Evaluación de un programa piloto de intervención en adultos con sobrepeso u obesidad, en riesgo de diabetes

Abstract

Evaluation of a pilot intervention program for overweight and obese adults at risk of type 2 diabetes Background: The Ministry of Health of Chile and selected obesity specialized centers implemented an interdisciplinary pilot program for overweight adults at risk of diabetes to decrease the risk of type 2 diabetes (T2D) and cardiovascular risk factors (CVRF). Aim: To assess the results of this program. Patients and methods: Beneficiaries of the public primary health system aged 18-45 years, with a body mass index (BMI) 25-38 kg/m 2 and fasting blood glucose 100-125 mg/dL or with any direct family member with T2D, were recruited. During the four months of the study, they were scheduled for three physician visits, four dietitian consultations, 14 physical activity sessions and four group workshops (two with a psychologist or therapist). In fasting blood samples, at the beginning and at the fourth month, glucose, insulin and lipids were determined. The Homeostasis model assessment (HOMA) index was calculated. Results: Two hundred-seventy-six patients were recruited and 160 (141 women), completed the four months of follow up. In this subgroup, at the start and end of the intervention, a BMI equal to or greater than 30 kg/m 2 was observed in 69% and 52% of subjects respectively, a systolic blood pressure equal to or greater than 140 mm Hg was observed in 24% and 6% respectively, a diastolic blood pressure equal to or greater than 90 mm Hg was observed in 28% and 9% respectively, a blood glucose equal to or greater than 100 mg/dL was observed in 61% and 19% respectively, a plasma insulin equal to or greater than 12,5 µUI/ml was observed in 49% and 34% respectively and a HOMA equal to or greater than 2.5 was observed in 63% and 42% respectively (all these comparisons are significant with a p <0.05). Conclusions: In those patients that completed the follow up period, this intervention induced a significant decrease of some CVRF, such as BMI, fasting glucose levels and HOMA index

Efectos de una intervención integral en la reducción de factores de riesgo cardiovascular en mujeres con sobrepeso u obesidad de la Región de Los Ríos

“…La intervención propiamente tal, tuvo una duración de 4 meses con un control tardío al 6º mes 11 . Este último fue realizado por nutricionista para evaluar antropometría y hábito de realizar AF.…”

“…Diversos estudios afirman que cambios en la alimentación junto a la práctica de AF son indispensables en el tratamiento del sobrepeso y la obesidad 11,15 , y que este proceso es más efectivo acompañado de terapia psicológica 19 . En este sentido y según la Encuesta de Calidad de Vida y Salud 2006, los > 40 años tienen mejores hábitos alimentarios que los < 20 años 3 , relacionado con el consumo de fibra, lácteos, comida chatarra, consumo de desayuno, etc.…”

“…De igual manera, en Finlandia un ensayo realizado en 522 sujetos a los cuales se les intervino durante 3,2 años mediante consejerías en estilos de vida saludables, estableció 58% de disminución en la incidencia de diabetes 10 . Bajo este contexto, en Chile el Ministerio de Salud puso en marcha el 2004 un programa piloto basado en la práctica habitual de AF y educación alimentaria para la prevención de enfermedades crónicas en adultos, el cual destacó resultados favorables en la reducción de peso y niveles de glicemia 11 . Basado en esta experiencia, el 2006 comenzó a implementarse a nivel nacional un programa preventivo-promocional de atención integral para pacientes sobrepeso u obesos con riesgo de padecer enfermedades crónicas no transmisibles.…”

Effectiveness of telenutrition in a women’s weight loss program

“…There are several studies which show that an overweight and obesity treatment to be performed for a few months attracts more women than men, but 42% leave for various reasons, including a lack of motivation with the results of weight loss and the economic costs (Carrasco et al, 2008). It has been demonstrated that social class, level of education, marital status, and alcohol and tobacco consumption are not regarded as influential factors in the successful outcome of treatment in overweight and obese patients (Kuzmar, Rizo & Cortés, 2014b).…”

Effectiveness of telenutrition in a women's weight loss program

“…There are several studies showing that an overweight and obesity treatment to be performed for a few months, more women than men attend, but leave 42% for various reasons, including a lack of motivation with the results of weight loss and the economic cost 14 and it is demonstrated that social classes, level of education, marital status, alcohol and tobacco consumption are not regarded as influential factors in the successful outcome of treatment in overweight and obese patients 10 .…”