Engaging patients in a group-based weight loss program is a challenge for the acute-care hospital outpatient setting. To evaluate the feasibility, effectiveness and costeffectiveness of a telephone-based weight loss service and an existing face-to-face, group-based service a nonrandomised, two-arm feasibility trial was used. Patients who declined a two-month existing outpatient groupbased program were offered a six-month research-based telephone program. Outcomes were assessed at baseline, two months (both groups) and six months (telephone program only) using paired t tests and linear regression models. Cost per healthy life year gained was calculated for both programs. The telephone program achieved significant weight loss (−4.1±5.0 %; p=0.001) for completers (n=35; 57 % of enrolees) at six months. Compared to the group-based program (n=33 completers; 66 %), the telephone program was associated with greater weight loss (mean difference [95%CI] −2.0 % [−3.4, −0.6]; p=0.007) at two months. The cost per healthy life year gained was $33,000 and $85,000, for the telephone and group program, respectively. Telephonedelivered weight management services may be effective and cost-effective within an acute-care hospital setting, likely more so than usual (group-based) care.
Background
Beverage intake in employees is important to quantify due to the potential of dehydration to increase the risk of errors and reduced work performance. This systematic review aimed to (1) characterise existing fluid intake measurement tools used in the workplace setting or among free‐living, healthy adults of working age and (2) report the current validation status of available assessment tools for use in a UK setting.
Methods
Three electronic databases were searched for publications measuring beverage intake using a defined tool or method. Additional studies were identified by hand from trial registers, grey literature and reference lists. Eligibility was determined using predefined inclusion/exclusion criteria. Study quality was assessed using a modified Strengthening the Reporting of Observational Studies in Epidemiology framework. Narrative synthesis was performed.
Results
The review identified 105 studies. The most frequently reported beverage assessment methods were total diet diaries/records (n = 22), fluid specific diaries/records (n = 18), food and fluid frequency questionnaires (n = 17), beverage‐specific frequency questionnaires (n = 23) and diet recalls (n = 11). General dietary measurement tools (measuring beverages as part of total diet) were used in 60 studies, and 45 studies used a beverage‐specific tool. This review identified 18 distinct dietary assessment tools, of which 6 were fluid/beverage specific. Twelve tools published relative validity for a beverage‐related variable and seven tools for total daily fluid intake (from whole diet or from beverages only).
Conclusions
Several fluid intake assessment tools were identified; however, few have been fully evaluated for total beverage intake, and none in a UK working population.
Increasing 24‐h demand for products, services and health care is resulting in a substantial portion of the workforce engaging in shift work. Observational studies suggest an association between shift work exposure and increased incidence of cardiometabolic disease. Shift workers report less healthy diets compared to day workers. As diet is a modifiable behaviour, it is important to understand how it might mediate the relationship between shift work and health. We reviewed online dietary advice for shift workers by searching for existing guidelines for shift workers published by websites of credible sources, for example institutions or government agencies. Based on the 26 guidelines retrieved, the most common categories of advice were eating patterns (n = 25), general healthy eating and/or specific food groups (n = 22), control of caffeine intake (n = 23) and maintaining hydration/fluid intake (n = 17). Although the majority of publicly available advice for shift workers follows general healthy eating guidelines, there are inconsistencies in the recommendations around the frequency of eating and snacking. Few studies have investigated modification of diet quality in shift workers. With the goal of adding to the evidence base, the Shift‐eat study is a feasibility trial designed to test whether dietary intakes in line with UK healthy eating recommendations during night work improve markers of health (interstitial glucose and heart rate variability) in free‐living shift‐working employees. Shift work is unavoidable and necessary for many industries. With an increasing section of the population employed in jobs requiring shift work, consistent dietary guidance based on evidence from shift‐working populations is urgently needed to support maintenance of health and wellbeing in employees working outside standard daytime hours.
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