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Weight change in the first 2 months of a lifestyle intervention predicts weight changes 8 years later.

ABSTRACT: OBJECTIVE:Examine the relationship between 1- and 2-month weight loss (WL) and 8-year WL among participants enrolled in a lifestyle intervention. METHODS:2,290 Look AHEAD participants (BMI: 35.65?±?5.93 kg/m(2) ) with type 2 diabetes received an intensive behavioral WL intervention. RESULTS:1- and 2-month WL were associated with yearly WL through Year 8 (P's?4% had 1.62 (95% CI: 1.32, 1.98) and 2.79 (95% CI: 2.21, 3.52) times higher odds of achieving ?5% WL at Year 4 and 1.28 (95% CI: 1.05,1.58) and 1.77 (95% CI: 1.40, 2.24) times higher odds of achieving ?5% WL at Year 8, compared to those losing <2% initially. At Month 2, 3-6% WL resulted in greater odds of achieving ?5% WL at Year 4 (OR?=?1.85; CI: 1.48, 2.32), and >6% WL resulted in the greatest odds of achieving ?5% WL at Year 4 (OR?=?3.85; CI: 3.05, 4.88) and Year 8 (OR?=?2.28; CI: 1.81, 2.89), compared to those losing <3%. Differences in adherence between WL categories were observed as early as Month 2. CONCLUSIONS:1- and 2-month WL was associated with 8-year WL. Future studies should examine whether alternative treatment strategies can be employed to improve treatment outcomes among those with low initial WL.

SUBMITTER: Unick JL

PROVIDER: S-EPMC4481874 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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Weight change in the first 2 months of a lifestyle intervention predicts weight changes 8 years later.

Unick Jessica L JL Neiberg Rebecca H RH Hogan Patricia E PE Cheskin Lawrence J LJ Dutton Gareth R GR Jeffery Robert R Nelson Julie A JA Pi-Sunyer Xavier X West Delia Smith DS Wing Rena R RR

Obesity (Silver Spring, Md.) 20150701 7

<h4>Objective</h4>Examine the relationship between 1- and 2-month weight loss (WL) and 8-year WL among participants enrolled in a lifestyle intervention.<h4>Methods</h4>2,290 Look AHEAD participants (BMI: 35.65 ± 5.93 kg/m(2) ) with type 2 diabetes received an intensive behavioral WL intervention.<h4>Results</h4>1- and 2-month WL were associated with yearly WL through Year 8 (P's < 0.0001). At Month 1, participants losing 2-4% and >4% had 1.62 (95% CI: 1.32, 1.98) and 2.79 (95% CI: 2.21, 3.52) t ...[more]

PMID: 26110890

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Project description:Excessive gestational weight gain (GWG) is associated with elevated weight retention in mothers and might be related to adiposity of their offspring. Little is known if lifestyle intervention during pregnancy has beneficial effects for mothers and children beyond gestation.A cluster-randomized controlled intervention trial was performed with 250 pregnant women in 8 gynaecological practices. Lifestyle intervention was carried out twice with individual counselling sessions on nutrition, physical activity and weight monitoring. Participants in the control group received routine prenatal care and an information leaflet. Follow-up data of women and their offspring were collected one year postpartum (pp) by phone call and/or via e-mail using a structured questionnaire. Maternal weight retention at 12 months pp and weight development of the children in their first year of life was compared between groups using linear regression. The association between energy and macronutrient intake during pregnancy with maternal weight retention and children weight development was also assessed.The intervention resulted in a trend towards lower mean weight retention 12 months pp (0.2 vs. 0.8 kg), but was not statistically significant (p = 0.321). Among women receiving lifestyle counselling, only 8% retained more than 5 kg weight while 17% in the control group retained >5 kg (OR: 0.40 (95% CI: 0.16, 0.97)). For the whole study cohort, an association between higher GWG and increased 12 month weight retention was found (0.4 kg weight retention per 1 kg increase in GWG, p < 0.001). Weight development of the infants did not differ between groups in the first months after birth. At the 10th-12th month weight measurement, infants born to mothers in the intervention group tended towards lower body weights. Both energy intake and macronutrient composition of the diet during pregnancy did not affect maternal weight retention and weight development of the infants.Lifestyle counselling during pregnancy to avoid GWG had a rather modest effect on maternal pp weight retention and weight development of the infants. However, larger intervention studies and longer follow-up are required to be able to draw definite conclusions.German Clinical Trials Register DRKS00003801.

Project description:ObjectiveTo examine the associations of a clinical and public health systems-change intervention on the prevalence of excess gestational weight gain among high-risk, low-income women.MethodsIn a quasi-experimental trial, we compared the prevalence of excess gestational weight gain among women before (n=643) and after (n=928) implementation of the First 1,000 Days program in two community health centers in Massachusetts. First 1,000 Days is a systematic program starting in early pregnancy and lasting through the first 24 months of childhood to prevent obesity among mother-child pairs. The program includes enhanced gestational weight gain tracking and counseling, screening for adverse health behaviors and sociocontextual factors, patient navigation and educational materials to support behavior change and social needs, and individualized health coaching for women at high risk for excess gestational weight gain based on their prepregnancy body mass index (BMI) or excess first-trimester weight gain. The primary outcome was gestational weight gain greater than the 2009 Institute of Medicine (now known as the National Academy of Medicine) guidelines according to prepregnancy BMI.ResultsAmong 1,571 women in the analytic sample, mean (SD) age was 30.0 (5.9) years and prepregnancy BMI was 28.1 (6.1); 65.8% of women started pregnancy with BMIs of 25 or higher, and 53.2% were Hispanic. We observed a lower prevalence (55.8-46.4%; unadjusted odds ratio [OR] 0.69, 95% CI 0.49-0.97), similar to results in a multivariable analysis (adjusted OR 0.69, 95% CI 0.49-0.99), of excess gestational weight gain among women with prepregnancy BMIs between 25 and 29.9. Among women who were overweight at the start of pregnancy, the lowest odds of excess gestational weight gain were observed among those with the most interaction with the program's components. Program enrollment was not associated with reduced excess gestational weight gain among women with prepregnancy BMIs of 30 or higher.ConclusionsImplementation of a systems-change intervention was associated with modest reduction in excess gestational weight gain among women who were overweight but not obese at the start of pregnancy.Clinical trial registrationClinicalTrials.gov, NCT03191591.

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Weight change in the first 2 months of a lifestyle intervention predicts weight changes 8 years later.

Publications

Weight change in the first 2 months of a lifestyle intervention predicts weight changes 8 years later.

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