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At least 721 records · Page 40Linked to original sources
PubMed1991

Effects of a very-low-calorie diet on long-term glycemic control in obese type 2 diabetic subjects.

We tested the hypothesis that the use of a very-low-calorie diet (VLCD) in combination with behavior modification would promote long-term glycemic control in obese type 2 diabetic subjects. Thirty-six diabetic subjects were randomly assigned to a standard behavior therapy program or to a behavior therapy program that included an 8-week period of VLCD. The behavior therapy group consumed a balanced diet of 4200 to 6300 J/d throughout the 20-week program. The VLCD group consumed a balanced diet of 4200 to 6300 J for weeks 1 to 4, followed by a VLCD (1680 J/d of lean meat, fish, and fowl) for weeks 5 to 12. The VLCD group then gradually reintroduced other foods during weeks 13 to 16 and consumed a balanced diet of 4200 to 6300 J/d for weeks 17 to 20. Thirty-three of the 36 subjects completed the 20-week program and the 1-year follow-up. Use of the VLCD produced greater decreases in fasting glucose at the end of the 20-week program and at 1-year follow-up and greater long-term reductions in HbA1. The VLCD group also had greater weight losses at week 20, but weight losses from pretreatment to 1-year follow-up were similar in the two treatment groups. The improved glycemic control with the VLCD appeared to be due to increased insulin secretion, but further research is needed to confirm this.

Adult↗
PubMed1986

[Effect of diet and exercise therapy on body weight, performance and lipid metabolism of post-infarct patients during a 4-week rehabilitation program].

From a total of 130 male patients following myocardial infarction a symptom-limited stress cycling ergometer was carried out at the beginning as well as at the end of a 4-week rehabilitation, as well as controls of body weight, the Broca-Index, and Triglyzeride, Cholesterol, HDL-Cholesterol, LDL-Cholesterol and VLDL-Cholesterol fractions. With regard to the Broca-Index, the patients received respectively a 1600 Kcal normal diet (Broca-Index 1.00, n = 34), a 1100 Kcal reductional diet (Broca-Index 1.20, n = 67) and a 600 Kcal reductional diet (Broca-Index 1.32, n = 29). During the whole duration of their stay, the patients underwent a program of physical exercise related to their personal physical performance, which consisted of gymnastic, cycle training, swimming (facultative) and physical training. The improvements of the physical performance were statistically significant, and consisted of 19.4% (normal diet), 18.2% (1100 Kcal diet), namely 11.3% in the 600 Kcal diet group. Weight, Broca-Index and parameters of fat-metabolism remained unchanged under a normal diet. In both reductional diet groups a significant reduction of weight and Broca-Index as well as all blood-fat-metabolism parameters were noted, with the exception of the HDL-Cholesterol fraction, which remained unchanged. Statistical significant correlations between weight reduction, namely increases of physical performance and parameters of blood-fat-metabolism were only noted in cases of a 600 Kcal diet. The noted changes in weight, physical performance and blood-fat-metabolism can be considered as a reduction of the cardiovascular risk profile.

Body Weight↗
PubMed2003

Behavior therapy and sibutramine for the treatment of adolescent obesity: a randomized controlled trial.

CONTEXT: Adolescent obesity is becoming a national public health problem. Weight-loss medications including sibutramine facilitate weight control in adults and could be used with obese adolescents in combination with behavior therapy (BT). OBJECTIVE: To examine whether increased weight loss in obese adolescents is induced when sibutramine is added to a family-based, behavioral weight control program. DESIGN, SETTING, AND PARTICIPANTS: Randomized, double-blind, placebo-controlled trial consisting of 82 adolescents aged 13 to 17 years with a body mass index (BMI) of 32 to 44 conducted from March 1999 to August 2002 at a university-based clinic for 6 months, followed by open-label treatment during months 7 to 12. INTERVENTIONS: For the first 6 months, participants received either BT and sibutramine or BT and placebo. From months 7 to 12, all participants received sibutramine in open-label treatment. MAIN OUTCOME MEASURES: Percentage change in BMI; systolic and diastolic blood pressure and pulse; and hunger. RESULTS: In intention-to-treat analysis at month 6, participants in the BT and sibutramine group lost a mean (SD) of 7.8 kg (6.3 kg) and had an 8.5% (6.8%) reduction in BMI, which was significantly more than weight loss of 3.2 kg (6.1 kg) and reduction in BMI of 4.0% (5.4%) in the BT and placebo group. Significantly greater reductions in hunger (P =.002) also were reported by participants who received BT and sibutramine. From months 7 to 12, adolescents initially treated with sibutramine gained 0.8 kg (10.5 kg) with continued use of the medication, whereas those who switched from placebo to sibutramine lost an additional 1.3 kg (5.4 kg). Medication dose was reduced (n = 23) or discontinued (n = 10) to manage increases in blood pressure, pulse rate, or other symptoms. CONCLUSIONS: The addition of sibutramine to a comprehensive behavioral program induced significantly more weight loss than did BT and placebo. Until more extensive safety and efficacy data are available, medications for weight loss should be used only on an experimental basis in adolescents and children.

Adolescent↗
PubMed2002

Impact of the coronary health improvement project (CHIP) on several employee populations.

The greatest potential to improve public health lies in the ability of individuals to adopt healthful behaviors. The purpose of this study was to determine whether participation in a facilitator-based video version of the Coronary Health Improvement Project (CHIP) would improve health behaviors and significantly reduce employee health risks. Employees (n = 442) from six worksites in metropolitan Rockford, Illinois, were used in a pretest/posttest design. Employees self-selected to participate in a facilitator-based, CHIP video program. Participants received instruction twice a week, for 8 weeks, via 15 videos shown at each participating worksite. Demographic and biometric data (body weight, body mass index, blood lipids, blood pressure, and fasting blood glucose) were evaluated at baseline and at 8 weeks. All sites individually and collectively demonstrated significant and meaningful reductions in body weight, body mass index, total cholesterol, low-density lipoprotein cholesterol, triglycerides, and fasting blood glucose. Men demonstrated greater improvement than women, and individuals with higher baseline health risks experienced the greatest reductions in risk. The CHIP video program appears to be an effective method of lowering employee health risks. Future research is needed to determine how long these reductions may persist.

Blood Pressure↗
PubMed2001

Physical activity, total and regional obesity: dose-response considerations.

PURPOSE: This review was undertaken to determine whether exercise-induced weight loss was associated with corresponding reductions in total, abdominal, and visceral fat in a dose-response manner. METHODS: A literature search (MEDLINE, 1966--2000) was performed using appropriate keywords to identify studies that consider the influence of exercise-induced weight loss on total and/or abdominal fat. The reference lists of those studies identified were cross-referenced for additional studies. RESULTS: Total fat. Review of available evidence suggested that studies evaluating the utility of physical activity as a means of obesity reduction could be subdivided into two categories based on study duration. Short-term studies (< or = 16 wk, N = 20) were characterized by exercise programs that increased energy expenditure by values double (2200 vs 1100 kcal.wk-1) that of long-term studies (> or = 26 wk, N = 11). Accordingly, short-term studies report reductions in body weight (-0.18 vs -0.06 kg x wk(-1)) and total fat (-0.21 vs -0.06 kg x wk(-1)) that are threefold higher than those reported in long-term studies. Moreover, with respect to dose-response issues, the evidence from short-term studies suggest that exercise-induced weight loss is positively related to reductions in total fat in a dose-response manner. No such relationship was observed when the results from long-term studies were examined. Abdominal fat. Limited evidence suggests that exercise-induced weight loss is associated with reductions in abdominal obesity as measured by waist circumference or imaging methods; however, at present there is insufficient evidence to determine a dose-response relationship between physical activity, and abdominal or visceral fat. CONCLUSION: In response to well-controlled, short-term trials, increasing physical activity expressed as energy expended per week is positively related to reductions in total adiposity in a dose-response manner. Although physical activity is associated with reduction in abdominal and visceral fat, there is insufficient evidence to determine a dose-response relationship.

Abdomen↗
PubMed1995

Weight regain following sustained weight reduction is predicted by relative insulin sensitivity.

Ten moderately obese women (body mass index 34.9 +/- 1.1 kg/m2, mean +/- SEM), had previously been through a 3-month weight loss program followed by 3 months of weight maintenance at the reduced weight. A euglycemic clamp for determination of insulin sensitivity was performed on each subject prior to weight loss, and another at the end of the weight maintenance phase. The mean weight loss for the group was 11.4 +/- 2.2 kg. The women were then seen for follow-up weights 12 months and 18 months after the conclusion of the weight maintenance period. All of the women except one had regained their weight by the time of the 12-month visit. It was found that the amount of weight regained both at 12 months and 18 months was correlated with the change in insulin sensitivity which occurred from the baseline study to after weight loss/maintenance. The data indicate that increased insulin sensitivity following sustained weight loss in obese women predicts weight regain.

Adult↗
PubMed1988

Exercise capacity and nitrogen loss during a high or low carbohydrate diet.

Twelve obese women completed a maximal and an endurance exercise test (70% peak VO2) during a weight maintenance week. For the next 4 wk, the women consumed either a high (71%) carbohydrate (HC) or a low (33%) carbohydrate (LC), isonitrogenous very-low-calorie diet (VLCD) of 2,219 kJ (530 kcal).d-1. A supervised exercise session at 60% peak VO2 took place 3 times.wk-1 for 30 to 45 min. Peak VO2 and exercise endurance tests were repeated during the fourth week of the VLCD. One week of a 4,186 kJ (1000 kcal) diet followed the VLCD. The average weekly weight loss was 1.7 +/- 0.1 kg for the HC group and 2.0 +/- 0.2 kg for the LC group. Urinary nitrogen loss was greater for the LC group early in the VLCD but not different than HC over the entire experimental period. Serum cholesterol and high-density lipoprotein-cholesterol decreased in both groups but the ratio of these lipids improved over the treatment. Serum beta-hydroxybutyrate and uric acid increased significantly more for the LC than the HC group. Although absolute peak VO2 decreased, VO2 relative to body weight was maintained. Time to exhaustion improved by 36% for both groups in the endurance exercise tests. The endurance exercise R ratio was significantly more depressed by the LC than the HC treatment. In summary, both supervised treatments were effective in causing substantial weight reduction and improved blood lipid profiles in healthy young women but caused a net loss of body protein. Neither treatment compromised ability to participate in a thrice weekly exercise program. Although peak aerobic capacity did not increase, aerobic endurance at a fixed sub-maximal exercise load was improved.

Adult↗
PubMed1997

The exercise prescription: focus on vascular mechanisms.

Recent recommendations by expert bodies for reducing cardiovascular risk factors have included accumulation of 30 min/day of moderate activity in an intermittent fashion. There is little support for this recommendation for blood pressure reduction, the most effective, proven exercise regimens being of moderate intensity, performed three or four times per week for durations of not less than 30 min. Although cycling and jogging have proven efficacious in blood pressure reduction, walking provides less benefit but might be preferable for older individuals, and for those with orthopedic and cardiac limitations. There are preliminary indications that moderate swimming programs reduce the systolic blood pressure. Benefit in reducing other risk factors including the lipid profile, insulin sensitivity, body composition and weight, neurohumoral factors and cardiac structure and functioning has also been shown to occur with continuous bouts of exercise. Vascular adaptation represents a particular mechanism of benefit. Aerobic training increases the large-artery compliance, contributing to a reduction in systolic blood pressure and an attenuation of the cardiac afterload. The release of endothelially derived nitric oxide increases with regular exercise and might modulate changes in arterial compliance to some extent. Moderate cycling for 4 weeks increased basal nitric oxide production in previously sedentary normal and hypercholesterolemic individuals. Highly trained athletes had increased forearm endothelium-dependent vasodilator reserve. This effect, if it is translatable to the coronary circulation, might provide protection against ischemia. The efficacy with which an increase in physical activity can impact on cardiovascular risk factors will depend largely on adherence to exercise programs. Adherence could improve with lower intensity, intermittent programs. Further study in this area is warranted in order to determine the impact of such interventions on risk factors and vascular changes.

Journal Article↗
PubMed1999

Proposal of a new hypothesis for the psychosomatic treatment of obesity and its application.

Dieting or a change in eating habits is the most widely used approach aimed at reducing body weight. However, it is also well known that many obese people cannot reduce body weight substantially, no matter how hard they try, and that they soon regain whatever they do lose. The conventional approach to the treatment of obesity is to control it by prohibition or suppression of overeating, and by orders to change eating habits. This paper presented and examined a new psychosomatic approach for obesity (NPAO). Taking the story of "The North Wind and the Sun" from Aesop's Fables as a metaphor, this hypothesis is based on the reduction of overstressors through a "Sun"-type approach as opposed to a "North Wind"-type approach. This "Sun"-type approach, which incorporates 2 principles and 3 basic rules, is useful in decreasing stressors such as prohibition, suppression and orders, and increasing pleasantness, which competes with unpleasant stress. The treatment based on this hypothesis was applied to 77 subjects: 62 men (age 46.2 +/- 8.0 years) and 15 women (age 50.6 +/- 4.5 years). All subjects were given medical checks just before and 6 months after the psychosomatic approach for obesity. For a proportion of cases, maximal oxygen uptake (VO2max) was measured before and after. In the practiced group (48 cases) except for three persons who had stopped the program within 3 months after the start, body weight and body mass index fell significantly by 5.2 kg (p < 0.001) and 2.0 kg/m2 (p < 0.001) respectively, after 6 months. There were significant reductions in total cholesterol and triglyceride (p < 0.01, p < 0.01 respectively). VO2max, however, increased significantly (p < 0.05). The subjects' impressions of this therapy, collected after 6 months were as follows: "It was comfortable" 67.7%, "It was hard going" 8.8%, "My body has become lighter" 79.4%, "I have become more energetic" 70.5%, and "I have become happier" 64.7%. During the period of the therapy, there was no report of any appearance of new physical or mental abnormalities such as fatigue or uncomfortableness. On the other hand, there were no significant changes in any parameters except for an increase of blood sugar in the non-practiced group (26 cases). These results strongly indicate that the NPAO is easy in practice, has a high success rate, shows no rebounding, reduces body weight safely, and results in an increase of vigor.

Behavior Therapy↗
PubMed2003

Practical clinical behavioral treatment of obesity.

The objective was to create a method/model that works in practical clinical treatment for health care personnel as well as for the patients, to educate and supervise health care staff according to this model and to initiate long-term treatment of obese patients in a health care setting. The hypothesis was that it is possible to successfully initiate behavior-modified treatment in the form of a structured treatment program as a method and a tool adapted to use in health care. The aim of this article is to describe an extensive structural cognitive behavioral treatment program for patients. The treatment program is documented in a handbook for supervisors and a self-monitoring book for patients. This handbook is used in the education of the health care personnel and supports the supervisor in the clinical work with the patients. The main purpose of all individual or group treatment is to bring about reduction of body weight or weight control. To obtain weight control through lifestyle changes a balance has to be found between eating behavior, physical activity and body weight control. To reach this kind of balance it is important to have treatment programs where the aim and goals are clearly declared. The structure and the content of the program shall motivate and create interest for changes in the overweight person's behavior. This treatment program includes a schematic survey and an example of a structured treatment program. Over the last few years, 850 nurses, dietitians and other health care personnel have been educated, representing 400 primary health care centers and hospitals within Sweden. Overall these participants find their education and supervision meaningful and valuable.

Clinical Competence↗
PubMedDate not supplied

Treating the obese patient. Suggestions for primary care practice.

Obesity is a major health problem in America. Weight loss is associated with improvements in obesity-related health complications, but patients and practitioners are frequently disappointed by the long-term results of weight control efforts. Recent research has yielded new findings concerning the causes of obesity, as well as new goals for obesity treatment. Traditionally, the goal of therapy has been reduction to ideal weight. Several scientific bodies, however, now recommend a more modest 5% to 15% reduction in initial weight. Current options for weight loss include behavioral or pharmacological management provided during primary care visits, self-help and commercial programs, hospital-based interventions, and bariatric surgery. Regardless of the approach selected, long-term care usually is required to facilitate the maintenance of weight loss.

Behavior Therapy↗
PubMedDate not supplied

Bone mineral density response to caloric restriction-induced weight loss or exercise-induced weight loss: a randomized controlled trial.

BACKGROUND: Bone loss often accompanies weight loss induced by caloric restriction (CR), but whether bone loss accompanies similar weight loss induced by exercise (EX) is unknown. We tested the hypothesis that EX-induced weight loss is associated with less bone loss compared with CR-induced weight loss. METHODS: Forty-eight adults (30 women; 18 men; mean +/- SD age, 57 +/- 3 years; and mean +/- SD body mass index, 27 +/- 2 kg/m2) were randomized to 1 of 3 groups for 1 year: CR group (n = 19), regular EX group (n = 19), or a healthy lifestyle (HL) control group (n = 10). Primary outcome measure was change in hip and spine bone mineral density (BMD). Secondary outcomes were bone markers and hormones. RESULTS: Body weight decreased similarly in the CR and EX groups (10.7% +/- 6.3% [-8.2 +/- 4.8 kg] vs 8.4% +/- 6.3% [-6.7 +/- 5.6 kg]; P = .21), whereas weight did not change in the HL group (-1.2% +/- 2.5% [-0.9 +/- 2.0 kg]). Compared with the HL group, the CR group had decreases in BMD at the total hip (-2.2% +/- 3.1% vs 1.2% +/- 2.1%; P = .02) and intertrochanter (-2.1% +/- 3.4% vs 1.7 +/- 2.8%; P = .03). The CR group had a decrease in spine BMD (-2.2% +/- 3.3%; P = .009). Despite weight loss, the EX group did not demonstrate a decrease in BMD at any site. Body weight changes correlated with BMD changes in the CR (R = 0.61; P = .007) but not in the EX group. Bone turnover increased in both CR and EX groups. CONCLUSIONS: CR-induced weight loss, but not EX-induced weight loss, is associated with reductions in BMD at clinically important sites of fracture. These data suggest that EX should be an important component of a weight loss program to offset adverse effects of CR on bone.

Alkaline Phosphatase↗
PubMed1978

Bilateral nephrectomy for hypertension in patients with chronic renal failure on a dialysis program.

During the last 6 years 33 bilateral nephrectomies have been performed for severe hypertension in patients with chronic renal failure on a dialysis program. Nephrectomy resulted in a prompt and sustained reduction in blood pressure, an improved sense of well-being and a gain of weight. Despite the fact that the mean hematocrit decreased from 25 to 18 per cent all patients thrived. The nephrectomy group showed an 85 per cent 5-year cumulative survival rate compared to 55 per cent in the non-nephrectomy group. There was 1 mortality and low morbidity. Simultaneous nephrectomy by 2 teams, using a posterior approach, proved more satisfactory than an anterior or bilateral flank apprach. The indications for and arguments against bilateral nephrectomy are discussed.

Adult↗
PubMed2005

[Thinking of acupuncture and moxibustion slimming treatment].

The authors think the problems at present in clinical slimming treatment of acupuncture and moxibustion, such as the effect and the mechanism of slimming, local slimming and the rebounding of body weight after slimming therapy, etc.. Holding that acupuncture and moxibustion slimming therapy has a certain therapeutic effect, acupuncture and moxibustion treatment combined with proper control of diet, sports and other methods can increase the effect of reduction of body weight; and regulation of the satiety center, inhibition of excessive appetite and mobilization of decomposition of lipids are an ideal program for acupuncture and moxibustion slimming treatment; local slimming treatment should be conducted on the basis of general slimming treatment; regulation of the satiety center, scientific combination of diet and proper sports are a tactic for prevention from rebounding of body weight after slimming treatment.

Acupuncture Points↗
PubMed2005

Analysis of weight loss outcomes using VLCD in black and white overweight and obese women with and without metabolic syndrome.

OBJECTIVE: To evaluate the efficacy of very low calorie diet (VLCD) in black and white obese women. Changes in weight, metabolic profile, and body composition are assessed. METHOD: Patients are enrolled in a self-paid, university-based, outpatient weight loss program. All are prescribed VLCD (500-800 Cal/day), an exercise regimen, and group behavioral counseling. Black and white patients are matched for age, weight, body mass index, and by metabolic syndrome (MS) status. RESULTS: A total of 304 black and white women (152 in each group) were included the analysis. Approximately 40% of patients had MS (white women: 39.5%; black women: 41.2%). Mean baseline weights were similar. After 12 weeks, weight reduction of 9.97% was seen in white women and 9.02% drop was seen in black women (both P<0.0001). However, the degree of weight change was not different between the groups (P = 0.244). Marked improvements in fasting glucose, total cholesterol, LDL, triglyceride, and blood pressures (BP) were observed (all P<0.01); however, no difference between cohorts were seen. Patients with MS had higher baseline weight, BP, glucose and triglyceride levels when compared to patients without MS (all P<0.01). Significant reductions in % body fat were seen in white and black patients, independent of MS status. CONCLUSION: Obese patients, independent of race, were able to achieve significant weight loss when enrolled in a structured outpatient program. Weight loss significantly correlated with all aspects of MS. Our results suggest that differences seen in past studies may be influenced by socioeconomic and behavioral factors rather than differences in physiological response to dieting.

Adult↗
PubMed1983

Randomized controlled trial of a nonpharmacologic cholesterol reduction program at the worksite.

Under experimental clinical conditions diet modification has been shown to reduce serum cholesterol levels. This paper reports such a positive response to a nonpharmacologic, behavioral education program at the worksite. Employees at the New York Telephone Company corporate headquarters were assigned randomly to treatment and control groups. Treatment consisted of an 8-week group cholesterol reduction program conducted during employee lunch hours. It comprised a multiple-treatment approach--food behavior change techniques combined with nutrition education, physical activity planning, and self-management skills. The treatment group showed substantial change compared with the control group at the program's completion. Those treated displayed a significant 6.4% reduction in total serum cholesterol (266 mg% average at baseline) as compared with control subjects with a corresponding decrease in high-density lipoprotein levels. A significant increase in nutrition knowledge and moderate weight loss were also documented for this group. The magnitudes of a participant's baseline serum cholesterol level and his/her reduction in percentage of ideal body weight were positively and independently correlated with percentage changes in serum cholesterol levels. Over the same period, decreases in high-density lipoprotein levels and no changes in serum cholesterol, weight, and nutrition knowledge were observed for the control group. Overall, participants in the treatment program successfully reduced the coronary heart disease risk factors of elevated cholesterol and weight. Directions for future study are suggested.

Behavior Therapy↗
PubMed2003

The Ashkelon Hypertension Detection and Control Program (AHDC Program): a community approach to reducing cardiovascular mortality.

BACKGROUND: Blood pressure (BP) reduction is crucial in reducing cardiovascular (CV) morbidity and mortality in the community. Subjects aged 20-65 seldom visit the primary care clinics, so they are unlikely to be detected without an active outreach screening program. The aim of the project was to prepare a professional doctor-nurse screening team, who will instruct those found to be at high risk in control of their risk factors, in order to reduce CV morbidity and mortality. METHODS: During a 10-year period (1980-1990), teams examined 12,202 subjects, (mean age 51 +/- 7 years, range 20-65 years) accounting for 23.4% of the total regional population. High risk subjects underwent an intensive CV risk factor control program. RESULTS: Subjects (3,506 or 28.6%) were found to have one or more CV risk factors (hypertension, obesity, smoking, hypercholesterolemia). During an average of 2 years, follow-up BP, weight reduction, and smoking cessation remained statistically significant. Total cholesterol was unchanged. Over this period, the standardized mortality ratio (SMR) in the area for acute MI fell from 100 to 76 (P < 0.01), for CV disease from 129 to 107 (P < 0.0001), and for hypertension from 121 to 87 (P < 0.1 NS). The project saved many life-years at no additional net cost to society, and cost effectiveness analysis showed positive results. CONCLUSIONS: A community approach with mainly nonpharmacological treatment is feasible and cost effective in reducing CV morbidity and mortality.

Adolescent↗