Home About us Contact
|
Home About us Contact | ||
|
|
||
Obese Adults (obese + adult)
Selected AbstractsIdentification, Evaluation, and Treatment of Overweight and Obese AdultsJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 5 2002APRN-C, Mary Jo Goolsby EdD This month's CPG review is on overweight and obese adults. With an estimated 97 million or more adults in the United States who are overweight or obese and as the second leading cause of preventable death in the United States, this guideline is expected to be of wide interest to nurse practitioners. [source] Telomere length and obesityACTA PAEDIATRICA, Issue 7 2008Raffaella Zannolli Abstract Aim: To assess the telomere length in apparently healthy obese and normal-weight subjects. Methods: Seventy-six Caucasian subjects were chosen including 53 children (age 8.2 ± 3.5 years) and 23 adults (age 40.5 ± 8.4 years). Among these, 22 (12 children and 10 adults) were obese with a body mass index (BMI, kg/m2) > 2 SD above the norm. Bioelectrical impedance analysis (BIA), measured with a multiple frequency analyzer, was used to estimate body composition. DNA extraction from white blood cells was used to estimate the telomere length by detection of terminal restriction fragments (TRF). Results: No difference was found between the TRF lengths of obese and normal children. Obese adults had shorter TRF lengths than adults who were not obese (mean TRF length difference, ,884.5; 95% confidence intervals ,1727 to ,41.8; t= 2.183; df = 17; p < 0.041). Conclusions: Obese adults have shorter telomeres than their normal-weight counterparts, while this phenomenon is not present in childhood. [source] Being ,fat' in today's world: a qualitative study of the lived experiences of people with obesity in AustraliaHEALTH EXPECTATIONS, Issue 4 2008Samantha L. Thomas PhD Abstract Objective, To develop an in-depth picture of both lived experience of obesity and the impact of socio-cultural factors on people living with obesity. Design, Qualitative methodology, utilizing in-depth semi-structured interviews with a community sample of obese adults (body mass index ,30). Community sampling methods were supplemented with purposive sampling techniques to ensure a diverse range of individuals were included. Results, Seventy-six individuals (aged 16,72) were interviewed. Most had struggled with their weight for most of their lives (n = 45). Almost all had experienced stigma and discrimination in childhood (n = 36), as adolescents (n = 41) or as adults (n = 72). About half stated that they had been humiliated by health professionals because of their weight. Participants felt an individual responsibility to lose weight, and many tried extreme forms of dieting to do so. Participants described an increasing culture of ,blame' against people living with obesity perpetuated by media and public health messages. Eighty percent said that they hated or disliked the word obesity and would rather be called fat or overweight. Discussion and Conclusion, There are four key conclusions: (i) the experiences of obesity are diverse, but there are common themes, (ii) people living with obesity have heard the messages but find it difficult to act upon them, (iii) interventions should be tailored to address both individual and community needs and (iv) we need to rethink how to approach obesity interventions to ensure that avoid recapitulating damaging social stereotypes and exacerbating social inequalities. [source] Obesity: attitudes of undergraduate student nurses and registered nursesJOURNAL OF CLINICAL NURSING, Issue 16 2009Man-Yuk Poon Aim., To investigate undergraduate student nurses' and registered nurses' attitudes towards obese persons and towards the management of obese patients. Background., Obesity is a global public health problem. Escalating rates of overweight and obesity are also taking a toll in Asian countries that have historically had much lower rates. Despite the growing prevalence of obesity worldwide, studies show that nurses and other health professionals hold negative attitudes towards obese people, which may affect the care of obese patients. Design., Cross-sectional study. Methods., A self-administered questionnaire was completed by 352 undergraduate student nurses and 198 registered nurses. The questionnaire consisted of the Fat Phobia Scale, the Attitudes Toward Obese Adult Patients Scale and a demographic profile. Data were analysed using descriptive statistics and student's t -tests. Results., Overall mean scores on the Fat Phobia Scale (3·53 SD 0·47) indicated average levels of fat phobia and mean scores on the Attitudes Toward Obese Adult Patients scale (2·64 SD 0·51) indicated neutral attitudes towards obese patients. Registered nurses had significantly higher levels of fat phobia and more negative attitudes than did student nurses. The majority of participants perceived that obese people liked food, overate and were shapeless, slow and unattractive. Additionally, over one-half of participants believed that obese adults should be put on a diet while in hospital. Conclusions., Results of this study show that both registered nurses and student nurses have negative perceptions of obesity and are unlikely to attribute positive characteristics to obese individuals. That registered nurses hold more negative attitudes towards obese person is cause for concern. Relevance to clinical practice., Given the increasing prevalence of obesity and the disproportionate number of obese persons affected by many health conditions, current and future nurses should have positive professional attitudes towards obese individuals. Obesity needs to more be adequately addressed, both in basic nursing education programs and in continuing professional education for practising nurses. [source] Comparison between intubation and the laryngeal mask airway in moderately obese adultsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2009M. ZOREMBA Background: Obesity is a well-established risk factor for perioperative pulmonary complications. Anaesthetic drugs and the effect of obesity on respiratory mechanics are responsible for these pathophysiological changes, but tracheal intubation with muscle relaxation may also contribute. This study evaluates the influence of airway management, i.e. intubation vs. laryngeal mask airway (LMA), on postoperative lung volumes and arterial oxygen saturation in the early postoperative period. Methods: We prospectively studied 134 moderately obese patients (BMI 30) undergoing minor peripheral surgery. They were randomly assigned to orotracheal intubation or LMA during general anaesthesia with mechanical ventilation. Premedication, general anaesthesia and respiratory settings were standardized. While breathing air, we measured arterial oxygen saturation by pulse oximetry. Inspiratory and expiratory lung function was measured preoperatively (baseline) and at 10 min, 0.5, 2 and 24 h after extubation, with the patient supine, in a 30° head-up position. The two groups were compared using repeated-measure analysis of variance (ANOVA) and t -test analysis. Statistical significance was considered to be P<0.05. Results: Postoperative pulmonary mechanical function was significantly reduced in both groups compared with preoperative values. However, within the first 24 h, lung function tests and oxygen saturation were significantly better in the LMA group (P<0.001; ANOVA). Conclusions: In moderately obese patients undergoing minor surgery, use of the LMA may be preferable to orotracheal intubation with respect to postoperative saturation and lung function. [source] What interventions should we add to weight reducing diets in adults with obesity?JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2004A systematic review of randomized controlled trials of adding drug therapy, behaviour therapy or combinations of these interventions, exercise Abstract Background, Evidence is needed for the effectiveness of interventions given with reducing diets for obese adults: drug therapy, exercise, or behaviour therapy. Methods, We systematically reviewed randomized controlled trials in any language. We searched 13 databases and handsearched journals. Trials lasted 1 year or more. One investigator extracted data and a second checked data extraction. Trial quality was assessed. Results, Adding orlistat to diet was associated with weight change for up to 24 months (,3.26 kg, 95% CI, ,4.15 to ,2.37 kg), and statistically significant beneficial changes were found for total and LDL cholesterol, blood pressure and glycaemic control. Adding sibutramine to diet was associated with a 12 month weight change of ,4.18 kg (95% CI, ,5.14 to ,3.21 kg), and statistically significant beneficial effects on high density lipoprotein cholesterol (HDL) and triglycerides (TGs), but an increase in diastolic blood pressure. Adding exercise to diet, or to diet and behaviour therapy, was associated with improved weight loss for up to 36 months and improvements in HDL, TGs and blood pressure. Adding behaviour therapy to diet, or to diet and sibutramine together, was associated with improved weight loss for up to 18 months. Adding drugs, exercise or behaviour therapy to dietary advice was each associated with similar weight change. Conclusions, Adding orlistat, sibutramine, exercise, or behaviour modification to dietary advice can improve long-term weight loss. [source] A new evidence-based model for weight management in primary care: the Counterweight ProgrammeJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 3 2004The Counterweight Project Team Abstract Background/Aims Obesity has become a global epidemic, and a major preventable cause of morbidity and mortality. Management strategies and treatment protocols are however poorly developed and evaluated. The aim of the Counterweight Programme is to develop an evidence-based model for the management of obesity in primary care. Methods The Counterweight Programme is based on the theoretical model of Evidence-Based Quality Assessment aimed at improving the management of obese adults (18,75 years) in primary care. The model consists of four phases: (1) practice audit and needs assessment, (2) practice support and training, (3) practice nurse-led patient intervention, and (4) evaluation. Patient intervention consisted of screening and treatment pathways incorporating evidence-based approaches, including patient-centred goal setting, prescribed eating plans, a group programme, physical activity and behavioural approaches, anti-obesity medication and weight maintenance strategies. Weight Management Advisers who are specialist obesity dietitians facilitated programme implementation. Eighty practices were recruited of which 18 practices were randomized to act as controls and receive deferred intervention 2 years after the initial audit. Results By February 2004, 58 of the 62 (93.5%) intervention practices had been trained to run the intervention programme, 47 (75.8%) practices were active in implementing the model and 1256 patients had been recruited (74% female, 26% male, mean age 50.6 years, SD 14). At baseline, 75% of patients had at one or more co-morbidity, and the mean body mass index (BMI) was 36.9 kg/m2 (SD 5.4). Of the 1256 patients recruited, 91% received one of the core lifestyle interventions in the first 12 months. For all patients followed up at 12 months, 34% achieved a clinical meaningful weight loss of 5% or more. A total of 51% of patients were classed as compliant in that they attended the required level of appointments in 3, 6, and 12 months. For fully compliant patients, weight loss improved with 43% achieving a weight loss of 5% or more at 12 months. Conclusion The Counterweight Programme is an evidence-based weight management model which is feasible to implement in primary care. [source] Integrating the transtheoretical model into the management of overweight and obese adultsJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 2 2007Judy Gainey Seals NP, MSN (Cardiovascular Nurse Practitioner) Abstract Purpose: To show how the nurse practitioner (NP) can incorporate stage-specific interventions from the transtheoretical model in the management of overweight and obese adults. Data sources: Research articles, clinical articles, and government guidelines pertaining to the management of overweight and obesity in adults. Conclusions: Overweight and obesity are complex and chronic conditions that require lifelong management. The NP can help clients to safely and successfully lose weight by developing stage-specific interventions, by using an expert multidisciplinary team, and by providing ongoing monitoring and motivation. Implications for practice: The prevalence of overweight and obesity continues to increase at an alarming rate and is a major public health concern. The NP has an important role in the assessment and management of clients with this condition. [source] Identification, Evaluation, and Treatment of Overweight and Obese AdultsJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 5 2002APRN-C, Mary Jo Goolsby EdD This month's CPG review is on overweight and obese adults. With an estimated 97 million or more adults in the United States who are overweight or obese and as the second leading cause of preventable death in the United States, this guideline is expected to be of wide interest to nurse practitioners. [source] Trends in overweight and obese adults in Malaysia (1996,2009): a systematic reviewOBESITY REVIEWS, Issue 6 2010A. Z. Khambalia Summary Like other nations experiencing rapid industrialization, urbanization and a nutrition transition, there is concern in Malaysia of a possible escalation in the prevalence of overweight and obesity. In 1996, the National Health and Morbidity Survey reported a 16.6% and 4.4% prevalence of overweight and obesity, respectively. In the following decade, there have been several national and community surveys on overweight and obesity in Malaysia. The objective of this systematic review is to describe the trend from 1996 to 2009 in the prevalence of overweight and obesity in adults in Malaysia nationally and by gender, age and race. Results indicate that there has been a small rise in overweight adults in the years 1996, 2003 and 2006 (20.7%, 26.7% and 29.1%) and a much more dramatic increase in obesity in 1996, 2003, 2004 and 2006 (5.5%, 12.2%, 12.3% and 14.0%). Evidence showed a greater risk for overweight and obesity among women compared with men. Based on the highest-quality studies, overweight and obesity levels were highest among adults 40,59 years old. Overweight levels were highest among Indians, followed by Malays, Chinese and Aboriginals, with less consistency across studies on the order of risk or obesity by ethnicity. [source] An integrative review of Canadian childhood obesity prevention programmesOBESITY REVIEWS, Issue 1 2007S. Conroy Summary To examine successful Canadian nursing and health promotion intervention programmes for childhood obesity prevention during gestation and infancy, an integrative review was performed of the literature from 1980 to September 2005. The following databases were used: PubMed; Cochrane Database of Systematic Reviews; Cochrane Controlled Trials Register; Database of Abstracts of Reviews of Effects; ACP Journal Club; MEDLINE; EMBASE; CINAHL; Web of Science; Scopus; Sociological Abstracts; Sport Discus; PsycInfo; ERIC and HealthStar. MeSH headings included: infancy (0,24 months), gestation, gestational diabetes, nutrition, prenatal care, pregnancy, health education, pregnancy outcome, dietary services with limits of Canadian, term birth. Of 2028 articles found, six Canadian childhood obesity prevention programmes implemented during gestation and/or infancy were found; three addressed gestational diabetes with five targeting low-income Canadian urban and/or Aboriginal populations. No intervention programmes specifically aimed to prevent childhood obesity during gestation or infancy. This paucity suggests that such a programme would be innovative and much needed in an effort to stem the alarming increase in obesity in children and adults. Any attempts either to develop new approaches or to replicate interventions used with obese adults or even older children need careful evaluation and pilot testing prior to sustained use within the perinatal period. [source] Acute and chronic effects of vitamin C on endothelial fibrinolytic function in overweight and obese adult humansTHE JOURNAL OF PHYSIOLOGY, Issue 14 2008Gary P. Van Guilder We determined the effects of acute intra-arterial vitamin C administration and chronic oral vitamin C supplementation on the capacity of the endothelium to release t-PA in overweight and obese adults. Net endothelial t-PA release was determined in vivo in response to intrabrachial infusions of bradykinin and sodium nitroprusside in 33 sedentary adults: 10 normal-weight (BMI: 23.4 ± 0.5 kg m,2; 7M/3F); and 23 overweight/obese (BMI: 31.2 ± 0.8 kg m,2; 15M/8F). In 10 normal weight and eight overweight/obese adults the dose,response curves to bradykinin and sodium nitroprusside were repeated with a coinfusion of the antioxidant vitamin C (24 mg min,1). Seventeen of the 23 overweight/obese adults completed a 3 month chronic oral vitamin C (500 mg day,1) supplementation intervention. Intra-arterial administration of vitamin C significantly potentiated t-PA release in overweight/obese adults. Net release of t-PA was ,95% higher (P < 0.01) after (from ,0.9 ± 1.1 to 94.6 ± 16.2 ng (100 ml tissue),1 min,1) compared with before (from ,0.8 ± 0.8 to 49.9 ± 7.7 ng (100 ml tissue),1 min,1) vitamin C administration. Daily vitamin C supplementation significantly increased t-PA release in overweight/obese adults (from 0.2 ± 0.9 to 48.2 ± 6.5 ng (100 ml tissue),1 min,1) before supplementation versus (0.3 ± 0.5 to 66.3 ± 8.7 ng (100 ml tissue),1 min,1) after supplementation. These results indicate that the antioxidant vitamin C favourably affects the capacity of the endothelium to release t-PA in overweight/obese adults. Daily vitamin C supplementation represents an effective lifestyle intervention strategy for improving endothelial fibrinolytic regulation in this at-risk population. [source] Effect of intra-operative pressure support vs pressure controlled ventilation on oxygenation and lung function in moderately obese adults*ANAESTHESIA, Issue 2 2010M. Zoremba Summary Obesity impairs peri-operative lung function. To evaluate the impact of pressure support ventilation vs pressure controlled ventilation in moderately obese adults upon early postoperative lung function, we randomly assigned 68 moderately obese patients (body mass index 25,35 kg.m,2) undergoing minor surgery to receive intra-operative ventilation either with pressure support or pressure controlled ventilation. We performed intra-operative blood gas analysis and measured pulse oximetry saturation, spirometry values at pre-operative assessment (baseline) and at 10 min, 30 min, 2 h and 24 h after extubation. The intra-operative oxygenation index (arterial partial pressure of oxygen/fraction of inspired oxygen) in the pressure support ventilation group was significantly improved over time (p < 0.0001). Postoperatively, the pressure support ventilation group also had better lung function and oxygenation values than did the pressure controlled ventilation group (p < 0.005). We conclude that pressure support ventilation better maintains lung function than pressure controlled ventilation in moderately overweight patients scheduled for minor surgery. [source] Association Study and Mutation Analysis of Adiponectin Shows Association of Variants in APM1 with Complex Obesity in WomenANNALS OF HUMAN GENETICS, Issue 5 2009Sigri Beckers Summary We performed an association study and mutation analysis of the adiponectin (APM1) gene to study its involvement in the development of obesity. We also studied the interaction with peroxisome proliferator-activated receptor , (PPAR,). 223 obese women and 87 healthy female control subjects were used for association analysis. Mutation analysis was done on 95 morbidly obese adults and 123 overweight and obese children and adolescents. We selected 6 haplotype tagging SNPs in APM1 and the Pro12Ala variant (rs1805192) in PPAR, to study the interaction. The G allele of rs2241766 was more common in controls (cases 10.8% vs. controls 18.4%, nominal p = 0.011; OR = 0.57, nominal p = 0.018). The rs2241766/rs3774261 haplotype was also associated with obesity (nominal p = 0.004). Only the latter association remained significant after controlling for the False Discovery Rate. Resequencing of exon 2, exon 3 and intron 2 in 95 individuals did not reveal any SNPs in high linkage disequilibrium with rs2241766. No interaction with the Pro12Ala variant in PPAR, was detected. Mutation analysis of APM1 did not identify mutations. In conclusion, we found an association of an APM1 haplotype with obesity and found that APM1 mutations are not a common cause of monogenic obesity in our cohort. [source] Dynamics of GH secretion during incremental exercise in obesity, before and after a short period of training at different work-loadsCLINICAL ENDOCRINOLOGY, Issue 4 2010Alberto Salvadori Summary Background, Growth hormone (GH) secretion is normally sensitive to physical exercise. Intensity and duration of exercise, fitness and age can all influence the GH response to exercise. In obesity, GH secretion is decreased both in basal conditions and in response to exercise. Objective, To analyse the dynamics of GH response to a progressive cycloergometric test, conducted up to exhaustion, in adult normal subjects and obese patients, after a reconditioning program at different workloads. Design and methods, We studied eight lean subjects (four men, mean age 34·3 years, range 26,47 years, mean body mass index (BMI) 22·1 kg/m2). GH was sampled at baseline and during the last 30 s of each power output increase. Anaerobic threshold (AT) was detected by the V-slope method. The same test was carried out in 16 obese subjects (seven men, mean age 39·1 years, range 20,59 years, mean BMI 35·8 kg/m2) and repeated after a 4-week reconditioning program consisting of aerobic workout (Group A, eight subjects, three men, mean age 40·5 years, range 22,59 years, mean BMI 33·6 kg/m2), and aerobic plus anaerobic work (group B, eight subjects, four men, mean age 37·6 years, range 20,56 years, mean BMI 38·0 kg/m2) for 6 days/week, with no dietary restrictions. Results, Mean exercise peak occurred at higher intensity in controls (140 vs 110 W, P < 0·05), and AT exceeded at higher work outputs than in obese subjects (102 vs 74 W, P < 0·05). In controls, GH response to exercise was prompt and further sustained after AT; in obese subjects, GH increased slowly and insignificantly before AT, thereafter it increased to lower levels than in controls (P < 0·001). Following the reconditioning period, both Group A and Group B of obese subjects failed to improve exercise performance as well as GH response to exercise before AT; beyond AT, a greater GH response to exercise occurred in Group B than Group A (7·59 ± 0·32 ,g/l at peak of exercise) with significantly different Delta AUCs (Area Under the Curves) following AT: 30·5 ± 12 ,g.min/l in Group A vs 124·2 ± 38 ,g.min/l in Group B, P < 0·05. Conclusions Our results confirm the blunted GH response to exercise in obese adults when compared to lean counterparts. With obesity, aerobic training poorly increases the GH response beyond AT, while supplemental anaerobic workload appears to increase GH response beyond AT. These observations may have implications for the prescription of physical exercise, which is one of the recommendations in the management of obesity. [source] Acute and chronic effects of vitamin C on endothelial fibrinolytic function in overweight and obese adult humansTHE JOURNAL OF PHYSIOLOGY, Issue 14 2008Gary P. Van Guilder We determined the effects of acute intra-arterial vitamin C administration and chronic oral vitamin C supplementation on the capacity of the endothelium to release t-PA in overweight and obese adults. Net endothelial t-PA release was determined in vivo in response to intrabrachial infusions of bradykinin and sodium nitroprusside in 33 sedentary adults: 10 normal-weight (BMI: 23.4 ± 0.5 kg m,2; 7M/3F); and 23 overweight/obese (BMI: 31.2 ± 0.8 kg m,2; 15M/8F). In 10 normal weight and eight overweight/obese adults the dose,response curves to bradykinin and sodium nitroprusside were repeated with a coinfusion of the antioxidant vitamin C (24 mg min,1). Seventeen of the 23 overweight/obese adults completed a 3 month chronic oral vitamin C (500 mg day,1) supplementation intervention. Intra-arterial administration of vitamin C significantly potentiated t-PA release in overweight/obese adults. Net release of t-PA was ,95% higher (P < 0.01) after (from ,0.9 ± 1.1 to 94.6 ± 16.2 ng (100 ml tissue),1 min,1) compared with before (from ,0.8 ± 0.8 to 49.9 ± 7.7 ng (100 ml tissue),1 min,1) vitamin C administration. Daily vitamin C supplementation significantly increased t-PA release in overweight/obese adults (from 0.2 ± 0.9 to 48.2 ± 6.5 ng (100 ml tissue),1 min,1) before supplementation versus (0.3 ± 0.5 to 66.3 ± 8.7 ng (100 ml tissue),1 min,1) after supplementation. These results indicate that the antioxidant vitamin C favourably affects the capacity of the endothelium to release t-PA in overweight/obese adults. Daily vitamin C supplementation represents an effective lifestyle intervention strategy for improving endothelial fibrinolytic regulation in this at-risk population. [source] | |||||||||||||