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跨学科方案对肥胖人群营养习惯和代谢合并症的影响:一项随机对照临床试验。

Effectiveness of an Interdisciplinary Program Performed on Obese People Regarding Nutritional Habits and Metabolic Comorbidity: A Randomized Controlled Clinical Trial.

机构信息

Nutrition Department, Hospital Clínico Universitario Virgen de la Arrixaca, 30120 El Palmar, Spain.

Department of Nursing, Faculty of Nursing, University of Murcia, 30100 Espinardo, Spain.

出版信息

Int J Environ Res Public Health. 2020 Jan 3;17(1):336. doi: 10.3390/ijerph17010336.

Abstract

Obesity is an important public health problem. The combined use of different therapies performed by an interdisciplinary group can improve the management of this health issue. The main goal of this research is to determine the effectiveness of a multidisciplinary program based on healthy eating, exercise, cognitive-behavioral therapy, and health education in improving metabolic comorbidity, Body Mass Index (BMI), and nutritional habits among obese adults, at short (12 months) and long term (24 months). A randomized controlled clinical trial was conducted at a community care center between February 2014 and February 2016. A random sampling was done (299), total population (3262). A sample of 74 subjects diagnosed with obesity (experimental group, = 37 and control group, = 37) was conducted. Inclusion criteria: obese people (BMI: >30 kg/m) with metabolic comorbidity and bad nutritional habits. Exclusion criteria: other comorbidities. A 12-month interdisciplinary program (with pre-test, 12 months and 24 months of follow-up) was applied. Intervention is based on healthy eating, exercise, and cognitive behavioral therapy. The intervention had a positive effect on nutritional habits (F2;144 = 115.305; < 0.001). The experimental group increased fruit and vegetable intake (F2;144 = 39.604, < 0.001), as well as fortified foods (F2;144 = 10,076, < 0.001) and reduced fats, oils, and sweets F2;144 = 24,086, < 0.001). In the experimental group, a BMI reduction of 2.6 to 24 months was observed. At follow-up, no participant had inadequate nutritional habits, compared to 35.1% of the control group (χ22 = 33,398; < 0.001). There was also a positive response of metabolic comorbidities in the intervention group. The interdisciplinary program improved all participants' metabolic parameters, BMI, and nutritional habits while maintaining the long-term effects (24 months).

摘要

肥胖是一个重要的公共卫生问题。通过跨学科团队联合使用不同的疗法,可以改善对这一健康问题的管理。本研究的主要目的是确定基于健康饮食、运动、认知行为疗法和健康教育的多学科方案在改善肥胖成年人代谢合并症、体重指数(BMI)和营养习惯方面的短期(12 个月)和长期(24 个月)效果。2014 年 2 月至 2016 年 2 月在社区护理中心进行了一项随机对照临床试验。采用随机抽样法(299 例,总人群 3262 例)。对 74 名被诊断为肥胖症的患者(实验组,n = 37;对照组,n = 37)进行了抽样。纳入标准:患有代谢合并症和不良营养习惯的肥胖者(BMI:>30 kg/m)。排除标准:其他合并症。实施了为期 12 个月的跨学科方案(包括前测、12 个月和 24 个月的随访)。干预措施基于健康饮食、运动和认知行为疗法。干预对营养习惯有积极影响(F2;144 = 115.305;<0.001)。实验组增加了水果和蔬菜的摄入量(F2;144 = 39.604,<0.001),以及强化食品(F2;144 = 10,076,<0.001)和减少脂肪、油和甜食(F2;144 = 24,0.001)。在实验组中,BMI 从 2 到 24 个月有所下降。在随访中,与对照组的 35.1%相比,没有参与者存在营养不足的情况(χ22 = 33.398;<0.001)。干预组的代谢合并症也有积极的反应。跨学科方案改善了所有参与者的代谢参数、BMI 和营养习惯,同时保持了长期效果(24 个月)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b4f/6981546/1ef5f9e879ca/ijerph-17-00336-g001.jpg

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