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Journal of Medical Internet Research Nov 2021Digital interventions have tremendous potential to improve well-being and health care conveyance by improving adequacy, proficiency, availability, and personalization.... (Review)
Review
BACKGROUND
Digital interventions have tremendous potential to improve well-being and health care conveyance by improving adequacy, proficiency, availability, and personalization. They have gained acknowledgment in interventions for the management of a healthy lifestyle. Therefore, we are reviewing existing conceptual frameworks, digital intervention approaches, and associated methods to identify the impact of digital intervention on adopting a healthier lifestyle.
OBJECTIVE
This study aims to evaluate the impact of digital interventions on weight management in maintaining a healthy lifestyle (eg, regular physical activity, healthy habits, and proper dietary patterns).
METHODS
We conducted a systematic literature review to search the scientific databases (Nature, SpringerLink, Elsevier, IEEE Xplore, and PubMed) that included digital interventions on healthy lifestyle, focusing on preventing obesity and being overweight as a prime objective. Peer-reviewed articles published between 2015 and 2020 were included. We used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and a framework for an evidence-based systematic review. Furthermore, we improved the review process by adopting the Rayyan tool and the Scale for the Assessment of Narrative Review Articles.
RESULTS
Our initial searches identified 780 potential studies through electronic and manual searches; however, 107 articles in the final stage were cited following the specified inclusion and exclusion criteria. The identified methods for a successful digital intervention to promote a healthy lifestyle are self-monitoring, self-motivation, goal setting, personalized feedback, participant engagement, psychological empowerment, persuasion, digital literacy, efficacy, and credibility. In this study, we identified existing conceptual frameworks for digital interventions, different approaches to provide digital interventions, associated methods, and execution challenges and their impact on the promotion of healthy lifestyle management.
CONCLUSIONS
This systematic literature review selected intervention principles (rules), theories, design features, ways to determine efficient interventions, and weaknesses in healthy lifestyle management from established digital intervention approaches. The results help us understand how digital interventions influence lifestyle management and overcome the existing shortcomings. It serves as a basis for further research with a focus on designing, developing, testing, and evaluating the generation of personalized lifestyle recommendations as a part of digital health interventions.
Topics: Healthy Lifestyle; Humans; Life Style; Motivation; Obesity; Overweight
PubMed: 34787575
DOI: 10.2196/26931 -
Nutrients Dec 2021Whether the gut microbiome in obesity is characterized by lower diversity and altered composition at the phylum or genus level may be more accurately investigated using... (Meta-Analysis)
Meta-Analysis
Whether the gut microbiome in obesity is characterized by lower diversity and altered composition at the phylum or genus level may be more accurately investigated using high-throughput sequencing technologies. We conducted a systematic review in PubMed and Embase including 32 cross-sectional studies assessing the gut microbiome composition by high-throughput sequencing in obese and non-obese adults. A significantly lower alpha diversity (Shannon index) in obese versus non-obese adults was observed in nine out of 22 studies, and meta-analysis of seven studies revealed a non-significant mean difference (-0.06, 95% CI -0.24, 0.12, = 81%). At the phylum level, significantly more Firmicutes and fewer Bacteroidetes in obese versus non-obese adults were observed in six out of seventeen, and in four out of eighteen studies, respectively. Meta-analyses of six studies revealed significantly higher Firmicutes (5.50, 95% 0.27, 10.73, = 81%) and non-significantly lower Bacteroidetes (-4.79, 95% CI -10.77, 1.20, = 86%). At the genus level, lower relative proportions of and and higher , , , , , , , , , , , , and were found in obese versus non-obese adults. Although a proportion of studies found lower diversity and differences in gut microbiome composition in obese versus non-obese adults, the observed heterogeneity across studies precludes clear answers.
Topics: Bacteria; Feces; Gastrointestinal Microbiome; High-Throughput Nucleotide Sequencing; Humans; Obesity
PubMed: 35010887
DOI: 10.3390/nu14010012 -
Advances in Nutrition (Bethesda, Md.) Oct 2022This WHO-commissioned review contributed to the update of complementary feeding recommendations, synthesizing evidence on effects of unhealthy food and beverage... (Meta-Analysis)
Meta-Analysis
This WHO-commissioned review contributed to the update of complementary feeding recommendations, synthesizing evidence on effects of unhealthy food and beverage consumption in children on overweight and obesity. We searched PubMed (Medline), Cochrane CENTRAL, and Embase for articles, irrespective of language or geography. Inclusion criteria were: 1) randomized controlled trials (RCTs), non-RCTs, cohort studies, and pre/post studies with control; 2) participants aged ≤10.9 y at exposure; 3) studies reporting greater consumption of unhealthy foods/beverages compared with no or low consumption; 4) studies assessing anthropometric and/or body composition; and 5) publication date ≥1971. Unhealthy foods and beverages were defined using nutrient- and food-based approaches. Risk of bias was assessed using the ROBINS-I (risk of bias in nonrandomized studies of interventions version I) and RoB2 [Cochrane RoB (version 2)] tools for nonrandomized and randomized studies, respectively. Narrative synthesis was complemented by meta-analyses where appropriate. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation. Of 26,542 identified citations, 60 studies from 71 articles were included. Most studies were observational (59/60), and no included studies were from low-income countries. The evidence base was low quality, as assessed by ROBINS-I and RoB2 tools. Evidence synthesis was limited by the different interventions and comparators across studies. Evidence indicated that consumption of sugar-sweetened beverages (SSBs) and unhealthy foods in childhood may increase BMI/BMI z-score, percentage body fat, or odds of overweight/obesity (low certainty of evidence). Artificially sweetened beverages and 100% fruit juice consumption make little/no difference to BMI, percentage body fat, or overweight/obesity outcomes (low certainty of evidence). Meta-analyses of a subset of studies indicated a positive association between SSB intake and percentage body fat, but no association with change in BMI and BMI z-score. High-quality epidemiological studies that are designed to assess the effects of unhealthy food consumption during childhood on risk of overweight/obesity are needed to contribute to a more robust evidence base upon which to design policy recommendations. This protocol was registered at https://www.crd.york.ac.uk/PROSPERO as CRD42020218109.
Topics: Beverages; Child; Food; Humans; Obesity; Overweight; Sugar-Sweetened Beverages
PubMed: 35362512
DOI: 10.1093/advances/nmac032 -
Frontiers in Immunology 2019To help inform decision making in the clinical setting, we carried out a systematic review and meta-analysis to estimate the association of thyroid disease risks with... (Meta-Analysis)
Meta-Analysis
To help inform decision making in the clinical setting, we carried out a systematic review and meta-analysis to estimate the association of thyroid disease risks with obesity. Pubmed, Embase, Web of Science, Cochrane database and Google Scholar electronic databases were searched from inception to October 31, 2018 without language restrictions to explore the relationship between thyroid disorders and obesity. The relative risk (RR) or odds risk (OR) for thyroid disorders were pooled using the SPSS and STATA software. A total of 22 studies were included in the study. (1) Meta-analysis showed that obesity was significantly associated with an increased risk of hypothyroidism (RR = 1.86, 95% CI 1.63-2.11, < 0.001). Meta-analyses after stratification further showed that obese population had increased risks of overt hypothyroidism (RR = 3.21, 95% CI 2.12-4.86, < 0.001) and subclinical hypothyroidism (RR = 1.70, 95% CI 1.42-2.03, < 0.001). (2) Further meta-analysis also showed obesity was clearly associated with Hashimoto's thyroiditis (RR = 1.91, 95% CI 1.10-3.32, = 0.022), but not with Graves' disease. (3) In the meta-analysis of antibodies, obesity was correlated with positive thyroid peroxidase antibody (TPOAb) (RR = 1.93, 95% CI 1.31-2.85, = 0.001), but not with positive thyroglobulin antibody (TGAb). Obesity was significantly related to hypothyroidism, HT, and TPOAb, implying that prevention of obesity is crucial for thyroid disorders. PROSPERO: CRD42018096897.
Topics: Autoimmunity; Biomarkers; Disease Susceptibility; Humans; Obesity; Odds Ratio; Thyroid Diseases; Thyroid Function Tests; Thyroid Gland
PubMed: 31681268
DOI: 10.3389/fimmu.2019.02349 -
BMJ Open Mar 2023To compare the efficacy and safety between and within glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT-2is) in... (Meta-Analysis)
Meta-Analysis
Efficacy and safety of GLP-1 receptor agonists versus SGLT-2 inhibitors in overweight/obese patients with or without diabetes mellitus: a systematic review and network meta-analysis.
OBJECTIVE
To compare the efficacy and safety between and within glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT-2is) in overweight or obese adults with or without diabetes mellitus.
METHODS
PubMed, ISI Web of Science, Embase and Cochrane Central Register of Controlled Trials database were comprehensively searched to identify randomised controlled trials (RCTs) of effects of GLP-1RAs and SGLT-2is in overweight or obese participants from inception to 16 January 2022. The efficacy outcomes were the changes of body weight, glucose level and blood pressure. The safety outcomes were serious adverse events and discontinuation due to adverse events. The mean differences, ORs, 95% credible intervals (95% CI), the surface under the cumulative ranking were evaluated for each outcome by network meta-analysis.
RESULTS
Sixty-one RCTs were included in our analysis. Both GLP-1RAs and SGLT-2is conferred greater extents in body weight reduction, achieving at least 5% wt loss, HbA1c and fasting plasma glucose decrease compared with placebo. GLP-1RAs was superior to SGLT-2is in HbA1c reduction (MD: -0.39%, 95% CI -0.70 to -0.08). GLP-1RAs had high risk of adverse events, while SGLT-2is were relatively safe. Based on intraclass comparison, semaglutide 2.4 mg was among the most effective interventions in losing body weight (MD: -11.51 kg, 95% CI -12.83 to -10.21), decreasing HbA1c (MD: -1.49%, 95% CI -2.07 to -0.92) and fasting plasma glucose (MD: -2.15 mmol/L, 95% CI -2.83 to -1.59), reducing systolic blood pressure (MD: -4.89 mm Hg, 95% CI -6.04 to -3.71) and diastolic blood pressure (MD: -1.59 mm Hg, 95% CI -2.37 to -0.86) with moderate certainty evidences, while it was associated with high risk of adverse events.
CONCLUSIONS
Semaglutide 2.4 mg showed the greatest effects on losing body weight, controlling glycaemic level and reducing blood pressure while it was associated with high risk of adverse events.PROSPERO registration numberCRD42021258103.
Topics: Adult; Humans; Blood Glucose; Body Weight; Diabetes Mellitus; Glucagon-Like Peptide-1 Receptor; Glycated Hemoglobin; Network Meta-Analysis; Obesity; Overweight; Sodium-Glucose Transporter 2 Inhibitors; Weight Loss
PubMed: 36882248
DOI: 10.1136/bmjopen-2022-061807 -
Nutrients Aug 2019Weight regain after a successful weight loss intervention is very common. Most studies show that, on average, the weight loss attained during a weight loss intervention... (Meta-Analysis)
Meta-Analysis
Weight regain after a successful weight loss intervention is very common. Most studies show that, on average, the weight loss attained during a weight loss intervention period is not or is not fully maintained during follow-up. We review what is currently known about dietary strategies for weight loss maintenance, focusing on nutrient composition by means of a systematic review and meta-analysis of studies and discuss other potential strategies that have not been studied so far. Twenty-one studies with 2875 participants who were overweight or obese are included in this systematic review and meta-analysis. Studies investigate increased protein intake (12 studies), lower dietary glycemic index (four studies), green tea (three studies), conjugated linoleic acid (three studies), higher fibre intake (three studies), and other miscellaneous interventions (six studies). The meta-analysis shows a significant beneficial effect of higher protein intake on the prevention of weight regain (SMD (standardized mean difference) -0.17 (95% CI -0.29, -0.05), = 2.80, = 0.005), without evidence for heterogeneity among the included studies. No significant effect of the other strategies is detected. Diets that combine higher protein intake with different other potentially beneficial strategies, such as anti-inflammatory or anti-insulinemic diets, may have more robust effects, but these have not been tested in randomized clinical trials yet.
Topics: Adolescent; Adult; Aged; Diet, Healthy; Dietary Fiber; Dietary Proteins; Dietary Supplements; Energy Intake; Female; Glycemic Index; Humans; Linoleic Acids, Conjugated; Male; Middle Aged; Nutritive Value; Obesity; Recurrence; Treatment Outcome; Weight Gain; Weight Loss; Young Adult
PubMed: 31443231
DOI: 10.3390/nu11081916 -
Nutrients May 2023Ultra-processed foods (UPF) are energy-dense, nutritionally unbalanced products, low in fiber but high in saturated fat, salt, and sugar. Recently, UPF consumption has... (Review)
Review
Ultra-processed foods (UPF) are energy-dense, nutritionally unbalanced products, low in fiber but high in saturated fat, salt, and sugar. Recently, UPF consumption has increased likewise the incidence of obesity and cardiometabolic diseases. To highlight a possible relationship, we conducted a systematic review of prospective studies from PubMed and Web of Science investigating the association between UPF consumption and the incidence of obesity and cardiometabolic risk factors. Seventeen studies were selected. Eight evaluated the incidence of general and abdominal obesity, one the incidence of impaired fasting blood glucose, four the incidence of diabetes, two the incidence of dyslipidemia, and only one the incidence of metabolic syndrome. Studies' quality was assessed according to the Critical Appraisal Checklist for cohort studies proposed by the Joanna Briggs Institute. Substantial agreement emerged among the studies in defining UPF consumption as being associated with the incident risk of general and abdominal obesity. More limited was the evidence on cardiometabolic risk. Nevertheless, most studies reported that UPF consumption as being associated with an increased risk of hypertension, diabetes, and dyslipidemia. In conclusion, evidence supports the existence of a relationship between UPF consumption and the incidence of obesity and cardiometabolic risk. However, further longitudinal studies considering diet quality and changes over time are needed.
Topics: Adult; Humans; Prospective Studies; Food, Processed; Obesity, Abdominal; Cardiometabolic Risk Factors; Incidence; Food Handling; Fast Foods; Obesity; Diet; Hypertension
PubMed: 37299546
DOI: 10.3390/nu15112583 -
Journal of Research in Health Sciences Sep 2021Up to now, different diet therapeutics interventions have been introduced for the treatment of obesity. The present study aimed to compare the diet therapeutics... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Up to now, different diet therapeutics interventions have been introduced for the treatment of obesity. The present study aimed to compare the diet therapeutics interventions for obesity simultaneously.
STUDY DESIGN
Systematic review and network meta-analysis METHODS: The major international databases, including Medline (via PubMed), Web of Science, Scopus, Cochrane Library, and Embase, were searched using a predesigned search strategy. Randomized controlled trials (RCTs) that had compared the diet therapy interventions were included. The mean difference with a 95% confidence interval was used to summarize the effect size in the network meta-analysis. The frequentist approach was used for data analysis.
RESULTS
In total, 36 RCTs out of 9335 retrieved references met the inclusion criteria in this review. The included RCTs formed nine independent networks. Based on the results, Hypocaloricdiet+Monoselect Camellia (MonCam, P=0.99), energy restriction, behavior modification+exercise (LED) (P=0.99), sweetener at 20% of total calories (HFCS20)+Ex (P=0.67), catechin-richgreentea(650)+inulin (P=0.68), very low calorie diet (VLCD) (P=1.00), normal protein diet+resistance exercise (NPD+RT) (P=0.80), low-calorie diets+exercise (Hyc+Ex) (P=0.85), high-soy-protein low-fat diet (SD) (P=0.75), calorie restriction+behavioral weight loss (Hyc+BWL) (P=0.99) were the better treatments for weight loss in the networks one to nine, respectively.
CONCLUSION
Based on the results of network meta-analysis, it seems that Hypocaloricdiet+MonCam, LED, HFCS20+Ex, catechin-rich green tea +inulin, VLCD, NPD+RT, Hyc+Ex, SD, Hyc+BWL, are the better treatments for weight loss in patients with overweight and obesity.
Topics: Diet; Humans; Network Meta-Analysis; Obesity; Overweight; Weight Loss
PubMed: 34698655
DOI: 10.34172/jrhs.2021.63 -
International Journal of Environmental... Feb 2023Emotional eating (EE) may be defined as a tendency to eat in response to negative emotions and energy-dense and palatable foods, and is common amongst adults with... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Emotional eating (EE) may be defined as a tendency to eat in response to negative emotions and energy-dense and palatable foods, and is common amongst adults with overweight or obesity. There is limited evidence regarding the effectiveness of interventions that address EE.
OBJECTIVES
To synthesize evidence on the effectiveness of EE interventions for weight loss and EE in adults living with overweight or obesity.
METHODS
This is a systematic review and meta-analysis. Adhering to the PRISMA guidance, a comprehensive electronic search was completed up to February 2022. Random effects meta-analysis was carried out to determine the percentage change in weight and EE scores.
RESULTS
Thirty-four studies were included. The combined effect size for percentage weight change was -1.08% (95% CI: -1.66 to -0.49, I = 64.65%, = 37), once adjusted for publication bias. Similarly, the combined effect size for percentage change in EE was -2.37%, (95% CI: -3.76 to -0.99, I = 87.77%, = 46). Cognitive Behavioural Therapy showed the most promise for reducing weight and improving EE.
CONCLUSIONS
Interventions to address EE showed promise in reducing EE and promoted a small amount of weight loss in adults living with overweight or obesity.
Topics: Adult; Humans; Overweight; Obesity; Weight Loss; Cognitive Behavioral Therapy; Emotions
PubMed: 36768088
DOI: 10.3390/ijerph20032722 -
International Journal of Clinical... 2022Liraglutide in a 3.0 mg subcutaneous dose daily is approved for weight reduction. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Liraglutide in a 3.0 mg subcutaneous dose daily is approved for weight reduction.
OBJECTIVES
Objectives are to evaluate the efficacy and safety of liraglutide 3.0 mg in patients with overweight and obesity irrespective of diabetic status.
METHODS
We conducted an electronic database search in PubMed, Embase, and https://ClinicalTrial.gov to identify all randomized control trials (RCTs) that evaluated the efficacy and safety of liraglutide 3.0 mg dose compared to placebo in overweight (≥27 kg/m) and obese (≥30 kg/m) patients above 18 years of age.
RESULTS
We compared the pooled estimate of the study results between liraglutide 3.0 mg groups and placebo groups both in diabetic and nondiabetic patients. The efficacy outcomes that were found to be significant among respective studies involving nondiabetic patients vs. diabetic patients were mean change in body weight from baseline: 12 studies [MD = -5.04 kg (95% CI = -5.60, -4.49), < 0.001, = 92.95%] vs. 2 studies [MD = -4.14 kg (95% CI = -4.95, -3.32), < 0.001, = 0%], reduction in waist circumference from baseline: 8 studies [MD = -3.64 cm (95% CI = -4.43, -2.85), < 0.001, = 96.5%] vs. 2 studies [MD = -3.11 cm (95% CI = -3.88, -2.34), < 0.001, = 0%], BMI reduction from baseline: 5 studies [MD = -1.95 kg/m (95% CI = -2.22, -1.68) vs. 1 study [MD = -1.86 kg/m (95% CI = -2.14, -1.57), < 0.001, = 0%, < 0.001, = 95.6%], proportion of patients losing more than 5% of weight loss from baseline: 8 studies [RR = 2.21, (95% CI = 1.89, 2.58), =0.03, = 59.02%] vs. 2 studies [RR = 2.34, (95% CI = 1.93, 2.85), =0.39, = 0.00%], and 10% weight loss from baseline: 7 studies [RR = 3.36, (95% CI = 1.92, 5.91), =0.00, = 87.03%] vs. 2 studies [RR = 3.64, (95% CI = 2.46, 5.40), =0.81, = 0.00%]. Safety outcome assessment with use of liraglutide 3.0 mg compared with placebo in respective nondiabetic vs. diabetic patients revealed significant proportion of patients experiencing the adverse events: 9 studies [RR = 1.11, (95% CI = 1.04, 1.18), =0.00 = 79.15%] vs. 2 studies [RR = 1.06, (95% CI = 1.01, 1.11), =0.42, = 0.03%] but similar risk of serious adverse events: 9 studies [RR = 1.03, (95% CI = 0.70, 1.51), =0.26, = 18.54%] vs. 2 studies [RR = 1.11, (95% CI = 0.67, 1.84), =0.25, = 23.77%] and TDAEs: 4 studies [RR = 0.89, (95% CI = 0.35, 2.28), =0.03, = 61.89%] vs. 1 study [RR = 2.53, (95% CI = 1.00, 6.37)]. However, the pooled estimates irrespective of the glycaemic status were mean change in body weight from baseline: 14 RCT [MD = -4.91 kg (95% CI = -5.43, -4.39), < 0.001, = 92.35%], reduction in waist circumference from baseline: 10 studies [MD = -3.55 cm, (95% CI = -4.21, -2.89), < 0.001, = 94.99%], BMI reduction from baseline: 6 studies [MD = -1.86 kg/m, (95% CI = -2.14, -1.57), < 0.001, = 96.14%], and proportion of patients losing more than 5% and 10% of weight from baseline: [RR = 2.23, (95% CI = 1.98, 2.52), < 0.001, = 48.87%] and [RR = 3.28, (95% CI = 2.23, 4.83), < 0.001, = 78.98%], respectively. Also, the proportion of patients experiencing the adverse event was more with liraglutide 3.0 mg compared with placebo 11 study [RR = 1.09, (95% CI = 1.04, 1.15), < 0.01, = 76.60%] and similar risk for both serious adverse events: 11 studies [RR = 1.09, (95% CI = 1.04, 1.15), < 0.01, = 76.60%] and TDAEs: 5 studies [RR = 1.14, (95% CI = 0.50, 2.60), < 0.01, = 64.93%] with liraglutide compared with placebo.
CONCLUSIONS
Liraglutide in 3.0 mg subcutaneous dose demonstrated significant weight reduction with a reasonable safety profile for patients with overweight or obesity regardless of diabetic status compared to placebo.
Topics: Diabetes Mellitus; Humans; Liraglutide; Obesity; Overweight; Weight Loss
PubMed: 35936066
DOI: 10.1155/2022/1201977