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高危患者的二级预防行为改变策略:对所有 BMI 类别都有益处。

Secondary-prevention behaviour-change strategy for high-risk patients: Benefits for all classes of body mass index.

机构信息

Nutrition & Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.

Nutrition and Dietetics Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.

出版信息

Nutr Diet. 2020 Nov;77(5):499-507. doi: 10.1111/1747-0080.12605. Epub 2020 Jan 9.

Abstract

AIM

Research is needed to support the long-term benefits of lifestyle interventions for management of high-risk patients with different BMI classifications. This prospective multicentre study assessed two-year outcomes of hospital-referred patients (BMI 25-61 kg/m ) attending a dietitian-led multidisciplinary Healthy Eating and Lifestyle Behaviour-Change Program in group or individual formats in hospital outpatient settings.

METHODS

Bodyweight, quality of life (Short Form-12) and intuitive eating (Intuitive Eating Scale) data were collected at pre-intervention, post-intervention and 2 years. Outcomes were reported in BMI classes.

RESULTS

At pre-intervention (n = 493), 11% had pre-obesity, 25% obesity class I, 30% obesity class II and 34% obesity class III. Characteristics of participants with available data at post-intervention (n = 290) and 2 years (n = 178) were comparable (P > .05). Significant mean weight loss was seen at post-intervention (-2.0 ± 0.4 kg, P < .001, n = 290) and 2 years (-4.3 ± 0.5 kg, P < .001, n = 178). All BMI classes had significant weight losses (P < .05). Participants with higher obesity (classes II and III) had greater improvements in mental quality of life (P < .05) and initial weight reductions (P < .05) than those with lower classes. However, those with obesity class I had the greatest long-term weight reductions and significant improvements in physical quality of life at 2 years (P < .05). All BMI classes reported similar improvements in intuitive eating. No effect was found for differences in intervention format, duration or setting (P > .05).

CONCLUSIONS

The results support dietitian-led multidisciplinary lifestyle interventions for multidisciplinary management of high-risk patients of all BMI classes.

摘要

目的

需要研究支持生活方式干预对不同 BMI 分类的高危患者的长期益处。这项前瞻性多中心研究评估了在医院门诊环境中以小组或个人形式参加营养师主导的多学科健康饮食和生活方式行为改变计划的医院转介患者(BMI 25-61kg/m )的两年结局,这些患者的 BMI 为 25-61kg/m 。

方法

在干预前、干预后和 2 年时收集体重、生活质量(简短形式-12)和直觉饮食(直觉饮食量表)数据。结果按 BMI 分类报告。

结果

在干预前(n=493),11%有前期肥胖,25%肥胖 I 级,30%肥胖 II 级,34%肥胖 III 级。有干预后(n=290)和 2 年(n=178)数据的参与者的特征相似(P>.05)。干预后(n=290)和 2 年(n=178)体重均显著减轻(-2.0±0.4kg,P<.001)。所有 BMI 分类的体重均有显著减轻(P<.05)。肥胖程度较高(II 级和 III 级)的患者心理生活质量(P<.05)和初始体重减轻(P<.05)改善更大。然而,肥胖 I 级患者在 2 年时体重减轻最大,身体生活质量有显著改善(P<.05)。所有 BMI 分类的直觉饮食均有相似改善。干预形式、持续时间或环境的差异无效果(P>.05)。

结论

结果支持营养师主导的多学科生活方式干预,用于管理所有 BMI 分类的高危患者。

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