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The objective of this study is to assess feasibility of the application of an adapted version, with permission, of Dr. Cenk Tek's Simplified Intervention to Modify Physical activity, Lifestyle, and Eating behavior (SIMPLE Program), at Pathways to Housing in Calgary, Alberta. Dr. Tek and his colleagues reviewed the literature and eloquently summarized how individuals with severe mental illness, particularly schizophrenia and schizoaffective disorder are disproportionately affected by obesity and its cardio-metabolic sequelae leading to markedly reduced longevity and increased healthcare costs. Most new antipsychotic medications, which are credited for significant advances in patients' quality of life, appear to induce further weight gain, compounding the problem of obesity and related medical morbidity and mortality. In addition to the weight gain associated with psychiatric medications, sedentary life style, lack of availability of healthy food options, poverty, low level of physical activity, cigarette smoking, and inadequate knowledge or understanding of health maintenance, appear to contribute to the increased obesity rates and poor health in the severely mentally ill. Dr. Tek and colleagues reviewed the available literature on weight loss interventions in individuals with severe mental illness. Despite the overwhelming problems related to obesity, Dr. Tek's team found that research on obesity interventions for persons with schizophrenia is relatively neglected and that there were no treatments that were convincingly shown to be effective for weight reduction in this population with unique needs. Sensing a major societal gap, they decided to create their own weight loss intervention specifically for individuals with severe mental illness. Toward this aim, they collaborated with Dr. Kelly Brownell who created the Lifestyle, Exercise, Attitudes, Relationships, and Nutrition or LEARN Program. This multi-faceted program is designed to promote positive changes in motivation, attitude and deeply ingrained habits that will lead to long lasting weight loss. Brownell's LEARN program is a self-directed weight loss program that empowers the user to make lifestyle changes. Dr. Tek and his colleagues modified and built upon the program by creating the Simplified Intervention to Modify Physical activity, Lifestyle, and Eating behavior or SIMPLE program specifically for individuals with severe mental illness (http://www.simpleprogram.org/). The SIMPLE program is a group weight loss intervention designed for obese patients with schizophrenia or schizoaffective disorder. Dr. Tek and his team piloted their modified weight loss program and published their findings in 2007. Their preliminary study yielded greater weight loss than any of the published randomized controlled trials for a chronic and stable schizophrenia sample, and was the only study to show continued weight loss after the intervention ended. These early results prompted a new larger randomized controlled trial with the largest sample studied to date, an extended period of follow-up, and more detailed testing of the effects of weight loss on schizophrenia symptoms, quality of life, and laboratory markers of obesity related illness risk over a period of up to 16 months. Preliminary results of this trial show significant, sustained weight loss. The goal of this study presented for ethics review, is to apply Dr. Tek's 16-week intervention to a small group of patients at the Pathways to Housing program in Calgary, Alberta. The study coordinator will use Dr. Tek's published manuals, giving full acknowledgment to the authors, to create weekly supportive educational sessions for the group of patients. Three Pathways to Housing staff members, who regularly create education groups for Pathways to Housing patients during a weekly "lifestyle group", will sit in on each session. Weight (to calculate BMI) and waist circumference will be measured weekly. There will be no control group. The proposed feasibility study is designed to fit seamlessly within existing frameworks at Pathways to Housing. Upon completion of the study, we will convene a debriefing session with both the participants and the three Pathways to Housing staff to learn whether patients found the intervention valuable, and whether staff members feel capable of implementing the program on their own going forward. If the program is found to be feasible, the materials created will be available for future use by the multidisciplinary team at Pathways to Housing.
Monocentric unblinded two parallel-group randomized controlled trial to evaluate the effect of diet with or without Nordic Walking on weight loss, physical performance and cardiovascular risk factors in overweight and obese population
The aim of this study is to analyze the impact of physical exercise through a protocol of concurrent training in the psychological, physical, hormonal and sexual aspects in middle aged men with androgen deficiency in the aging male (ADAM). The study design with randomized clinical trial, comprising men in middle age (40 to 59 years) with ADAM, should be divided into two groups: 1) Control group (CG); 2) Experimental group (EG). Information related to sociodemographic and clinical profile will be collected; Psychological aspects (depressive and anxiety symptoms - Hospital Anxiety and Depression Scale ; stress - Perceived Stress Scale); Physical acpects (IMC; Percentage of body fat; Abdominal obesity - waist circumference in cm; Muscle strength - Biodex System 4 PRO isokinetic dynamometer; cardiorespiratory Fitness - Cycle-ergometer - CASE ECG Stress Testing System, General Electric Medical Systems, Milwaukee, WI); Hormonal aspects (total and free testosterone - blood collection); Sexual Aspect (Sexual satisfaction- International Index of Erectile Function); DAEM (scale of symptoms of aging). Apply a physical exercise protocol using the functional training method over a six-month period. All information will be collected before and after the intervention period. For statistical analysis, use the SPSS statistical package, version 20.0. (Kolmogorov-Smirnov or Shapiro-Wilk test) for the selection of statistical tests.
This randomized, placebo-controlled, double-blind, controlled study was designed to investigate the efficacy of electrical muscle simulation (EMS) for treatment of waist circumference (WC) reduction in abdominal obese adults. 60 patients with abdominal obese, man with WC > 90 cm and woman with WC > 80 cm, received EMS as experimental group (EG) or transcutaneous electrical nerve stimulation (TENS) as control group (CG) 5 times a week for 12 weeks.
The prevalence of overweight and lifestyle related diseases such as cardiovascular disease (CVD) and type 2 diabetes (T2D) is increasing world wide. The metabolic syndrome (MeS) is a condition characterized by abdominal obesity, high blood lipids, high blood pressure and elevated blood sugar. MeS is associated with an increased risk of developing CVD and T2D. Dietary fibers and whey protein have independently shown beneficial effects on several of these risk factors in previous studies. Whey protein is furthermore seen to show positive effects on bone turnover. The purpose of this trial is to investigate whether an increased intake of dietary fibers and whey protein (separately or combined) over a period of 12 weeks will affect the risk markers of MeS and bone turnover in abdominally obese subjects. A total of 80 people with abdominal obesity will be included. The design is a randomized, double blinded, controlled dietary intervention trial. Subjects are assigned to one of four experimental groups. Each group are provided with test products containing either high or low whey protein and high or low dietary fibers to replace part of their regular diet. The subjects are instructed in how to incorporate the test products in their habitual diets in order to maintain weight stability. The primary outcome is postprandial lipaemia (PPL) - an independent risk factor of developing CVD. PPL is estimated by performing a standardized high fat meal test during which postprandial level of triglycerides is measured. The authors hypothesize that a diet of high content of whey protein and high dietary fiber during 12 weeks will induce a reduction in PPL.
Aging has been associated with reduced bioavailability of nitric oxide (NO) and endothelial dysfunction. Beetroot consumption, a nitrate-rich food, has been associated with increased NO bioconversion, which may promote beneficial effects on vascular health. The present study evaluated the effects of a beetroot-based nutritional gel (BG) on vascular function, arterial stiffness and blood pressure in the elderly at cardiometabolic risk. Twenty elderly individuals were submitted to BG and nitrate-depleted gel (PLA) interventions. Brachial flow-mediated dilation (FMD), blood flow velocity (BFV), peak wave velocity (PWVβ), augmentation index (AI), stiffness parameter (β), pressure-strain elasticity modulus (Ep), arterial compliance (AC), muscle oxygenation and function were measured 90 min after interventions. Urinary nitrate, nitrite, systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured at baseline, 90 min and 150 min after interventions.
The purpose of the WorkACTIVE-P study is to assess the outcome of an innovative multi-component intervention focused on increasing energy expenditure and re-balancing the disrupted energy balance equation of sedentary workplaces with an ultimate target of reducing workers' abdominal obesity.
To evaluate the effectiveness of acupuncture therapy combined with healthy education for patients with abdominal obesity.
Abdominal obesity and its metabolic consequences, particularly type 2 diabetes, require personalized nutritional monitoring. Today, it is not always possible to provide patients with appropriate care to both, the diet plan, physical activity, stress and sleep management. Emerging data have shown the effectiveness of remote support (e- coaching), in order to increase the level of physical activity and reducing calorie intake which causes weight loss similar to that obtained during a face to face consultation. Compared to a food survey conducted by a dietician, the dietary survey MXS computer software showed similar results on the collection of nutritional data. Furthermore, users preferred this method of remote collection compared to direct interview. The investigators recently developed a tool for e-coaching combining this computerized dietary survey and education and support modules on diet and physical activity (MXS- health program) for the patients. The aim of the investigators' study is to compare efficacy of this new software vs usual care.
In the Belly Fat study, the effects of two different caloric-restricted diets on metabolic health will be examined in male and female subjects with increased abdominal adiposity (BMI >27 kg/m2). Metabolic health is defined as health of the primary metabolic organs the liver, gut and the adipose tissue, examined in a static state as well as after the application of a challenge test. The diets are equally caloric-restricted, but differ in nutrient composition. It is hypothesized that one of the two diets causes a larger improvement in organ health and reduction in liver fat.