (mean age, 56 +/- 7.4 years) with angiographically defined coronary atherosclerosis were randomly assigned to usual care (n = 155) or multifactor risk reduction (n = 145). Patients assigned to risk reduction were provided individualized programs involving a low-fat and -cholesterol diet, exercise, weight loss, smoking cessation, and medications to favorably alter lipoprotein profiles. Computer-assisted quantitative coronary arteriography was performed at baseline and after 4 years. The main angiographic outcome was the rate of change in the minimal diameter of diseased segments. All subjects underwent medical and risk factor evaluations at baseline and yearly for 4 years, and reasons for all hospitalizations and deaths were documented. Of the 300 subjects randomized, 274 (91.3%) completed a follow-up arteriogram, and 246 (82%) had comparative measurements of segments with visible disease at baseline and follow-up. Intensive risk reduction resulted in highly significant improvements in various risk factors, including low-density lipoprotein cholesterol and apolipoprotein B (both, 22%), high-density lipoprotein cholesterol (+12%), plasma triglycerides (-20%), body weight (-4%), exercise capacity (+20%), and intake of dietary fat (-24%) and cholesterol (-40%) compared with relatively small changes in the usual-care group. No change was observed in lipoprotein(a) in either group. The risk-reduction group showed a rate of narrowing of diseased coronary artery segments that was 47% less than that for subjects in the usual-care group (change in minimal diameter, -0.024 +/- 0.066 mm/y versus -0.045 +/- 0.073 mm/y; P < .02, two-tailed). Three deaths occurred in each group. There were 25 hospitalizations in the risk-reduction group initiated by clinical cardiac events compared with 44 in the usual-care group (rate ratio, 0.61; P = .05; 95% confidence interval, 0.4 to 0.9). CONCLUSIONS: Intensive multifactor risk reduction conducted over 4 years favorably altered the rate of luminal narrowing in coronary arteries of men and women with coronary artery disease and decreased hospitalizations for clinical cardiac events.

California↗

PubMed2006

Design of the Dutch Obesity Intervention in Teenagers (NRG-DOiT): systematic development, implementation and evaluation of a school-based intervention aimed at the prevention of excessive weight gain in adolescents.

BACKGROUND: Only limited data are available on the development, implementation, and evaluation processes of weight gain prevention programs in adolescents. To be able to learn from successes and failures of such interventions, integral written and published reports are needed. METHODS: Applying the Intervention Mapping (IM) protocol, this paper describes the development, implementation, and evaluation of the Dutch Obesity Intervention in Teenagers (DOiT), a school-based intervention program aimed at the prevention of excessive weight gain. The intervention focussed on the following health behaviours: (1) reduction of the consumption of sugar-sweetened beverages, (2) reduction of energy intake derived from snacks, (3) decrease of levels of sedentary behaviour, and (4) increase of levels of physical activity (i.e. active transport behaviour and sports participation). The intervention program consisted of an individual classroom-based component (i.e. an educational program, covering 11 lessons of both biology and physical education classes), and an environmental component (i.e. encouraging and supporting changes at the school canteens, as well as offering additional physical education classes). We evaluated the effectiveness of the intervention program using a randomised controlled trial design. We assessed the effects of the intervention on body composition (primary outcome measure), as well as on behaviour, behavioural determinants, and aerobic fitness (secondary outcome measures). Furthermore, we conducted a process evaluation. DISCUSSION: The development of the DOiT-intervention resulted in a comprehensive school-based weight gain prevention program, tailored to the needs of Dutch adolescents from low socio-economic background.

Adolescent↗

PubMed1985

High blood pressure: what level to treat?

Recent trials of the treatment of mild hypertension have suggested that there may be benefit from drug treatment of quite modest or borderline levels of pressure. Drug treatment of subjects with diastolic pressures over 95 mm Hg would pose a major problem in the efficient organization of such a long-term program and would also be costly. Perhaps about 350 patient years of treatment might be necessary to prolong one patient's life by 1 year. The side effects as well as the costs of such a program should make us cautious about offering such treatment solely on the results of measurement of arterial pressure. In people with diastolic pressures in the range of 90-100 mm Hg we should carefully consider several factors such as age, sex, cholesterol concentrations, diabetes, family history, and smoking habit which might also interact to identify particularly high risks and exclude those individuals with a particularly benign prognosis. The results of the more recent trials can give very little information about such subgroup analysis, which would be possible only with much larger samples. The untreated subjects with raised pressure should be carefully followed and offered advice on nondrug strategies such as weight reduction, treatment of lipid abnormalities, and reduction in dietary salt intake. This type of program demands careful, possibly computerized, records and follow-up.

Aging↗

PubMed2002

Feeding behaviors and weight loss outcomes over 64 months.

Maintenance of reduced body weight following intentional weight loss is often unsuccessful. Identification of behaviors associated with sustained reductions should aid in dietary weight management. This survey assessed associations between an array of appetitive indices and weight loss outcomes in a sample of 80 adults participating in an open-labeled, unsupervised weight management program over a 64-month period. Participants were divided into maintainers (weight loss >5 kg at Year 1, sustained reduction >75% at Month 64), rebounders (weight loss >5 kg at Year 1, <75% reduction at Month 64), and nonresponders (weight loss <5 kg at Year 1). Nonresponders spent significantly more time shopping for food weekly, tended to have the highest total exposure time to food and to eat with fewer people than the other groups. Maintainers reported higher mean hunger over the course of a day, tended to spend more time preparing food and consumed less energy from fat and foods that they rated as predominantly bitter. Rebounders had significantly lower dietary restraint scores and tended to have less control over the purchase and preparation of foods in their diet. Individuals with different long-term weight loss outcomes possess distinct feeding-related attributes that may provide a basis for improved intervention strategies.

Journal Article↗

PubMed1995

Electroacupuncture and exercise in body weight reduction and their application in rehabilitating patients with knee osteoarthritis.

The efficacy of ear electroacupuncture on appetite and weight control was investigated in 3 separate studies. Part I: The Stomach, Hunger, or placebo ear points were stimulated in three different groups. Stimulating the Stomach, or Hunger, points was significantly more effective in appetite control than stimulating the placebo points. Part II: Stimulation of 3 pairs of ear points (Stomach, Hunger, and Shen Men) was performed on 61 obese subjects for 8 weeks. Only 43 subjects engaged, in addition, in an exercise program. 79% of the subjects succeeded to follow a low calorie diet for 8 weeks with subsequent weight reduction. Active exercises significantly increased weight loss. Part III: 19 obese patients with knee osteoarthritis participated in electroacupuncture, diet, and exercise program and 89% of them lost 5-10 kg in 8 weeks.

Acupuncture Points↗

PubMed2006

Aerobic exercise in water versus walking on land: effects on indices of fat reduction and weight loss of obese women.

AIM: It has been suggested, that water exercise is less effective than weight-bearing exercise on land for body fat reduction. METHODS: To test this hypothesis 38 middle-aged obese women (25-47% body fat) participated in a 13 week exercise-diet program to compare the effects of aerobic exercise in water versus walking on land on indices of fat reduction and weight loss changes. Subjects were randomly assigned to 1 of 3 exercise groups: 1) walking on land (WL), 2) swimming (SW) at 27 degrees C water temperature and 3) walking in 29 degrees C water (WW) at the shallow end of a declining pool with the water at navel height. Subjects in the SW group alternated breast-, side-, and backstroke swimming without face immersion. Exercise parameters were kept constant for all three groups. Subjects participated in supervised exercise sessions for 40 min, 4 times a week at 70% of age-predicted maximum heart rate. Subjects were tested before and after the 13-week experimental period. RESULTS: Significant reductions in body weight, (5.9 kg), percent body fat, (3.7%), and skinfold and girth measurements, occurred in all groups. There where no significant differences between groups. CONCLUSIONS: The results of this study indicate that there are no differences in the effect of aerobic activities in the water versus weight-bearing aerobic exercise on land on body composition components as long as similar intensity, duration and frequency are used.

Adult↗

PubMed2003

Reduction in obesity and coronary risk factors after high caloric exercise training in overweight coronary patients.

BACKGROUND: The majority of patients with coronary heart disease (CHD) are overweight. However, little weight loss occurs with participation in a standard cardiac rehabilitation (CR) program. METHODS: Fifteen overweight patients (average body mass index of 31.0 kg/m2) with CHD completed a 4-month exercise training program in a CR program. The exercise program consisted primarily of walking long duration (60-90 minutes per session) 5 to 7 days per week at a relatively low intensity of 50% to 60% of peak VO2. Measures of body composition by dual-energy x-ray absorptiometry, body fat distribution by computed tomography, plasma lipid-lipoprotein, glucose and insulin concentrations, and peak VO2 were obtained before and after the exercise intervention. Patients maintained an isocaloric diet throughout the study. RESULTS: Patients had reductions in total body weight (-4.6 kg), fat mass (-3.6 kg), percent body fat (-2.9%), and waist circumference (-5.6 cm) (all P <.001) while maintaining fat-free mass. Subcutaneous adipose tissue was reduced by 12% (P <.001) and visceral adipose tissue was lowered by 14% (P <.001). There were favorable changes in the lipid-metabolic profile with reductions in triglyceride levels (-23.7%), total cholesterol/HDL-C ratio (-14.3%), and fasting insulin levels (-22.3%) (all P <.05). Peak VO2 increased by 21.2% (P <.001). CONCLUSIONS: The present pilot study results suggest that a high caloric training exercise training program in the CR setting may be effective in promoting weight loss and improving coronary risk factors in overweight coronary patients. Although additional research with randomized control patients is needed, this alternative to traditional CR may be considered to maximize weight loss as part of a secondary prevention program.

Aged↗

PubMed2006

Effect of weight loss resulting from a combined low-fat diet/exercise regimen on low-density lipoprotein particle size and distribution in obese women.

Weight loss resulting from diet interventions has been shown to favorably affect low-density lipoprotein (LDL) particle size and distribution, and, hence, decrease cardiovascular disease risk. However, the effect of a dietary weight loss strategy when combined with exercise, on LDL electrophoretic characteristics, has yet to be tested. This study examined the effect of a weight loss intervention that combined a low-fat diet with moderate endurance training, on LDL particle size and distribution in obese women. Thirty obese, hypercholesterolemic women participated in a controlled longitudinal weight loss trial, which consisted of (1) a 2-week pre-stabilization phase, (2) a 20-week weight loss phase, and (3) a 2-week post-stabilization phase. Weight reduction resulted from a low-fat diet (<30% fat, 50%-60% carbohydrate, 20% protein) combined with an endurance training program (>40 minutes moderate training, 3 times per week). Mean weight loss was 14.8% (P < .01) of initial body weight. Total, LDL cholesterol, and triacylglycerol concentrations decreased (P < .01) by 8.9%, 7.5%, and 27.1%, respectively, whereas high-density lipoprotein cholesterol concentrations increased (P < .01) by 9.9%. No significant differences were noted for LDL peak or integrated particle size. The relative proportion of small, medium, and large particles was not significantly different posttreatment. Estimated cholesterol concentrations in large- and medium-sized LDL particles decreased (P < .05) by 15.3% and 5.9%, respectively, as a result of weight loss. No effect was noted for estimated cholesterol concentrations in small size LDL particles. In conclusion, these findings suggest that weight loss, resulting from a low-fat diet/exercise program, has only a minimal effect on LDL particle size and distribution.

Adult↗

PubMed2005

Stunting at 2 years in relation to body composition at 9 years in African urban children.

OBJECTIVE: To determine whether African urban children who were stunted at 2 years of age demonstrated an altered body composition by the end of childhood, before entering puberty, at 9 years of age. RESEARCH METHODS AND PROCEDURES: This was a mixed-longitudinal study of 330 prepubertal African children (182 boys) from Soweto-Johannesburg, South Africa. Anthropometric data at 2 years of age were compared with anthropometric, DXA-determined body composition and fat patterning in late childhood (7 to 9 years). RESULTS: Children who had been stunted at 2 years were significantly shorter and lighter than non-stunted children at 7 to 9 years, but there were no differences in their BMI or centralization of body fat. Previously stunted status significantly predicted reduced weight and height at 7 to 9 years but did not predict BMI, body composition, or fat patterning after controlling for potential confounding factors. The odds ratio for stunting at 2 years as a predictor of overweight at 7 to 9 years was not significant at 1.09 (95% confidence limits: 0.30, 3.98). DISCUSSION: Greater BMI in stunted infants does not demonstrate a tendency toward overweight or obesity but is a reflection of the greater reduction in height rather than weight in stunted children. Stunted children may be programmed to accumulate greater body fat at central sites during adolescence, but we have been unable to show that these changes are evident before the initiation of pubertal development.

Absorptiometry, Photon↗

PubMed1998

Weight loss in the clinical setting: applications for cardiac rehabilitation.

Obese coronary patients could benefit significantly from weight reduction. Unfortunately, weight management is not considered a standard component of cardiac rehabilitation programs. This article reviews the characteristics, approach and outcome data for behavioral weigh loss programs. Strategies for implementing a behavior modification treatment as part of a cardiac rehabilitation program are discussed.

Behavior Therapy↗

PubMed1996

Effect of physical activity on bone mass.

Maintenance of bone mass depends on several factors, including proper level of physical activity, hormones, and nutrition. Prescribing effective weight-training and weight-bearing exercise programs for improving bone mass is highly desirable. Specificity of each exercise program can contribute to an increment or reduction of bone mass. Cessation of physical activity induces rapid metabolic bone changes, although the effects on bone mass take time to develop. Therefore, weight-bearing and periodic high-intensity loading exercises are recommended for maintenance of bone mass in the spine and lower extremities. Patients who endure a period of immobility such as prolonged bed rest should resume their daily activities in addition to supervised exertional exercises. While research continues in an effort to find ways to increase bone mass despite aging and negative genetic factors, more focus can be given to building a solid skeletal foundation through good nutritional and exercise habits developed early in life.

Animals↗

PubMed2004

The spa as a model of an optimal healing environment.

"Spa" is an acronym for salus per aqua, or health through water. There currently are approximately 10,000 spas of all types in the United States. Most now focus on eating and weight programs with subcategories of sports activities and nutrition most prominent. The main reasons stated by clients for their use are stress reduction, specific medical or other health issues, eating and weight loss, rest and relaxation, fitness and exercise, and pampering and beauty. A detailed description of the Canyon Ranch, a spa facility in Tucson, AZ, is presented as a case study in this paper. It appears that the three most critical factors in creating an optimal healing environment in a spa venue are (1) a dedicated caring staff at all levels, (2) a mission driven organization that will not compromise, and (3) a sound business model and leadership that will ensure permanency.

Arizona↗

PubMed1992

Effects of weight loss on the fatty acid composition of serum lipids in obese women.

The effect of a weight reduction regimen, consisting of a protein-sparing modified fast and an exercise program, on the fatty acid composition of serum phospholipids and cholesterol esters of obese women, is described. In phospholipids, this treatment did not induce any significant change of the different fatty acid families (total saturated, monounsaturated, omega 9, omega 7, omega 6 and trans-fatty acids), except for total omega 3 fatty acids which increased. Within families, individual fatty acids change however. The changes are compatible with increased delta 5 and delta 6 desaturase activity. In cholesteryl esters, significant changes occurred which are suggestive of an increase in serum of the fraction of cholesteryl esters of intracellular origin. The changes in fatty acid compositions may not be beneficial with respect to atherosclerosis.

Adolescent↗

PubMed1994

National High Blood Pressure Education Program Working Group Report on Hypertension in the Elderly. National High Blood Pressure Education Program Working Group.

Raised blood pressures in the elderly and the increased prevalence of hypertension in this population are not benign occurrences and should not be viewed as a normal or inevitable consequence of aging. In fact, the relation of systolic and diastolic blood pressures to cardiovascular events is generally more pronounced in people aged 65 years and older when compared with those aged 35 to 64. The relative risk of cardiovascular disease is greater among the elderly at every level of blood pressure. Furthermore, the absolute likelihood that an older individual will have a cardiovascular event is substantially greater than for someone younger, reflecting the increased prevalence of other cardiovascular disease risk factors in this age group. Thus, equivalent blood pressure reduction is likely to produce a greater benefit in the elderly than in younger patients at every level of blood pressure. This report, an update of the 1985 Working Group Report on Hypertension in the Elderly, has two aims: to guide clinicians in their care of elderly patients with hypertension and to assist health care professionals participating in high blood pressure control programs that serve the elderly. The role of lifestyle modifications--weight loss, dietary sodium restriction, alcohol reduction, and exercise--as definitive or adjunctive therapy to drug treatment is discussed. In addition, the report reviews the relative advantages and disadvantages of the specific classes of antihypertensive medications.

Aged↗

PubMed1994

The scope of nutrition intervention trials with cancer-related endpoints.

The National Cancer Institute currently is supporting three full-scale dietary modification trials with cancer-related endpoints. These studies are the dietary component of the Women's Health Initiative, designed to determine whether a low-fat diet will reduce the incidence of breast and colorectal cancer and/or coronary heart disease; the Women's Intervention Nutrition Study, designed to test whether a dietary fat reduction program will decrease breast cancer recurrence and increase patient survival; and the Polyp Prevention Trial, designed to determine whether a low-fat, high-fiber diet will reduce the recurrence of adenomatous polyps. Design issues associated with these full-scale dietary modification outcome trials have been addressed successfully in a series of feasibility studies. The ability to achieve a sustained reduction of 50% in dietary fat intake with maintenance of nutritional adequacy has been demonstrated in randomized trials of postmenopausal populations with resected breast cancer and in populations at increased risk for breast cancer. In these studies comparing dietary fat reduction programs with control lifestyles, a series of associated biologic changes, consistent with the self-reported dietary alterations, have been observed. These changes include body weight reduction, serum and/or plasma estradiol concentration reduction, fasting plasma cholesterol concentration reduction, and alteration in free fatty acid levels. Such results provide a substantial basis for reliably estimating the level of adherence that can be anticipated in trials of dietary change, a prerequisite for appropriate calculation of the sample size needed for multicenter, full-scale outcome studies. As a result, the efficacy of a series of dietary alterations (including fat reduction, fiber addition, and/or increased fruit and vegetable intake) on cancer-related endpoints with potential major public health significance (breast cancer recurrence, breast cancer development, and colonic polyp recurrence) now are being addressed definitively in prospective clinical trials.

Breast Neoplasms↗

PubMed2003

A 6-month randomized, placebo-controlled, dose-ranging trial of topiramate for weight loss in obesity.

OBJECTIVE: To evaluate the efficacy and safety of topiramate (TPM) for weight loss in healthy obese subjects. RESEARCH METHODS AND PROCEDURES: A randomized, double-blind, placebo-controlled, dose-ranging trial was conducted. Three hundred eighty-five subjects, 18 and 75 years of age, were randomized to receive either placebo or TPM at 64, 96, 192, or 384 mg daily. Dosing began at 16 mg once daily. In week 2, the dose was increased to 16 mg twice daily. Thereafter, the dose was raised every week by 32 mg/d (16 mg twice daily) until subjects reached their target dose. Twenty-four weeks after beginning treatment, all subjects were tapered off treatment by a dose reduction of 50% per week. All participants received the same lifestyle program. RESULTS: Mean percent weight loss from baseline to week 24 was -2.6% in placebo-treated patients vs. -5.0%, -4.8%, -6.3%, and -6.3% in the 64, 96, 192, and 384 mg/d TPM groups, respectively. Greater percentages of TPM-treated patients lost at least 5% or 10% of body weight compared with placebo. The most frequent adverse events were related to the central or peripheral nervous system, including paresthesia, somnolence, and difficulty with memory, concentration, and attention. Most events were dose-related, occurred early in treatment, and usually resolved spontaneously; only 21% receiving TPM withdrew due to adverse events compared with 11% on placebo. DISCUSSION: TPM produced significantly greater weight loss than placebo at all doses.

Adolescent↗