Obesity
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Multicenter Study Comparative Study
BMI and all-cause mortality among Japanese older adults: findings from the Japan collaborative cohort study.
The association between BMI and all-cause mortality may vary with gender, age, and ethnic groups. However, few prospective cohort studies have reported the relationship in older Asian populations. We evaluated the association between BMI and all-cause mortality in a cohort comprised 26,747 Japanese subjects aged 65-79 years at baseline (1988-1990). ⋯ In contrast, being neither overweight (BMI: 25.0-29.9) nor obese (BMI: > or =30.0) elevated the risk among men; however among women, HR was slightly elevated in the obese group but not in the overweight group compared with the mid-normal-range group. Among Japanese older adults, a low BMI was associated with increased risk of all-cause mortality, even among those with a lower normal BMI range. The wide range of BMI between 20.0 and 29.9 in both older men and women showed the lowest all-cause mortality risk.
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Weight loss outcomes achieved through conventional behavior change interventions are prone to deterioration over time. Basic learning laboratory studies in the area of behavioral extinction and renewal and multilevel models of weight control offer clues as to why newly acquired weight loss skills are prone to relapse. According to these models, current clinic-based interventions may not be of sufficient duration or scope to allow for the practice of new skills across the multiple community contexts necessary to promote sustainable weight loss. ⋯ A 12.9% decrease in POW at 30 months was estimated based upon the midway point between models of "best-case" and "worst-case" weight maintenance scenarios. Preliminary data and further analyses, including biosimulation projections, suggest that our socio-environmental approach to weight loss maintenance treatment is promising and warrants evaluation in a large-scale RCT. Biosimulation techniques may have utility in the design of future community-level interventions for the treatment and prevention of childhood overweight.
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Randomized Controlled Trial Multicenter Study
Randomized controlled trial of the MEND program: a family-based community intervention for childhood obesity.
The aim of this study was to evaluate the effectiveness of the Mind, Exercise, Nutrition, Do it (MEND) Program, a multicomponent community-based childhood obesity intervention (www.mendcentral.org). One hundred and sixteen obese children (BMI >or= 98 th percentile, UK 1990 reference data) were randomly assigned to intervention or waiting list control (6-month delayed intervention). Parents and children attended eighteen 2-h group educational and physical activity sessions held twice weekly in sports centers and schools, followed by a 12-week free family swimming pass. ⋯ At 12 months, children in the intervention group had reduced their waist and BMI z-scores by 0.47 (P < 0.0001) and 0.23 (P < 0.0001), respectively, and benefits in cardiovascular fitness, physical activity levels, and self-esteem were sustained. High-attendance rates suggest that families found this intensive community-based intervention acceptable. Further larger controlled trials are currently underway to confirm the promising findings of this initial trial.
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Randomized Controlled Trial
Healthy Home Offerings via the Mealtime Environment (HOME): feasibility, acceptability, and outcomes of a pilot study.
The primary objective was to develop and test the feasibility and acceptability of the Healthy Home Offerings via the Mealtime Environment (HOME) program, a pilot childhood obesity prevention intervention aimed at increasing the quality of foods in the home and at family meals. Forty-four child/parent dyads participated in a randomized controlled trial (n = 22 in intervention and n = 22 in control conditions). The intervention program, held at neighborhood facilities, included five, 90-min sessions consisting of interactive nutrition education, taste testing, cooking skill building, parent discussion groups, and hands-on meal preparation. ⋯ Not all findings were sustained at 6-month follow-up. Obesity prevention programming with families in community settings is feasible and well accepted. Results demonstrate the potential of the HOME program.