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Results for “Weight Reduction Programs”

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At least 595 records · Page 33Linked to original sources

PubMed1999

A meta-analysis of psychoeduational programs for coronary heart disease patients.

In a meta-analysis of 37 studies, the effects of psychoeducational (health education and stress management) programs for coronary heart disease patients were examined. The results suggest that these programs yielded a 34% reduction in cardiac mortality; a 29% reduction in recurrence of myocardial infarction (MI); and significant (p < .025) positive effects on blood pressure, cholesterol, body weight, smoking behavior, physical exercise, and eating habits. No effects of psychoeducational programs were found in regard to coronary bypass surgery, anxiety, or depression. The results also suggest that cardiac rehabilitation programs that were successful on proximal targets (systolic blood pressure, smoking behavior, physical exercise, emotional distress) were more effective on distal targets (cardiac mortality and MI recurrences) than programs without success on proximal targets.

Adaptation, Psychological↗

PubMed1997

Dietary and exercise interventions for juvenile obesity: long-term effect of behavioral and public health models.

We investigated the influence of nutrition and exercise interventions within cognitive/behavioral and public health formats on weight and blood lipid profiles in obese children. Compliance was also examined as well as the relationship of the compliance measures with clinical outcome variables. Three conditions were compared over 16 sessions: nutrition and eating-habit change followed by exercise (NE), exercise followed by nutrition and eating-habit change (EN), and an information control (INFO). NE and EN were presented in a cognitive/ behavioral framework which focused on the development of self-regulation whereas the INFO condition received the same material in a public health/educational model. NE and EN participants evidenced modest, yet significant, reductions in weight and blood lipids, and the impact of these two interventions endured at a five-year follow-up. In contrast, INFO participants displayed stable weight and blood lipids during the course of the program, and most remained morbidly obese at follow-up. Improved nutrition, increased physical activity and fitness were significantly correlated with weight and lipid reductions.

Adolescent↗

PubMedDate not supplied

Health risks and educational interests in an HMO.

A health survey was randomly administered to 1000 members of a 250,000 member HMO to help develop education programs and establish baseline risks and interests among HMO members. The sample was found to have lower than average risks related to smoking, average risks for weight, and above average risks related to exercise compared to state and national reference standards. The highest level of interest was reported for exercise, followed by stress reduction, weight loss, and smoking cessation. The older age groups were less likely to report an interest in attending fitness programs. The more educated respondents were less likely to attend weight control and stress programs. Based on these results, strategies for increasing involvement in educational programs to reduce health risks are discussed.

Aged↗

PubMed1994

Short-term response to dietary counseling of hyperlipidemic outpatients of a lipid clinic.

OBJECTIVE: To evaluate the efficacy of a limited dietary intervention delivered by dietitians in a single counseling session on plasma lipid levels in free-living subjects with hyperlipidemia. DESIGN: A 2-month, nonrandomized comparative study of dietary counseling efficacy in subjects with hyperlipidemia. Dietary instruction was conducted in a lipid clinic by dietitians. Subjects were instructed to follow a diet low in saturated fat and cholesterol (National Education Cholesterol Program step 1 or 2 diets) for 2 months with concomitant energy restriction for weight reduction when necessary. Another group of patients who did not receive dietary counseling during the same period served as a control. SUBJECTS: Ambulatory patients were recruited from the Lipid Clinic of the Montreal Clinical Research Institute. INTERVENTION: Dietary counseling was provided to 104 subjects with hypercholesterolemia and 113 subjects with hypertriglyceridemia. They were compared with 72 subjects with hypercholesterolemia and 80 subjects with hypertriglyceridemia who did not receive dietary counseling. RESULTS: In the hypercholesterolemic group, significant reductions in plasma cholesterol (mean +/- standard deviation = -5.7 +/- 11.7%) and low-density lipoprotein cholesterol (LDL-C) (-7.3 +/- 14.2%) and no changes in plasma very-low-density lipoprotein cholesterol (VLDL-C) or high-density lipoprotein cholesterol (HDL-C) were observed after dietary counseling. The LDL-C response to diet was normally distributed, and 20% of the individuals with hypercholesterolemia reached LDL-C levels below 4.1 mmol/L. In patients with hypercholesterolemia and no clinical evidence of familial hypercholesterolemia, (n = 76) the reductions in plasma cholesterol (-6.6 +/- 10.8%) and LDL-C (-8.2 +/- 14%) were more pronounced. Among the latter patients, 27.6% reached LDL-C levels below 4.1 mmol/L. In subjects with hypertriglyceridemia, the reductions in plasma cholesterol (-4.8 +/- 12.8%), triglycerides (-20.7 +/- 33%), and VLDL-C (-19.5 +/- 29%) were associated with an increase in LDL-C (+8.5 +/- 25.7%) and HDL-C (+5.5 +/- 18%). Of the subjects with hypertriglyceridemia, 20% had triglyceride levels below 2.3 mmol/L after treatment. No significant changes were observed in the control groups during the same period. CONCLUSIONS: Dietary counseling of subjects with hypercholesterolemia or hypertriglyceridemia was associated with beneficial changes in plasma lipid levels after 2 months of dietary intervention. However, longer and more controlled dietary interventions are necessary for most patients to achieve lipid goals.

Adult↗

PubMed2005

Electroacupuncture therapy for weight loss reduces serum total cholesterol, triglycerides, and LDL cholesterol levels in obese women.

Our purpose in this study was to investigate the effect of acupuncture therapy on body weight and on levels of the serum total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol in obese women. Fifty-five women were studied in three groups as follows: (1) control group (n = 12; mean age = 43.3 +/- 4.3, and mean body mass index {BMI} = 32.2 +/- 3.4); (2) electroacupuncture (EA) (n = 22; mean age = 39.8 +/- 5.3, and BMI = 34.8 +/- 3.3); and (3) diet restriction (n = 21; mean age = 42.7 +/- 3.9, and BMI = 34.9 +/- 3.3). EA was performed using the ear points, Sanjiao (Hungry) and Shen Men (Stomach), and the body points, LI 4, LI 11, St 25, St 36, St 44 and Liv 3, once daily, for 30 minutes, for 20 days, whereas patients on diet restriction had a 1425 Kcal diet program, that consisted of 1425 Kcal daily for 20 days. There was a 4.8% weight reduction in patients with EA application, whereas patients on diet restriction had a 2.5% weight reduction. There were significant decreases in total cholesterol and triglyceride levels in EA and diet groups compared with the control group (p < 0.05 in both cases). Furthermore, there was a decrease in LDL levels in the EA group compared with the control group (p < 0.05). No significant changes could be found in HDL levels among the three groups. Our results suggest that EA application in obese women may decrease the serum total cholesterol, triglyceride, and LDL cholesterol levels by increasing the serum beta endorphin level. This lipolytic effect of EA may also reduce the morbidity of obesity by mobilizing the energy stores that result in weight reduction.

Adult↗

PubMed1991

Metabolic effects of hypocaloric diets in management of gestational diabetes.

Although hypocaloric diets have been advocated for the management of the obese gravida and the obese mother with gestational diabetes, there is no general agreement on how severely calories should be restricted or on how this therapeutic approach compares with insulin therapy. The lack of consensus is in part because of the lack of studies comparing insulin management with the effects of different degrees of hypocaloric feeding and its effects on metabolism and glycemic status. We review the effects of 50 and 33% calorie restriction on glycemic status and intermediary fuel status in obese gestational diabetic subjects and compare the results with the administration of 20 U NPH and 10 U regular insulin every morning, a therapy of proven value in reducing macrosomia in gestational diabetes. When the two calorie-restriction regimens were compared after a 9-h overnight fast, glycemic status improved 10-20% on both. Ketonuria increased about twofold with 50% calorie restriction, but on average no increase in ketonuria was seen on the 33% calorie-restriction regimen. Both calorie-restriction programs led to a reduction in levels of plasma triglyceride, a correlate of infant birth weight. In contrast, the insulin regimen diminished ketonuria, but glycemic status improved little, and plasma triglyceride concentrations did not decline. Although more studies are needed to confirm these trends, the beneficial effect of 33% calorie restriction, which occurred without marked ketonuria, is consistent with previous studies in gestational diabetes. In addition, the simultaneous improvements observed in plasma glucose and triglyceride concentrations suggest that moderate calorie restriction may be valuable in preventing macrosomia in the offspring of the obese subject with gestational diabetes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2006

The self-reliant system for alternative care of diabetes mellitus patients--experience macrobiotic management in Trad Province.

BACKGROUND AND OBJECTIVE: Diabetes mellitus is a costly and growing health issue for the individual as well as the nation with much concern needed to change the way of life globally, Thailand included. Conventional medical care comprises of lifestyle modifications and the use of diabetic drugs but even with the development of new drugs, little achievement has been noted in relation to reducing the disease's complications. Macrobiotic is a holistic, alternative health care method. In macrobiotic principle, humans should live, drink and eat in conjunction with the laws of nature that will lead to good health, freedom and wisdom in understanding the laws of nature. The macrobiotic way of living is therefore the caring of body, mind, spirit and the environment in an independent manner based on adequacy and symbiotic support. MATERIAL AND METHOD: The present study consists of forty-four type 2 diabetes mellitus patients from the DM clinic, Trad Provincial Hospital. 4 subjects were insulin treated, observing the macrobiotic ways of living together at the Wanakaset Research Facility of Kasetsart University, Trad Province which lies in a natural forest area approximately 45 kilometers away from the city for a period of between 2 to 14 weeks. The volunteers were required to refrain from using all kind of drugs or chemicals and eating Formula 2 food as set forth by the International Un Punto Macrobiotico Foundation, Italy while participating in all camp activities. RESULTS: The findings at the end of the program together with QOL assessment questionnaires noted a statistically significant reduction in blood sugar levels, weight, blood pressure and heart beat ratios. Subjects were in significantly better health, more vibrant, more peaceful, and more energetic. The 4 insulin treated volunteers managed to maintain their blood sugar level within the range of 110-171 mg% without any insulin injection and all volunteers are free of any adverse events. CONCLUSION: The results of the present study can be a guideline in the modification of health care policies that can lead to the development of effective, and alternative care of diabetes mellitus patients.

Analysis of Variance↗

PubMed1976

Clinical use of oral hypoglycemic agents.

The pharmacology, mechanism of action, indications, interactions and clinical effectiveness of oral hypoglycemic agents, specifically the sulfonylureas and biguanides, are reviewed. The use of these agents is discussed in view of the findings of the University Group Diabetes Program study. It is concluded that oral hypoglycemic agents, in conjunction with diet and weight reduction, may be useful in selected patients but that insulin is preferable in most instances.

Biguanides↗

PubMed1985

United Kingdom Heart Disease Prevention Project: 12-year follow-up of risk factors.

Ten of the original 24 factories from the United Kingdom Heart Disease Prevention Project were resurveyed in 1983 to assess the long-term (12-year) effects of an education program on diet, smoking, and exercise. These 10 factories had previously been grouped into five pairs matched for size, location, and nature of industry, with one of each pair randomly chosen for intervention. Men in intervention factories were given advice on reduction of cholesterol in diet, stopping smoking, weight reduction, and regular exercise. High-risk workers (13%) received personal counseling in addition to the factory-wide education program. A total of 1,204 workers randomly selected from those still employed in 1978 were surveyed. There were significant differences observed in cigarette consumption, butter use, and several other dietary behaviors; however, the differences were small and insignificant for the proportion smoking and leisure-time exercise. The largest effects were in the high-risk group who had received personal counseling. This education program appears to have some lasting effects on behavior associated with coronary disease risk factors. Similarly designed programs may serve as models for community-wide coronary disease prevention programs.

Adult↗

PubMedDate not supplied

Maintenance of cholesterol reduction using automated telephone calls.

A critical problem in the dietary treatment of hypercholesterolemia is the long-term maintenance of cholesterol reduction. A system to maintain contact and provide feedback through a computer-interactive phone system was used with 115 subjects who completed a four-week diet and behavioral cholesterol reduction program. The subjects, mean age 48 years, were 87% non-Hispanic Caucasian and 74.8% were female. They were randomized to a control or maintenance group. The maintenance group received calls twice a month for six months. Total cholesterol (TC) and weight (lb) were obtained before and after a four-week program and after the six-month maintenance period. Neither group of subjects with all cholesterol measurements fully maintained initial cholesterol reductions (mean TC: in maintenance [n = 48) 248, 221, 231 versus control [n = 43] 243, 224, 232 mg/dL). All (n = 59) of the maintenance subjects used the phone system, with 83.3% of a subset evaluating it indicating the phone messages were helpful. Patients (n = 25) with > or = 5 lb weight loss and 10% TC decrease from baseline had a better maintenance of TC reduction in the maintenance versus control group (273,208,231 versus 259,205,246 mg/dL) (P < .05). We conclude that (1) maintenance remains a problem for cholesterol-lowering diet interventions, (2)automated phone calls are capable of maintaining contact and providing patient feedback, and (3) this system may help in the maintenance of TC levels for patients who made greater changes.

Cholesterol↗

PubMed1997

A prospective study of malnutrition in relation to child mortality in the Sudan.

We examined prospectively the relation between malnutrition and mortality among Sudanese children. A cohort of 28753 children between the ages of 6 mo and 6 y was examined every 6 mo for 18 mo. Two hundred thirty-two children died during 18 mo of follow-up (480624 child-months). Low weight-for-height was associated with an increased risk of mortality (P < 0.0001). Even children with Z scores between -1 and -2 were 50% more likely to die in the following 6 mo than were children with Z scores > -1 (multivariate relative mortality: 1.5; 95% CI: 1.1, 2.2). There was also an inverse relation between height-for-age and mortality (P < 0.0001). Among breast-fed children, the relative mortality associated with a Z score for weight-for-height of < -3 compared with > -2 was 7.3 (95% CI: 3.3, 15.9); among children not breast-fed, it was 26.0 (95% CI: 12.8, 53.0; P for interaction = 0.001). A strong and significant synergy was also found between infection and wasting or stunting as predictors of child mortality (P for interaction = 0.001 and 0.02. respectively). In developing countries, children who are below the customary cutoff point of -2 Z for weight-for-height may be at higher risk of death. Breast-feeding and reduction of morbidity should be advocated in programs designed to reduce malnutrition and mortality among children.

Aging↗

PubMed2001

Meta-analysis of HIV risk-reduction interventions within drug abuse treatment programs.

A meta-analysis was conducted on studies using a treatment-comparison group design to evaluate HIV/AIDS risk-reduction interventions for clients enrolled in drug abuse treatment programs. Overall, the interventions studied were found to have a reliable positive (weighted) effect size (d = 0.31), and this was unlikely to be due to publication bias. Effect sizes for specific categories of outcome variables were 0.31 for knowledge, attitudes, and beliefs; 0.26 for sexual behavior; 0.62 for risk-reduction skills; and 0.04 for injection practices. A number of potential moderators were examined. Effect sizes were negatively correlated with the presence of predominantly ethnic minority samples and positively correlated with the number of intervention techniques used, the intensity of the intervention, intervention delivery at a later stage of drug treatment or within methadone treatment, and the presence of a number of specific intervention techniques.

Acquired Immunodeficiency Syndrome↗

PubMed1995

Health ahead--the Heart Smart Family approach to prevention of cardiovascular disease.

The Heart Smart Family Health Promotion program is a unique approach to education and skills development aimed at improving the cardiovascular health of entire families. By including the entire family system, rather than singling out one individual for behavior change, social support and self-confidence are enhanced and the probability for maintenance of behavioral skills is increased. The Family Health Promotion program uses a format that minimizes lecture and maximizes awareness, skills development, problem-solving, and real-life application over a 12- to 16-week agenda. Behavioral counseling and contingency contracting provide opportunities for the practice and reinforcement of new behaviors. Initial evaluations of the program model developed with cardiovascular high-risk children and their parents indicated that parents significantly increased health knowledge, lowered blood pressure, became more physically active, and decreased their intake of total fat, saturated fat, and sodium. A clinically significant reduction in children's blood pressure also was observed. Children's weight (adjusted for height) remained stable. The Family Health Promotion program resulted in positive changes in cardiovascular risk factors and can be adapted to any clinical or health-promotion setting.

Cardiovascular Diseases↗

PubMed2000

[Very-low-calorie-diets: is there a place for them in the management of the obese diabetic?].

It is well-recognized that standard caloric restrictions (1500 kcal/day) are usually poorly effective in achieving weight losses in overweight type 2 diabetic patients. For that reason very-low-calorie-diets (VLCDs) were developed as a mean for initiating or accelerating weight reduction. Short-term studies indicate that VLCDs result generally in weight losses that are three times greater than those obtained with standard low-calorie-diets. Fasting blood glucose values are improving in parallel to weight losses and in many patients the improvement in glycemic control is better than that expected from the magnitude of weight losses. However the results are rather disappointing after several months or years of follow-up. For example it has been demonstrated that weight regain can be observed as soon as the patient is shifted to a refeeding or maintenance dietary program at the end of the VLCD period. Long-term results on glycemic control and body weight reduction are generally similar with standard low-calorie-diets and with VLCDs, the final results depending on the magnitude of weight loss whatever the prescribed diet. At short-term the VLCDs can be helpful first for initiating weight losses and second for sensitizing the patient to the potential benefits of complying to dietary measures.

Blood Glucose↗

PubMed1987

Effect of rapid weight loss with supplemented fasting on liver tests.

We monitored serum liver tests in 46 obese persons undergoing rapid weight reduction with a supplemented fasting diet containing a mixture of protein, glucose, essential fatty acids, vitamins, and minerals. Levels of SGOT, SGPT, alkaline phosphatase, lactic dehydrogenase (LDH) and serum concentrations of bilirubin, total protein, and albumin were within normal limits at the onset of the study. SGOT, SGPT, LDH, alkaline phosphatase, and serum total bilirubin rose mildly but significantly 2 weeks after the institution of the supplemented fasting program. Thereafter, the values began to decline, approaching baseline levels within 4-6 weeks despite the continued dietary restrictions. We conclude that rapid weight reduction using a supplemented fasting regimen can lead to a mild hepatic test abnormality. The resultant liver test abnormalities are transient and reversible and may not require extensive diagnostic investigations.

Adult↗

PubMed1999

How should the obese patient be managed? Possible approaches to a national obesity management network.

There is clearly a need for novel approaches to obesity and its management. This has been addressed by the Czech Society for the Study of Obesity, which established a multi-level obesity management network in response to the increasing prevalence of obesity in the Czech Republic. This network includes obesity management centres attached to major teaching hospitals, combined with input from obesity specialists, other specialists, primary healthcare physicians and weight reduction groups. Such an obesity management system aims to provide appropriate diagnostic and treatment facilities for various degrees of obesity throughout the country. The proposed density of the obesity management network takes into account the limited resources in the healthcare system. The network is designed to overcome the current poor level of understanding of obesity and the lack of time and financial resources which have been the most significant barriers to more involvement of primary care physicians in obesity management. In order to implement this system, a comprehensive education programme on obesity was initiated with postgraduate courses for obesity specialists and with training for counsellors of weight reduction groups.

Czech Republic↗

PubMed1980

Cognitive stimulus-control program for obesity with emphasis on anxiety and depression reduction.

A 20-week cognitive stimulus-control treatment program for obesity was conducted in which 27 subjects participated. The program utilized stimulus control procedures, anxiety and depression reduction exercises, and assertiveness training. Statistically significant differences were obtained in weight loss (P < 0.001), anxiety (P < 0.05) and depression (P < 0.01) reduction when comparing pre- and post-treatment scores. Pre-and post-treatmet anxiety (P < 0.05) and pre-and post-treatment depression (P < 0.05) are significantly related. Pre-and post-treatment percent over ideal weight (P < 0.05) is significantly related. A significant relationship exists between years overweight and percentage overweight (P < 0.05); and a significant relationship between pre-treament depression and pounds lost (P < 0.05) is noted. Predictors of success in an obesity-control program are discussed.

Adult↗

PubMed1998

Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services.

OBJECTIVES: The development of recommendations for physicians, nurse practitioners, and nutritionists to guide the evaluation and treatment of overweight children and adolescents. METHODS: The Maternal and Child Health Bureau, Health Resources and Services Administration, the Department of Health and Human Services convened a committee of pediatric obesity experts to develop the recommendations. RESULTS: The Committee recommended that children with a body mass index (BMI) greater than or equal to the 85th percentile with complications of obesity or with a BMI greater than or equal to the 95th percentile, with or without complications, undergo evaluation and possible treatment. Clinicians should be aware of signs of the rare exogenous causes of obesity, including genetic syndromes, endocrinologic diseases, and psychologic disorders. They should screen for complications of obesity, including hypertension, dyslipidemias, orthopedic disorders, sleep disorders, gall bladder disease, and insulin resistance. Conditions that indicate consultation with a pediatric obesity specialist include pseudotumor cerebri, obesity-related sleep disorders, orthopedic problems, massive obesity, and obesity in children younger than 2 years of age. Recommendations for treatment evaluation included an assessment of patient and family readiness to engage in a weight-management program and a focused assessment of diet and physical activity habits. The primary goal of obesity therapy should be healthy eating and activity. The use of weight maintenance versus weight loss to achieve weight goals depends on each patient's age, baseline BMI percentile, and presence of medical complications. The Committee recommended treatment that begins early, involves the family, and institutes permanent changes in a stepwise manner. Parenting skills are the foundation for successful intervention that puts in place gradual, targeted increases in activity and targeted reductions in high-fat, high-calorie foods. Ongoing support for families after the initial weight-management program will help families maintain their new behaviors. CONCLUSIONS: These recommendations provide practical guidance to pediatric clinicians who evaluate and treat overweight children.

Adolescent↗