Community-based programmes achieved good results for most risk factors except BMI and ( glycated haemoglobin ) HbA1c .
INTRODUCTION Although cardiovascular disease ( CVD ) and type 2 diabetes mellitus ( T2DM ) prevention programmes have been effective in urban residents , their effectiveness in non-urban setting s , where cardio-metabolic risk is typically elevated , is unknown .
We systematic ally review ed the effectiveness of primary prevention programmes aim ed at reducing risk factors for CVD/T2DM , including blood pressure , body mass index ( BMI ) , blood lipid and glucose , diet , lifestyle , and knowledge in adults residing in non-urban areas .
Randomized trial of lifestyle modification and pharmacotherapy for obesity.
BACKGROUND Weight-loss medications are recommended as an adjunct to a comprehensive program of diet , exercise , and behavior therapy but are typically prescribed with minimal or no lifestyle modification . This practice is likely to limit therapeutic benefits . METHODS In this one-year trial , we r and omly assigned 224 obese adults to receive 15 mg of sibutramine per day alone , delivered by a primary care provider in eight visits of 10 to 15 minutes each ; lifestyle-modification counseling alone , delivered in 30 group sessions ; sibutramine plus 30 group sessions of lifestyle-modification counseling ( i.e. , combined therapy ) ; or sibutramine plus brief lifestyle-modification counseling delivered by a primary care provider in eight visits of 10 to 15 minutes each . All subjects were prescribed a diet of 1200 to 1500 kcal per day and the same exercise regimen . RESULTS At one year , subjects who received combined therapy lost a mean ( + /-SD ) of 12.1+/-9.8 kg , whereas those receiving sibutramine alone lost 5.0+/-7.4 kg , those treated by lifestyle modification alone lost 6.7+/-7.9 kg , and those receiving sibutramine plus brief therapy lost 7.5+/-8.0 kg ( P<0.001 ) . Those in the combined-therapy group who frequently recorded their food intake lost more weight than those who did so infrequently ( 18.1+/-9.8 kg vs. 7.7+/-7.5 kg , P=0.04 ) . CONCLUSIONS The combination of medication and group lifestyle modification result ed in more weight loss than either medication or lifestyle modification alone . The results underscore the importance of prescribing weight-loss medications in combination with , rather than in lieu of , lifestyle modification
Community-based programmes achieved good results for most risk factors except BMI and ( glycated haemoglobin ) HbA1c .
INTRODUCTION Although cardiovascular disease ( CVD ) and type 2 diabetes mellitus ( T2DM ) prevention programmes have been effective in urban residents , their effectiveness in non-urban setting s , where cardio-metabolic risk is typically elevated , is unknown .
We systematic ally review ed the effectiveness of primary prevention programmes aim ed at reducing risk factors for CVD/T2DM , including blood pressure , body mass index ( BMI ) , blood lipid and glucose , diet , lifestyle , and knowledge in adults residing in non-urban areas .