scholarly journals A Mobile-Based Intervention for Dietary Behavior and Physical Activity Change in Individuals at High Risk for Type 2 Diabetes Mellitus: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Zidu Xu ◽  
Ji Geng ◽  
Shuai Zhang ◽  
Kexin Zhang ◽  
Lin Yang ◽  
...  

BACKGROUND Intensive lifestyle modifications have proved effective in preventing type 2 diabetes mellitus (T2DM), yet the efficiency and effectiveness of these modifications need to be improved. Emerging social media interventions are considered useful in promoting these lifestyles; nevertheless, few studies have investigated the effectiveness of combining them with behavior theory. OBJECTIVE This study aims to examine the effectiveness of a 6-month mobile-based intervention (DHealthBar, a WeChat applet) combined with behavioral theory compared with a printed intervention in improving dietary behaviors, physical activity, and intention to change these behaviors among populations at high risk for T2DM. METHODS Participants aged 23 to 67 years were recruited offline in Beijing, China, and were randomized into the intervention group or the control group, which received educational content via DHealthBar or a printed handbook, respectively. Educational materials were culturally tailored recommendations on improving dietary behaviors, physical activity, and intention to change based on the transtheoretical model. Participants in the intervention arm received push notifications twice per week on WeChat and had access to the educational content for the 6-month study period. Participants in the control arm received the same intervention content through printed materials. The outcomes of participants’ behavior change, intention to change behavior, and anthropometric characteristics were collected via online measuring tools at baseline, 3 months, and 6 months. RESULTS In this study, 79 enrolled individuals completed baseline information collection (control: n=38 vs intervention: n=41), and 96% (76/79) completed the 6-month follow-up visit. Attrition rates did not differ significantly between the 2 groups (<i>χ</i><sup>2</sup><sub>1</sub>=0.0, <i>P</i>=.61). Baseline equivalence was found. Participants in both groups reported a statistically significant decrease in energy intake at the 2 follow-up assessments compared with baseline (3 months, control: exp[<strong>β</strong>]=0.83, 95% CI 0.74-0.92 vs intervention: exp[<strong>β</strong>]=0.76, 95% CI 0.68-0.85; 6 months, control: exp[<strong>β</strong>]=0.87, 95% CI 0.78-0.96 vs intervention: exp[<strong>β</strong>]=0.57, 95% CI 0.51-0.64). At 6 months, a significantly larger decrease was observed in the intervention group in energy, fat, and carbohydrate intake, accompanied with a significantly larger increase in moderate-intensity physical activity compared with the control group (energy: exp[<strong>β</strong>]=0.66, 95% CI 0.56-0.77; fat: exp[<strong>β</strong>]=0.71, 95% CI 0.54-0.95; carbohydrates: exp[<strong>β</strong>]=0.83, 95% CI 0.66-1.03; moderate-intensity physical activity: exp[<strong>β</strong>]=2.05, 95% CI 1.23-3.44). After 6 months of the intervention, participants in the intervention group were more likely to be at higher stages of dietary behaviors (exp[<strong>β</strong>]=26.80, 95% CI 3.51-204.91) and physical activity (exp[<strong>β</strong>]=15.60, 95% CI 2.67-91.04) than the control group. CONCLUSIONS DHealthBar was initially effective in improving dietary behavior, physical activity, and intention to change these behaviors among populations who were at high risk of developing T2DM, with significant differences in the changes of outcomes over the 6-month intervention period. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR2000032323; https://tinyurl.com/y4h8q4uf

10.2196/19869 ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. e19869
Author(s):  
Zidu Xu ◽  
Ji Geng ◽  
Shuai Zhang ◽  
Kexin Zhang ◽  
Lin Yang ◽  
...  

Background Intensive lifestyle modifications have proved effective in preventing type 2 diabetes mellitus (T2DM), yet the efficiency and effectiveness of these modifications need to be improved. Emerging social media interventions are considered useful in promoting these lifestyles; nevertheless, few studies have investigated the effectiveness of combining them with behavior theory. Objective This study aims to examine the effectiveness of a 6-month mobile-based intervention (DHealthBar, a WeChat applet) combined with behavioral theory compared with a printed intervention in improving dietary behaviors, physical activity, and intention to change these behaviors among populations at high risk for T2DM. Methods Participants aged 23 to 67 years were recruited offline in Beijing, China, and were randomized into the intervention group or the control group, which received educational content via DHealthBar or a printed handbook, respectively. Educational materials were culturally tailored recommendations on improving dietary behaviors, physical activity, and intention to change based on the transtheoretical model. Participants in the intervention arm received push notifications twice per week on WeChat and had access to the educational content for the 6-month study period. Participants in the control arm received the same intervention content through printed materials. The outcomes of participants’ behavior change, intention to change behavior, and anthropometric characteristics were collected via online measuring tools at baseline, 3 months, and 6 months. Results In this study, 79 enrolled individuals completed baseline information collection (control: n=38 vs intervention: n=41), and 96% (76/79) completed the 6-month follow-up visit. Attrition rates did not differ significantly between the 2 groups (χ21=0.0, P=.61). Baseline equivalence was found. Participants in both groups reported a statistically significant decrease in energy intake at the 2 follow-up assessments compared with baseline (3 months, control: exp[β]=0.83, 95% CI 0.74-0.92 vs intervention: exp[β]=0.76, 95% CI 0.68-0.85; 6 months, control: exp[β]=0.87, 95% CI 0.78-0.96 vs intervention: exp[β]=0.57, 95% CI 0.51-0.64). At 6 months, a significantly larger decrease was observed in the intervention group in energy, fat, and carbohydrate intake, accompanied with a significantly larger increase in moderate-intensity physical activity compared with the control group (energy: exp[β]=0.66, 95% CI 0.56-0.77; fat: exp[β]=0.71, 95% CI 0.54-0.95; carbohydrates: exp[β]=0.83, 95% CI 0.66-1.03; moderate-intensity physical activity: exp[β]=2.05, 95% CI 1.23-3.44). After 6 months of the intervention, participants in the intervention group were more likely to be at higher stages of dietary behaviors (exp[β]=26.80, 95% CI 3.51-204.91) and physical activity (exp[β]=15.60, 95% CI 2.67-91.04) than the control group. Conclusions DHealthBar was initially effective in improving dietary behavior, physical activity, and intention to change these behaviors among populations who were at high risk of developing T2DM, with significant differences in the changes of outcomes over the 6-month intervention period. Trial Registration Chinese Clinical Trial Registry ChiCTR2000032323; https://tinyurl.com/y4h8q4uf


2021 ◽  
Vol 29 (10) ◽  
pp. 550-556
Author(s):  
Ralph Smith ◽  
Ashley Ridout ◽  
Angus Livingstone ◽  
Nicola Wango ◽  
Yvonne Kenworthy ◽  
...  

Regular physical activity improves glycaemic control in pregnant women with gestational diabetes. Motivational interviewing is an effective technique for increasing activity levels. This report evaluates a clinical pathway developed to integrate physical activity motivational interviewing into routine gestational diabetes care. Women attending a single-centre NHS clinic were invited to engage in a physical activity-focused motivational interview. The aerobic physical activity levels of 62 women were evaluated at baseline and at a 2-week telephone follow up, coded into three categories by minutes of moderate intensity physical activity per week: red (<30 minutes), amber (30–149 minutes) and green (≥150 minutes). At baseline, 30.6% of participants were coded red, 41.9% amber and 27.4% green. At follow up, 4.8% women coded red, 38.7% amber and 56.5% green, demonstrating a significant association for increased activity levels after motivational interviewing (P<0.001). This clinical pathway provides encouraging results that physical activity increased significantly in the short term.


Author(s):  
Gilmar Mercês de Jesus ◽  
Lizziane Andrade Dias ◽  
Anna Karolina Cerqueira Barros ◽  
Lara Daniele Matos dos Santos Araujo ◽  
Emil Kupek ◽  
...  

ABSTRACT We analyzed the effect of obesity on daily physical activity (DPA), light-intensity physical activity (LPA), moderate-intensity physical activity (MPA) and vigorous- intensity physical activity (VPA) in children and adolescents. Overall, 462 students from a public school (53.6% boys; aged 7-12 years) were involved in this one-year longitudinal study. Physical activities and sedentary behaviors (SB) were reported in the questionnaire Food Intake and Physical Activity of Students (Web-CAAFE). Obesity was evaluated through Body Mass Index (BMI z score ≥ 2). Obesity was observed in 16.5% of participants, but it did not influence LPA, MPA or DPA. However, VPA were 20% less frequent among obese students (β2=0.80; CI 95%: 0.66-0.98). Obese girls showed less frequency of VPA than non-obese boys (Mean Difference = -0.97; CI 95%: -1.36 to -0.57). Non-obese girls showed less VPA than non-obese boys (Mean Difference = -1.18; CI 95%: -1.40 to -0.95) and obese ones (Mean Difference = -0.57; CI 95%: -0.90 to -0.24). Obese boys showed fewer VPA, if compared to non-obese ones (Mean Difference = -0.61; CI 95%: -0.96 to -0.26). The analysis of the obesity-sex-age interaction showed a greater reduction in VPA among obese girls aged 10 years or more when compared to obese girls aged 7-9 years, and among boys obese and non-obese regardless of age. Amounts of VPA and SB increased simultaneously among non-obese boys and non-obese children aged 7-9 years. Obesity reduced VPA in the sample during the follow up of one year, independently of age and SB.


2020 ◽  
Author(s):  
Ruth Hunter ◽  
Jennifer M. Murray ◽  
Helen G. Coleman

Abstract Background Evidence is suggestive of sedentary behaviour being associated with an increased risk of endometrial cancer, but the evidence base is too limited to draw any conclusions for other cancers. The aim of the study was to investigate the association between recreational sedentary behaviour and site-specific, and total, cancer incidence. Methods We analysed data from the prospective UK Biobank cohort study. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) between recreational sedentary behaviour (including television (TV) viewing time, computer use time and daily total screen time) and cancer risk. Partition models and isotemporal substitution models investigated the impact of substituting recreational sedentary behaviour with physical activity. Results During a mean follow-up of 7.6 years, 28,992 incident cancers were identified among 470,578 adults. A 1-hour increase in daily TV viewing time was associated with higher risks of oropharyngeal, oesophago-gastric and colon cancer in fully adjusted models. Participants who reported ≤1, compared with 1-≤3, hours/day of TV viewing time had lower risks of lung, breast, and oesophago-gastric cancer. Findings were inconsistent for computer use and daily total screen time. The majority of observed associations were small, and were attenuated after excluding cancers diagnosed within the first two years of follow-up, except for oesophago-gastric and colon cancers (HR 1.05, 95% CI: 1.01-1.10; and HR 1.04, 95% CI: 1.01-1.07 per 1-hour increase in daily TV viewing time, respectively). However, isotemporal substitution models showed reduced risk of total cancer (HR 0.97, 95% CI: 0.95, 0.99) and some site-specific (oropharyngeal, lung, breast and colorectal) cancers when replacing 1-hour/day of TV viewing with 1-hour of moderate-intensity physical activity or walking. Conclusions Our findings show that recreational sedentary behaviours, particularly TV viewing, were associated with small increased risks of oesophago-gastric and colon cancer. Replacing 1-hour per day of TV viewing with 1-hour of moderate-intensity physical activity or walking was associated with lower risk of total cancer and oropharyngeal, lung, breast and colorectal cancers. Further research from other large prospective cohort studies is required, while mechanistic research is warranted to enhance the biological plausibility of these findings.


2021 ◽  
Author(s):  
Ahmed Negm ◽  
Milad Yavarai ◽  
Gian Jhangri ◽  
Robert Haennel ◽  
Allyson Jones

Abstract BackgroundThe increase rate seen in Total Hip Arthroplasty (THA) for younger patients has implications for future rehabilitation demands for primary and revision THA surgery. This study aims to determine the impact of a 6-week post-operative rehabilitation program designed for THA patients ≤ 60 years on physical activity (PA) and function compared to age- and a sex-matched control group received usual postoperative care at 12-week post-THA. MethodsIn this quasi-experimental study, a cohort of THA candidates was recruited during their 6-week postoperative visit to their surgeons. The out-patient rehabilitation program consisted of 12 structured exercise classes (2 hrs/class) over 6 weeks. Physical activity was assessed using Sense Wear Pro ArmbandTM [SWA]. Participants completed the Hip Osteoarthritis Outcome Score (HOOS), and THA satisfaction questionnaire before and immediately after the intervention. ResultsThe intervention group took significantly more steps/day at the follow-up compared to baseline. The intervention group had a higher mean change in the number of weekly PA bouts than the control group. Within the intervention groups, all HOOS subscales were significantly higher at the follow-up compared to baseline. ConclusionThe augmented rehabilitation program may have immediate effects on pain relief and symptom reduction for patients (≤60 years) following THA.


2018 ◽  
Vol 49 (2) ◽  
Author(s):  
Zorislava Bajić ◽  
Nela Rašeta ◽  
Nenad Ponorac

Introduction: Bone formation marker osteocalcin (OC) and bone resorption marker C-terminal telopeptide of type 1 collagen (CTX) can be used to detect or to monitor the early responses of the skeleton to physical activity. Literature suggests that it is likely that higher body mass index (BMI) has positive effect on bones and can postpone onset of osteoporosis.Aim of the Study: The aim of this study is to:1.Determine the effect of aerobic physical acitivity on OC and CTX in young women2.Investigate correlation of OC, CTX and BMI in young women engaged into structured aerobic excerciseMaterial and methods: Study included 64 healthy young women, aged 19 to 25 years, devided into two groups: intervention group (n=32) and control group (n=32). The study duration was six weeks with follow-up period of four weeks. The intervention group underwent structured aerobic physical activity program for six weeks, but the control group did not receive such program. Level of OC, CTX and BMI were measured at baseline, after 6-week aerobic program, and after 4-week follow up (only intervention group).Results: There was significant increase of OC level after 6-week aerobic program, while level of CTX did not changed. OC level was at its maximum immediately after finishing the program in the participants with normal BMI (p<0.001). There was no statistically significant interaction of BMI and CTX level.Conclusion: Aerobic physical activity increases level of osteocalcin, suggesting that it has positive influence on bone formation in young women, primarily in women with normal BMI.


1999 ◽  
Vol 2 (3a) ◽  
pp. 383-390 ◽  
Author(s):  
Rainer Rauramaa ◽  
SB Väisänen

AbstractRegular moderate intensity physical activity and habitual diet providing no more than one third of energy from fats have been recommended for the prevention of atherosclerotic diseases. The background for these guidelines is the key role of plasma lipids. However, the importance of thrombogenesis in acute myocardial infarction has become obvious during the last decade. Hyperlipidaemia and excess of adipose tissue increase platelet aggregability and blood coagulation, and decrease fibrinolysis. Both regular physical activity and dietary fat reduction decrease blood lipids and body fat thereby diminishing the risk of thrombosis. Currently, data on interactions between physical activity and diet on haemostasis are scarce, and the few studies available have not demonstrated additional effects when these two lifestyle modifications have been combined. This paper is restricted only to studies using controlled randomized design. Regular moderate intensity physical activity as well as diet rich in omega-3 fatty acids decrease platelet aggregability. The effects of regular physical activity on plasma fibrinogen remain contradictory, while the impact of diet is even less clear. Plasminogen activator inhibitor-1, a possible link between insulin resistance syndrome and coronary heart disease, may decrease due to physical training or low fat diet. It can be hypothesized that moderation in physical activity and diet carries a more powerful impact on blood coagulation and fibrinolysis than either lifestyle modification alone. Studies focusing on the interactions of regular moderate physical activity and fat-modified diet are needed in efforts to optimize the preventive actions by lifestyle changes.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Joshua R Sparks ◽  
Xuewen F Wang

Background: Glucose concentrations in a fasted and during a glucose challenged state rely on different mechanisms for regulation. In a fasted state, hepatic regulation of glucose is important; while in a glucose challenged state, muscle glucose disposal becomes more important. Evidence suggests that physical activity of moderate or higher intensities can increase muscle glucose disposal during an insulin-stimulated state, but has less effect on hepatic insulin sensitivity. The purpose of this study was to examine the associations between glucose concentrations (fasting and after an oral glucose ingestion) and minutes of physical activity at moderate- and vigorous-intensity in a large population. Methods: The sample included 2,807 adults (47.4% male and 52.6% female) aged 18-80 years who participated in the National Health and Nutritional Examination Surveys (NHANES) from 2013-2014 and who did not take any diabetic medications. Minutes being physically active at moderate- and vigorous-intensities during work, and recreationally, were collected using the Physical Activity Questionnaire, which was based on the Global Physical Activity Questionnaire. Moderate-intensity physical activity was defined as any activity that caused a small increase in breathing or heart rate, while vigorous-intensity physical activity was defined as large increases in breathing or heart rate. Both intensities had to be performed for a minimum of 10 continuous minutes. Plasma glucose concentrations at fasting and 2 hours after consumption of a drink containing 75g glucose (2-hour glucose) were determined. Pearson product correlations were performed for analysis. Results: The population had 141±133 (mean±SD) minutes of moderate-intensity physical activity during work and 63±56 minutes recreationally, as well as 174±156 minutes of vigorous-intensity physical activity during work and 77±56 minutes recreationally. Minutes of vigorous-intensity physical activity performed during work was associated with 2-hour plasma glucose concentrations (r=0.15; p=0.045); this association was not affected after adjusting for age, race, and sex (p=0.049), but was no longer significant after BMI was also adjusted (p=0.059). Recreational or total minutes of vigorous-intensity physical activity, and moderate-intensity physical activity was not associated with 2-hour glucose (p>0.20). Additionally, none of the physical activity minutes was associated with fasting glucose (p>0.27). Conclusion: Self-reported vigorous-intensity physical activity during work was positively associated with 2-hour glucose, but not fasting glucose. The results are surprising. Further studies with objective physical activity measures are needed to examine the associations with fasting and 2-hour glucose.


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