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Steps ahead: a randomized trial to reduce unhealthy weight gain in the Lower Mississippi Delta.

ABSTRACT: The Lower Mississippi Delta (LMD) region of the United States is characterized by high levels of obesity and physical inactivity. The objective was to test the effectiveness of adapting the 2010 Dietary Guidelines for Americans (DG), with and without a physical activity (PA) component, for attenuating weight gain.Overall, 121 white and African-American adults (35-64 years; body mass index 25-34.9 kg/m(2)) were randomized to a DG only group (n = 61) or a DG + PA group (n = 60). Both groups received a 12-week dietary education and behavior change intervention. The DG + PA group also received PA education and a pedometer. Changes in weight (kg), %weight, and waist circumference (WC; cm) were determined. Analyses considered all completers (n = 99) and those who engaged with ?80% of the intervention (n = 83). General linear models compared mean changes between groups after adjustment for baseline values, race, and sex.Weight, %weight, and WC significantly decreased from baseline to follow-up in both groups (p < 0.05; unadjusted values). Adjusted analysis showed a main effect of group for weight (p = 0.041) and %weight (p = 0.047) in the completers analysis, and WC (p = 0.046) in the ?80% attendance analysis, with the DG + PA group improving weight-related outcomes more.Low-burden behavioral interventions could be effective strategies in attenuating unhealthy weight gain in the LMD.

SUBMITTER: Harrington DM

PROVIDER: S-EPMC4008693 | biostudies-literature | 2014 May

REPOSITORIES: biostudies-literature

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Steps ahead: a randomized trial to reduce unhealthy weight gain in the Lower Mississippi Delta.

Harrington Deirdre M DM Champagne Catherine M CM Broyles Stephanie T ST Johnson William D WD Tudor-Locke Catrine C Katzmarzyk Peter T PT

Obesity (Silver Spring, Md.) 20140125 5

<h4>Objective</h4>The Lower Mississippi Delta (LMD) region of the United States is characterized by high levels of obesity and physical inactivity. The objective was to test the effectiveness of adapting the 2010 Dietary Guidelines for Americans (DG), with and without a physical activity (PA) component, for attenuating weight gain.<h4>Methods</h4>Overall, 121 white and African-American adults (35-64 years; body mass index 25-34.9 kg/m(2)) were randomized to a DG only group (n = 61) or a DG + PA ...[more]

PMID: 24376252

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Project description:BACKGROUND:Weight gain is common for people with schizophrenia and this has serious implications for health and well being. OBJECTIVES:To determine the effects of both pharmacological (excluding medication switching) and non pharmacological strategies for reducing or preventing weight gain in people with schizophrenia. SEARCH STRATEGY:We searched key databases and the Cochrane Schizophrenia Group's trials register (April 2006), reference sections within relevant papers, hand searched key journals, and contacted the first author of each relevant study and other experts to collect further information. SELECTION CRITERIA:We included all clinical randomised controlled trials comparing any pharmacological or non pharmacological intervention for weight gain (diet and exercise counselling) with standard care or other treatments for people with schizophrenia or schizophrenia-like illnesses. DATA COLLECTION AND ANALYSIS:We reliably selected, quality assessed and extracted data from studies. As weight is a continuous outcome measurement, weighted mean differences (WMD) of the change from baseline were calculated. The primary outcome measure was weight loss. MAIN RESULTS:Twenty-three randomised controlled trials met the inclusion criteria for this review. Five trials assessed a cognitive/behavioural intervention and eighteen assessed a pharmacological adjunct. In terms of prevention, two cognitive/behavioural trials showed significant treatment effect (mean weight change) at end of treatment (n=104, 2 RCTs, WMD -3.38 kg CI -4.2 to -2.0). Pharmacological adjunct treatments were significant with a modest prevention of weight gain (n=274, 6 RCTs, WMD - 1.16 kg CI -1.9 to -0.4). In terms of treatments for weight loss, we found significantly greater weight reduction in the cognitive behavioural intervention group (n=129, 3 RCTs, WMD -1.69 kg CI -2.8 to -0.6) compared with standard care. AUTHORS' CONCLUSIONS:Modest weight loss can be achieved with selective pharmacological and non pharmacological interventions. However, interpretation is limited by the small number of studies, small sample size, short study duration and by variability of the interventions themselves, their intensity and duration. Future studies adequately powered, with longer treatment duration and rigorous methodology will be needed in further evaluating the efficacy and safety of weight loss interventions for moderating weight gain. At this stage, there is insufficient evidence to support the general use of pharmacological interventions for weight management in people with schizophrenia.

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Steps ahead: a randomized trial to reduce unhealthy weight gain in the Lower Mississippi Delta.

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Steps ahead: a randomized trial to reduce unhealthy weight gain in the Lower Mississippi Delta.

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