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      The degree of engagement of overweight/obese adult women in the recommended activities of the Chilean "Vida Sana" program is directly correlated with its effectiveness Translated title: El grado de participación de las mujeres adultas con sobrepeso/obesidad en las actividades recomendadas por el programa chileno "Vida Sana" se correlaciona directamente con su efectividad

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          Abstract

          Abstract Introduction: the Chilean Ministry of Health implements the Vida Sana (VS) program with the objective of reducing risk factors for chronic diseases in overweight/obese (OW/OB) individuals, aged 2-64. Objective: to determine the effectiveness of VS in OW/OB women (20-44 yrs) in terms of their engagement in the recommended activities. These consist of participating in a minimum number each of three core activities (psychologist consultations, lifestyle workshops, and physical activity sessions) during 6 months, to obtain a 5 % weight loss and improved physical fitness (PF). Methods: a retrospective study involving secondary analyses of the 2017 VS database (n = 5,179 OW/OB women). We determined effectiveness by: a) comparing changes in weight and PF in participants who achieved one or both outcomes, using t-tests and tests of proportions, and b) assessing the probability of achieving the program's goal, according to participation in 1, 2, or 3 core activities, individually and jointly, using the OR (95 % CI) and trend analysis. Results: around 32 %, 88 %, and 29 % of women achieved 5 % weight loss, improved PF, and both, respectively. The high percentage of women who improved PF was due to a permissive criterion. Although 20 % of women attained the program's goal with 0 engagement, among participants, the ORs (95 % CI) for achieving the program's goal when engaging in 1, 2, or 3 core activities were 1.55 (CI 1.2-2.03), 2.34 (1.76-3.11), and 3.5 (2.21-5.53), respectively. Conclusion: effectiveness parallels degree of engagement in the recommended activities of VS. A characterization of a program's participation rate is crucial for improving its effectiveness.

          Translated abstract

          Resumen Introducción: el objetivo del programa chileno Vida Sana (VS) es reducir los factores de riesgo de enfermedades crónicas en personas de 2-64 años con sobrepeso/obesidad (SP/OB). Objetivo: determinar la efectividad del programa VS en mujeres SP/OB (20-44 años) a través de su participación en cada una de las actividades recomendadas (consultas con psicólogo, talleres y actividad física) durante 6 meses, para lograr perder un 5 % de peso y mejorar la condición física (CF). Métodos: estudio retrospectivo con análisis secundario de la base de datos VS de 2017 (n = 5179 mujeres SP/OB). Se determinó la efectividad: a) comparando los cambios en el peso y la CF de las participantes que lograron uno o ambos resultados, usando el test de la "t" y el de proporciones; b) evaluando la probabilidad de lograr el objetivo de acuerdo con la participación en 1, 2 o 3 actividades, de manera individual y conjunta, calculando los OR (IC 95 %) y el análisis de tendencias. Resultados: el 32 %, 88 % y 29 % de las mujeres perdieron un 5 % de peso, mejoraron la CF o consiguieron ambas cosas, respectivamente. El alto porcentaje que mejoró la CF se debió a un criterio permisivo. Aunque el 20 % de las mujeres lograron el objetivo del programa con una participación "0", los OR (IC del 95 %) de lograr el objetivo al participar en 1, 2 o 3 de las actividades fueron de 1,55 (IC: 1,2-2,03), 2,34 (IC: 1,76-3,11) y 3,5 (IC: 2,21-5,53), respectivamente. Conclusión: la efectividad del programa VS se asocia directamente con el grado de participación en las actividades. Caracterizar la participación de un programa es clave para mejorar su efectividad.

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          Most cited references34

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          ATS statement: guidelines for the six-minute walk test.

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            Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.

            Type 2 diabetes affects approximately 8 percent of adults in the United States. Some risk factors--elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle--are potentially reversible. We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes. We randomly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin (850 mg twice daily), or a lifestyle-modification program with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week. The mean age of the participants was 51 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 34.0; 68 percent were women, and 45 percent were members of minority groups. The average follow-up was 2.8 years. The incidence of diabetes was 11.0, 7.8, and 4.8 cases per 100 person-years in the placebo, metformin, and lifestyle groups, respectively. The lifestyle intervention reduced the incidence by 58 percent (95 percent confidence interval, 48 to 66 percent) and metformin by 31 percent (95 percent confidence interval, 17 to 43 percent), as compared with placebo; the lifestyle intervention was significantly more effective than metformin. To prevent one case of diabetes during a period of three years, 6.9 persons would have to participate in the lifestyle-intervention program, and 13.9 would have to receive metformin. Lifestyle changes and treatment with metformin both reduced the incidence of diabetes in persons at high risk. The lifestyle intervention was more effective than metformin.
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              Energy balance and obesity: what are the main drivers?

              Purpose The aim of this paper is to review the evidence of the association between energy balance and obesity. Methods In December 2015, the International Agency for Research on Cancer (IARC), Lyon, France convened a Working Group of international experts to review the evidence regarding energy balance and obesity, with a focus on Low and Middle Income Countries (LMIC). Results The global epidemic of obesity and the double burden, in LMICs, of malnutrition (coexistence of undernutrition and overnutrition) are both related to poor quality diet and unbalanced energy intake. Dietary patterns consistent with a traditional Mediterranean diet and other measures of diet quality can contribute to long-term weight control. Limiting consumption of sugar-sweetened beverages has a particularly important role in weight control. Genetic factors alone cannot explain the global epidemic of obesity. However, genetic, epigenetic factors and the microbiota could influence individual responses to diet and physical activity. Conclusion Energy intake that exceeds energy expenditure is the main driver of weight gain. The quality of the diet may exert its effect on energy balance through complex hormonal and neurological pathways that influence satiety and possibly through other mechanisms. The food environment, marketing of unhealthy foods and urbanization, and reduction in sedentary behaviors and physical activity play important roles. Most of the evidence comes from High Income Countries and more research is needed in LMICs.
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                Author and article information

                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                August 2021
                : 38
                : 4
                : 807-813
                Affiliations
                [1] Santiago Santiago de Chile orgnameUniversidad de Chile orgdiv1Instituto de Nutrición y Tecnología de los Alimentos (INTA) Chile
                [2] Durham North Carolina orgnameDuke University School of Medicine orgdiv1Department of Medicine orgdiv2Division of General Internal Medicine USA
                Article
                S0212-16112021000400807 S0212-1611(21)03800400807
                10.20960/nh.03461
                33703910
                aa86ca06-015c-4e60-b6ac-1550cce17ca3

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 20 December 2020
                : 30 November 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 7
                Product

                SciELO Spain

                Categories
                Original Papers

                Physical fitness,Chile,Participación,Efectividad,Condición física,Obesidad,Sobrepeso,Participation,Effectiveness,Obesity,Overweight

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