Bmc Med
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Clinical Trial Observational Study
Weight loss required by the severely obese to achieve clinically important differences in health-related quality of life: two-year prospective cohort study.
Guidelines and experts describe 5% to 10% reductions in body weight as 'clinically important'; however, it is not clear if 5% to 10% weight reductions correspond to clinically important improvements in health-related quality of life (HRQL). Our objective was to calculate the amount of weight loss required to attain established minimal clinically important differences (MCIDs) in HRQL, measured using three validated instruments. ⋯ Weight reductions to achieve MCIDs for most HRQL instruments are markedly higher than the conventional threshold of 5% to 10%. Surgical, but not medical treatment, consistently led to clinically important improvements in HRQL over two years.
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Environmental enteropathy (EE) is a poorly defined state of intestinal inflammation without overt diarrhea that occurs in individuals exposed over time to poor sanitation and hygiene. It is implicated as a cause of stunting and malnutrition, oral vaccine failure and impaired development in children from low-income countries. The burden on child health of malnutrition alone, which affects 25% of all children and is estimated to result in more than a million deaths annually due to heightened susceptibility to infection, makes urgent a solution to EE. ⋯ The aminosalicylate mesalazine was found to be safe in short-term treatment of a small number of severely malnourished children, although efficacy was not established. Whether such treatment trials are premature, or instead a way both to understand and intervene in EE, is the focus of this article. Please see related article: http://www.biomedcentral.com/1741-7015/12/133.
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Randomized Controlled Trial
The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on neonatal health outcomes: the LIMIT randomised trial.
Overweight and obesity during pregnancy represents a considerable health burden. While research has focused on interventions to limit gestational weight gain, there is little information describing their impact on neonatal health. Our aim was to investigate the effect on a range of pre-specified secondary neonatal outcomes of providing antenatal dietary and lifestyle advice to women who are overweight or obese. ⋯ Australian and New Zealand Clinical Trials Registry ( ACTRN12607000161426 ).
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The increased prevalence of obesity has led to major health care issues in obstetric practice. Nevertheless, despite a major international effort, there is little evidence for interventions which can improve clinical outcome. ⋯ The improvements in maternal lifestyle, albeit modest, may account for a previously reported reduction in the number of macrosomic infants born to LIMIT participants randomised to the intervention arm of the trial. Please see related articles: http://www.biomedcentral.com/1741-7015/12/161 and http://www.biomedcentral.com/1741-7015/12/163.
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Randomized Controlled Trial
The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on maternal diet and physical activity: the LIMIT randomised trial.
Overweight and obesity is a significant health concern during pregnancy. Our aim was to investigate the effect of providing antenatal dietary and lifestyle advice to women who are overweight or obese on components of maternal diet and physical activity. ⋯ For women who are overweight or obese, antenatal lifestyle advice improves maternal diet and physical activity during pregnancy. Please see related articles: http://www.biomedcentral.com/1741-7015/12/163 and http://www.biomedcentral.com/1741-7015/12/201.