Improvements in Cardiovascular Risk Factors in Young Adults in a Randomized Trial of Approaches to Weight Gain Prevention

Low dose of liraglutide combined with metformin leads to a significant weight loss in Chinese Han women with polycystic ovary syndrome: a retrospective study

BACKGROUND

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder with complex pathophysiological mechanism. It is reported that even a modest weight loss of 5-10% substantially may improve the reproductive and metabolic profile. This study aims to assess the efficacy of the low dose of liraglutide (0.6 mg QD) combined with metformin (0.85 mg BID) in weight loss in Chinese Han women with PCOS.

METHODS

We included clinical data of 102 obese/overweight (≥18 years, body mass index ≥28 kg/m² or ≥24 kg/m²) women who were diagnosed with PCOS from October 2016 to March 2018 in Wuhan Union Hospital initially. They were treated with dinae-35, low dose of liraglutide (0.6 mg QD) and metformin (0.85 mg BID) for 12 weeks. The demographic and clinical data were retrieved retrospectively, and weight loss was the main outcome measure. Student's paired t-test and Wilcoxon rank sum test were used to compare the differences before and after therapy, p < 0.05 was considered statistically significant.

RESULTS

Participants(n = 102)had lost a mean of 7.20 ± 3.42 kg of body weight (95%CI: 6.55-7.86, p < 0.001), and the mean reduction of BMI was 2.87 ± 1.36 kg/m² (95%CI: 0.02-0.27, p < 0.001). A total of 88.24% of participants lost more than 5% of their body weight.

CONCLUSION

The combination of low dose of liraglutide and metformin was associated with significant reduction of body weight in Chinese Han women with PCOS. Additionally, a larger randomized double-blind multicenter controlled clinical trial is needed to confirm that.

TRIAL REGISTRATION

The study was registered on http://www.chictr.org.cn as ChiCTR1900024384.

Weight gain prevention interventions in the Study of Novel Approaches to Weight Gain Prevention (SNAP) trial promote ideal cardiovascular health in young adults

OBJECTIVE

Cardiovascular health (CVH) declines in young adulthood. This study assessed whether weight gain prevention interventions promoted ideal CVH.

METHODS

Young adults (n = 599; age 18-35 years; BMI: 21.0-30.9 kg/m2 ) from a randomized controlled trial comparing two weight gain prevention interventions (self-regulation with large or small changes) and a self-guided control group completed anthropometric and clinical assessments at baseline and 2 years. CVH was quantified via the American Heart Association's Life's Simple 7 (LS7) number of ideal components met.

RESULTS

Both interventions showed significant improvements in the average number of ideal LS7 components met at 2 years compared with control (pre- to post-treatment means; large change: 0.24, small change: 0.34, control: -0.2, p < 0.05). Moreover, a greater percentage of participants in both interventions improved by ≥1 ideal component (large change: 35%, small change: 37%, control: 29%) and a smaller percentage declined by ≥1 ideal component (large change: 16%, small change: 20%, control: 30%) compared with control. For individual LS7 components, the odds of having an ideal BMI and glucose varied by treatment condition at 2 years.

CONCLUSIONS

Two weight gain prevention interventions led to improvements in ideal CVH at 2 years. Interventions explicitly focused on a broader constellation of LS7 domains might lead to even greater changes in CVH.

A qualitative investigation of the need for and feasibility of weight loss programs on university campuses

BACKGROUND

Despite the public health significance of overweight and obesity, weight management has remained a low priority for health-related programming on university campuses.

OBJECTIVE

Investigate the need for and feasibility of implementing university-based weight loss programs.

METHODS

The Practical, Robust Implementation and Sustainability Model (PRISM) was used as a framework. Semi-structured individual interviews were conducted with fifteen university staff and students from two large U.S. universities in the Northeast and Mid-Atlantic. Interviews aimed to assess readiness, preferences, characteristics, barriers and facilitators in each of the four adapted PRISM domains: (1) Organizational and Recipient (Student) Perspectives on the Intervention, (2) Recipient (Student) Characteristics, (3) Internal Environment (organizational characteristics and infrastructure), and (4) External Environment. Verbatim transcriptions were analyzed using inductive and deductive thematic analyses. Themes were extracted as outlined by Consensual Qualitative Research.

RESULTS

Participants supported university-based weight loss programs, but recognized barriers of resources, coordination across entities, and competing health issues taking priority for school programming. Campus built environment and students' busy schedules were identified as barriers to maintaining healthy weight and participation in weight loss programs. Recommendations included designing weight loss programming with a positive and holistic approach, minimizing weight-stigma, ensuring support from university leaders and students, and securing external funding.

CONCLUSIONS

The identified themes provide recommendations for universities looking to develop and implement weight loss programming.

Changes in Cardiovascular Risk Factors Over 6 Years in Young Adults in a Randomized Trial of Weight Gain Prevention

OBJECTIVE

This study aimed to determine the impact of weight gain prevention interventions on changes in cardiovascular risk factors over 6 years.

METHODS

The Study of Novel Approaches to Weight Gain Prevention (SNAP) randomized 599 participants (ages 18-35; 46% with BMI 21-25; 54% with BMI 25-30) to Large Changes (produce buffer by losing 5-10 pounds initially), Small Changes (daily small changes in intake and activity) or Control and followed 355 participants with ongoing intervention and assessments through 6 years.

RESULTS

There were no significant differences among interventions for changes in weight or cardiovascular disease (CVD) risk factors from baseline to 6 years. However, 44% of participants gained ≥5%, and only 14% lost ≥5% over 6 years. Weight changes, from baseline to year 6, were significantly associated with changes in risk factors, especially insulin and high-density lipoprotein cholesterol. Earlier weight changes (e.g., weight cycling) had no beneficial or adverse effect on changes in CVD risk factors at 6 years, independent of 6-year weight changes.

CONCLUSIONS

Despite participation in a weight gain prevention trial, almost half of these young adults gained ≥5% or more over 6 years, with significant worsening in CVD risk factors. Greater attention to long-term weight gain prevention in young adults is needed.

Weight Gain Over 6 Years in Young Adults: The Study of Novel Approaches to Weight Gain Prevention Randomized Trial

OBJECTIVE

The study objective was to determine whether two self-regulation interventions that reduced 3-year weight gain in young adults remain effective at 6 years.

METHODS

A randomized trial was conducted in two academic settings in 599 young adults, aged 18 to 35 years, with normal weight or overweight; 504 (84%) reconsented for a 6-year extension (Study of Novel Approaches to Weight Gain Prevention-Extended [SNAP-E]) with ongoing intervention and assessments. Weight gain over 6 years was compared for all assigned to Control, Large Changes (LC; lose 5-10 pounds initially), and Small Changes (SC; make small daily changes in intake and activity).

RESULTS

Weight change from baseline to 6 years did not differ significantly among the three groups (Control = 3.9 kg, SC = 4.1 kg, and LC = 2.8 kg). However, there was a significant age-by-treatment interaction (P = 0.002). Among those < 25 years old, weight gain from baseline to 6 years averaged 7.3 kg in the Control group and was reduced by almost 50% in LC and SC. LC also significantly reduced mean weight gain (area under the curve) over 6 years compared with Control or SC.

CONCLUSIONS

Although the interventions did not reduce weight gain at 6 years for the full cohort, they were effective in those < 25 years old. Future efforts should focus on young adults aged 18 to 24.9 and test more intensive interventions with more diverse participants.

Eating pathology and psychological outcomes in young adults in self-regulation interventions using daily self-weighing

OBJECTIVE

Self-regulation interventions encouraging daily weighing prevent weight gain in young adults; however, concerns have been raised that such interventions may have undesirable effects on eating pathology, depression, and health-related quality of life (HRQL). The present study examined whether self-regulation interventions and self-weighing frequency were associated with these indices in normal weight individuals and those with overweight or obesity.

METHODS

Young adults (n = 599), 18-35 years with a body mass index (BMI) 21.0-30.9 kg/m² were randomized to control, self-regulation with small changes (SC) or self-regulation with large changes (LC). Interventions taught frequent self-weighing to guide behavioral changes. SC prescribed daily small decreases in intake and increases in physical activity. LC prescribed a 5- to 10-lb weight loss to buffer against anticipated gains. Psychological indices were assessed at baseline and periodically over 2 years of follow-up.

RESULTS

There was no evidence that the interventions increased depressive symptoms or compensatory behaviors or decreased HRQL relative to control. LC increased flexible and rigid control and SC decreased disinhibition. Results did not differ by weight status with the exception of rigid control; here, differences between LC and the other conditions were smaller among those with BMI ≥ 25. Greater self-weighing frequency over time was associated with increases in flexible and rigid control, dietary restraint, and improvements in HRQL.

CONCLUSIONS

The self-regulation interventions and increases in self-weighing had no untoward effects. Encouraging weight gain prevention in young adults through frequent weighing and self-regulation appears to be safe for normal weight young adults and those with overweight. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Weight gain prevention buffers the impact of CETP rs3764261 on high density lipoprotein cholesterol in young adulthood: The Study of Novel Approaches to Weight Gain Prevention (SNAP)

BACKGROUND AND AIMS

Two weight gain prevention strategies, one targeting small changes to diet and physical activity and a second targeting large changes, significantly reduced weight gain in young adulthood. We examined whether weight gain prevention blunts genetic risk for body weight increase and/or high density lipoprotein cholesterol (HDL-C) lowering over two years.

METHODS AND RESULTS

Participants were 524 male and female young adults (mean age = 28.2, SD = 4.3; mean BMI = 25.5, SD = 2.6). Obesity-related SNPs accounting for ≥ 0.04% of the variance were genotyped and combined into a genetic risk score. For HDL-C, SNPs within CETP, LIPC and FADS2 were genotyped. The obesity-related genetic risk score did not predict change in BMI independently or in interaction with treatment arm. However, consistent with the prior literature, each copy of the HDL-C risk, C, allele at CETP rs3764261 was associated with lower HDL-C at baseline. Moreover, significant interaction between SNP and treatment arm for change in HDL-C was observed (p = 0.02). In the control group, HDL-C change was dependent upon rs3764261 (p = 0.004) with C allele carriers showing a continued reduction in HDL-C. In contrast, within the two intervention groups, HDL-C increased on average with no differential effect of rs3764261 (p > 0.24). Notably, even among carriers of the CC genotype, small and large change arms were associated with increased HDL-C and the control arm a reduction (p = 0.013).

CONCLUSIONS

The C allele at CETP rs3764261 is a strong risk factor for low HDL-C in young adulthood but weight gain prevention may mitigate this risk. CLINICAL TRIAL REGISTRY NUMBER AND WEBSITE: clinicaltrials.gov Identifier: NCT01183689, https://clinicaltrials.gov/.