NAASO 2007 Abstract 2
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The document describes a study that compared the effectiveness of a novel in-house intensive weight loss program (LOSE PLUS) to a commercial weight loss program (LOSE Too) for class III obese school employees. Eighty participants were randomly assigned to one of the two programs. Both programs included goal setting and weekly sessions for 6 months, with the option of weight loss medications after 16 weeks. While the dropout rate was higher for LOSE Too, both programs produced similar weight loss outcomes at 6 months. However, both programs were effective at reducing risks for diabetes and heart disease. The results suggest that behavioral intervention programs can effectively produce short-term weight loss for those who are severely obese. Further long-term study is recommended.
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New approaches to providing interventions.
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- After one week, participants experienced statistically significant weight loss of 7.5 lbs on average accompanied by decreased body fat percentage, waist circumference, and other measurements. Cholesterol and triglycerides also decreased significantly.
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The document discusses a study examining the physiological and behavioral correlates of baseline stages of change in a health program called the Health Plus Challenge for employees of the Polk County School District. The study found that stage of change for weight management was weakly correlated with exercise frequency and total health risk appraisal score. Stage of change for weight management was moderately correlated with other stages of change for diet, exercise, and stress. Biometric measures like BMI and body fat, as well as health risk appraisal scores, were poor predictors of stage of change for weight management.
Thinking About Success and Failure in Obesity Care
Even though obesity has officially been classified as disease by important groups like the American Medical Association, many people – doctors included – put all the emphasis on the scale and on other measures like body mass index (BMI). In this talk we will look at how success is measured now and other ways to define success after bariatric surgery. Time allowing, we will also talk about some of the long-term issues related to health and nutrition after bariatric surgery, with a focus on things that contribute to weight regain.
Weight loss 7
This study examined weight loss strategies used by overweight adults with type 2 diabetes participating in the Look AHEAD clinical trial. Less than half of participants self-weighed at least weekly. Participants ate breakfast most days but also ate several meals and snacks per day and almost two fast food meals per week on average. The most common weight control practices involved increasing fruits and vegetables or reducing sweets or high-carbohydrate foods. Self-weighing less than weekly, eating more fast food meals, and fewer breakfast meals were associated with higher BMI after controlling for other factors. Regular self-weighing and breakfast consumption along with limiting fast food were related to lower BMI.
PHSU practicum poster
This study assessed the impact of a care coordination program called livingwell CARES (LWC) on health outcomes for diabetic patients. Key findings include:
1) Patients in the LWC program experienced decreases over time in blood pressure, body mass index, LDL cholesterol, and HbA1c levels compared to the control group, indicating improved health.
2) There was a statistically significant difference in reduced diastolic blood pressure between the LWC and control groups.
3) Patients reported high satisfaction rates with the LWC program and its positive impact on their health.
Risck reduction programe for diabetes
This document outlines several diabetes risk reduction programs:
1. A quality improvement program at community health centers that significantly improved processes of care for diabetes and asthma but not outcomes.
2. A lifestyle intervention program and metformin treatment that both reduced incidence of type 2 diabetes, with lifestyle changes proving more effective.
3. A study finding that increased colonic propionate reduced brain responses to high-calorie foods and led to less food appeal and calorie intake.
4. A nutrition education program tailored for low-literacy adults that significantly improved fat-related knowledge and behaviors over general nutrition classes.
5. An online health promotion program for older workers that significantly improved diet and exercise self-effic
AOWMC-05-00134
The document discusses the emerging role of diet coaching in obesity treatment and weight management. It notes that while dietitians receive training in nutrition science, they often lack skills in behavior change and coaching needed to help clients maintain long-term weight loss and lifestyle changes. The document argues that dietitians should receive additional training in techniques like cognitive behavioral therapy, neuro-linguistic programming, and health coaching in order to more effectively promote sustainable behavior change and wellness among clients.
Diabetes prevention and control
Case management involves coordinating healthcare services for people with diabetes. The Task Force found strong evidence that diabetes case management improves glycemic control. Case management includes appointing a case manager to oversee services, assessing needs, developing care plans, implementing plans, and monitoring results. A review of 15 studies found case management reduced average HbA1c levels by 0.53% when combined with disease management and 0.40% without it. However, the evidence was insufficient to determine the effectiveness on other health outcomes.
Similar to NAASO 2007 Abstract 2 (20)
Thinking About Success and Failure in Obesity Care
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AHA NPAM EPI 2009 Abstract
A comprehensive wellness program was provided to school employees over two years that included health screenings, counseling, and educational interventions. Screenings of over 1,700 employees found improvements in cholesterol, LDL, triglycerides, and glucose levels after two screenings. The program cost $1.3 million but resulted in $2.3-3.1 million in healthcare cost savings, providing a return on investment of $1.72-$2.31 for every dollar spent. The results suggest such wellness programs can lower disease risk for employees while being cost effective.
AHA NPAM EPI 2007 Abstract
The study explored the relationship between metabolic syndrome risk factors, the Framingham Risk Score (FRS), and 10-year coronary heart disease risk (CHDR) in 73 extremely obese individuals. Triglycerides best predicted FRS, but the model fit was poor. A model including HDL, triglycerides, and waist circumference best predicted CHDR, accounting for slightly over half the variance. However, neither model was able to fully explain the variance, suggesting metabolic syndrome variables alone are not sufficient to accurately predict 10-year risk of myocardial infarction or coronary heart disease.
AACVPR 2002
The document presents a study that compares the accuracy of common clinical treadmill and arm ergometry equations in estimating oxygen consumption for males with coronary artery disease. Fifteen males with coronary artery disease underwent graded exercise tests on a treadmill and arm ergometer. Their measured oxygen consumption was compared to estimated values derived from popular estimation equations. The study found that the Bruce Cardiac Max equation provided the most accurate estimation of maximal oxygen consumption during treadmill exercise, while other equations over- or underestimated values.
NAASO October 2003
The study examined the relationship between body mass index (BMI) and coronary revascularization (CR) in 86 post-cardiac rehabilitation patients over 3.8 years on average. Discriminant function analysis revealed that only time since rehabilitation and diastolic blood pressure significantly predicted whether patients received CR, but not BMI, total cholesterol, or systolic blood pressure. The results suggest BMI may not be an important factor in predicting if post-cardiac rehab patients receive further CR procedures.
NAASO 2005 Power Point
This study conducted a two-year intervention program aimed at reducing risk factors for diabetes and cardiovascular disease among employees. It found favorable shifts in biometrics after two years for most modifiable risk factors. The pilot group had average yearly health claims costs that were $613 and $498 lower than other employees, translating to savings of over $1 million each year. The results suggest the targeted intervention programs were effective at reaching goals of reducing risk factors and healthcare costs.
NAASO 2007 Abstract 1
This study compared two equations, the Mifflin-St. Jeor (MSJ) equation and the de Luis equation, for predicting resting energy expenditure (REE) in class III obese individuals against measurements from indirect calorimetry. The study found that while both equations were correlated with measured REE, only the MSJ equation was significantly different. The de Luis equation may therefore be more accurate for predicting REE in class III obese individuals when indirect calorimetry is not available. The study measured height, weight, and waist circumference in 40 class III obese subjects to calculate predicted REE using the two equations and compare to REE measured via indirect calorimetry.
NAASO 2006 Abstract
This document summarizes a study examining the physiological and behavioral correlates of baseline stages of change in the Health Plus Challenge program. The study found that among 1532 program participants with a mean age of 47 and BMI of 32, stage of change for weight management had only a moderate correlation with exercise levels. All other factors, including BMI, failed to reach a reasonable level of correlation with stage of change. This suggests that factors other than stage of change need to be considered to explain the observed reduction in body mass in this population.
ACSM 2005
This study examined the effects of low and high intensity endurance exercise training on the apolipoprotein-B/apolipoprotein-A1 ratio in 26 hypercholesterolemic men over 24 weeks. The men were randomly assigned to either high intensity (80% maximal oxygen uptake) or moderate intensity (50% maximal oxygen uptake) exercise training three days per week. The apolipoprotein-B/apolipoprotein-A1 ratio did not significantly change from baseline in either group over the 24 weeks. While exercise training did not alter this risk ratio, the ratios for both groups exceeded the recommended level of 0.5 or less, suggesting an elevated risk of myocardial infarction.
AACVPR 2002 Presentation
1) The study examined the validity of an equation to predict VO2 max using self-reported exercise frequency for elderly cardiac patients by comparing it to three other VO2 max prediction equations.
2) The results found the predicted VO2 max was similar to two equations but significantly overestimated VO2 max compared to the most accurate equation for cardiac patients.
3) Due to the overestimation and issues with self-reported exercise frequency, the validity of using the prediction equation in elderly cardiac patients requires further study.
AACVPR 2002
Twenty-four elderly cardiac patients were asked about their weekly vigorous exercise to predict maximal oxygen uptake (VO2max) using an equation from Ainsworth et al. This predicted VO2max was compared to values from three other equations from Milani et al. No differences in males and females were found. The predicted VO2max and values from two equations overestimated VO2max compared to the most accurate equation for cardiac patients from Milani et al. This suggests the validity of using the Ainsworth equation to predict VO2max in elderly cardiac patients requires further study due to potential overestimation compared to measured values.
AACVPR 2006
This study examined waist-to-tallness ratio (WTR) as a marker for cardiovascular disease (CVD) risk in 887 adults. The results found that both male and female WTR met or exceeded proposed cut-off points suggesting increased CVD risk, despite waist circumference being below thresholds. Males had higher BMI, blood pressure, and WTR than females. Additionally, WTR alone may not adequately predict overall CVD risk, and gender differences should be considered in primary prevention programs to reduce CVD risk.
AACVPR 2003
This study examined the relationship between the number of years since completing a cardiac rehabilitation program and the frequency of vigorous aerobic exercise in 731 former patients. The results showed that a greater number of years since completing the program significantly predicted a higher frequency of weekly exercise. Specifically, patients who had completed the program 8 years ago exercised significantly more frequently per week than those who had completed it 1 year ago. However, the average amount and intensity of exercise was still below recommended levels to reverse coronary artery disease. More research is needed to develop interventions to further increase physical activity after cardiac rehabilitation.
AACVPR 2006
This study examined waist-to-tallness ratio (WTR) as a marker for cardiovascular disease (CVD) risk in 887 adults. Both males and females were found to have increased CVD risk based on previous WTR cut-off points, despite waist circumference being below current cut-offs. Male WTR was greater than the cut-off point and associated with higher BMI, blood pressure, whereas female WTR equaled the cut-off point. The results suggest WTR alone may not adequately predict overall CVD risk and that gender differences should be considered in prevention strategies.
AACVPR 2000
The document summarizes a study that examined changes in physical activity levels following an intensive cardiac risk intervention program. The study found that (1) physical activity, moderate activity, and high intensity activity all increased significantly after the 12-week program, but (2) began declining again by the 6-month and 1-year follow-ups, with high intensity activity declining more rapidly than moderate activity. (3) The results suggest it is important for exercise prescriptions for cardiac patients to consider the type of physical activity, whether high or moderate intensity, to help maintain compliance long-term.
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NAASO 2007 Abstract 2
- 1. A Novel Weight Loss Program for Class III Obese School Employees Page 1 of 1 Print this Abstract A Novel Weight Loss Program for Class III Obese School Employees ROBERT LOWE, JENNIFER PATZKOWSKY Polk County School employees are 68% overweight and obese, while 35% are classified as obese and 19% are classified as extremely obese. PURPOSE: To compare the effectiveness of a novel weight loss program designed for Class III obese school employees to a similar group of employees who chose a self-selected commercial weight loss program. METHODS: Eighty participants (47.5±9 yrs; BMI=41.7±10) were randomly selected from a pool of applicants meeting the following criteria: BMI ≥ 30 or BMI ≥ 27 with 2 or more co-morbidities (HTN, dyslipidemia, DM, CAD, stroke, and OA). Forty participants were randomly assigned to either a commercial weight loss group (LOSE Too; LT) or to an in-house intensive weight loss program (LOSE PLUS; LP). Biometrics were measured at baseline and 6 months. All Participants received goal setting and were required to attend 16 weekly sessions followed by monthly sessions thereafter in order to be eligible for weight loss medications (MEDS). Fifteen participants were prescribed MEDS (n=11, LT and n=4, LP). The LP group kept diet and exercise logs, wore pedometers, and received weekly feedback regarding their progress. The LT group followed the recommendations of their chosen commercial weight loss program (Weight Watchers, TOPS, LA Weight Loss, or Jenny Craig). Comparisons between groups were explored by t-test; Pearson correlation was utilized to describe relationships among the selected variables. RESULTS: No differences were noted at baseline between groups for any variable (p>0.05). The dropout rate was 25% for LP and 42% for LT at 6 months. The LP attended 80% and the LT attended 85% of the required classes; class attendance did not influence weight loss (p>0.05). There was no correlation between taking weight loss drugs and weight loss at 6 months for either group (p>0.05). There were no significant differences between LP and LT for any variable at 6 months. CONCLUSIONS: Following a 6 month program of behavioral intervention both LP and LT produced similar outcomes. However, both LP and LT experienced reductions in DM and CAD risk. These results suggest that programs which include a strong behavioral component are effective in producing weight loss in the short-term. Further study is recommended to explore possible long-term benefits. http://www.softconference.com/naaso/abstract.asp?SID=98798 10/12/2008