The effects of supervised exercise training 12–24 months after bariatric surgery on physical function and body composition: a randomised controlled trial

Background:Bariatric surgery is effective for the treatment of stage II and III obesity and its related diseases, although increasing evidence is showing weight regain ~12–24 months postsurgery. Weight regain increases the risk of physical function decline, which negatively affects an individual's ability to undertake activities of daily living. The study assessed the effects of a 12-week supervised exercise intervention on physical function and body composition in patients between 12 and 24 months post bariatric surgery.Methods:Twenty-four inactive adult bariatric surgery patients whose body mass index remained ⩾30 kg m2 12 to 24 months post surgery were randomised to an exercise intervention (n=12) or control group (n=12). Supervised exercise consisted of three 60-min gym sessions per week of moderate intensity aerobic and resistance training for 12 weeks. Control participants received usual care. The incremental shuttle walk test (ISWT) was used to assess functional walking performance after the 12-week exercise intervention, and at 24 weeks follow-up. Measures of anthropometric, physical activity, cardiovascular and psychological outcomes were also examined. Using an intention-to-treat protocol, independent t-tests were used to compare outcome measures between groups.Results:Significant improvements in the exercise group were observed for the ISWT, body composition, physical function, cardiovascular and self-efficacy measures from baseline to 12 weeks. A large baseline to 12-week change was observed for the ISWT (exercise: 325.00±117.28 m; control: 355.00±80.62 m, P<0.001). The exercise group at 24 weeks recorded an overall mean improvement of 143.3±86.6 m and the control group recorded a reduction of −32.50±75.93 m. Findings show a 5.6 kg difference between groups in body mass change from baseline to 24 weeks favouring the exercise group.Conclusions:A 12-week supervised exercise intervention led to significant improvements in body mass and functional walking ability post intervention, with further improvements at the 24-week follow-up

Changes in physical activity behaviour and physical function after bariatric surgery: A systematic review and meta-analysis

© 2016 World Obesity. Although physical activity performed after bariatric surgery is associated with enhanced weight loss outcomes, there is limited information on patients' physical activity behaviour in this context. This systematic review and meta-analysis assessed pre-operative to post-operative changes in physical activity and physical function outcomes among obese adults undergoing bariatric surgery. A total of 50 studies met inclusion criteria with 26 papers reporting data for meta-analysis. Increases in both objectively recorded and self-reported physical activity at 12months were demonstrated. Studies indicated that there was a shift towards a greater amount of active time, but of a lower intensity within the first 6months of bariatric surgery, suggested by a reduction in moderate to vigorous physical activity but an increase in step count. A standardized mean difference (SMD) of 1.53 (95% CI: 1.02-2.04) based on nine studies indicated improved walking performance at 12months. Similarly, analysis of five studies demonstrated increased musculoskeletal function at 3-6months (SMD: 1.51; 95% CI: 0.60-2.42). No relationship was identified between changes in weight and walking performance post-surgery. More studies assessing physical activity, physical function and weight loss would help understand the role of physical activity in optimizing post-operative weight and functional outcomes

Association between lifestyle factors and the incidence of multimorbidity in an older English population.

Background: Evidence on the role of lifestyle factors in relation to multimorbidity, especially in elderly populations, is scarce. We assessed the association between five lifestyle factors and incident multimorbidity (presence of ≥2 chronic conditions) in an English cohort aged ≥50 years. Methods: We used data from wave 4, 5 and 6 of the English Longitudinal Study of Ageing. Data on smoking, alcohol consumption, physical activity, fruit and vegetable consumption and BMI were extracted and combined to generate a sum of unhealthy lifestyle factors for each individual. We examined whether these lifestyle factors individually or in combination predicted during the subsequent wave. We used marginal structural Cox proportional hazard models, adjusted for both time-constant and time-varying factors. Results: A total of 5,476 participants contributed 232,749 person-months of follow-up during which 1,156 cases of incident multimorbidity were recorded. Physical inactivity increased the risk of multimorbidity by 33% (adjusted Hazard Ratio (aHR) 1.33, 95% CI 1.03-1.73). The risk was about two-three times higher when inactivity was combined with obesity (aHR 2.87, 95% CI 1.55-5.31) or smoking (aHR 2.35, 95% CI 1.36-4.08) and about four times when combined with both (aHR 3.98, 95% CI 1.02-17.00). Any combination of 2, 3 and 4 or more unhealthy lifestyle factors significantly increased the multimorbidity hazard, compared to none, from 42% to 114%. Conclusion: This study provides evidence of a temporal association between combinations of different unhealthy lifestyle factors with multimorbidity. Population level interventions should include reinforcing positive lifestyle changes in the population to reduce the risk of developing multimorbidity

Image processing using Android device - gas-meter value recognition

Diplomová práce se zabývá návrhem zpracování obrazu v systému Android. Volbou vývojového prostředí a jeho implementací. Pracovní postup řešení problematiky zahrnuje vytvoření aplikace a grafického uživatelského rozhraní. Text zahrnuje popis funkcionality aplikace, komunikace s fotoaparátem, uložení a načítání dat. Dále popisuje použité algoritmy a metody zpracování obrazu pro detekci hodnot plynoměru.This thesis describes the design of the image processing for Android system, consisting of the choice of the development environment and its implementation. Workflow solution to the problem involves development of the Androidapplication and it’s graphical user interface. The text includes description of the application functionality, communicationwith a camera, storing and retrieving data. It also describes used algorithms and image processing methods used for detecting values from the counter of the gas meter.

Dietary Prevention of Type 2 Diabetes: The Role of Fruit and Vegetable Intake

This thesis begins with a background chapter which explores the current diabetes epidemic and examines the role of obesity and oxidative stress as causative factors. Current dietary recommendations for prevention of type 2 diabetes are critically evaluated. A systematic review and meta-analysis was conducted to determine the independent role of fruit and vegetables in preventing diabetes. Convincing benefit for greater consumption of green leafy vegetables was demonstrated. An insignificant trend towards benefit was observed for fruit and vegetables. The Fruit and Vegetable Intake and Glucose Control Study (FIVE) is a sub study of the Let’s Prevent Diabetes Study. FIVE includes cross sectional analysis of baseline plasma vitamin C, (a biomarker for fruit and vegetable intake) from 2101 participants. FIVE further includes 12 months analysis of individuals with impaired glucose regulation, randomised to receive group education or usual care. Results demonstrate 29% of the population consumed at least 5 portions of fruit and vegetables a day. Fewer South Asian individuals met the recommendation compared to White Europeans (21% vs. 30% p = 0.003). Each additional piece of fruit or vegetable consumed (21.8μmol/l plasma vitamin C) was associated with a reduction of 0.04% in HbA1c, 0.05mmol/l in fasting and 0.22mol/l in 2 hour blood glucose. Participants who consumed 5 portions a day compared to those who did not, had a 24% associated reduced risk of being diagnosed with impaired glucose regulation (OR = 0.76, 95% CI: 0.59 to 0.98). At 12 months follow up those receiving lifestyle education had greater levels of plasma vitamin C compared to those in the usual care arm (36.1μmol/l (SD 20.7) vs.29.9μmol/l (SD 20.3)). No statistical difference in mean change between intervention arms was seen. The thesis provides novel, robust nutritional biomarker data from a large at risk, multi ethnic population. Results support recommendations to promote fruit and vegetables in the diet to prevent diabetes. The potential for tailored advice on increasing green leafy vegetables among those at risk of diabetes should be investigated further

Changes in physical activity behaviour and physical function after bariatric surgery: a systematic review and meta-analysis

Although physical activity performed after bariatric surgery is associated with enhanced weight loss outcomes, there is limited information on patients' physical activity behaviour in this context. This systematic review and meta-analysis assessed pre-operative to post-operative changes in physical activity and physical function outcomes among obese adults undergoing bariatric surgery. A total of 50 studies met inclusion criteria with 26 papers reporting data for meta-analysis. Increases in both objectively recorded and self-reported physical activity at 12 months were demonstrated. Studies indicated that there was a shift towards a greater amount of active time, but of a lower intensity within the first 6 months of bariatric surgery, suggested by a reduction in moderate to vigorous physical activity but an increase in step count. A standardized mean difference (SMD) of 1.53 (95% CI: 1.02–2.04) based on nine studies indicated improved walking performance at 12 months. Similarly, analysis of five studies demonstrated increased musculoskeletal function at 3–6 months (SMD: 1.51; 95% CI: 0.60–2.42). No relationship was identified between changes in weight and walking performance post-surgery. More studies assessing physical activity, physical function and weight loss would help understand the role of physical activity in optimizing post-operative weight and functional outcomes

晚上新世一早更新世北太平洋和黄土高原的风尘沉积记录的初步对比

Table S1. Example search strategy (MEDLINE In process& other non-indexed citations and OVID MEDLINE (R) 1946 to present). (DOCX 15 kb

Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis.

OBJECTIVE: To investigate the independent effects of intake of fruit and vegetables on incidence of type 2 diabetes. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Embase, CINAHL, British Nursing Index (BNI), and the Cochrane library were searched for medical subject headings and keywords on diabetes, prediabetes, fruit, and vegetables. Expert opinions were sought and reference lists of relevant articles checked. STUDY SELECTION: Prospective cohort studies with an independent measure of intake of fruit, vegetables, or fruit and vegetables and data on incidence of type 2 diabetes. RESULTS: Six studies met the inclusion criteria; four of these studies also provided separate information on the consumption of green leafy vegetables. Summary estimates showed that greater intake of green leafy vegetables was associated with a 14% (hazard ratio 0.86, 95% confidence interval 0.77 to 0.97) reduction in risk of type 2 diabetes (P=0.01). The summary estimates showed no significant benefits of increasing the consumption of vegetables, fruit, or fruit and vegetables combined. CONCLUSION: Increasing daily intake of green leafy vegetables could significantly reduce the risk of type 2 diabetes and should be investigated further

South Asian individuals at high risk of type 2 diabetes have lower plasma vitamin C levels than white Europeans.

Individuals of South Asian origin are at high risk of developing type 2 diabetes; the relationship between this risk and diet remains to be investigated fully. Furthermore, fruit and vegetable intake remains low throughout the world and previous data suggest that intake is associated with risk of diabetes. The aim of this research study was to compare plasma vitamin C concentrations, measured as a biomarker for fruit and vegetable intake, in South Asian and white European individuals. Participants recruited as part of the Let's Prevent Diabetes Study provided samples for the quantification of plasma vitamin C. We compared vitamin C levels by ethnicity using multiple regression, both unadjusted and adjusted for confounders, including glycaemic status. Mean plasma vitamin C was significantly lower in the South Asian participants compared with white European participants (34.5 (sd 19·8) v. 39·9 (sd 22·1) µmol/l, respectively; P ≤ 0·0001). Significantly fewer South Asian individuals consumed five portions of fruit and vegetables per d, as determined by a plasma vitamin C concentration of ≥ 50 µmol/l (23·2 % (n 58) v. 31·4 % (n 558); P = 0·01). Vitamin C reflects habitual fruit and vegetable consumption; thus results suggest that South Asians have lower fruit and vegetable intake. However, it cannot be excluded that vitamin C is utilised differently. Dietary advice specifically targeting the South Asian population should be developed

Serum potassium and glucose regulation in the ADDITION- Leicester screening study

Introduction: Previous observational studies have shown conflicting results between plasma K+ concentrations and risk of type 2 diabetes. To help clarify the evidence we aimed to determine whether an association existed between serum K+ and glucose regulation within a UK multi ethnic population Methods: Participants were recruited as part of the ADDITION Leicester study, a population based screening study. Individuals from primary care between the age of 40-75 years if White European or 25-75 years if South Asian or Afro Caribbean were recruited. Tests for associations between baseline characteristics and K+ quartiles were conducted using linear regression models. Results: Data showed individuals in the lowest K+ quartile had significantly greater 2-hour glucose levels (0.53mmol/l, 95% CI: 0.36-0.70, p≤0.001) than those in the highest K+ quartile. This estimation did not change with adjustment for potential confounders. Conversely, participants in the lowest K+ quartile had a 0.14% lower HbA1c (95% CI - 0.19- 0.10: P≤0.001) compared to those in the highest K+ quartile. Conclusion: This cross sectional analysis demonstrated that lower K+ was associated with greater 2hr-glucose. The data supports the possibility that K+ may influence glucose regulation and further research is warranted