Dataset Information

Life Events, Physical Activity, and Weight Loss Maintenance: Decomposing Mediating and Moderating Effects of Health Behavior.

ABSTRACT: BACKGROUND:This analysis helps clarify the individual and joint effects of moderate to vigorous physical activity (MVPA) in concert with significant life events (eg, divorce, marriage, job change or loss, pregnancy, etc) on weight following a behavioral weight loss intervention. METHODS:Data from the Tracking Study weight loss trial were utilized to perform a 4-way decomposition of moderation and mediation of life events (??1 vs 0) and MVPA (low <2500 kcal vs high ? 2500 kcal) on 24-month weight. RESULTS:The total effect of life events and MVPA on weight was estimated to be 1.63 kg (95% confidence interval?=?0.30 to 2.96; P?=?.02). The controlled direct effect of life events on 24-month weight suggested that experiencing at least one life event controlling for MVPA was associated with an increase of 2.31 kg (95% confidence interval?=?0.29 to 4.33) at 24 months. Other interaction and mediation estimates were not statistically significant. CONCLUSIONS:This analysis offers new potential for examining health behaviors that may act as both mediators and effect modifiers of health. Although more work is needed to understand the interaction of life events and MVPA on weight loss maintenance, findings help rule out mediation. Life events and MVPA should be considered for their unique effects on weight loss maintenance in the future.

SUBMITTER: Gavin KL

PROVIDER: S-EPMC6768397 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Life Events, Physical Activity, and Weight Loss Maintenance: Decomposing Mediating and Moderating Effects of Health Behavior.

Gavin Kara L KL Wolfson Julian J Pereira Mark M Sherwood Nancy N Linde Jennifer A JA

Journal of physical activity & health 20190308 4

<h4>Background</h4>This analysis helps clarify the individual and joint effects of moderate to vigorous physical activity (MVPA) in concert with significant life events (eg, divorce, marriage, job change or loss, pregnancy, etc) on weight following a behavioral weight loss intervention.<h4>Methods</h4>Data from the Tracking Study weight loss trial were utilized to perform a 4-way decomposition of moderation and mediation of life events (≥ 1 vs 0) and MVPA (low <2500 kcal vs high ≥ 2500 kcal) on ...[more]

PMID: 30849928

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Project description:In this secondary analysis of the DiOGenes study, we investigated whether physical activity (PA) contributes to diet-induced weight loss and helps to reduce subsequent regain. We also studied the associations of PA with changes in cardiometabolic variables. Adults with overweight were included and followed an 8-week low-calorie diet (LCD). When successful (>8% weight loss), participants were randomized to different ad libitum diet groups and were advised to maintain their weight loss over the 6-month intervention period. Body weight (BW), body composition, cardiometabolic variables and subjectively-assessed PA were measured at baseline, at the end of weight loss and at the end of the intervention. BW was reduced by the LCD (from 99.8 ± 16.7 to 88.4 ± 14.9 kg; P < 0.001). This reduction was maintained during the weight maintenance period (89.2 ± 16.0 kg). Total PA (sum score of the three subscales of the Baecke questionnaire) increased during the weight loss period (from 8.16 ± 0.83 to 8.39 ± 0.78; P < 0.001) and this increase was subsequently maintained (8.42 ± 0.90). We found no evidence that baseline PA predicted weight loss. However, a higher level of baseline PA predicted a larger weight-loss-induced improvement in total cholesterol, triglycerides, glucose and CRP, and in post-prandial insulin sensitivity (Matsuda index). Subsequent weight and fat mass maintenance were predicted by the post-weight loss level of PA and associated with changes in PA during the weight maintenance phase. In conclusion, despite the fact that higher baseline levels of PA did not predict more weight loss during the LCD, nor that an increase in PA during the LCD was associated with more weight loss, higher PA levels were associated with more improvements in several cardiometabolic variables. The positive effect of higher PA on weight loss maintenance seems in contrast to randomized controlled trials that have not been able to confirm a positive effect of exercise training programmes on weight loss maintenance. This analysis supports the notion that higher self-imposed levels of PA may improve the cardiometabolic risk profile during weight loss and help to maintain weight loss afterwards.

Project description:Despite high obesity prevalence rates, few low-income midlife women participate in weight loss maintenance trials. This pilot study aims to assess the effectiveness of two weight loss maintenance interventions in this under-represented population.Low-income midlife women who completed a 16-week weight loss intervention and lost ???8 lbs (3.6 kg) were eligible to enroll in one of two 12-month maintenance programs. The programs were similar in content and had the same number of total contacts, but were different in the contact modality (Phone?+?Face-to-Face vs. Face-to-Face Only). Two criteria were used to assess successful weight loss maintenance at 12 months: (1) retaining a loss of? ??5% of body weight from the start of the weight loss phase and (2) a change in body weight of? <?3%, from the start to the end of the maintenance program. Outcome measures of changes in physiologic and psychosocial factors, and evaluations of process measures and program acceptability (measured at 12 months) are also reported. For categorical variables, likelihood ratio or Fisher's Exact (for small samples) tests were used to evaluate statistically significant relationships; for continuous variables, t-tests or their equivalents were used to assess differences between means and also to identify correlates of weight loss maintenance.Overall, during the 12-month maintenance period, 41% (24/58) of participants maintained a loss of ???5% of initial weight and 43% (25/58) had a <3% change in weight. None of the comparisons between the two maintenance programs were statistically significant. However, improvements in blood pressure and dietary behaviors remained significant at the end of the 12-month maintenance period for participants in both programs. Participant attendance and acceptability were high for both programs.The effectiveness of two pilot 12-month maintenance interventions provides support for further research in weight loss maintenance among high-risk, low-income women.ClinicalTrials.gov Identifier: NCT00288301.

Dataset Information

Life Events, Physical Activity, and Weight Loss Maintenance: Decomposing Mediating and Moderating Effects of Health Behavior.

Publications

Life Events, Physical Activity, and Weight Loss Maintenance: Decomposing Mediating and Moderating Effects of Health Behavior.

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