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It Is High Time for Personalized Dietary Counseling in Celiac Disease: A Systematic Review and Meta-Analysis on Body Composition.
Vereczkei, Z, Farkas, N, Hegyi, P, Imrei, M, Földi, M, Szakács, Z, Kiss, S, Solymár, M, Nagy, R, Bajor, J
Nutrients. 2021;(9)
Abstract
The body composition of patients with celiac disease (CD), on which the effects of a gluten-free diet (GFD) are controversial, differs from that of the average population. In this study, we aimed to compare the body composition across CD patients before a GFD, CD patients after a one-year GFD and non-celiac control subjects. A systematic search was conducted using five electronic databases up to 15 July 2021 for studies that reported at least one of the pre-specified outcomes. In meta-analyses, weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated. A total of 25 studies were eligible for systematic review, seven of which were included in meta-analysis. During a ≥1-year GFD, fat mass of CD patients, compared to that at baseline, significantly increased (WMD = 4.1 kg, 95% CI = 1.5 to 6.6, three studies). In CD patients after a ≥1-year GFD, compared to non-celiac controls, fat mass (WMD = -5.8 kg, 95% CI = -8.7 to -2.9, three studies) and fat-free mass (WMD = -1.9 kg, 95% CI = -3.0 to -0.7, three studies) were significantly lower. In conclusion, body composition-related parameters of CD patients differ from that of the non-celiac control subjects even after a longstanding GFD.
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2.
Motivational Interviewing and Fat Consumption in Older Adults: A Meta-Analysis.
Stallings, DT, Kraenzle Schneider, J
Journal of gerontological nursing. 2018;(11):33-43
Abstract
Diets high in fat increase the risks for obesity and chronic diseases, even for older adults, the largest growing population in the United States. In the current study, a meta-analysis was performed to examine the effects of motivational interviewing (MI) dietary interventions on fat consumption in older adults. Electronic databases, journals, and unpublished literature were searched. Six primary studies were retrieved, providing seven comparisons between intervention and control groups and a total of 1,351 participants. MI had a moderate effect on fat intake in older adults (effect size = 0.354, p < 0.01). Studies with indicators of higher design quality showed greater MI effects. Nurses and providers can incorporate MI into health education and counseling to improve older adults' dietary health behaviors. [Journal of Gerontological Nursing, 44(11), 33-43.].
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3.
Effects of weekly supervised exercise or physical activity counseling on fasting blood glucose in women diagnosed with gestational diabetes mellitus: A systematic review and meta-analysis of randomized trials.
Bgeginski, R, Ribeiro, PAB, Mottola, MF, Ramos, JGL
Journal of diabetes. 2017;(11):1023-1032
Abstract
BACKGROUND Exercise is an important part of gestational diabetes mellitus (GDM) lifestyle management. However, no meta-analysis has analyzed the effects of exercise programs on fasting blood glucose (FBG) in women with GDM. A systematic review with meta-analysis was performed to evaluate the effects of weekly supervised exercise (EXE) or physical activity counseling (PA) in women with GDM compared with usual prenatal care (UPN) on glycemic control. METHODS Eligible trials were identified from Medline, EMBASE, Web of Science, Scopus and SportDiscus up to December 2016. Data were retrieved from randomized controlled trials comparing UPN with UPN plus weekly supervised (at least once a week) prenatal exercise or PA counseling for which FBG values before and after intervention were available. Random-effects meta-analysis was performed for mean difference in FBG after exercise intervention. RESULTS The search yielded 781 publications, of which 82 were assessed for eligibility and eight were included in the meta-analysis. The overall effect on absolute FBG concentrations was not significant (P = 0.11) compared with UPN. However, PA versus UPN showed a significant reduction in absolute FBG concentrations (weighted mean difference -3.88 mg/dL; 95% confidence interval -7.33, -0.42 mg/dL; I 2 48%; P heterogeneity < 0.15). CONCLUSIONS Physical activity counseling in women with GDM showed a significant effect compared with UPN on FBG concentrations, possibly due to a longer follow-up time compared with the EXE groups. This result highlights the importance of an early intervention that lasts to delivery for best practice of GDM management.
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Counseling for health behavior change in people with COPD: systematic review.
Williams, MT, Effing, TW, Paquet, C, Gibbs, CA, Lewthwaite, H, Li, LSK, Phillips, AC, Johnston, KN
International journal of chronic obstructive pulmonary disease. 2017;:2165-2178
Abstract
Counseling has been suggested as a promising approach for facilitating changes in health behavior. The aim of this systematic review of counseling interventions for people with COPD was to describe: 1) counseling definitions, 2) targeted health behaviors, 3) counseling techniques and 4) whether commonalities in counseling techniques were associated with improved health behaviors. Ten databases were searched for original randomized controlled trials which included adults with COPD, used the term "counseling" as a sole or component of a multifaceted intervention and were published in the previous 10 years. Data extraction, study appraisal and coding for behavior change techniques (BCTs) were completed by two independent reviewers. Data were synthesized descriptively, with meta-analysis conducted where possible. Of the 182 studies reviewed as full-text, 22 were included. A single study provided a definition for counseling. Two key behaviors were the main foci of counseling: physical activity (n=9) and smoking cessation (n=8). Six studies (27%) reported underlying models and/or theoretical frameworks. Counseling was the sole intervention in 10 studies and part of a multicomponent intervention in 12. Interventions targeting physical activity included a mean of 6.3 (±3.1) BCTs, smoking cessation 4.9 (±2.9) BCTs and other behaviors 6.5 (±3.9) BCTs. The most frequent BCTs were social support unspecified (n=22; 100%), goal setting behavior (n=11), problem-solving (n=11) and instructions on how to perform the behavior (n=10). No studies shared identical BCT profiles. Counseling had a significant positive effect for smoking cessation and positive but not significant effect for physical activity. Counseling for health behavior change was rarely defined and effectiveness varied by target behavior. Provision of specific details when reporting studies of counseling interventions (definition, BCTs, dosage) would allow clarification of the effectiveness of counseling as an approach to health behavior change in people with COPD.
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Does nutritional counseling in telemedicine improve treatment outcomes for diabetes? A systematic review and meta-analysis of results from 92 studies.
Su, D, McBride, C, Zhou, J, Kelley, MS
Journal of telemedicine and telecare. 2016;(6):333-47
Abstract
BACKGROUND A growing number of studies and reviews have documented the impact of telemedicine on diabetes management. However, no meta-analysis has assessed whether including nutritional counseling as part of a telemedicine program has a significant impact on diabetes outcomes or what kind of nutritional counseling is most effective. METHODS Original research articles examining the effect of telemedicine interventions on HbA1c levels in patients with Type 1 or Type 2 diabetes were included in this study. A literature search was performed and 92 studies were retained for analysis. We examined stratified results by differentiating interventions using no nutritional counseling from those that used nutritional counseling. We further compared between nutritional counseling administered via short message systems (SMS) such as email and text messages, and nutritional counseling administered via telephone or videoconference. RESULTS Telemedicine programs that include a nutritional component show similar effect in diabetes management as those programs that do not. Furthermore, subgroup analysis reveals that nutritional intervention via SMS such as email and text messages is at least as equally effective in reducing HbA1c when compared to personal nutritional counseling with a practitioner over videoconference or telephone. CONCLUSION The inclusion of nutritional counseling as part of a telemedicine program does not make a significant difference to diabetes outcomes. Incorporating nutritional counseling into telemedicine programs via SMS is at least as effective as counseling via telephone or videoconference.