ABSTRACT
ABSTRACT Introduction Disparate to the development of society, health indices in Chinese college students have shown a pronounced decline in recent years. Government concern over this recent challenge has encouraged research for practical solutions, including optimized physical activity protocols. Objective Explore the effects of an exercise intervention on the health of Chinese university students. Methods Full-time university students (80 males and 55 females) were selected and randomly assigned into two groups. Before and after the experiment, the college students' body composition scale and exercise experience were tested, focusing on the relationship between exercise prescription and changes in physical and mental health indicators. Results The body fat percentage of male and female students decreased significantly after the experiment. After eight weeks of the exercise prescription experiment, the weight of male and female college students was controlled or reduced. The suggested exercise prescription achieved a good moderating effect on the weight of the volunteers. There was a significant difference between the two groups, indicating that the experiment had a beneficial effect on vital capacity (p<0.01). Conclusion The suggested exercise prescription proved to be feasible to guide and intervene in the physical exercise of college students aiming at a beneficial impact on the physical health of college students. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução Díspares ao desenvolvimento da sociedade, os índices de saúde nos estudantes universitários chineses apresentam uma queda acentuada nos últimos anos. A preocupação governamental sobre esse recente desafio tem incentivado pesquisas para soluções práticas, incluindo protocolos de atividades físicas otimizados. Objetivo Explorar os efeitos da intervenção por exercícios físicos na saúde dos estudantes universitários chineses. Métodos Universitários de período integral (80 homens e 55 mulheres) foram selecionados e distribuídos aleatoriamente em dois grupos. Antes e depois do experimento, foi testada a escala de composição corporal e experiência de exercício dos universitários, com foco na relação entre prescrição de exercício e mudanças nos indicadores de saúde física e mental. Resultados O percentual de gordura corporal de estudantes do sexo masculino e feminino diminuiu significativamente após o experimento. Após 8 semanas de experimento de prescrição de exercícios, o peso de estudantes universitários do sexo masculino e feminino foi controlado ou reduzido. A prescrição de exercícios sugerida alcançou um bom efeito moderador no peso dos voluntários. Houve diferença significativa entre os dois grupos, indicando que o experimento teve efeito benéfico sobre a capacidade vital (p<0,01). Conclusão A prescrição de exercícios sugerida demonstrou-se viável para orientar e intervir no exercício físico dos universitários visando um impacto benéfico sobre a saúde física nos universitários. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción A diferencia del desarrollo de la sociedad, los índices de salud de los estudiantes universitarios chinos muestran un fuerte descenso en los últimos años. La preocupación de los gobiernos por este reciente desafío ha fomentado la investigación de soluciones prácticas, entre ellas la optimización de los protocolos de actividad física. Objetivo Explorar los efectos de la intervención de ejercicio en la salud de los estudiantes universitarios chinos. Métodos Se seleccionaron estudiantes universitarios a tiempo completo (80 hombres y 55 mujeres) y se asignaron al azar en dos grupos. Antes y después del experimento, se analizó la escala de composición corporal de los estudiantes universitarios y su experiencia con el ejercicio, centrándose en la relación entre la prescripción de ejercicio y los cambios en los indicadores de salud física y mental. Resultados El porcentaje de grasa corporal de los estudiantes masculinos y femeninos disminuyó significativamente después del experimento. Tras 8 semanas del experimento de prescripción de ejercicio, el peso de los estudiantes universitarios de ambos sexos se controló o redujo. La prescripción de ejercicio sugerida logró un buen efecto moderador en el peso de los voluntarios. Hubo una diferencia significativa entre los dos grupos, lo que indica que el experimento tuvo un efecto beneficioso sobre la capacidad vital (p<0,01). Conclusión La prescripción de ejercicio sugerida demostró ser factible para guiar e intervenir en el ejercicio físico de los estudiantes universitarios apuntando a un impacto beneficioso en la salud física de los estudiantes universitarios. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
Subject(s)
Humans , Male , Female , Student Health Services , Exercise Therapy , Obesity/therapy , Weight Loss , Body Mass Index , Case-Control StudiesABSTRACT
ABSTRACT Introduction: The unregulated development in the current life pattern has strengthened obesity among adolescents, and this problem is becoming more serious. Objective: Compare the impact of two exercise methods on the physical health of obese adolescents. Methods: 24 obese adolescents (12 females; BMI>30% ± 3%; age concentrated between 10 and 16 years) were selected and divided into group I and group II for a 4-week experimental study, and changes in physical fitness and function were recorded. Results: After four weeks of aerobic exercise control (group I), waist circumference, hip circumference, skinfold thickness, and abdominal fold thickness were significantly reduced in boys (p<0.05), and girls' body shape indicators were significantly altered (p<0.05). After four weeks of aerobic exercise combined with resistance training (group II), the effects of weight, BMI, and body size were significant in boys and girls. Conclusion: Aerobic exercise can effectively improve the physical problems of obese adolescents. Under the same external conditions, the effect of aerobic exercise was shown to be more effective when combined with resistance training in the physical improvement of the analyzed group. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução: O desenvolvimento desregrado no padrão de vida atual fortaleceu a obesidade entre os adolescentes e esse problema está se tornando cada vez mais grave. Objetivo: Comparar o impacto entre dois métodos de exercício na saúde física de adolescentes obesos. Métodos: Foram selecionados 24 adolescentes obesos (12 mulheres; IMC>30% ± 3%; idade concentrada entre 10 e 16 anos) e divididos no grupo I e no grupo II para um estudo experimental de 4 semanas, sendo registradas as alterações no condicionamento e função física. Resultados: Após 4 semanas de controle de exercício aeróbico (grupo I), a circunferência da cintura, circunferência do quadril, espessura da dobra cutânea e espessura da dobra abdominal foram significativamente reduzidas em meninos (p<0,05), e os indicadores de forma corporal das meninas foram significativamente alterados (p<0,05). Após 4 semanas de exercício aeróbico combinado com treinamento de resistência (grupo II), os efeitos do peso, IMC e tamanho do corpo foram significativos em meninos e meninas. Conclusão: O exercício aeróbico pode melhorar efetivamente os problemas físicos dos adolescentes obesos. Sob as mesmas condições externas, o efeito do exercício aeróbico demonstrou-se mais eficaz quando aliado ao treinamento de resistência na melhoria física do grupo analisado. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción: El desarrollo desordenado en el patrón de vida actual ha potenciado la obesidad entre los adolescentes y este problema es cada vez más grave. Objetivo: Comparar el impacto de dos métodos de ejercicio en la salud física de adolescentes obesos. Métodos: Se seleccionaron 24 adolescentes obesos (12 mujeres; IMC>30% ± 3%; edad concentrada entre 10 y 16 años) y se dividieron en el grupo I y el grupo II para un estudio experimental de 4 semanas, y se registraron los cambios en la aptitud física y la función. Resultados: Después de 4 semanas de control de ejercicio aeróbico (grupo I), la circunferencia de la cintura, la circunferencia de la cadera, el grosor de los pliegues cutáneos y el grosor de los pliegues abdominales se redujeron significativamente en los niños (p<0,05), y los indicadores de la forma corporal de las niñas se alteraron significativamente (p<0,05). Tras 4 semanas de ejercicio aeróbico combinado con entrenamiento de resistencia (grupo II), los efectos del peso, el IMC y el tamaño corporal fueron significativos en chicos y chicas. Conclusión: El ejercicio aeróbico puede mejorar eficazmente los problemas físicos de los adolescentes obesos. En las mismas condiciones externas, el efecto del ejercicio aeróbico se mostró más eficaz cuando se combinó con el entrenamiento de resistencia en la mejora física del grupo analizado. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
Subject(s)
Humans , Male , Female , Adolescent , Exercise Therapy/methods , Obesity/therapy , Weight Loss , Body Mass Index , Inspiratory Capacity , Arterial Pressure/physiology , Heart Rate/physiologyABSTRACT
Nos últimos anos, a obesidade vem aumentando consideravelmente entre adultos e crianças e, segundo a OMS, estima-se que em 2025 o número de obesos ultrapasse a 2,3 milhões em todo o mundo. O indivíduo obeso apresenta maiores riscos de desenvolver doenças crônicas não transmissíveis, como diabetes, doenças cardiovasculares, dislipidemias e ainda alguns tipos de cânceres. O tratamento para a obesidade é variado e inclui mudanças no estilo de vida como: hábitos alimentares e prática de atividade física, tratamento medicamentoso, cirurgia bariátrica e fitoterápicos com o potencial de auxiliar no tratamento. O objetivo deste trabalho foi realizar uma revisão bibliográfica a fim de avaliar os benefícios da utilização de medicamentos fitoterápicos como auxiliar no tratamento da obesidade, seus principais ativos, mecanismos de ação e sua utilização popular. Dentre as plantas pesquisadas e que demonstraram potencial para atuar no tratamento da obesidade encontram-se Camelia sinensis, Citrus aurantium, Hibiscus sabdariffa, Coffea arabica, Ephedra sinica, Zingiber oficinale e Senna alexandrina. Os principais mecanismos de ação envolvidos no potencial anti-obesidade das plantas medicinais são a capacidade de controle do apetite e ingestão de energia, estímulo da termogênese, inibição da lipase pancreática e redução da absorção de gordura, diminuição da lipogênese e aumento da lipólise. Desta forma, conclui-se que as plantas selecionadas neste estudo apresentaram efeitos positivos nos parâmetros bioquímicos e físicos, podendo ser incluídas nos protocolos como coadjuvantes nos tratamentos de emagrecimento.
In recent years, obesity has increased considerably among adults and children and according to the WHO, it is estimated that in 2025 the number of obese people will exceed 2.3 million worldwide. The obese individual is at greater risk of developing non-communicable chronic diseases, such as diabetes, cardiovascular disease, dyslipidemia and even some types of cancer. The treatment for obesity is varied, including changes in lifestyle such as eating habits and physical activity, drug treatment, bariatric surgery and phytotherapy with the potential to aid in the treatment. The objective of this work was to carry out a literature review, evaluating the benefits of using herbal medicines as an aid in the treatment of obesity, their main assets, mechanisms of action and their popular use. Among the plants researched and that have shown potential to act in the treatment of obesity are Camelia sinensis, Citrus aurantium, Hibiscus sabdariffa, Coffea arabica, Ephedra sinica, Zingiber officiale and Senna alexandrina. The main mechanisms of action involved in the antiobesity potential of medicinal plants are the ability to control appetite and energy intake, thermogenesis stimulation, pancreatic lipase inhibition and reduction of fat absorption, lipogenesis decrease and lipolysis increase. Thus, it is concluded that the plants selected in this study showed positive effects on biochemical and physical parameters, and can be included in the protocols as adjuvants in weight loss treatments.
En los últimos años, la obesidad ha aumentado considerablemente entre adultos y niños y, según la OMS, se estima que en 2025 el número de obesos superará los 2,3 millones en todo el mundo. Los individuos obesos tienen un mayor riesgo de desarrollar enfermedades crónicas no transmisibles, como la diabetes, las enfermedades cardiovasculares, las dislipidemias e incluso algunos tipos de cáncer. El tratamiento de la obesidad es variado e incluye cambios en el estilo de vida como: hábitos alimenticios y práctica de actividad física, tratamiento farmacológico, cirugía bariátrica y medicamentos a base de hierbas con potencial para ayudar en el tratamiento. El objetivo de este trabajo fue realizar una revisión bibliográfica para evaluar los beneficios del uso de las hierbas medicinales como ayuda en el tratamiento de la obesidad, sus principales activos, mecanismos de acción y su uso popular. Entre las plantas investigadas y que mostraron potencial para actuar en el tratamiento de la obesidad están Camelia sinensis, Citrus aurantium, Hibiscus sabdariffa, Coffea arabica, Ephedra sinica, Zingiber oficinale y Senna alexandrina. Los principales mecanismos de acción implicados en el potencial antiobesidad de las plantas medicinales son la capacidad de controlar el apetito y la ingesta de energía, estimular la termogénesis, inhibir la lipasa pancreática y reducir la absorción de grasas, disminuir la lipogénesis y aumentar la lipólisis. Por lo tanto, se concluye que las plantas seleccionadas en este estudio mostraron efectos positivos sobre los parámetros bioquímicos y físicos, y pueden ser incluidas en los protocolos como coadyuvantes en los tratamientos de pérdida de peso.
Subject(s)
Phytotherapeutic Drugs , Obesity/therapy , Plants, Medicinal/drug effects , Tea/drug effects , Weight Loss/drug effects , Citrus/drug effects , Ginger/drug effects , Overweight/therapyABSTRACT
Introduction: Bariatric surgery is considered the most effective obesity treatment. Obese patients have a high prevalence of eating disorders. Objectives: Evaluate the occurrence of eating disorders and eating patterns in candidates for bariatric surgery and associate eating disorders with sociodemographic and clinical characteristics. Methods: A retrospective study was conducted using electronic charts of candidates for bariatric surgery. Data were collected on sex, age, marital status, schooling, occupation, non-communicable diseases, body mass index (BMI), eating disorders, and eating patterns. Results: Among the 281 patients evaluated, eating disorders were detected in 26.7%; 10.3% had binge eating disorder, 6.6% had bulimia nervosa, and 5.3% had the night-eating syndrome. The specific eating patterns were overeating (46.6%), binge eating during periods of stress (9.3%), eating sweets (4%), and snaking (1.3%). BMI ranged from 35.38 to 59.03 kg/m² (mean: 44.37 ± 5.89). All individuals (100%) had systemic arterial hypertension, and 23.3% had type 2 diabetes mellitus or dyslipidemia. Conclusions: The frequency of eating disorders was low in the sample studied, the most common of which was binge eating disorder. Non-communicable diseases were associated with eating disorders. Among the eating patterns observed, the most frequent was overeating (AU)
Introdução: A cirurgia bariátrica é considerada o tratamento mais eficaz para a obesidade. Pacientes obesos possuem elevada prevalência de transtornos alimentares. Objetivos: Avaliar a presença de transtornos alimentares e padrões alimentares em candidatos à cirurgia bariátrica, associando os transtornos alimentares aos dados sociodemográficos e clínicos. Métodos: Estudo retrospectivo de cunho documental, com base em prontuários eletrônicos de pacientes candidatos à cirurgia bariátrica. Foram obtidas variáveis como sexo, idade, estado civil, nível de escolaridade, ocupação, doenças crônicas não transmissíveis, índice de massa corporal (IMC), transtorno e padrão alimentar. Resultados: Dos 281 pacientes avaliados, foi detectado 26,7% de transtornos alimentares, sendo 10,3% transtorno de compulsão alimentar periódica, 6,6% de bulimia nervosa e 5,3% de síndrome do comer noturno. Os padrões alimentares específicos encontrados foram: glutões (46,6%), compulsivos alimentares em períodos de estresse (9,3%), comedores de doces (4%) e beliscadores (1,3%). O IMC variou de 35,38 a 59,03 kg/m² (44,37±5,89), com 100% do grupo apresentando Hipertensão Arterial Sistêmica e 23,3% com Diabetes Mellitus tipo 2 ou dislipidemia. Conclusões: Constatou-se baixa frequência de transtornos alimentares na amostra estudada, sendo o transtorno de compulsão alimentar periódica o mais observado. Doenças crônicas não transmissíveis foram associadas com a presença de transtornos alimentares. Dentre os padrões alimentares observados, os glutões foram os mais frequentes (AU)
Subject(s)
Humans , Bariatric Surgery/psychology , Binge-Eating Disorder/epidemiology , Obesity/therapyABSTRACT
Introducción: A nivel global ha existido un incremento en el peso corporal. Ante ello, se han implementado programas para diagnosticar y tratar la obesidad. Se requiere documentar si dichos programas han propiciado que las personas con obesidad reciban diagnóstico y tratamiento eficaz. Objetivo: Determinar y comparar los cambios entre 2006 y 2018 en las prevalencias de diagnóstico y tratamiento de la obesidad y pérdida intencional de peso en adultos mexicanos e identificar si en este periodo existieron cambios en las disparidades sociales en dichos eventos. Materiales y métodos: Se analizaron las bases de datos de la Encuesta Nacional de Salud y Nutrición de México realizada en 2006 (N=26.738) y 2018 (N= 12.205), Los eventos fueron diagnóstico y tratamiento de obesidad y de pérdida intencional de peso en adultos mexicanos con IMC > 30. Las variables independientes fueron: sexo, edad, índice de masa corporal, nivel socioeconómico y región geográfica. Resultados: De 2006 a 2018, aumentó la prevalencia de personas con obesidad que recibieron diagnóstico (de 20,4% a 51,1%) o tratamiento (de 8,3% a 21,4%). La prevalencia de pérdida intencional de peso también aumentó (de 5,5% a 10,0%), pero esto básicamente ocurrió en las personas con nivel socioeconómico alto. En modelos multivariados se observó que, las mujeres, las personas con mayor IMC y quienes tenían mayor nivel socioeconómico tuvieron mayor probabilidad de recibir diagnóstico y tratamiento. Conclusiones: Aunque en México el acceso a diagnóstico y tratamiento a la obesidad se ha incrementado, la prevalencia de pérdida intencional de peso es baja, además, persisten disparidades socioeconómicas en estos eventos(AU)
Introduction: Worldwide, there has been an increase in body weight. Because of this, programs have been implemented to diagnose and treat obesity. It is required to document whether these programs have led people with obesity to receive effective diagnosis and treatment. Objective: To determine and compare the changes between 2006 and 2018 in the prevalences of diagnosis and treatment of obesity and intentional weight loss among Mexican adults and to identify whether there were changes in the social disparities in these events during this period. Materials and methods: The databases of the National Health and Nutrition Survey of Mexico carried out in 2006 (N=26,738) and 2018 (N= 12,205) were analyzed. The events were diagnosis and treatment of obesity and intentional weight loss in Mexican adults with BMI > 30. The independent variables were sex, age, body mass index, socioeconomic status, and geographic region. Results: From 2006 to 2018, the prevalence of people with obesity who received the diagnosis (from 20.4% to 51.1%) or treatment (from 8.3% to 21.4%) increased. The prevalence of intentional weight loss also increased (from 5.5% to 10.0%), but this was mainly in people with high socioeconomic status, Multivariate regression models revealed that, women, people with a higher BMI, and those with a higher socioeconomic status were more likely to receive diagnosis and treatment. Conclusions: Although in Mexico access to diagnosis and treatment of obesity has increased, the prevalence of intentional weight loss is low,In addition, socioeconomic disparities persist in these events(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Weight Loss , Obesity/diagnosis , Obesity/therapy , Socioeconomic Factors , Body Weight , Body Mass Index , Overweight , Sociodemographic FactorsABSTRACT
Theoretically, a new diagnosis of type 2 diabetes mellitus (T2DM) requires a dramatic change in an individual's way of life. Weight loss and physical activity can lead to remission of diabetes, which has been associated with a lower risk of developing complications. Today, the importance of a healthy lifestyle is further highlighted by data showing that obesity and diabetes increase the risk of severe complications from coronavirus disease 2019. However, remission rarely occurs in reality, probably due to the inability of people with T2DM to adhere to the intensive lifestyle interventions that are necessary. The complexity of contributing factors may explain why making these changes is so challenging and underscore the fact that there is no magical solution for T2DM. Instead, hard work from both patients and health care providers is needed for the conversion to be achieved. This article calls for more research on the underlying reasons why adhering to a healthy way of life is so difficult for people with diabetes and obesity. Clearly defining these barriers would facilitate the planning of effective policies to promote the adoption of appropriate lifestyle changes early in the course of the disease.
Subject(s)
COVID-19 , Diabetes Mellitus, Type 2/therapy , Exercise , Humans , Life Style , Obesity/therapyABSTRACT
Abstract Aim: This quasi-experimental study, analyzes if periodized combined training's influence on plasma cytokine levels, muscle strength, and cardiorespiratory fitness in physically active women with overweight and/or obesity over 50 years. Methods: The sample was composed of 33 physically active women who were randomly allocated to three groups: Non-Periodized (NP) (n = 11); Undulating Periodization (UP) (n = 9); and Flexible Undulating Periodization (FUP) (n = 13). This study was conducted for 17 weeks, which included adaptation (weeks 1-3), baseline testing (week 4), training program (weeks 5-16), and post-evaluation (week 17). The training frequency comprised of three weekly sessions, with 30 min of aerobic exercise and 45 min of strength exercises. The data were analyzed using descriptive statistics and analysis of variance. The level of significance was p ≤ 0.05. Results: No differences were observed in weight parameters, plasma levels of cytokines, and biochemical parameters in any group, before and after the completion of the training period. Participants demonstrated increase in strength of the upper limbs in the UP (p = 0.032) and FUP (p = 0.021) groups, an increase in aerobic fitness in the NP (p = 0.041) and UP (p = 0.005) groups, and an increase in the amount of time of vigorous activity per week in the NP group (p = 0.019). Conclusion: This study shows that periodized combined training in physically active women with overweight and/or obesity over 50 years proved to be beneficial for all groups; although, the UP group exhibited better performance.
Subject(s)
Humans , Female , Middle Aged , Aged , Aging/physiology , Circuit-Based Exercise/instrumentation , Cardiorespiratory Fitness/physiology , Obesity/therapy , Analysis of Variance , Non-Randomized Controlled Trials as Topic/instrumentationSubject(s)
Humans , Male , Female , Adult , Middle Aged , Body Weight/drug effects , Glucagon-Like Peptides/administration & dosage , Glucagon-Like Peptides/agonists , Overweight/drug therapy , Liraglutide/administration & dosage , Hypoglycemic Agents/administration & dosage , Obesity/drug therapy , Patient Dropouts/statistics & numerical data , Placebos/administration & dosage , United States , Drug Administration Schedule , Weight Loss , Randomized Controlled Trials as Topic , Multicenter Studies as Topic , Treatment Outcome , Clinical Trials, Phase III as Topic , Diabetes Mellitus , Glucagon-Like Peptides/adverse effects , Overweight/therapy , Liraglutide/adverse effects , Hypoglycemic Agents/adverse effects , Injections, Subcutaneous , Obesity/therapyABSTRACT
OBJECTIVE@#To explore the therapeutic effect and safety of acupoint thread embedding therapy in treatment of simple obesity of stomach heat and damp obstruction.@*METHODS@#A total of 144 patients with simple obesity of stomach heat and damp obstruction were randomized into an acupoint thread embedding group (72 cases, 3 cases dropped off and 1 case removed) and a sham-embedding group (72 cases, 6 cases dropped off and 3 cases removed). On the base of the lifestyle adjustment, the acupoint thread embedding therapy with PGLA thread was applied to Tianshu (ST 25), Zhongwan (CV 12), Ganshu (BL 18), Shuidao (ST 28), etc. in the acupoint thread embedding group, while in the sham-embedding group, the acupoint selection and operation were all same as the acupoint thread embedding group, but without PGLA thread embedded. In either group, the treatment was given once every 2 weeks, consecutively for 12 weeks and the follow-up was conducted for 3 months after treatment. Separately, before and after treatment as well as in follow-up, the obesity indices (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR] and fat percentage [F%]) were observed in the two groups. Before and after treatment, the indices of blood glucose and insulin (fasting blood glucose [FBG], fasting insulin [FINS] and insulin resistance index [HOMA-IR]), adipocyte factor indices (adiponectin, leptin [LP] and serine protease inhibitor [Vaspin]) and inflammatory factor indices (tumor nercosis factor [TNF-α], interleukin-1β [IL-1β] and interleukin-6 [IL-6]) were observed separately in the two groups. The therapeutic effect and safety were compared between the two groups.@*RESULTS@#After treatment and in follow-up, except WC and WHR in the sham-embedding group, BMI, WC, WHR and F% were all reduced as compared with those before treatment in the two groups (P<0.01, P<0.05), and the values in the acupoint thread embedding group were lower than the sham-embedding group (P<0.01). After treatment, except FBG, LP and Vaspin in the sham-embedding group, FBG, FINS, HOMA-IR, LP and Vaspin were all reduced as compared with those before treatment in the two groups (P<0.01, P<0.05), and adiponectin was increased as compared with that before treatment (P<0.01, P<0.05); the improvements in the acupoint thread embedding group were more significant than the sham-embedding group (P<0.01). After treatment, the levels of serum TNF-α, IL-1β and IL-6 in the acupoint thread embedding group were reduced as compared with the values before treatment and those in the sham-embedding group separately (P<0.01). The total effective rate was 89.7% (61/68) in the acupoint thread embedding group, higher than 19.0% (12/63) in the sham-embedding group (P<0.01). There was no severe adverse reaction reported in the two groups.@*CONCLUSION@#Acupoint thread embedding therapy with PGLA thread can alleviate obesity, regulate glucose metabolism and adipocyte factors activity, improve insulin resistance and inhibit the expression of pro-inflammatory factors in the patients with simple obesity with stomach heat and damp obstruction, and this therapy presents a satisfactory safety in treatment.
Subject(s)
Acupuncture Points , Acupuncture Therapy , Body Mass Index , Hot Temperature , Humans , Obesity/therapy , StomachABSTRACT
ABSTRACT Objective: To investigate the effects of an interdisciplinary intervention on biomarkers of inflammation and their relationship with fibroblast growth factor 21 (FGF21) concentrations in women with overweight and obesity. Subjects and methods: Thirty-one women were enrolled in a 12-week interdisciplinary weight loss program delivered by a team comprising an endocrinologist, nutritionist and exercise physiologist. Body composition; anthropometric measures; metabolic and inflammatory markers including adiponectin, leptin, and atrial natriuretic peptide (ANP) were assessed at baseline and post-therapy. The homeostasis model assessment of insulin resistance (HOMA-IR) and the homeostasis model assessment of adiponectin (HOMA-AD) were calculated. The participants were divided into two groups: those with increased FGF21, and those with decreased FGF21. Results: The sample comprised women aged 32 ± 5 years with a body mass index of 33.64 ± 3.49 kg/m2. Body weight, waist circumference and leptin concentration were decreased in the whole sample after therapy. However, only the group with an increase in FGF21 concentration presented significant improvements in adiponectin concentration and adiponectin/leptin ratio. Moreover, although there was a reduction of leptin in both groups, it was greater in the increased FGF21 groups. There was a reduction in ANP in the decreased FGF21 group. Conclusions: Changes in FGF21 concentrations were different among the women participating in the weight loss program, with some having increased levels and some reduced levels. Furthermore, improvements in adiponectin and the adiponectin/leptin ratio were found only in the group with increased FGF21 concentration.
Subject(s)
Humans , Female , Adult , Weight Reduction Programs , Obesity/therapy , Insulin Resistance , Biomarkers/blood , Body Mass Index , Leptin , Adiponectin , Fibroblast Growth Factors/bloodABSTRACT
Contexto: As práticas de atividade física são fortes aliadas na redução dos riscos à saúde, bem como no tratamento de doenças. Destaca-se sua relevância no cuidado a pessoas com doenças crônicas não transmissíveis, para as quais é importante investir na qualidade de vida. Esta revisão rápida aborda os efeitos não-clínicos das intervenções de atividade física em pessoas com diabetes mellitus tipo 2, hipertensão arterial sistêmica e sobrepeso/obesidade. Pergunta: Quais são os efeitos não-clínicos de diferentes modalidades de atividade física no tratamento de pessoas com diabetes, hipertensão ou obesidade? Métodos: Seguindo protocolo prévio, foram realizadas buscas por revisões sistemáticas (RS) em oito bases eletrônicas da literatura, em setembro de 2021. Nesta revisão rápida foram incluídas RS publicadas nos últimos 10 anos, com algumas especificações quanto a contexto e população. Apenas o processo de seleção foi realizado em duplicata e de forma independente. A avaliação da qualidade das RS foi feita por um revisor e checada por outro, por meio da ferramenta AMSTAR 2. Os resultados foram reunidos em síntese narrativa conforme similaridade do tipo de atividade física e população. Resultados: De 4.421 relatos encontrados nas bases de dados, 23 RS foram incluídas após processo de seleção e elegibilidade. Na avaliação da qualidade metodológica, uma RS foi considerada de confiança moderada, uma de confiança baixa e as demais de confiança criticamente baixa. As revisões apresentaram resultados de exercícios aeróbicos, anaeróbicos, combinados e de tipo não informado, envolvendo pessoas com diabetes mellitus tipo 2, hipertensão arterial sistêmica e sobrepeso/obesidade. O tipo de atividade mais presente foi de exercícios aeróbicos e a condição mais estudada foi diabetes mellitus tipo 2. Apenas uma RS apresentou informação a respeito da segurança da prática de atividade física, sem ocorrência de eventos adversos. Diversas modalidades de atividade física mostraram promover benefícios não-clínicos no tratamento de pessoas com diabetes, hipertensão e obesidade. Considerações finais: As evidências indicam que pessoas com diabetes ou hipertensão podem ter sua qualidade de vida melhorada com a prática de exercícios, em especial os aeróbicos. Para pessoas com obesidade ou comorbidades, as evidências são menos robustas. É importante levar em consideração algumas incertezas apontadas pelas RS, bem como as falhas metodológicas da maioria dessas RS.
Context: Physical activity practices are strong allies in reducing health risks, as well as in the treatment of diseases. Its relevance in the care of people with non-communicable chronic diseases is highlighted, for whom it is important to invest in quality of life. This rapid review addresses the non-clinical effects of physical activity interventions in people with type 2 diabetes mellitus, systemic arterial hypertension, and overweight/obesity. Question: What are the non-clinical effects of different physical activity modalities in the treatment of people with diabetes, hypertension or obesity? Methods: Following a previous protocol, searches for systematic reviews (SR) were carried out in eight electronic databases of the literature, in September 2021. This rapid review included SRs published in the last 10 years, with some specifications regarding context and population. Only the selection process was carried out in duplicate and independently. The evaluation of the quality of the SRs was carried out by one reviewer and checked by another, using the AMSTAR 2 tool. The results were gathered in a narrative synthesis according to the similarity of the type of physical activity and population. Results: Of the 4,421 reports found in the databases, 23 SRs were included after the selection and eligibility process. In the evaluation of methodological quality, one SR was considered moderately reliable, one of low confidence and the others of critically low confidence. The reviews presented results of aerobic, anaerobic, combined and unreported exercises involving people with type 2 diabetes mellitus, systemic arterial hypertension and overweight/obesity. The most common type of activity was aerobic exercises and the most studied condition was type 2 diabetes mellitus. Only one SR presented information about the safety of physical activity, without the occurrence of adverse events. Several modalities of physical activity have been shown to promote non-clinical benefits in the treatment of people with diabetes, hypertension and obesity. Final considerations: The evidence indicates that people with diabetes or hypertension can have their quality of life improved with the practice of exercises, especially aerobic ones. For people with obesity or comorbidities, the evidence is less robust. It is important to take into account some uncertainties pointed out by the SRs, as well as the methodological flaws of most of these SRs.
Subject(s)
Humans , Exercise , Diabetes Mellitus/therapy , Hypertension/therapy , Obesity/therapy , Quality of LifeABSTRACT
Introducción: La estrecha relación que existe entre diabetes mellitus tipo 2 y obesidad ha dado lugar a la creación del término "diabesidad", considerándose la nueva enfermedad del siglo XXI. La dupla entre estas produce grave lesión en el tejido hepático, músculo esquelético y sistema cardiovascular. Es importante un estilo de vida saludable y buena adherencia farmacológica para combatir esta pandemia. Objetivo: Describir aspectos generales acerca de la fisiopatología y el tratamiento de la diabesidad. Método: Se realizó una búsqueda bibliográfica no sistemática en las bases de datos Science Direct, EMBASE, LILACS, Redalyc, SciELO y PubMed. Los criterios de inclusión fueron publicaciones en inglés y español, en las que el título, palabras clave o resumen incluyen información pertinente al objetivo de estudio, periodicidad no mayor de cinco años. En la búsqueda se obtuvieron 50 artículos, de los cuales fueron seleccionados 35. Conclusión: La insulinorresistencia es el factor determinante para la progresión hacia diabetes mellitus tipo 2, en calidad de respuesta del tejido adiposo frente a altos niveles de ácidos grasos libres (lipotoxicidad), consecuencia de la obesidad, obligando al páncreas a secretar grandes cantidades de insulina, que con el tiempo compromete su funcionalidad. En la actualidad, existen diversas alternativas no farmacológicas, farmacológicas y quirúrgicas para el abordaje de la diabesidad, donde la prevención representa un aspecto de vital importancia(AU)
Introduction: The close relation among diabetes mellitus type 2 and obesity has led to the creation of the term "diabesity," considering it the new disease of XXI century. The fusion of these two diseases produces severe lesions in the hepatic tissue, the skeletal muscle and the cardiovascular system. It is important a healthy lifestyle and a good pharmacological adherence to fight this so called pandemic. Objective: Describe general aspects related to the physiopathology and treatment of diabesity. Method: It was carried out a non-systematic bibliographic search in databases like Science Direct, EMBASE, LILACS, Redalyc, SciELO and PubMed. The inclusion criteria were publications in English and Spanish language, with a periodicity of no more than 5 years, in which the title, keywords and abstract included information that will be relevant for the objective of the study. In the search 50 articles were found, of which 35 were selected. Conclusions: Insulin resistance is the key factor for the progression towards diabetes mellitus type 2, as a response of the adipose tissue to high levels of free fatty acids (lipotoxicity), which is a consequence of obesity, and obligates the pancreas to secrete big amounts of insulin that as time goes by compromises its functionality. Nowadays, there are different non-pharmacological, pharmacological and surgical alternatives to address the diabesity, in which prevention represents an aspect of vital importance(AU)
Subject(s)
Humans , Insulin Resistance , Diabetes Mellitus, Type 2/physiopathology , Healthy Lifestyle , Obesity/physiopathology , Review Literature as Topic , Databases, Bibliographic , Diabetes Mellitus, Type 2/therapy , Obesity/therapyABSTRACT
Abstract Introduction Obesity is defined as a multifactorial metabolic syndrome in which there is an excessive number of fat cells within the tissues. It is discussed that intestinal microbiota might have a relevant relation with obesity, since it is relevantly altered in obese patients. Objectives To assess the effect of stool transplantation (ST) in the condition of obesity and its outcomes in an experimental model of cafeteria diet by analyzing histology and weight gain. Methods Forty male Wistar rats were randomly assigned to 5 groups: control (CO), control with antibiotics (CO+ATB), obesity (CAF+ATB), stool transplantation (ATB+ ST) and obesity with stool transplantation (CAF+ATB+ST). During the experiment, obesity induction groups received cafeteria diet, whereas the remaining groups had normal diet ad libitum. After 3 months, daily ST was carried out for 8 weeks by gavage procedure. The animals were euthanized, and the small intestine was harvested for further analysis. Results It was observed that before starting the ST, the cafeteria and normal diet groups had significant weight difference (p<0,0001). In the comparison between CAF+ATB and CAF+ATB+ST during the gavage period, the CAF+ATB+ST group presented lower weight gain (p=0.0017). The histopathological evaluation show that the ATB+ST group did not present intestinal crypt distortion. Conclusion Cafeteria diet resulted in an expected weight gain. In relation to the ST, it has been shown that the procedure is effective in reducing weekly weight gain. Apparently, there was no induction of disabsortive syndrome in nonobese animals that received ST.
Resumo Introdução A obesidade é definida como uma síndrome metabólica multifatorial, na qual existe um número excessivo de células de gordura nos tecidos. Discute-se que a microbiota intestinal pode estar relacionada com a obesidade, uma vez que ela é alterada de forma relevante em pacientes obesos. Objetivos Avaliar o efeito do transplante de fezes (TF) na obesidade induzida por um modelo experimental de dieta de cafeteria. Métodos Quarenta ratos Wistar foram distribuídos aleatoriamente em 5 grupos: controle (CO), controle com antibióticos (CO+ATB), obesidade (CAF+ATB), transplante de fezes (ATB+TF) e obesidade com transplante de fezes (CAF+ATB+TF). Durante o experimento, os grupos de indução de obesidade receberam dieta de cafeteria, enquanto os demais grupos tiveram dieta ad libitum normal. Após 3 meses, o TF diário foi realizado por 8 semanas por meio de gavagem intragástrica. Os animais foram sacrificados e o intestino delgado foi colhido para análise posterior. Resultados Observou-se que antes de iniciar o TF, os grupos de dieta de cafeteria e dieta normocalórica apresentavam diferença significativa de peso (p<0,0001). Ao comparar os grupos CAF+ATB e CAF+ATB+TF durante o período de gavagem, o grupo CAF+ATB+TF apresentou menor ganho de peso (p=0,0017). A avaliação histopatológica mostra que nenhum dos animais do grupo TF+ATB apresentou distorções nas criptas intestinais. Conclusão A dieta da cafeteria resultou em um ganho de peso esperado. Em relação ao TF, demonstrou-se que o procedimento é eficaz na redução do ganho de peso semanal. Aparentemente, não houve indução da síndrome disabsortiva em animais não obesos que receberam TF.
Subject(s)
Animals , Rats , Body Weight/physiology , Fecal Microbiota Transplantation/statistics & numerical data , Obesity Management/methods , Obesity/therapyABSTRACT
Resumo Objetivo Avaliar a experiência do monitoramento remoto de enfermagem na perspectiva de mulheres com excesso de peso. Método Estudo descritivo, de abordagem qualitativa, realizado em ambulatório de referência em obesidade em Salvador-Bahia, com 42 mulheres com excesso de peso, as quais haviam participado do grupo intervenção de um ensaio clínico randomizado. Realizaram-se entrevistas semiestruturadas entre janeiro a março de 2017 e os dados foram analisados através da técnica de análise de conteúdo temática. Resultados Dos depoimentos emergiu a categoria central "Aumentando a consciência do cuidado de si", a qual foi representada por três categorias temáticas: Vivenciando um feedback frequente e interativo com a enfermeira para o controle de peso, Melhorando o cuidado de si e Sentindo satisfação com os resultados alcançados. Conclusão e implicações para a prática As participantes vivenciaram e reconheceram a melhora do conhecimento para o controle do peso e mudanças positivas nos modos de viver ou conviver com o excesso de peso. Os resultados evidenciaram que atividades educativas por meio da telenfermagem, numa perspectiva dialógica, contribuem para potencializar o autocuidado.
Resumen Objetivo Evaluar la experiencia de la monitorización remota de enfermería en la perspectiva de las mujeres con exceso de peso. Método Estudio descriptivo, de enfoque cualitativo, realizado en ambulatorio de referencia en obesidad en Salvador-Bahia, con 42 mujeres con exceso de peso, las cuales habían participado del grupo de intervención de un ensayo clínico aleatorio. Se realizaron entrevistas semiestructuradas entre enero y marzo de 2017 y los datos fueron analizados mediante la técnica de análisis de contenido temático. Resultados De los testimonios surgió la categoría central " Aumentando la conciencia sobre el autocuidado", la cual estaba representada por tres categorías temáticas: Vivenciando un feedback frecuente e interactivo con la enfermera para el control del peso, Mejorando el autocuidado y Sintiendo satisfacción con los resultados logrados. Conclusión e implicaciones para la práctica Las participantes vivenciaron y reconocieron la mejora del conocimiento para el control del peso y cambios positivos en los modos de vivir o convivir con exceso de peso. Los resultados evidenciaron que actividades educativas por medio de la teleenfermería, en una perspectiva dialógica, contribuyen para potencializar el autocuidado.
Abstract Objective To evaluate the experience of remote nursing monitoring from the perspective of overweight women. Method Descriptive, qualitative approach study, carried out in a reference outpatient clinic in obesity in Salvador-Bahia, with 42 overweight women, who had participated in the intervention group of a randomized clinical trial. Semi-structured interviews were conducted between January and March 2017. The data were analyzed using the thematic content analysis technique. Semi-structured interviews were conducted between January and March 2017, with the data having been analyzed through thematic content analysis. Results From their statements the central category "Increasing awareness for self-care" was identified, which was represented by three thematic categories: Experiencing a frequent and interactive feedback with the nurse for weight control, Improving self-care and Feeling satisfaction with the results obtained. Conclusion and implications for practice The participants experienced and recognized improved knowledge for weight control and positive changes in ways of living or living with excess weight. The results evidenced that educational activities, through telenursing, in a dialogical perspective, contribute towards enhancing self-care.
Subject(s)
Humans , Female , Adult , Middle Aged , Overweight/nursing , Telenursing , Telemonitoring , Obesity/therapy , Self Care , Qualitative Research , Overweight/therapyABSTRACT
OBJECTIVE@#To explore the mechanism of electroacupuncture (EA) for the regulation of lipid production and improvement in obesity by mediating Wnt/β-catenin pathway through activating silent information regulator 1 (SIRT1).@*METHODS@#Of 75 Wistar male rats, 10 rats were selected randomly as the normal group and fed with standard diet. The rest rats were fed with high-fat diet for 8 weeks to establish the obesity model. Forty rats of successful modeling were randomized into a model group, an EA group, an EA plus inhibitor group (EA+I group) and an agonist group, 10 rats in each one. In the EA group, EA was applied at "Guanyuan" (CV 4), "Zhongwan" (CV 12), "Zusanli" (ST 36) and "Fenglong" (ST 40), with continuous wave, 2 Hz in frequency and around 1 mA in intensity. The needles were retained for 20 min. In the EA+I group, sirtinol solution was injected from caudal vein and EA was exerted simultaneously. In the agonist group, resveratrol solution was given by intragastric administration. The intervention of the above three groups was given once every two days, 3 times a week, consecutively for 8 weeks. Before and after intervention, body mass and Lee's index were recorded in the rats of each group. After intervention, the levels of serum total cholesterol (TC), triglyceride (TG) and free fatty acid (FFA) were detected in the rats of each group. After intervention, the mass of white adipose tissue (WAT) and the area of adipocytes were compared in the rats among the 5 groups. Using Western blot method, the protein expressions of SIRT1, glycogen synthase kinase-3β (GSK3β), β-catenin, cyclin D1 and peroxisome proliferators-activated receptor γ (PPARγ) were detected in WAT in the rats of each group.@*RESULTS@#After intervention, compared with the model group, the body mass and Lee's index were reduced in the rats of the EA group and the agonist group (@*CONCLUSION@#Electroacupuncture remarkably improves the body mass, Lee's index and blood lipid metabolism and reduces WAT mass and adipocyte size in obesity model rats, which is probably related to up-regulating the protein expression of SIRT1 in WAT, activating Wnt/β-catenin pathway and inhibiting the expression of PPARγ of downstream lipogenic gene so as to affect lipid production.
Subject(s)
Acupuncture Points , Animals , Electroacupuncture , Male , Obesity/therapy , Rats , Rats, Wistar , Sirtuin 1/genetics , Triglycerides , beta Catenin/geneticsABSTRACT
A obesidade é considerada um problema epidêmico, que acarreta graves prejuízos na saúde física e emocional dos indivíduos. Em busca de investigar os fenômenos psicológicos e culturais envolvidos na obesidade, propõe-se uma visão compreensiva-simbólica dos discursos de mulheres obesas pacientes de um Hospital Geral em Curitiba-Pr. O estudo baseou-se em constructos teóricos como: a Teoria dos Complexos para Jung, o Inconsciente Cultural para Henderson, o Complexo Cultural para Singer e Kimbles. A partir desses visa-se propor um novo constructo teórico: o Complexo do Comer, que é representado pelas experiências vinculadas ao tema alimentação, e relacioná-lo com o Complexo Cultural. Observa-se, a partir dos discursos, que ambos os Complexos expressam-se, paradoxalmente, a forma de incorporar ideias inconscientes de um corpo ideal, que repousam em uma imagem arquetípica da fome e da falta. Num contexto da saúde, esta falta marca a necessidade de um preencher que muitas vezes se faz excessivo e desnaturado, a qual deve ser considerada no tratamento multidisciplinar da obesidade, por meio de estratégias terapêuticas que contemplem essa realidade e a visão de totalidade psíquica.
Obesity is considered an epidemic problem, which causes serious damage to the physical and emotional health of individuals. In order to investigate the psychological and cultural phenomena involved in obesity, we propouse a comprehensive and symbolic view of the discourses of obese women, patients from a General Hospital in Curitiba-Pr. The study was based on theoretical constructs such as: Jung's Complex Theory, Henderson's Cultural Unconscious, Singer and Kimbles' Cultural Complex. From these theories, it is aimed to propose a new theoretical construct: the Eating Complex, which is represented by experiences related to the theme of food, and relate it to the Cultural Complex. It is observed from the discourses that both Complexes paradoxically express themselves in a way to incorporate unconscious ideas of an ideal body, that rests in an archetypal image of hunger and lack. In a context of health, this lack marks the need for a filling that is often excessive and denatured, which should be considered in the multidisciplinary treatment of obesity, through therapeutic strategies that contemplate this reality and the vision of psyche totality.
La obesidad es considerada un problema epidémico, que acarrea graves perjuicios en la salud física y emocional de los individuos. En busca de investigar los fenómenos psicológicos y culturales involucrados en la obesidad, se propone una visión comprensiva-simbólica de los discursos de mujeres obesas pacientes de un Hospital General en Curitiba-Pr. El estudio se basó en constructos teóricos como: la Teoría de los Complejos para Jung, el Inconsciente Cultural para Henderson, el Complejo Cultural para Singer y Kimbles. A partir de estos se pretende proponer un nuevo constructo teórico: el Complejo del Comer, que es representado por las experiencias vinculadas al tema alimentación, y relacionarlo con el Complejo Cultural. Se observa, a partir de los discursos, que ambos Complejos se expresan paradójicamente la forma de incorporar ideas inconscientes de un cuerpo ideal, que reposan en una imagen arquetípica del hambre y de la falta. En un contexto de la salud, esta falta marca la necesidad de un relleno que muchas veces se hace excesivo y desnaturalizado, la cual debe ser considerada en el tratamiento multidisciplinario de la obesidad, a través de estrategias terapéuticas que contemplen esa realidad y la visión de totalidad psíquica.
Subject(s)
Humans , Female , Self Concept , Diet/psychology , Obesity/therapyABSTRACT
Esta revisão rápida foi comissionada e subsidiada pelo Ministério da Saúde, no âmbito do projeto GEREB-010-FIO-20 e faz parte da Coleção "Rapid response for health promotion". Pergunta: Qual é a eficácia/efetividade e a segurança das intervenções oferecidas via telessaúde (teleconsulta), aplicativos de celular e uso de mensagens de texto/SMS na atenção a adultos com sobrepeso e obesidade (IMC ≥ 25)? Métodos: A partir de um protocolo prévio, nove bases eletrônicas da literatura foram consultadas em novembro de 2020, para identificar revisões sistemáticas (RS), publicadas em inglês, português e espanhol, sem restrição quanto ao ano de publicação. A qualidade metodológica das revisões sistemáticas foi avaliada utilizando o instrumento AMSTAR 2. Para executar está revisão rápida em 15 dias, apenas o processo de triagem de títulos e resumos foi realizado em duplicidade e de forma independente. Resultados: A busca nas bases de dados resultou em 1.269 estudos e após seleção foram incluídas 14 revisões sistemáticas. Com relação à qualidade metodológica, uma revisão foi categorizada como de confiança alta, cinco apresentaram confiança baixa e oito criticamente baixa. A análise dos estudos trouxe resultados de intervenções individuais e em grupo, com tecnologias únicas e combinadas. As ferramentas usadas variaram entre interações online, mensagens de texto, e-mail, programas, websites, fóruns, chats, aplicativos, telefone e automonitoramento. A maioria de participantes foi composta por mulheres, que receberam intervenções de 4 semanas a 30 meses, e cujos desfechos se referiam a peso, Índice de Massa Corporal (IMC), circunferência da cintura, hábitos alimentares ou de atividade física e proporção de gordura corporal. De modo geral, o uso de diferentes tecnologias proporcionou maior facilidade de acesso aos cuidados em saúde e práticas para melhorar a qualidade de vida. O desfecho mais estudado e que apresenta maior quantidade de resultados favoráveis é a perda de peso, avaliada com relação a intervenções de telessaúde, seguidos por aplicativos de celular, mensagem de texto, websites/computador e tecnologias combinadas. O Índice de Massa Corporal (IMC) resultou em pelo menos um resultado favorável para intervenções por meio de aplicativos de celular, mensagens de texto e tecnologias combinadas, enquanto para a mudança de circunferência da cintura os resultados foram indiferentes aos comparadores. Os estudos voltados para mudança de hábitos alimentares e atividades físicas foram indiferentes ou mais favoráveis a atividade presencial em detrimento do uso de aplicativos. Apenas uma comparação de intervenções analisou o efeito sobre a produção de gordura corporal e obteve bons resultados para programas online e aconselhamento contínuo por telefone celular. Conclusão: A revisão mostrou que intervenções por meio de aplicativos, ferramentas online, mensagens de texto e telessaúde podem ter efeitos positivos para alcançar a redução de peso, IMC e proporção da gordura corporal. Desta forma, vale a pena considerar o uso de tais ferramentas em programas de saúde. No entanto, também é preciso compreender que os resultados aqui apresentados são quase todos provenientes de estudos primários citados nas revisões sistemáticas, e não de metanálises. Além disso, chamamos a atenção para a qualidade metodológica das RS analisadas
This rapid review was commissioned and subsidized by the Ministry of Health, within the scope of the GEREB-010-FIO-20 project and is part of the "Rapid response for health promotion" Collection. Question: What is the efficacy/effectiveness and safety of interventions offered via telehealth (teleconsultation), mobile apps, and use of text messages/SMS in caring for overweight and obese adults (BMI ≥ 25)? Methods: Based on a previous protocol, nine electronic literature databases were consulted in November 2020 to identify systematic reviews (SR), published in English, Portuguese and Spanish, without restriction as to the year of publication. The methodological quality of the systematic reviews was evaluated using the AMSTAR 2 instrument. To perform this rapid review in 15 days, only the process of screening titles and abstracts was carried out in duplicate and independently. Results: The search in the databases resulted in 1,269 studies and, after selection, 14 systematic reviews were included. With regard to methodological quality, one review was categorized as having high confidence, five had low confidence and eight critically low. The analysis of the studies brought results from individual and group interventions, with single and combined technologies. The tools used ranged from online interactions, text messages, email, programs, websites, forums, chats, apps, phone and self-monitoring. Most participants were women, who received interventions from 4 weeks to 30 months, and whose outcomes referred to weight, Body Mass Index (BMI), waist circumference, eating or physical activity habits and body fat proportion. . In general, the use of different technologies provided easier access to health care and practices to improve quality of life. The most studied outcome with the highest number of favorable results is weight loss, evaluated in relation to telehealth interventions, followed by mobile apps, text messaging, websites/computer and combined technologies. The BMI resulted in at least one favorable result for interventions through mobile apps, text messages and combined technologies, while for the change in waist circumference the results were indifferent to the comparators. Studies aimed at changing eating habits and physical activities were indifferent or more favorable to face-to-face activity over the use of apps. Only one comparison of interventions looked at the effect on body fat production and found good results for online programs and ongoing cell phone counseling. Conclusion: The review showed that interventions through apps, online tools, text messages and telehealth can have positive effects in achieving weight reduction, BMI and body fat ratio. Therefore, it is worth considering the use of such tools in health programs. However, it is also necessary to understand that the results presented here are almost all from primary studies cited in systematic reviews, and not from meta-analyses. In addition, we draw attention to the methodological quality of the analyzed SRs.
Subject(s)
Humans , Adult , Telemedicine , Remote Consultation , Overweight/therapy , Text Messaging/standards , Mobile Applications/standards , Obesity/therapyABSTRACT
INTRODUÇÃO: A obesidade no idoso, além de estar associada à piora de doenças relacionadas à síndrome metabólica e a distúrbios osteoarticulares, aumenta o risco de quedas, síndrome de fragilidade, depressão e demência, com consequente perda de funcionalidade. Entre todos os tratamentos disponíveis, a cirurgia bariátrica é uma alternativa em pacientes elegíveis. OBJETIVOS: Discutir aspectos relacionados à segurança e aos benefícios da cirurgia bariátrica para o controle ou a remissão de comorbidades no idoso. METODOLOGIA: Foi realizada revisão de literatura em bases de dados utilizando os seguintes descritores: bariatric surgery and elderly or aged or older adult and comorbidities or safety. Foram incluídos ensaios clínicos, estudos observacionais, estudos comparativos e revisões que avaliaram o efeito da cirurgia bariátrica no controle ou na remissão de comorbidades em idosos. RESULTADOS: Nos últimos anos, vários estudos têm demonstrado não apenas controle ou remissão de comorbidades como diabetes, hipertensão e síndrome da apneia do sono, mas também reduzida taxa de complicações, semelhante à observada em jovens. CONCLUSÕES: Com base nos resultados desses estudos, há espaço para que procedimentos de cirurgia bariátrica sejam indicados a idosos elegíveis, sem limite de idade, considerando também aspectos funcionais e de expectativa de vida.
INTRODUCTION: In addition to being associated with worsening of diseases related to metabolic syndrome and musculoskeletal disorders, obesity in older adults increases the risk of falls, frailty syndrome, depression, and dementia, with consequent functional loss. Among all treatments available, bariatric surgery is an option for eligible patients. OBJECTIVES: To discuss aspects related to the safety and benefits of bariatric surgery for the control or remission of comorbidities in older adults. METHODS: This literature review was carried out in databases, using the following keywords: bariatric surgery and elderly or aged or older adult and comorbidities or safety. We included clinical trials, observational studies, comparative studies, and reviews that evaluated the effect of bariatric surgery on the control or remission of comorbidities in older adults. RESULTS: In recent years, several studies have evidenced not only control or remission of comorbidities, such as diabetes, hypertension, and sleep apnea syndrome, but also a low rate of complications, similar to those observed in young people. CONCLUSIONS: Based on the results of these studies, bariatric surgical procedures can be indicated for eligible older adults, without age restriction, taking into account functional and life expectancy aspects.
Subject(s)
Humans , Aged , Bariatric Surgery/mortality , Bariatric Surgery/rehabilitation , Obesity/therapy , Postoperative Complications , Comorbidity , Health of the ElderlyABSTRACT
RESUMEN Introducción: La obesidad es una enfermedad crónica multifactorial cuyo mejor tratamiento lo constituye en la actualidad la cirugía bariátrica. Objetivo: Describir los resultados a corto y largo plazo de la gastroplicatura vertical laparoscópica como técnica de cirugía bariátrica restrictiva. Métodos: Se realizó un estudio descriptivo, retrospectivo, longitudinal en 436 pacientes obesos intervenidos por gastroplicatura vertical laparoscópica, de enero 2010 a enero 2020, en Hospital Universitario General Calixto García. Se incluyeron pacientes de ambos géneros, mayores de 18 años. Variables analizadas: edad, sexo, peso, talla, índice de masa corporal, grado de obesidad, perímetro de cintura, enfermedades asociadas, valores de glucemia, colesterol y triglicéridos, tiempo quirúrgico, pérdidas sanguíneas intraoperatorias, complicaciones perioperatorias y porcentaje de sobrepeso perdido al año. Resultados: Edad promedio 38,48 años, con predominio del sexo femenino. El índice de masa corporal medio fue de 45,41 Kg/m2. Las enfermedades asociadas fueron: hipertensión arterial, síndrome de apnea obstructiva del sueño y diabetes mellitus. El 8,6 por ciento presentó complicación intraoperatoria, mientras que en el posoperatorio hubo un 5,9 por ciento de complicaciones. Tuvieron mayor relación con índice cintura/cadera incrementado y solo se reportó un fallecido. Conclusiones: Los resultados de las gastroplicatura vertical laparoscópica son prometedores como técnica bariátrica restrictiva según lo descrito en la serie de pacientes tratados durante un periodo de 10 años. La misma permitió una disminución significativa del Índice de Masa Corporal y grado de obesidad con repercusión importante en el porcentaje de peso perdido y escasas complicaciones(AU)
ABSTRACT Introduction: Obesity is a multifactorial chronic disease whose best treatment is currently bariatric surgery. Objective: To describe the short- and long-term outcomes of laparoscopic vertical gastroplication as a restrictive bariatric surgery technique. Methods: A descriptive, retrospective and longitudinal study was carried out in 436 obese patients who received laparoscopic vertical gastroplication, from January 2010 to January 2020, at General Calixto García University Hospital. Patients of both genders, older than 18 years, were included. The variables analyzed were age, sex, weight, height, body mass index, degree of obesity, waist circumference, associated diseases, blood glucose, cholesterol and triglyceride values, surgical time, intraoperative blood loss, perioperative complications, and percentage of overweight lost at one year. Results: The average age 38.48 years, with a predominance of the female sex. The mean body mass index was 45.41 kg/m2. The associated diseases were arterial hypertension, obstructive sleep apnea syndrome, and diabetes mellitus. 8.6 percent presented intraoperative complication, while there were 5.9 percent of complications in the postoperative period. They were more related to the increased waist/hip ratio and only one death was reported. Conclusions: The results of laparoscopic vertical gastroplication are promising based on the usefulness of the restrictive bariatric technique as described in the series of patients treated over a period of ten years. It allowed a significant decrease in body mass index and the degree of obesity, with a significant impact on the percentage of lost weight lost and with few complications(AU)