weight cycling

重量循环
  • 文章类型: Journal Article
    肥胖是一种全身性慢性炎症,严重危害人们的健康。人们倾向于节食来控制体重,节食减肥的短期效果是显著的,但预后有限。随着体重减轻和恢复的频繁发生,人们专注于体重骑自行车。体重循环对身体某些组织的影响也有不同的结论。因此,本文系统地回顾了体重循环对身体的影响,发现多重体重循环(1)增加了中部地区的脂肪沉积,瘦体重在减肥期减少,在体重恢复期脂肪量增加,伤害身体成分和骨骼肌质量;(2)增强脂肪组织的炎症反应,巨噬细胞渗入脂肪组织,并增加了脂肪细胞中促炎介质的产生;(3)血糖浓度突变和高胰岛素血症引起胰腺β细胞群的增加或减少,导致β细胞疲劳并导致β细胞衰竭;(4)由于心血管疾病加重而对心血管系统造成额外负担。体力活动结合热量限制可以有效减少代谢性疾病和慢性炎症,减轻体重循环对身体的不利影响。
    Obesity is a systemic and chronic inflammation, which seriously endangers people\'s health. People tend to diet to control weight, and the short-term effect of dieting in losing weight is significant, but the prognosis is limited. With weight loss and recovery occurring frequently, people focus on weight cycling. The effect of weight cycling on a certain tissue of the body also has different conclusions. Therefore, this article systematically reviews the effects of body weight cycling on the body and finds that multiple weight cycling (1) increased fat deposition in central areas, lean mass decreased in weight loss period, and fat mass increased in weight recovery period, which harms body composition and skeletal muscle mass; (2) enhanced the inflammatory response of adipose tissue, macrophages infiltrated into adipose tissue, and increased the production of pro-inflammatory mediators in adipocytes; (3) blood glucose concentration mutation and hyperinsulinemia caused the increase or decrease in pancreatic β-cell population, which makes β-cell fatigue and leads to β-cell failure; (4) resulted in additional burden on the cardiovascular system because of cardiovascular rick escalation. Physical activity combined with calorie restriction can effectively reduce metabolic disease and chronic inflammation, alleviating the adverse effects of weight cycling on the body.
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  • 文章类型: Systematic Review
    本系统评价的目的是全面评估不同格斗运动(CS)中的减肥(WL)实践。审查方案已在PROSPERO预注册[CRD42023487196]。搜索了三个数据库(WebofScience,EBSCOhost,和PubMed)至2023年12月8日。符合条件的研究必须符合五个标准:它们必须是(a)用英语写的,(b)发表在同行评审的期刊上,(c)使用调查设计调查CS运动员的WL做法,和(d)使用5分量表报告了运动员使用的WL方法。包括26项研究(来自14个CS的3994名参与者)。本综述发现(1)WL在CS运动员中非常普遍;(2)许多CS运动员每年从青少年开始减肥两到三次;(3)CS运动员通常在比赛前7-14天内体重下降<5%;(4)增加运动和逐渐节食是最常用的WL方法;(5)科学从业者对运动员的影响可以忽略不计。CS运动员的习惯性做法可能相对无害,但在一些特殊情况下,CS运动员也进行极端的WL练习。科学从业者对他们的WL实践影响不大,这可能会形成不合格影响力的恶性循环。
    The aim of this systematic review is to comprehensively assess the weight loss (WL) practices in different combat sports (CS). The review protocol was preregistered with PROSPERO [CRD42023487196]. Three databases were searched (Web of Science, EBSCOhost, and PubMed) until 8 December 2023. Eligible studies had to meet five criteria: they must have been (a) written in English, (b) published in a peer-reviewed journal, (c) used a survey design to investigate the WL practices of CS athletes, and (d) reported the WL methods used by athletes using a five-point scale. Twenty-six studies (3994 participants from 14 CS) were included. This review found that (1) WL is highly prevalent in CS athletes; (2) many CS athletes started losing weight for competition as teenagers two to three times a year; (3) CS athletes usually lose <5% body weight in 7-14 days before competition; (4) increasing exercise and gradually dieting are the most commonly used WL methods; and (5) the influence of scientific practitioners on athletes is negligible. The habitual practices of CS athletes may be relatively harmless, but in some special cases, CS athletes also perform extreme WL practices. Scientific practitioners have little influence on their WL practices, which may form a vicious cycle of non-qualified influence.
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  • 文章类型: Clinical Trial
    背景:肥胖是一个全球性的公共卫生问题。这项研究的目的是了解饮食习惯是否可以调解有体重循环史的人群的心理困扰与体重维持之间的关系。
    方法:对153名参与者进行了为期3个月的门诊干预,包括饮食和运动计划。心理困扰,食欲,和行为在研究开始和结束时进行评估。在基线和6个月时进行人体测量。
    结果:结构方程模型建立后,研究发现,肥胖和体重循环史患者的心理状况与减肥效果(3个月和6个月)相关。这种效应是由与饮食行为相关的因素介导的。联想心理因素对进食行为有直接影响(三个月:β=0.181,95%CI:0.055-0.310;六个月:β=0.182,95%CI:0.039-0.332),食欲对进食行为有直接影响(三个月:β=0.600,95%CI:0.514-0.717;六个月:β=0.581,95%CI:0.457-0.713),两者均显著(p<0.01)。三个月后,心理困扰对体重变化有更大的积极影响,饮食行为充当部分中介。六个月的时候,没有支持食欲在饮食行为中的调节作用。
    结论:研究结果表明,应加强心理干预以提高减肥效果,特别是有体重自行车史的参与者,使减肥更加复杂,容易反弹。
    背景:该研究已在临床试验中注册(NCT05311462)。
    BACKGROUND: Obesity is a global public health concern. The goal of this study was to see if eating habits could mediate the relationship between psychological distress and weight maintenance in a population with a history of weight cycling.
    METHODS: A 3-month outpatient intervention consisting of a diet and exercise program was provided to 153 participants. Psychological distress, appetite, and behavior were assessed at the beginning and end of the study. Anthropometric measurements were taken at baseline and six months.
    RESULTS: After the structural equation model was developed, it was discovered that the psychological status of people with obesity and weight cycling histories correlated with the weight loss outcome effect (three and six months). This effect was mediated by factors related to eating behavior. Associative psychological factors had a direct effect on eating behavior (three months: β = 0.181, 95% CI: 0.055-0.310; six months: β = 0.182, 95% CI: 0.039-0.332) and appetite had a direct effect on eating behavior (three months: β = 0.600, 95% CI: 0.514-0.717; six months: β = 0.581, 95% CI: 0.457-0.713), both of which were significant (p < 0.01). At three months, psychological distress has a more substantial positive impact on weight change, with eating behavior acting as a partial mediator. At six months, there was no support for appetite\'s moderating role in eating behavior.
    CONCLUSIONS: The findings suggest that psychological interventions should be strengthened to improve weight loss effectiveness, particularly in participants with a history of weight cycling, making weight loss more complicated and prone to rebound.
    BACKGROUND: The study has been registered in Clinical Trials (NCT05311462).
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  • 文章类型: Journal Article
    体重循环是肥胖管理中的主要挑战。已知热量限制会促进这种现象,但节食过程中大量营养素变化的影响仍不清楚。这项研究旨在通过在两种高热量饮食之间交替进行,确定在没有热量限制的情况下维持体重的大量营养素变化的作用:高碳水化合物,高脂肪西方饮食(WD)和低碳水化合物,高脂肪饮食(LCHDF)。通过10周的WD喂养在8周龄C57BL/6雄性小鼠中诱导肥胖。然后,对小鼠进行12周的LCHFD穿插WD(I-WD),3个为期2周的LCHFD,然后是2个为期3周的WD,或连续12周的WD(C-WD)。将C-WD和I-WD小鼠与标准饮食(SD)小鼠进行比较。在I-WD组中,每个LCHFD周期都会减少体重增加,但WD恢复后小鼠体重恢复。I-WD小鼠表现出肥胖,血脂异常,和葡萄糖不耐受,与C-WD小鼠相似。I-WD小鼠也发展为非酒精性脂肪性肝炎,与III型胶原基因表达增加和FGF21蛋白水平降低相关,与SD相比。I-WD小鼠出现体重循环,尽管保持高热量消耗,这表明节食过程中大量营养素的变化也是体重恢复的触发因素。
    Weight cycling is a major challenge in obesity management. Caloric restriction is known to promote this phenomenon, but the impact of macronutrient changes during dieting remains unclear. This study aimed to determine the role of macronutrient changes in weight maintenance without caloric restriction by alternating between two hypercaloric diets: a high-carbohydrate, high-fat Western diet (WD) and a low-carbohydrate, high-fat diet (LCHDF). Obesity was induced in 8-week-old C57BL/6 male mice by 10 weeks of WD feeding. Then, the mice were subjected to 12 weeks of LCHFD interspersed with WD (I-WD), 3 periods of 2-week LCHFD followed by 2 periods of 3-week WD, or 12 weeks of continuous WD (C-WD). C-WD and I-WD mice were compared to standard diet (SD) mice. In the I-WD group, each LCHFD period decreased weight gain, but mice regained weight after WD resumption. I-WD mice exhibited obesity, dyslipidemia, and glucose intolerance, similarly to the C-WD mice. I-WD mice also developed nonalcoholic steatohepatitis, associated with an increase in type-III collagen gene expression and a decrease in FGF21 protein levels, in comparison with SD. I-WD mice developed weight cycling despite maintaining a high caloric consumption, suggesting that changes in macronutrients during dieting are also a trigger of weight regain.
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  • 文章类型: Journal Article
    寻求竞争优势的战斗运动运动员经常从事体重管理实践,使其变得比对手大,最终包括逐渐减轻体重的时期,快速减肥,和体重恢复。这种体重减轻和恢复的模式被称为体重循环,通常包括能量利用率低的时期,使格斗运动运动员容易发生代谢功能障碍。这篇叙述性综述代表了探索与体重循环相关的代谢扰动的努力,并概述了短,medium-,以及对代谢灵活性的长期影响,函数,和健康。快速减肥的短期影响,如降低的代谢率和改变胰岛素和瘦素水平,可能是体重恢复过程中发生的更明显的代谢紊乱的前奏,如胰岛素抵抗。尽管目前尚无明确的支持,随着时间的推移,这种体重减轻和恢复以及相关代谢变化的循环可能导致代谢综合征或其他代谢功能障碍.
    Combat sports athletes seeking a competitive edge often engage in weight management practices to become larger than their opponents, which ultimately includes periods of gradual weight loss, rapid weight loss, and weight regain. This pattern of weight loss and regain is known as weight cycling and often includes periods of low energy availability, making combat sports athletes susceptible to metabolic dysfunction. This narrative review represents an effort to explore the metabolic perturbations associated with weight cycling and outline the short-, medium-, and long-term effects on metabolic flexibility, function, and health. The short-term effects of rapid weight loss, such as a reduced metabolic rate and alterations to insulin and leptin levels, may prelude the more pronounced metabolic disturbances that occur during weight regain, such as insulin resistance. Although definitive support is not currently available, this cycle of weight loss and regain and associated metabolic changes may contribute to metabolic syndrome or other metabolic dysfunctions over time.
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  • 文章类型: Journal Article
    不良儿童经历(ACE)预测肥胖的发作;然而,ACEs与体重循环史之间的关系尚未得到充分探讨.考虑到减肥维持的难度以及ACE对肥胖发展的影响,这种差距是有问题的。慢性,和相关的体重污名。这项研究的目的是在超重/肥胖的寻求减肥治疗的成年人样本中,检查自我报告的ACE病史与体重循环之间的关联。
    分析样本中的参与者人数为78人,主要是白人受过教育的成年女性(80%为女性,81%白种人,75%≥学士学位)肥胖过多的肥胖患者参加了肥胖的认知和自我调节机制研究。使用ACE量表在基线测量ACE。使用记录10磅或更多磅的体重减轻的体重和生活方式清单来测量体重循环的历史。
    较高的ACE评分与报告体重循环史的更大可能性相关。与没有ACE的参与者相比,有四个或更多ACE的参与者报告体重循环的几率高8倍(OR=8.301,95%CI=2.271-54.209,p=0.027)。在这个样本中,那些认可一到三个ACE的人的体重循环相关性不显著(OR=2.3,95%CI=0.771-6.857,p=0.135)。
    ACE在健康中的作用可能与体重循环有关。结果表明,与没有ACE的人相比,报告四个或更多ACE的人报告体重循环的几率明显更高。需要进一步的研究来进一步探索ACE如何预测体重循环的可能性,这可能是持续减肥治疗反应和体重污名影响的预后。
    UNASSIGNED: Adverse childhood experiences (ACEs) predict obesity onset; however, the relationship between ACEs and history of weight cycling has not been adequately explored. This gap is problematic given the difficulty in weight loss maintenance and the impact of ACEs on obesity development, chronicity, and associated weight stigma. The objective of this study was to examine associations between self-reported history of ACEs and weight cycling in a sample of weight loss treatment-seeking adults with overweight/obesity.
    UNASSIGNED: The number of participants in the analyzed sample was 78, mostly white educated adult women (80% female, 81% Caucasian, 75% ≥ bachelor\'s degree) with excess adiposity enrolled in the Cognitive and Self-regulatory Mechanisms of Obesity Study. ACEs were measured at baseline using the ACEs Scale. History of weight cycling was measured using the Weight and Lifestyle Inventory that documented weight loss(es) of 10 or more pounds.
    UNASSIGNED: Higher ACE scores were associated with a greater likelihood of reporting a history of weight cycling. Participants with four or more ACEs had 8 times higher odds (OR = 8.301, 95% CI = 2.271-54.209, p = 0.027) of reporting weight cycling compared with participants with no ACEs. The association of weight cycling for those who endorsed one to three ACEs was not significant (OR = 2.3, 95% CI = 0.771-6.857, p = 0.135) in this sample.
    UNASSIGNED: The role of ACEs in health may be related to associations with weight cycling. Results indicated that those who reported four or more ACEs had significantly higher odds of reporting weight cycling compared with those with no ACEs. Further research is needed to further explore how ACEs predict the likelihood of weight cycling, which may be prognostic for sustained weight loss treatment response and weight stigma impacts.
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  • 文章类型: Journal Article
    设置了车身组成标准,以确保现役军人的作战准备。为了达到身体成分标准,一些人,然而,可能从事不健康的体重控制行为(即,体重循环和饮食紊乱)。这项审查的目的是:(1)评估有关身体成分的证据以及与身体和军事特定表现的关联;(2)讨论身体成分和潜在的健康后果;(3)检查军事人员体重循环和饮食行为紊乱的证据以控制体重。
    于2023年2月20日在PubMed使用医学主题词(MeSH)进行了系统搜索,以识别同行评审的研究文章,包括但不限于“军事人员”,“战术运动员”,“减肥”,“身体组成”,和“体重循环”。
    共确定了225篇研究文章。该列表已缩小到过去20年(2003-2023年)军事人员的文章。仅包括直接测量身体脂肪百分比的研究,从而产生了17篇研究文章。
    基于证据的研究仅限于身体组成与操作准备之间的关系。据报道,体重循环和饮食行为紊乱也可以控制体重。然而,还需要更多的研究。具体来说,未来的研究应该集中在女性服务人员上,种族和民族差异,年龄,和产后状况,并包括其他服务部门(即,空军和海军)。一项关于举重自行车的全面调查,饮食紊乱,和体重管理对于确定这一问题的患病率和程度将是有价值的。这些信息以及绩效数据将指导决策者了解现有机构组成标准的相关性和适当性。
    UNASSIGNED: Body composition standards are set to ensure operational readiness in active-duty military personnel. To meet body composition standards, some individuals, however, may engage in unhealthy weight control behaviors (i.e., weight cycling and disordered eating). The objectives of this review are to: (1) evaluate the evidence regarding body composition and the associations to physical and military specific performance; (2) discuss body composition and potential health consequences; and (3) examine the evidence of weight cycling and disordered eating behaviors in military personnel for weight control.
    UNASSIGNED: A systematic search to identify peer-reviewed research articles was conducted in PubMed on 2/20/2023 using Medical Subject Headings (MeSH) including but not limited to \"Military Personnel\", \"Tactical Athlete\", \"Weight Loss\", \"Body Composition\", and \"Weight Cycling\".
    UNASSIGNED: A total of 225 research articles were identified. The list was narrowed down to articles from the last 20 years (2003-2023) in military personnel. Only studies in which percent body fat was directly measured were included resulting in 17 research articles for this review.
    UNASSIGNED: Evidence-based research is limited on the relationship between body composition and operational readiness. Weight cycling and disordered eating behaviors also has been reported for weight control, yet additional research is needed. Specifically, future research should focus on female service members, racial and ethnic differences, age, and postpartum status and include other service branches (i.e., Air Force and Navy). A comprehensive survey on weight cycling, disordered eating, and weight management would be valuable to determine the prevalence and extent of this issue. This information along with performance data would guide policy makers on the relevance and appropriateness of existing body composition standards.
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  • 文章类型: Journal Article
    背景:体重循环是反复发作,表现为有意的体重减轻和随后的无意体重增加。体重循环的频率和幅度是否与独立于体重指数(BMI)的结直肠癌风险相关仍未知。
    方法:两项前瞻性队列研究,护士健康研究I和健康专业人员随访研究,从1992年到2014年,追踪85,562名参与者。参与者在基线时完成了一份关于过去4年有意减肥的频率和程度的问卷。使用Cox比例风险模型估计风险比(HR)和95%置信区间(CI)。
    结果:我们在长达22年的随访中发现了1626例结直肠癌病例。在HPFS和NHS的汇总分析中,与非重量自行车相比,调整混杂因素后,适度的体重循环(有意减重≥2.3-4.4kg的≥3次)与降低结直肠癌风险相关,包括体重循环后达到的BMI(HR=0.82,95%CI0.69,0.97)。然而,在轻度体重循环器和重度体重循环器中未观察到显著关联.
    结论:与BMI无关,中等体重循环与较低的结直肠癌风险相关。这一发现需要进一步研究复制和推定的生物学机制。
    Weight cycling is the repeated episodes manifesting intentional weight loss and subsequent unintentional weight gain. Whether the frequency and magnitude of weight cycling is associated with colorectal cancer risk independent of body mass index (BMI) remains unknown.
    Two prospective cohort studies, Nurses\' Health Study I and Health Professionals Follow-up Study, followed 85,562 participants from 1992 to 2014. Participants completed a questionnaire regarding the frequency and magnitude of intentional weight loss in the past 4 years at the baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard model.
    We identified 1626 colorectal cancer cases during up to 22 years of follow-up. In the pooled analysis of HPFS and NHS, compared to non-weight cycling, moderate weight cycling (≥3 times of intentional weight loss of ≥2.3-4.4 kg) was associated with a reduced risk of colorectal cancer after adjustment for confounders, including attained BMI after weight cycling (HR = 0.82, 95% CI 0.69, 0.97). However, no significant association was observed in mild weight cyclers and in severe weight cyclers.
    Moderate weight cycling was associated with a lower risk of colorectal cancer independent of BMI. This finding needs further studies for replication and putative biological mechanisms.
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  • 文章类型: Journal Article
    热量限制(CR)导致体重减轻,但与恢复随意喂养后体重迅速恢复有关。我们的目的是研究饮食中大量营养素组成对老年小鼠体重减轻和恢复的影响。男性,18个月大,对C57BL/6J菌株进行4周的30%CR,然后对高碳水化合物(HC)进行4周的随意再饲喂,高脂肪(HF)或高蛋白(HP)饮食(每个n=22)。随意饲喂食物饮食的小鼠(n=11)作为对照组(CON)。每天监测体重和食物摄入量。使用24小时间接量热法评估能量消耗和底物氧化。通过解剖组织来评估肌肉和脂肪量。还测量了血清瘦素和生长素释放肽水平。CR诱导的体重减轻在饮食之间没有差异。HF的体重恢复特别快,因为当HC和HP小鼠达到CON组的体重时,小鼠在重新喂食4周后超过其初始体重12.8±5.7%。体重恢复与各组的能量摄入密切相关。HF小鼠的呼吸交换率(0.81±0.03)低于HC(0.94±0.06,p<0.001),在重新喂养期间,HP(0.89±0.04,p<0.001)和CON小鼠(0.91±0.06,p<0.01)。HF小鼠的血清瘦素水平(1.03±0.50ng/mL)高于HC(0.46±0.14,p<0.001),HP(0.63±0.28,p<0.05)或CON小鼠(0.41±0.14,p<0.001)。因此,CR在衰老小鼠中诱导类似的体重减轻,而与饮食的大量营养素组成无关。尽管在CR后的再饲喂过程中脂肪氧化和血清瘦素增加,但HF饮食会导致过多的能量摄入和体内脂肪明显增加。
    Caloric restriction (CR) induces weight loss, but is associated with rapid weight regain upon return to ad libitum feeding. Our aim was to investigate effects of the macronutrient composition of the diet on weight loss and regain in elderly mice. Males, 18 months old, of the C57BL/6J strain were subjected to 4-week 30% CR followed by 4 weeks of ad libitum refeeding on either high-carb (HC), high-fat (HF) or high-protein (HP) diets (n = 22 each). Mice (n = 11) fed a chow diet ad libitum served as a control group (CON). Body mass and food intake were monitored daily. Twenty-four-hour indirect calorimetry was used to assess energy expenditure and substrate oxidation. Muscle and fat mass were evaluated with dissection of the tissues. Serum leptin and ghrelin levels were also measured. CR-induced weight loss did not differ between the diets. Weight regain was particularly fast for HF as mice overshot their initial weight by 12.8 ± 5.7% after 4-week refeeding when HC and HP mice reached the weight of the CON group. Weight regain strongly correlated with energy intake across the groups. The respiratory exchange ratio was lower in HF mice (0.81 ± 0.03) compared to HC (0.94 ± 0.06, p < 0.001), HP (0.89 ± 0.04, p < 0.001) and CON mice (0.91 ± 0.06, p < 0.01) during the refeeding. Serum leptin levels were higher in HF mice (1.03 ± 0.50 ng/mL) compared to HC (0.46 ± 0.14, p < 0.001), HP (0.63 ± 0.28, p < 0.05) or CON mice (0.41 ± 0.14, p < 0.001). Thus, CR induces similar weight loss in aging mice irrespective of the diet\'s macronutrient composition. An HF diet leads to excessive energy intake and pronounced gain in body fat in spite of increased fat oxidation and serum leptin during the refeeding after CR.
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  • 文章类型: Journal Article
    体重显著影响健康和生活质量,是膝骨关节炎(OA)发展的主要危险因素。与稳定的高或低体重相比,体重循环可能会产生更多的负面健康后果。使用骨关节炎倡议数据集,我们研究了体重循环对身体机能的影响,生活质量,与稳定或单向体重轨迹相比,超过72个月的抑郁症。参与者(n=731)患有膝关节OA,分为:(1)稳定低(BMI<25),(2)稳定超重(BMI=25-29.9),和(3)稳定肥胖(BMI≥30);(4)稳定体重减轻;(5)稳定体重增加(每2年体重减轻/增加≥2.2kg);(6)增益-损失-增益体重循环,和(7)损失-增益-损失体重循环(返回基线的体重减轻/增益),基于两年一次的评估。我们比较了膝关节损伤和骨关节炎的结果与膝关节相关的生活质量,在体育和娱乐中的功能,老年人的身体活动,简短的SF-12,重复的椅子上升,20米的步态速度,和流行病学研究中心抑郁症使用重复测量方差分析。稳定减肥组表现出最严重的疼痛,物理功能,随着时间的推移,抑郁症状(p<0.05)。需要更多的研究来证实这些发现,并阐明稳定体重减轻与膝关节OA功能下降相关的机制。
    Body weight significantly impacts health and quality of life, and is a leading risk factor for the development of knee osteoarthritis (OA). Weight cycling may have more negative health consequences compared to steady high or low weight. Using the Osteoarthritis Initiative dataset, we investigated the effects of weight cycling on physical function, quality of life, and depression over 72-months compared to stable or unidirectional body weight trajectories. Participants (n = 731) had knee OA and were classified as: (1) stable-low (BMI < 25), (2) stable-overweight (BMI = 25-29.9), and (3) stable-obese (BMI ≥ 30); (4) steady-weight-loss; (5) steady-weight-gain (weight loss/gain ≥ 2.2 kg every 2-years); (6) gain-loss-gain weight cycling, and (7) loss-gain-loss weight cycling (weight loss/gain with return to baseline), based on bi-annual assessments. We compared Knee Injury and Osteoarthritis Outcome Knee-Related Quality of Life, Function in Sports and Recreation, Physical Activity in the Elderly, Short Form SF-12, repeated chair rise, 20-m gait speed, and Center for Epidemiological Studies Depression using repeated-measures ANOVA. The steady weight loss group demonstrated the worst pain, physical function, and depressive symptoms over time (p\'s < 0.05). More research is needed to confirm these findings, and elucidate the mechanisms by which steady weight loss is associated with functional decline in knee OA.
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