State of the Art Reviews: Relationship Between Diet/ Physical Activity                and Health

O’Neil, Carol E.; Nicklas, Theresa A.

doi:10.1177/1559827607306433.

Cited by 17 publications

(6 citation statements)

References 373 publications

(344 reference statements)

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“…ese observations cast doubt as to whether the overweight/obesity seen among these recipients is merely a side e ect of ART. e reversion from overweight/obesity to normal BMI, for instance, is easy to comprehend as this might be a simple e ect of regular physical exercise [26,27]. On the other hand, it is hard to comprehend how overweight/ obese recipients became underweight a er ART initiation.…”

Section: Characteristicsmentioning

confidence: 99%

Overweight and Obesity among Recipients of Antiretroviral Therapy at HIV Clinics in Gaborone, Botswana: Factors Associated with Change in Body Mass Index

Tshikuka

Magafu

Rankgoane-Pono

et al. 2020

AIDS Research and Treatment

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Background. Factors associated with overweight/obesity among antiretroviral therapy (ART) recipients have not been sufficiently studied in Botswana. Objectives. To: (i) estimate the prevalence and trends in overweight/obesity by duration of exposure to ART among recipients, (ii) assess changes in BMI categories among ART recipients between their first clinic visit (BMI-1) and their last clinic visit (BMI-2), (iii) identify ART regimen that predicts overweight/obesity better than the others and factors associated with BMI changes among ART recipients. Methods. A 12-year retrospective record-based review was conducted. Potential predictors of BMI change among patients after at least three years of ART exposure were examined using a multiple logistic regression model. Adjusted odds ratios (AOR) and their 95% confidence intervals (CIs) were computed. ART regimens, duration of exposure to ART, and recipients’ demographic and biomedical characteristics including the presence or absence of diabetes mellitus-related comorbidities (DRC), defined as any morbidity associated with type 2 diabetes as described in the international statistical classification of diseases and related health problems (ICD-10-CM) codebook index, were investigated as potential predictors of overweight/obesity. Results. Twenty-nine percent of recipients were overweight, 16.6% had obesity of whom 2.4% were morbidly-obese at the last clinic visit. Overweight/obese recipients were more likely to be female, to have DRC and less likely to have CD4 count between 201 and 249 cells/mm3. Neither the first-line nor the second-, third-line ART regimens predicted overweight/obesity better than the other and neither did the duration of exposure to ART. No significant linear trends were observed in the prevalence of overweight/obesity by the duration of exposure to ART. Conclusion. These results suggest that the ART regimens studied have a comparable effect on overweight/obesity and that the duration of exposure does not affect the outcome. This study calls for further research to elucidate the relative contribution of various factors to BMI change among recipients, including ART regimens.

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Section: Characteristicsmentioning

confidence: 99%

Overweight and Obesity among Recipients of Antiretroviral Therapy at HIV Clinics in Gaborone, Botswana: Factors Associated with Change in Body Mass Index

Tshikuka

Magafu

Rankgoane-Pono

et al. 2020

AIDS Research and Treatment

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“…While most of the risk associated with obesity is mediated through hypertension, dyslipidemia, and hypertension, obesity itself is an independent risk factor. The pathogenetic events leading to raised cardiovascular risk in overweight and obesity are complex, heavily researched, remain ill-understood, but extend beyond metabolic, hormonal, and cytokine dysregulation 329 – 343 to include endothelial dysfunction, local pericardial fat accumulation, 341 , 342 liver involvement, and adrenergic disturbances. 315 Even when evidence-based targets are attained in all areas of traditional risk factors, residual risk persists.…”

Section: Residual Risk Remains a Source Of Concernmentioning

confidence: 99%

Primary prevention of coronary heart disease: integration of new data, evolving views, revised goals, and role of rosuvastatin in management. A comprehensive survey

Kones¹

2011

DDDT

218

145

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A recent explosion in the amount of cardiovascular risk and incipient, undetected subclinical cardiovascular pathology has swept across the globe. Nearly 70% of adult Americans are overweight or obese; the prevalence of visceral obesity stands at 53% and continues to rise. At any one time, 55% of the population is on a weight-loss diet, and almost all fail. Fewer than 15% of adults or children exercise sufficiently, and over 60% engage in no vigorous activity. Among adults, 11%–13% have diabetes, 34% have hypertension, 36% have prehypertension, 36% have prediabetes, 12% have both prediabetes and prehypertension, and 15% of the population with either diabetes, hypertension, or dyslipidemia are undiagnosed. About one-third of the adult population, and 80% of the obese, have fatty livers. With 34% of children overweight or obese, prevalence having doubled in just a few years, type 2 diabetes, hypertension, dyslipidemia, and fatty livers in children are at their highest levels ever. Half of adults have at least one cardiovascular risk factor. Not even 1% of the population attains ideal cardiovascular health. Despite falling coronary death rates for decades, coronary heart disease (CHD) death rates in US women 35 to 54 years of age may now be increasing because of the obesity epidemic. Up to 65% of patients do not have their conventional risk biomarkers under control. Only 30% of high risk patients with CHD achieve aggressive low density lipoprotein (LDL) targets. Of those patients with multiple risk factors, fewer than 10% have all of them adequately controlled. Even when patients are titrated to evidence-based targets, about 70% of cardiac events remain unaddressed. Undertreatment is also common. About two-thirds of high risk primary care patients are not taking needed medications for dyslipidemia. Poor patient adherence, typically below 50%, adds further difficulty. Hence, after all such fractional reductions are multiplied, only a modest portion of total cardiovascular risk burden is actually being eliminated, and the full potential of risk reduction remains unrealized. Worldwide the situation is similar, with the prevalence of metabolic syndrome approaching 50%. Primordial prevention, resulting from healthful lifestyle habits that do not permit the appearance of risk factors, is the preferred method to lower cardiovascular risk. Lowering the prevalence of obesity is the most urgent matter, and is pleiotropic since it affects blood pressure, lipid profiles, glucose metabolism, inflammation, and atherothrombotic disease progression. Physical activity also improves several risk factors, with the additional potential to lower heart rate. Given the current obstacles, success of primordial prevention remains uncertain. At the same time, the consequences of delay and inaction will inevitably be disastrous, and the sense of urgency mounts. Since most CHD events arise in a large subpopulation of low- to moderate-risk individuals, identifying a high proportion of those who will go on to develop events with accuracy remains...

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“…No longer simply an epidemic, DM is now considered a pandemic (Meetoo, McGovern, & Safadi, 2007). O’Neil's and Nicklas's (2007) literature review indicates that obesity is linked to too many calories, carbohydrates, fat grams, and a sedentary lifestyle and is associated with the development of type 2 DM. Typically more serious in rural regions, DM is related to obesity and a sedentary and high‐fat diet lifestyle (Gamm et al., 2003).…”

Section: Review Of the Literaturementioning

confidence: 99%

Effectiveness of nurse practitioner coordinated team group visits for type 2 diabetes in medically underserved Appalachia

Jessee

Rutledge

2012

Journal of the American Academy of Nurse Practitioners

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State of the Art Reviews: Relationship Between Diet/ Physical Activity and Health

Cited by 17 publications

References 373 publications

Overweight and Obesity among Recipients of Antiretroviral Therapy at HIV Clinics in Gaborone, Botswana: Factors Associated with Change in Body Mass Index

Overweight and Obesity among Recipients of Antiretroviral Therapy at HIV Clinics in Gaborone, Botswana: Factors Associated with Change in Body Mass Index

Primary prevention of coronary heart disease: integration of new data, evolving views, revised goals, and role of rosuvastatin in management. A comprehensive survey

Effectiveness of nurse practitioner coordinated team group visits for type 2 diabetes in medically underserved Appalachia

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