Extended follow-up of a short total diet replacement programme: results of the Doctor Referral of Overweight People to Low Energy total diet replacement Treatment (DROPLET) randomised controlled trial at 3 years
| Autor: | Nerys M. Astbury, Rhiannon M. Edwards, Jill Mollison, Fitsum Ghebretinsea, Susan A. Jebb, Paul Aveyard, Milensu Shanyinde |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Referral Endocrinology Diabetes and Metabolism Aftercare Medicine (miscellaneous) 030209 endocrinology & metabolism Overweight Article law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Weight loss law Weight management Diabetes mellitus Internal medicine medicine Humans 030212 general & internal medicine Referral and Consultation Nutrition and Dietetics Framingham Risk Score business.industry Translational research Middle Aged medicine.disease Obesity United Kingdom Weight Reduction Programs Blood pressure medicine.symptom business Diet Therapy Follow-Up Studies |
| Zdroj: | International Journal of Obesity (2005) |
| ISSN: | 1476-5497 0307-0565 |
| DOI: | 10.1038/s41366-021-00915-1 |
| Popis: | Objectives To test the long-term effectiveness of a total diet replacement programme (TDR) for routine treatment of obesity in a primary care setting. Methods This study was a pragmatic, two-arm, parallel-group, open-label, individually randomised controlled trial in adults with obesity. The outcomes were change in weight and biomarkers of diabetes and cardiovascular disease risk from baseline to 3 years, analysed as intention-to-treat with mixed effects models. Interventions The intervention was TDR for 8 weeks, followed by food-reintroduction over 4 weeks. Behavioural support was provided weekly for 8 weeks, bi-weekly for the next 4 weeks, then monthly for 3 months after which no further support was provided. The usual care (UC) group received dietary advice and behavioural support from a practice nurse for up to 3 months. Results Outcome measures were collected from 179 (66%) participants. Compared with baseline, at 3 years the TDR group lost −6.2 kg (SD 9.1) and usual care −2.7 kg (SD 7.7); adjusted mean difference −3.3 kg (95% CI: −5.2, −1.5), p P P = 0.024), and systolic blood pressure (mean differences −3.7 mmHg (95% CI: −7.4; 0.1) P = 0.057). There was no evidence of differences between groups in the change from baseline to 3 years HbA1c (−1.9 mmol/mol (95% CI: −0.7; 4.5; P = 0.15), LDL cholesterol concentrations (0.2 mmol/L (95% CI −0.3, 0.7) P = 0.39), cardiovascular risk score (QRISK2) (−0.37 (95% CI −0.96; 0.22); P = 0.22). Conclusions Treatment of people with obesity with a TDR programme compared with support from a practice nurse leads to greater weight loss which persists to at least 3 years, but there was only evidence of sustained improvements in BP and not in other aspects of cardiometabolic risk. |
| Databáze: | OpenAIRE |
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