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  • 1.
    Hemmingsson, Erik
    et al.
    Karolinska institutet.
    Hellénius, Mai-Lis
    Ekelund, Ulf
    Bergström, Jakob
    Rössner, Stephan
    Impact of social support intensity on walking in the severely obese: a randomized clinical trial.2008In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 16, no 6, p. 1731-8Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: There are few established methods for promoting physical activity (PA) in the severely obese. Because social support is a potential method for promoting PA, we compared mean steps/day during 18 weeks in severely obese outpatients receiving either standard support (SS) or added support (AS).

    METHODS AND PROCEDURES: Eighty severely obese outpatients from an obesity clinic were invited; 66 provided written consent, 55 were randomized, and 42 were included in final analyses (9 men, 33 women; age 44.4 +/- 13.1 years; BMI 41.9 +/- 5.5 kg/m(2)). All participants received a pedometer and a walking promotion booklet. In addition to SS, the AS group received ten 2-h group counseling sessions aimed at increasing weekly accumulated steps, every second week during the study. Each participant was asked to complete a 7-day walking diary every second week (10 observations).

    RESULTS: Baseline steps/day was 6,912 for the AS group and 5,311 for the SS group (P = 0.023). Data at 18 weeks showed that the AS group recorded 10,136 steps/day and the SS group 6,118 steps/day (P = 0.024). There was no allocation x time interaction (P = 0.46). During the follow-up period as a whole, the AS group recorded 1,794 more steps/day than the SS group (P = 0.0074).

    DISCUSSION: The AS group recorded more steps/day than the SS group, reaching a mean level of approximately 10,000 steps/day. However, the nonsignificant interaction between allocation x time suggests that this difference was present already at baseline and did not increase during follow-up.

  • 2.
    Hemmingsson, Erik
    et al.
    Karolinska institutet.
    Uddén, Joanna
    Neovius, Martin
    No apparent progress in bioelectrical impedance accuracy: validation against metabolic risk and DXA.2009In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 17, no 1, p. 183-7Article in journal (Refereed)
    Abstract [en]

    Bioelectrical impedance (BIA) is quick, easy, and safe when quantifying fat and lean tissue. New BIA models (Tanita BC-418 MA, abbreviated BIA(8)) can perform segmental body composition analysis, e.g., estimate %trunkal fatness (%TF). It is not known, however, whether new BIA models can detect metabolic risk factors (MRFs) better than older models (Tanita TBF-300, abbreviated BIA(4)). We therefore tested the correlation between MRF and percentage whole-body fat (%BF) from BIA(4) and BIA(8) and compared these with the correlation between MRF and dual-energy X-ray absorptiometry (DXA, used as gold standard), BMI and waist circumference (WC). The sample consisted of 136 abdominally obese (WC >or= 88 cm), middle-aged (30-60 years) women. MRF included fasting blood glucose and insulin; high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides; high sensitive C-reactive protein, plasminogen activator inhibitor-1 (PAI-1), and fibrinogen; and alanine transaminase (ALT) liver enzyme. We found that similar to DXA, but in contrast to BMI, neither %BF BIA(4) nor %BF BIA(8) correlated with blood lipids or ALT. In the segmental analysis of %TF, BIA(8) only correlated with inflammatory markers, but not insulin, blood lipids, or ALT liver enzyme (in contrast to WC and %TF DXA). %TF DXA was associated with homeostatic model assessment insulin resistance (HOMA-IR) independently of WC (P = 0.03), whereas %TF BIA(8) was not (P = 0.53). Receiver-operating characteristic (ROC) curves confirmed that %TF BIA(8) did not differ from chance in the detection of insulin resistance (P = 0.26). BIA estimates of fatness were, at best, weakly correlated with obesity-related risk factors in abdominally obese women, even the new eight-electrode model. Our data support the continued use of WC and BMI.

  • 3. Neovius, Martin
    et al.
    Hemmingsson, Erik
    Karolinska institutet.
    Freyschuss, Bo
    Uddén, Joanna
    Bioelectrical impedance underestimates total and truncal fatness in abdominally obese women.2006In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 14, no 10, p. 1731-8Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To compare estimates of total and truncal fatness from eight-electrode bioelectrical impedance analysis equipment (BIA(8)) with those from DXA in centrally obese women. The secondary aim was to examine BMI and waist circumference (WC) as proxy measures for percentage total body fat (%TBF) and truncal body fat percentage (tr%BF).

    RESEARCH METHODS AND PROCEDURES: This was a cross-sectional study of 136 women (age, 48.1 +/- 7.7 years; BMI, 30.4 +/- 2.9 kg/m(2); %TBF(DXA), 46.0 +/- 3.7%; WC, 104 +/- 8 cm). Fatness was measured by DXA and Tanita BC-418 equipment (Tanita Corp., Tokyo, Japan). Agreement among methods was assessed by Bland-Altman plots, and regression analysis was used to evaluate anthropometric measures as proxies for total and abdominal fatness.

    RESULTS: The percentage of overweight subjects was 41.9%, whereas 55.9% of the subjects were obese, as defined by BMI, and all subjects had a WC exceeding the World Health Organization cut-off point for abdominal obesity. Compared with DXA, the BIA(8) equipment significantly underestimated total %BF (-5.0; -3.6 to -8.5 [mean; 95% confidence interval]), fat mass (-3.6; -3.9 to -3.2), and tr%BF (-8.5; -9.1 to -7.9). The discrepancies between the methods increased with increasing adiposity for both %TBF and tr%BF (both p < 0.001). Variation in BMI explained 28% of the variation in %TBF(DXA) and 51% of %TBF(BIA8). Using WC as a proxy for truncal adiposity, it explained only 18% of tr%BF(DXA) variance and 27% of tr%BF(BIA8) variance. The corresponding figures for truncal fat mass were 49% and 35%, respectively. No significant age effects were observed in any of the regressions.

    DISCUSSION: BIA(8) underestimated both total and truncal fatness, compared with DXA, with higher dispersion for tr%BF than %TBF. The discrepancies increased with degree of adiposity, suggesting that the accuracy of BIA is negatively affected by obesity.

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