EuroHeartCare 2021:关注情绪是改善肥胖患者心脏健康的关键

2021-06-17 Sunny MedSci原创

先开心,后减肥。

根据今天在欧洲心脏病学会(ESC)在线科学大会EuroHeartCare - ACNAP大会2021上公布的一项研究,参加非评判性和个性化的生活方式调整计划的肥胖症患者在短短10周内改善了他们的血管和心理健康。

专注于改变行为和改善人们与食物的关系,许多参与者曾尝试过有严格规定的饮食,并对他们不能吃的食物有恐惧感。该研究方案没有饮食或膳食计划,也不排除任何食物。每个人都设定自己的目标,每周进行一次审查,这种方法是非评判性的,在受试者中建立了融洽的关系并获得了信任。

肥胖的形成有多种原因,为自己的体重自责会阻止他们获得医疗保健和建议。它可能导致情绪化的饮食和感觉太过自我而无法进行运动锻炼。研究人员表示,通过确定每个人的触发因素,可以制定替代的应对策略,所有这些都是在他们的工作、护理责任、外部压力等背景下进行的。对于一些人来说,参加这样的小组可能是他们一周内或多年来唯一的社会接触。人们分享经验并支持他们的同伴。

超重和肥胖都与心血管疾病的风险增加有关。减肥通常会被建议以进一步控制血压、血脂和患2型糖尿病的风险,从而降低患心脏病的可能性。这项研究分析了以社区为基础的生活方式调整计划对戈尔韦大学医院减肥专科服务所转介的肥胖症患者的身体和心理健康的影响。研究人员审查了2013年至2019年期间1122名参与者的数据。

为期10周的Croí CLANN(通过活动和营养改变生活方式)计划开始时,由护士、营养师和物理治疗师进行评估,并对体重、血压、胆固醇、血糖、体能以及焦虑和抑郁水平进行基线测量。与每位患者合作商定了个性化目标和管理计划。

参与者每周参加一次2.5小时的治疗,持续8周。前30分钟用于一对一的目标设定。接下来是由物理治疗师带领的1小时的运动课。随后是1小时的健康促进讲座,主题包括健康饮食、分量、阅读食物标签、情感饥饿与生理饥饿、压力管理技巧(如冥想)、体育活动、久坐行为、心血管风险因素,以及做出和保持改变。参与者使用活动追踪器并保持食物日记,以确定情绪化饮食的触发因素。

在上周,患者与护士、营养师和物理治疗师一起结束了计划评估,以查看结果。然后他们被转诊回医院。

在基线时,平均体重指数(BMI)为47.0 kg/m2,56.4%的参与者的BMI超过45 kg/m2。此外,26.7%有2型糖尿病,31.4%有抑郁症病史。

超过四分之三的参与者(78%)完成了该计划。心理社会健康使用 21 分医院焦虑和抑郁量表 (HADS) 进行评估,其中 0-7 为正常,8-10 为轻度,11-15 为中度,16-21 为重度。在整个计划过程中,焦虑和抑郁评分分别下降了 1.5 和 2.2 分。开始时焦虑评分大于11的比例从30.8%下降到19.9%;对于抑郁症,相应的比例为 21.8%,下降到 9.5%。

总体而言,体重平均减少了 2.0 公斤,27.2% 的参与者减掉了初始体重的 3% 以上。达到推荐的身体活动水平的比例增加了 31%。总胆固醇、低密度脂蛋白 (LDL) 胆固醇和血压显着降低。高血压比例从基线时的 37.4% 下降到 10 周时的 31.1%。在2型糖尿病患者中,达到推荐血糖目标的比例从47.6%上升到57.4%。

将近80%的人完成了该计划,这表明项目的内容和形式是可以接受的。我们观察到,在相对较短的时间内,所有的社会心理和健康结果都有所改善,这表明这可以成为其他中心的服务模式。

原始出处:

EuroHeartCare - ACNAP Congress 2021

Abstract title: Evaluation of a 10-week lifestyle and weight management programme on cardiovascular disease risk factors in a group of people living with obesity referred from a specialist bariatric clinic.

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    2021-10-09 paperyu
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    2021-06-19 zhaojie88
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    2021-06-19 slcumt
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  6. [GetPortalCommentsPageByObjectIdResponse(id=1685356, encodeId=af9516853567f, content=<a href='/topic/show?id=66011e19807' target=_blank style='color:#2F92EE;'>#TCA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17198, encryptionId=66011e19807, topicName=TCA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=766728143581, createdName=paperyu, createdTime=Sat Oct 09 14:18:56 CST 2021, time=2021-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357719, encodeId=3b62135e7190a, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Jun 19 07:18:56 CST 2021, time=2021-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1515068, encodeId=1fcb1515068c7, content=<a href='/topic/show?id=3806514304b' target=_blank style='color:#2F92EE;'>#心脏健康#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51430, encryptionId=3806514304b, topicName=心脏健康)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0c810711035, createdName=1179102698_36768929, createdTime=Sat Jun 19 07:18:56 CST 2021, time=2021-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563468, encodeId=9f5d156346894, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Jun 19 07:18:56 CST 2021, time=2021-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1951037, encodeId=6600195103e6f, content=<a href='/topic/show?id=72078190803' target=_blank style='color:#2F92EE;'>#肥胖患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81908, encryptionId=72078190803, topicName=肥胖患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28b7142, createdName=liuquan, createdTime=Wed May 18 19:18:56 CST 2022, time=2022-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=974651, encodeId=a0be9e465101, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5a832571815, createdName=蕾蕾, createdTime=Fri Jun 18 14:21:16 CST 2021, time=2021-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=974445, encodeId=9b909e44458e, content=好赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200803/bf55cfcb09b74a0cbf751a980fe04576/e4480eaa47ab42da91303dd1c72e723e.jpg, createdBy=89fd5188713, createdName=莉莉安 Lillian C., createdTime=Thu Jun 17 18:52:30 CST 2021, time=2021-06-17, status=1, ipAttribution=)]
    2021-06-18 蕾蕾

    学习了

    0

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    2021-06-17 莉莉安 Lillian C.

    好赞

    0