How Can We Predict Which Morbidly Obese Patients Will Adhere to Weight-Loss Programs Based in Life Style Changes?

How can we predict which morbidly obese patients will adhere to weight-loss programs based in life style changes?

Endocrinol Nutr. 2013 Apr 19;
Tur JJ, Escudero AJ, Romaguera D, Burguera B

INTRODUCTION: Dropout is a highly prevalent and serious problem in assessing the effectiveness of weight loss studies and a major cause of treatment failure in the management of morbidly obese patients. OBJECTIVES: To determine which tests used for the psychometric evaluation of morbidly obese patients are more predictive of success/dropout in a weight loss program. METHODS: Sixty patients aged 18-65 attending the Outpatient Obesity Clinic between 2009 and 2011, were recruited for an intensive life style weight loss program. We compared the results obtained in Hamilton Depression scale, Hamilton Anxiety scale, Golombok Rust Inventory of Sexual Satisfaction, Eating Disorders Inventory-2, SF-36 Health Survey and Plutchik’s Impulsivity questionnaire between patients who completed the intervention with those obtained in patients who did not complete it. RESULTS: The rate of decline in the patients attending our program was 41.6% in the first year. Our results suggest that the Plutchik Impulsivity questionnaire, could be used as a predictive tool for success/attrition in intensive life style weight loss program. CONCLUSIONS: Our results suggest that the Plutchik Impulsivity questionnaire, could be used as a predictive tool for success/attrition in intensive life style weight loss program. The screening of patients prior to inclusion in these programs should help to optimize its efficacy and efficiency. HubMed – eating

The impact of a brief lifestyle intervention delivered by generalist community nurses (CN SNAP trial).

BMC Public Health. 2013 Apr 22; 13(1): 375
Harris MF, Chan BC, Laws RA, Williams AM, Powell Davies G, Jayasinghe UW, Fanaian M, Orr N, Milat A

BACKGROUND: The risk factors for chronic disease, smoking, poor nutrition, hazardous alcohol consumption, physical inactivity and weight (SNAPW) are common in primary health care (PHC) affording opportunity for preventive interventions. Community nurses are an important component of PHC in Australia. However there has been little research evaluating the effectiveness of lifestyle interventions in routine community nursing practice. This study aimed to address this gap in our knowledge. METHODS: The study was a quasi-experimental trial involving four generalist community nursing (CN) services in New South Wales, Australia. Two services were randomly allocated to an ‘early intervention’ and two to a ‘late intervention’ group. Nurses in the early intervention group received training and support in identifying risk factors and offering brief lifestyle intervention for clients. Those in the late intervention group provided usual care for the first 6 months and then received training. Clients aged 30–80 years who were referred to the services between September 2009 and September 2010 were recruited prior to being seen by the nurse and baseline self-reported data collected. Data on their SNAPW risk factors, readiness to change these behaviours and advice and referral received about their risk factors in the previous 3 months were collected at baseline, 3 and 6 months. Analysis compared changes using univariate and multilevel regression techniques. RESULTS: 804 participants were recruited from 2361 (34.1%) eligible clients. The proportion of clients who recalled receiving dietary or physical activity advice increased between baseline and 3 months in the early intervention group (from 12.9 to 23.3% and 12.3 to 19.1% respectively) as did the proportion who recalled being referred for dietary or physical activity interventions (from 9.5 to 15.6% and 5.8 to 21.0% respectively). There was no change in the late intervention group. There a shift towards greater readiness to change in those who were physically inactive in the early but not the comparison group. Clients in both groups reported being more physically active and eating more fruit and vegetables but there were no significant differences between groups at 6 months. CONCLUSION: The study demonstrated that although the intervention was associated with increases in advice and referral for diet or physical activity and readiness for change in physical activity, this did not translate into significant changes in lifestyle behaviours or weight. This suggests a need to facilitate referral to more intensive long-term interventions for clients with risk factors identified by primary health care nurses.Trial registration: ACTRN12609001081202. HubMed – eating

Neural response to movement of the hand and mouth in the secondary somatosensory cortex of Japanese monkeys during a simple feeding task.

Somatosens Mot Res. 2013 Apr 22;
Taoka M, Tanaka M, Hihara S, Ojima H, Iriki A

Abstract Neural activity was recorded in the secondary somatosensory cortex (SII) of macaque monkeys during a simple feeding task. Around the border between the representations of the hand and face in SII, we found neurons that became active during both retrieving with the hand and eating; 59% had receptive fields (RFs) in the hand/face and the remaining 41% had no RFs. Neurons that responded to touching objects were rarely found. This suggests their sensorimotor function rather than tactile object recognition. HubMed – eating

Quantitative evaluation of oral function in acute and recovery phase of idiopathic facial palsy; A preliminary controlled study.

Clin Otolaryngol. 2013 Apr 23;
Kato Y, Kamo H, Kobayashi A, Abe S, Okada-Ogawa A, Noma N, Kukimoto N, Omori H, Nakazato H, Kishi H, Ikeda M, Imamura Y

OBJECTIVE: Patients with peripheral facial palsy frequently complain of fluid leakage and food retention during meals. We investigated oral function during eating in adults with peripheral facial palsy. DESIGN: a prospective two-phase controlled observational study. SETTING: Data were collected at the ENT clinic in Nihon University Itabashi Hospital (patients) and Nihon University Dental Hospital (controls) between September 2009 and August 2011 and analyzed at the Department of Oral Diagnostic Sciences in Nihon University School of Dentistry. PARTICIPANTS: Fourteen patients with acute idiopathic facial palsy and 14 controls completed Study 1. Sixteen patients with acute idiopathic facial palsy and 16 controls completed Study 2. MAIN OUTCOME MEASURES: In Study 1, oral vestibular cleansing capability was assessed by measuring the amount of rice remaining in the oral vestibule after mastication. In Study 2, masticatory efficiency was evaluated by measuring glucose eluted from gummy jelly during chewing. These oral functions were observed at the first visit and final visit (after patients with facial palsy had recovered). RESULTS: Oral vestibular cleansing capability at the first visit was significantly decreased by facial palsy (p<0.001 vs healthy volunteers and p<0.001 vs contralateral side) but recovered as facial muscular function improved (p=0.034). There was a significant correlation between improvement in paralysis and decreased food retention (r=-0.528, p=0.010). At the first visit, masticatory efficiency on the affected side was significantly lower than that of controls (p=0.002) but had mostly recovered after resolution of facial palsy (p=0.033). CONCLUSIONS: Oral functions were decreased by peripheral facial palsy. Oral vestibular cleansing capability was more significantly associated than masticatory efficiency with facial muscle function. Our data suggest that peripheral facial palsy impairs eating and worsens oral hygiene, which may result in oral disease. This article is protected by copyright. All rights reserved. %%T::46%%%%T::47%%HubMed - eating%%T::48%%%%T::48%% %%T::48%% %%T::48%% %%T::48%%Ischemic heart disease risk factors in lead exposed workers: research study.%%T::48%% %%T::48%%%%T::48%%J Occup Med Toxicol%%T::48%%. 2013 Apr 22; 8(1): 11%%T::48%%Ghiasvand M, Aghakhani K, Salimi A, Kumar R%%T::48%%BACKGROUND: Review of other epidemiological studies reveal inconsistent results of relationships between high blood lead level and risk of hypertension, hyperlipidemia and hyperglycemia. In this study we wanted to find if there is a relationship between blood lead level and these ischemic heart disease risk factors. METHODS: This cross-sectional study was conducted in a battery recycling plant, and 497 male workers with the mean age of 41.7 (+/-6.50) years were recruited from all over the plant (those from the products and maintenance sections were classed as "high lead exposed group" and those from amongst the office, laboratory, security services and food services sections as "low lead exposed group"). Personal information such as demographics and work history was obtained through a questionnaire.Mean (+/-Standard deviation) for quantitative variables, Frequency (Percent) for qualitative variables, and Odd's ratio (OR) with 95% confidence interval (95% CI) for estimating the effect of blood lead level on lipid profile[triglyceride (TG), cholesterol(CHOL), low density lipoprotein -- Cholesterol(LDL-C),high density lipoprotein --Cholesterol(HDL-C)], hypertension(HTN) and fasting blood sugar (FBS) level. Logistic regression modeling was used for multivariate analysis and adjusting the effect of different variables (age, body mass index(BMI), eating habits, cigarette smoking). RESULTS: The mean Blood Lead Level (BLL) was >40 mug/dl in 281 (56.6%) subjects, <=40 mug in 216 (43.4%) subjects and the mean BLL was 43.3 mug/dl (n = 497). The mean job experience involving lead exposure was 13 years. There was no significant correlation between BLL and FBS (p = 0.68), between BLL and TG (P = 0.32), between BLL and HDL-C (p = 0.49), between BLL and LDL-C (p = 0.17), between BLL and CHOL(p = 0.96), between BLL and systolic blood pressure (p = 0.12). The adjusted Odd's ratio for the effect of BLL >40.0 mug/dl on diastolic blood pressure was1.03 (95%CI: 1.01–1.05) with p = 0.05. CONCLUSION: This study showed an association of high BLL with diastolic blood pressure but not with TG, FBS, and HDL-C, LDL-C and CHOL . This result persisted even after adjustment was made for age, BMI and job experience, smoking and eating habits. Attention to health-protective policies, individual behavioral changes and regular periodic medical examination with focus on diastolic blood pressure in lead exposed workers is likely to decrease the public health burden of ischemic heart disease. HubMed – eating