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Mortada EM, Al Awaji NN, Zaidi U, Aldhahi MI, Alsaleh H, Alroqaiba N, Awad SS. Unveiling the Moderating Factors in the Relationship between Physical Activity and Health-Related Quality of Life among University Students during COVID-19: A Mixed Study Design. Healthcare (Basel) 2024; 12:1389. [PMID: 39057532 PMCID: PMC11276181 DOI: 10.3390/healthcare12141389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/09/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
This study examines the moderating effects of various factors on the relationship between physical activity (PA) and health-related quality of life (HRQoL) among 287 female college students during the COVID-19 pandemic. Data were collected through an online questionnaire covering health issues, PA, self-esteem, HRQoL, and sociodemographic information, supplemented by semi-structured interviews and focus groups with six participants. Results showed that 46% of respondents had good HRQoL, and 38% were physically active. The interactions of age, socioeconomic status (SES), and academic performance with PA on HRQoL were insignificant. However, physical and mental health problems significantly moderated the PA-HRQoL relationship, accounting for 1% and 4% of the variance, respectively. The qualitative analysis highlighted the need for student activity clubs and mental health support to enhance coping strategies and overall HRQoL. In conclusion, age and SES did not moderate the PA-HRQoL relationship, while physical and mental health issues did. Programs targeting students with health problems are crucial to improving their physical and mental health, thereby enhancing their well-being.
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Affiliation(s)
- Eman M. Mortada
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), Riyadh 11671, Saudi Arabia; (E.M.M.); (U.Z.); (N.A.)
| | - Nisreen N. Al Awaji
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), Riyadh 11671, Saudi Arabia; (N.N.A.A.); (H.A.)
| | - Uzma Zaidi
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), Riyadh 11671, Saudi Arabia; (E.M.M.); (U.Z.); (N.A.)
| | - Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), Riyadh 11671, Saudi Arabia;
| | - Hadel Alsaleh
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), Riyadh 11671, Saudi Arabia; (N.N.A.A.); (H.A.)
| | - Nouf Alroqaiba
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), Riyadh 11671, Saudi Arabia; (E.M.M.); (U.Z.); (N.A.)
| | - Salwa S. Awad
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), Riyadh 11671, Saudi Arabia;
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2
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van Baak MA, Mariman ECM. Obesity-induced and weight-loss-induced physiological factors affecting weight regain. Nat Rev Endocrinol 2023; 19:655-670. [PMID: 37696920 DOI: 10.1038/s41574-023-00887-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 09/13/2023]
Abstract
Weight regain after successful weight loss resulting from lifestyle interventions is a major challenge in the management of overweight and obesity. Knowledge of the causal mechanisms for weight regain can help researchers and clinicians to find effective strategies to tackle weight regain and reduce obesity-associated metabolic and cardiovascular complications. This Review summarizes the current understanding of a number of potential physiological mechanisms underlying weight regain after weight loss, including: the role of adipose tissue immune cells; hormonal and neuronal factors affecting hunger, satiety and reward; resting energy expenditure and adaptive thermogenesis; and lipid metabolism (lipolysis and lipid oxidation). We describe and discuss obesity-associated changes in these mechanisms, their persistence during weight loss and weight regain and their association with weight regain. Interventions to prevent or limit weight regain based on these factors, such as diet, exercise, pharmacotherapy and biomedical strategies, and current knowledge on the effectiveness of these interventions are also reviewed.
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Affiliation(s)
- Marleen A van Baak
- NUTRIM School for Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University, Maastricht, Netherlands.
| | - Edwin C M Mariman
- NUTRIM School for Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University, Maastricht, Netherlands
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3
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Emerson JA, Schumacher LM, Bond DS, Thomas JG, Lillis J. Physical activity changes during an automated online weight loss program. J Behav Med 2023; 46:680-688. [PMID: 36602619 DOI: 10.1007/s10865-022-00383-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 11/06/2022] [Indexed: 01/06/2023]
Abstract
Evidence-based online behavioral weight loss (BWL) treatment targets a combination of diet, physical activity, and behavioral skills training. While weight loss outcomes are well documented, little is known about changes in physical activity. This study examined changes in objectively measured physical activity across the energy expenditure spectrum during a fully automated, online BWL program. Adults with overweight or obesity (n = 63) completed a 12-week, online BWL program. Participants wore an accelerometer for 7 days and body weight was measured in-clinic at pre- and post-treatment. At post-treatment, mean daily moderate-to-vigorous physical activity increased by about 4 min (SE = 1.59, p = 0.01). There were no statistically significant changes in light physical activity or time spent sedentary (p's > 0.05). Despite only minimal changes in moderate-to-vigorous physical activity overall, larger increases correlated with greater weight loss (r = - 0.28, p = 0.02), which averaged 6.1% of baseline weight at post-treatment. Though achieving important weight loss outcomes, online programs may fail to produce clinically relevant improvements in physical activity, which can put weight loss maintenance at risk.
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Affiliation(s)
- Jessica A Emerson
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, USA
| | - Leah M Schumacher
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 222 Richmond St., Providence, RI, 02903, USA
| | - Dale S Bond
- Hartford Hospital/Hartford HealthCare, 80 Seymour Street, Hartford, CT, 06106, USA
| | - J Graham Thomas
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, USA.
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 222 Richmond St., Providence, RI, 02903, USA.
| | - Jason Lillis
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 222 Richmond St., Providence, RI, 02903, USA
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4
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Katzmarzyk PT, Mire EF, Martin CK, Newton RL, Apolzan JW, Denstel KD, Johnson WD. Physical activity and weight loss in a pragmatic weight loss trial. Int J Obes (Lond) 2023; 47:244-248. [PMID: 36702913 PMCID: PMC11079994 DOI: 10.1038/s41366-023-01260-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/27/2023]
Abstract
The purpose of this study was to determine the association between changes in physical activity and changes in body weight in a cluster-randomized weight loss trial conducted in an underserved population in Louisiana. This study reports analyses conducted in the intervention group only, which was a 24-month multi-component weight loss program delivered by health coaches embedded in primary care clinics. Physical activity was assessed at baseline and at 6, 12, and 24 months of follow-up and changes in body weight were expressed as percent weight change from baseline. Among the sample of 402 patients, percent changes in body weight (mean ± SE) across increasing tertiles of changes in walking between baseline and 24 months were -3.2 ± 1.0%, -5.5 ± 0.9%, and -7.3 ± 0.9%, respectively (p = 0.001). Changes in body weight across increasing tertiles of changes in moderate-to-vigorous-intensity activity between baseline and 24 months were -4.3 ± 1.0%, -5.0 ± 0.9%, and -7.0 ± 0.9%, respectively (p = 0.04). In conclusion, this multi-component intervention resulted in clinically significant weight loss, and greater increases in physical activity over the intervention period were associated with greater percent reductions in body weight. These results are consistent with those from other studies conducted primarily in non-underserved populations.
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Affiliation(s)
| | - Emily F Mire
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | | - John W Apolzan
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Kara D Denstel
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
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Bourdier P, Simon C, Bessesen DH, Blanc S, Bergouignan A. The role of physical activity in the regulation of body weight: The overlooked contribution of light physical activity and sedentary behaviors. Obes Rev 2023; 24:e13528. [PMID: 36394185 PMCID: PMC10910694 DOI: 10.1111/obr.13528] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/31/2022] [Accepted: 10/23/2022] [Indexed: 11/18/2022]
Abstract
The role of physical activity (PA) in the regulation of body weight is still a major topic of debate. This may be because studies have essentially focused on the effects of moderate/vigorous PA (MVPA) on body weight while overlooking the other components of PA, namely, light-intensity PA (LPA, daily life activities) and sedentary behaviors (SB, too much sitting). In this review, we will (i) describe the history of changes in PA behaviors that occurred with modernization; (ii) review data from cross-sectional and longitudinal studies that examined the associations between PA, SB, and measures of obesity; (iii) review interventional studies that investigated the effects of changes in PA and SB on body weight and adiposity; and (iv) discuss experimental studies that addressed potential biological mechanisms underlying the effects of PA and SB on weight regulation. Overall recent findings support the importance of considering all components of PA to better understand the regulation of energy balance and suggest an important role for LPA and SB in addition to MVPA on body weight regulation. Longitudinal large-scale rigorous studies are needed to advance our knowledge of the role of PA/SB in combating the obesity epidemic.
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Affiliation(s)
- Pierre Bourdier
- CNRS IPHC UMR 7178 Université de Strasbourg, Strasbourg, France
| | - Chantal Simon
- CarMen Laboratory, INSERM 1060, INRAE 1397, University of Lyon, Oullins, France
- Human Nutrition Research Centre of Rhône-Alpes, Hospices Civils de Lyon, Lyon, France
| | - Daniel H. Bessesen
- Anschutz Health and Wellness Center, Division of Endocrinology, University of Colorado, Aurora, Colorado, USA
| | - Stéphane Blanc
- CNRS IPHC UMR 7178 Université de Strasbourg, Strasbourg, France
| | - Audrey Bergouignan
- CNRS IPHC UMR 7178 Université de Strasbourg, Strasbourg, France
- Anschutz Health and Wellness Center, Division of Endocrinology, University of Colorado, Aurora, Colorado, USA
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Adams MA, Todd M, Angadi SS, Hurley JC, Stecher C, Berardi V, Phillips CB, McEntee ML, Hovell MF, Hooker SP. Adaptive Goals and Reinforcement Timing to Increase Physical Activity in Adults: A Factorial Randomized Trial. Am J Prev Med 2022; 62:e57-e68. [PMID: 35000693 PMCID: PMC8820277 DOI: 10.1016/j.amepre.2021.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 08/24/2021] [Accepted: 09/26/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Potent lifestyle interventions to increase moderate-to-vigorous physical activity are urgently needed for population-level chronic disease prevention. This trial tested the independent and joint effects of a mobile health system automating adaptive goal setting and immediate financial reinforcement for increasing daily walking among insufficiently active adults. STUDY DESIGN Participants were randomized into a 2 (adaptive versus static goal setting) X 2 (immediate versus delayed financial incentive timing) condition factorial trial to increase walking. SETTINGS/PARTICIPANTS Participants (N=512 adults) were recruited between 2016 and 2018 and were 64.5% female, aged 18-60 years, 18.8% Hispanic, 6.1% African American, and 83% White. INTERVENTION Principles of reinforcement and behavioral economics directed intervention design. MAIN OUTCOME MEASURES Participants wore accelerometers daily (133,876 day-level observations) that remotely measured moderate-to-vigorous physical activity bout minutes of ≥3 minutes/day for 1 year. Primary outcomes were between-condition differences in (1) engaging ≥1 bout of moderate-to-vigorous physical activity on each day and (2) on days with ≥1 bout, daily total moderate-to-vigorous physical activity minutes. RESULTS Mixed-effects hurdle models tested treatment group X phase (time) interactions using an intent-to-treat approach in 2021. Engaging in any ambulatory moderate-to-vigorous physical activity was greater for Adaptive than for Static Goal groups (OR=2.34, 95% CI=2.10, 2.60 vs OR=1.66, 95% CI=1.50, 1.84; p<0.001) and for Immediate than for Static Reinforcement groups (OR=2.16 95% CI=1.94, 2.40 vs OR=1.77, 95% CI=1.59, 1.97; p<0.01). The Immediate Reinforcement group increased by 16.54 moderate-to-vigorous physical activity minutes/day, whereas the Delayed Reinforcement group increased by 9.91 minutes/day (p<0.001). The combined Adaptive Goals + Immediate Reinforcement group increased by 16.52 moderate-to-vigorous physical activity minutes/day, significantly more than that of either Delayed Reinforcement group. CONCLUSIONS This study offers automated and scalable-behavior change strategies for increasing walking among adults most at-risk for chronic diseases attributed to sedentary lifestyles. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov (ClinicalTrials.gov Identifier: NCT02717663).
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Affiliation(s)
- Marc A Adams
- College of Health Solutions, Arizona State University, Phoenix, Arizona.
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
| | - Siddhartha S Angadi
- College of Health Solutions, Arizona State University, Phoenix, Arizona; Department of Kinesiology, School of Education and Human Development, University of Virginia, Charlottesville, Virginia
| | - Jane C Hurley
- College of Health Solutions, Arizona State University, Phoenix, Arizona
| | - Chad Stecher
- College of Health Solutions, Arizona State University, Phoenix, Arizona
| | - Vincent Berardi
- Department of Psychology, Crean College of Health and Behavioral Sciences, Chapman University, Orange, California
| | | | - Mindy L McEntee
- College of Health Solutions, Arizona State University, Phoenix, Arizona
| | - Melbourne F Hovell
- School of Public Health, San Diego State University, San Diego, California
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, San Diego, California
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West DS, Krukowski RA, Monroe CM, Stansbury ML, Carpenter CA, Finkelstein EA, Naud S, Ogden D, Harvey JR. Randomized controlled trial of financial incentives during weight-loss induction and maintenance in online group weight control. Obesity (Silver Spring) 2022; 30:106-116. [PMID: 34932889 PMCID: PMC10519100 DOI: 10.1002/oby.23322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study examined the impact of a financial incentive scheme integrating process and outcome incentives across weight-loss induction and weight maintenance on 18-month weight outcomes. METHODS This was a randomized controlled trial. Participants with overweight or obesity (n = 418; 91% female; 28% racial/ethnic minority) were randomized to an 18-month, online, group-based behavioral weight-control program (Internet-Only) or the same program with financial incentives provided for 12 months, contingent on self-regulatory weight-control behaviors (self-weighing, dietary self-monitoring, and physical activity) and weight-outcome benchmarks (Internet+Incentives). No financial incentives were provided from Months 13 to 18 to examine the durability of weight-control behaviors and outcomes without incentives. RESULTS Weight-loss induction at Month 6 was significantly greater for Internet+Incentives than Internet-Only (6.8% vs. 4.9%, respectively, p = 0.01). Individuals receiving incentives were significantly more likely to maintain weight loss ≥ 5% at Month 12 (45% in Internet+Incentives vs. 32% in Internet-Only, p < 0.02) and remain weight stable (39% vs. 27%, respectively, p < 0.01). Internet+Incentives participants also reported significantly greater behavioral engagement through Month 12. However, once incentives ceased, there were no differences in sustained weight outcomes (Month 18), and engagement declined dramatically. CONCLUSIONS Despite promoting greater treatment engagement and initial weight loss, financial incentives as offered in this study did not promote better extended weight control.
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Affiliation(s)
- Delia S. West
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Rebecca A. Krukowski
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Courtney M. Monroe
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Melissa L. Stansbury
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Chelsea A. Carpenter
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, USA
| | - Eric A. Finkelstein
- Duke-NUS Medical School and Duke University Global Health Institute, Singapore and Durham, NC, USA
| | - Shelly Naud
- Department of Medical Biostatistics, University of Vermont, Burlington, Vermont, USA
| | - Doris Ogden
- Department of Nutrition and Food Sciences, University of Vermont, Burlington, Vermont, USA
| | - Jean R. Harvey
- Department of Nutrition and Food Sciences, University of Vermont, Burlington, Vermont, USA
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Smith KE, Mason TB, Wang WL, Schumacher LM, Pellegrini CA, Goldschmidt AB, Unick JL. Dynamic associations between anxiety, stress, physical activity, and eating regulation over the course of a behavioral weight loss intervention. Appetite 2022; 168:105706. [PMID: 34560159 PMCID: PMC8671217 DOI: 10.1016/j.appet.2021.105706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 07/23/2021] [Accepted: 09/20/2021] [Indexed: 01/03/2023]
Abstract
Negative emotional experiences are associated with dysregulated eating behaviors that impede weight management. While weight loss interventions promote physical activity and self-regulation of eating, no studies have examined how physical activity may directly influence eating by attenuating associations between negative emotions and eating. OBJECTIVE The current study examined how momentary negative emotions (stress and anxiety), moderate-to-vigorous intensity physical activity (MVPA), and their interactions predict eating dysregulation (i.e., intensity of eating temptations, inability to resist eating tempting foods, overeating), as well as how these associations change during a weight loss intervention. METHODS Women with overweight/obesity (N = 55) completed 14-day ecological momentary assessment (EMA) protocols with objective measurement of physical activity (i.e., bout-related MVPA time) before and after a three-month internet-based weight loss program. RESULTS Three-way interactions emerged predicting overeating and eating tempting foods. When women experienced higher than usual levels of momentary anxiety or stress at end-of-treatment, they were less likely to subsequently overeat or eat tempting foods when they had recently engaged in more MVPA (relative to their usual level). No significant associations were found for ratings of temptation intensity. CONCLUSIONS Findings suggest MVPA may exert direct effects on eating regulation. Specifically, MVPA appears to increasingly buffer the effect of negative emotional states on dysregulated eating behavior over the course of a weight loss intervention. Future work is needed to develop ways of communicating to patients how activity can have both indirect and direct effects on body weight, and examine whether such knowledge improves outcomes.
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Affiliation(s)
- Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA.
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Wei-Lin Wang
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Leah M Schumacher
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Christine A Pellegrini
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | | | - Jessica L Unick
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI, USA
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Creasy SA, Hibbing PR, Cotton E, Lyden K, Ostendorf DM, Willis EA, Pan Z, Melanson EL, Catenacci VA. Temporal patterns of physical activity in successful weight loss maintainers. Int J Obes (Lond) 2021; 45:2074-2082. [PMID: 34127805 PMCID: PMC8388061 DOI: 10.1038/s41366-021-00877-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 05/12/2021] [Accepted: 05/27/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND/OBJECTIVES Individuals successful at weight loss maintenance engage in high amounts of physical activity (PA). Understanding how and when weight loss maintainers accumulate PA within a day and across the week may inform PA promotion strategies and recommendations for weight management. METHODS We compared patterns of PA in a cohort of weight loss maintainers (WLM, n = 28, maintaining ≥13.6 kg weight loss for ≥1 year, BMI 23.6 ± 2.3 kg/m2), controls without obesity (NC, n = 30, BMI similar to current BMI of WLM, BMI 22.8 ± 1.9 kg/m2), and controls with overweight/obesity (OC, n = 26, BMI similar to pre-weight loss BMI of WLM, 33.6 ± 5.1 kg/m2). PA was assessed during 7 consecutive days using the activPALTM activity monitor. The following variables were quantified; sleep duration, sedentary time (SED), light-intensity PA (LPA), moderate-to-vigorous intensity PA (MVPA), and steps. Data were examined to determine differences in patterns of PA across the week and across the day using mixed effect models. RESULTS Across the week, WLM engaged in ≥60 min of MVPA on 73% of days, significantly more than OC (36%, p < 0.001) and similar to NC (59%, p = 0.10). Across the day, WLM accumulated more MVPA in the morning (i.e., within 3 h of waking) compared to both NC and OC (p < 0.01). WLM engaged in significantly more MVPA accumulated in bouts ≥10 min compared to NC and OC (p < 0.05). Specifically, WLM engaged in more MVPA accumulated in bouts of ≥60 min compared to NC and OC (p < 0.05). CONCLUSIONS WLM engage in high amounts of MVPA (≥60 min/d) on more days of the week, accumulate more MVPA in sustained bouts, and accumulate more MVPA in the morning compared to controls. Future research should investigate if these distinct patterns of PA help to promote weight loss maintenance.
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Affiliation(s)
- Seth A. Creasy
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO,Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Paul R. Hibbing
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN
| | - Eleanor Cotton
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kate Lyden
- Department of Kinesiology, University of Massachusetts, Amherst, MA
| | - Danielle M. Ostendorf
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO,Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Erik A. Willis
- Center for Health Promotion Disease Prevention, University of North Carolina-Chapel Hill, Chapel Hill, NC,Department of Nutrition, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Zhaoxing Pan
- Biostatistics Core, Research Institute of Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Edward L. Melanson
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO,Eastern Colorado VA Geriatric Research, Education, and Clinical Center, Aurora, CO,Division of Geriatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Victoria A. Catenacci
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO,Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO
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10
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Aronne LJ, Hall KD, Jakicic JM, Leibel RL, Lowe MR, Rosenbaum M, Klein S. Describing the Weight-Reduced State: Physiology, Behavior, and Interventions. Obesity (Silver Spring) 2021; 29 Suppl 1:S9-S24. [PMID: 33759395 PMCID: PMC9022199 DOI: 10.1002/oby.23086] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/26/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022]
Abstract
Although many persons with obesity can lose weight by lifestyle (diet and physical activity) therapy, successful long-term weight loss is difficult to achieve, and most people who lose weight regain their lost weight over time. The neurohormonal, physiological, and behavioral factors that promote weight recidivism are unclear and complex. The National Institute of Diabetes and Digestive and Kidney Diseases convened a workshop in June 2019, titled "The Physiology of the Weight-Reduced State," to explore the mechanisms and integrative physiology of adaptations in appetite, energy expenditure, and thermogenesis that occur in the weight-reduced state and that may oppose weight-loss maintenance. The proceedings from the first session of this workshop are presented here. Drs. Michael Rosenbaum, Kevin Hall, and Rudolph Leibel discussed the physiological factors that contribute to weight regain; Dr. Michael Lowe discussed the biobehavioral issues involved in weight-loss maintenance; Dr. John Jakicic discussed the influence of physical activity on long-term weight-loss maintenance; and Dr. Louis Aronne discussed the ability of drug therapy to maintain weight loss.
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Affiliation(s)
- Louis J. Aronne
- Weill Cornell Medicine Comprehensive Weight Control Center, New York, New York, USA
| | - Kevin D. Hall
- Laboratory of Biological Modeling, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - John M. Jakicic
- Healthy Lifestyle Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rudolph L. Leibel
- Departments of Pediatrics and Medicine, Division of Molecular Genetics, Columbia University, New York, New York, USA
| | - Michael R. Lowe
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Michael Rosenbaum
- Departments of Pediatrics and Medicine, Division of Molecular Genetics, Columbia University, New York, New York, USA
| | - Samuel Klein
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
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11
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Laughlin MR, Osganian SK, Yanovski SZ, Lynch CJ. Physiology of the Weight-Reduced State: A Report from a National Institute of Diabetes and Digestive and Kidney Diseases Workshop. Obesity (Silver Spring) 2021; 29 Suppl 1:S5-S8. [PMID: 33759392 PMCID: PMC8978330 DOI: 10.1002/oby.23079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/11/2020] [Indexed: 12/19/2022]
Abstract
Preventing regain of lost weight is the most difficult challenge in the treatment of obesity. The National Institute of Diabetes and Digestive and Kidney Diseases convened a workshop, "The Physiology of the Weight-Reduced State," on June 3 to 4, 2019, in order to explore the physiologic mechanisms of appetitive and metabolic adaptation that take place in the weight-reduced state and counter an individual's efforts to maintain reduced weight following weight loss.
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Affiliation(s)
- Maren R Laughlin
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Stavroula K Osganian
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Susan Z Yanovski
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Christopher J Lynch
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
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12
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Jakicic JM, Davis KK, Rogers RJ, Sherman SA, Barr S, Marcin ML, Collins KA, Collins AM, Yuan N, Lang W. Feasibility of Integration of Yoga in a Behavioral Weight-Loss Intervention: A Randomized Trial. Obesity (Silver Spring) 2021; 29:512-520. [PMID: 33528905 PMCID: PMC7904652 DOI: 10.1002/oby.23089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This study examined the feasibility and comparison of two styles of yoga within the context of a standard behavioral weight-loss intervention (SBWI). METHODS Fifty adults with obesity (BMI: 31.3 ± 3.8 kg/m2 ) participated in this 6-month study that included a SBWI and a calorie- and fat-reduced diet. Randomization was to restorative Hatha (SBWI+RES) or Vinyasa (SBWI+VIN) yoga. Yoga was prescribed to increase from 20 to 40 to 60 minutes per session across the intervention. Weight was assessed at baseline and 6 months. Perceptions of yoga were assessed at the completion of the intervention. RESULTS Adjusted weight loss was -3.4 kg (95% CI: -6.4 to -0.5) in SBWI+RES and -3.8 kg (95% CI: -6.8 to -0.9) in SBWI+VIN (P < 0.001), with no difference between groups. Of all participants, 74.4% reported that they would continue participation in yoga after the SBWI. Session duration was a barrier as yoga increased from 20 to 40 to 60 minutes per day, with 0%, 7.5%, and 48.8% reporting this barrier, respectively. CONCLUSIONS Among adults with obesity, yoga participation, within the context of a SBWI, appears to be feasible, with weight loss not differing by style of yoga. Progressing to 60 minutes per session appears to be a barrier to engagement in yoga in this population.
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Affiliation(s)
- John M Jakicic
- Healthy Lifestyle Institute, Physical Activity and Weight Management Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kelliann K Davis
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania,, USA
| | - Renee J Rogers
- Healthy Lifestyle Institute, Physical Activity and Weight Management Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sally A Sherman
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania,, USA
| | - Susan Barr
- Healthy Lifestyle Institute, Physical Activity and Weight Management Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Marissa L Marcin
- Healthy Lifestyle Institute, Physical Activity and Weight Management Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Katherine A Collins
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, North Carolina,, USA
| | - Audrey M Collins
- Healthy Lifestyle Institute, Physical Activity and Weight Management Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nalingna Yuan
- Healthy Lifestyle Institute, Physical Activity and Weight Management Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Wei Lang
- Center on Aging and Mobility, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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13
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Li JB, Qiu ZY, Liu Z, Zhou Q, Feng LF, Li JD, Zhang X. Gender Differences in Factors Associated with Clinically Meaningful Weight Loss among Adults Who Were Overweight or Obese: A Population-Based Cohort Study. Obes Facts 2021; 14:108-120. [PMID: 33352568 PMCID: PMC7983648 DOI: 10.1159/000512294] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 09/25/2020] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES The impact of heterogeneity on gender difference for achieving clinically meaningful weight loss (cmWL) remains unclear. Here, we explored the potential gender differences in factors associated with cmWL. METHODS A total of 60,668 participants with body mass index (BMI) ≥25 kg/m2 at study entry and available BMI values at follow-up were included in this study. cmWL was defined as a weight loss of ≥5% from the study entry to follow-up. The associations of social-demographic factors, personal history of chronic diseases, lifestyle behaviors, and history of BMI with cmWL were evaluated using logistic regression models. RESULTS During a median follow-up of 9.13 years, 26.6% of the participants had a cmWL (30.8% for females vs. 23.1% in males; p < 0.001). Participants with older age, obesity at study entry, being more physical activity compared to 10 years ago, being relapsed smokers or consistent current smokers, having a history of chronic diseases (i.e., diabetes, osteoporosis, and stroke), cancer diagnosis during the study period, and more than 10-year follow-up were more likely to achieve cmWL in both males and females (all p < 0.05). The new smoking quitters and participants with less active in physical activity compared to 10 years ago were less likely to achieve cmWL in both males and females (all p < 0.05). Specifically, males with a history of emphysema were more likely to reach cmWL, and for females, those being overweight at 20 years old and current drinkers were more likely to reach cmWL (p < 0.05). Sensitivity analyses demonstrated similar results. CONCLUSION Age, BMI status, physical activity, smoking status, family income, and health status were independent factors in males and females for weight management. However, further well-designed prospective studies are warranted to confirm our findings.
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Affiliation(s)
- Ji-Bin Li
- Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Zhi-Yu Qiu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
- Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhen Liu
- Department of Rehabilitation Medicine, The First People's Hospital of Foshan, Foshan, China
| | - Qian Zhou
- Clinical Research Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Li-Fen Feng
- Department of Statistics, Government Affairs Service Center of Health Commission of Guangdong Province, Guangzhou, China
| | - Jun-Dong Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
- Department of Gynecologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
- **Jun-Dong Li, Department of Gynecologic Oncology, Sun Yat-sen University Cancer Center, Dong Feng East Road 651, Guangzhou 510060 (PR China),
| | - Xi Zhang
- Clinical Research Unit, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Xi Zhang, Clinical Research Unit, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Kejiao Building 233B, Shanghai 200092 (PR China),
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14
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Adding Financial Incentives to Online Group-Based Behavioral Weight Control: An RCT. Am J Prev Med 2020; 59:237-246. [PMID: 32446752 PMCID: PMC8510645 DOI: 10.1016/j.amepre.2020.03.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 02/24/2020] [Accepted: 03/29/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Internet-delivered behavioral weight control is promising for expanding the reach and availability of weight management, but online programs produce lower weight losses than typically achieved in person. Financial incentives have been shown to increase weight losses. This study examined whether adding financial incentives for self-monitoring and achieving target weight losses increases weight losses attained in a fully online, group-based behavioral weight management program compared with the same program alone. STUDY DESIGN This study was an RCT. SETTING/PARTICIPANTS Adults with overweight and obesity (n=418; 91% female; 28% minority) were recruited from 2 clinical centers. INTERVENTION The intervention was a 24-session online group-based behavioral weight control program with weekly synchronous chat sessions (Internet-only) or the same program with weekly financial incentives for self-monitoring body weight and dietary intake daily and for achieving target weight losses at 2 and 6 months (Internet + incentives). MAIN OUTCOME MEASURES This study measured weight loss at 6 months and treatment engagement (attendance, self-monitoring of body weight, dietary intake, and physical activity). Data were collected between February 2016 and August 2018, and analyses were completed in 2019. RESULTS Participants randomized to the Internet + incentives group lost more weight (-6.4 [SD=5.5] kg) than those in the Internet-only group (-4.7 [SD=6.6] kg; p<0.01). Further, a higher proportion of the Internet + incentives group achieved ≥5% weight loss (55%) than those in the Internet-only group (40%; p<0.05). Treatment engagement was higher in the Internet + incentives condition, with greater self-monitoring of behaviors targeted by incentives, as well as higher rates of behaviors not targeted and higher self-reported physical activity. Study retention was higher among those in the Internet + incentives condition (91%) than those in the Internet-only condition (81%; p=0.003). CONCLUSIONS Adding financial incentives to a program delivered fully online increases weight losses compared with the program alone and can achieve weight losses comparable to in-person programs, offering potential for substantial geographic reach. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT02688621.
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Jakicic JM, Rogers RJ, Collins AM, Jackson R. Strategies for Physical Activity Interventions in the Treatment of Obesity. Endocrinol Metab Clin North Am 2020; 49:289-301. [PMID: 32418591 DOI: 10.1016/j.ecl.2020.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Physical activity contributes to body weight regulation. At least 150 minutes per week of moderate-to-vigorous intensity physical activity may be needed. When not coupled with dietary restriction, physical activity contributes to an average weight loss of approximately 2 to 3 kg in interventions up to 6 months in duration; when added to modest dietary restriction it adds 20% additional weight loss compared with modest dietary restriction alone. Physical activity is associated with enhanced long-term weight loss and attenuation of weight regain and should be included within clinical and public health approaches to prevent weight regain and to treat obesity.
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Affiliation(s)
- John M Jakicic
- Healthy Lifestyle Institute, University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA 15261, USA.
| | - Renee J Rogers
- Healthy Lifestyle Institute, University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA 15261, USA. https://twitter.com/ReneeJRogers
| | - Audrey M Collins
- Healthy Lifestyle Institute, University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA 15261, USA. https://twitter.com/audcollins
| | - Ronald Jackson
- Healthy Lifestyle Institute, University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA 15261, USA
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16
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Befort CA, Kimler BF, Bantis LE, Phillips TA, Fabian CJ. Effects of Weight Loss and Weight Regain on Circulating Biomarkers in Overweight/Obese Breast Cancer Survivors Enrolled in a Weight Loss Trial in the Rural Midwest. Cancer Epidemiol Biomarkers Prev 2020; 29:1321-1328. [PMID: 32277008 DOI: 10.1158/1055-9965.epi-19-1572] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/23/2020] [Accepted: 04/07/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Obesity 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. METHODS Overweight/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. RESULTS Mean 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. CONCLUSIONS These findings are consistent with a clinical target of 10% weight. IMPACT Sustained increases in adiponectin likely confer benefits for breast cancer prognosis even with weight regain.
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Affiliation(s)
- Christie A Befort
- University of Kansas Medical Center, University of Kansas Cancer Center, Kansas City, Kansas.
| | - Bruce F Kimler
- University of Kansas Medical Center, University of Kansas Cancer Center, Kansas City, Kansas
| | - Leonidas E Bantis
- University of Kansas Medical Center, University of Kansas Cancer Center, Kansas City, Kansas
| | - Teresa A Phillips
- University of Kansas Medical Center, University of Kansas Cancer Center, Kansas City, Kansas
| | - Carol J Fabian
- University of Kansas Medical Center, University of Kansas Cancer Center, Kansas City, Kansas
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17
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Annesi JJ. Predicting 2-year weight loss through temporally specific earlier losses, relevant behaviors, and their psychological correlates: Implications for behavioral treatment architectures. Scand J Psychol 2020; 61:625-633. [PMID: 32064618 DOI: 10.1111/sjop.12619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 12/10/2019] [Indexed: 12/01/2022]
Abstract
Maintaining loss of weight beyond an initial 6-9 months remains problematic, with research indicating little recent progress. A poor understanding of how and when prior weight loss, behavioral changes, and psychosocial predictors are associated with long-term weight changes persists. To better-inform behavioral treatments for long-term success with weight loss, women with obesity (N = 86; Mage = 48.6 years) volunteered for research incorporating community-based weight-management treatments. They were assessed at months 6, 12, and 24 on theory-based psychosocial and behavioral factors, and over 24 months on weight. Considering the included times and temporal ranges, it was found that change in weight from month 6-24 was the strongest predictor of 24-month weight change, and physical activity and fruit/vegetable intake at month 24 best predicted that change in weight. Self-regulation, self-efficacy, and mood at month 24 best predicted both physical activity and fruit/vegetable intake at month 24, with body satisfaction also a significant predictor of physical activity. From these data, mediation analyses found that the predictions of long-term weight loss by scores of self-regulation, self-efficacy, body satisfaction, and mood at month 24 were significantly mediated by fruit/vegetable intake and physical activity in separate equations. Findings indicated both psychosocial and behavioral targets, and timing for those targets, most indicative of long-term success with weight loss.
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Affiliation(s)
- James J Annesi
- YMCA of Metro Atlanta, Atlanta, Georgia, USA.,University of Alabama at Birmingham, Birmingham, Alabama, USA
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18
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Blackman Carr LT, Samuel-Hodge CD, Ward DS, Evenson KR, Bangdiwala SI, Tate DF. Comparative effectiveness of a standard behavioral and physical activity enhanced behavioral weight loss intervention in Black women. Women Health 2019; 60:676-691. [PMID: 31814531 DOI: 10.1080/03630242.2019.1700585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Black women typically lose small amounts of weight in behavioral weight loss interventions, partially due to low engagement in physical activity. Culturally relevant enhancement of the physical activity component may improve weight loss. This study compared the effectiveness of a culturally-relevant, physical activity-enhanced behavioral weight loss intervention to a standard behavioral weight loss intervention in Black women (n = 85) over 6 months. The study was conducted in two cohorts from March 2016 to February 2017 at the University of North Carolina at Chapel Hill. Participants had an average age of 48.30 ± 11.02 years with an average body mass index of 36.46 ± 4.50 kg/m2. Standard and enhanced groups' weight change (-2.83 kg and -2.08 kg, respectively) and change in physical activity (43.93 min/ week and 15.29 min/week, respectively) did not differ between groups. Significantly more standard group participants lost 5% of baseline weight compared to enhanced group participants. This study produced typical weight loss results in Black women. Behavioral weight loss treatment remains moderately effective for Black women. Strategies to increase attendance and self-monitoring, and the inclusion of cultural contexts to weight-related behaviors are needed to improve outcomes.
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Affiliation(s)
- Loneke T Blackman Carr
- Department of Nutritional Sciences, University of Connecticut , Storrs, Connecticut, USA.,Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
| | - Carmen D Samuel-Hodge
- Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
| | - Dianne S Ward
- Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
| | - Kelly R Evenson
- Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
| | - Shrikant I Bangdiwala
- Department of Health Research Methods, Evidence and Impact, McMaster University , Hamilton, Ontario, Canada
| | - Deborah F Tate
- Department of Health Behavior, Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
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Catenacci VA, Ostendorf DM, Pan Z, Bing K, Wayland LT, Seyoum E, Stauffer BL, Phelan S, Creasy SA, Caldwell AE, Wyatt HR, Bessesen DH, Melanson EL. The Impact of Timing of Exercise Initiation on Weight Loss: An 18-Month Randomized Clinical Trial. Obesity (Silver Spring) 2019; 27:1828-1838. [PMID: 31565869 PMCID: PMC6832769 DOI: 10.1002/oby.22624] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/25/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to evaluate the impact of timing of exercise initiation on weight loss within a behavioral weight loss program. METHODS Adults with overweight or obesity (N = 170; age 18-55 years; BMI 25-42 kg/m2 ; 83.5% women) were enrolled in an 18-month behavioral weight loss program consisting of a reduced-calorie diet, exercise, and group-based support. The standard group (STD) received a supervised exercise program (progressing to 300 min/wk of moderate-intensity aerobic exercise) during months 0 to 6. The sequential group (SEQ) was asked to refrain from changing exercise during months 0 to 6 and received the supervised exercise program during months 7 to 12. On completion of supervised exercise, both groups were instructed to continue 300 min/wk of moderate-intensity exercise for the study duration. RESULTS At 6 months, the STD group exhibited greater reductions in body weight (-8.7 ± 0.7 kg) compared with the SEQ group (-6.9 ± 0.6 kg; P = 0.047). Between 6 and 18 months, the STD group regained more weight (2.5 ± 0.8 kg vs. 0.0 ± 0.8 kg; P = 0.02). At 18 months, there were no between-group differences in changes in weight (STD: -6.9 ± 1.2 kg; SEQ: -7.9 ± 1.2 kg), fat mass, lean mass, physical activity, or attrition. CONCLUSIONS Both immediate and delayed exercise initiation within a behavioral weight loss program resulted in clinically meaningful weight loss at 18 months. Thus, timing of exercise initiation can be personalized based on patient preference.
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Affiliation(s)
- Victoria A. Catenacci
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Danielle M. Ostendorf
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Zhaoxing Pan
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kristen Bing
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Liza T. Wayland
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Emmanuel Seyoum
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Brian L. Stauffer
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Suzanne Phelan
- California Polytechnic State University, San Luis Obispo CA
| | - Seth A. Creasy
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Ann E. Caldwell
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Holly R. Wyatt
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Daniel H. Bessesen
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Edward L. Melanson
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical Center, Denver, CO, USA
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McNeil J, Liepert M, Brenner DR, Courneya KS, Friedenreich CM. Behavioral Predictors of Weight Regain in Postmenopausal Women: Exploratory Results From the Breast Cancer and Exercise Trial in Alberta. Obesity (Silver Spring) 2019; 27:1451-1463. [PMID: 31318492 PMCID: PMC6771620 DOI: 10.1002/oby.22569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/27/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This secondary analysis assessed associations between changes in energy balance and sleep behaviors and the risk of weight regain following exercise-induced weight loss. METHODS Of 400 participants initially randomized in the Breast Cancer and Exercise Trial in Alberta (BETA), 227 lost weight following the moderate- to vigorous-intensity exercise intervention (-4.2 ± 3.6 kg) and were included in this analysis. Self-reported energy intake (EI), sleep duration, quality and timing, and objective measurements of physical activity (PA) and sedentary time were collected at the end of the intervention and the end of follow-up. Linear regression models assessed associations between changes in these behaviors and risk of weight regain during follow-up. RESULTS Participants regained 43% of the weight lost during follow-up. Reductions in moderate to vigorous PA (β = -1.00; 95% CI = -1.74 to -0.25 h/d; P = 0.01) and steps per day (β = -0.0003; 95% CI = -0.0005 to -0.0001 steps/d; P = 0.004); increases in sedentary time (β = 0.54; 95% CI = 0.67 to 1.02 h/d; P = 0.03), EI (β = 0.001; 95% CI = 0.0003 to 0.002 kcal; P = 0.01), and fat intake (β = 0.004; 95% CI = 0.001 to 0.006 kcal; P = 0.002); and delayed sleep timing midpoint (β = 0.02; 95% CI = 0.004 to 0.03 min; P = 0.01) were associated with weight regain during follow-up. CONCLUSIONS These exploratory results suggest that reductions in moderate to vigorous PA; increases in EI, fat intake, and sedentary time; and delayed sleep timing midpoint were significantly associated with risk of weight regain.
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Affiliation(s)
- Jessica McNeil
- Department of Cancer Epidemiology and Prevention ResearchCancerControl Alberta, Alberta Health ServicesCalgaryAlbertaCanada
| | - Maryah Liepert
- Department of Cancer Epidemiology and Prevention ResearchCancerControl Alberta, Alberta Health ServicesCalgaryAlbertaCanada
| | - Darren R. Brenner
- Department of Cancer Epidemiology and Prevention ResearchCancerControl Alberta, Alberta Health ServicesCalgaryAlbertaCanada
- Departments of Oncology and Community Health Sciences, Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Kerry S. Courneya
- Faculty of Kinesiology, Sport, and RecreationUniversity of AlbertaEdmontonAlbertaCanada
| | - Christine M. Friedenreich
- Department of Cancer Epidemiology and Prevention ResearchCancerControl Alberta, Alberta Health ServicesCalgaryAlbertaCanada
- Departments of Oncology and Community Health Sciences, Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
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Ostendorf DM, Caldwell AE, Creasy SA, Pan Z, Lyden K, Bergouignan A, MacLean PS, Wyatt HR, Hill JO, Melanson EL, Catenacci VA. Physical Activity Energy Expenditure and Total Daily Energy Expenditure in Successful Weight Loss Maintainers. Obesity (Silver Spring) 2019; 27:496-504. [PMID: 30801984 PMCID: PMC6392078 DOI: 10.1002/oby.22373] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/02/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The objective of this study was to compare physical activity energy expenditure (PAEE) and total daily energy expenditure (TDEE) in successful weight loss maintainers (WLM) with normal weight controls (NC) and controls with overweight/obesity (OC). METHODS Participants were recruited in three groups: WLM (n = 25, BMI 24.1 ± 2.3 kg/m2 ; maintaining ≥ 13.6-kg weight loss for ≥ 1 year), NC (n = 27, BMI 23.0 ± 2.0 kg/m2 ; similar to current BMI of WLM), and OC (n = 28, BMI 34.3 ± 4.8 kg/m2 ; similar to pre-weight loss BMI of WLM). TDEE was measured using the doubly labeled water method. Resting energy expenditure (REE) was measured using indirect calorimetry. PAEE was calculated as (TDEE - [0.1 × TDEE] - REE). RESULTS PAEE in WLM (812 ± 268 kcal/d, mean ± SD) was significantly higher compared with that in both NC (621 ± 285 kcal/d, P < 0.01) and OC (637 ± 271 kcal/d, P = 0.02). As a result, TDEE in WLM (2,495 ± 366 kcal/d) was higher compared with that in NC (2,195 ± 521 kcal/d, P = 0.01) but was not significantly different from that in OC (2,573 ± 391 kcal/d). CONCLUSIONS The high levels of PAEE and TDEE observed in individuals maintaining a substantial weight loss (-26.2 ± 9.8 kg maintained for 9.0 ± 10.2 years) suggest that this group relies on high levels of energy expended in physical activity to remain in energy balance (and avoid weight regain) at a reduced body weight.
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Affiliation(s)
- Danielle M. Ostendorf
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus,
Aurora, CO, USA
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz
Medical Campus, Aurora, CO, USA
| | - Ann E. Caldwell
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus,
Aurora, CO, USA
| | - Seth A. Creasy
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz
Medical Campus, Aurora, CO, USA
| | - Zhaoxing Pan
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO,
USA
| | - Kate Lyden
- KAL Research & Consulting, LLC, Denver, CO, USA
| | - Audrey Bergouignan
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus,
Aurora, CO, USA
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz
Medical Campus, Aurora, CO, USA
- Institut Pluridisciplinaire Hubert Curien, Département d’Ecologie, Physiologie, et Ethologie,
Strasbourg, France
- UMR 7178 Centre National de la Recherche scientifique (CNRS), Strasbourg, France
| | - Paul S. MacLean
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz
Medical Campus, Aurora, CO, USA
| | - Holly R. Wyatt
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus,
Aurora, CO, USA
| | - James O. Hill
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus,
Aurora, CO, USA
| | - Edward L. Melanson
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz
Medical Campus, Aurora, CO, USA
- Department of Medicine, Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus,
Aurora, CO, USA
- Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical Center, Denver, CO, USA
| | - Victoria A. Catenacci
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus,
Aurora, CO, USA
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz
Medical Campus, Aurora, CO, USA
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22
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JAKICIC JOHNM, ROGERS RENEEJ, DONNELLY JOSEPHE. The Health Risks of Obesity Have Not Been Exaggerated. Med Sci Sports Exerc 2019; 51:222-225. [DOI: 10.1249/mss.0000000000001747] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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23
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Creasy SA, Lang W, Tate DF, Davis KK, Jakicic JM. Pattern of Daily Steps is Associated with Weight Loss: Secondary Analysis from the Step-Up Randomized Trial. Obesity (Silver Spring) 2018; 26:977-984. [PMID: 29633583 PMCID: PMC5970037 DOI: 10.1002/oby.22171] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 01/12/2018] [Accepted: 02/10/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this study was to examine the association between the amount, intensity, and pattern of steps·day-1 with weight loss. METHODS Participants (N = 260; age = 42.8 ± 8.9 y; BMI = 32.8 ± 3.5 kg/m2 ) completed an 18-month weight-loss intervention that included a calorie-restricted diet and prescribed physical activity. Participants were categorized by 18-month weight loss as weight gain (GAIN), weight loss of 0% to < 5% (WL < 5%), 5% to < 10% (WL < 10%), or ≥ 10% (WL ≥ 10%). Steps·day-1 were measured at 0, 6, 12, and 18 months and defined as total steps·day-1 , total steps·day-1 of moderate-to-vigorous physical activity (MVPA) (≥3 metabolic equivalents) in bouts of ≥ 10 minutes (BOUT-MVPA), MVPA in bouts of < 10 minutes (NON-BOUT-MVPA), or non-MVPA steps·day-1 (NON-MVPA). RESULTS There was a weight-loss category by time interaction (P < 0.0001) for total and BOUT-MVPA steps·day-1 . The total steps·day-1 at 18 months were WL ≥ 10% = 9,822 (95% CI: 9,073-10,571), WL < 10% = 8,612 (7,613-9,610), WL < 5% = 7,802 (6,782-8,822), and GAIN = 7,801 (6,549-9,053). BOUT-MVPA steps·day-1 at 18 months were WL ≥ 10% = 3,482 (2,982-3,981), WL < 10% = 1,949 (1,269-2,629), WL < 5% = 1,735 (1,045-2,426), and GAIN = 1,075 (210-1,941). Participants were also categorized based on achieving ≥ 10% weight loss at either 6 or 18 months, and a similar pattern was observed. CONCLUSIONS These findings show that 10,000 steps·day-1 , with approximately 3,500 steps·day-1 performed as BOUT-MVPA, are associated with enhanced weight loss in a behavioral intervention.
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Affiliation(s)
- Seth A. Creasy
- University of Colorado Denver, Anschutz Medical Campus, Denver, Colorado USA
| | - Wei Lang
- Wake Forest University School of Medicine, Winston-Salem, NC
| | - Deborah F. Tate
- University of North Carolina at Chapel Hill, Chapel Hill, NC
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24
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Kang LL, Kim HN, Jung YA, Hwang HS, Park HK, Park KY. The Effects of Weight Control Behaviors among Korean Obese Adults. Korean J Fam Med 2018; 39:247-252. [PMID: 29973039 PMCID: PMC6056401 DOI: 10.4082/kjfm.17.0021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/19/2017] [Accepted: 07/11/2017] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND This study aimed to identify and examine the effects of weight control behaviors correlated with weight loss in obese individuals who attempted to lose weight within the past year. METHODS In this cross-sectional study, data from 9,461 obese individuals were collected from the fifth and sixth Korean National Health and Nutrition Examination Survey (2010-2014). Three of nine verified methods of weight control suggested in the survey were selected: diet therapy (reduced food intake), exercise therapy (exercise), and medication therapy (prescribed weight loss medications). Participants were divided into one of seven groups (diet therapy alone; exercise therapy alone; drug therapy alone; combined diet and exercise therapy; combined exercise and drug therapy; combined diet and drug therapy; or combined diet, exercise, and drug therapy). Logistic regression analysis was used to determine whether the group that tried to lose weight in the past year had indeed lost weight compared to the group that did not. RESULTS The odds ratios for weight loss (≥3 but <6 kg vs. ≥6 but <10 kg) for the combined therapies were 2.05 (95% confidence interval, 1.23-3.41) for combined diet and exercise therapy and 5.43 (1.74-16.92) for combined diet, exercise, and drug therapy. CONCLUSION All levels of weight loss were significantly associated with combined diet and exercise therapy. Weight loss ≥6 kg but <10 kg was significantly associated with combined diet and exercise therapy as well as with combined diet, exercise, and medication therapy among individuals who tried to lose weight in the past year.
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Affiliation(s)
- Li-Ly Kang
- Department of Family Medicine, Hanyang University Medical Center, Seoul, Korea
| | - Ha-Nui Kim
- Department of Family Medicine, Hanyang University Medical Center, Seoul, Korea
| | - Young-Ah Jung
- Department of Family Medicine, Hanyang University Medical Center, Seoul, Korea
| | - Hwan-Sik Hwang
- Department of Family Medicine, Hanyang University Medical Center, Seoul, Korea
| | - Hoon-Ki Park
- Department of Family Medicine, Hanyang University Medical Center, Seoul, Korea
| | - Kye-Yeung Park
- Department of Family Medicine, Hanyang University Medical Center, Seoul, Korea
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25
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Creasy SA, Rynders CA, Bergouignan A, Kealey EH, Bessesen DH. Free-Living Responses in Energy Balance to Short-Term Overfeeding in Adults Differing in Propensity for Obesity. Obesity (Silver Spring) 2018; 26:696-702. [PMID: 29570248 PMCID: PMC5868430 DOI: 10.1002/oby.22121] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 12/06/2017] [Accepted: 12/30/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Free-living adaptive responses to short-term overfeeding (OF) were explored as predictors of longitudinal weight change in adults classified as having obesity resistance (OR) or obesity proneness (OP) based on self-identification and personal/family weight history. METHODS Adults identified as OP (n = 21; BMI: 23.8 ± 2.5 kg/m2 ) and OR (n = 20; BMI: 20.2 ± 2.1 kg/m2 ) completed 3 days of eucaloric feeding (EU; 100% of energy needs) and 3 days of OF (140% of energy needs). Following each condition, adaptive responses in physical activity (PA), total daily energy expenditure, ad libitum energy intake, and energy balance were objectively measured for 3 days in a free-living environment. Body mass and composition were measured annually by using dual-energy x-ray absorptiometry for 5 years. Adaptive responses to OF were correlated with 5-year changes in body mass and composition. RESULTS Increases in sedentary time correlated with longitudinally measured changes in fat mass (r = 0.34, P = 0.04) in the cohort taken as a whole. Those with OP reduced their levels of PA following OF, whereas those with OR maintained or increased their PA. No other variables were found to correlate with weight gain. CONCLUSIONS Failure to decrease sedentary behavior following short-term OF is one mechanism that may be contributing to fat mass gain.
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Affiliation(s)
- Seth A. Creasy
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Corey A. Rynders
- Division of Geriatric Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Audrey Bergouignan
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health & Wellness Center at the University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- IPHC-DEPE, Universite de Strasbourg, Strasbourg, France
- UMR 7178 Centre National de la Recherche scientifique (CNRS), Strasbourg, France
| | - Elizabeth H. Kealey
- Anschutz Health & Wellness Center at the University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Daniel H. Bessesen
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health & Wellness Center at the University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Denver Health Medical Center, Division of Endocrinology, Denver, Colorado, USA
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26
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Ostendorf DM, Lyden K, Pan Z, Wyatt HR, Hill JO, Melanson EL, Catenacci VA. Objectively Measured Physical Activity and Sedentary Behavior in Successful Weight Loss Maintainers. Obesity (Silver Spring) 2018; 26:53-60. [PMID: 29090513 PMCID: PMC5739988 DOI: 10.1002/oby.22052] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 09/22/2017] [Accepted: 09/25/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objective of this study was to compare patterns of objectively measured moderate-to-vigorous physical activity (MVPA, ≥ 3.00 metabolic equivalents [METs]), light-intensity physical activity (LPA, 1.50-2.99 METs), and sedentary behavior (SB, < 1.50 METs) in successful weight loss maintainers (WLMs), normal weight controls (NC), and controls with overweight/obesity (OC). METHODS Participants (18-65 y) were recruited in three groups: WLM (maintaining ≥ 13.6-kg weight loss for ≥ 1 year, n = 30), NC (BMI matched to current BMI of WLM, n = 33), and OC (BMI matched to pre-weight loss BMI of WLM, n = 27). All participants wore the activPAL for 1 week. RESULTS Compared with OC and NC, WLM spent more awake time in total MVPA (WLM: 9.6 ± 3.9%, NC: 7.1 ± 2.1%, OC: 5.9 ± 2.0%; P < 0.01) and more time in sustained (≥ 10 min) bouts of MVPA (WLM: 39 ± 33, NC: 17 ± 14, OC: 9 ± 11 min/d; P < 0.01). Compared with OC, WLM and NC spent more awake time in LPA (WLM: 29.6 ± 7.9%, NC: 29.1 ± 8.3%, OC: 24.8 ± 6.7%; P = 0.04) and less awake time sedentary (WLM: 60.8 ± 9.3%, NC: 63.8 ± 9.5%, OC: 69.3 ± 7.5%; P < 0.01). CONCLUSIONS Results provide additional data supporting the important role of MVPA in weight loss maintenance and suggest notable differences in LPA and SB between normal weight individuals and those with overweight/obesity. Increasing LPA and/or decreasing SB may be additional potential targets for weight management interventions.
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Affiliation(s)
- Danielle M. Ostendorf
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora CO
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora CO
| | - Kate Lyden
- KAL Research & Consulting LLC, Denver, CO
| | - Zhaoxing Pan
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora CO
| | - Holly R. Wyatt
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora CO
| | - James O. Hill
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora CO
| | - Edward L. Melanson
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora CO
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora CO
- Eastern Colorado VA Geriatric Research, Education, and Clinical Center, Denver CO
| | - Victoria A. Catenacci
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora CO
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora CO
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27
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Late breast cancer treatment-related symptoms and functioning: associations with physical activity adoption and maintenance during a lifestyle intervention for rural survivors. Breast Cancer Res Treat 2017; 168:755-761. [PMID: 29273954 DOI: 10.1007/s10549-017-4603-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 11/30/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE Physical activity may be difficult for survivors with poorer functioning following primary treatment. The study examined whether late symptoms of breast cancer treatment impact PA adoption (0-6 months) and maintenance (6-18 months) during a weight management intervention, and whether late symptoms influence PA when accounting for overall functioning. METHODS Secondary analyses were conducted using a sample of survivors participating in a weight management intervention and who provided valid weight and accelerometer data at baseline and 6 months (N = 176). The Breast Cancer Prevention Trial Symptom Checklist (BCPT) assessed late treatment-related symptoms. SF-12 Physical Component Scale (PCS) and Mental Component Scale (MCS) scores assessed functioning. RESULTS Change in bouted moderate to vigorous physical activity (MVPA) min/week from baseline to 6 months was not associated with BCPT scales (all p values > 0.05). When adding SF-12 scores to the model, change in bouted MVPA min/week was significantly associated with the PCS (p = 0.045). Change in MVPA min/week from 6 to 18 months was significantly associated with cognitive symptoms (p = 0.004), but not musculoskeletal or vasomotor symptoms (p values > 0.05). When adding 6-month SF-12 scores to the model, MVPA min/week was significantly associated with PCS (p = 0.001) and MCS (p = 0.028); however, BCPT cognitive problems score became non-significant (p > 0.05). CONCLUSIONS Poorer physical functioning was associated with lower PA adoption, and poorer mental and physical functioning was associated with lower maintenance of PA, while late symptoms generally were not. Interventionists should consider level of functioning when identifying individual PA goals during weight management interventions.
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28
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Jakicic JM, Rogers RJ, Davis KK, Collins KA. Role of Physical Activity and Exercise in Treating Patients with Overweight and Obesity. Clin Chem 2017; 64:99-107. [PMID: 29158251 DOI: 10.1373/clinchem.2017.272443] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 11/02/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Overweight and obesity are significant public health concerns that are linked to numerous negative health consequences. Physical activity is an important lifestyle behavior that contributes to body weight regulation. CONTENT Physical activity is inversely associated with weight gain and the incidence of obesity. Physical activity also contributes to additional weight loss when coupled with dietary modification, and it can result in modest weight loss when not coupled with dietary modification. Moreover, physical activity is associated with improved long-term weight loss and prevention of weight gain following initial weight loss. Current evidence supports that physical activity should be moderate to vigorous in intensity to influence body weight regulation. There is also a growing body of evidence that physical activity can be accumulated throughout the day in shorter periods of time rather than being performed during a structured and longer period, and that physical activity performed in this manner can be important for body weight regulation. SUMMARY The literature supports the inclusion of physical activity as an important lifestyle behavior for regulating body weight. There are multiple intervention approaches that may be effective for enhancing physical activity engagement within the context of weight control.
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Affiliation(s)
- John M Jakicic
- Physical Activity and Weight Management Research Center, Healthy Lifestyle Institute, University of Pittsburgh, Pittsburg, PA.
| | - Renee J Rogers
- Physical Activity and Weight Management Research Center, Healthy Lifestyle Institute, University of Pittsburgh, Pittsburg, PA
| | - Kelliann K Davis
- Physical Activity and Weight Management Research Center, Healthy Lifestyle Institute, University of Pittsburgh, Pittsburg, PA
| | - Katherine A Collins
- Physical Activity and Weight Management Research Center, Healthy Lifestyle Institute, University of Pittsburgh, Pittsburg, PA
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29
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The influence of Aqua Power aerobics on body mass reduction in middle-aged, overweight women. Turk J Phys Med Rehabil 2017; 63:293-298. [PMID: 31453470 DOI: 10.5606/tftrd.2017.853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 01/25/2017] [Indexed: 02/05/2023] Open
Abstract
Objectives This study aims to evaluate the effects of Aqua Power exercises on the body composition and cardiovascular response in middle- aged, overweight women after a six-month intervention. Patients and methods Between November 2013 and May 2014, a total of 37 middle-aged, overweight women (mean age 42.6 years, range 36 to 57 years) participated in the Aqua Power aerobic sessions twice per week for six months. The body composition was evaluated using the near-infrared method. The heart rate was self-controlled by the participant during the exercise. Results The majority of the body composition elements decreased after six months of the Aqua Power aerobic training. The heart rate values decreased in the females after the intervention period. Conclusion Aqua Power aerobics can be recommended for middle-aged females for the treatment of overweight and in the process of cardiopulmonary fitness improvement.
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30
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Kerns JC, Guo J, Fothergill E, Howard L, Knuth ND, Brychta R, Chen KY, Skarulis MC, Walter PJ, Hall KD. Increased Physical Activity Associated with Less Weight Regain Six Years After "The Biggest Loser" Competition. Obesity (Silver Spring) 2017; 25:1838-1843. [PMID: 29086499 PMCID: PMC5757520 DOI: 10.1002/oby.21986] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 07/27/2017] [Accepted: 08/09/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of this study was to explore how physical activity (PA) and energy intake (EI) changes were related to weight loss and regain following "The Biggest Loser" competition. METHODS At baseline, week 6 and week 30 of the competition, and 6 years after the competition, body composition was measured via dual-energy x-ray absorptiometry, resting energy expenditure was measured by using indirect calorimetry, and EI and PA were measured by using doubly labeled water. RESULTS Six years after the competition, median weight loss in 14 of "The Biggest Loser" participants was 13%, with those maintaining a greater weight loss (mean ± SE) of 24.9% ± 3.8% having increased PA by 160% ± 23%, compared with a PA increase of 34% ± 25% (P = 0.0033) in the weight regainers who were 1.1% ± 4.0% heavier than the precompetition baseline. EI changes were similar between weight loss maintainers and regainers (-8.7% ± 5.6% vs. -7.4% ± 2.7%, respectively; P = 0.83). Weight regain was inversely associated with absolute changes in PA (r = -0.82; P = 0.0003) but not with changes in EI (r = -0.15; P = 0.61). EI and PA changes explained 93% of the individual weight loss variability at 6 years. CONCLUSIONS Consistent with previous reports, large and persistent increases in PA may be required for long-term maintenance of lost weight.
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Affiliation(s)
| | - Juen Guo
- National Institute of Diabetes and Digestive and Kidney Diseases
| | - Erin Fothergill
- National Institute of Diabetes and Digestive and Kidney Diseases
| | - Lilian Howard
- National Institute of Diabetes and Digestive and Kidney Diseases
| | | | - Robert Brychta
- National Institute of Diabetes and Digestive and Kidney Diseases
| | - Kong Y. Chen
- National Institute of Diabetes and Digestive and Kidney Diseases
| | | | - Peter J. Walter
- National Institute of Diabetes and Digestive and Kidney Diseases
| | - Kevin D. Hall
- National Institute of Diabetes and Digestive and Kidney Diseases
- To whom correspondence should be addressed: Kevin D. Hall, PhD, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, 12A South Drive, Room 4007, Bethesda, MD 20892-5621, phone: 301-402-8248, fax: 301-402-0535,
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31
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Fazzino TL, Fabian C, Befort CA. Change in Physical Activity During a Weight Management Intervention for Breast Cancer Survivors: Association with Weight Outcomes. Obesity (Silver Spring) 2017; 25 Suppl 2:S109-S115. [PMID: 29086523 PMCID: PMC5679351 DOI: 10.1002/oby.22007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 08/18/2017] [Accepted: 08/21/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study examined the effects of a group phone-based weight management intervention on change in physical activity as measured via accelerometer and self-report in rural breast cancer survivors. The study also evaluated the role of physical activity on clinically meaningful cut points for weight loss (baseline to 6 months) and weight loss maintenance (6 to 18 months). METHODS Participants were breast cancer survivors in a weight management intervention who provided valid weight and accelerometer data (N = 142). Participants were categorized into four groups based on weight loss ≥10% and weight regain ≥5% at 18 months. RESULTS Accelerometer-measured moderate-to-vigorous physical activity (MVPA) significantly increased from baseline to 6 months (+46.9 minutes). MVPA declined during maintenance but remained significantly greater than baseline. Self-reported MVPA followed a similar pattern as accelerometer MVPA, but estimates were significantly higher. Participants in the high loss, low regain group had significantly higher MVPA at all points. CONCLUSIONS A distance-based weight management intervention for survivors improved physical activity outcomes over 18 months. Self-reported physical activity was substantially higher than accelerometer measured. Findings highlight the importance of device-based measurement for characterizing the magnitude of physical activity change as well as the role of physical activity in weight management outcomes.
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Affiliation(s)
- Tera L Fazzino
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Carol Fabian
- Department of Internal Medicine, Division of Medical Oncology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Christie A Befort
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas, USA
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Unick JL, Gaussoin SA, Hill JO, Jakicic JM, Bond DS, Hellgren M, Johnson KC, Peters AL, Coday M, Kitzman DW, Bossart S, Wing RR. Objectively Assessed Physical Activity and Weight Loss Maintenance among Individuals Enrolled in a Lifestyle Intervention. Obesity (Silver Spring) 2017; 25:1903-1909. [PMID: 28940967 PMCID: PMC5695666 DOI: 10.1002/oby.21971] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 11/07/2022]
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.
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Affiliation(s)
- Jessica L Unick
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Sarah A Gaussoin
- Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - James O Hill
- Center for Human Nutrition, School of Medicine, University of Colorado, Denver, Colorado
| | - John M Jakicic
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Dale S Bond
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA
| | - Margareta Hellgren
- Department of Public Health and Community Medicine/Primary Health Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karen C Johnson
- Department of Preventive Medicine, Health Science Center, University of Tennessee, Memphis, Tennessee, USA
| | - Anne L Peters
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Mace Coday
- Department of Preventive Medicine, Health Science Center, University of Tennessee, Memphis, Tennessee, USA
| | - Dalane W Kitzman
- Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Suzette Bossart
- Center for Human Nutrition, School of Medicine, University of Colorado, Denver, Colorado
| | - Rena R Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA
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Bryan AD, Jakicic JM, Hunter CM, Evans ME, Yanovski SZ, Epstein LH. Behavioral and Psychological Phenotyping of Physical Activity and Sedentary Behavior: Implications for Weight Management. Obesity (Silver Spring) 2017; 25:1653-1659. [PMID: 28948719 PMCID: PMC5657446 DOI: 10.1002/oby.21924] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 06/07/2017] [Accepted: 06/08/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Risk for obesity is determined by a complex mix of genetics and lifetime exposures at multiple levels, from the metabolic milieu to psychosocial and environmental influences. These phenotypic differences underlie the variability in risk for obesity and response to weight management interventions, including differences in physical activity and sedentary behavior. METHODS As part of a broader effort focused on behavioral and psychological phenotyping in obesity research, the National Institutes of Health convened a multidisciplinary workshop to explore the state of the science in behavioral and psychological phenotyping in humans to explain individual differences in physical activity, both as a risk factor for obesity development and in response to activity-enhancing interventions. RESULTS Understanding the behavioral and psychological phenotypes that contribute to differences in physical activity and sedentary behavior could allow for improved treatment matching and inform new targets for tailored, innovative, and effective weight management interventions. CONCLUSIONS This summary provides the rationale for identifying psychological and behavioral phenotypes relevant to physical activity and identifies opportunities for future research to better understand, define, measure, and validate putative phenotypic factors and characterize emerging phenotypes that are empirically associated with initiation of physical activity, response to intervention, and sustained changes in physical activity.
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Affiliation(s)
| | | | - Christine M. Hunter
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Mary E. Evans
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Susan Z. Yanovski
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Leonard H. Epstein
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
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Creasy SA, Rogers RJ, Davis KK, Gibbs BB, Kershaw EE, Jakicic JM. Effects of supervised and unsupervised physical activity programmes for weight loss. Obes Sci Pract 2017; 3:143-152. [PMID: 28713583 PMCID: PMC5478811 DOI: 10.1002/osp4.107] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 03/20/2017] [Accepted: 03/21/2017] [Indexed: 11/12/2022] Open
Abstract
Objectives Physical activity is important for weight management. However, it remains unclear what type of physical activity prescription/programme is optimal for increasing physical activity during a standard behavioural weight loss intervention. This study examined changes in physical activity after a 12‐week supervised programme prescribed in minutes per week (SUP‐PA), an unsupervised programme prescribed in minutes per week (UNSUP‐PA) and an unsupervised programme prescribed in steps per day (STEP). Methods Fifty‐two adults who were overweight or obese (age: 43.5 ± 10.1 years, BMI: 31.5 ± 3.5 kg·m−2) were randomized to STEP (n = 18), UNSUP‐PA (n = 17) and SUP‐PA (n = 17). Subjects attended weekly in‐person group intervention sessions and were prescribed a calorie‐restricted diet (1,200–1,800 kcals·day−1) combined with increased physical activity (150 min·week−1 or 10,000 steps·day−1 with 2,500 brisk steps·day−1). Results All three groups significantly increased moderate‐to‐vigorous physical activity (STEP: 80.6 ± 218.5 min·week−1, UNSUP‐PA: 112.9 ± 180.4 min·week−1 and SUP‐PA: 151.1 ± 174.0 min·week−1, p < 0.001) with no differences between groups (p = 0.94) or group by time interaction (p = 0.81). In addition, there were no significant differences in weight loss between the groups (p = 0.81). Conclusions In this short‐term study, all three physical activity programmes increased physical activity and elicited modest weight loss when combined with a standard behavioural weight loss intervention.
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Affiliation(s)
- S A Creasy
- Department of Health and Physical Activity, Physical Activity and Weight Management Research Center University of Pittsburgh Pittsburgh PA USA.,Division of Endocrinology, Metabolism and Diabetes University of Colorado Anschutz Medical Campus Aurora CO USA
| | - R J Rogers
- Department of Health and Physical Activity, Physical Activity and Weight Management Research Center University of Pittsburgh Pittsburgh PA USA
| | - K K Davis
- Department of Health and Physical Activity, Physical Activity and Weight Management Research Center University of Pittsburgh Pittsburgh PA USA
| | - B B Gibbs
- Department of Health and Physical Activity, Physical Activity and Weight Management Research Center University of Pittsburgh Pittsburgh PA USA
| | - E E Kershaw
- Division of Endocrinology and Metabolism University of Pittsburgh Pittsburgh PA USA
| | - J M Jakicic
- Department of Health and Physical Activity, Physical Activity and Weight Management Research Center University of Pittsburgh Pittsburgh PA USA
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Bond DS, Thomas JG, Vithiananthan S, Unick J, Webster J, Roye GD, Ryder BA, Sax HC. Intervention-related increases in preoperative physical activity are maintained 6-months after Bariatric surgery: results from the bari-active trial. Int J Obes (Lond) 2016; 41:467-470. [PMID: 28025574 PMCID: PMC5340609 DOI: 10.1038/ijo.2016.237] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 11/08/2016] [Accepted: 12/11/2016] [Indexed: 12/25/2022]
Abstract
Higher preoperative physical activity (PA) strongly predicts higher post-operative PA in bariatric surgery (BS) patients, providing rationale for preoperative PA interventions (PAIs). However, whether PAI-related increases can be maintained post-operatively has not been examined. This study compared PA changes across pre- (baseline, post-intervention) and post-operative (6-month follow up) periods in participants randomized to 6 weeks of preoperative PAI or standard care control (SC). Of 75 participants initially randomized, 36 (PAI n=22; SC n=14) underwent BS. Changes in daily bout-related (⩾10-min bouts) moderate-to-vigorous PA (MVPA) and steps were assessed via the SenseWear Armband monitor. PAI received weekly counseling to increase walking exercise. Retention (86%) at post-operative follow up was similar between groups. Intent-to-treat analyses showed that PAI vs SC had greater increases across time (baseline, post-intervention, follow up) in bout-related MVPA minutes/day (4.3±5.1, 26.3±21.3, 28.7±26.3 vs 10.4±22.9, 11.4±16.0, 18.5±28.2; P=0.013) and steps/day (5163±2901, 7950±3286, 7870±3936 vs 5163±2901, 5601±3368, 5087±2603; P<0.001). PAI differed from SC on bout-related MVPA at post-intervention (P=0.016; d=0.91), but not follow up (P=0.15; d=0.41), and steps at post-intervention (P=0.031; d=0.78) and follow up (P=0.024; d=0.84). PAI participants maintained preoperative PA increases post-operatively. Findings support preoperative PAIs and research to test whether PA changes can be sustained and influence surgical outcomes beyond the initial post-operative period.
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Affiliation(s)
- D S Bond
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - J G Thomas
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - S Vithiananthan
- Department of Surgery, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - J Unick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - J Webster
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - G D Roye
- Department of Surgery, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - B A Ryder
- Department of Surgery, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - H C Sax
- Department of Surgery, Cedars-Sinai Medicine, Hollywood, CA, USA
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Jefferis BJ, Parsons TJ, Sartini C, Ash S, Lennon LT, Wannamethee SG, Lee IM, Whincup PH. Does duration of physical activity bouts matter for adiposity and metabolic syndrome? A cross-sectional study of older British men. Int J Behav Nutr Phys Act 2016; 13:36. [PMID: 26980183 PMCID: PMC4793648 DOI: 10.1186/s12966-016-0361-2] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 03/08/2016] [Indexed: 11/10/2022] Open
Abstract
Background Older adults have low physical activity(PA) and high sedentary behaviour(SB) levels. We investigate how total volume and specific patterns of moderate to vigorous PA(MVPA), light PA(LPA) and SB are related to adiposity and metabolic syndrome (MS). Then, with reference to physical activity guidelines which encourage MVPA in bouts > =10 min and avoiding “long” sedentary bouts, we investigate whether accumulating PA and SB in bouts of different defined durations are differently associated with these outcomes. Methods Cross-sectional study of men (71–91 years) recruited in UK primary care centres. Nurses made physical measures (weight, height, bio-impedance, blood pressure) and took fasting blood samples. 1528/3137 (49 %) surviving men had ≥3 valid days (≥600 min) accelerometer data. 450 men with pre-existing chronic disease were excluded. 1009/1078 (93.6 %) had complete covariate data. Results Men (n = 1009, mean age 78.5(SD 4.7) years) spent 612(SD 83), 202(SD 64) and 42(SD 33) minutes in SB, LIPA and MVPA respectively. Each additional 30 min/day of SB and MVPA were associated with 0.32 (95 % CI 0.23, 0.40)Kg/m2 higher Body Mass Index (BMI) and −0.72(−0.93, −0.51) lower BMI Kg/m2 respectively. Patterns for waist circumference (WC), fat mass index (FMI), fasting insulin and MS were similar. MVPA in bouts lasting <10 min or ≥10 min duration were not associated differently with outcomes. In models adjusted for total MVPA, each minute accumulated in SB bouts lasting 1–15 min was associated with lower BMI −0.012 kg/m2, WC −0.029 cm, and OR 0.989 for MS (all p < 0.05), and coefficients for LPA bouts 1–9 min were very similar in separate models adjusted for total MVPA. Minutes accumulated in SB bouts 1–15 min and LPA bouts 1–9 min were correlated, r = 0.62. Conclusions Objectively measured MVPA, LPA and SB were all associated with lower adiposity and metabolic risk. The beneficial associations of LPA are encouraging for older adults for whom initiating MVPA and maintaining bouts lasting ≥10 min may be particularly challenging. Findings that short bouts of LPA (1–9 min) and SB (1–15 min), but that all MVPA, not just MVPA accumulated in bouts ≥10 min were associated with lower adiposity and better metabolic health could help refine older adult PA guidelines.
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Affiliation(s)
- Barbara J Jefferis
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK. .,UCL Physical Activity Research Group, London, UK.
| | - Tessa J Parsons
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK.,UCL Physical Activity Research Group, London, UK
| | - Claudio Sartini
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK.,UCL Physical Activity Research Group, London, UK
| | - Sarah Ash
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK
| | - Lucy T Lennon
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK
| | - S Goya Wannamethee
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK
| | - I-Min Lee
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02215, USA
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
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Karimi N, Dabidi Roshan V, Fathi Bayatiyani Z. Individually and Combined Water-Based Exercise With Ginger Supplement, on Systemic Inflammation and Metabolic Syndrome Indices, Among the Obese Women With Breast Neoplasms. IRANIAN JOURNAL OF CANCER PREVENTION 2015; 8:e3856. [PMID: 26855719 PMCID: PMC4736069 DOI: 10.17795/ijcp-3856] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 09/16/2015] [Accepted: 11/15/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Breast neoplasms has known as the most common cancer among the women worldwide, and relationship between obesity, metabolic syndrome, inflammation and cancer has been recognized since many years ago. OBJECTIVES The aim of this study was to determine the individual and concomitant effect of 6-weeks water-based exercise and oral ginger supplement on markers that have related to metabolic syndrome and systemic inflammation in obese women with breast neoplasms. PATIENTS AND METHODS Forty women whose have diagnosed with breast neoplasms have volunteered to participate in the study. Subjects have randomly assigned into four groups; placebo, exercise training, ginger supplement and exercise training+ ginger supplement groups. Subjects in the ginger supplement group and the exercise training+ ginger supplement group have orally received 4 capsules, 7 days a week and for 6 weeks. The water-based exercise training program have collected at a progressive intensity and time, have ranged from 50% to 75% of heart rate reserve, in a pool, 4 times a week for 6 weeks. Fasting blood sampling has collected at the pretest and post-test. RESULTS The ginger supplementation and the water-base exercise have resulted in a reduction of hs-CRP, IL-10, insulin, glucose, insulin resistance, LDL-C, TG; but an increase in HDL-C and HDL-C/LDL-C. The water-base exercise and ginger supplement group have significantly shown larger positive effect in all outcomes, in comparison with the water-base exercise or ginger supplement alone groups. CONCLUSIONS Findings have suggested that obese breast neoplasms survivors have commonly shown metabolic syndrome and elevated inflammation, which placed them at an increased risk for cardiovascular diseases. Moreover, data has indicated a protective effect of the nondrug strategies, such as water-base exercise and ginger supplementation have played an important role in pathogenesis of inflammatory and metabolic responses, among diagnosed breast neoplasms.
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Affiliation(s)
- Niloofar Karimi
- Department of Sport Physiology, Faculty of Physical Education and Sport Sciences, University of Mazandaran, Babolsar, IR Iran
| | - Valiollah Dabidi Roshan
- Department of Sport Physiology, Faculty of Physical Education and Sport Sciences, University of Mazandaran, Babolsar, IR Iran
| | - Zohreh Fathi Bayatiyani
- Department of Sport Physiology, Faculty of Physical Education and Sport Sciences, University of Mazandaran, Babolsar, IR Iran
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Jakicic JM, King WC, Marcus MD, Davis KK, Helsel D, Rickman AD, Gibbs BB, Rogers RJ, Wahed A, Belle SH. Short-term weight loss with diet and physical activity in young adults: The IDEA study. Obesity (Silver Spring) 2015; 23:2385-97. [PMID: 26538477 PMCID: PMC4701624 DOI: 10.1002/oby.21241] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Revised: 07/20/2015] [Accepted: 07/20/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study examined the effect of a behavioral weight loss intervention (BWLI) on young adults (age = 18-35 years). METHODS Participants (N = 470) enrolled in a 6-month BWLI that included weekly group sessions, a prescribed energy-restricted diet, and moderate to vigorous physical activity (MVPA). Assessments included weight, body composition, fitness, lipids, glucose, insulin, resting blood pressure and heart rate, physical activity, and dietary intake. Data are presented as median [25th, 75th percentiles]. RESULTS Retention was 90% (N = 424; age: 30.9 [27.8, 33.7] years; BMI: 31.2 [28.4, 34.3] kg m(-2) ). Participants completed 87.5% [76.1%, 95.5%] of scheduled intervention contacts. Weight and body fat decreased while fitness increased (P < 0.0001). MVPA in bouts ≥10 min increased (P < 0.0001), though total MVPA did not change significantly. Sedentary time decreased (P = 0.03). Energy and percent fat intake decreased, while percent carbohydrate and protein intake increased (P < 0.0001). Systolic and diastolic blood pressure, total cholesterol, LDL cholesterol, triglycerides, glucose, and insulin decreased (P < 0.0001). CONCLUSIONS A 6-month BWLI produced favorable changes in dietary intake and physical activity and elicited favorable changes in weight and other health outcomes in young adults. MVPA performed in bouts of ≥10 min was associated with greater weight loss, but sedentary behavior was not.
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Affiliation(s)
- John M. Jakicic
- Department of Health and Physical Activity, Physical Activity and Weight Management Research Center, University of Pittsburgh
| | - Wendy C. King
- Department of Epidemiology and Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh
| | - Marsha D. Marcus
- Department of Psychiatry, School of Medicine, University of Pittsburgh
| | - Kelliann K. Davis
- Department of Health and Physical Activity, Physical Activity and Weight Management Research Center, University of Pittsburgh
| | - Diane Helsel
- Department of Nutrition and Exercise Science, Bastyr University
| | - Amy D. Rickman
- Department of Health and Physical Activity, Physical Activity and Weight Management Research Center, University of Pittsburgh
| | - Bethany Barone Gibbs
- Department of Health and Physical Activity, Physical Activity and Weight Management Research Center, University of Pittsburgh
| | - Renee J. Rogers
- Department of Health and Physical Activity, Physical Activity and Weight Management Research Center, University of Pittsburgh
| | - Abdus Wahed
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh
| | - Steven H. Belle
- Department of Psychiatry, School of Medicine, University of Pittsburgh
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh
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