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Avoiding weight gain in cardiometabolic disease: a systematic review.

Maruthur NM, Gudzune K, Hutfless S, Fawole OA, Wilson RF, Lau BD, Anderson CA, Bleich SN, Segal J - J Obes (2014)

Bottom Line: Patients with cardiometabolic disease are at higher risk for obesity-related adverse effects.We performed a systematic review to identify the effect of nonweight loss-focused lifestyle interventions in adults with cardiometabolic disease.Future studies should confirm these findings and evaluate additional risk factors and clinical outcomes.

View Article: PubMed Central - PubMed

Affiliation: Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA ; Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21287, USA ; Department of Epidemiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

ABSTRACT
Patients with cardiometabolic disease are at higher risk for obesity-related adverse effects. Even without weight loss, weight maintenance may be beneficial. We performed a systematic review to identify the effect of nonweight loss-focused lifestyle interventions in adults with cardiometabolic disease. We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify comparative studies of lifestyle interventions (self-management, diet, exercise, or their combination) without a weight loss focus in adults with or at risk for diabetes and cardiovascular disease. Weight, BMI, and waist circumference at ≥12 months were the primary outcomes. Of 24,870 citations, we included 12 trials (self-management, n = 2; diet, n = 2; exercise, n = 2; combination, n = 6) studying 4,206 participants. Self-management plus physical activity ± diet versus minimal/no intervention avoided meaningful weight (-0.65 to -1.3 kg) and BMI (-0.4 to -0.7 kg/m(2)) increases. Self-management and/or physical activity prevented meaningful waist circumference increases versus control (-2 to -4 cm). In patients with cardiometabolic disease, self-management plus exercise may prevent weight and BMI increases and self-management and/or exercise may prevent waist circumference increases versus minimal/no intervention. Future studies should confirm these findings and evaluate additional risk factors and clinical outcomes.

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Related in: MedlinePlus

Selection of included studies. ∗Sum of reasons for exclusion of abstracts and articles exceeds total number of excluded abstracts and articles because reviewers were not required to agree on reasons for exclusion. †Fourteen articles of 12 individual studies included.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4291140&req=5

fig1: Selection of included studies. ∗Sum of reasons for exclusion of abstracts and articles exceeds total number of excluded abstracts and articles because reviewers were not required to agree on reasons for exclusion. †Fourteen articles of 12 individual studies included.

Mentions: Of 24,870 electronic citations, 9,041 abstracts, and 1,426 full text articles, we identified 11 RCTs [17–29] and one nonrandomized clinical trial [16] evaluating the effect of self-management, dietary, or physical activity interventions without a weight loss focus in persons with or at risk for diabetes and/or CVD (Figure 1). We did not identify observational studies meeting our inclusion criteria.


Avoiding weight gain in cardiometabolic disease: a systematic review.

Maruthur NM, Gudzune K, Hutfless S, Fawole OA, Wilson RF, Lau BD, Anderson CA, Bleich SN, Segal J - J Obes (2014)

Selection of included studies. ∗Sum of reasons for exclusion of abstracts and articles exceeds total number of excluded abstracts and articles because reviewers were not required to agree on reasons for exclusion. †Fourteen articles of 12 individual studies included.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4291140&req=5

fig1: Selection of included studies. ∗Sum of reasons for exclusion of abstracts and articles exceeds total number of excluded abstracts and articles because reviewers were not required to agree on reasons for exclusion. †Fourteen articles of 12 individual studies included.
Mentions: Of 24,870 electronic citations, 9,041 abstracts, and 1,426 full text articles, we identified 11 RCTs [17–29] and one nonrandomized clinical trial [16] evaluating the effect of self-management, dietary, or physical activity interventions without a weight loss focus in persons with or at risk for diabetes and/or CVD (Figure 1). We did not identify observational studies meeting our inclusion criteria.

Bottom Line: Patients with cardiometabolic disease are at higher risk for obesity-related adverse effects.We performed a systematic review to identify the effect of nonweight loss-focused lifestyle interventions in adults with cardiometabolic disease.Future studies should confirm these findings and evaluate additional risk factors and clinical outcomes.

View Article: PubMed Central - PubMed

Affiliation: Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA ; Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21287, USA ; Department of Epidemiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

ABSTRACT
Patients with cardiometabolic disease are at higher risk for obesity-related adverse effects. Even without weight loss, weight maintenance may be beneficial. We performed a systematic review to identify the effect of nonweight loss-focused lifestyle interventions in adults with cardiometabolic disease. We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify comparative studies of lifestyle interventions (self-management, diet, exercise, or their combination) without a weight loss focus in adults with or at risk for diabetes and cardiovascular disease. Weight, BMI, and waist circumference at ≥12 months were the primary outcomes. Of 24,870 citations, we included 12 trials (self-management, n = 2; diet, n = 2; exercise, n = 2; combination, n = 6) studying 4,206 participants. Self-management plus physical activity ± diet versus minimal/no intervention avoided meaningful weight (-0.65 to -1.3 kg) and BMI (-0.4 to -0.7 kg/m(2)) increases. Self-management and/or physical activity prevented meaningful waist circumference increases versus control (-2 to -4 cm). In patients with cardiometabolic disease, self-management plus exercise may prevent weight and BMI increases and self-management and/or exercise may prevent waist circumference increases versus minimal/no intervention. Future studies should confirm these findings and evaluate additional risk factors and clinical outcomes.

Show MeSH
Related in: MedlinePlus