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PubMedDate not supplied

Effect of an aerobic exercise training program on resting metabolic rate in chronically beta-adrenergic blocked hypertensive patients.

PURPOSE: There is substantial evidence that the use of beta-adrenergic receptor blockers (beta-blockers) is associated with a reduction in resting metabolic rate (RMR) and that a weight gain usually occurs in the first few months of treatment. The purpose of this study was to determine if RMR of overweight and sedentary subjects consuming beta-blockers can be increased following an aerobic exercise training program. METHODS: Twenty-four subjects participated in the study; 11 (6 women, 5 men) were treated with beta-blockers for hypertension and 13 (9 women, 4 men) were nonmedicated (control group). Body composition, RMR, and peak oxygen uptake (VO2peak) were assessed for all subjects before and after a 12-week aerobic exercise training program. Weekly exercise energy expenditure equaled 83.68 kJ (20 kcal) per kg of body weight while exercise intensity was maintained between 60% and 70% of the VO2 reserve. RESULTS: Body composition, RMR, and VO2peak did not differ among groups at the beginning of the study. Body weight (-1.4 kg for beta-blockers, P < .05; -2.5 kg for control, P < .05) and VO2peak (+2.2 mL x kg(-1) x min(-1) for beta-blockers, P < .05; +4.1 mL x kg(-1) x min(-1) for control, P < .001) were significantly improved in both groups, whereas RMR (-272 kJ x day(-1) for beta-blockers, NS; +573 kJ x day(-1) for control, P < .05) was increased only in the control group after the aerobic exercise training program. CONCLUSIONS: These results suggest that beta-blockers limit the increase in RMR normally observed following an aerobic exercise training program. Consequently, obtaining a negative energy balance in an attempt to lose weight may be more difficult.

Adrenergic beta-Antagonists↗

PubMed1990

Energy expenditure and physical performance in overweight women: response to training with and without caloric restriction.

The metabolic effects of exercise training and the influence of a moderate calorie restriction on the training response were examined in overweight women. Ten healthy women, 119% to 141% of desirable weight, completed the 14-week study. After a 2-week stabilization period, in which diets were designed to maintain body weight (BW), five women were assigned to a 12-week experimental program of diet and exercise (D + EX) that included a 50% reduction in energy intake and a program of moderate intensity aerobic exercise 6 days per week. The other five women were assigned to the same daily exercise (EX) and continued to consume the stabilization diet. Periodic measurements of resting metabolic rate (RMR), thermic effect of food (TEF), energy cost of exercise, and predicted maximal aerobic capacity (VO2 max) were obtained, and the respiratory quotient (RQ) was determined during rest and exercise. Body composition was monitored weekly. Tests of strength and anaerobic capacity were conducted. D + EX lost an average of approximately 1.1 kg/wk, which was 67% fat, 33% lean. EX lost approximately 0.5 kg/wk, which was 86% fat, 14% lean. In both groups, the exercise program resulted in an 11% to 13% improvement in VO2 max and an 8% to 16% decrease in energy expenditure at submaximal workloads. The caloric restriction significantly increased fat utilization during exercise. The RMR declined 9% in D + EX, from 1,550 to 1,411 kcal/d, whereas it was maintained in EX, 1,608 to 1,626 kcal/d. The decrease in RMR observed in D + EX was consistent with the loss of fat-free mass (FFM).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2000

Development and initial evaluation of a culturally sensitive cholesterol-lowering diet program for Mexican and African American patients with systemic lupus erythematosus.

OBJECTIVE: To develop and evaluate acceptability of an intensive and ethnic-specific cholesterol-lowering diet program with a strong behavioral component in patients with systemic lupus erythematosus (SLE). METHOD: A comprehensive program with a behavioral component and culturally sensitive menus was developed in an effort to alter dietary behavior in patients with SLE. Four SLE patients, 2 African American and 2 Mexican American, enrolled in this program. Data on food intake (3-day food record), acceptability of the program (subjective response), and physiologic variables were collected at baseline, 6 weeks, and 12 weeks. RESULTS: The program was highly rated by all patients and found to be informative, easy to understand, ethnically sensitive, and to contain useful behavioral maintenance strategies. All 4 patients surpassed or were close to their diet goals at both 6 and 12 weeks. In this small group of patients, there was a statistically significant reduction in low-density lipoprotein cholesterol (P = 0.04) and body weight (P = 0.001), as assessed by repeated measures analysis of variance. CONCLUSION: The culturally specific cholesterol-reducing diet program was highly rated and appeared to be effective in changing the diet of this small group of SLE patients, as determined by their food records and body weight. The impact of this program, including the individual components on cardiovascular disease risk factors, needs to be evaluated in a larger multiple-arm study with a lengthier intervention.

Adult↗

PubMed1999

Concurrent reductions of serum leptin and lipids during weight loss in obese men with type II diabetes.

The aim of the study was to examine the effects of weight reduction by exercise and diet on metabolic control in obese subjects with insulin resistance, particularly investigating if changes in serum leptin concentrations were directly associated with improvements in metabolic control. Twenty obese men (48 +/- 8 yr; body mass index 32. 1 +/- 3.9 kg/m(2)) with previously diagnosed type II diabetes mellitus were assigned to a 4-wk intervention program of exercise (2, 200 kcal/wk) and diet (1,000 kcal/day; 50% carbohydrates, 25% protein, 25% fat; polyunsaturated-to-saturated fatty acid ratio 1.0). Intervention induced significant reductions in body weight and serum leptin levels, and improvements in lipoprotein profile and glucose control. Reductions in leptin levels were directly associated with reductions in serum triglycerides and cholesterol, a finding that was independent of improvements in glucose control. These data show that serum leptin concentrations can be reduced with caloric restriction and exercise in male patients with type II diabetes, and they suggest a direct relationship between leptin and lipoprotein metabolism that is not solely due to weight reduction.

Adult↗

PubMed2000

Antenatal education for self-diagnosis of the onset of active labour at term.

BACKGROUND: A specific program designed to teach women to recognise active labour may be beneficial through potentially decreasing the incidence of early admission to hospital, increasing women's confidence and decreasing their anxiety. OBJECTIVES: The objective of this review was to assess the effects of teaching pregnant women specific criteria for self-diagnosis of active labour onset in term pregnancy. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. SELECTION CRITERIA: Randomised trials comparing a structured antenatal education intervention for the identification of symptoms for self-diagnosis of active labour with usual care. DATA COLLECTION AND ANALYSIS: Trial quality was assessed. MAIN RESULTS: One study involving 245 women was included. Method of randomisation was unclear and 15% of the sample was lost to follow-up in this trial. A specific antenatal education program was associated with a reduction in the mean number of visits to the labour suite before the onset of labour (weighted mean difference -0. 29, 95% confidence interval -0.47 to -0.11). It is unclear whether this resulted in fewer women being sent home because they were not in labour. REVIEWER'S CONCLUSIONS: There is not enough evidence to evaluate the use of a specific set of criteria for self-diagnosis of active labour.

Female↗

PubMed2006

Personal and non-occupational risk factors and occupational injury/illness.

BACKGROUND: The materials handling industry performs is an essential function in the world economy, however, it is plagued with occupationally related injuries and illnesses. Understanding the risk factors may assist this industry in alleviating these injuries and illnesses, as well as their associated costs. METHODS: Forty-eight personal and non-occupational risk factors were measured and evaluated for statistically significant relationships with occupational injury in 442 volunteer manual material handlers who worked for three different companies, at nine US locations, with 15 different job descriptions. OSHA 200 logs were used to ascertain evidence of occupational injury within this population for 1 year after the testing and measurement was completed. RESULTS: Higher occurrences of injury were significantly associated with six risk factors in the univariate model (odds ratios 1.51-4.00). The significantly (P < 0.05) related risk factors in the univariate model were aerobic power, smoking status, perceived fitness level, fishing/hunting as a hobby, speed limit obeyance, and witnessing or being involved in a violent fight. In the multivariate analysis, five risk factors (aerobic power, smoking status, percent body fat, body mass index, and sit-and-reach measured flexibility) were significantly (P < 0.05) associated with occupational injury. Odds ratios in the multivariate analysis varied from 1.42 to 10.11. CONCLUSION: Evidence of an association of occupational injury occurrence with certain risk factors presented in personal and non-occupational univariate and multivariate models is shown. In industry, effective injury reduction programs should go beyond traditional methods of job-related ergonomic risk factors and include personal factors such as smoking, weight control, and alcohol abuse.

Adult↗

PubMed1994

Key modifiable factors in weight maintenance: fat intake, exercise, and weight cycling.

OBJECTIVE: This 6- to 42-month follow-up study of a 6-month worksite weight control intervention examined predictors of weight maintenance, with a focus on those that could be modified. SUBJECTS: Twenty-nine participants, 14 men and 15 women, from a behavior modification program completed follow-up measurements. MAIN OUTCOME MEASURES: Height, weight, waist-to-hip ratio, food and beverage intake from a 3-day food record, weight history, social support and physical activity were the main outcome measures. RESULTS: One third of the participants maintained their weight losses within 2 kg at follow-up, although all had higher relative weights at follow-up than immediately after the program. High daily fat consumption (r = .40) and reduced time in physical activity (r = .34) correlated with increased relative weight at follow-up (P < .05). APPLICATION: Because previous weight cycling was so strongly related to weight loss maintenance (r = .55), potential weight program participants should learn and practice the weight maintenance behaviors of reduced dietary fat and regular exercise, independently of and before weight reduction attempts.

Adult↗

PubMed2005

Anesthesia for pediatric obesity.

This article discusses the unique anesthetic implications of obesity, with an emphasis on children and adolescents. It also touches on the issues surrounding bariatric surgery in the morbidly obese adolescent population. Adolescent bariatric surgery is moving to the forefront as a treatment modality because weight-loss programs alone are not keeping pace with the growth of the problem. Bariatric surgery offers the potential to achieve the weight reductions necessary to reverse the debilitating and costly comorbidities of obesity.

Anastomosis, Roux-en-Y↗

PubMed2006

Perceived effectiveness and side effects of intermaxillary fixation for diet control.

Weight loss is one of the major side effects associated with intermaxillary fixation (IMF) following orthognathic surgery or jaw fractures. The aim of this study was to retrospectively interview patients treated with intermaxillary fixation for diet control (IMFDC) to collect base-line information regarding: (1) perceived effectiveness, patients' compliance and patients' satisfaction with the treatment; (2) the frequency of side effects associated with IMFDC. The results show that IMFDC significantly reduced weight by a mean of 6.8 kg during treatment, and a mean of 4.1 kg at a minimum of 1 month following IMFDC removal (P<0.0001). Only 32.5% of the patients complied with the planned period of IMFDC treatment while 70% were satisfied with the treatment results. The most common side effects were speech problems and oral-facial pain with a prevalence of 52.5 and 32.5%, respectively. IMFDC treatment is not effective for long-term weight reduction and may only be used for a very short period of time to initiate weight loss. Exercise and/or special diet programs are healthier and better means to treat obesity and maintain weight loss.

Adult↗

PubMed1993

Holistic Self-Care Model for permanent weight control.

Nearly one fourth of adult women in the United States are currently overweight, despite numerous approaches to weight control. Nurses are confused about appropriate interventions for overweight women who weight cycle--that is, experience repeated periods of weight loss followed by weight regain. Women continue to suffer the negative physical, psychological, and financial consequences of weight cycling, which is related to increased adiposity, an additional important health risk. Moderately successful, long-term weight control treatments are programs that have a combined intervention prescribing both controlled amounts of health food intake and aerobic exercise. Although such a physical program can promote weight loss, the psychological components often are not considered and are the reasons why so many diet/exercise programs fail. The Holistic Self-Care Model combines the successful physical, cognitive, and psychological essentials of healthy approaches for weight reduction as a means of stopping weight cycling and promoting weight control.

Adult↗

PubMed1975

Frequency of training as a determinant for improvement in cardiovascular function and body composition of middle-aged men.

Frequency, duration and intensity of training have been shown to be important determinants for improving various physiological functions. This report represents a series of six training investigations conducted by the investigators over the past seven years. Within the six investigations ten separate groups were studied. These data were combined and tabulated to look at frequency of training as a determinant for improving cardiovascular function and body composition of middle-aged men. The subjects included 148 healthy, sedentary, volunteer men ranging from 28 to 64 years of age (x equal to 41). The experiments were carefully controlled and included running 30 to 45 minutes for two (four groups), three (three groups) or four (three groups) days each week for 20 weeks. The results show that all frequencies had a significant effect on cardiovascular function, but only three and four days/week regimens showed reduction in total body weight and fat. Changes in maximum oxygen consumption (VO2 max) were similar for two and three days/week programs, and significantly greater for four days. The data support the notion of frequency of training being an important criterion for improving cardiovascular function and body composition.

Adipose Tissue↗

PubMed2004

[Clinical trials to evaluate interventions aimed to prevent or delay the development of diabetes in high risk IGT].

Numerous clinical trials have been completed to evaluate interventions aimed to prevent or delay the development of diabetes in high risk populations and ultimately to reduce the risk of CVD. There have been several trials emphasizing lifestyle modification, including weight reduction and increased physical activity, such as the Da Qing Study, the Finnish Diabetes Prevention Study and the Diabetes Prevention Program. Pharmacologic agents such as metformin, alpha-glucosidase inhibitors, and TZDs have also been shown to reduce the risk of developing type 2 diabetes.

Diabetes Mellitus, Type 2↗

PubMed1978

Contribution of twin pregnancy to perinatal mortality and fetal growth retardation; reversal of growth retardation after birth.

A survey of factors associated with perinatal mortality in 511 twins and fetal growth retardation and its reversal in 262 twins is presented. The incidence of stillbirth was almost 50% higher in twins than in singletons and the neonatal mortality was six times as high. Eighty percent of the neonatal deaths occurred in infants born prior to or at 30 weeks of gestation; 93% of the deaths were in infants weighing less than 1500 g and 75% occurred within 48 hours of birth. Fetal malnutrition was the main cause of stillbirth, and respiratory distress syndrome and asphyxia neonatorum were the main causes of neonatal death. One quarter of the twins had fetal growth retardation, a prevalence 10 times that in singletons. In almost all, the growth retardation was reversed by high-energy feedings. Although twins represented only 1% of all pregnancies and 2% of live births, they composed 12% of infants with early neonatal death and 17% of growth-retarded infants. A program is suggested for reduction of twin mortality and morbidity.

Birth Weight↗

PubMed2005

Vascular risk management through nurse-led self-management programs.

In current clinical practice, adequate cardiovascular risk reduction is difficult to achieve. Treatment is primarily focused on clinical vascular disease and not on long-term risk reduction. Pertinent to success in vascular risk reduction are proper medication use, weight control, healthy food choices, smoking cessation, and physical exercise. Atherosclerotic vascular disease and its risk constitute a chronic condition, which poses specific requirements on affected patients and caregivers who should be aware of the chronicity. In patients with vascular disease, there is lack of awareness of their chronic condition because of the invisibility of most risk factors. In other patient groups with chronic illness, self-management programs were successful in achieving behavioral change. This strategy can also be useful for patients with vascular disease to adapt and adhere to an improved lifestyle. Self-management refers to the individual's ability to manage both physical and psychosocial consequences including lifestyle changes inherent to living with a chronic condition. Interventions that promote self-management are based on enhancing self-efficacy. In self-management, attention can be given to what is important and motivational to the individual patient. In this article the challenge of nursing care promoting self-management for patients with vascular risk and how this care can be applied will be explained. Nurses can play a central role in vascular risk management with a self-management approach for patients with chronic vascular disease. In vascular prevention clinics, nursing care can be delivered that includes medical treatment of vascular risks (hypertension, hypercholesterolemia, hyperglycemia, and hyperhomocystinemia) and counseling on promoting self-management (changes in diet, body weight, smoking habits, and level of exercise). Nursing interventions based on self-management promotion can provide a new and promising approach to actually achieve vascular risk reduction.

Adaptation, Psychological↗

PubMed2004

Brazilian multicenter study of the intragastric balloon.

BACKGROUND: Intragastric balloons have been used in obese patients to provide early satiety and thereby induce weight loss. Several studies have reported promising results with a new balloon (BIB((R))) designed to overcome some of the technical pitfalls of earlier devices. We assessed both safety and effectiveness of the BIB((R)). METHOD: From November 2000 to February 2004, 483 overweight and obese patients were treated with the BIB((R)). 323 patients completed a 6-month follow-up, and 85 of them completed a 1-year follow-up. All patients took part in a multidisciplinary program involving clinical, psychiatric, physical training, and dietary approaches. RESULTS: Compared to baseline values, after a 6-month follow-up subjects showed significant reductions in weight (15.2 +/- 10.5 kg), percent excess weight loss (48.3 +/- 28.1), and BMI (-5.3 +/- 3.4 kg/m(2)) (P < 0.000). At 1-year follow-up, 85 patients have maintained more than 90% of their BMI reduction. The main side-effects were nausea/vomiting (40%), and epigastric pain (20%), requiring removal of the BIB (R) in 11 patients (3.4%). Minor complications were reflux esophagitis (12%) and symptomatic gastric stasis (9%). Balloon impaction occurred in 2 cases (0.6%), and in 1 patient (0.3%) there was spontaneous deflation of the balloon leading to a small-bowel obstruction solved by a surgical approach. CONCLUSION: The BIB((R)) has been effective to temporarily control obesity, inducing an excess weight loss of approximately 48%. It was not associated with mortality and showed minimal risk of major complications.

Adult↗

PubMed2006

Increased level of Eimeria sensitivity to diclazuril after using a live coccidial vaccine.

Anticoccidial vaccine and an anticoccidial drug rotation program were compared to determine which program was more effective in producing coccidia populations sensitive of 1 ppm diclazuril. The study used an anticoccidial drug-sensitivity battery test (AST) to determine the baseline level of diclazuril sensitivity to field isolates of Eimeria spp. from seven broiler complexes that had used diclazuril. Based on percentage reduction in weight gain and lesion scores, 25% or fewer of the isolates were effectively controlled by diclazuril. Following the baseline sampling, four of the complexes switched to a nondiclazuril in-feed anticoccidial drug program and three of the complexes switched to a vaccination program for two broiler grow-out cycles as the sole coccidiosis-control program. This study demonstrated that the vaccine used (Coccivac-B) contained anticoccidial drug-sensitive strains. Eimeria isolates were subsequently collected from the identical houses and diclazuril AST results were compared with the baseline AST results. Following the two grow-out cycles, sensitivity of the isolates to diclazuril from the four complexes that continued to use in-feed anticoccidial drugs remained essentially unchanged. The isolates from the three complexes that switched to the vaccination program demonstrated a marked increase in diclazuril sensitivity, with 60%-100% of the isolates from each complex effectively controlled by diclazuril. Vaccination with the anticoccidial drug-sensitive strains produced a measurable increase in the level of sensitivity to diclazuril.

Animals↗

PubMed2003

The nurse's role and skills in hypertension care: a review.

The aim of this review was to examine studies on nursing in hypertension care to find out the nurse's role and skills. Articles were searched during the period 1966-1997. About 650 abstracts were read, and 148 were selected for examination. Forty-two articles were judged to be relevant for the study. The role of the nurse in programs was described as that of a team member, an educator in nonpharmacological treatment, and a translator for the physician with a holistic and psychosocial approach. A nurse participating in hypertension care promoted blood pressure reductions as the patients decreased their weight and sodium intake, stopped smoking, increased their physical activity, took their medication more correctly, and returned for follow-up visits more frequently, and the cost of drugs and visits to the physician decreased. Local programs for hypertension care should be developed with nurses' holistic and psychosocial approach and skills taken into account. More well-designed studies are needed to develop nursing care for hypertensive patients.

Blood Pressure Determination↗

PubMed2005

Efficacy of moxidectin injectable and pour-on formulations in a pilot control program against bovine hypodermosis in Southern Italy.

Bovine hypodermosis is a myiasis caused by Hypoderma bovis and Hypoderma lineatum (Diptera, Oestridae) larvae, which has a severe economic impact on the livestock industry. Though myiasis is widespread throughout Italy, no nationwide eradication program has ever been planned, unlike in other European Countries. With a view to setting up a national control program, a pilot study was carried out in Southern Italy on 9939 cattle bred in an area with a high prevalence of cattle hypodermosis, using moxidectin 0.5% pour-on (Cydectin, Fort Dodge) and 1% injectable (Cydectin, Fort Dodge) formulations. At the recommended dosage, moxidectin displayed efficacy levels of 99.9% in the pour-on and 100% in the injectable formulation, whereas the microdose (1 mg per head regardless of body weight) was less effective (65.7%). This trial contributed to a significant reduction in infestation rates in the study area and represented the first step through which a national program for eradicating warble fly infestation in Italy.

Administration, Cutaneous↗