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Effectiveness of a brief behavioural intervention to prevent weight gain over the Christmas holiday period: randomised controlled trial.

ABSTRACT: OBJECTIVE:To test the effectiveness of a brief behavioural intervention to prevent weight gain over the Christmas holiday period. DESIGN:Two group, double blinded randomised controlled trial. SETTING:Recruitment from workplaces, social media platforms, and schools pre-Christmas 2016 and 2017 in Birmingham, UK. PARTICIPANTS:272 adults aged 18 years or more with a body mass index of 20 or more: 136 were randomised to a brief behavioural intervention and 136 to a leaflet on healthy living (comparator). Baseline assessments were conducted in November and December with follow-up assessments in January and February (4-8 weeks after baseline). INTERVENTIONS:The intervention aimed to increase restraint of eating and drinking through regular self weighing and recording of weight and reflection on weight trajectory; providing information on good weight management strategies over the Christmas period; and pictorial information on the physical activity calorie equivalent (PACE) of regularly consumed festive foods and drinks. The goal was to gain no more than 0.5 kg of baseline weight. The comparator group received a leaflet on healthy living. MAIN OUTCOME MEASURES:The primary outcome was weight at follow-up. The primary analysis compared weight at follow-up between the intervention and comparator arms, adjusting for baseline weight and the stratification variable of attendance at a commercial weight loss programme. Secondary outcomes (recorded at follow-up) were: weight gain of 0.5 kg or less, self reported frequency of self weighing (at least twice weekly versus less than twice weekly), percentage body fat, and cognitive restraint of eating, emotional eating, and uncontrolled eating. RESULTS:Mean weight change was -0.13 kg (95% confidence interval -0.4 to 0.15) in the intervention group and 0.37 kg (0.12 to 0.62) in the comparator group. The adjusted mean difference in weight (intervention-comparator) was -0.49 kg (95% confidence interval -0.85 to -0.13, P=0.008). The odds ratio for gaining no more than 0.5 kg was non-significant (1.22, 95% confidence interval 0.74 to 2.00, P=0.44). CONCLUSION:A brief behavioural intervention involving regular self weighing, weight management advice, and information about the amount of physical activity required to expend the calories in festive foods and drinks prevented weight gain over the Christmas holiday period. TRIAL REGISTRATION:ISRCTN Registry ISRCTN15071781.

SUBMITTER: Mason F

PROVIDER: S-EPMC6287121 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Effectiveness of a brief behavioural intervention to prevent weight gain over the Christmas holiday period: randomised controlled trial.

Mason Frances F Farley Amanda A Pallan Miranda M Sitch Alice A Easter Christina C Daley Amanda J AJ

BMJ (Clinical research ed.) 20181210

<h4>Objective</h4>To test the effectiveness of a brief behavioural intervention to prevent weight gain over the Christmas holiday period.<h4>Design</h4>Two group, double blinded randomised controlled trial.<h4>Setting</h4>Recruitment from workplaces, social media platforms, and schools pre-Christmas 2016 and 2017 in Birmingham, UK.<h4>Participants</h4>272 adults aged 18 years or more with a body mass index of 20 or more: 136 were randomised to a brief behavioural intervention and 136 to a leafle ...[more]

PMID: 30530821

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Project description:BACKGROUND/OBJECTIVES:The winter holiday season in the United States, which spans mid-November to mid-January, contributes to over half of annual body weight gain. Although self-reported data have linked this weight change to both increased energy intake and reduced physical activity, objective techniques have never been used; and thus, the actual cause of holiday weight gain is controversial. Here, we aimed to determine changes in components of energy balance leading to the holiday weight gain. METHODS:Body weight change was compared between the pre-holiday (mid-September to mid-November) and the holiday period (mid-November to early January). Total energy expenditure (TEE) was measured using doubly labeled water during holiday time (early to mid-December). Subjective (ratings) and physiological (appetite-regulating hormones) measures of appetite, eating-away-from-home frequency, and incentive salience of food pictures were also evaluated. RESULTS:In 23 obese adults (87% female), body weight change during the holidays (0.41?±?0.42?kg) was significantly higher (P?=?0.02) than the body weight change during the pre-holiday period (-0.86?±?0.42?kg). TEE was unchanged during the two periods, suggesting no role of energy expenditure on weight gain. However, participants reported lower satisfaction after a meal pre-load which was significantly correlated with increased body weight during the holiday period. An increase in number of episodes of eating at sit-down restaurants was also reported during that period. Overall, these changing behaviors were supported by a non-significant increase in energy intake (+80?kcal/day, P?=?0.07) observed during the study holiday period. CONCLUSION:We conclude that a decrease in energy expenditure does not result in the weight increase, but that increase in food intake is the more likely cause. Our data imply that compromised internal satiety mechanisms in presence of external food cues and diet-related behavioral variables during the holidays may influence weight gain.

Project description:ObjectivesTo assess the effectiveness of a brief behavioural intervention based on routine antenatal weighing to prevent excessive gestational weight gain (defined by US Institute of Medicine).DesignRandomised controlled trial.SettingAntenatal clinic in England.ParticipantsWomen between 10+0 and 14+6 weeks gestation, not requiring specialist obstetric care.InterventionsParticipants were randomised to usual antenatal care or usual care (UC) plus the intervention. The intervention involved community midwives weighing women at antenatal appointments, setting maximum weight gain limits between appointments and providing brief feedback. Women were encouraged to monitor and record their own weight weekly to assess their progress against the maximum limits set by their midwife. The comparator was usual maternity care.Primary and secondary outcome measuresExcessive gestational weight gain, depression, anxiety and physical activity.ResultsSix hundred and fifty-six women from four maternity centres were recruited: 329 women were randomised to the intervention group and 327 to UC. We found no evidence that the intervention decreased excessive gestational weight gain. At 38 weeks gestation, the proportions gaining excessive gestational weight were 27.6% (81/305) versus 28.9% (90/311) (adjusted OR 0.84, 95% CI: 0.53 to 1.33) in the intervention and UC group, respectively. There were no significant difference between the groups in anxiety or depression scores (anxiety: adjusted mean -0.58, 95% CI:-1.25 to -0.8; depression: adjusted mean -0.60, 95% CI:-1.24 to -0.05). There were no significant differences in physical activity scores between the groups.ConclusionsA behavioural intervention delivered by community midwives involving routine weighing throughout pregnancy, setting maximum weight gain targets and encouraging women to weigh themselves each week to check progress did not prevent excessive gestational weight gain. There was no evidence of psychological harm.Trial registration numberISRCTN67427351.

Dataset Information

Effectiveness of a brief behavioural intervention to prevent weight gain over the Christmas holiday period: randomised controlled trial.

Publications

Effectiveness of a brief behavioural intervention to prevent weight gain over the Christmas holiday period: randomised controlled trial.

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