Interventions to achieve long-term weight loss in obese older people: A systematic review and meta-analysis

Purpose: the prevalence of obesity is rapidly increasing in older adults. Information is required about what interventions are effective in reducing obesity and influencing health outcomes in this age group. Design: systematic review and meta-analysis. Data sources: thirteen databases were searched, earliest date 1966 to December 2008, including Medline, CINAHL, PsycINFO, the Cochrane database and EMBASE. Study selection: we included studies with participants�۪ mean age 60 years and mean body mass index 30 kg/m2, with outcomes at a minimum of 1 year. Data were independently extracted by two reviewers and differences resolved by consensus. Data extraction: nine eligible trials were included. Study interventions targeted diet, physical activity and mixed approaches. Populations included patients with coronary artery disease, diabetes mellitus and osteoarthritis. Results: meta-analysis (seven studies) demonstrated a modest but significant weight loss of 3.0 kg [95% confidence interval (CI) 5.1���0.9] at 1 year. Total cholesterol (four studies) did not show a significant change: ���0.36 mmol/l (95% CI ���0.75 to 0.04). There was no significant change in high-density lipoprotein, low-density lipoprotein or triglycerides. In one study, recurrence of hypertension or cardiovascular events was significantly reduced (hazard ratio 0.65, 95% CI 0.50���0.85). Six-minute walk test did not significantly change in one study. Health-related quality of life significantly improved in one study but did not improve in a second study. Conclusions: although modest weight reductions were observed, there is a lack of high-quality evidence to support the efficacy of weight loss programmes in older people. ��Keywords: obesity, older, weight loss, meta-analysis, elderly, systematic review

Statistics on obesity, physical activity and diet: England, January 2008

This statistical report from the Information Centre presents a range of information on obesity, physical activity and diet, drawn together from a variety of sources. The publication also summarises government plans and targets in this area, as well as providing sources of further information and links to relevant documents and key sources. There are several notable additions to this, The Information Centre's second report on obesity, physical activity and diet. Waist circumference analysis has been included where possible to reflect the importance of using this measurement in conjunction with Body Mass Index (BMI) in order to identify those at increased risk of health problems associated with obesity. More regional data is presented with a greater number of tables providing government office region and Strategic Health Authority breakdowns. Where possible information at a more local level has been reported on.

National Diet and Nutrition Survey: assessment of dietary sodium in adults (19 to 64 years) in England, 2014

There is an established relationship between salt intake and risk of high blood pressure (BP). High blood pressure (hypertension) is a risk factor for cardiovascular disease (CVD) and scientific evidence shows that a high salt intake can contribute to the development of elevated blood pressure. The Scientific Advisory Committee on Nutrition (SACN) recommend a target reduction in the average salt intake of the population to no more than 6g per day. This figure has been adopted by the UK government as the recommended maximum salt intake for adults and children aged 11 years and over. Following publication of the SACN report in 2003, the government began a programme of reformulation work with the food industry aimed at reducing the salt content of processed food products. Voluntary salt reduction targets were first set in 2006, and subsequently in 2009, 2011 and 2014, for a range of food categories that contribute the most to the population’s salt intakes. Population representative urinary sodium data were collected in England in 2005-06, 2008 (UK), 2011 and 2014. In the latest survey assessment, estimated salt intake of adults aged 19 to 64 years in England was assessed from 24-hour urinary sodium excretion of 689 adults, selected to be representative of this section of the population. Estimated salt intake was calculated using the equation 17.1mmol of sodium = 1g of salt and assumes all sodium was derived from salt. The data were validated as representing daily intake by checking completeness of the urine collections by the para-amino benzoic acid (PABA) method. Urine samples were collected over five months (May to September) in 2014, concurrently with a similar survey in Scotland. This report presents the results for the latest survey assessment (2014) and a new analysis of the trend in estimated salt intake over time. The trend analysis is based on data for urinary sodium excretion from this survey and previous sodium surveys (including data from the National Diet and Nutrition Survey Rolling Programme (NDNS RP) Years 1 to 5) carried out in England over the last ten years, between 2005-06 and 2014. This data has been adjusted to take account of biases resulting from differences between surveys in laboratory analytical methods used for sodium. The analysis provides a revised assessment of the trend in estimated salt intake over time. The trend analysis in this report supersedes the trend analysis published in the report of the 2011 England urinary sodium survey.