Diet and Obesity Issues in the Underserved

Grubb, Maria C. Mejia de; Levine, Robert S.; Zoorob, Roger

doi:10.1016/j.cpha.2018.08.020

Cited by 3 publications

(2 citation statements)

References 39 publications

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“…As obesity and its comorbidities continue to plague our patients and health systems, there is an increasing need to provide comprehensive obesity treatment within primary care with maximal reach to patients, particularly those who reside in remote areas. Digital technologies can facilitate the reach of efficacious treatments to medically vulnerable patients [66][67][68], those in dire need of effective weight management programs, but with the least access to these interventions [10,11,[69][70][71]. Comprehensive obesity treatment solutions that comprise both weight loss and weight gain prevention interventions are particularly needed, especially by those in medically vulnerable circumstances.…”

Section: Discussionmentioning

confidence: 99%

The Balance protocol: a pragmatic weight gain prevention randomized controlled trial for medically vulnerable patients within primary care

et al. 2019

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Background: For patients with obesity who are not ready for or experience barriers to weight loss, clinical practice guidelines recommend provider counseling on preventing further weight gain as a first-line treatment approach. Unfortunately, evidence-based weight gain prevention interventions are not routinely available within primary care. To address this gap, we will implement a pragmatic 12-month randomized controlled trial of a digital weight gain prevention intervention delivered to patients receiving primary care within a network of Federally Qualified Community Health Centers in central North Carolina. Methods: Balance (Equilibrio in Spanish) is a pragmatic effectiveness trial that will randomize adult patients who have overweight or obesity (BMI of 25-40 kg/m 2) to either: 1) a weight gain prevention intervention with tailored behavior change goals and tracking, daily weighing on a network-connected electronic scale, and responsive weight and goal coaching delivered remotely by health center registered dietitians; or 2) a usual care program with automated healthy living text messages and print materials and routine primary care. The primary outcome will be weight gain prevention at 24-months, defined as ≤3% change in baseline weight. To align with its pragmatic design, trial outcome data will be pulled from the electronic health record of the community health center network. Discussion: For underserved, often rurally-located patients with obesity, digital approaches to promote a healthy lifestyle can curb further weight gain. Yet enrolling medically vulnerable patients into a weight gain prevention trial, many of whom are from racial/ethnic minorities, can be difficult. Despite these potential challenges, we plan to recruit a large, diverse sample from rural areas, and will implement a remotely-delivered weight gain prevention intervention to medically vulnerable patients. Upcoming trial results will demonstrate the effectiveness of this pragmatic approach to implement and evaluate a digital weight gain prevention intervention within primary care.

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Section: Discussionmentioning

confidence: 99%

The Balance protocol: a pragmatic weight gain prevention randomized controlled trial for medically vulnerable patients within primary care

et al. 2019

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“…The incidence of non-alcoholic fatty liver disease (NAFLD) is on the rise, particularly in Western nations. Increasing rates of obesity, unhealthy fast food consumption, sedentary lifestyles, an increase in childhood obesity, and an extended life expectancy are all potential explanations (1) .…”

Section: Introductionmentioning

confidence: 99%

Diabetic and Non-Diabetic Non-Alcoholic Fatty Liver Disease Patients: Assessment Using Non-Invasive Diagnostic Tools

2024

The Egyptian Journal of Hospital Medicine

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Background: Non-alcoholic fatty liver disease (NAFLD) incidence is rapidly increasing. Objective: Our study aimed to assess diabetic and non-diabetic NAFLD using non-invasive imaging tools; conventional US, Chemical shift MRI, and MRE to evaluate the degree of liver steatosis and fibrosis. Patients and methods: In this case-control study, a total of 130 subjects including 90 NAFLD patients {50 diabetic (Group I) & 40 non-diabetic (Group II), as well as 40 controls (Group III) }, were enrolled. The mean age in the present study was 51.46 ± 7.54 years in group I, 48.40 ± 7.47 years in group II, and 49.55 ± 7.95 years in group III (controls). Most of our subjects were females (78%, 77.5%, and 65% in groups I, II, and III respectively). Assessment of liver steatosis was done using conventional US and chemical shift (in-phase and out-of-phase) MR imaging. Assessment of liver stiffness to detect the degree of fibrosis/cirrhosis was done using magnetic resonance enterography (MRE). Results: Diabetic NAFLD patients (group I) had a higher degree of liver steatosis (scores 2 and 3), measured by conventional US, compared to group II (non-diabetic NAFLD). Group I patients had a significantly higher degree of liver steatosis (p = 0.007), measured by chemical shift (in-phase and out-phase) MRI, compared to group II. Liver stiffness measurement by MRE was significantly higher (p = 0.038) in group I (Mean 2.88 ± 0.81 kPa) than in group II (mean 2.46 ± 0.71kPa). Liver fibrosis (≥ F2) was significantly higher (p = 0.021) in group 1 (20 of 50 patients (40%)) than in group II (7 of 40 patients (17.5%)). Conclusions: Current non-invasive imaging methods demonstrated their value as non-invasive imaging biomarkers to evaluate the degree of liver steatosis in NAFLD and its progression into fibrosis/cirrhosis.

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Evaluation of Eating Disorders, Emotional State, and Quality of Life in Bariatric Surgery Patients: Cross-Sectional Study

Aycan,

Acikgoz Pinar,

Avci

et al. 2024

Bariatric Surgical Practice and Patient Care

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Diet and Obesity Issues in the Underserved

Cited by 3 publications

References 39 publications

The Balance protocol: a pragmatic weight gain prevention randomized controlled trial for medically vulnerable patients within primary care

The Balance protocol: a pragmatic weight gain prevention randomized controlled trial for medically vulnerable patients within primary care

Diabetic and Non-Diabetic Non-Alcoholic Fatty Liver Disease Patients: Assessment Using Non-Invasive Diagnostic Tools

Evaluation of Eating Disorders, Emotional State, and Quality of Life in Bariatric Surgery Patients: Cross-Sectional Study

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