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Randomized Control Trial for Reduction of Body Weight, Body Fat Patterning, and Cardiometabolic Risk Factors in Overweight Worksite Employees in Delhi, India.

ABSTRACT: Background:We studied the impact of the multicomponent interventions on body weight and cardiometabolic risk factors in overweight individuals working in corporate worksites. Methods:Overweight (BMI???23?kg/m2) subjects were recruited from four randomised worksites [two active intervention (n, recruited, 180, completed 156) and two control (n, recruited 130, completed 111)]. Intensive intervention was given at intervention worksite. Results:High prevalence (%) of obesity (90.9, 80.2), abdominal obesity (93.5, 84.3), excess skinfold thickness (70.3, 75.9), and low high-density lipoprotein cholesterol (HDL-c) levels (56.8, 63.7) were seen in the intervention and the control group, respectively. At the end of intervention, the following significant changes were observed in the intervention group: decrease in weight, BMI, waist circumference, serum triglycerides, and increase in HDL-c. Weight loss of more than 5% was seen in 12% and 4% individuals in the intervention and control groups, respectively. Most importantly, the sum of all the skinfold measurements (mm) in the intervention group decreased significantly more than the control group (12.51?±?10.38 versus 3.50?±?8.18, resp.). Conclusion:This multicomponent worksite trial showed a reduction in weight, excess subcutaneous fat, and cardiometabolic risk factors after 6 months of active intervention in overweight Asian Indians. Trial Registration:This trial is registered with NCT03249610.

SUBMITTER: Shrivastava U

PROVIDER: S-EPMC5727835 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Randomized Control Trial for Reduction of Body Weight, Body Fat Patterning, and Cardiometabolic Risk Factors in Overweight Worksite Employees in Delhi, India.

Shrivastava Usha U Fatma Mahrukh M Mohan Smriti S Singh Padam P Misra Anoop A

Journal of diabetes research 20171129

<h4>Background</h4>We studied the impact of the multicomponent interventions on body weight and cardiometabolic risk factors in overweight individuals working in corporate worksites.<h4>Methods</h4>Overweight (BMI ≥ 23 kg/m<sup>2</sup>) subjects were recruited from four randomised worksites [two active intervention (<i>n</i>, recruited, 180, completed 156) and two control (<i>n</i>, recruited 130, completed 111)]. Intensive intervention was given at intervention worksite.<h4>Results</h4>High pre ...[more]

PMID: 29318159

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Project description:Abstract Objectives We sought to understand the feasibility, acceptability, and sustainability of using peer educators to deliver a worksite-based lifestyle intervention program to reduce cardiometabolic risk in India. Methods INtegrating DIAbetes prevention in WORKplaceS (INDIA-WORKS, Clinicaltrial.gov #NCT02813668) is an implementation study to evaluate a lifestyle intervention program targeting employees with prediabetes or newly diagnosed diabetes in ten worksites in India. Peer educators were recruited at each worksite and trained to teach lifestyle classes. We conducted in-depth interviews with managers (n = 16), peer educators (n = 29), and implementation team members (n = 8) and focus group discussions with employees participating in the program (n = 13) to evaluate program delivery, including use of peer educators in this setting. Interviews and focus groups were conducted in-person, audio-recorded, and transcribed verbatim. Data were analyzed using thematic analysis. Results Peer educators’ involvement in teaching classes varied across worksites. This variation was related to differences in the training peer educators received, degree of management support provided, and peer educators’ levels of confidence to teach classes (e.g., discuss nutrition topics). Most peer educators liked their role, as it allowed them to learn about lifestyle change and benefit other employees (e.g., by encouraging them to be physically active), themselves (e.g., by losing weight), and their families (e.g., by preparing and serving healthier meals at home). Many employees participating in the program were satisfied with the peer educators, though some preferred “experts” such as implementation team members to lead classes. For program sustainability, there remains a need to increase peer educators’ capacity to teach classes and maintain their motivation. Conclusions Findings indicate that while it may be feasible for peer educators to deliver worksite-based lifestyle programs in India, it is critical to ensure that they have confidence and training, management support, and motivation to carry out their role. Research is needed to understand the type of training and support necessary to develop a cadre of effective peer educators and strategies for sustaining their engagement in the program. Funding Sources NIH R01HL125442 NIH D43TW009337.

Project description:The food environment has been implicated as an underlying contributor to the global obesity epidemic. However, few studies have evaluated the relationship between the food environment, dietary intake, and overweight/obesity in low- and middle-income countries (LMICs). The aim of this study was to assess the association of full service and fast food restaurant density with dietary intake and overweight/obesity in Delhi, India.Data are from a cross-sectional, population-based study conducted in Delhi. Using multilevel cluster random sampling, 5364 participants were selected from 134 census enumeration blocks (CEBs). Geographic information system data were available for 131 CEBs (n = 5264) from a field survey conducted using hand-held global positioning system devices. The number of full service and fast food restaurants within a 1-km buffer of CEBs was recorded by trained staff using ArcGIS software, and participants were assigned to tertiles of full service and fast food restaurant density based on their resident CEB. Height and weight were measured using standardized procedures and overweight/obesity was defined as a BMI ≥25 kg/m2.The most common full service and fast food restaurants were Indian savory restaurants (57.2%) and Indian sweet shops (25.8%). Only 14.1% of full service and fast food restaurants were Western style. After adjustment for age, household income, education, and tobacco and alcohol use, participants in the highest tertile of full service and fast food restaurant density were less likely to consume fruit and more likely to consume refined grains compared to participants in the lowest tertile (both p < 0.05). In unadjusted logistic regression models, participants in the highest versus lowest tertile of full service and fast food restaurant density were significantly more likely to be overweight/obese: odds ratio (95% confidence interval), 1.44 (1.24, 1.67). After adjustment for age, household income, and education, the effect was attenuated: 1.08 (0.92, 1.26). Results were consistent with further adjustment for tobacco and alcohol use, moderate physical activity, and owning a bicycle or motorized vehicle.Most full service and fast food restaurants were Indian, suggesting that the nutrition transition in this megacity may be better characterized by the large number of unhealthy Indian food outlets rather than the Western food outlets. Full service and fast food restaurant density in the residence area of adults in Delhi, India, was associated with poor dietary intake. It was also positively associated with overweight/obesity, but this was largely explained by socioeconomic status. Further research is needed exploring these associations prospectively and in other LMICs.

Dataset Information

Randomized Control Trial for Reduction of Body Weight, Body Fat Patterning, and Cardiometabolic Risk Factors in Overweight Worksite Employees in Delhi, India.

Publications

Randomized Control Trial for Reduction of Body Weight, Body Fat Patterning, and Cardiometabolic Risk Factors in Overweight Worksite Employees in Delhi, India.

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