Evaluation of Latent Models Assessing Physical Fitness and the Healthy Eating Index in Community Studies: Time-, Sex-, and Diabetes-Status Invariance

Maitland, Scott B.; Brauer, Paula; Mutch, David M.; Royall, Dawna; Klein, Doug; Tremblay, Angelo; Rhéaume, Caroline; Dhaliwal, Rupinder; Jeejeebhoy, Khursheed N.

doi:10.3390/nu13124258

Cited by 3 publications

(4 citation statements)

References 64 publications

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“…Equations for the reduced HEI-C, composite tness scores and Gurka/MetS score are shown in Additional File 2 (22). Some variables were not measured at 6 and 9 months, therefore this analysis focused on three time points -baseline, 3 and 12 months.…”

Section: Outcome Measurementsmentioning

confidence: 99%

“…To assess whether differences in diet quality or tness score changes by response groups could have accounted for the changes in the Gurka/MetS scores over time, RMANCOVA analysis was completed on the reduced HEI-C score and composite tness scores from our previous SEM analysis (22). As previously, the overall RMANCOVA model and the time effect were signi cant (i.e., there was improvement or increase in the scores over time), but the time*group interaction was not signi cant (i.e., there were no differences between Gurka/MetS Groups on diet quality (Fig.…”

Section: Interventionsmentioning

confidence: 99%

“…Therefore, the objective of this exploratory analysis was to identify possible subgroups by differences in response as measured by changes in the Gurka/MetS z-score over the 12-month study and to compare baseline characteristics and changes in diet quality and physical tness using our improved indicators from the SEM analysis (22).…”

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confidence: 99%

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Exploratory Analysis of the Variable Response to an Intensive Lifestyle Change Program for Metabolic Syndrome

Maitland,

Brauer,

Mutch

et al. 2023

Preprint

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Background Wide variability in response to lifestyle interventions has been recognized for many years, and researchers have begun to disentangle sources of error from inherent differences in individual responsiveness. The objective of this secondary analysis of an intensive lifestyle intervention (diet and exercise) for metabolic syndrome (MetS) was to identify potentially important differences among study completers grouped by treatment response as measured by change in a continuous metabolic syndrome (Gurka/MetS) score. Methods All study completers from a 12-month primary care study were categorized into one of five groups according to change in the Gurka/MetS score. A change of 0.4 in z-score defined clinically relevant change in line with results of previous studies. Repeated measures analysis of covariance was used to examine the Gurka/MetS score over 12 months, looking for differences in response over time by the five groups. Results Of 176 participants, 50% (n = 88) had stable scores, 10% (n = 18) had relevant change scores in the first 3 months only and reverted toward baseline, 20% (n = 35) achieved meaningful change over the whole study, 11% (n = 20) had a delayed response at 3–12 months, and 9% (n = 15) demonstrated worsening scores. Significant response group*time differences were noted (p < 0.001). Improvement in diet quality and fitness scores were similar across all groups. Available other variables did not account for the differences. Conclusion Work is needed to identify key factors that account for differences in responses to lifestyle interventions that can be used to guide treatment decisions for intensive lifestyle interventions for this common condition. Trial Registration ClinicalTrials.gov Identifier: NCT01616563; first registered June 12, 2012.

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Section: Outcome Measurementsmentioning

confidence: 99%

Section: Interventionsmentioning

confidence: 99%

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Exploratory Analysis of the Variable Response to an Intensive Lifestyle Change Program for Metabolic Syndrome

Maitland,

Brauer,

Mutch

et al. 2023

Preprint

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“…In a recent article in ‘Nutrients’ [ 27 ] (Figure 6, p. 18) present an SEM with 78 unidirectional arrows. Leaving all other matters aside, what is the chance of this model being ‘right’ with regard to just the causal direction of all these 78 arrows?…”

Section: Certainty Risk and Uncertainty In Experimental And Observati...mentioning

confidence: 99%

The Relative Merits of Observational and Experimental Research: Four Key Principles for Optimising Observational Research Designs

Hamlin

2022

Nutrients

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The main barrier to the publication of observational research is a perceived inferiority to randomised designs with regard to the reliability of their conclusions. This commentary addresses this issue and makes a set of recommendations. It analyses the issue of research reliability in detail and fully describes the three sources of research unreliability (certainty, risk and uncertainty). Two of these (certainty and uncertainty) are not adequately addressed in most research texts. It establishes that randomised designs are vulnerable as observation studies to these two sources of unreliability, and are therefore not automatically superior to observational research in all research situations. Two key principles for reducing research unreliability are taken from R.A. Fisher’s early work on agricultural research. These principles and their application are described in detail. The principles are then developed into four key principles that observational researchers should follow when they are designing observational research exercises in nutrition. It notes that there is an optimal sample size for any particular research exercise that should not be exceeded. It concludes that best practice in observational research is to replicate this optimal sized observational exercise multiple times in order to establish reliability and credibility.

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Exploratory analysis of the variable response to an intensive lifestyle change program for metabolic syndrome

Maitland,

Brauer,

Mutch

et al. 2024

BMC Prim. Care

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Background Substantial variability in response to lifestyle interventions has been recognized for many years, and researchers have begun to disentangle sources of error from inherent differences in individual responsiveness. The objective of this secondary analysis of an intensive lifestyle intervention (diet and exercise) for metabolic syndrome (MetS) was to identify potentially important differences among study completers grouped by treatment response as measured by change in a continuous metabolic syndrome score (Gurka/MetS). Methods All study completers from a 12-month primary care study were categorized into one of five groups according to change in the Gurka/MetS score. A change of 0.4 in z-score defined clinically relevant change in line with results of previous studies. Repeated measures analysis of variance was used to examine cardiovascular disease risk and individual clinical indicators of MetS over 12 months, looking for differences in response over time by the five groups. Results Of 176 participants, 50% ( n = 88) had stable scores, 10% ( n = 18) had relevant change scores in the first 3 months only and reverted toward baseline, 20% ( n = 35) achieved meaningful change over the whole study, 11% ( n = 20) had a delayed response at 3–12 months, and 9% ( n = 15) demonstrated worsening scores. Significant differential patterns were noted for groups over the duration of the intervention ( p < .001). Improvement in diet quality and fitness scores were similar across all groups. Other available variables were tested and did not account for the differences. Conclusion Work is needed to identify key factors that account for differences in responses to lifestyle interventions that can be used to guide treatment decisions for intensive lifestyle interventions for this common condition. Trial Registration ClinicalTrials.gov Identifier: NCT01616563; first registered June 12, 2012. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-024-02608-w.

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Evaluation of Latent Models Assessing Physical Fitness and the Healthy Eating Index in Community Studies: Time-, Sex-, and Diabetes-Status Invariance

Cited by 3 publications

References 64 publications

Exploratory Analysis of the Variable Response to an Intensive Lifestyle Change Program for Metabolic Syndrome

Exploratory Analysis of the Variable Response to an Intensive Lifestyle Change Program for Metabolic Syndrome

The Relative Merits of Observational and Experimental Research: Four Key Principles for Optimising Observational Research Designs

Exploratory analysis of the variable response to an intensive lifestyle change program for metabolic syndrome

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