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- Englund, Anja, et al.
(author)
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The behaviour change technique : profile of a multimodal lifestyle intervention
- 2024
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In: Lifestyle Medicine. - : John Wiley & Sons. - 2688-3740. ; 5:1
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Journal article (peer-reviewed)abstract
- Introduction: The behaviour change technique taxonomy version 1 was developed to identify the smallest active ingredients of a lifestyle intervention, that is, behaviour change techniques (BCTs) based on a written description. By participation and direct observation of an intervention, we intend to not only identify BCTs but also assess exposure time for each BCT. Adding the dimension of exposure time should enable us to make quantitative comparisons between the different BCTs employed. We intend to demonstrate this by studying the hypotheses that exposure to information-related BCTs is similar for all targeted lifestyle modalities but decreases in the course of the intervention.Methods: During 5-week intensive multimodal lifestyle interventions at a Swedish clinic for lifestyle medicine, we identified BCTs according to behaviour change technique taxonomy version 1 and noted exposure times to BCTs in all mandatory parts of the behaviour change intervention.Results: Two hundred thirty-one independent intervention components were evaluated. BCTs 8.1 Behavioural practice/rehearsal (126 h), 4.1 Instruction on how to perform the behaviour (98 h) and 6.1 Demonstration of the behaviour (65 h) were the most common in terms of exposure time. Relative exposure to BCTs with an informative nature was similar for the different treatment phases (33%−37%−28%; p = 0.09) but higher for physical activity compared to food habits, stress management and unspecific lifestyle medicine (63%−25%−22%−25%; p < 0.001).Conclusions: The behaviour change technique taxonomy version 1 can be extended by adding exposure time for different BCTs. The resulting BCT–exposure profile can be used for assessing the relative importance of different behaviour change strategies.
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- Heikkila, H. M., et al.
(author)
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Combined low-saturated fat intake and high fitness may counterbalance diabetogenic effects of obesity : the DR's EXTRA Study
- 2013
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In: European Journal of Clinical Nutrition. - : Nature Publishing Group. - 0954-3007 .- 1476-5640. ; 67:9, s. 1000-1002
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Journal article (peer-reviewed)abstract
- We report associations of saturated fat (SF) intake with impaired fasting glucose (IFG), impaired glucose tolerance (IGT), concurrent IFG+IGT and type 2 diabetes (T2DM) at different levels of cardiorespiratory fitness and body mass index (BMI). In a population-based sample (n = 1261, age 58-78 years), oral glucose tolerance, 4-day food intake and maximal oxygen uptake were measured. High intake of SF (>11.4 E%) was associated with elevated risk for IFG (4.36; 1.93-9.88), concurrent IFG+IGT (6.03; 1.25-29.20) and T2DM (4.77; 1.93-11.82) in the category of high BMI (>26.5) and high fitness, whereas there was no significantly elevated risk in individuals reporting low intake of SF. Concurrent high BMI and low fitness were associated with elevated risks. In general, SF intake and fitness did not differentiate the risk of abnormal glucose metabolism among subjects with low BMI. Limited intake of SF may protect from diabetogenic effects of adiposity, but only in individuals with high level of fitness.
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- Heikkila, Harri M., et al.
(author)
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Diet, insulin secretion and insulin sensitivity : the Dose-Responses to Exercise Training (DR's EXTRA) Study (ISRCTN45977199)
- 2014
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In: British Journal of Nutrition. - 0007-1145 .- 1475-2662. ; 112:9, s. 1530-1541
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Journal article (peer-reviewed)abstract
- Intakes of saturated fat (SF) and dietary fibre, body mass and physical activity are all associated with the incidence of type 2 diabetes mellitus. Their relative importance for the maintenance of normal glucose metabolism is not fully known. In a population-based sample of 1114 individuals, aged 58-78 years, dietary intakes were assessed by 4 d food records and cardiorespiratory fitness as maximal oxygen uptake. Insulin secretion, insulin sensitivity, the early-phase disposition index (DI30) and the total disposition index (DI120) were assessed based on an oral glucose tolerance test. Linear associations were modelled using linear regression. Combined effects were studied by introducing SF and fibre intakes, as well as cardiorespiratory fitness and waist circumference (WC) as dichotomised variables in general linear models. Intakes of dietary fibre and whole-grain bread were positively associated with insulin sensitivity, independent of physical fitness and WC. In women, dietary fibre intake was also positively associated with DI30. The negative association of high WC with DI30 was attenuated by a combination of low SF intake and high cardiorespiratory fitness. In conclusion, dietary fibre and a combination of low SF intake and high cardiorespiratory fitness may contribute to the maintenance of normal glucose metabolism, independent of WC.
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| 5. |
- Heikkilä, HM, et al.
(author)
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Dietary associations with prediabetic states : the DR's EXTRA study (ISRCTN45977199)
- 2012
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In: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 66:7, s. 819-824
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Journal article (peer-reviewed)abstract
- Background/objectives: Impaired fasting plasma glucose (IFG) and impaired glucose tolerance (IGT) predict development of type 2 diabetes (T2D), but display different pathophysiology for T2D. We studied the association of selected food items and nutrients with IFG, IGT and combined IFG and IGT (IFG+IGT), independent of cardiorespiratory fitness (VO(2max)).Subjects/methods: In a population-based sample of 1261 individuals, aged 58-78 years, we identified 126 subjects with IFG, 97 with IGT and 49 with simultaneous IFG and IGT by an oral glucose tolerance test. Dietary intake was assessed by 4-day food records. Cardiorespiratory fitness was assessed by defining maximal oxygen uptake (VO(2max)) from respiratory gas analysis during a maximal symptom-limited exercise stress test on a bicycle ergometer.Results: Increased intake of saturated fat was associated with higher odds for IFG (OR 1.07; 1.01-1.14) after adjustment for age, gender, VO(2max) and energy misreporting variable. Consumption of additional whole-grain bread (50 g/1000 kcal) and intake of dietary fiber (g/1000 kcal) were inversely associated with IGT (OR 0.61; 0.41-0.92, OR 0.91; CI 0.85-0.97, respectively).Conclusion: Dietary fiber and sources of cereal fiber are negatively associated with IGT, and saturated fat intake is positively associated with IFG, but not with IGT. The present data give practical dietary means at the population level for the elimination of prediabetic conditions. European Journal of Clinical Nutrition advance online publication, 14 March 2012; doi:10.1038/ejcn.2012.23.
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- Krachler, Benno, 1966-, et al.
(author)
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BMI and an anthropometry-based estimate of fat mass percentage are both valid discriminators of cardiometabolic risk : A comparison with DXA and bioimpedance
- 2013
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In: Journal of Obesity. - : Hindawi Publishing Corporation. - 2090-0708 .- 2090-0716. ; 2013
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Journal article (peer-reviewed)abstract
- Objective: To determine whether categories of obesity based on BMI and an anthropometry-based estimate of fat mass percentage (FM% equation) have similar discriminative ability for markers of cardiometabolic risk as measurements of FM% by dual-energy X-ray absorptiometry (DXA) or bioimpedance analysis (BIA).Design and Methods: A study of 40-79-year-old male (n = 205) and female (n = 388) Finns. Weight, height, blood pressure, triacylglycerols, HDL cholesterol, and fasting blood glucose were measured. Body composition was assessed by DXA and BIA and a FM%-equation.Results: For grade 1 hypertension, dyslipidaemia, and impaired fasting glucose >6.1 mmol/L, the categories of obesity as defined by BMI and the FM% equation had 1.9% to 3.7% (P < 0.01) higher discriminative power compared to DXA. For grade 2 hypertension the FM% equation discriminated 1.2% (P = 0.05) lower than DXA and 2.8% (P < 0.01) lower than BIA. Receiver operation characteristics confirmed BIA as best predictor of grade 2 hypertension and the FM% equation as best predictor of grade 1 hypertension. All other differences in area under curve were small (≤0.04) and 95% confidence intervals included 0.Conclusions: Both BMI and FM% equations may predict cardiometabolic risk with similar discriminative ability as FM% measured by DXA or BIA.
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| 8. |
- Krachler, Benno, et al.
(author)
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Cardiopulmonary fitness is a function of lean mass, not total body weight : The DR's EXTRA study
- 2015
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In: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 22:9, s. 1171-1179
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Journal article (peer-reviewed)abstract
- Background: Division by total body weight is the usual way to standardise peak oxygen uptake (peak VO2) for body size. However, this method systematically underestimates cardiopulmonary fitness in obese individuals. Our aim was to analyse whether lean-mass is a better base for a body mass-independent standard of cardiopulmonary fitness. Methods: A population based sample of 578 men (body mass index (BMI) 19-47kg/m(2)) and 592 women (BMI 16-49kg/m(2)) 57-78 years of age. Peak VO2 was assessed by respiratory gas analysis during a maximal exercise test on a cycle ergometer. We studied the validity of the weight-ratio and the lean mass-ratio standards in a linear regression model. Results: The weight-ratio standard implies an increase of peak VO2 per additional kg body weight with 20.7ml/min (95% confidence interval (CI): 20.3-21.1) in women and 26.9ml/min (95% CI: 26.4-27.5) in men. The observed increase per kg is only 8.5ml/min (95% CI: 6.5-10.5) in men and 10.4ml/min (95% CI: 7.5-13.4) in women. For the lean mass-ratio standard expected and observed increases in peak VO2 per kg lean mass were 32.3 (95% CI: 31.8-32.9) and 34.6 (95% CI: 30.0-39.1) ml/min for women and 36.2 (95% CI: 35.6-36.8) and 37.3 (95% CI: 32.1-42.4) ml/min in men. The lean mass-ratio standard is a body mass-independent measure of cardiopulmonary fitness in 100% of women and 58% of men; corresponding values for the weight-ratio standard were 11% and 16%. Conclusions: For comparisons of cardiopulmonary fitness across different categories of body mass, the lean mass-ratio standard should be used.
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