The present study was designed to evaluate the 3 year effects of a lifestyle intervention on weight loss and maintenance, dietary, and physical activity habits and eating behavior of patients following vertical banded gastroplasty (VBG). Thirty severely obese female volunteers were included in the study and they were randomly assigned to one of two intervention groups: usual care (UC) or lifestyle intervention (LS) group. Patients were followed for 3 years postoperatively. Outcome measures included weight loss, dietary habits, physical activity level (PAL), and eating behavior changes. Weight was significantly lower in the LS group after 12 months (84.4 ± 3.9 kg vs. 98.4 ± 4.4 kg, P < 0.05), 24 months (83.0 ± 3.3 vs. 101.9 ± 5.3 kg, P < 0.05), and 36 months following surgery (84.2 ± 3.3 vs. 102.5 ± 3.5 kg, P < 0.05). Repeated measures ANOVA revealed significant differences between the two groups overall and at specific time points for the PAL and TV viewing. With regard to eating behavior, the LS group scored significantly better in total Dutch Eating Behavior Questionnaire (DEBQ), Restraint Eating and External Eating scales at all postoperative time points. Similarly, significant differences were found between the two groups in dietary intake. These findings outline the importance of lifestyle intervention on weight loss and maintenance following bariatric surgery. The favorable effects of lifestyle intervention may be through adoption of healthier eating behaviors and increased physical activity.

Aim: To examine the validity of published resting energy expenditure (REE) equations in Greek adults, and if indicated, develop new cohort-specific predictive REE equations. Methods: Indirect calorimetry and anthropometric data were obtained from 226 adult volunteers of diverse age groups and body mass index ranges (18–60 years, 16.6–67.7 kg·m^–2). Measured REE was compared to preexisting prediction equations via correlation, regression, and Bland-Altman analysis. Then, cohort-specific REE equations were developed using curve estimation and nonlinear regression. To reduce type I error, presently derived equations were validated by splitting the sample into a training and validation group. Results: Preexisting equations over-predicted in-cohort REE. Equations by Livigston and Kohlstadt were most accurate at the individual level (63% accuracy), while formulas by Owen and collaborators elicited highest accuracy at the group level (–1.8% bias). Bland-Altman analysis showed proportional bias for most equations. Currently developed equations showed highest overall accuracy with 70% at the individual and group level (1.0% bias), with small differences between measured and predicted REE values (mean, 95% CI 36 [–15 to 88] kcal·day^–1). Conclusion: Data indicate currently developed equations to be the most accurate and valid for estimating REE in Greek adults. Further studies should examine the developed equations in an independent sample.

No abstract

Οι γρήγοροι ρυθμοί αύξησης της παχυσαρκίας μπορούν να δικαιολογήσουν το κομμάτι εκείνο της επιστημονικής κοινότητας που την κατατάσσει στα όρια της επιδημίας, καθώς σε πολλές χώρες περισσότεροι από 1 στους 2 έχουν βάρος μεγαλύτερο από αυτό που θεωρείται υγειές. Ακόμα πιο ανησυχητικοί είναι οι ρυθμοί αύξησης της νοσογόνου παχυσαρκίας, οι οποίοι είναι διπλάσιοι από τους αντίστοιχους της μη νοσογόνου παχυσαρκίας. Οι χειρουργικές επεμβάσεις φαίνεται να αποτελούν την πιο αποτελεσματική λύση για την αντιμετώπισή της. Παράλληλα, γνωρίζουμε ότι η ταυτόχρονη εφαρμογή τεχνικών τροποποίησης συμπεριφοράς βελτιώνουν την αποτελεσματικότητα μη-χειρουργικών παρεμβάσεων. Έτσι, σκοπός της παρούσας διατριβής ήταν να μελετήσει αν η εφαρμογή ενός εντατικού προγράμματος τροποποίησης συμπεριφοράς (ΤΣ) μετά από χειρουργική παρέμβαση (και συγκεκριμένα μια περιοριστικού τύπου, ενισχυμένη κάθετη γαστροπλαστική, ΕΚΓ) βελτιώνει την απώλεια βάρους σε νοσογόνα παχύσαρκους ασθενείς (μελέτη 1). Ταυτόχρονα, συγκρίθηκε ένα εντατικό συνδυαστικό πρόγραμμα ΤΑ με ολιγοθερμιδική δίαιτα, τόσο με συνδυαστικό πρόγραμμα τροποποίησης συμπεριφοράς μετά από χειρουργική παρέμβαση (μελέτη 2), όσο και με τη χειρουργική επέμβαση μόνο (μελέτη 3). Τέλος, δεδομένων των ερευνητικών κενών που υπάρχουν στη βιβλιογραφία όσον αφορά την επίδραση της συχνής αυξομείωσης βάρους σε παραμέτρου όπως ο ΔΜΣ, η σύσταση σώματος, ο μεταβολικός ρυθμός ηρεμίας και διάφορες διατροφικές συμπεριφορές, εξετάστηκε η πιθανή συσχέτιση της αυξομείωσης βάρους νοσογόνα παχύσαρκων ασθενών με τις παραπάνω παραμέτρους (μελέτη 4). […]

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