Browsing by Subject "ylipaino"
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(2023)Background: Adults’ obesity prevalence has become threefold world widely during the last 50 years, and the rate is estimated to continue to increase in the future. Overweight and obesity are a health challenge, as they create health problems to persons and load the health care. Both obesity prevention and treatment are a constituent of health care. Updated Obesity Current Care Guideline (2020) has been created to support the work of health professionals. It has not been previously studied nationally, how the obesity guideline is known, and how the prevention and treatment are handled in different health care sectors, areas, and occupational groups in Finland. Aims: This thesis aimed to find out, who of the health professionals had familiarized with the updated obesity guideline and how they perceive it has affected their work. Additionally, the prevention and treatment methods, procedures of the health care, and attitudes of the health professionals were studied. Methods: The used material was part of the questionnaire regarding the Obesity Current Care Guideline. Electronic questionnaire was sent with an open link to the professionals and supervisors working in primary health care, special health care and public and private occupational health care. 760 professionals responded to the questionnaire. Here, 447 responses from professionals, who mainly work in the prevention and treatment of adults’ obesity, are used as data. Microsoft Excel 2208 -program and IBM SPSS Statistics 29.0 -program’s cross-tabulation and Chi-square test were used to analyze the results. Results: Half (52 %) of the professionals, who participated in the study, were familiarized with the updated obesity guideline. Nutritional therapists and doctors were familiarized more than other occupational groups (p<0,001). Of those, who had familiarized with the guideline, 45 % considered that the guideline has affected to the procedures of their work. The methods of the guideline were used in the health care to some degree, especially professionals brought up obesity topic into discussion and used lifestyle treatment. Professionals working mainly with adults estimated that health care procedures do not follow completely the guideline, and many professionals were not aware of the obesity prevention and treatment procedures of their organization and area. The attitudes of the professionals were mainly positive. One fourth of the responders did not consider that bringing up obesity topic into discussion is natural. Conclusions: The Obesity Current Care Guideline implementation should be improved, so that all health professionals would know the content of the guideline and take advantage it in their work. The procedures of the obesity prevention and treatment must be developed, since they were not in line with the guideline and many professionals were not aware of the procedures of their own organization, like weight management groups. Professionals’ attitudes were mainly positive indicating high interest towards obesity prevention and treatment. Some professionals considered bringing up obesity topic into discussion not being natural, which indicates the need for education and communication about already existing materials. These could help the work of the professionals and lead to better support of the patients. When examining the results of this thesis, it is essential to keep in mind the option of biased results, because of the small number of answers – the results cannot be generalized to total health care of Finland. However, the results can be used in developing the Obesity Current Care Guideline work and adults’ obesity prevention and treatment in the health care. The topic should be studied more with advanced methods and with a representative sample.
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(2018)Background: Overweight and obesity are major global health concerns causing millions of annual deaths worldwide. Although there is much knowledge of preventing overweight and losing weight, these are proven to be extremely challenging in practice. The knowledge of differences in weight loss success between individuals is still incomplete. The association between psychological factors such as stress and eating behaviour aspects and weight is quite well known but the association between these psychological factors and successful weight loss is somewhat incomplete. Aim: The primary aim of this study was to examine the association between stress and psychological eating behaviour aspects (cognitive restraint, disinhibition and hunger) and weight loss results during an eight week low calorie diet among persons with an elevated type 2 diabetes risk. The secondary aim was to examine the association between the quality of food intake prior to weight loss, age, gender, body composition and BMI and weight loss results. Methods: This study was based on the internationsl PREVIEW study’s Finnish material and the PREVIEW study’s eight week low calorie diet phase. The participants (n=260) had an elevated type 2 diabetes risk. Perceived stress was assessed with the PSS and psychological eating behaviour with the TFEQ questionnaires. The quality of nutrient intake was assessed using four days food diaries (n=79). The nutrient intake was assessed with the Aivo Diet recording program (Aivo Finland Oy, Turku, Finland). Statistical analyses were performed with the IBM SPSS Statistics 24 program. The independent samples t-test was used analysing statistically significant differences between two groups. One-way analysis of variance was used examining differences between BMI classes. When examining several classified factors together two-way analysis of variance was used. Nutrient intakes prior to weight loss were assessed with the energy adjusted residual method. The association between variables and weight loss results were examined with Pearson and Spearman correlation coefficients. Results: Cognitive restraint was negatively associated with lost weight (p<0,001). Baseline BMI and waist circumference was positively associated with lost weight (p<0,001). Age was negatively associated with lost weight (p=0,047) and fat percentage was negatively associated with weight loss percentage (p<0,001). There were no association between the other psychological or physiological factors and weight loss. Nutrient intake prior to weight loss was not associated with lost weight or weight loss percentage. Energy intake prior to weight loss was positively associated with lost weight (p=0,003). Conclusions: The results of this study do not explain the great variation in lost weight during the eight week low calorie diet. Individual differences in realisation of the diet may be a fundamental explanation to the variation. Differences in personal biological factors such as genetics and gut microbiota might also explain the variations. In order to make more distinct conclusions concerning the association between stress and psychological eating behaviours, physiological factors and nutrient intake prior to weight loss and weight loss during low calorie diets requires more research.
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(2016)BACKGROUND Obesity has increased all over the world and also in Finland, which is causing nationwide health problems. Two out of three Finnish men and half of the women are overweight and every fifth Finn is obese. People face nowadays numerous food choice decisions daily. In order to be able to understand, which attitudinal factors may be risk factors for obesity, more information is needed about how people make food choices and whether body weight is associated with the importance of food choice motives. The area of weight, dieting and food choice motives hasn’t been researched much in the Finnish population before. OBJECTIVES The objective of this thesis was to study, whether there are differences in the importance of food choice motives among 25−64 years old Finns according to their body weight or dieting status. In addition, the prevalence of the factors related to weight and dieting in this population was also discussed. MATERIALS AND METHODS The data examined in this study was collected in FINRISKI 2012 -population study conducted in five different areas in Finland. The target group of this study were Finnish adults aged 25-64 years who filled in the questionnaires and attended the physical examination (n=4447). There were 2059 men and 2388 women. From the basic questionnaire was examined the socio-demographic factors, meal frequency, weight history and weight perception. From the follow-up questionnaire the data on dieting history, dieting status and food choice motives was utilized. From food choice motives only the most relevant motives regarding weight and weight control were examined. Methods used were cross-tabulation, linear regression and chi square -test (χ2-test). RESULTS AND CONCLUSION There were no major differences between different BMI groups for women or for men regarding which food choice motives the respondents rated important. Anyhow, some differences were detected regarding the favouring of low-fat foods and emotional eating. Overweight and obese respondents rated these food choice motives more important than normal weight respondents. Also those who had dieted more often, current dieters and those who perceived themselves as overweight also considered low-fat foods and emotional eating important. Finnish adults with different body weights considered most of the food choice motives equally important for the most part and thus weight is not associated with the perceived importance of food choice motives. The explanation for the lack of differences between body weight groups could be that overweight and obese people are overly conscious about their weight status. Also women considered the food choice motives more important than men, which might be explained by the more active role in food shopping and better knowledge about healthy food. Based on the results of this study, both the normal and over weight people as well as the obese have knowledge about healthy food choices and consider that knowledge as an important factor in the food choice situations. The perceived importance of emotional eating varies between weight groups, and that’s why the psychological factors relating to weight control and food choice should be taken into account in weight control groups and obesity interventions in order to prevent emotional eating.
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(2016)Tutkimuksissa on saatu näyttöä suolistomikrobiston eroavuuksien yhteydestä lisääntyneeseen riskiin sairastua lihavuuteen yhdistettyihin metabolisiin häiriöihin. Ruokavaliolla on suuri merkitys suolistomikrobiston eroavuuksiin, mikä lisää sen merkitystä aineenvaihduntasairauksien ennaltaehkäisyssä. Suoliston bakteereihin ja niiden tuottamiin metaboliitteihin on osoitettu voitavan vaikuttaa myös probiooteilla ja prebiooteilla. Tämä voi tarjota uusia mahdollisuuksia myös elimistön aineenvaihdunnan säätelyyn. Pro gradu -tutkielman tavoitteena oli tutkia onko puolen vuoden prebiootin, probiootin tai synbiootin (prebiootti + probiootti) käytöllä vaikutusta tulehdusmarkkereihin ylipainoisilla ja lihavilla, ja onko ravintoaineiden saannilla ja prebiootti- tai probioottikäsittelyllä yhdysvaikutusta. Myös intervention vaikutusta tutkittavien ravintoaineiden saantiin selvitettiin. Lisäksi tutkittiin ravintoaineiden saannin ja painoindeksin yhteyttä matala-asteisen tulehduksen merkkiaineisiin sekä keskivartalorasvan määrään ylipainoisilla ja lihavilla. Tutkimuksessa käytettiin DuPont Nutrition and Health:in rahoittaman MetSProb-interventiotutkimuksen aineistoa. Tutkittavat (n=225) oli randomisoitu neljään ravintolisää syövään ryhmään: prebiootti-, probiootti-, synbiootti- ja plaseboryhmä. Prebioottina tutkimuksessa oli polydekstoosi, probioottina Bifidobacterium animalis ssp. lactis 420 ja plaseboryhmä sai mikrokiteistä selluloosaa. Ravintolisäjauhe nautittiin kerran päivässä tutkimuksessa saadun hedelmä- tai marjasmoothien kanssa. Tutkittavat olivat terveitä keski-iältään 49-vuotiaita koehenkilöitä, joista naisia oli 80 %. Tutkittavien BMI oli rekrytoitaessa välillä 28,0‒34,9 kg/m² ja vyötärö-lantiosuhde miehillä ≥0,88 ja naisilla ≥0,83. Ruoankäyttö selvitettiin intervention alussa ja lopussa viiden vuorokauden ruokapäiväkirjojen avulla. Tulehdusta kuvaavat markkerit olivat plasmasta mitattu herkkä CRP (hs-CRP), interleukiini 6 (IL-6) sekä lipopolysakkaridi (LPS). Näiden lisäksi vastemuuttujana oli DXA:lla (Dual-energy X-ray Absorptiometry) määritetty keskivartalorasvan määrä. Intervention tulokset analysoitiin kahdelle tutkimuspopulaatiolle: ITT (Intention To Treat) ja PP (Per Protocol), joista PP (n=134) täytti tutkimukselle asetetut tiukat laatukriteerit. ITT:ssä (n=209) oli huomattavaa poikkeamaa mm. ravintolisän ja antibioottien käytön suhteen. Ravintoaineiden saantia ja BMI:n yhteyttä vastemuuttujiin tutkittiin lähtötilanteessa ITT-aineistossa. Tarkastelu tehtiin ravintoaineiden saannin mukaan jaetuissa tertiileissä ANOVA:lla tai Kruskal-Wallis -testillä. Lisäksi tutkittiin logistisella regressioanalyysillä, lisääkö BMI tai joidenkin ravintoaineiden saanti kohonneen keskivartalonrasvan määrän tai tulehdusmerkkiaineiden riskiä. Intervention vaikutusta muuttujiin tutkittiin ANOVA:lla, Tukeyn parivertailulla, ANCOVA:lla ja Kruskal-Wallis -testillä. Tutkimuksen tulos ruokavalion sakkaroosipitoisuuden yhteydestä hs-CRP:n pitoisuuteen on samansuuntainen aikaisempien tutkimustuloksien kanssa, joissa sakkaroosin saanti on yhdistetty matala-asteiseen tulehdukseen. Kokonaisuutena ravintomuuttujilla ja BMI:llä saavutettu selitysaste jäi pieneksi logistisissa regressioanalyyseissä, ja ANOVA:n tuloksissa keskihajonta oli melko suurta. Interventiossa puolen vuoden prebiootin, probiootin tai synbiootin käyttö ei saanut aikaan merkitseviä muutoksia hs-CRP:n ja IL-6:n pitoisuuksissa verrattuna plaseboryhmään. Interventiossa havaittu merkitsevä ero keskivartalorasvan määrän muutoksessa plasebo- ja synbioottiryhmän välillä viittaa siihen, että synbiootin käyttö saattaa suojata keskivartalorasvan kertymiseltä. Probioottiryhmän muita pienempi koko todennäköisesti vaikutti siihen, ettei tulos ollut ryhmässä merkitsevä. Tutkimuksen tilastollinen voima jäi heikoksi; vaikka rasvan määrän muutos ryhmissä oli suurempaa kuin voimalaskelmaan arvioitiin, myös keskihajonta oli huomattavasti arvioitua suurempaa. Tutkimuksen tulos on kuitenkin samansuuntainen kuin aikaisempien eläinkokeiden tulokset, joissa suolistomikrobistoa muokkaavilla ainesosilla on pystytty vähentämään rasvamassaa ylipainoisilla ja lihavilla eläimillä.
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