INDIVIDUO: Results from a patient-centered lifestyle intervention for obesity surgery candidates

被引:16
|
作者
Camolas, Jose [1 ,2 ]
Santos, Osvaldo [3 ,4 ]
Moreira, Pedro [5 ]
do Carmo, Isabel [1 ]
机构
[1] Univ Lisbon, Fac Med, Hosp Santa Maria, Lisbon, Portugal
[2] Inst Super Ciencias Saude Egas Moniz, Monte De Caparica, Portugal
[3] Univ Lisbon, Fac Med, Inst Med Prevent & Saude Publ, Lisbon, Portugal
[4] Univ Lisbon, Fac Med, Inst Saude Ambiental, Lisbon, Portugal
[5] Univ Porto, Fac Ciencias Nutr & Alimentacao, Oporto, Portugal
关键词
Bariatric surgery preoperative diet; Severe obesity; Patient centered care; Clinical effectiveness; PREOPERATIVE WEIGHT-LOSS; SELF-REPORT INSTRUMENT; ENERGY-EXPENDITURE; PHYSICAL-ACTIVITY; BEHAVIOR-CHANGE; METABOLIC-RATE; BODY-WEIGHT; RISK; DIET; ADULTS;
D O I
10.1016/j.orcp.2016.08.003
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Preoperative nutritional counseling provides an opportunity to ameliorate patients' clinical condition and build-up adequate habits and perception of competence. Study aimed to evaluate: (a) the effect of INDIVIDUO on weight and metabolic control; (b) the impact of INDIVIDUO on psychosocial variables associated with successful weight-control. Methods: Two-arms randomised controlled single-site study, with six-month duration. Patients were recruited from an Obesity Treatment Unit's waiting list. For the intervention group (IG), an operating procedure manual was used, nutritionists received training/supervision regarding INDIVIDUO's procedures. Control group (CG) received health literacy-promoting intervention. Intention-to-treat and per-control analysis were used. Outcomes included weight, metabolic control variables (blood pressure, glycemia, insulinemia, triglycerides, cholesterol), measures of eating and physical activity patterns, hedonic hunger, autonomous/controlled regulation, perceived competence for diet (PCS-diet) and quality of life. Primary outcomes were weight and metabolic control. Effect size was estimated by odds ratio and Cohens'd coefficient. Results: Overall, 94 patients participated (IG: 45; CG: 49) and 60 completed the study( IG: 29; CG: 31). Intervention patients lost an excess 9.68% body weight (%EWL), vs. 0.51% for CG. Adjusting for age and baseline BMI, allocation group remained an independent predictor of % EWL (B = 8.43, 95% CI: 2.79-14.06). IG had a six-fold higher-probability (OR: 6.35, 95% CI: 1.28-31.56) of having adequate/ controlled fastingglycemia final evaluation. PCS-diet at final evaluation was independently predictedby baseline PCS-diet (B = 0.31, 95% CI: 0.06-0.64), variation in autonomous regulation( B = 0.43, 95% CI: 0.15-0.71) and allocation group (B = 0.26, 95% CI: 0.04-1.36). Conclusions: Results on weight and metabolic control support INDIVIDUO as a valuable clinical tool for obesity surgery candidates counseling. Additionally, interventionassociated with perceived competence for weight-control behaviours and autonomousregulation. (C) 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:475 / 488
页数:14
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