Healthcare workers have played a crucial role in preventing and controlling the COVID-19 pandemic. However, the heightened risk of infection and intense work schedules have not only induced occupational burnout among them but also significantly impacted their mental health and lifestyles. A large number of foreign studies have shown that the COVID-19 pandemic has led to unreasonable diet, reduced exercise, irregular work and rest, and decreased sleep quality among HCWs, increasing the risk of overweight and obesity. Despite this, research on weight and lifestyle changes among Chinese healthcare workers during the pandemic is limited, and the key lifestyle factors contributing to these weight changes remain unclear.
To analyze the predictors of overweight and obesity in Chinese healthcare workers by constructing a Bayesian network model, and to provide a scientific basis for the prevention and control of overweight and obesity.
In August 2022, Chinese healthcare workers in 100 medical institutions from five provinces/autonomous regions/municipalities were randomly sampled, and the questionnaire (Cronbach's α=0.820, AVCR=63.55%) was prepared by the researchers to collect data. All respondents were required to scan QR code generated by the "Wenjuanxing" to answer the e-questionnaire and submit. The "bnlearn" package of R 4.3.0 software was used to construct a Bayesian network model, and Netica 6.09 software was used for Bayesian network risk prediction.
The study surveyed a total of 20 261 healthcare workers, of whom females accounted for 67.57% (13 690/20 261) ; The average age was (40.2±9.2) years old; 73.28% (14 848/20 261) had a college or undergraduate education level. In 2019 and 2022, the overweight/obesity rates were 43.06% (8 726/20 261) and 45.71% (9 262/20 261), respectively. From 2019 to 2022, 12.64% (1 458/11 535) of survey respondents' BMI changed from underweight/normal to overweight/obese. The Bayesian network model included a total of 15 nodes, and the amount of consumption of vegetables and fruits, breakfast frequency, alcohol drinking, and appetite were the parent nodes of BMI changing from underweight/normal to overweight/obesity, and when there were "a reduction" in the consumption of vegetables and fruits, "no change" in frequency of eating breakfast, alcohol drinking consumption "no change", and "a great increase" in the appetite the risk of BMI changing from underweight/normal to overweight/obese was the highest (75.00%). And when there were "a great increase" in consumption of vegetables and fruits, "an increase" in the frequency of eating breakfast, "never or rarely" in alcohol drinking and "a reduction" in appetite, the risk of becoming overweight/obese was the lowest (2.04%) .
Consumption of vegetables and fruits, eating breakfast frequently, drinking alcohol and appetite are the direct predictors of overweight/obesity of Chinese healthcare workers. During the epidemic of major infectious diseases such as the COVID-19, on the premise of ensuring the normal operation of medical and health institutions, a reasonable rotation system is implemented to provide psychological support and lifestyle behavior intervention services, which is conducive to the prevention and control of obesity of healthcare workers.
The 6-minute walk test (6MWT) is extensively used to assess the exercise capacity of obese populations and offers a reference for devising intervention measures. While reference equations for the 6MWT distance for various populations have been proposed internationally, there is a scarcity of studies on reference equations for the 6MWT distance among Chinese obese subjects aged 17 to 45 years with a BMI ≥ 30 kg/m2.
To develop reference equations for the 6MWT distance for outpatient obese subjects aged 17 to 45 years and to assess its influencing factors.
Following the American Thoracic Society guidelines, from June 2022 to September 2023, 143 adults aged 17 to 45 years with a BMI ≥30 kg/m2 (71 males and 72 females) who visitied the Department of Endocrinology, Northern Jiangsu People's Hospital, were prospectively selected for anthropometric measurements and the 6MWT. A stepwise multiple regression model was employed to establish reference equations for the 6MWT distance, and the newly developed equations were compared with existing prediction equations.
The average 6MWT distance for the 143 subjects was (506.1±49.8) m, with males averaging (515.7±50.14) m, which was greater than the females' average of (496.6±47.9) m (P<0.05). Across age groups 17-23, 24-30, 31-37, and 38-45 years, differences in 6MWT distances between males and females were statistically significant (P<0.05). In males, weight, BMI, HRmax, resting heart rate difference (ΔHR), waist circumference, diastolic blood pressure difference (ΔDBP), and Borg scale score difference (ΔBorg) were related to 6MWT distance (P<0.05), whereas in females, weight, BMI, and waist circumference were related to 6MWT distance (P<0.05). Incorporating potential influencing factors into a stepwise multiple linear regression equation, the final reference formulas were established as follows: for males, y=494.463+1.414×ΔHR-3.903×BMI+0.874×HRmax, R2=0.429; for females, y=670.448+0.299×ΔHR-4.342×BMI-0.195×HRmax, R2=0.312.
In outpatient obese patients aged 17 to 45 years, males had a longer average 6MWT distance than females, with significant differences across different age groups. Factors such as weight, BMI, HRmax, ΔHR, wait cirumference ΔDBP, and ΔBorg were associated with 6MWT distance in males, while weight, BMI, waist cirumference and ΔSBP were related to 6MWT distance in females. Through multiple linear regression analysis, reference equations predicting 6MWT distance were established for males and females, providing valuable references for assessing individual physical fitness levels.
Research has linked the physical constitution of overweight/obese individuals to obesity, with a potential bidirectional association. Although FATmax exercise can boost their fitness, the exact magnitude of this benefit needs further study.
Systematic evaluation is needed to assess the impact of FATmax exercise on physical fitness indicators among overweight or obese populations.
Retrieve RCTs from PubMed, Web of Science, EBSCO, CNKI, VIP, Wanfang Data (January 2001 to January 2024) on FATmax exercise effects on body composition, cardiovascular endurance, lipid metabolism in overweight/obese patients. Evaluate quality with Cochrane tool, Meta-analysis with RevMan 5.4.
A total of 16 randomized controlled trials were included, including 568 overweight or obese patients. The Meta-analysis results showed that compared with the control group, the FATmax exercise intervention group significantly improved body composition (BMI: WMD=-1.82, P<0.01; BFR: WMD=-2.86, P<0.01; WHR: WMD=-0.04, P<0.01), cardiovascular endurance (VO2max: WMD=3.34, P<0.01), and lipid metabolism except for TC (TG: WMD=-0.24, P<0.01; HDL-C: WMD=0.14, P<0.01; LDL-C: WMD=-0.27, P<0.01). Optimal results vary: ≥12 weeks, 3-5 times/week, 60-minute running for body composition; ≥12 weeks, 5 times/week, <60 minutes combined for VO2max; ≥12 weeks, 3 times/week, 60-minute running for TG; <12 weeks, 4 times/week, 60-minute combined for HDL-C; <12 weeks, 4 times/week, >60-minute combined for LDL-C.
FATmax exercise benefits body composition, cardiovascular endurance, and lipid metabolism (except TC) in overweight/obese patients.
