Tag Archive: control

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Commercial weight loss programs more effective than NHS-based services, UK study finds

December 11th, 2011 / tags:, , , , , , / categories: Uncategorized /

ScienceDaily (Nov. 3, 2011) — Commercial weight loss programmes are more effective and cheaper than primary care based services led by specially trained staff, finds a study published on bmj.com.

Almost a quarter of the population of England are now classified as obese. Good evidence shows that commercial weight management services can be effective, but the effectiveness of obesity management in primary care is still unclear.

So researchers at the University of Birmingham compared the effectiveness of several commercial weight loss programmes of 12 weeks’ duration with primary care led programmes and a control group.

A total of 740 obese and overweight men and women took part. Follow-up data were available for 658 (89%) participants at the end of each 12-week programme and 522 (71%) at one year.

The programmes included in the analyses were Weight Watchers; Slimming World; Rosemary Conley; a group-based dietetics programme; general practice one to one counselling, pharmacy one to one counselling; or a choice of any of the six programmes.

A control group was provided with 12 vouchers enabling free entrance to a local leisure (fitness) centre.

All programmes achieved significant weight loss after 12 weeks, with the average weight loss ranging from 4.4 kg (Weight Watchers) to 1.4 kg (general practice provision). The primary care programmes were no better than the control group at 12 weeks.

At one year, statistically significant weight loss occurred in all groups apart from the one to one programmes in general practice and pharmacy settings. However, Weight Watchers was the only programme to achieve significantly greater weight loss than the control group.

All groups showed some increase in physical activity, although the smallest increase was in those allocated to the general practice programme.

Attendance seemed to be an important factor; the highest attendance rate was in Weight Watchers and the lowest for the primary care programmes. The primary care programmes were also the most costly to provide.

“Our findings suggest that a 12 week group based dedicated programme of weight management can result in clinically useful amounts of weight loss that are sustained at one year,” say the authors.

They add: “Commercially provided weight management services are more effective and cheaper than primary care based services led by specially trained staff, which are ineffective.”

In an accompanying editorial, nutrition experts Helen Truby and Maxine Bonham at Monash University in Australia say: “Lighten Up shows that there is no simple solution to the obesity epidemic.”

They believe that the NHS should be mindful of the level of investment needed to develop its own expert workforce to manage complex obesity, and it can gain much information from commercial companies in how to deliver what consumers want.

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The above story is reprinted from materials provided by BMJ-British Medical Journal.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal References:

  1. K. Jolly, A. Lewis, J. Beach, J. Denley, P. Adab, J. J. Deeks, A. Daley, P. Aveyard. Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: Lighten Up randomised controlled trial. BMJ, 2011; 343 (nov03 2): d6500 DOI: 10.1136/bmj.d6500
  2. H. Truby, M. Bonham. What makes a weight loss programme successful? BMJ, 2011; 343 (nov03 2): d6629 DOI: 10.1136/bmj.d6629

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Article source: http://www.sciencedaily.com/releases/2011/11/111103212622.htm

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Web-based intervention appears ineffective for preventing weight gain in adolescents

December 10th, 2011 / tags:, , , , , , / categories: Uncategorized /

ScienceDaily (Nov. 7, 2011) — A web-based computer-tailored intervention aiming to increase physical activity, decrease sedentary behavior, and promote healthy eating among adolescents was not associated with positive long-term outcome measures, but may have positive short-term effects on eating behaviors, according to a report published Online First by Archives of Pediatrics Adolescent Medicine, one of the JAMA/Archives journals.

“The high prevalence of overweight and obesity among adolescents is a major public health concern because of its association with various chronic diseases,” the authors write as background information in the article. “Computer tailoring has been recognized as a promising health communication technique to promote energy balance-related behaviors.”

To evaluate short- and long-term effectiveness of a web-based computer-tailored intervention on preventing excessive weight gain in adolescents, Nicole P. M. Ezendam, Ph.D., then of Erasmus University Medical Center, Rotterdam, the Netherlands, now of Tilburg University, Tilburg, the Netherlands, and colleagues developed the online school-based, FATaintPHAT intervention. The intervention included 20 schools in the Netherlands, and a total of 883 students ranging from 12 to 13 years of age. The main objectives of the intervention were to improve dietary behaviors (including reducing consumption of sugar-sweetened beverages, and increasing intake of fruits, vegetables and whole grains), reduce sedentary behavior and increase physical activity. Students not meeting behavioral guidelines at the start of the study were considered “at risk.”

The FATaintPHAT intervention included eight modules that addressed issues of weight management and energy balance-behaviors. Each module contained information about the behavior-health link, an assessment of behavior, individually tailored feedback on the behavior and an option to formulate an implementation intention to prompt specific goal setting and action planning.

The complete analysis showed no intervention effects on BMI (body mass index), waist circumference, or percentage of students being overweight or obese in the total sample. At the four-month follow-up, students in the intervention group were less likely to report drinking more than 400 milliliters (13.52 ounces) of sugar-sweetened beverages per day compared with students in the control group in the total sample, but not in the at-risk group. Average self-reported snack consumption was lower in the intervention group than the control group at the four-month follow-up; however, the difference was not statistically significant at the two-year follow-up.

Among the students at risk, those in the intervention group reported eating more pieces of fruit than those in the control group at the four-month follow-up. Students in the intervention group also reported eating more grams per day of vegetables than those in the control group for both the total sample and among at-risk students. There were no differences in self-reported consumption of whole-wheat bread between the intervention group and control group. An inverse relationship was observed for students in the intervention group, as at-risk students in the intervention group were less likely to report participating in sports at the four-month follow-up than students in the control group.

“The FATaintPHAT intervention was associated with positive short-term effects on diet but with no effects or unfavorable effects on physical activity and sedentary behavior,” the authors write. “In conclusion, our study shows that the computer-tailored intervention FATaintPHAT was not effective in modifying anthropometric outcome measures but that it can have a positive effect on dietary behaviors among adolescents at short-term follow-up.”

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The above story is reprinted from materials provided by JAMA and Archives Journals.

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Journal Reference:

  1. N. P. M. Ezendam, J. Brug, A. Oenema. Evaluation of the Web-Based Computer-Tailored FATaintPHAT Intervention to Promote Energy Balance Among Adolescents: Results From a School Cluster Randomized Trial. Archives of Pediatrics and Adolescent Medicine, 2011; DOI: 10.1001/archpediatrics.2011.204

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Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Article source: http://www.sciencedaily.com/releases/2011/11/111107162736.htm

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Abnormal number of neurons in brains of children with autism, preliminary study finds

December 10th, 2011 / tags:, , , , , , , / categories: Uncategorized /

ScienceDaily (Nov. 8, 2011) — In a small, preliminary study that included 13 male children, those with autism had an average 67 percent more prefrontal brain neurons and larger than average brain weight, than children without autism, according to a study in the November 9 issue of JAMA.

Brain and head overgrowth in children with autism and neural dysfunction are evident at young ages in multiple brain regions, including the prefrontal cortex (PFC), that are involved in higher-order social, emotional, communication, and cognitive development. “Therefore, knowledge of the neural basis of overgrowth could point to early causal mechanisms in autism and elucidate the neural functional defects that engender autistic symptoms. In the first magnetic resonance imaging (MRI) report of early brain overgrowth in autism a decade ago, it was theorized that excess numbers of neurons could be an underlying cause, perhaps due to prenatal dysregulation of proliferation, apoptosis [cell death], or both. However, the neural basis of early overgrowth remains unknown and can only be known from direct quantitative studies of the young postmortem autistic brain,” according to background information in the article.

Eric Courchesne, Ph.D., of the NIH-UCSD School of Medicine Autism Center of Excellence, La Jolla, Calif., and colleagues examined whether early brain overgrowth in children with autism involves excess neuron numbers in the PFC. The study included postmortem prefrontal tissue from 7 autistic and 6 control male children, ages 2 to 16 years, which was examined by expert anatomists who were blinded to diagnostic status. Number and size of neurons were quantified within the dorsolateral (DL-PFC) and mesial (M-PFC) subdivisions of the PFC. Cases were from the eastern and southeastern United States and died between 2000 and 2006.

The researchers found statistically significant differences in neuron counts in the PFC in the autistic children compared with controls. There were 79 percent more neurons in DL-PFC in the autistic cases compared with the control cases and 29 percent more in M-PFC. The average DL-PFC count in the autistic children was 1.57 billion neurons compared with an average of 0.88 billion neurons in control children. The average M-PFC count in the autistic group was 0.36 billion neurons compared with an average of 0.28 billion neurons in controls. “Together, these 2 subdivisions gave a total combined prefrontal neuron count that was 67 percent greater in the autistic children compared with controls,” the authors write.

The researchers also found that the brain weight in the autistic sample deviated from normative average weight for age by 17.6 percent, while control brains deviated from age-based norms by 0.2 percent.

“Our sample of autistic children was not large enough to statistically examine brain-behavior relationships. Future studies with many more cases of autistic children might reveal important relationships between neuron counts and symptom severity or intellectual ability,” the authors write.

“To our knowledge, this study is the first direct quantitative test and confirmation of the theory that a pathological overabundance of neurons in critical brain regions is present at a young age in autism. Because cortical neurons are generated in prenatal, not postnatal life, pathological overabundance of neurons indicates early developmental disturbances in molecular and genetic mechanisms that govern proliferation, cell cycle regulation, and apoptosis. Therefore, the finding has significance for understanding the etiological and neural development and functional origins of autism.”

Editorial: Increased Neuron Number and Head Size in Autism

“The results of the study by Courchesne et al show that the relationship between increased neuron count, brain overgrowth, and increased brain weight in autism is complex,” writes Janet E. Lainhart, M.D., of the University of Utah, Salt Lake City, and Nicholas Lange, Sc.D., of the Harvard University Schools of Medicine and Public Health, Boston, in an accompanying editorial.

“Prefrontal neuron number and brain weight were increased in the autism group but were not significantly correlated. Future studies of prefrontal neuron numbers are needed in children and adolescents with autism who do not have brain overgrowth and in nonautistic children with benign megalencephaly [an abnormally large brain] to determine if increased prefrontal neuron count in autism is associated with autism only, brain overgrowth only, or some combination of both. Neuroimaging studies suggest that other regions of the brain, including the temporal lobe, deserve further investigation by postmortem tissue analysis. Because neurons in all brain areas except the olfactory bulb and hippocampus are generated before birth, the present findings add significantly to mounting biological evidence that the developmental neuropathology of idiopathic autism begins before birth in some, possibly all, cases. The study by Courchesne et al also adds to frequently reported findings in neuroanatomical studies of autism, including increased variance and loss of typical relationships between measured components of the brain. Factors that normally organize the brain appear to be disrupted.”

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The above story is reprinted from materials provided by JAMA and Archives Journals.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal References:

  1. E. Courchesne, P. R. Mouton, M. E. Calhoun, K. Semendeferi, C. Ahrens-Barbeau, M. J. Hallet, C. C. Barnes, K. Pierce. Neuron Number and Size in Prefrontal Cortex of Children With Autism. JAMA: The Journal of the American Medical Association, 2011; 306 (18): 2001 DOI: 10.1001/jama.2011.1638
  2. J. E. Lainhart, N. Lange. Increased Neuron Number and Head Size in Autism. JAMA: The Journal of the American Medical Association, 2011; 306 (18): 2031 DOI: 10.1001/jama.2011.1633

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Article source: http://www.sciencedaily.com/releases/2011/11/111108200710.htm

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