NR 505 Week 5 Research Summary Assignment

Sample Answer

PICOT Statement

In adults (ages 18-65 years) who are overweight or obese, what is the effect of implementing a structured weight loss program, including dietary changes and physical activity, with a focus on health promotion in comparison to no weight loss interventions on long-term weight loss maintenance at 3, 6, and 12 months and improvements in overall health indicators?

QUANTITATIVE STUDIES

Full reference for article (APA 7th Ed.Format)

• Brooker, P. G., Gomersall, S. R., King, N. A., & Leveritt, M. D. (2023). The efficacy of morning versus evening exercise for weight loss A randomized controlled trial. Obesity, 31(1), 83–95. https //doi.org/10.1002/oby.23605
• DOI of article/ article link https //doi.org/10.1002/oby.23605

Problem-related to PICOT

The study investigated the effectiveness of physical activity on weight loss. The researchers used obese or overweight individuals to determine the effect of physical activity on cardiometabolic health, weight loss, and components of energy balance. The project findings inform the PICOT question since it increases understanding of the role of exercise on weight loss.

Methods

The study was a three-arm randomized controlled trial. The participants were randomly assigned to three groups, which included morning exercise, evening exercise, and waitlist control groups. The participants must have met the inclusion criteria, which entailed being insufficiently active, obese or overweight, and having stale weight over the last three months.

Sample and Participants

The sample in this study was 100 inactive adults with obesity or overweight.

Major Findings/Conclusions

Morning and evening exercises were associated with significant weight loss as compared to those on the waitlist. Cardiorespiratory fitness increased in both the intervention groups and not the control group. Total energy intake also reduced significantly in the morning and evening groups and not in the control group.

Relevance to Practice Issue or Proposed Intervention

The study is relevant to the practice issue. It shows that physical activity promotes modest weight loss among overweight and obese individuals. The benefits can be optimized when other interventions such as dietary modification and counseling are incorporated into the treatment plan.

QUALITATIVE STUDIES

Full reference for article (APA 7th Ed.Format)

• Ingels, J. S., Hansell, A., & Zizzi, S. (2018). Beyond weight loss A qualitative exploration of participant expectations and strategies for measuring progress during a weight management program. SAGE Open Medicine, 6, 2050312118807618. https //doi.org/10.1177/2050312118807618
• DOI of article/ article link https //doi.org/10.1177/2050312118807618

Purpose and Type of Research

The purpose of this study was to explore participant expectations and strategies for measuring progress during a community-based weight management program. The research was a qualitative study.

Sample

The sample comprised 22 participants with obese or overweight and enrolled in a 2-year weight management program.

Data Collection Method

Interviews over the phone were conducted with the participants following a semi-structured format. The interviews were audio recorded. The interviews focused on participant experiences with the weight loss program.

Study Findings

The study revealed that participant expectations included improved health, mood, and fitness, gaining support, and developing new habits. Participants measured their success based on weight loss and changes in their body, mood, improved health, creation of new habits, and additional support.

Key Findings/Themes

Participants have positive expectations with their participation in weight loss management programs.

Relevance to Practice Issue or Proposed Intervention

The study is relevant to the practice issue. It informs the objectives that must be met when implementing a weight loss program for obesity and overweight. It also provides accurate measures for evaluating the success of change interventions aiming at weight management.

QUANTITATIVE STUDIES

Full reference for article (APA 7th Ed.Format)

• Cleo, G., Glasziou, P., Beller, E., Isenring, E., & Thomas, R. (2019). Habit-based interventions for weight loss maintenance in adults with overweight and obesity A randomized controlled trial. International Journal of Obesity, 43(2), Article 2. https //doi.org/10.1038/s41366-018-0067-4
• DOI of article/ article link https //doi.org/10.1038/s41366-018-0067-4

Problem-related to PICOT

The researchers investigated the effectiveness of different interventions for obesity and overweight. The researchers examined the effectiveness of two habit-based loss interventions, which included Ten Top Tips and Do Something Different for weight loss. The duration of the investigation was twelve months. The interventions in the habit-based strategies included physical activity, counseling, and dietary modifications, hence, the relevance of the study to the project.

Methods

Participants in the study must have met the stated criteria, which included being obese or overweight, living around the study site, and could access an email, and being free from limiting comorbidities. The participants were randomly assigned to either Top Ten Things, Doing Something, or control groups.

Sample and Participants

The participants comprised obese and overweight individuals without limiting comorbidities. The study used 130 participants who met the inclusion criteria.

Major Findings/Conclusions

The study found that participants in the Do Something Different and Ten Top Tips had significant weight loss as compared to those in the waitlist control. The intervention groups continued to lose further weight to the 12-month follow-up. At 12 months post-intervention, 65% of the participants in the intervention groups had lost their total body weight by at least 5%, which was considered a clinically important change.

Relevance to Practice Issue or Proposed Intervention

The study is relevant to the proposed project. It shows that incorporating dietary modifications, physical activity, and health promotion into weight loss initiatives can be habits for weight loss. They are also effective and sustainable.

QUANTITATIVE STUDIES

Full reference for article (APA 7th Ed.Format)

• Hakim, A., Bagheri, R., & Ahmadi Angali, K. (2022). The effect of diet counseling and physical activity on the components of metabolic syndrome in children A Randomized Clinical Trial. SAGE Open Medicine, 10, 20503121221100336. https //doi.org/10.1177/20503121221100335
• DOI of article/ article link https //doi.org/10.1177/20503121221100335

Problem-related to PICOT

The authors investigated the effect of physical activities and dietary counseling on metabolic syndrome. Metabolic syndrome refers to metabolic abnormalities that predispose patients to diabetes and cardiovascular disease. Patients with obesity and overweight have a risk of these health problems, hence, the alignment of the article with the PICOT.

Methods

The study was a randomized controlled trial where participants were divided into three groups that include intervention group and a control group. The participants in the three groups received dietary counseling, physical activity counseling, and diet and physical activity counseling group. Interviews were used for data collection.

Sample and Participants

The participants comprised individuals with metabolic syndrome. The sample comprised 60 children with metabolic syndrome who met the inclusion criteria.

Major Findings/Conclusions

The participants in the intervention groups had statistically significant improvements in abdominal obesity, fasting blood sugar, hypertension, high-density lipoproteins, and triglycerides as compared to those in the control group. Diet, physical activity, and counseling are effective in facilitating weight loss among individuals with and at risk of metabolic syndrome.

Relevance to Practice Issue or Proposed Intervention

The article is relevant to the practice issue of overweight and obesity. It shows that counseling, dietary modifications, and physical activity reduce weight among obese and overweight individuals. They also lower metabolic syndrome risks.

QUANTITATIVE STUDIES

Full reference for article (APA 7th Ed.Format)

• Höchsmann, C., Dorling, J. L., Martin, C. K., Earnest, C. P., & Church, T. S. (2022). Association between weight loss, change in physical activity, and change in quality of life following a corporately sponsored, online weight loss program. BMC Public Health, 22(1), 451. https //doi.org/10.1186/s12889-022-12835-4
• DOI of article/ article link https //doi.org/10.1186/s12889-022-12835-4

Problem-related to PICOT

This study investigates the effect of an online weight loss program on quality of life. The interventions in the online weight loss program include physical activity and dietary modification. The focus on these interventions aligns with the PICOT of the proposed project.

Methods

The targeted individuals participated in an online behaviorally oriented commercial weight loss program for company employees in the USA. The program lasted for a year to determine its sustainability in improving weight among the participants. The interventions incorporated counseling strategies such as educating the participants about stress and emotions management.

Sample and Participants

The participants included company employees with a BMI of at least 25. The sample used in the study was 26658 participants.

Major Findings/Conclusions

A progressive increase in physical activity was associated with increasing weight loss and improvements in quality of life for the participants. The improvements in quality of life were in aspects that included energy, sleep, mood, self-confidence, indigestion, and musculoskeletal pain. The participants also demonstrated positive improvements in dietary choices.

Relevance to Practice Issue or Proposed Intervention

The study is relevant to the practice issue. It shows the significance of lifestyle modifications on weight loss and improved quality of life. The study also shows the potential for sustained improvements with weight loss interventions such as physical activity.

QUANTITATIVE STUDIES

Full reference for article (APA 7th Ed.Format)

• Ro, S., Lackey, A., Aymes, S., McCauley, J., Davis, T., Wang, R., Stanley, W., Ratner, S., Machineni, S., & Fiscus, L. (2023). Impact of a Community-Based Weight Management Program in a North Carolina Health Care System. Family Medicine, 55(3), 189–194. https //doi.org/10.22454/FamMed.2023.603918
• DOI of article/ article link https //doi.org/10.22454/FamMed.2023.603918

Problem-related to PICOT

The study focused on the effectiveness of different evidence-based strategies for reducing weight among obese individuals. The interventions included lifestyle counseling, dietary modification counseling, and education about the importance of physical exercises.

Methods

Physicians evaluated potential participants on areas that included sleep, physical activity, weight history, and metabolic data. Targeted lifestyle counseling, including nutrition counseling and emphasizing physical activity, were offered to the participants. Follow-up visits were offered to assess treatment adherence by the participants.

Sample and Participants

The participants were obese individuals visiting three facilities in North Carolina. The study utilized 550 participants.

Major Findings/Conclusions

Of the 550 participants, 209 had adequate program exposure, as evidenced by four or more completed visits. The participants received targeted lifestyle counseling and antiobesity medication. Patients who completed at least four sessions had an average total body weight loss of 5.7% as compared to 1.5% in those with only one visit. 53% of the participants achieved more than 5% weight loss and 20% achieved more than 10% weight loss.

Relevance to Practice Issue or Proposed Intervention

The article is relevant to the proposed intervention. It shows that professionally delivered lifestyle interventions are effective in weight loss among obese individuals. The study also shows that professional support and follow-up improve the sustainability of the project outcomes.

QUANTITATIVE STUDIES

Full reference for article (APA 7th Ed.Format)

• Salas-Salvadó, J., Díaz-López, A., Ruiz-Canela, M., Basora, J., Fitó, M., Corella, D., Serra-Majem, L., Wärnberg, J., Romaguera, D., & Estruch, R. (2019). Effect of a lifestyle intervention program with energy-restricted Mediterranean diet and exercise on weight loss and cardiovascular risk factors One-year results of the PREDIMED-Plus trial. Diabetes Care, 42(5), 777–788. https //doi.org/10.2337/dc18-0836
• DOI of article/article link https //doi.org/10.2337/dc18-0836

Problem-related to PICOT

The study investigated the effect of a lifestyle intervention program with an energy-restricted Mediterranean diet and exercise on cardiovascular risk factors and weight loss in obese and overweight individuals. The study focus aligns with the PICOT of the proposed project since it answers questions about the effectiveness of the proposed interventions on weight reduction and their sustainability.

Methods

Participants were randomized to an intensive weight loss lifestyle intervention based on an energy-restricted Mediterranean diet (erMedDiet), physical activity promotion, and behavioral support or a control group. The participants were included in the study if they did not have a documented history of cardiovascular diseases. Participants in the intervention group received behavioral support and erMedDiet and physical activity promotion while those in the control group received educational sessions on an ad libitum MedDiet.

Sample and Participants

The participants in this study were men aged 55-75 years and women aged 60-75 years old without a documented history of cardiovascular diseases.

Major Findings/Conclusions

Physical and dietary interventions were associated with significant improvements in the intervention group as compared to the control group. Participants in the intervention group lost an average of 3.2 kg vs. 0.7 kg in the control group after 12 months. Weight loss of at least 5% occurred in 33.7% of participants in the intervention group as compared to 11.9% in the control group. There were also significant improvements in cardiovascular risk factors such as fasting glucose, waist circumference, and high-density lipoproteins in the intervention group. Reductions in HbA1c and circulating levels of interleukin-18, leptin, and MCP-1 were higher in the intervention group than in the control group.

Relevance to Practice Issue or Proposed Intervention

The article is relevant to the proposed intervention. It shows the effectiveness of counseling, physical activity, and dietary modifications in weight loss and producing sustained improvements in body weight.

QUANTITATIVE STUDIES

Full reference for article (APA 7th Ed.Format)

• Yang, Q., Wang, K., Tian, Q., Zhang, J., Qi, L., & Chen, T. (2022). Effect of Diet and Exercise-Induced Weight Loss among Metabolically Healthy and Metabolically Unhealthy Obese Children and Adolescents. International Journal of Environmental Research and Public Health, 19(10), 6120. https //doi.org/10.3390/ijerph19106120
• DOI of article/ article link https //doi.org/10.3390/ijerph19106120

Problem-related to PICOT

The study relates to the PICOT of the project. It examines the effect of exercise and diet-induced weight loss among metabolically healthy and unhealthy individuals. The study seeks to determine if implementing diet and exercise-based lifestyle interventions would result in weight loss. This focus aligns with the project focus.

Methods

282 participants were enrolled in the study. The participants were educated on establishing healthy lifestyle habits based on the 5D Weight Loss Education System. Participants were excluded from the program if they had co-existing comorbidities such as renal, cardiac, or hepatic diseases personal.

Sample and Participants

The participants in this study were obese children and adolescents. The sample comprised 282 obese children and adolescents who met the inclusion criteria.

Major Findings/Conclusions

Exercise and dietary interventions were associated with significant benefits that included improved body weight, body mass index, waist circumference, body fat ratio, diastolic blood pressure, systolic blood pressure, triglycerides, resting heart rate, low-density lipoprotein-cholesterol levels, and total cholesterol levels. High-density lipoprotein-cholesterol levels decreased in both groups after interventions.

Relevance to Practice Issue or Proposed Intervention

The article is relevant to the practice issue. It shows that diet and exercise interventions are beneficial to both metabolically healthy and unhealthy individuals. The benefits can be seen from the reduction in metabolic health indicators such as weight, body-fat ratio, systolic and diastolic blood pressure, and high-density lipoproteins-cholesterols.

QUANTITATIVE STUDIES

Full reference for article (APA 7th Ed.Format)

• Lundgren, J. R., Janus, C., Jensen, S. B. K., Juhl, C. R., Olsen, L. M., Christensen, R. M., Svane, M. S., Bandholm, T., Bojsen-Møller, K. N., Blond, M. B., Jensen, J.-E. B., Stallknecht, B. M., Holst, J. J., Madsbad, S., & Torekov, S. S. (2021). Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined. New England Journal of Medicine, 384(18), 1719–1730. https //doi.org/10.1056/NEJMoa2028198
• DOI of article/ article link https //doi.org/10.1056/NEJMoa2028198

Problem-related to PICOT

The problem related to PICOT in the study is investing the effect of dietary modification, and exercise on weight loss among obese individuals. The study also evaluates the sustainability of the interventions after one year, hence, relevance to the PICOT question.

Methods

The study was a randomized, head-to-head, placebo-controlled trial. Participants were required to follow a low-calorie diet of 800 kcal per day. Participants were randomly assigned in a 1 1 1 1 ratio to either exercise plus placebo, liraglutide plus usual activity, or placebo plus usual activity for one year.

Sample and Participants

Eligible participants for the study were adults aged 18-65 years old with obesity. The study used 195 participants who met the inclusion criteria.

Major Findings/Conclusions

There was a mean decrease in body weight of 13.1 kg in all the participants after 8 weeks. At 1 year, all the active treatment strategies were associated with greater weight loss than placebo. the combination strategy was associated with greater weight loss than exercise and not liraglutide. The combination strategy also decreased body fat by 3.9 percent, which was about twice the decrease seen in the exercise group and the liraglutide group. Combination therapy also improved insulin sensitivity, glycated hemoglobin, and cardiorespiratory fitness.

Relevance to Practice Issue or Proposed Intervention

The study is relevant to the practice issue because it shows the effectiveness of physical activity and dietary modifications on weight loss. The study also shows the significance of combining the interventions to achieve optimum outcomes in weight reduction.

META-ANALYSIS STUDIES

Full reference for article (APA 7th Ed.Format)

• Min, J., Kim, S.-Y., Shin, I.-S., Park, Y.-B., & Lim, Y.-W. (2021). The Effect of Meal Replacement on Weight Loss According to Calorie-Restriction Type and Proportion of Energy Intake A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of the Academy of Nutrition and Dietetics, 121(8), 1551-1564.e3. https //doi.org/10.1016/j.jand.2021.05.001
• DOI of article/ article link https //doi.org/10.1016/j.jand.2021.05.001

Purpose of Research Article

The study assessed the effects of weight reduction interventions and meal replacement plans compared with food-based diets on weight loss, according to calorie restriction types and energy intake proportions from meal replacement.

Search Selection Method

Electronic databases that include PubMed, Cochrane Central Register of Controlled Trials, Research Information Sharing Service, and Embase were used to obtain the required articles. The inclusion criteria were studies that used individuals aged 18-65 years old, studies on calorie-restricted diets, and weight loss interventions.

Meta-Analysis Model	Preferred Reporting Items for Systematic Reviews and Meta-analysis Guidelines
Consistency/Variation of Studies	Five studies used adequate randomization processes while seven studies had a low risk for missing outcome data.
Summary of Findings	22 studies were included in the systematic review and meta-analysis. The results revealed that the effect size of meal replacement and weight management interventions was higher than low-energy diets for weight loss. Diets with at least 60% of total daily energy intake from meal replacement were associated with medium effect size, which implies that meal replacement has a high impact on weight loss among obese and overweight individuals. The authors conclude that incorporating meal replacement into conventional weight loss strategies such as physical activity could result in further reductions in weight loss and sustained outcomes.

 

References

• Brooker, P. G., Gomersall, S. R., King, N. A., & Leveritt, M. D. (2023). The efficacy of morning versus evening exercise for weight loss A randomized controlled trial. Obesity, 31(1), 83–95. https //doi.org/10.1002/oby.23605
• Cleo, G., Glasziou, P., Beller, E., Isenring, E., & Thomas, R. (2019). Habit-based interventions for weight loss maintenance in adults with overweight and obesity A randomized controlled trial. International Journal of Obesity, 43(2), Article 2. https //doi.org/10.1038/s41366-018-0067-4
• Hakim, A., Bagheri, R., & Ahmadi Angali, K. (2022). The effect of diet counseling and physical activity on the components of metabolic syndrome in children A Randomized Clinical Trial. SAGE Open Medicine, 10, 20503121221100336. https //doi.org/10.1177/20503121221100335
• Höchsmann, C., Dorling, J. L., Martin, C. K., Earnest, C. P., & Church, T. S. (2022). Association between weight loss, change in physical activity, and change in quality of life following a corporately sponsored, online weight loss program. BMC Public Health, 22(1), 451. https //doi.org/10.1186/s12889-022-12835-4
• Ingels, J. S., Hansell, A., & Zizzi, S. (2018). Beyond weight loss A qualitative exploration of participant expectations and strategies for measuring progress during a weight management program. SAGE Open Medicine, 6, 2050312118807618. https //doi.org/10.1177/2050312118807618
• Lundgren, J. R., Janus, C., Jensen, S. B. K., Juhl, C. R., Olsen, L. M., Christensen, R. M., Svane, M. S., Bandholm, T., Bojsen-Møller, K. N., Blond, M. B., Jensen, J.-E. B., Stallknecht, B. M., Holst, J. J., Madsbad, S., & Torekov, S. S. (2021). Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined. New England Journal of Medicine, 384(18), 1719–1730. https //doi.org/10.1056/NEJMoa2028198
• Min, J., Kim, S.-Y., Shin, I.-S., Park, Y.-B., & Lim, Y.-W. (2021). The Effect of Meal Replacement on Weight Loss According to Calorie-Restriction Type and Proportion of Energy Intake A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of the Academy of Nutrition and Dietetics, 121(8), 1551-1564.e3. https //doi.org/10.1016/j.jand.2021.05.001
• Ro, S., Lackey, A., Aymes, S., McCauley, J., Davis, T., Wang, R., Stanley, W., Ratner, S., Machineni, S., & Fiscus, L. (2023). Impact of a Community-Based Weight Management Program in a North Carolina Health Care System. Family Medicine, 55(3), 189–194. https //doi.org/10.22454/FamMed.2023.603918
• Salas-Salvadó, J., Díaz-López, A., Ruiz-Canela, M., Basora, J., Fitó, M., Corella, D., Serra-Majem, L., Wärnberg, J., Romaguera, D., & Estruch, R. (2019). Effect of a lifestyle intervention program with energy-restricted Mediterranean diet and exercise on weight loss and cardiovascular risk factors One-year results of the PREDIMED-Plus trial. Diabetes Care, 42(5), 777–788.
• Yang, Q., Wang, K., Tian, Q., Zhang, J., Qi, L., & Chen, T. (2022). Effect of Diet and Exercise-Induced Weight Loss among Metabolically Healthy and Metabolically Unhealthy Obese Children and Adolescents. International Journal of Environmental Research and Public Health, 19(10), 6120. https //doi.org/10.3390/ijerph19106120