997 resultados para diet shift
Resumo:
Aim:
Background:
Diabetes education has become a priority area in primary and secondary care, and many education programmes are now embedded within a patient’s care package. There are few contemporaneous explorations of patients’ views about lifestyle self-management. Such research is vital in order to identify areas that require further support, refinement or enhancement in terms of patient education.
Methods:
Focus groups were held with patients recently diagnosed with type 2 diabetes (n516, 38% female, aged 45–73 years). In-depth semi-structured interviews were conducted with HPs (n57). Discussions focussed on self-management specifically in relation to making dietary and physical activity changes. All discussions were tape recorded, transcribed and analysed by emergent themes analysis using NVivo to manage the coded data.
Findings:
Barriers were divided into six main categories: difficulty changing well- stablished habits, negative perception of the ‘new’ or recommended regimen, barriers relating to social circumstances, lack of knowledge and understanding, lack of motivation and barriers relating to the practicalities of making lifestyle changes. HPs generally echoed the views of patients. In conclusion, even against a background of diabetes education, recently diagnosed patients with type 2 diabetes discussed a wide range of barriers to self-management of diet and physical activity. The findings could help to provide HPs with a deeper understanding of the needs of recently diagnosed patients and may help refine current diabetes education activities and inform the development of educational resources.
Resumo:
Class II and III obesity (BMI >35 kg·m2) have increased dramatically in recent years. Current clinical guidelines suggest diet and exercise as first line treatment for adults throughout the spectrum of overweight and obesity. However, to date there is no systematic review that examines the effects of diet and exercise on this high risk population. This systematic review will examine the combined effects of diet versus diet and exercise on body composition in severe obesity. Medline and Cinahl were searched for randomised controlled trials comparing diet and exercise to diet alone. Studies published until July 2013 were included if they used reliable methods for analysing body composition in adults with BMI ≥ 35 kg·m2. Five of 459 studies met the inclusion criteria. Two studies, both in older adults, reported that exercise reduced lean mass loss during weight loss. Two studies showed that exercise facilitated (greater) fat mass loss. The remaining study reported no differences in body composition when exercise is added to energy restriction. Exercise training during energy restriction for individuals with BMI ≥35 kg.m2 may influence body composition outcomes but the evidence is limited. Further studies should focus on the efficacy of different exercise protocols during energy restriction for this population in order to better inform decision making for the treatment of severe obesity in respect to favourable body composition outcomes.
Resumo:
The past four decades have seen enormous social change in Indonesia as the nation continues to experience rapid urbanization and social pressures in the globalized economy that have led to tensions between traditional cultures and the modern mainstream around the nation. This cultural shift has been felt strongly in West Sumatra, a region of Indonesia inhabited almost entirely by members of the matrilineal Minangkabau ethnic group. While the traditional social values of the area remain strong, they are eroding, and the Minang are becoming more like other Indonesians in terms of their family structure, occupations, and lifestyle. This has had a significant impact on the experience of old age as social and culture change has affected the traditional matrilineal structures that supported and ensured care for the elderly in past generations. This paper will describe the ways in which traditional institutions accommodated older individuals and describe how these systems have changed in the present day. Case studies across generations will be presented to illustrate the ways in which traditional matrilineal social structures are, and have been, perceived in the context of aging. Further, the paper will describe what this means for the elderly and their families in terms of cultural consonance in today’s society, and discussion will focus on the changing experience of old age in a society in transition against a backdrop of rapid urbanization and modernization.
