Objective The purpose of this study was to investigate the relationship between body mass index (BMI) class and physical activity and sedentary behavior in patients with acute coronary syndrome (ACS) during cardiac rehabilitation (CR). Methods This study was a secondary analysis of the OPTICARE trial. Physical activity and sedentary behavior were measured in participants with ACS (n = 359) using actigraphy at baseline, directly after completion of a multidisciplinary 12-week exercise-based CR program and 9 months thereafter. Outcome measures were step count and duration of time (percentage of wear time) spent in light physical activity, moderate-to-vigorous physical activity, and sedentary behavior. Participants were classified as normal weight (BMI = 18.5–24.99 kg/m2; n = 82), overweight (BMI = 25.0–29.99 kg/m2; n = 182), or obese (BMI ≥ 30.0 kg/m2; n = 95). Linear mixed-effects models were applied to study the relationship between BMI class and physical activity and sedentary behavior. Results At the start of CR, compared with participants with normal weight, participants with obesity made on average 1.11 steps fewer per minute (952 steps/d), spent 2.9% (25 min/d) less time in light physical activity, and spent 3.31% (28 min/d) more time in sedentary behavior. Participants of all BMI classes improved their physical activity and sedentary behavior levels similarly during CR, and these improvements were maintained after completion of CR. Conclusion Participants with ACS who had obesity started CR with a less favorable physical activity and sedentary behavior profile than that of participants with normal weight. Because all BMI classes showed similar improvement during CR, this deficit was preserved. Impact This study indicates that reconsideration of the CR program in the Netherlands for patients with ACS and obesity is warranted, and development of more inclusive interventions for specific populations is needed. A new program for people with obesity should include added counseling on increasing physical activity and preventing sedentary behavior to facilitate weight loss and reduce mortality risk. Lay Summary People with ACS who have obesity are less active and sit more than individuals with normal weight, both during and after CR. This study suggests that CR needs to be changed to help individuals increase their physical activity to help them lose weight and reduce their risk of death.
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Objective: This study evaluated the effect of an after-school group-based medium-intensity multicomponent behavioural intervention programme for children aged 8–12 years classified as overweight, obese or at risk for overweight on body mass index standard deviation score (BMI SDS). In accordance with standardized protocols body weight and height were measured in 195 participants (88 boys, 107 girls) at baseline and at the end of the programme. A total of 166 children derived from a school-based monitoring system served as control group. Multivariate regression analyses examined the effect of the intervention and the independent factors associated with better outcomes in the intervention group. Results: Analysis of covariance showed a significant intervention effect on BMO SDS in favour of the intervention group (b-coefficient - 0.13 ± 0.03; p < 0.01) compared with the control group. Change in BMI SDS between baseline and follow-up in the intervention group was associated with baseline age (b-coefficient 0.03 ± 0.02; p=0.04) but was independent from gender, ethnicity, baseline BMI SDS, time between baseline and follow-up, school year and attendance rate.
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Rationale: Sarcopenia and obesity are prevalent conditions and are both associated with negative health outcomes. ESPEN and EASO reached consensus on the definition and diagnostic criteria for sarcopenic obesity (SO) encompassing indicators fat mass, muscle mass, and muscle function. However, few studies report on the effect of lifestyle interventions on these SO indicators. This study aimed to evaluate the effect of combined lifestyle interventions on SO indicators and on a composite SO index.Methods: Analyses were performed on two pooled RCT’s (MPS, PROBE) in older adults with obesity participating in a 13-wk program targeting weight loss while preserving muscle mass, providing a combination of caloric restriction, higher protein intake and resistance exercise training. SO indicators measured at baseline and post-intervention included 5x chair stand test (CST) in seconds for muscle function, fat mass percentage (FM%) and appendicular lean mass divided by body weight (ALM/W) using DXA. The SO index was calculated using sex-specific z-scores: -CST(s) + ALM/W – FM%; higher scores indicating better muscle function and body composition. Mixed model analyses were performed to assess the changes from baseline to post-intervention, adjusted for sex and age.Results: A total of 154 participants (age 65±6y; 59% male, BMI 33.1±4.3kg/m2) were included. After the 13-wk lifestyle interventions, weight (-2.87kg 95%CI -4.16;-1.64) and FM% (-1.81% 95%CI -2.42;-1.21) decreased significantly, CST improved significantly (-1.51s 95%CI -2.02;-1.00) from baseline and ALM/W was maintained (0kg/kg 95%CI 0.01;0.01). The SO index improved (+1.16 z-score 95%CI 0.86;1.44).Conclusion: Lifestyle interventions combining nutrition & exercise improved individual SO indicators and the SO index in older adults with obesity. The SO index could be a useful and sensitive criterion in the prevention and management of sarcopenic obesity.
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