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Effectiveness of wearable activity trackers to increase physical activity and improve health: a systematic review of systematic reviews and meta-analyses.
Ferguson, T, Olds, T, Curtis, R, Blake, H, Crozier, AJ, Dankiw, K, Dumuid, D, Kasai, D, O'Connor, E, Virgara, R, et al
The Lancet. Digital health. 2022;4(8):e615-e626
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A sedentary or physically inactive lifestyle significantly contributes to non-communicable diseases such as coronary heart disease, type 2 diabetes and stroke. Wearable activity trackers are low-cost solutions that encourage users to engage in physical activity. This umbrella review of systematic reviews and meta-analyses investigated the benefits of wearable activity trackers in improving physical activity levels and their beneficial effects on physiological and psychosocial outcomes. This umbrella review included thirty-nine systematic reviews, of which twenty-five systematic reviews included meta-analyses of the benefits of wearable trackers on physical activity levels. Results of this umbrella review suggest that wearable trackers increased physical activity levels, especially daily steps count and energy expenditure. The physiological outcomes included improvements in BMI, blood pressure, cholesterol, glycosylated haemoglobin, waist circumference, and body weight. There was also a slight improvement in the quality of life of the participants who used wearable activity trackers. Further robust studies are required to evaluate the effects of wearable trackers on the psychosocial outcomes in people with mental illness. However, healthcare professionals can use the results of this study to understand the impact of wearable trackers on physiological and psychosocial effects in a non-clinical population.
Abstract
Wearable activity trackers offer an appealing, low-cost tool to address physical inactivity. This systematic review of systematic reviews and meta-analyses (umbrella review) aimed to examine the effectiveness of activity trackers for improving physical activity and related physiological and psychosocial outcomes in clinical and non-clinical populations. Seven databases (Embase, MEDLINE, Ovid Emcare, Scopus, SPORTDiscus, the Cochrane Library, and Web of Science) were searched from database inception to April 8, 2021. Systematic reviews of primary studies using activity trackers as interventions and reporting physical activity, physiological, or psychosocial outcomes were eligible for inclusion. In total, 39 systematic reviews and meta-analyses were identified, reporting results from 163 992 participants spanning all age groups, from both healthy and clinical populations. Taken together, the meta-analyses suggested activity trackers improved physical activity (standardised mean difference [SMD] 0·3-0·6), body composition (SMD 0·7-2·0), and fitness (SMD 0·3), equating to approximately 1800 extra steps per day, 40 min per day more walking, and reductions of approximately 1 kg in bodyweight. Effects for other physiological (blood pressure, cholesterol, and glycosylated haemoglobin) and psychosocial (quality of life and pain) outcomes were typically small and often non-significant. Activity trackers appear to be effective at increasing physical activity in a variety of age groups and clinical and non-clinical populations. The benefit is clinically important and is sustained over time. Based on the studies evaluated, there is sufficient evidence to recommend the use of activity trackers.
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A Systematic Review of the Impact of the First Year of COVID-19 on Obesity Risk Factors: A Pandemic Fueling a Pandemic?
Daniels, NF, Burrin, C, Chan, T, Fusco, F
Current developments in nutrition. 2022;6(4):nzac011
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Coronavirus disease 2019 (COVID-19) is one of the most serious infectious disease outbreaks in recent history. Among the factors that can increase the risk of obesity, some seem to play a more prominent role than others such as depression, emotional eating, sedentary lifestyle and the socioeconomic status. The aim of this study was to explore the indirect effects of the first year of COVID-19 on obesity and its risk factors. This study is a systematic review of 87 studies with over 350,000 participants. Results show that: - overall, there was a general trend of weight gain during the pandemic. - there were differences in dietary changes, with some studies showing an improvement in diet. - some beneficial effects were observed in the dieting domain, such as higher consumption of home-cooked meals and healthy food (e.g., vegetables). However, there was an increasing trend in the overall food and alcohol consumption. - financial hardship and job loss were unavoidable consequences of the pandemic lockdown. However, although the impact of the countermeasures used to curb the COVID-19 pandemic was evident on obesity risk factors, none of the studies included in the research explored the direct impact of the risk factors on obesity itself. Authors conclude by pointing out the need for future research that aims at strengthening the link between stressful circumstances and a rise in risk factors for obesity and weight gain.
Abstract
Obesity is increasingly prevalent worldwide. Associated risk factors, including depression, socioeconomic stress, poor diet, and lack of physical activity, have all been impacted by the coronavirus disease 2019 (COVID-19) pandemic. This systematic review aims to explore the indirect effects of the first year of COVID-19 on obesity and its risk factors. A literature search of PubMed and EMBASE was performed from 1 January 2020 to 31 December 2020 to identify relevant studies pertaining to the first year of the COVID-19 pandemic (PROSPERO; CRD42020219433). All English-language studies on weight change and key obesity risk factors (psychosocial and socioeconomic health) during the COVID-19 pandemic were considered for inclusion. Of 805 full-text articles that were reviewed, 87 were included for analysis. The included studies observed increased food and alcohol consumption, increased sedentary time, worsening depressive symptoms, and increased financial stress. Overall, these results suggest that COVID-19 has exacerbated the current risk factors for obesity and is likely to worsen obesity rates in the near future. Future studies, and policy makers, will need to carefully consider their interdependency to develop effective interventions able to mitigate the obesity pandemic.
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Effects of Attentional Focus on Muscular Endurance: A Meta-Analysis.
Grgic, J, Mikulic, P
International journal of environmental research and public health. 2021;19(1)
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For over 20 years, the effects of attentional focus on motor learning have been explored. Several muscular qualities are important when discussing resistance exercise, including muscular endurance. The aim of this study was to perform a meta-analysis examining the effects of external focus vs. internal focus vs. control on muscular endurance. This study is a meta-analysis of five studies. The pooled number of participants among the included studies was 141 (24 females and 117 males). Results indicate that adopting an external focus of attention enhances muscular endurance. These performance-enhancing effects of external focus were found when comparing both with an internal focus and control condition. However, there was no significant difference between the internal focus and control conditions. Authors conclude that individuals should use an external focus of attention for acute enhancement of muscular endurance.
Abstract
Several studies explored the effects of attentional focus on resistance exercise, but their analysed outcomes most commonly involved surface electromyography variables. Therefore, the effects of attentional focus on resistance exercise performance remain unclear. The aim of this review was to perform a meta-analysis examining the acute effects of external focus vs. internal focus vs. control on muscular endurance. Five databases were searched to find relevant studies. The data were pooled in a random-effects meta-analysis. In the analysis for external vs. internal focus of attention, there were seven comparisons with 14 study groups. In the analyses for external focus vs. control and internal focus vs. control, there were six comparisons with 12 study groups. An external focus of attention enhanced muscular endurance when compared with an internal focus (Cohen's d: 0.58; 95% confidence interval (CI): 0.34 and 0.82) and control (Cohen's d: 0.42; 95% CI: 0.08 and 0.76). In the analysis for internal focus vs. control, there was no significant difference between the conditions (Cohen's d: -0.19; 95% CI: -0.45 and 0.07). Generally, these results remained consistent in the subgroup analyses for upper-body vs. lower-body exercises. From a practical perspective, the results presented in this review suggest that individuals should use an external focus of attention for acute enhancement of muscular endurance.
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Commissioning guidance for weight assessment and management in adults and children with severe complex obesity.
Welbourn, R, Hopkins, J, Dixon, JB, Finer, N, Hughes, C, Viner, R, Wass, J
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2018;19(1):14-27
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Treating severe and complex obesity requires specialist multi-professional teams for assessment, management and optimizing patients’ health outcomes. The aim of this study was to review existing evidence for defining commissioning and delivery of primary or secondary care weight assessment and management clinics to patients needing specialist care for severe and complex obesity. Twenty-two UK royal colleges and professional organizations were invited to develop the guidance revision according to the NICE-accreditation process. Fifty references were included in the final report. The following additions have been identified as new emergent developments to be included in the guidance: - multi-disciplinary team pathways for children/adolescent patients and their transition to adult care, and - anaesthetic assessment and recommendations for ongoing shared care with general practitioners, as a chronic disease management pathway. Authors indicate that the Guidance Development Group recommends the use of the NICE-accredited commissioning guidance as healthcare services in different countries develop services to manage patients with severe and complex obesity.
Abstract
The challenge of managing the epidemic of patients with severe and complex obesity disease in secondary care is largely unmet. In England, the National Institute of Health and Care Excellence and the National Health Service England have published guidance on the provision of specialist (non-surgical) weight management services. We have undertaken a systematic review of 'what evidence exists for what should happen in/commissioning of: primary or secondary care weight assessment and management clinics in patients needing specialist care for severe and complex obesity?' using an accredited methodology to produce a model for organization of multidisciplinary team clinics that could be developed in every healthcare system, as an update to a previous review. Additions to the previous guidance were multidisciplinary team pathways for children/adolescent patients and their transition to adult care, anaesthetic assessment and recommendations for ongoing shared care with general practitioners, as a chronic disease management pathway.