Assuntos
Obesidade/terapia , Atenção Primária à Saúde/métodos , Adulto , Índice de Massa Corporal , Canadá , Feminino , Humanos , Masculino , GravidezRESUMO
Obesity is a complex chronic disease in which abnormal or excess body fat (adiposity) impairs health, increases the risk of long-term medical complications and reduces lifespan.1 Epidemiologic studies define obesity using the body mass index (BMI; weight/height2), which can stratify obesity-related health risks at the population level. Obesity is operationally defined as a BMI exceeding 30 kg/m2 and is subclassified into class 1 (3034.9), class 2 (3539.9) and class 3 (≥ 40). At the population level, health complications from excess body fat increase as BMI increases.2 At the individual level, complications occur because of excess adiposity, location and distribution of adiposity and many other factors, including environmental, genetic, biologic and socioeconomic factors.
Assuntos
Humanos , Adulto , Determinantes Sociais da Saúde , Manejo da Obesidade , Obesidade/terapia , Índice de Massa Corporal , Terapia Nutricional , Estilo de Vida Saudável , Obesidade/complicaçõesRESUMO
The commercial weight loss industry is enormous. Clinicians should familiarize themselves with the commercial obesity management offerings in their vicinity. Criteria have been published to evaluate whether a commercial program is safe and potentially successful (i.e., offering a combination of nutrition, physical activity and behaviour change support; with realistic weight loss goals of 0.51.0 kg per week, a long-term weight maintenance approach; a good safety profile and reasonable costs). None of the weight loss products from the commercial industry that were studied in randomized control trials of more than 12 weeks duration were shown to produce clinically meaningful weight loss. Some commercial programs that combine nutrition, physical activity and support (Jenny Craig®, Nutrisystem®, Optifast®, WW® (formerly Weight Watchers) can be used to induce modest weight loss. Some programs have also shown improvement in glycemic control in patients with obesity and diabetes but no effect on lipids or blood pressure have been demonstrated.
Assuntos
Humanos , Fármacos Antiobesidade , Indústria Farmacêutica , Manejo da Obesidade , Obesidade/prevenção & controleRESUMO
AIM: Adherence to dietary change is crucial for long-term benefit and a key element of adherence is the satisfaction of a given diet. We aimed to develop a brief questionnaire, suitable for use in clinical practice that can assess satisfaction with a diet, and to conduct preliminary evaluation of its reliability and validity. METHODS: The questionnaire was developed and drafts were sent to two expert panels for content review. The final questionnaire was assessed for internal consistency, face and construct validity, and test-retest reliability. Expert feedback was provided by nine clinicians/researchers. The tool was assessed in three phases in different international populations who were recruited using social media. It included adults who were currently following a diet (total n = 1604), and those who had recently abandoned their diet (phase 3 only). RESULTS: The Diet Satisfaction Score consisted of 10 items measuring one dimension (Cronbach's alpha = 0.85), and participants had a mean total Diet Satisfaction Score of 3.7 (SD = 0.50) from a possible range of 1 to 5. Test-retest reliability was good as indicated by an intraclass correlation coefficient of 0.64 and a mean difference (95% confidence interval, CI) between repeated test scores of 0.03 (-0.02, 0.09). Each 1-point increase in Diet Satisfaction Score was associated with longer diet duration by 1.7 weeks (95% CI = 1.5, 2.0, P < .001). CONCLUSIONS: The Diet Satisfaction Score showed good reliability and preliminary validity and may be a useful clinical tool for assessing diet satisfaction and has the potential to predict adherence.
Assuntos
Dieta , Satisfação Pessoal , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto JovemRESUMO
The purpose of this paper is to critique how the promotion of physical activity (PA) is communicated and offer evidence-based alternative framings to encourage PA in youth. We argue that PA promotion messaging should not be tied to outcomes that focus on changing physical appearance, preventing or treating diseases, or sport performance or competition. From a public health perspective, we suggest that PA should instead focus on campaigns, policies, and programs that tie PA to enjoyment, wellbeing, and play.
Assuntos
Exercício Físico , Promoção da Saúde , Saúde Pública , Adolescente , Canadá , Política de Saúde , Humanos , PrazerRESUMO
BACKGROUND: Celebrities are highly influential people whose actions and decisions are watched and often emulated by wide audiences. Many celebrities have used their prominent social standing to offer medical advice or endorse health products, a trend that is expected to increase. However, the extent of the impact that celebrities have in shaping the public's health-related knowledge, attitudes, behaviors, and status is unclear. This systematic review seeks to answer the following questions: (1) Which health-related outcomes are influenced by celebrities? (2) How large of an impact do celebrities actually have on these health-related outcomes? (3) Under what circumstances do celebrities produce either beneficial or harmful impacts? METHODS: Ten databases were searched, including MEDLINE, EMBASE, PsycINFO, PubMed, CINAHL, Communication Complete, Sociological Abstracts, Social Sciences Citation Index, Journals @ Scholars Portal, and ProQuest Dissertations & Theses A&I. Two reviewers conducted title and abstract screening and full-text screening to identify primary studies that employed empirical methods (either quantitative or qualitative) to examine celebrities' impact on health-related knowledge, attitudes, behaviors, or status outcomes. DISCUSSION: The results of this review will contribute to our understanding of celebrity influences and how to design positive evidence-based celebrity health promotion activities. In addition, these findings can help inform the development of media reporting guidelines pertaining to celebrity health news and provide guidance to public health authorities on whether and how to respond to or work with celebrities. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015019268.
Assuntos
Pessoas Famosas , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Meios de Comunicação de Massa , Revisões Sistemáticas como Assunto , Guias como Assunto , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Humanos , Metanálise como Assunto , Saúde Pública , Projetos de PesquisaAssuntos
Dieta com Restrição de Carboidratos , Dieta com Restrição de Gorduras , Dieta Redutora/métodos , Ingestão de Energia , Metabolismo Energético , Estilo de Vida , Obesidade/dietoterapia , Cooperação do Paciente , Comorbidade , Culinária , Emprego , Humanos , Obesidade/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Meio Social , Fatores Socioeconômicos , Aumento de Peso , Redução de PesoRESUMO
OBJECTIVE: To adapt the 5 As model in order to provide primary care practitioners with a framework for obesity counseling. SOURCES OF INFORMATION: A systematic literature search of MEDLINE using the search terms 5 A's (49 articles retrieved, all relevant) and 5 A's and primary care (8 articles retrieved, all redundant) was conducted. The National Institute of Health and the World Health Organization websites were also searched. MAIN MESSAGE: The 5 As (ask, assess, advise, agree, and assist), developed for smoking cessation, can be adapted for obesity counseling. Ask permission to discuss weight; be nonjudgmental and explore the patient's readiness for change. Assess body mass index, waist circumference, and obesity stage; explore drivers and complications of excess weight. Advise the patient about the health risks of obesity, the benefits of modest weight loss, the need for a long-term strategy, and treatment options. Agree on realistic weight-loss expectations, targets, behavioural changes, and specific details of the treatment plan. Assist in identifying and addressing barriers; provide resources, assist in finding and consulting with appropriate providers, and arrange regular follow-up. CONCLUSION: The 5 As comprise a manageable evidence-based behavioural intervention strategy that has the potential to improve the success of weight management within primary care.