Browsing by Subject "lifestyle modification"

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    Patient and Partner Strategies for Talking about Lifestyle Change Following a Cardiac Event
    (2011-11) Goldsmith, Daena J.; Bute, Jennifer J.; Lindholm, Kristin A.
    Heart patients are frequently advised to make lifestyle changes and communication with a romantic partner can help or hinder adoption of heart healthy behaviors. However, talking about lifestyle change can have both positive and negative meanings and this can create dilemmas for couples. We engaged in an interpretive analysis of interviews with 25 patients and 16 partners to identify the ways they managed the meanings of lifestyle change talk. Their communicative strategies included rationing talk, saying it nicely and framing it cooperatively. Each strategy had advantages and disadvantages as well as optimal conditions. We also identified interpretive lenses that shaped the meaning of talk, including legitimacy, patience, emphasizing the positive, moderation, benefits for both people, and perceived compliance. Finally, environmental resources (such as household patterns and communication with the social network) contextualized the meaning of talk. We proposed a model of the interrelated influence of communication, interpretation, and environment on the meanings of talking about lifestyle change.
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    Sex Differences in Diabetes Risk and the Effect of Intensive Lifestyle Modification in the Diabetes Prevention Program
    (2008-07) Perreault, Leigh; Ma, Yong; Dagogo-Jack, Sam; Horton, Edward; Marrero, David G.; Crandall, Jill; Barrett-Connor, Elizabeth
    OBJECTIVE—In participants of the Diabetes Prevention Program (DPP) randomized to intensive lifestyle modification (ILS), meeting ILS goals strongly correlated with prevention of diabetes in the group as a whole. Men met significantly more ILS goals than women but had a similar incidence of diabetes. Therefore, we explored sex differences in risk factors for diabetes and the effect of ILS on risk factors. RESEARCH DESIGN AND METHODS—Baseline risk factors for diabetes and percent change in risk factors over the first year in men versus women were compared using Wilcoxon's rank-sum tests. RESULTS—At baseline, men were older and had a larger waist circumference; higher fasting plasma glucose concentration, caloric intake, and blood pressure; and lower HDL cholesterol and corrected insulin response than women, who were less physically active and had a higher BMI (P < 0.01 for all comparisons). Over the first year of the DPP, no sex difference in risk factors for diabetes was observed for those who lost <3% body weight. Weight loss of 3–7% body weight yielded greater decreases in 2-h glucose (P < 0.01), insulin concentration (P < 0.04), and insulin resistance (P < 0.03) in men than in women. Weight loss of >7% body weight resulted in greater decreases in 2-h glucose (P < 0.01), triglyceride level (P < 0.01), and A1C (P < 0.03) in men than in women. CONCLUSIONS—Weight loss >3% body weight yielded greater reduction in risk factors for diabetes in men than in women. Despite the more favorable effects of ILS in men, baseline risk factors were more numerous in men and likely obscured any sex difference in incident diabetes.