Sleep duration and weight loss among overweight/obese women enrolled in a behavioral weight loss program.
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ABSTRACT:
SUBMITTER: O'Brien EM
PROVIDER: S-EPMC3461353 | biostudies-other | 2012 Sep
REPOSITORIES: biostudies-other
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Project description:BackgroundWe conducted secondary data analyses to examine the associations between sleep duration, sleep quality, sleep disturbance and ≥ 5% of weight loss in low-income overweight or obese postpartum women enrolled in a community-based lifestyle behavior intervention study aimed at prevention of weight gain.MethodsParticipants were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in Michigan. The Pittsburgh Sleep Quality Index was used to assess sleep duration, sleep quality, and sleep disturbance. All participants were assessed and weighed at baseline (T1, 569 participants), 4-month (T2, 367 participants), and 7-month from T1 (T3, 332 participants). Descriptive statistics and mixed-effects regression analysis were performed.ResultsParticipants reported longer sleep duration (p = 0.048), better sleep quality (p = 0.003) and less sleep disturbance (p < 0.001) over time. There were no significant mean body weight changes at T2 and T3. However, a significantly higher proportion of women lost ≥5% of body weight at T3 (23.1%) than T2 (12.5%, p = 0.001). Sleep duration, quality, and disturbance were not significantly associated with ≥5% of weight loss.ConclusionImprovements in sleep duration, sleep quality and sleep disturbance over time were not associated with ≥5% of weight loss in low-income overweight or obese postpartum women.Trial registrationClinical Trials NCT01839708; retrospectively registered February 28, 2013.
| S-EPMC6442411 | biostudies-literature
Project description:BackgroundSleep has been identified as having an influence on the success of weight-loss interventions; however, knowledge of the mechanisms and the extent to which sleep disturbances affect the magnitude of weight reduction is inconclusive.ObjectiveTo determine if sleep duration and quality can predict the magnitude of weight reduction in a weight-loss intervention program for overweight and obese women.MethodsNinety overweight and obese women aged 25-65 years completed the 7-month weight-loss phase of our weight-loss intervention. Sleep duration and quality were evaluated before the intervention by the Pittsburg Sleep Quality Index (PSQI), a self-report questionnaire, and by actigraphy. Serum levels of ghrelin, leptin, cortisol and insulin also were measured at baseline. Insulin resistance was measured by the homeostasis model assessment of insulin resistance (HOMA-IR).ResultsThe mean reduction rate of body mass index (BMI) after the intervention was 13.6%. Multiple linear regression revealed that the number of wake episodes (WEs) per night had a significant relationship with the reduction of BMI even after adjusting for other clinical variables (β=-0.341, P=0.001). The participants with five or more WEs per night (high-WE group) had a significantly lower reduction in BMI compared with those with fewer than five (normal-WE group), after adjusting for confounding variables. In contrast, the PSQI-assessed parameters, reflecting the subjective assessments of sleep quality and duration, failed to detect an association with the reduction in BMI. Baseline HOMA-IR was significantly higher in the high-WE group than in the normal-WE group after adjusting for confounding variables.ConclusionsHigher sleep fragmentation, as manifested by the increased number of WEs, predicts a lower magnitude of weight reduction in persons participating in weight-loss programs.
| S-EPMC4217002 | biostudies-literature
Project description:BackgroundObesity is an established and modifiable risk factor for urinary incontinence, but conclusive evidence for a beneficial effect of weight loss on urinary incontinence is lacking.MethodsWe randomly assigned 338 overweight and obese women with at least 10 urinary-incontinence episodes per week to an intensive 6-month weight-loss program that included diet, exercise, and behavior modification (226 patients) or to a structured education program (112 patients).ResultsThe mean (+/-SD) age of the participants was 53+/-11 years. The body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters) and the weekly number of incontinence episodes as recorded in a 7-day diary of voiding were similar in the intervention group and the control group at baseline (BMI, 36+/-6 and 36+/-5, respectively; incontinence episodes, 24+/-18 and 24+/-16, respectively). The women in the intervention group had a mean weight loss of 8.0% (7.8 kg), as compared with 1.6% (1.5 kg) in the control group (P<0.001). After 6 months, the mean weekly number of incontinence episodes decreased by 47% in the intervention group, as compared with 28% in the control group (P=0.01). As compared with the control group, the intervention group had a greater decrease in the frequency of stress-incontinence episodes (P=0.02), but not of urge-incontinence episodes (P=0.14). A higher proportion of the intervention group than of the control group had a clinically relevant reduction of 70% or more in the frequency of all incontinence episodes (P<0.001), stress-incontinence episodes (P=0.009), and urge-incontinence episodes (P=0.04).ConclusionsA 6-month behavioral intervention targeting weight loss reduced the frequency of self-reported urinary-incontinence episodes among overweight and obese women as compared with a control group. A decrease in urinary incontinence may be another benefit among the extensive health improvements associated with moderate weight reduction. (ClinicalTrials.gov number, NCT00091988.)
| S-EPMC2877497 | biostudies-literature
Project description:ObjectiveThe objective of this study was to estimate the association between body mass index (BMI) and pelvic organ prolapse symptoms and bother among overweight and obese women with urinary incontinence before and after weight loss.MethodsWomen (N = 338) were randomized to either an intensive 6-month weight loss or educational program (control); they were evaluated for prolapse symptoms at baseline and 6 months. Symptomatic prolapse was defined as a positive response to at least 1 prolapse subscale question of the Urogenital Distress Inventory. "Bother" was defined as responses of slight, moderate, or great. Women with prolapse symptoms were analyzed by baseline BMI category: overweight, obese, and severely obese at baseline and at 6 months. Proportional odds regression and χ tests for trend were used for analysis.ResultsAge mean was 53 (SD, 10) years, BMI mean was 36 (SD, 6) kg/m, and 78% were white. A higher proportion of obese women reported feeling vaginal bulging compared with overweight women (13% vs 0%, P = <0.01). At baseline, 37% (n = 124) reported bothersome "lower abdominal pressure"; 18% (n = 62), bothersome "heaviness in the pelvic area"; and 14% (n = 48), bothersome "pelvic discomfort when standing." Nine percent (n = 31) reported bothersome "feeling," and 2% (n = 6) reported bothersome "seeing a bulge" in the vagina. At 6 months, there were no significant differences in improvement of self-reported bothersome prolapse symptoms in women in the weight loss or the control group.ConclusionsIn this study of overweight and obese women, increasing BMI was associated with only "feeling" a vaginal bulge. Weight loss did not improve bothersome prolapse symptoms.
| S-EPMC4247226 | biostudies-literature
Project description:ObjectiveTo examine the relationship between magnitude of weight loss and changes in urinary incontinence frequency.MethodsOverweight and obese women (N=338) with 10 or more urinary incontinence episodes per week were assigned randomly to an intensive 6-month behavioral weight loss program followed immediately by a 12-month weight maintenance program (intervention; n=226) or to a structured education program (control; n=112). The intervention and control groups were combined to examine the effects of the magnitude of weight loss on changes in urinary incontinence assessed by 7-day voiding diary, pad test, and self-reported satisfaction with change in urinary incontinence.ResultsCompared with participants who gained weight (reference), those who lost 5% to less than 10% or 10% or more of their body weight had significantly greater percent reductions in urinary incontinence episodes and were more likely to achieve at least a 70% reduction in the frequency of total and urge urinary incontinence episodes at 6, 12, and 18 months. Satisfaction was also related to magnitude of weight loss; approximately 75% of women who lost 5% to less than 10% of their body weight reported being moderately or very satisfied with their changes in urine leakage.ConclusionWeight losses between 5% and 10% of body weight were sufficient for significant urinary incontinence benefits. Thus, weight loss should be considered as initial treatment for incontinence in overweight and obese women.Clinical trial registrationClinicalTrials.gov, www.clinicaltrials.gov, NCT00091988.Level of evidenceII.
| S-EPMC3038422 | biostudies-literature
Project description:Little is known about the effect of intentional weight loss and subsequent weight regain on cardiometabolic risk factors in older adults. The objective of this study was to determine how cardiometabolic risk factors change in the year following significant intentional weight loss in postmenopausal women, and if observed changes were affected by weight and fat regain.Eighty, overweight and obese, older women (age = 58.8±5.1 years) were followed through a 5-month weight loss intervention and a subsequent 12-month nonintervention period. Body weight/composition and cardiometabolic risk factors (blood pressure; total, high-density lipoprotein, and low-density lipoprotein cholesterol; triglycerides; fasting glucose and insulin; and Homeostatic Model Assessment of Insulin Resistance) were analyzed at baseline, immediately postintervention, and 6- and 12-months postintervention.Average weight loss during the 5-month intervention was 11.4±4.1kg and 31.4% of lost weight was regained during the 12-month follow-up. On average, all risk factor variables were significantly improved with weight loss but regressed toward baseline values during the year subsequent to weight loss. Increases in total cholesterol, triglycerides, glucose, insulin, and Homeostatic Model Assessment of Insulin Resistance during the postintervention follow-up were significantly (p < .05) associated with weight and fat mass regain. Among women who regained weight, model-adjusted total cholesterol (205.8±4.0 vs 199.7±2.9mg/dL), low-density lipoprotein cholesterol (128.4±3.4 vs 122.7±2.4mg/dL), insulin (12.6±0.7 vs 11.4±0.7mg/dL), and Homeostatic Model Assessment of Insulin Resistance (55.8±3.5 vs 50.9±3.7mg/dL) were higher at follow-up compared with baseline.For postmenopausal women, even partial weight regain following intentional weight loss is associated with increased cardiometabolic risk. Conversely, maintenance of or continued weight loss is associated with sustained improvement in the cardiometabolic profile.
| S-EPMC3660120 | biostudies-literature
Project description:OBJECTIVE: To examine the associations between eating behavior traits and weight loss according to sleep quality and duration in adults enrolled in common weight-loss interventions. METHODS: Participants included overweight and obese men and women (n=150) (mean±s.d. age, 38.8±8.6 years; mean±s.d. body mass index (BMI), 33.3±3.5 kg m(-2)) who were subjected to a dietary intervention over a period of 12-16 weeks. Anthropometric measurements, eating behavior traits (Three-Factor Eating Questionnaire), sleep quality (total Pittsburgh Sleep Quality Index (PSQI) score) and sleep duration (hours per night, self-reported from the PSQI) were assessed at both baseline and post intervention. Linear regression analysis was used to quantify the relationships between eating behavior traits and changes in anthropometric markers for all subjects and by sleep categories (short sleep: <7 h per night vs recommended sleep: ⩾7 h per night; poor sleep quality: ⩾5 PSQI score vs good sleep quality: <5 PSQI score). We adjusted for age, sex and baseline BMI in analyses. RESULTS: Baseline eating behavior traits were modest predictors of weight-loss success, but they were all significantly associated with their changes over the weight-loss intervention (P<0.01). The diet intervention induced significant changes in eating behavior traits and even more for those having a non-favorable eating behavior profile at baseline. We observed that changes in flexible control and strategic dieting behavior were constantly negatively associated with changes in body weight and fat mass (P<0.05) for recommended duration sleepers. The change in situational susceptibility to disinhibition was positively associated with the change in fat mass and body weight for those having healthy sleeping habits (P<0.05). For poor quality sleepers, the change in avoidance of fattening foods was negatively associated with changes in adiposity (P<0.05). CONCLUSION: Eating behavior traits and sleep may act together to influence the outcome of weight-loss programs.
| S-EPMC4217000 | biostudies-other
Project description:BackgroundObesity is associated with worse breast cancer prognosis, however little is known about the level of weight loss required to improve pathway biomarkers. The effects of weight regain on biomarkers are also largely unknown.MethodsOverweight/obese breast cancer survivors enrolled in an 18-month behavioral weight loss trial provided weight and serum biomarkers [leptin, adiponectin, insulin, plasminogen activator inhibitor-1 (PAI-1), IL-6, TNFα, and hepatocyte growth factor HGF] at baseline, 6, and 18 months (n = 138). Change in biomarkers over time and by weight loss thresholds were examined.ResultsMean weight loss at 6 months was 13.3 ± 5.0 kg; from 6 to 18 months, mean regain was 4.0 ± 5.2 kg. Favorable biomarker modulations were observed at 6 months for leptin, adiponectin, insulin, PAI-1, IL-6, and HGF (P < 0.006 to P < 0.0001). These changes remained significant overall at 18 months despite attenuation in some. Women who lost <10% of baseline weight showed significantly smaller modulation effects for leptin (P < 0.0001), adiponectin:leptin (A/L) ratio (P < 0.0001), PAI-1 (P < 0.001), and insulin (P = 0.003) compared with women who lost >10%. Women who lost >10% observed a significant increase in adiponectin (P < 0.0001), and these women continued to show improved adiponectin from 6 to 18 months despite weight regain. Physical activity contributed additional effects on biomarker change for leptin, A/L ratio, and PAI-1.ConclusionsThese findings are consistent with a clinical target of 10% weight.ImpactSustained increases in adiponectin likely confer benefits for breast cancer prognosis even with weight regain.
| S-EPMC7334095 | biostudies-literature
Project description:BackgroundNon-Hispanic Black (NHB) emerging adult (EA) women are at disproportionate risk for obesity but experience limited benefit from behavioral weight loss (BWL) programs. Race-related stress could play a role; the goal of this study was to examine the association between racial discrimination (RD) and early (3 months) changes in adiposity, and to explore potential protective factors, among EA in an adapted BWL program.MethodsThis is an ancillary study of non-Hispanic White (NHW) and NHB EA women enrolled in an adapted BWL trial (N = 49; 55.1% NHB; Age 21.2 (2.1); BMI = 33.0 + 4.3 kg/m2). At baseline, group- and personal-level RD (RD-group and RD-personal), racial identity (NHB women only), vigilant coping, and social support were assessed via validated questionnaires. Weight and waist circumference were measured objectively at 0 and 3 months.ResultsNHW women manifested greater reductions in waist circumference relative to NHB women (p = .004). RD-personal did not predict change in waist circumference at 3 months (p = .402); however, the association between RD-group and change in waist circumference was statistically significant (p = .015), such that reporting greater group-level discrimination predicted a smaller decrease in waist circumference; the model explained 22% of the variance. Social support and vigilant coping were not statistically significant in the model. Among NHB women only, higher racial identity-centrality predicted greater reduction in waist circumference (p = .019).ConclusionFindings suggest racial discrimination could contribute to greater cardiometabolic risk during this developmental period. Future research should examine how experiences of racial discrimination unfold in the daily lives of NHB women to inform mechanistic interventions to enhance health and well-being.Trial registrationNCT02736981. Low Intensity Weight Loss for Young Adults.
| S-EPMC9558300 | biostudies-literature
Project description:PurposeComorbid medical conditions are common among breast cancer survivors, contribute to poorer long-term survival and increased overall mortality, and may be ameliorated by weight loss. This secondary analysis evaluated the impact of a weight loss intervention on comorbid medical conditions immediately following an intervention (12 months) and 1-year postintervention (24 months) using data from the Exercise and Nutrition to Enhance Recovery and Good health for You (ENERGY) trial-a phase III trial which was aimed at and successfully promoted weight loss.MethodsENERGY randomized 692 overweight/obese women who had completed treatment for early stage breast cancer to either a 1-year group-based behavioral intervention designed to achieve and maintain weight loss or to a less intensive control intervention. Minimal support was provided postintervention. New medical conditions, medical conditions in which non-cancer medications were prescribed, hospitalizations, and emergency room visits, were compared at baseline, year 1, and year 2. Changes over time were analyzed using chi-squared tests, Kaplan-Meier, and logistic regression analyses.ResultsAt 12 months, women randomized to the intervention had fewer new medical conditions compared to the control group (19.6 vs. 32.2 %, p < 0.001); however, by 24 months, there was no longer a significant difference. No difference was observed in each of the four conditions for which non-cancer medications were prescribed, hospital visits, or emergency visits at either 12 or 24 months.ConclusionsThese results support a short-term benefit of modest weight loss on the likelihood of comorbid conditions; however, recidivism and weight regain likely explain no benefit at 1-year postintervention follow-up.
| S-EPMC5323258 | biostudies-literature