3 research outputs found
Effects of an eight-week supervised, structured lifestyle modification programme on anthropometric, metabolic and cardiovascular risk factors in severely obese adults
Background: Lifestyle modification is fundamental to obesity treatment, but few studies have described the effects
of structured lifestyle programmes specifically in bariatric patients. We sought to describe changes in
anthropometric and metabolic characteristics in a cohort of bariatric patients after participation in a nurse-led,
structured lifestyle programme.
Methods: We conducted a retrospective, observational cohort study of adults with a body mass index (BMI) ≥40 kgm−2
(or ≥35 kgm−2 with significant co-morbidity) who were attending a regional bariatric service and who completed a single
centre, 8-week, nurse-led multidisciplinary lifestyle modification programme. Weight, height, waist circumference, blood
pressure, HbA1c, fasting glucose and lipid profiles as well as functional capacity (Incremental Shuttle Walk Test) and
questionnaire-based anxiety and depression scores before and after the programme were compared in per-protocol
analyses.
Results: Of 183 bariatric patients enrolled, 150 (81.9 %) completed the programme. Mean age of completers was 47.9
± 11.2 years. 34.7 % were male. There were statistically significant reductions in weight (129.6 ± 25.9 v 126.9 ± 26.1 kg,
p < 0.001), BMI (46.3 ± 8.3 v 44.9 ± 9.0 kgm−2, p < 0.001), waist circumference (133.0 ± 17.1 v 129.3 ± 17.5 cm in women
and 143.8 ± 19.0 v 135.1 ± 17.9 cm in men, both p < 0.001) as well as anxiety and depression scores, total- and
LDL-cholesterol and triglyceride levels, with an increase in functional capacity (5.9 ± 1.7 v 6.8 ± 2.1 metabolic
equivalents of thermogenesis (METS), p < 0.001) in completers at the end of the programme compared to the start.
Blood pressure improved, with reductions in systolic and diastolic blood pressure from 135 ± 16.2 to 131.6 ± 17.1
(p = 0.009) and 84.7 ± 10.2 to 81.4 ± 10.9 mmHg (p < 0.001), respectively. The proportion of patients achieving target
blood pressure increased from 50.3 to 59.3 % (p = 0.04). The proportion of patients with diabetes achieving
HbA1c <53 mmol/mol increased from 28.6 to 42.9 %, p = 0.02.
(Continued on next page)Conclusions: Bariatric patients completing an 8 week, nurse-led structured lifestyle programme had improved
adiposity, fitness, lipid profiles, psychosocial health, blood pressure and glycaemia. Further assessment of this
programme in a pragmatic randomised controlled trial seems warranted.
Keywords: Bariatric, Structured lifestyle modification, Cardiovascular risk, CLANN (Changing Lifestyle with Activity and
Nutrition) Programme, Nurse-led, Diabete
Effects of an eight-week supervised, structured lifestyle modification programme on anthropometric, metabolic and cardiovascular risk factors in severely obese adults
Background
Lifestyle modification is fundamental to obesity treatment, but few studies have described the effects of structured lifestyle programmes specifically in bariatric patients. We sought to describe changes in anthropometric and metabolic characteristics in a cohort of bariatric patients after participation in a nurse-led, structured lifestyle programme.
Methods
We conducted a retrospective, observational cohort study of adults with a body mass index (BMI) ≥40 kgm−2 (or ≥35 kgm−2 with significant co-morbidity) who were attending a regional bariatric service and who completed a single centre, 8-week, nurse-led multidisciplinary lifestyle modification programme. Weight, height, waist circumference, blood pressure, HbA1c, fasting glucose and lipid profiles as well as functional capacity (Incremental Shuttle Walk Test) and questionnaire-based anxiety and depression scores before and after the programme were compared in per-protocol analyses.
Results
Of 183 bariatric patients enrolled, 150 (81.9 %) completed the programme. Mean age of completers was 47.9 ± 11.2 years. 34.7 % were male. There were statistically significant reductions in weight (129.6 ± 25.9 v 126.9 ± 26.1 kg, p < 0.001), BMI (46.3 ± 8.3 v 44.9 ± 9.0 kgm−2, p < 0.001), waist circumference (133.0 ± 17.1 v 129.3 ± 17.5 cm in women and 143.8 ± 19.0 v 135.1 ± 17.9 cm in men, both p < 0.001) as well as anxiety and depression scores, total- and LDL-cholesterol and triglyceride levels, with an increase in functional capacity (5.9 ± 1.7 v 6.8 ± 2.1 metabolic equivalents of thermogenesis (METS), p < 0.001) in completers at the end of the programme compared to the start. Blood pressure improved, with reductions in systolic and diastolic blood pressure from 135 ± 16.2 to 131.6 ± 17.1 (p = 0.009) and 84.7 ± 10.2 to 81.4 ± 10.9 mmHg (p < 0.001), respectively. The proportion of patients achieving target blood pressure increased from 50.3 to 59.3 % (p = 0.04). The proportion of patients with diabetes achieving HbA1c <53 mmol/mol increased from 28.6 to 42.9 %, p = 0.02.
Conclusions
Bariatric patients completing an 8 week, nurse-led structured lifestyle programme had improved adiposity, fitness, lipid profiles, psychosocial health, blood pressure and glycaemia. Further assessment of this programme in a pragmatic randomised controlled trial seems warranted.The authors would like to thank the patients attending the Bariatric Medicine Service at Galway University Hospital and the clinical staff who provide care to these patients. The programme was designed by and delivered at the Croi (West of Ireland Cardiac Foundation) Heart and Stroke Centre, Newcastle, Galway, Ireland. We are grateful to Paul Bassett for help with statistical analyses. This programme was funded by a project grant from the Health Service Executive, Ireland
Effects of an eight-week supervised, structured lifestyle modification programme on anthropometric, metabolic and cardiovascular risk factors in severely obese adults
Background: Lifestyle modification is fundamental to obesity treatment, but few studies have described the effects of structured lifestyle programmes specifically in bariatric patients. We sought to describe changes in anthropometric and metabolic characteristics in a cohort of bariatric patients after participation in a nurse-led, structured lifestyle programme.
Methods: We conducted a retrospective, observational cohort study of adults with a body mass index (BMI) &gt;= 40 kgm(-2) (or &gt;= 35 kgm(-2) with significant co-morbidity) who were attending a regional bariatric service and who completed a single centre, 8-week, nurse-led multidisciplinary lifestyle modification programme. Weight, height, waist circumference, blood pressure, HbA1c, fasting glucose and lipid profiles as well as functional capacity (Incremental Shuttle Walk Test) and questionnaire-based anxiety and depression scores before and after the programme were compared in per-protocol analyses.
Results: Of 183 bariatric patients enrolled, 150 (81.9 %) completed the programme. Mean age of completers was 47.9 +/- 11.2 years. 34.7 % were male. There were statistically significant reductions in weight (129.6 +/- 25.9 v 126.9 +/- 26.1 kg, p &lt; 0.001), BMI (46.3 +/- 8.3 v 44.9 +/- 9.0 kgm(-2), p &lt; 0.001), waist circumference (133.0 +/- 17.1 v 129.3 +/- 17.5 cm in women and 143.8 +/- 19.0 v 135.1 +/- 17.9 cm in men, both p &lt; 0.001) as well as anxiety and depression scores, total-and LDL-cholesterol and triglyceride levels, with an increase in functional capacity (5.9 +/- 1.7 v 6.8 +/- 2.1 metabolic equivalents of thermogenesis (METS), p &lt; 0.001) in completers at the end of the programme compared to the start. Blood pressure improved, with reductions in systolic and diastolic blood pressure from 135 +/- 16.2 to 131.6 +/- 17.1 (p = 0.009) and 84.7 +/- 10.2 to 81.4 +/- 10.9 mmHg (p &lt; 0.001), respectively. The proportion of patients achieving target blood pressure increased from 50.3 to 59.3 % (p = 0.04). The proportion of patients with diabetes achieving HbA1c &lt; 53 mmol/mol increased from 28.6 to 42.9 %, p = 0.02.
Conclusions: Bariatric patients completing an 8 week, nurse-led structured lifestyle programme had improved adiposity, fitness, lipid profiles, psychosocial health, blood pressure and glycaemia. Further assessment of this programme in a pragmatic randomised controlled trial seems warranted