Dataset Information

Objectively Assessed Physical Activity and Weight Loss Maintenance among Individuals Enrolled in a Lifestyle Intervention.

ABSTRACT:

Objective

To examine the relationship between objectively assessed moderate-to-vigorous intensity physical activity (MVPA) and 4-year weight loss (WL) and WL maintenance among individuals with diabetes enrolled in the Look AHEAD trial.

Methods

MVPA was measured in a subgroup of lifestyle intervention participants with accelerometry data at baseline and at 1 and 4 years (n = 553; age: 59.7 ± 6.8 y; BMI: 35.5 ± 5.9 kg/m² ). Minutes per week of bout-related MVPA were calculated (≥ 3 metabolic equivalents, ≥ 10-min bouts), and adherence to the national physical activity (PA) recommendation for WL maintenance (≥ 250 min/wk) was assessed.

Results

Independent of 1-year WL, 4-year MVPA (β = -0.003, SE = 0.002, P = 0.006), but not 1-year MVPA (β = 0.0001, SE = 0.001, P = 0.50), was significantly associated with 4-year WL. Compared with "nonmaintainers" (≥ 10% WL at year 1, but < 10% at year 4; n = 132), WL maintainers (≥ 10% WL at years 1 and 4; n = 103) had higher MVPA at year 1 (253.4 ± 251.8 vs. 163.9 ± 158.2 min/wk, P = 0.002) and year 4 (155.3 ± 180.6 vs. 111.4 ± 154.5 min/wk, P = 0.046). Although 38.8% and 22.3% of WL maintainers engaged in ≥ 250 min/wk at years 1 and 4, respectively, many engaged in < 150 min/wk (year 1: 41%, year 4: 61%).

Conclusions

Higher weekly MVPA is associated with greater long-term WL and weight maintenance; however, many individuals are able to maintain ≥ 10% WL while engaging in little MVPA.

SUBMITTER: Unick JL

PROVIDER: S-EPMC5695666 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Publications

Objectively Assessed Physical Activity and Weight Loss Maintenance among Individuals Enrolled in a Lifestyle Intervention.

Unick Jessica L JL Gaussoin Sarah A SA Hill James O JO Jakicic John M JM Bond Dale S DS Hellgren Margareta M Johnson Karen C KC Peters Anne L AL Coday Mace M Kitzman Dalane W DW Bossart Suzette S Wing Rena R RR

Obesity (Silver Spring, Md.) 20170920 11

<h4>Objective</h4>To examine the relationship between objectively assessed moderate-to-vigorous intensity physical activity (MVPA) and 4-year weight loss (WL) and WL maintenance among individuals with diabetes enrolled in the Look AHEAD trial.<h4>Methods</h4>MVPA was measured in a subgroup of lifestyle intervention participants with accelerometry data at baseline and at 1 and 4 years (n = 553; age: 59.7 ± 6.8 y; BMI: 35.5 ± 5.9 kg/m<sup>2</sup> ). Minutes per week of bout-related MVPA were calcu ...[more]

PMID: 28940967

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Project description:BACKGROUND:Reductions in physical activity (PA) are common throughout young adulthood and low PA is associated with weight gain. The SNAP Trial previously reported that two self-regulation approaches to weight gain prevention reduced weight gain over a 2-year period in 18-35 year olds. Presented here are secondary analyses examining changes in PA and the relationship between PA and weight change over 2 years. METHODS:599 young adults (age: 27.4 ± 4.4 yrs.; BMI: 25.4 ± 2.6 kg/m2) were randomly assigned to 1 of 3 treatment arms: Small Changes (reduce calorie intake by 100 kcals/day & add 2000 steps/day), Large Changes (lose 2.3-4.5 kg initially & increase PA to ≥250 min/wk), or Self-guided (control condition). Small and Large Changes received 10, face-to-face group sessions (months 1-4), and two 4-week refresher courses each subsequent year. Body weight and PA were objectively-measured at baseline, 4 months, 1 and 2 years. Daily steps and bout-related moderate-to-vigorous intensity PA (MVPA: ≥3 METs, ≥10-min bouts) was calculated. RESULTS:Changes in bout-related MVPA and daily steps did not differ among treatment groups over the 2-year period (p's > 0.16). Collapsed across groups, participants gaining >1 lb. (n = 187; 39.6%) had smaller changes in bout-related MVPA at 4 months, 1 and 2 years relative to those maintaining or losing weight (≤1 lb. weight gain; n = 282, 60.4%, p's < 0.05). Averaged across time points, this difference equated to 47.8 min/week. Those gaining and not gaining >1 lb. did not differ on daily steps (p's > 0.10). Among participants engaging in ≥250 min/wk. of MVPA at 2 years (n = 181), 30% gained >1 lb. from baseline to 2 years, which was not different from those engaging in 150-250 min/wk. (n = 87; 36%; p = 0.40), but this percentage was significantly lower when compared to those engaging in <150 min/wk. (n = 176; 49%; p < 0.001). CONCLUSIONS:On average, PA differences were not observed between young adults assigned to small or large changes self-regulation interventions to prevent weight gain. Regardless of group assignment, higher levels of MVPA were associated with better weight gain prevention over 2 years. Our data suggest that achieving >150 min/week of MVPA is needed for weight gain prevention and that increasing MVPA, rather than steps, should be targeted. TRIAL REGISTRATION:www.clinicaltrials.gov (NCT01183689). Registered Aug 13, 2010.

Project description:ObjectivesThe STRIDE study assessed whether a lifestyle intervention, tailored for individuals with serious mental illnesses, reduced weight and diabetes risk. The authors hypothesized that the STRIDE intervention would be more effective than usual care in reducing weight and improving glucose metabolism.MethodThe study design was a multisite, parallel two-arm randomized controlled trial in community settings and an integrated health plan. Participants who met inclusion criteria were ≥18 years old, were taking antipsychotic agents for ≥30 days, and had a body mass index ≥27. Exclusions were significant cognitive impairment, pregnancy/breastfeeding, recent psychiatric hospitalization, bariatric surgery, cancer, heart attack, or stroke. The intervention emphasized moderate caloric reduction, the DASH (Dietary Approaches to Stop Hypertension) diet, and physical activity. Blinded staff collected data at baseline, 6 months, and 12 months.ResultsParticipants (men, N=56; women, N=144; mean age=47.2 years [SD=10.6]) were randomly assigned to usual care (N=96) or a 6-month weekly group intervention plus six monthly maintenance sessions (N=104). A total of 181 participants (90.5%) completed 6-month assessments, and 170 (85%) completed 12-month assessments, without differential attrition. Participants attended 14.5 of 24 sessions over 6 months. Intent-to-treat analyses revealed that intervention participants lost 4.4 kg more than control participants from baseline to 6 months (95% CI=-6.96 kg to -1.78 kg) and 2.6 kg more than control participants from baseline to 12 months (95% CI=-5.14 kg to -0.07 kg). At 12 months, fasting glucose levels in the control group had increased from 106.0 mg/dL to 109.5 mg/dL and decreased in the intervention group from 106.3 mg/dL to 100.4 mg/dL. No serious adverse events were study-related; medical hospitalizations were reduced in the intervention group (6.7%) compared with the control group (18.8%).ConclusionsIndividuals taking antipsychotic medications can lose weight and improve fasting glucose levels. Increasing reach of the intervention is an important future step.

Project description:Introduction: Due to the increasing prevalence of obesity, approaches for a more effective treatment especially in the long-term perspective are needed. However, studies on weight loss and maintenance show heterogeneous results with large inter-individual variations. Therefore, it is of interest to identify factors that contribute to inter-individual differences and predict the success of long-term weight management. Methods and Analysis: The primary outcome of the Lifestyle Intervention (LION) Study is to evaluate the effect of two diets (low carb vs. low fat) and two digital counseling tools (newsletter vs. mobile application) on weight maintenance 12 months after weight loss. The identification of predictive factors (e.g., genetic, epigenetic, physiological, psychological) for the success of weight loss and maintenance is a secondary outcome. Men and women with a body mass index (BMI) between 30.0 and 39.9 kg/m2, aged 18-65 years, and without severe diseases are considered eligible. After phenotyping (e.g., anthropometry, resting metabolic rate, meal challenges, blood parameters) participants will follow a formula-based, low-calorie diet (LCD) for 8 weeks. In addition, the intake of 200 g raw or cooked non-starchy vegetables are allowed per day. Subsequently, 252 participants will be randomized into one of the four intervention groups (low carb/app, low carb/newsletter, low fat/app, low fat/newsletter) for the 12-month weight maintenance step. The study will be concluded after another 12 months of follow-up. Results should provide indications for successful weight management and give insights into the personalized treatment of obesity. Ethics and Dissemination: This study has been granted ethical approval by the local Ethics Review Committee of the School of Medicine, Technical University of Munich (vote: 69/19 S). Trial Registration Number: This study has been registered within ClinicalTrials.gov (NCT04023942) and the German Clinical Trials Register (DRKS00017819).

Project description:BackgroundIndividuals diagnosed with serious mental illnesses are at increased risk of obesity- and cardiovascular-related morbidity and early mortality. Lifestyle interventions aimed at weight loss, even those adapted to suit the needs of this particular subgroup, have rarely produced clinically meaningful reductions in weight.Methods/designThe STRIDE study is a multi-site, parallel, two-arm randomized controlled translational trial. Participants were recruited from community mental health clinics and an integrated not-for-profit health system. Participants were randomized either to usual care or to a 12-month intervention that consisted of: 1) weekly group participation for six months covering topics on nutrition, physical activity and lifestyle changes; 2) monthly group participation for an additional six month maintenance period; and 3) individual monthly contacts from intervention group facilitators during the second six month phase. All participants are assessed at baseline, 6, 12, and 24 months post-enrollment. Process and implementation evaluations are included and the study design includes a cost-utility analysis. Participants include 200 individuals with serious mental illness with an average age of 47.1 years, a mean body-mass index of 38.3 kg/m(2) and taking an average of 3.2 psychiatric medications at baseline. Baseline physiological measures included mean blood pressure (SBP/DBP) measurements of 119.2 (SD = 14.7)/79.4 (SD = 10.1); 35% reported a hypertension diagnosis and 11% took antihypertensive medications. Average lipid levels (mg/dL) were: a) triglycerides 188.0 (SD = 138.6), ranged from 43 to 1145; b) LDL 101.4 (SD = 32.9) and ranged from 17 to 185; c) HDL 45.8 (SD = 12.7) and ranged from 22 to 89; and d) total cholesterol 181.6 (SD = 39.7) and ranged from 50 to 324. Average fasting glucose levels were 108.9 (SD = 32.5) and ranged from 24 to 289. Average fasting insulin levels were 13.0 (SD=11.9) and ranged from 2 to 99.DiscussionThe STRIDE study is based on a modified version of the PREMIER comprehensive lifestyle intervention, DASH diet arm. STRIDE has successfully enrolled 200 individuals with serious mental illness in community-based settings. Baseline characteristics present a population at high risk for obesity-related negative health outcomes and demonstrate the need for evidence-based interventions to reduce these risks.Trial registrationClinical Trials.gov NCT00790517.

Dataset Information

Objectively Assessed Physical Activity and Weight Loss Maintenance among Individuals Enrolled in a Lifestyle Intervention.

Objective

Methods

Results

Conclusions

Publications

Objectively Assessed Physical Activity and Weight Loss Maintenance among Individuals Enrolled in a Lifestyle Intervention.

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