scholarly journals Lifestyle information and access to a commercial weight management group to promote maternal postnatal weight management and positive lifestyle behaviour: the SWAN feasibility RCT

2020 ◽  
Vol 8 (9) ◽  
pp. 1-176
Author(s):  
Debra Bick ◽  
Cath Taylor ◽  
Vanita Bhavnani ◽  
Andy Healey ◽  
Paul Seed ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Management ◽  
Body Mass ◽  
Health Research ◽  
Controlled Trial ◽  
Public Health Research ◽  
Normal Body Mass Index ◽  
Lifestyle Behaviour ◽  
Normal Body ◽  
Randomised Controlled

Background Increasing numbers of UK women have overweight or obese body mass index scores when they become pregnant, or gain excessive weight in pregnancy, increasing their risk of adverse outcomes. Failure to manage postnatal weight is linked to smoking, non-healthy dietary choices, lack of regular exercise and poorer longer-term health. Women living in areas of higher social deprivation are more likely to experience weight management problems postnatally. Objectives The objectives were to assess the feasibility of conducting a definitive randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of lifestyle information and access to a commercial weight management group focusing on self-monitoring, goal-setting and motivation to achieve dietary change commencing 8–16 weeks postnatally to achieve and maintain weight management and positive lifestyle behaviour. Design The design was a randomised two-arm feasibility trial with a nested mixed-methods process evaluation. Setting The setting was a single centre in an inner city setting in the south of England. Participants Participants were women with body mass index scores of > 25 kg/m2 at antenatal ‘booking’ and women with normal body mass index scores (18.0–24.9 kg/m2) at antenatal booking who developed excessive gestational weight gain as assessed at 36 weeks’ gestation. Main outcome measures Recruitment, retention, acceptability of trial processes and identification of relevant economic data were the feasibility objectives. The proposed primary outcome was difference between groups in weight at 12 months postnatally, expressed as percentage weight change and weight loss from antenatal booking. Other proposed outcomes included assessment of diet, physical activity, smoking, alcohol consumption, body image, maternal esteem, mental health, infant feeding and NHS costs. Results Most objectives were achieved. A total of 193 women were recruited, 98 allocated to the intervention arm and 95 to the control arm. High follow-up rates (> 80%) were achieved to 12 months. There was an 8.8% difference in weight loss at 12 months between women allocated to the intervention arm and women allocated to the control arm (13.0% vs. 4.2%, respectively; p = 0.062); 47% of women in the intervention arm attended at least one weight management session, with low risk of contamination between arms. The greatest benefit was among women who attended ≥ 10 sessions. Barriers to attending sessions included capability, opportunity and motivation issues. Data collection tools were appropriate to support economic evaluation in a definitive trial, and economic modelling is feasible to quantify resource impacts and outcomes not directly measurable within a trial. Limitations The trial recruited from only one site. It was not possible to recruit women with normal body mass index scores who developed excessive pregnancy weight gain. Conclusions It was feasible to recruit and retain women with overweight or obese body mass index scores at antenatal booking to a trial comparing postnatal weight management plus standard care with standard care only and collect relevant data to assess outcomes. Approaches to recruit women with normal body mass index scores who gain excessive gestational weight need to be considered. Commercial weight management groups could support women’s weight management as assessed at 12 months postnatally, with probable greater benefit from attending ≥ 10 sessions. Process evaluation findings highlighted the importance of providing more information about the intervention on trial allocation, extended duration of time to commence sessions following birth and extended number of sessions offered to enhance uptake and retention. Results support the conduct of a future randomised controlled trial. Trial registration Current Controlled Trials ISRCTN39186148. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 9. See the NIHR Journals Library website for further project information.

scholarly journals Football Fans in Training (FFIT): a randomised controlled trial of a gender-sensitised weight loss and healthy living programme for men – end of study report

2015 ◽  
Vol 3 (2) ◽  
pp. 1-130 ◽  
Author(s):  
Sally Wyke ◽  
Kate Hunt ◽  
Cindy M Gray ◽  
Elisabeth Fenwick ◽  
Christopher Bunn ◽  
...  
Keyword(s):  
Weight Loss ◽  
Cost Effectiveness ◽  
Weight Management ◽  
Health Research ◽  
Controlled Trial ◽  
Cost Effective ◽  
Public Health Research ◽  
Randomised Controlled ◽  
Objectively Measured ◽  
Cost Effectiveness Threshold

BackgroundThe prevalence of male obesity is increasing alongside low uptake of existing weight management programmes by men. Football Fans in Training (FFIT) is a group-based, weight management and healthy living programme delivered by community coaches.ObjectivesTo assess (1) the effectiveness and cost-effectiveness of FFIT, (2) fidelity of delivery and (3) coach and participant experiences of FFIT.DesignA two-arm, pragmatic, randomised controlled trial; associated cost-effectiveness [in terms of incremental cost per quality-adjusted life-year (QALY) within trial and over individuals’ lifetimes]; and process evaluation. Participants were block randomised in a 1 : 1 ratio, stratified by club; the intervention group started FFIT within 3 weeks and the comparison group were put on a 12-month waiting list.SettingThirteen professional football clubs in Scotland, UK.ParticipantsA total of 747 men aged 35–65 years with an objectively measured body mass index (BMI) of ≥ 28 kg/m2.InterventionsFFIT was gender sensitised in context, content and style of delivery. A total of 12 weekly sessions delivered at club stadia combined effective behaviour change techniques with dietary information and physical activity sessions. Men carried out a pedometer-based walking programme. A light-touch maintenance programme included six e-mails and a reunion session at 9 months. At baseline, both groups received a weight management booklet, feedback on their BMI and advice to consult their general practitioner if blood pressure was high.Primary outcomeMean difference in weight loss between groups at 12 months expressed as absolute weight and a percentage. Intention-to-treat analyses used all available data.Data sourcesObjective measurements, questionnaires, observations, focus groups and coach interviews.ResultsA total of 374 men were allocated to the intervention and 333 (89%) completed 12-month assessments; a total of 374 were allocated to the comparator and 355 (95%) completed 12-month assessments. At 12 months, the mean difference in weight loss between groups, adjusted for baseline weight and club, was 4.94 kg [95% confidence interval (CI) 3.95 kg to 5.94 kg]; percentage weight loss, similarly adjusted, was 4.36% (95% CI 3.64% to 5.08%), in favour of the intervention (p < 0.0001). Sensitivity analyses gave similar results. Pre-specified subgroup analyses found no significant predictors of primary outcome. Highly significant differences in favour of the intervention were observed for objectively measured waist, percentage body fat, systolic and diastolic blood pressure, and self-reported physical activity, diet and indicators of well-being and physical aspects of quality of life. Eight serious adverse events were reported, of which two were reported as related to FFIT participation. From the within-trial analysis, FFIT was estimated to cost £862 per additional man maintaining a 5% weight reduction at 12 months and £13,847 per additional QALY, both compared with no intervention. For a cost-effectiveness threshold of £20,000/QALY, the probability that FFIT is cost-effective, compared with no active intervention, is 0.72. This probability rises to 0.89 for a cost-effectiveness threshold of £30,000/QALY. From the longer-term analysis, FFIT was estimated to cost £2535 per life-year gained and £2810 per QALY gained. FFIT was largely delivered as intended. The process evaluation demonstrated the powerful draw of football to attract men at high risk of ill health. FFIT was popular and analyses suggest that it enabled lifestyle change in ways that were congruent with participants’ identities.ConclusionsParticipation in FFIT led to significant reductions in weight at 12 months. It was cost-effective at standard levels employed in the UK, attracted men at high risk of future ill health and was enjoyable. Further research should investigate whether or not participants retained weight loss in the long term, how the programme could be optimised in relation to effectiveness and intensity of delivery and how group-based programmes may operate to enhance weight loss in comparison with individualised approaches.Study registrationCurrent Controlled Trials ISRCTN32677491.FundingScottish Government and The Football Pools funded the delivery of FFIT. National Institute for Health Research Public Health Research programme funded the evaluation and will be published in full inPublic Health Research; Vol. 3, No. 2. See the NIHR Journals Library website for further project information.

KEJADIAN PENYAKIT HIPERTENSI DAN INDEKS MASSA TUBUH PADA PEREMPUAN YANG TINGGAL DI PEDESAAN DAN PERKOTAAN

2019 ◽  
pp. 127-136
Author(s):  
Venti Agustina
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Body Mass ◽  
Rural Women ◽  
Urban Areas ◽  
Stage I ◽  
Normal Body Mass Index ◽  
Cross Sectional ◽  
Normal Body ◽  
Stadium I

Hipertensiadalah penyebab kematian utama di Indonesia. Kematian akibat hipertensi lebih banyak terjadi di perkotaan dibandingkan di desa. Tingginya kejadian hipertensi dipengaruhi oleh faktor yang dapat dikontrol (obesitas,berat badan lebih, konsumsi garam berlebih,aktivitas fisik rendah, perokok, dan konsumsi alkohol) dan faktor yang tidak dapat dikontrol (genetik, usia, dan jenis kelamin). Penelitian bertujuan memberikan gambarandistribusi tekanan darah dan indeks massa tubuh (IMT) pendudukperempuan di kota maupun di desa.Desain penelitian adalah deskriptif kuatitatif dengan pendekatan cross sectional. Data primer didapatkan melalui pengukuran tekanan darah, tinggi badan dan berat badan. Penelitian dilakukan di Desa Kutowinangun Kidul, Kecamatan Tingkir,Salatiga yang mewakili penduduk perempuan di perkotaan dan Desa Batur, Kecamatan Getasan, Kabupaten Semarangyang mewakili penduduk perempuan pedesaan. Adapun jumlah sampel masing-masing 66 respondendan 72responden. Hasil penelitian menunjukkan bahwa kejadian penyakit hipertensi, resiko obese dan obese lebih didominasi oleh respondendi perkotaan dibandingkan di pedesaan dengan rentang usia di atas 46 tahun. Respondendi desa dengan indeks massa tubuh normal cenderung mengalami pre-hipertensi (8,3%) dan hipertensi stadium I (6,9%) sementararesponden dengan resiko obese dan obese cenderung mengalami hipertensi stadium I (1,4%).Respondendi kota dengan indeks massa tubuh normal cenderung mengalami pre hipertensi (6,06%), hipertensi stadium I (4,5%) dan II (7,5%). Responden dengan resiko obese cenderung mengalami hipertensi stadium I (4,5%), dan responden dengan obese I dan II cenderung mengalami pre-hipertensi (4,5%).   Hypertension is the leading cause of death in Indonesia. Deaths due to hypertension are more common in urban areas than in villages. The high incidence of hypertension is influenced by factors that can be controlled (obesity, overweight, excessive salt consumption, low physical activity, smokers, and alcohol consumption) and factors that cannot be controlled (genetic, age, and sex). The study aimed to provide an overview of blood pressure distribution and body mass index (BMI) of female residents in cities and villages. The study design was descriptive quantitative with a cross sectional approach. Primary data was obtained through measurements of blood pressure, height and weight. The study was conducted in Kutowinangun Kidul Village, Tingkir Subdistrict, Salatiga representing women in urban areas and Batur Village, Getasan Subdistrict, Semarang Regency, representing rural women. The number of samples was 66 respondents and 72 respondents respectively. The results showed that the incidence of hypertension, the risk of obese and obese was more dominated by respondents in urban areas than in rural areas with ages above 46 years. Respondents in villages with normal body mass index tended to experience pre-hypertension (8.3%) and stage I hypertension (6.9%) while respondents with obese and obese risk tended to experience stage I hypertension (1.4%). Respondents in cities with normal body mass index tended to experience pre-hypertension (6.06%), stage I hypertension (4.5%) and II (7.5%). Respondents with obese risk tended to experience stage I hypertension (4.5%), and respondents with obese I and II tended to experience pre-hypertension (4.5%).

scholarly journals Maternal Body Mass Index and Use of Labor Neuraxial Analgesia

2018 ◽  
Vol 129 (3) ◽  
pp. 448-458 ◽  
Author(s):  
Alexander J. Butwick ◽  
Cynthia A. Wong ◽  
Nan Guo
Keyword(s):  
Body Mass Index ◽  
Relative Risk ◽  
Body Mass ◽  
Normal Body Mass Index ◽  
Adjusted Relative Risk ◽  
Obese Women ◽  
Obesity Class ◽  
Normal Body ◽  
Neuraxial Analgesia ◽  
Obese Class

Abstract What We Already Know about This Topic What This Article Tells Us That Is New Background Neuraxial labor analgesia may benefit obese women by optimizing cardiorespiratory function and mitigating complications related to emergency general anesthesia. We hypothesized that obese women have a higher rate of neuraxial analgesia compared with nonobese parturients. Methods Using U.S. natality data, our cohort comprised 17,220,680 deliveries, which accounts for 61.5% of 28 million births in the United States between 2009 and 2015. We examined the relationships between body mass index class and neuraxial labor analgesia, adjusting for sociodemographic, antenatal, pregnancy, and peripartum factors. Results The study cohort comprised 17,220,680 women; 0.1% were underweight, 12.7% were normal body mass index, 37% were overweight, and 28.3%, 13.5%, and 8.4% were obesity class I, II, and III, respectively. Rates of neuraxial analgesia by body mass index class were as follows: underweight, 59.7% (9,030/15,128); normal body mass index, 68.1% (1,487,117/2,182,797); overweight, 70.3% (4,476,685/6,368,656); obesity class I, 71.8% (3,503,321/4,881,938); obesity class II, 73.4% (1,710,099/2,330,028); and obesity class III, 75.6% (1,089,668/1,442,133). Compared to women with normal body mass index, the likelihood of receiving neuraxial analgesia was slightly increased for overweight women (adjusted relative risk, 1.02; 95% CI, 1.02 to 1.02), obese class I (adjusted relative risk, 1.04; 95% CI, 1.04 to 1.04), obese class II (adjusted relative risk, 1.05; 95% CI, 1.05 to 1.05), and obese class III (adjusted relative risk, 1.06; 95% CI, 1.06 to 1.06). Conclusions Our findings suggest that the likelihood of receiving neuraxial analgesia is only marginally increased for morbidly obese women compared to women with normal body mass index.

scholarly journals Association of Body Fat and Risk of Breast Cancer in Postmenopausal Women With Normal Body Mass Index

JAMA Oncology ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. 155 ◽  
Author(s):  
Neil M. Iyengar ◽  
Rhonda Arthur ◽  
JoAnn E. Manson ◽  
Rowan T. Chlebowski ◽  
Candyce H. Kroenke ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Postmenopausal Women ◽  
Body Mass ◽  
Body Fat ◽  
Normal Body Mass Index ◽  
Normal Body

scholarly journals An assets-based intervention before and after birth to improve breastfeeding initiation and continuation: the ABA feasibility RCT

2020 ◽  
Vol 8 (7) ◽  
pp. 1-156
Author(s):  
Joanne L Clarke ◽  
Jenny Ingram ◽  
Debbie Johnson ◽  
Gill Thomson ◽  
Heather Trickey ◽  
...  
Keyword(s):  
Public Health ◽  
Randomised Controlled Trial ◽  
Infant Feeding ◽  
Health Research ◽  
Controlled Trial ◽  
Intervention Group ◽  
Public Health Research ◽  
Breastfeeding Initiation ◽  
Before And After ◽  
Randomised Controlled

Background The UK has low levels of breastfeeding initiation and continuation, with evident socioeconomic disparities. To be inclusive, peer-support interventions should be woman-centred rather than breastfeeding-centred. Assets-based approaches to public health focus on the positive capabilities of individuals and communities, rather than their deficits and problems. The Assets-based feeding help Before and After birth (ABA) intervention offers an assets-based approach based on behaviour change theory. Objective To investigate the feasibility of delivering the ABA infant feeding intervention in a randomised controlled trial. Design This was an individually randomised controlled feasibility trial; women were randomised in a 1 : 1 ratio to either the intervention group or the comparator (usual care) group. Setting Two separate English sites were selected because they had an existing breastfeeding peer support service, relatively high levels of socioeconomic disadvantage and low rates of breastfeeding. Participants Women aged ≥ 16 years who were pregnant with their first child, irrespective of feeding intention (n = 103), were recruited by researchers in antenatal clinics. Interventions Proactive, woman-centred support, using an assets-based approach and including behaviour change techniques, was provided by an infant-feeding helper (a breastfeeding peer supporter trained in the ABA intervention) and delivered through face-to-face contact, telephone conversations and text messages. The intervention commenced at around 30 weeks’ gestation and could continue until 5 months postnatally. Main outcome measures The main outcome measures were feasibility of intervention delivery with the requisite intensity and duration; acceptability to women, infant-feeding helpers and maternity services; and feasibility of a future randomised controlled trial. Outcomes included recruitment rates and follow-up rates at 3 days, 8 weeks and 6 months postnatally, and outcomes for a future full trial were collected via participant questionnaires. A mixed-methods process evaluation included qualitative interviews with women, infant-feeding helpers and maternity services; infant-feeding helper logs; and audio-recordings of antenatal contacts to check intervention fidelity. Results Of the 135 eligible women approached, 103 (76.3%) agreed to participate. The study was successful in recruiting teenagers (8.7%) and women living in areas of socioeconomic disadvantage (37.3% resided in the most deprived 40% of small areas in England). Postnatal follow-up rates were 68.0%, 85.4% and 80.6% at 3 days, 8 weeks and 6 months, respectively. Feeding status at 8 weeks was obtained for 95.1% of participants. Recruitment took place from February 2017 until August 2017. It was possible to recruit and train existing peer supporters to the infant-feeding helper role. The intervention was delivered to most women with relatively high fidelity. Among the 50 women in the intervention group, 39 received antenatal visits and 40 received postnatal support. Qualitative data showed that the intervention was acceptable. There was no evidence of intervention-related harms. Limitations Birth notification delays resulted in delays in the collection of postnatal feeding status data and in the offer of postnatal support. In addition, the intervention needs to better consider all infant-feeding types and did not adequately accommodate women who delivered prematurely. Conclusion It is feasible to deliver the intervention and trial. Future work The intervention should be tested in a fully powered randomised controlled trial. Trial registration Current Controlled Trials ISRCTN14760978. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 7. See the NIHR Journals Library website for further project information.

scholarly journals The effect of insulin resistance on inflammation markers in individuals with obesity

2021 ◽  
Vol 8 (10) ◽  
pp. 619-622
Author(s):  
Hasan Atlı ◽  
Erhan Önalan ◽  
Burkay Yakar ◽  
Deccane Duzenci ◽  
Emir Dönder
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Body Mass ◽  
Normal Body Mass Index ◽  
Low Grade ◽  
Inflammation Markers ◽  
Predictive Values ◽  
Lymphocyte Ratio ◽  
Normal Body ◽  
Significant Difference

Objective: Obesity has recently been recognized as a chronic low-grade inflammation condition. We aimed to compare the predictive values of insulin resistance and inflammatory indices in individuals with obesity. Materials and Methods: 124 people who had a health check for obesity-related risk factors in our hospital between June 2018 and September 2019 were included in the study. Inflammatory markers of the patients were evaluated. Results: The study group consists of a total of 224 people, and we compared the demographic data and laboratory parameters of the individuals. C-reactive protein (CRP) levels of obese individuals were statistically higher than those with normal body mass index (p <0.001). There was no statistically significant difference between the groups in terms of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) values, among other inflammation markers. A positive and statistically significant correlation was found between body mass index and CRP level (r = 0.334, p <0.001). There was no significant correlation between body mass index and NLR and PLR. Conclusion: As a result, CRP levels of obese individuals were statistically higher than individuals with normal body mass index. No statistically significant difference was found between the groups in terms of NLR and PLR values among other inflammation markers.

scholarly journals Body mass index related electrocardiographic findings in healthy young individuals with a normal body mass index

2019 ◽  
Vol 27 (10) ◽  
pp. 506-512 ◽  
Author(s):  
G. J. Hassing ◽  
H. E. C. van der Wall ◽  
G. J. P. van Westen ◽  
M. J. B. Kemme ◽  
A. Adiyaman ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Normal Body Mass Index ◽  
Normal Body ◽  
Electrocardiographic Findings
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