Effects of an eight-week supervised, structured lifestyle modification programme on anthropometric, metabolic and cardiovascular risk factors in severely obese adults

BMC Endocrine Disorders

Francis M Finucane⁴  Jenni Jones²  Tim O′Brien⁴  Helena Griffin³  Katriona Kilkelly³  Brian McGuire⁵  Mary Hynes⁵  Paula M. O′Shea¹  Jane Windle⁶  Caroline Costello⁶  Claire Kerins⁶  Katie Cunningham⁶  Irene Gibson⁶  Catherine Crowe³ 

[1] Department of Clinical Biochemistry, Galway University Hospitals, Galway, Ireland;National Institute of Preventive Cardiology, Galway, Ireland;Bariatric Medicine Service, Galway Diabetes Research Centre, HRB Clinical Research Facility, Galway University Hospital, Galway, Ireland;Discipline of Health Promotion, National University of Ireland, Galway, Ireland;School of Psychology, National University of Ireland, Galway, Ireland;Croi, the West of Ireland Cardiac Foundation, Heart and Stroke Centre, Moyola Lane, Newcastle, Galway, Ireland

关键词: Diabetes;    Nurse-led;    CLANN (Changing Lifestyle with Activity and Nutrition) Programme;    Cardiovascular risk;    Structured lifestyle modification;    Bariatric;   

Others  :  1221627
DOI  :  10.1186/s12902-015-0038-x

 received in 2015-01-17, accepted in 2015-07-24,  发布年份 2015

【 摘 要 】

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 ⁻²with 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.

【 授权许可】

   
2015 Crowe et al.

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