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Ehmann MM, LaFata EM, McCausland HC, Knudsen FM, Butryn ML. Perceived importance of moderate-to-vigorous physical activity as a weight control strategy in behavioral weight loss. Obes Sci Pract 2023; 9:631-640. [PMID: 38090685 PMCID: PMC10712407 DOI: 10.1002/osp4.695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/13/2023] [Accepted: 06/27/2023] [Indexed: 02/01/2024] Open
Abstract
Background Previous research has established the importance of moderate-to-vigorous physical activity (MVPA) for weight control. One area of unexplored investigation is the relationship between individuals' perceptions of the importance of MVPA for weight control and MVPA engagement. This study examined the associations between the perceived importance of MVPA and MVPA engagement, weight loss, barriers to PA, and exercise enjoyment in adults enrolled in a long-term behavioral weight loss (BWL) intervention. Methods Adults (N = 301) with overweight/obesity (BMI = 27-45 kg/m2) completed an 18-month BWL intervention, followed by a no-intervention 18-month follow-up. At baseline, 6 months, 18 months (i.e., post-treatment), and 36 months (i.e., follow-up), participants ranked the importance of six strategies for weight control: keeping a food record, MVPA, light PA, self-weighing, small portions, and low-calorie diet. Observed MVPA (measured by accelerometer), percent weight loss, perceived barriers to PA, and exercise enjoyment were also measured at each assessment. Results Results showed that most participants perceived MVPA as a primary weight control strategy (first, second, or third most important) throughout the intervention, regardless of the weight control goal (weight loss vs. maintenance). Individuals who ranked MVPA as a primary strategy for weight control at concurrent time points, compared to those who did not, engaged in significantly more MVPA at post-treatment, had greater weight loss at follow-up, endorsed fewer barriers to PA at post-treatment and follow-up, and reported greater exercise enjoyment at baseline and post-treatment. Conclusion Perceived importance of MVPA was related to subjective experiences of MVPA, MVPA adherence, and weight loss in a long-term BWL intervention.
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Affiliation(s)
- Marny M. Ehmann
- Department of Psychological and Brain Sciences and Center for WeightEating and Lifestyle Science (WELL Center)Drexel UniversityPhiladelphiaPennsylvaniaUSA
| | - Erica M. LaFata
- Department of Psychological and Brain Sciences and Center for WeightEating and Lifestyle Science (WELL Center)Drexel UniversityPhiladelphiaPennsylvaniaUSA
| | - Hannah C. McCausland
- Department of Psychological and Brain Sciences and Center for WeightEating and Lifestyle Science (WELL Center)Drexel UniversityPhiladelphiaPennsylvaniaUSA
| | - Francesca M. Knudsen
- Department of Psychological and Brain Sciences and Center for WeightEating and Lifestyle Science (WELL Center)Drexel UniversityPhiladelphiaPennsylvaniaUSA
| | - Meghan L. Butryn
- Department of Psychological and Brain Sciences and Center for WeightEating and Lifestyle Science (WELL Center)Drexel UniversityPhiladelphiaPennsylvaniaUSA
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Flanagan EW, Spann R, Berry SE, Berthoud HR, Broyles S, Foster GD, Krakoff J, Loos RJF, Lowe MR, Ostendorf DM, Powell-Wiley TM, Redman LM, Rosenbaum M, Schauer PR, Seeley RJ, Swinburn BA, Hall K, Ravussin E. New insights in the mechanisms of weight-loss maintenance: Summary from a Pennington symposium. Obesity (Silver Spring) 2023; 31:2895-2908. [PMID: 37845825 PMCID: PMC10915908 DOI: 10.1002/oby.23905] [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: 05/17/2023] [Revised: 07/18/2023] [Accepted: 08/04/2023] [Indexed: 10/18/2023]
Abstract
Obesity is a chronic disease that affects more than 650 million adults worldwide. Obesity not only is a significant health concern on its own, but predisposes to cardiometabolic comorbidities, including coronary heart disease, dyslipidemia, hypertension, type 2 diabetes, and some cancers. Lifestyle interventions effectively promote weight loss of 5% to 10%, and pharmacological and surgical interventions even more, with some novel approved drugs inducing up to an average of 25% weight loss. Yet, maintaining weight loss over the long-term remains extremely challenging, and subsequent weight gain is typical. The mechanisms underlying weight regain remain to be fully elucidated. The purpose of this Pennington Biomedical Scientific Symposium was to review and highlight the complex interplay between the physiological, behavioral, and environmental systems controlling energy intake and expenditure. Each of these contributions were further discussed in the context of weight-loss maintenance, and systems-level viewpoints were highlighted to interpret gaps in current approaches. The invited speakers built upon the science of obesity and weight loss to collectively propose future research directions that will aid in revealing the complicated mechanisms involved in the weight-reduced state.
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Affiliation(s)
| | - Redin Spann
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Sarah E. Berry
- Department of Nutritional Sciences, King’s College London, London, UK
| | | | | | - Gary D. Foster
- WW International, New York, New York, USA
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology & Clinical Research Branch, NIDDK-Phoenix, Phoenix, Arizona, USA
| | - Ruth J. F. Loos
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Danielle M. Ostendorf
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Tiffany M. Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Leanne M. Redman
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Michael Rosenbaum
- Division of Molecular Genetics and Irving Center for Clinical and Translational Research, Columbia University Irving Medical Center, New York, New York, USA
| | | | - Randy J. Seeley
- Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Boyd A. Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Kevin Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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3
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Phelan S, Cardel MI, Lee AM, Alarcon N, Foster GD. Behavioral, psychological, and environmental predictors of weight regain in a group of successful weight losers in a widely available weight-management program. Obesity (Silver Spring) 2023; 31:2709-2719. [PMID: 37840409 DOI: 10.1002/oby.23903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE The aim of this study was to identify predictors of weight regain and continued weight maintenance among individuals already successful at long-term weight loss in a widely available weight-management program. METHODS Participants were 2843 weight-loss maintainers in WeightWatchers who had maintained weight loss ≥9.1 kg for ≥1 year (average 25.5 kg for 3.5 years; BMI = 26.7 kg/m2 ). Validated behavioral, psychosocial, and home environmental questionnaires were administered at study entry and 1 year later. Discriminant analysis identified variables that discriminated gainers (≥2.3-kg gain) from maintainers (±2.3-kg change). RESULTS Over the 1 year of follow-up, 43% were gainers (mean [SD], 7.2 [5.4] kg), and 57% were maintainers (0.4 [1.2] kg). Compared with maintainers, gainers were younger and had higher initial weight, more recent weight losses, and larger initial weight losses. Standardized canonical coefficients indicated that the 1-year changes that most discriminated gainers from maintainers were greater decreases in the ability to accept uncomfortable food cravings, urges, and desires to overeat (0.232); self-monitoring (0.166); body image (0.363); and body satisfaction (0.194) and greater increases in disinhibition (0.309) and bodily pain (0.147). The canonical correlation was 0.505 (p < 0.001). CONCLUSIONS Future interventions to prevent regain should consider targeting overeating in response to internal and external food cues and declines in self-monitoring and body image.
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Affiliation(s)
- Suzanne Phelan
- Department of Kinesiology & Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, California, USA
| | - Michelle I Cardel
- WW International, Inc., New York, New York, USA
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
| | | | - Noemi Alarcon
- Department of Kinesiology & Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, California, USA
| | - Gary D Foster
- WW International, Inc., New York, New York, USA
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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4
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Perchoux C, Brondeel R, Klein S, Klein O, Thierry B, Kestens Y, Chaix B, Gerber P. Does the built environment influence location- and trip-based sedentary behaviors? Evidence from a GPS-based activity space approach of neighborhood effects on older adults. ENVIRONMENT INTERNATIONAL 2023; 180:108184. [PMID: 37783123 DOI: 10.1016/j.envint.2023.108184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 08/18/2023] [Accepted: 09/02/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVE Evidence on the influence of built environments on sedentary behaviors remains unclear and is often contradictory. The main limitations encompass the use of self-reported proxies of sedentary time (ST), the scarce consideration of the plurality of sedentary behaviors, and environmental exposures limited to the residential neighborhood. We investigated the relationships between GPS-based activity space measures of environmental exposures and accelerometer-based ST measured in total, at the place of residence, at all locations, and during trips. METHODS This study is part of the CURHA project, based on 471 older adults residing in Luxembourg, who wore a GPS receiver and a tri-axial accelerometer during 7 days. Daily ST was computed in total, at the residence, at all locations and during trips. Environmental exposures included exposure to green spaces, walking, biking, and motorized transportation infrastructures. Associations between environments and ST were examined using linear and negative binomial mixed models, adjusted for demographics, self-rated health, residential self-selection, weather conditions and wear time. RESULTS Participants accumulated, on average, 8 h and 14 min of ST per day excluding sleep time. ST spent at locations accounted for 83 % of the total ST. ST spent at the residence accounted for 87 % of the location-based ST and 71 % of the total ST. Trip-based ST represents 13 % of total ST, and 4 % remained unclassified. Higher street connectivity was negatively associated with total ST, while the density of parking areas correlated positively with total and location-based ST. Stronger associations were observed for sedentary bouts (uninterrupted ST over 20 and 30 min). CONCLUSION Improving street connectivity and controlling the construction of new parking, while avoiding the spatial segregation of populations with limited access to public transport, may contribute to limit ST. Such urban planning interventions may be especially efficient in limiting the harmful uninterrupted bouts of ST among older adults.
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Affiliation(s)
- C Perchoux
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research (LISER), Esch-sur-Alzette, Luxembourg.
| | - R Brondeel
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - S Klein
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research (LISER), Esch-sur-Alzette, Luxembourg
| | - O Klein
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research (LISER), Esch-sur-Alzette, Luxembourg
| | - B Thierry
- Université de Montréal/Centre de Recherche du CHUM, Pavillon S, 850 rue St-Denis, Montréal, QC H2X 0A9, Canada
| | - Y Kestens
- Université de Montréal/Centre de Recherche du CHUM, Pavillon S, 850 rue St-Denis, Montréal, QC H2X 0A9, Canada
| | - B Chaix
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Nemesis Team, Faculté de Médecine Saint-Antoine, Paris, France
| | - P Gerber
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research (LISER), Esch-sur-Alzette, Luxembourg
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Uncovering Barriers and Facilitators of Weight Loss and Weight Loss Maintenance: Insights from Qualitative Research. Nutrients 2023; 15:nu15051297. [PMID: 36904294 PMCID: PMC10005538 DOI: 10.3390/nu15051297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 03/08/2023] Open
Abstract
Long-term weight loss maintenance is often difficult to achieve. This review analysed qualitative data on self-perceived barriers and facilitators of weight loss and weight loss maintenance among weight loss intervention participants. A literature search was conducted using electronic databases. Qualitative studies written in English and published between 2011-2021 were eligible for inclusion if they explored the perspectives and experiences of individuals who received standardised dietary and behavioural support for weight loss. Studies were excluded if weight loss was achieved through self-directed methods, only increasing physical activity, or surgical or pharmacological interventions. Fourteen studies were included, totaling 501 participants from six countries. Thematic analysis was used to identify four aggregate themes: internal factors (i.e., motivation and self-efficacy), programme-specific factors (i.e., the intervention diet), social factors (i.e., supporters and saboteurs), and environmental factors (i.e., an obesogenic environment). Our findings demonstrate that internal, social, and environmental factors all influence weight loss success, as well as the acceptability of the weight loss intervention. Future interventions may be more successful if they prioritise participant acceptability and engagement by, for example, providing tailored interventions, a structured relapse management plan, strategies to enhance autonomous motivation and emotional self-regulation, and extended contact during weight loss maintenance.
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Halliday TM, McFadden M, Cedillo M, Barone Gibbs B, Hess R, Bryce C, Fischer GS, Huber K, McTigue KM, Conroy MB. Lifestyle strategies after intentional weight loss: results from the MAINTAIN-pc randomized trial. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2023; 8:e000220. [PMID: 37458000 PMCID: PMC10348773 DOI: 10.1249/tjx.0000000000000220] [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] [Indexed: 02/16/2023]
Abstract
Introduction/Purpose Weight maintenance following intentional weight loss is challenging and often unsuccessful. Physical activity and self-monitoring are strategies associated with successful weight loss maintenance. However, less is known about the type and number of lifestyle strategies used following intentional weight loss. The purpose of this study was to determine the types and amounts of strategies associated with successful long-term weight loss maintenance. Methods Data from the 24-month Maintaining Activity and Nutrition Through Technology-Assisted Innovation in Primary Care (MAINTAIN-pc) trial were analyzed. MAINTAIN-pc recruited adults (n=194; 53.4±12.2 years of age, body mass index (BMI): 30.4±5.9 kg/m2, 74% female) with recent intentional weight loss of ≥5%, randomized to tracking tools plus coaching (i.e., coaching group) or tracking tools without coaching (i.e., tracking-only group). At baseline, 6, 12, and 24 months, participants reported lifestyle strategies used in the past 6 months, including self-monitoring, group support, behavioral skills, and professional support. General linear models evaluated changes in the number of strategies over time between groups and the consistency of strategies used over the 24-month intervention. Results At baseline, 100% used behavioral skills, 73% used group support, 69% used self-monitoring, and 68% used professional support in the past 6 months; at 24 months, these rates were 98%, 60%, 75%, and 61%, respectively. While the number of participants utilizing individual strategies did not change significantly over time, the overall number of strategies participants reported decreased. More strategies were used at baseline and 6 months compared to 12- and 24-month follow-ups. The coaching group used more strategies at months 6 and 12 than the tracking-only group. Consistent use of professional support strategies over the 24-month study period was associated with less weight regain. Conclusion Weight loss maintenance interventions that incorporate continued follow-up and support from healthcare professionals are likely to prevent weight regain after intentional weight loss.
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Affiliation(s)
- Tanya M. Halliday
- Department of Health and Kinesiology, College of Health, University of Utah, Salt Lake City, UT, USA
| | - Molly McFadden
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Maribel Cedillo
- Division of General Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Bethany Barone Gibbs
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rachel Hess
- Division of Health System Innovation and Research, Departments of Population Health Sciences and Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Cindy Bryce
- Department of Health Policy & Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh PA, USA
| | - Gary S. Fischer
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kimberly Huber
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathleen M. McTigue
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Molly B. Conroy
- Division of General Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
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7
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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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8
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Barinas JL, McDermott RC, Williams SG, Fruh SM, Hauff C, Hudson GM, Graves RJ, Melnyk BM. Positive and negative psychosocial factors related to healthy and unhealthy weight control among nursing students. J Prof Nurs 2022; 42:290-300. [PMID: 36150873 PMCID: PMC9783016 DOI: 10.1016/j.profnurs.2022.07.017] [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: 11/17/2021] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Although nursing students are educated on the importance of exercising regularly and maintaining a well-balanced diet, many do not practice healthy weight management behaviors, and some even use unhealthy weight loss methods. Yet, little research has examined both positive and negative psychosocial variables related to weight control among nursing students. PURPOSE The present study aimed to identify the most salient psychosocial variables related to healthy and unhealthy weight control among nursing students. METHOD Using survey data from 241 nursing students, structural equation modeling was conducted to examine the relative contributions of eight interrelated psychosocial variables, including constructs from a strengths perspective (health-specific hope, health self-efficacy, social support, and body satisfaction) and from a deficit perspective (depression, anxiety, weight perception, and barriers to physical activity). RESULTS Results showed that the degree to which individuals perceive themselves to be overweight was related to both healthy and unhealthy weight control. Aside from weight perception, health self-efficacy produced the strongest association with healthy weight control, and anxiety produced the strongest association with unhealthy weight control. The structural model explained 23 % of the variance in healthy weight control and 29 % of the variance in unhealthy weight control. CONCLUSIONS These findings emphasize the need for tailored, integrated weight management interventions for nursing students that equip them with effective anxiety management skills and build self-efficacy.
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Affiliation(s)
- Jennifer L Barinas
- Department of Psychology, University Commons 1000, University of South Alabama, Mobile, AL 36608, United States of America.
| | - Ryon C McDermott
- Department of Counseling and Instructional Sciences, University Commons 3800, University of South Alabama, Mobile, AL 36688, United States of America
| | - Susan G Williams
- College of Nursing, 5721 USA Drive North, University of South Alabama, Mobile, AL 36688, United States of America
| | - Sharon M Fruh
- College of Nursing, 5721 USA Drive North, University of South Alabama, Mobile, AL 36688, United States of America
| | - Caitlyn Hauff
- Department of Health, Kinesiology, and Sport, Suite 1016, University of South Alabama, Mobile, AL 36688, United States of America
| | - Geoffrey M Hudson
- Department of Health, Kinesiology, and Sport, Suite 1016, University of South Alabama, Mobile, AL 36688, United States of America
| | - Rebecca J Graves
- College of Nursing, 5721 USA Drive North, University of South Alabama, Mobile, AL 36688, United States of America
| | - Bernadette Mazurek Melnyk
- College of Nursing, 1585 Neil Avenue, The Ohio State University, Columbus, OH 43210, United States of America
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9
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Caldwell AE, Purcell SA, Gray B, Smieja H, Catenacci VA. The impact of yoga on components of energy balance in adults with overweight or obesity: A systematic review. Obes Sci Pract 2022; 8:219-232. [PMID: 35388342 PMCID: PMC8976548 DOI: 10.1002/osp4.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/02/2021] [Accepted: 07/08/2021] [Indexed: 12/02/2022] Open
Abstract
Background Yoga may reduce body weight in individuals with overweight or obesity, but whether this occurs through decreased energy intake (EI) or increased energy expenditure (EE)/physical activity (PA) is unclear. Methods A systematic search of PubMed, Web of Science, Embase, and PsychINFO was conducted from inception until April 26, 2021. Eligible studies included randomized controlled trials or single‐arm pre‐post studies with any type and duration of yoga intervention in adults with overweight or obesity. Studies with measures related to EI , EE, or PA were eligible. The review initially identified 1,373 articles. Results Of the 10 included studies, one used indirect calorimeter measures of resting EE, while nine used self‐reported measures of EI and PA. Of the seven studies measuring parameters related to EI, only one found greater decreases in EI relative to the control group, although three other investigations reported trends toward improved dietary intake. Of the eight studies measuring PA, two reported greater increases in resting EE or PA in the yoga group relative to the control group. Two reported significant within‐group increases in PA from pre‐post intervention, and four studies reported a trend for increased PA with no p‐values reported. Conclusions Limited evidence suggests yoga may reduce EI and increase PA in adults with overweight or obesity. Additional studies that investigate the effects of yoga interventions on energy balance parameters using objective techniques are warranted.
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Affiliation(s)
- Ann E. Caldwell
- Division of Endocrinology, Metabolism, and Diabetes School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
- Anschutz Health and Wellness Center School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
| | - Sarah A. Purcell
- Division of Endocrinology, Metabolism, and Diabetes School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
- Anschutz Health and Wellness Center School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
| | - Bethany Gray
- Anschutz Health and Wellness Center School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
| | - Hailey Smieja
- Anschutz Health and Wellness Center School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
| | - Victoria A. Catenacci
- Division of Endocrinology, Metabolism, and Diabetes School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
- Anschutz Health and Wellness Center School of Medicine University of Colorado – Anschutz Medical Campus Aurora Colorado USA
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10
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Casanova N, Beaulieu K, Oustric P, O'Connor D, Gibbons C, Blundell J, Finlayson G, Hopkins M. Increases in physical activity are associated with a faster rate of weight loss during dietary energy restriction in women with overweight and obesity. Br J Nutr 2022; 129:1-28. [PMID: 35249565 DOI: 10.1017/s000711452200023x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This secondary analysis examined the influence of changes in physical activity (PA), sedentary time and energy expenditure (EE) during dietary energy restriction on the rate of weight loss (WL) and 1-year follow-up weight change in women with overweight/obesity.Measurements of body weight and composition (air-displacement plethysmography), resting metabolic rate (indirect calorimetry), total daily (TDEE) and activity EE (AEE), minutes of PA and sedentary time (PA monitor) were taken at baseline, after 2 weeks, after ≥5% WL or 12 weeks of continuous (25% daily energy deficit) or intermittent (75% daily energy deficit alternated with ad libitum day) energy restriction, and at 1-year post-WL. The rate of WL was calculated as total %WL/number of dieting weeks. Data from both groups were combined for analyses.Thirty-seven participants (age=35±10y; BMI=29.1±2.3kg/m2) completed the intervention (WL=-5.9±1.6%) and 18 returned at 1-year post-WL (weight change=+4.5±5.2%). Changes in sedentary time at 2 weeks were associated with the rate of WL during energy restriction (r=-0.38; p=0.03). Changes in total (r=0.54; p<0.01), light (r=0.43; p=0.01) and moderate-to-vigorous PA (r=0.55; p<0.01), sedentary time (r=-0.52; p<0.01), steps per day (r=0.39; p=0.02), TDEE (r=0.46; p<0.01) and AEE (r=0.51; p<0.01) during energy restriction were associated with the rate of WL. Changes in total (r=-0.50; p=0.04) and moderate-to-vigorous PA (r=-0.61; p=0.01) between post-WL and follow-up were associated with 1-year weight change (r=-0.51; p=0.04).These findings highlight that PA and sedentary time could act as modifiable behavioural targets to promote better weight outcomes during dietary energy restriction and/or weight maintenance.
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Affiliation(s)
- Nuno Casanova
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK
- KinesioLab, Research Unit in Human Movement Analysis, Piaget Institute, Av. Jorge Peixinho 30 Quinta da Arreinela, 2805-059 Almada, Portugal
| | - Kristine Beaulieu
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Pauline Oustric
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Dominic O'Connor
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Catherine Gibbons
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - John Blundell
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Graham Finlayson
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Mark Hopkins
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK
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11
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Fanning J, Rejeski WJ, Leng I, Barnett C, Lovato JF, Lyles MF, Nicklas BJ. Intervening on exercise and daylong movement for weight loss maintenance in older adults: A randomized, clinical trial. Obesity (Silver Spring) 2022; 30:85-95. [PMID: 34932885 PMCID: PMC8711609 DOI: 10.1002/oby.23318] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study aimed to determine the impact of dietary weight loss (WL) plus aerobic exercise (EX) and a "move more, more often" approach to activity promotion (SitLess; SL) on WL and maintenance. METHODS Low-active older adults (age 65-86 years) with obesity were randomized to WL+EX, WL+SL, or WL+EX+SL. Participants received a social-cognitive group-mediated behavioral WL program for 6 months, followed by a 12-month maintenance period. EX participants received guided walking exercise with the goal of walking 150 min/wk. SL attempted to achieve a step goal by moving frequently during the day. The primary outcome was body weight at 18 months, with secondary outcomes including weight regain from 6 to 18 months and objectively assessed physical activity and sedentary behavior at each time point. RESULTS All groups demonstrated significant WL over 6 months (p < 0.001), with no group differences. Groups that received SL improved total activity time (p ≤ 0.05), and those who received EX improved moderate-to-vigorous activity time (p = 0.003). Over the 12-month follow-up period, those who received WL+EX demonstrated greater weight regain (5.2 kg; 95% CI: 3.5-6.9) relative to WL+SL (2.4 kg; 95% CI: 0.8-4.0). CONCLUSIONS Pairing dietary WL with a recommendation to accumulate physical activity contributed to similar WL and less weight regain compared with traditional aerobic exercise.
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Affiliation(s)
- Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Iris Leng
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Cheyenne Barnett
- Department of Internal Medicine, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - James F Lovato
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Mary F Lyles
- Department of Internal Medicine, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Barbara J Nicklas
- Department of Internal Medicine, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
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12
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Willis EA, Creasy SA, Saint-Maurice PF, Keadle SK, Pontzer H, Schoeller D, Troiano RP, Matthews CE. Physical Activity and Total Daily Energy Expenditure in Older US Adults: Constrained versus Additive Models. Med Sci Sports Exerc 2022; 54:98-105. [PMID: 34334719 PMCID: PMC8678174 DOI: 10.1249/mss.0000000000002759] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE This study aimed to examine the shape of the relationship between physical activity (PA) and total energy expenditure (TEE) and to explore the role of energy balance status (negative, stable, positive) in influencing this association. METHODS Cross-sectional. Participants were 584 older adults (50-74 yr) participating in the Interactive Diet and Activity Tracking in AARP study. TEE was assessed by doubly labeled water and PA by accelerometer. The relationship between PA and TEE was assessed visually and using nonlinear methods (restricted cubic splines). Percent weight change (>3%) over a 6-month period was used as a proxy measurement of energy balance status. RESULTS TEE generally increased with increasing deciles of PA averaging 2354 (SD, 351) kcal·d-1 in the bottom decile to 2693 (SD, 480) kcal·d-1 in the top decile. Cubic spline models showed an approximate linear association between PA and TEE (linear relation, P < 0.0001; curvature, P = 0.920). Results were similar in subgroup analyses for individuals classified as stable or positive energy balance. For those in negative energy balance, TEE was generally flat with increasing deciles of PA averaging 2428 (SD, 285) kcal·d-1 in the bottom decile to 2372 (SD, 560) kcal·d-1 in the top decile. CONCLUSIONS Energy balance status seems to play an important role in the relationship between PA and TEE. When in a positive energy balance, the relationship between TEE and PA was consistent with an additive model; however, when energy balance was negative, TEE seems to be consistent with a constrained model. These findings support PA for weight gain prevention by increasing TEE; however, the effect of PA on TEE during periods of weight loss may be limited. An adequately powered, prospective study is warranted to confirm these exploratory findings.
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Affiliation(s)
- 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
| | - 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
| | - Pedro F. Saint-Maurice
- Division of Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, Bethesda, MD
| | - Sarah Kozey Keadle
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA
| | - Hermann Pontzer
- Department of Evolutionary Anthropology, Duke University, Durham, NC
- Duke Global Health Institute, Duke University, Durham, NC
| | - Dale Schoeller
- Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
| | - Richard P. Troiano
- Risk Factor Assessment Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Charles E. Matthews
- Division of Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, Bethesda, MD
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13
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Blankenship JM, Rosenberg RC, Rynders CA, Melanson EL, Catenacci VA, Creasy SA. Examining the Role of Exercise Timing in Weight Management: A Review. Int J Sports Med 2021; 42:967-978. [PMID: 34034354 PMCID: PMC8591839 DOI: 10.1055/a-1485-1293] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Many adults cite exercise as a primary strategy for losing weight, yet exercise alone is modestly effective for weight loss and results in variable weight loss responses. It is possible that some of the variability in weight loss may be explained by the time of day that exercise is performed. Few studies have directly compared the effects of exercise performed at different times of the day (i. e., morning versus evening exercise). Results from these existing studies are mixed with some studies demonstrating superior weight and fat mass loss from morning exercise, while other studies have found that evening exercise may be better for weight management. Exercise timing may alter modifiable lifestyle behaviors involved in weight management, such as non-exercise physical activity, energy intake, and sleep. The purpose of this review is to summarize evidence for and against time-of-day dependent effects of exercise on weight management. Although limited, we also review studies that have examined the effect of exercise timing on other lifestyle behaviors linked to body weight regulation. While exercise at any time of day is beneficial for health, understanding whether there is an optimal time of day to exercise may advance personalized treatment paradigms for weight management.
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Affiliation(s)
- Jennifer M. Blankenship
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | - Corey A. Rynders
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, 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
- Department of Geriatrics, VA Eastern Colorado Health Care System, Aurora, CO
| | - Victoria A. Catenacci
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Seth A. Creasy
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, 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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14
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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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15
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O'Driscoll R, Turicchi J, Hopkins M, Duarte C, Horgan GW, Finlayson G, Stubbs RJ. Comparison of the Validity and Generalizability of Machine Learning Algorithms for the Prediction of Energy Expenditure: Validation Study. JMIR Mhealth Uhealth 2021; 9:e23938. [PMID: 34346890 PMCID: PMC8374660 DOI: 10.2196/23938] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/18/2020] [Accepted: 05/18/2021] [Indexed: 01/17/2023] Open
Abstract
Background Accurate solutions for the estimation of physical activity and energy expenditure at scale are needed for a range of medical and health research fields. Machine learning techniques show promise in research-grade accelerometers, and some evidence indicates that these techniques can be applied to more scalable commercial devices. Objective This study aims to test the validity and out-of-sample generalizability of algorithms for the prediction of energy expenditure in several wearables (ie, Fitbit Charge 2, ActiGraph GT3-x, SenseWear Armband Mini, and Polar H7) using two laboratory data sets comprising different activities. Methods Two laboratory studies (study 1: n=59, age 44.4 years, weight 75.7 kg; study 2: n=30, age=31.9 years, weight=70.6 kg), in which adult participants performed a sequential lab-based activity protocol consisting of resting, household, ambulatory, and nonambulatory tasks, were combined in this study. In both studies, accelerometer and physiological data were collected from the wearables alongside energy expenditure using indirect calorimetry. Three regression algorithms were used to predict metabolic equivalents (METs; ie, random forest, gradient boosting, and neural networks), and five classification algorithms (ie, k-nearest neighbor, support vector machine, random forest, gradient boosting, and neural networks) were used for physical activity intensity classification as sedentary, light, or moderate to vigorous. Algorithms were evaluated using leave-one-subject-out cross-validations and out-of-sample validations. Results The root mean square error (RMSE) was lowest for gradient boosting applied to SenseWear and Polar H7 data (0.91 METs), and in the classification task, gradient boost applied to SenseWear and Polar H7 was the most accurate (85.5%). Fitbit models achieved an RMSE of 1.36 METs and 78.2% accuracy for classification. Errors tended to increase in out-of-sample validations with the SenseWear neural network achieving RMSE values of 1.22 METs in the regression tasks and the SenseWear gradient boost and random forest achieving an accuracy of 80% in classification tasks. Conclusions Algorithms trained on combined data sets demonstrated high predictive accuracy, with a tendency for superior performance of random forests and gradient boosting for most but not all wearable devices. Predictions were poorer in the between-study validations, which creates uncertainty regarding the generalizability of the tested algorithms.
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Affiliation(s)
- Ruairi O'Driscoll
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Jake Turicchi
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Mark Hopkins
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, United Kingdom
| | - Cristiana Duarte
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Graham W Horgan
- Biomathematics & Statistics Scotland, Aberdeen, United Kingdom
| | - Graham Finlayson
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, United Kingdom
| | - R James Stubbs
- Appetite Control and Energy Balance Group, School of Psychology, University of Leeds, Leeds, United Kingdom
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16
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Iłowiecka K, Glibowski P, Skrzypek M, Styk W. The Long-Term Dietitian and Psychological Support of Obese Patients Who Have Reduced Their Weight Allows Them to Maintain the Effects. Nutrients 2021; 13:nu13062020. [PMID: 34208363 PMCID: PMC8231289 DOI: 10.3390/nu13062020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 12/25/2022] Open
Abstract
The role of post-therapeutic support after weight loss in obesity treatment is not fully understood. Therefore, weight maintenance after a successful weight loss intervention is not very common, especially in obese individuals. This randomized controlled study was conducted to explore the efficacy of following dietary and psychological support in a group of 36 obese individuals. Participants (22 women, 14 men aged 35.58 ± 9.85 years, BMI 35.04 ± 3.80 kg/m2) who completed a 12-month weight loss phase (balanced energy-restricted diet) were randomly allocated to receive 18-month support (SG) or no additional care (CG). The support phase included some elements of Ten Top Tips (TTT), cognitive behavioral therapy (CBT), motivational interviewing (MI) in combination with nutritional education and assessment of the level of physical activity. The primary outcome was the maintenance of anthropometric parameters at an 18-month follow-up. The secondary outcomes included evaluation of biochemical parameters and single nucleotide polymorphisms (SNPs) in genes connected with obesity. A comparison of SG vs. CG after a 30-month period of the study revealed significant differences in weight changes (−3.83 ± 6.09 vs. 2.48 ± 6.24 kg), Body Mass Index (−1.27 ± 2.02 vs. 0.72 ± 2.12 kg/m2), visceral adipose tissue (−0.58 ± 0.63 vs. 0.45 ± 0.74 L), and waist circumference (−4.83 ± 4.05 vs. 1.83 ± 5.97 cm). Analysis of SNPs (rs9939609 FTO, rs987237 TFAP2B, and rs894160 PLIN1) provided further insight into the potential modulating effect of certain genotypes on weight loss and maintenance and extended the knowledge of the potential benefits of personalized medicine. Post-therapeutical support in current clinical practice may increase the chances of long-term weight loss maintenance in obesity treatment even in patients with a genetic predisposition to excessive weight.
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Affiliation(s)
- Katarzyna Iłowiecka
- Department of Biotechnology, Microbiology and Human Nutrition, University of Life Sciences in Lublin, 20-704 Lublin, Poland;
| | - Paweł Glibowski
- Department of Biotechnology, Microbiology and Human Nutrition, University of Life Sciences in Lublin, 20-704 Lublin, Poland;
- Correspondence: ; Tel.: +48-(81)-462-33-49
| | - Michał Skrzypek
- Department of Clinical Dietetics, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Wojciech Styk
- Institute of Psychology, The John Paul II Catholic University of Lublin, 20-950 Lublin, Poland;
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17
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Roake J, Phelan S, Alarcon N, Keadle SK, Rethorst CD, Foster GD. Sitting Time, Type, and Context Among Long-Term Weight-Loss Maintainers. Obesity (Silver Spring) 2021; 29:1067-1073. [PMID: 34029443 DOI: 10.1002/oby.23148] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 02/01/2021] [Accepted: 02/09/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This study aimed to investigate sitting time, the home sedentary environment, and physical activity among weight-loss maintainers in WW (formerly Weight Watchers). METHODS Participants were 4,305 weight-loss maintainers who had maintained ≥9.1 kg of weight loss (24.7 kg on average) for 3.3 years and had an average current BMI of 27.6 kg/m2 . A control group of weight-stable individuals with obesity (n = 619) had an average BMI of 38.9 kg/m2 . The Multicontext Sitting Time Questionnaire and Paffenbarger physical activity questionnaire were administered. RESULTS Weight-loss maintainers versus controls spent 3 hours less per day sitting during the week (10.9 vs. 13.9; η p 2 = 0.039; P = 0.0001) and weekends (9.7 vs. 12.6; η p 2 = 0.038). Weight-loss maintainers versus controls spent 1 hour less per day in non-work-related sitting using a computer or video games during the week (1.4 vs. 2.3; η p 2 = 0.03; P = 0.0001) and weekends (1.5 vs. 2.5; η p 2 = 0.03; P = 0.0001). Weight-loss maintainers versus controls had similar numbers of sedentary-promoting devices (15.8 vs. 14.8) and expended significantly more calories per week in physical activity (1,835 vs. 785; η p 2 = 0.036; P = 0.0001). CONCLUSIONS Weight-loss maintainers reported less time sitting than weight-stable individuals with obesity. Future research should test the efficacy of targeting sitting time to help promote long-term weight-loss maintenance.
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Affiliation(s)
- James Roake
- Department of Kinesiology & Public Health & The Center for Health Research, California Polytechnic State University, San Luis Obispo, California, USA
| | - Suzanne Phelan
- Department of Kinesiology & Public Health & The Center for Health Research, California Polytechnic State University, San Luis Obispo, California, USA
| | - Noemi Alarcon
- Department of Kinesiology & Public Health & The Center for Health Research, California Polytechnic State University, San Luis Obispo, California, USA
| | - Sarah K Keadle
- Department of Kinesiology & Public Health & The Center for Health Research, California Polytechnic State University, San Luis Obispo, California, USA
| | | | - Gary D Foster
- WW International, Inc., New York, New York, USA
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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18
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Knell G, Li Q, Morales-Marroquin E, Drope J, Gabriel KP, Shuval K. Physical Activity, Sleep, and Sedentary Behavior among Successful Long-Term Weight Loss Maintainers: Findings from a U.S. National Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115557. [PMID: 34067414 PMCID: PMC8196944 DOI: 10.3390/ijerph18115557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 11/25/2022]
Abstract
Despite adults’ desire to reduce body mass (weight) for numerous health benefits, few are able to successfully lose at least 5% of their starting weight. There is evidence on the independent associations of physical activity, sedentary behaviors, and sleep with weight loss; however, this study provided insight on the combined effects of these behaviors on long-term body weight loss success. Hence, the purpose of this cross-sectional study was to evaluate the joint relations of sleep, physical activity, and sedentary behaviors with successful long-term weight loss. Data are from the 2005–2006 wave of the National Health and Examination Survey (NHANES). Physical activity and sedentary behavior were measured with an accelerometer, whereas sleep time was self-reported. Physical activity and sleep were dichotomized into meeting guidelines (active/not active, ideal sleep/short sleep), and sedentary time was categorized into prolonged sedentary time (4th quartile) compared to low sedentary time (1st–3rd quartiles). The dichotomized behaviors were combined to form 12 unique behavioral combinations. Two-step multivariable regression models were used to determine the associations between the behavioral combinations with (1) long-term weight loss success (≥5% body mass reduction for ≥12-months) and (2) the amount of body mass reduction among those who were successful. After adjustment for relevant factors, there were no significant associations between any of the independent body weight loss behaviors (physical activity, sedentary time, and sleep) and successful long-term weight loss. However, after combining the behaviors, those who were active (≥150 min MVPA weekly), regardless of their sedentary time, were significantly (p < 0.05) more likely to have long-term weight loss success compared to the inactive and sedentary referent group. These results should be confirmed in longitudinal analyses, including investigation of characteristics of waking (type, domain, and context) and sleep (quality metrics) behaviors for their association with long-term weight loss success.
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Affiliation(s)
- Gregory Knell
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77030, USA;
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, TX 75390, USA
- Children’s Health Andrews Institute for Orthopaedics and Sports Medicine, Plano, TX 75024, USA
- Correspondence: ; Tel.: +01-972-546-2943
| | - Qing Li
- Department of Intramural Research, American Cancer Society, Atlanta, GA 30303, USA;
| | - Elisa Morales-Marroquin
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77030, USA;
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, TX 75390, USA
| | - Jeffrey Drope
- Department of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL 60608, USA;
| | - Kelley Pettee Gabriel
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Kerem Shuval
- The Cooper Institute, Dallas, TX 75230, USA;
- Department of Epidemiology, School of Public Health, University of Haifa, Haifa 3498838, Israel
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19
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Dahle JH, Ostendorf DM, Zaman A, Pan Z, Melanson EL, Catenacci VA. Underreporting of energy intake in weight loss maintainers. Am J Clin Nutr 2021; 114:257-266. [PMID: 33742193 PMCID: PMC8246606 DOI: 10.1093/ajcn/nqab012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/08/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Individuals with overweight or obesity commonly underreport energy intake (EI), but it is unknown if the tendency to underreport persists in formerly obese individuals who lose significant weight and maintain their weight loss over long periods of time. OBJECTIVE Assess the accuracy of self-reported EI in successful weight loss maintainers (WLM) compared with controls of normal body weight (NC) and controls with overweight/obesity (OC). METHODS Participants for this case-controlled study were recruited in 3 groups: WLM [n = 26, BMI (in kg/m2) 24.1 ± 2.3; maintaining ≥13.6 kg weight loss for ≥1 y], NC (n = 33, BMI 22.7 ± 1.9; similar to current BMI of WLM), and OC (n = 32, BMI 34.0 ± 4.6; similar to pre-weight loss BMI of WLM). Total daily energy expenditure (TDEE) was measured over 7 d using the doubly labeled water (DLW) method, and self-reported EI was concurrently measured from 3-d diet diaries. DLW TDEE and self-reported EI were compared to determine accuracy of self-reported EI. RESULTS WLM underreported EI (median, interquartile range) (-605, -915 to -314 kcal/d) to a greater degree than NC (-308, -471 to -68 kcal/d; P < 0.01) but not more than OC (-310, -970 to 18 kcal/d; P = 0.21). WLM also showed a greater degree of relative underreporting (-25.3%, -32.9% to -12.5%) compared with NC (-14.3%, -19.6% to -3.1%; P = 0.02) but not OC (-11.2%, -34.1% to -0.7%; P = 0.16). A greater proportion of WLM was classified as underreporters (30.8%) than NC (9.1%; P = 0.05) but not OC (28.1%; P = 1.00). CONCLUSIONS WLM underreported EI in both absolute and relative terms to a greater extent than NC but not OC. These findings call into question the accuracy of self-reported EI in WLM published in previous studies and align with recent data suggesting that WLM rely less on chronic EI restriction and more on high levels of physical activity to maintain weight loss. This trial was registered at clinicaltrials.gov as NCT03422380.
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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
| | - Adnin Zaman
- 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
| | - Edward L Melanson
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, 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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20
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Dedov II, Shestakova MV, Melnichenko GA, Mazurina NV, Andreeva EN, Bondarenko IZ, Gusova ZR, Dzgoeva FK, Eliseev MS, Ershova EV, Zhuravleva MV, Zakharchuk TA, Isakov VA, Klepikova MV, Komshilova KA, Krysanova VS, Nedogoda SV, Novikova AM, Ostroumova OD, Pereverzev AP, Rozhivanov RV, Romantsova TI, Ruyatkina LA, Salasyuk AS, Sasunova AN, Smetanina SA, Starodubova AV, Suplotova LA, Tkacheva ON, Troshina EA, Khamoshina MV, Chechelnitskaya SM, Shestakova EA, Sheremet’eva EV. INTERDISCIPLINARY CLINICAL PRACTICE GUIDELINES "MANAGEMENT OF OBESITY AND ITS COMORBIDITIES". OBESITY AND METABOLISM 2021; 18:5-99. [DOI: 10.14341/omet12714] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | - M. S. Eliseev
- Research Institute of Rheumatogy named after V.A. Nasonova
| | | | | | | | - V. A. Isakov
- Federal Research Center of Nutrition, Biotechnology and Food Safety
| | - M. V. Klepikova
- Russian Medical Academy of Continuous Professional Education
| | | | | | | | - A. M. Novikova
- Research Institute of Rheumatogy named after V.A. Nasonova
| | - O. D. Ostroumova
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry
| | - A. P. Pereverzev
- Russian National Research Medical University named after N.I. Pirogov
| | | | | | | | | | - A. N. Sasunova
- Federal Research Center of Nutrition, Biotechnology and Food Safety
| | | | | | | | - O. N. Tkacheva
- Russian National Research Medical University named after N.I. Pirogov
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21
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Washburn RA, Szabo-Reed AN, Gorczyca AM, Sullivan DK, Honas JJ, Mayo MS, Krebill R, Goetz J, Ptomey LT, Lee J, Donnelly JE. A Randomized Trial Evaluating Exercise for the Prevention of Weight Regain. Obesity (Silver Spring) 2021; 29:62-70. [PMID: 34494375 PMCID: PMC9260853 DOI: 10.1002/oby.23022] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of three levels of exercise on weight regain subsequent to clinically meaningful weight loss (WL). METHODS Adults with overweight or obesity (n = 298) initiated a 3-month behavioral WL intervention, which included reduced energy intake, increased exercise, and weekly behavioral counseling. Participants achieving ≥5% WL (n = 235) began a 12-month behavioral WL maintenance intervention and were randomized to 150 min/wk (n = 76), 225 min/wk (n = 80), or 300 min/wk (n = 79) of partially supervised moderate-to-vigorous-intensity exercise. RESULTS Participants randomized to 150, 225, and 300 minutes of exercise completed 129 ± 30, 153 ± 49 and 179 ± 62 min/wk of exercise (supervised + unsupervised), respectively. Mean WL at 3 months (9.5 ± 3.1 kg) was similar across randomized groups (P = 0.68). Weight change across 12 months was 1.1 ± 6.5 kg, 3.2 ± 5.7 kg, and 2.8 ± 6.9 kg in the 150, 225, and 300 min/wk groups, respectively. Intent-to-treat analysis revealed no significant overall trend across the three treatment groups (P = 0.09), effects for group (P = 0.08), or sex (P = 0.21). CONCLUSIONS This study found no evidence for an association between the volume of moderate-to-vigorous-intensity exercise and weight regain across 12 months following clinically relevant WL. Further, results suggest that exercise volumes lower than those currently recommended for WL maintenance, when completed in conjunction with a behavioral weight-maintenance intervention, may minimize weight regain over 12 months.
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Affiliation(s)
- Richard A. Washburn
- Department of Internal Medicine, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Amanda N. Szabo-Reed
- Department of Internal Medicine, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Anna M. Gorczyca
- Department of Internal Medicine, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Debra K. Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Jeffery J. Honas
- Department of Internal Medicine, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Matthew S. Mayo
- Department of Biostatistics & Data Science, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Ronald Krebill
- Department of Biostatistics & Data Science, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Jeannine Goetz
- Department of Dietetics and Nutrition, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Lauren T. Ptomey
- Department of Internal Medicine, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
| | - Jaehoon Lee
- Department of Educational Psychology and Leadership, Texas Tech University, Lubbock, Texas, USA
| | - Joseph E. Donnelly
- Department of Internal Medicine, University of Kansas Medical Center, University of Kansas, Kansas City, Kansas, USA
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22
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Leisure Sedentary Behavior Levels and Meeting Program Goals in a Community Lifestyle Intervention for Diabetes Prevention. J Phys Act Health 2020; 18:44-51. [PMID: 33361473 DOI: 10.1123/jpah.2020-0052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 10/05/2020] [Accepted: 10/11/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The importance of leisure sedentary behavior (LSB) change in diabetes prevention efforts is not well known. This study examines the relationships between changes in self-reported LSB and the primary intervention goals (weight and moderate-intensity to vigorous-intensity physical activity [MVPA]) during a community-based translation of the Diabetes Prevention Program (the Group Lifestyle Balance Program). METHODS A total of 322 adults at risk for type 2 diabetes were recruited from 3 community centers, a worksite, and military site. Community and worksite participants were randomized to immediate or delayed-delivery (control) intervention. All military site participants (n = 99) received immediate intervention. Logistic and linear generalized estimating equations were used to determine associations between LSB changes and weight-related outcomes and MVPA. RESULTS Results were obtained for 259 (80.4%) participants. The LSB decreased after 6 and 12 months (mean [95% confidence interval]: -25.7 [-38.6 to -12.8] and -16.1 [-28.2 to -3.9] min/d; both P < .05). Each 20-minute reduction in LSB was associated with a 5% increase in odds of meeting the weight-loss goal (6 mo: odds ratio = 1.05 [1.002 to 1.102]; P = .042; adjusted model including MVPA), but LSB was not related to changes in reported MVPA minutes or MVPA goal achievement. CONCLUSION Within the context of existing lifestyle intervention programs, reducing sedentary behavior has the potential to contribute to weight loss separately from reported MVPA improvement.
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23
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Killeen TK, Wolf B, Greer TL, Carmody T, Rethorst CD, Trivedi MH. Gender and racial/ethnic differences in physiologic responses in the Stimulant Reduction Intervention using Dosed Exercise Study. Addict Behav 2020; 110:106546. [PMID: 32688225 PMCID: PMC7416606 DOI: 10.1016/j.addbeh.2020.106546] [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] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/31/2020] [Accepted: 07/05/2020] [Indexed: 10/23/2022]
Abstract
Exercise may be beneficial for individuals in substance use disorder (SUD) treatment given the higher rates of both medical and psychiatric comorbidity, namely mood and anxiety disorders, compared to the general population. Gender and/or racial/ethnic differences in health benefits and response to prescribed exercise have been reported and may have implications for designing exercise interventions in SUD programs. METHOD Data are from the National Drug Abuse Treatment Clinical Trials Network (NIDA/CTN) Stimulant Reduction Intervention using Dosed Exercise (STRIDE) trial. Gender differences across racial/ethnic groups in physiological responses and stimulant withdrawal severity across time were analyzed using linear mixed effects models. RESULTS Males completed significantly more exercise sessions than females and were more adherent to the prescribed exercise dose of 12 Kcal/Kg/Week. Controlling for age, race/ethnicity, treatment group and stimulant withdrawal severity, there was a significant gender by time interaction for body mass index (BMI) (p < 0.001), waist circumference (p < 0.001) and heart rate measured prior to exercise sessions (p < 0.01). For females, body mass index (BMI) and waist circumference increased over time while for males BMI and waist circumference stayed unchanged or slightly decreased with time. Heart rate over time significantly increased for females at a higher rate than in males. Stimulant withdrawal severity was similar in males and females at baseline but males exhibited a significant decrease over time while females did not. Although baseline differences were observed, there were no time by race/ethnicity differences in physiologic responses. DISCUSSION Gender differences in response to exercise may have implications for developing gender specific exercise interventions in SUD programs.
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Affiliation(s)
- T K Killeen
- Medical University of South Carolina, Charleston, SC, USA.
| | - B Wolf
- Medical University of South Carolina, Charleston, SC, USA
| | - T L Greer
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - T Carmody
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C D Rethorst
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - M H Trivedi
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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24
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Frane AV. Misguided Opposition to Multiplicity Adjustment Remains a Problem. JOURNAL OF MODERN APPLIED STATISTICAL METHODS 2020. [DOI: 10.22237/jmasm/1556669400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Fallacious arguments against multiplicity adjustment have been cited with increasing frequency to defend unadjusted tests. These arguments and their enduring impact are discussed in this paper.
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25
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Lawlor ER, Hughes CA, Duschinsky R, Pountain GD, Hill AJ, Griffin SJ, Ahern AL. Cognitive and behavioural strategies employed to overcome "lapses" and prevent "relapse" among weight-loss maintainers and regainers: A qualitative study. Clin Obes 2020; 10:e12395. [PMID: 32767708 PMCID: PMC7116423 DOI: 10.1111/cob.12395] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/30/2020] [Accepted: 07/10/2020] [Indexed: 02/02/2023]
Abstract
While many behavioural weight management programmes are effective in the short-term, post-programme weight regain is common. Overcoming "lapses" and preventing "relapse" has been highlighted as important in weight-loss maintenance, but little is known on how this is achieved. This study aimed to compare the cognitive and behavioural strategies employed to overcome "lapses" and prevent "relapse" by people who had regained weight or maintained weight-loss after participating in a weight management programme. By investigating differences between groups, we intended to identify strategies associated with better weight-loss maintenance. Semi-structured interviews were conducted with 26 participants (58% female) recruited from the 5-year follow-up of the Weight Loss Referrals for Adults in Primary Care (WRAP) trial (evaluation of a commercial weight-loss programme). Participants who had lost ≥5% baseline weight during the active intervention were purposively sampled according to 5-year weight trajectories (n = 16 'Regainers', n = 10 'Maintainers'). Interviews were audio-recorded, transcribed verbatim, and analysed thematically. Key differences in strategies were that Maintainers continued to pay attention to their dietary intake, anticipated and planned for potential lapses in high-risk situations, and managed impulses using distraction techniques. Regainers did not report making plans, used relaxed dietary monitoring, found distraction techniques to be ineffective and appeared to have difficulty navigating food within interpersonal relationships. This study is one of the longest qualitative follow-ups of a weight loss trial to date, offering unique insights into long-term maintenance. Future programmes should emphasize strategies focusing on self-monitoring, planning and managing interpersonal relationships to help participants successfully maintain weight-loss in the longer-term.
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Affiliation(s)
- Emma R Lawlor
- MRC Epidemiology Unit, University of Cambridge, Cambridge, England
| | - Carly A Hughes
- Fakenham Medical Practice, Norfolk, United Kingdom
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Robbie Duschinsky
- Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, England
| | | | - Andrew J Hill
- Division of Psychological & Social Medicine, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Simon J Griffin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, England
- Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, England
| | - Amy L Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, England
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26
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Wilhelmi de Toledo F, Grundler F, Sirtori CR, Ruscica M. Unravelling the health effects of fasting: a long road from obesity treatment to healthy life span increase and improved cognition. Ann Med 2020; 52:147-161. [PMID: 32519900 PMCID: PMC7877980 DOI: 10.1080/07853890.2020.1770849] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
In recent years a revival of interest has emerged in the health benefits of intermittent fasting and long-term fasting, as well as of other related nutritional strategies. In addition to meal size and composition a new focus on time and frequency of meals has gained attention. The present review will investigate the effects of the main forms of fasting, activating the metabolic switch from glucose to fat and ketones (G-to-K), starting 12-16 h after cessation or strong reduction of food intake. During fasting the deactivation of mTOR regulated nutrient signalling pathways and activation of the AMP protein kinase trigger cell repair and inhibit anabolic processes. Clinical and animal studies have clearly indicated that modulating diet and meal frequency, as well as application of fasting patterns, e.g. intermittent fasting, periodic fasting, or long-term fasting are part of a new lifestyle approach leading to increased life and health span, enhanced intrinsic defences against oxidative and metabolic stresses, improved cognition, as well as a decrease in cardiovascular risk in both obese and non-obese subjects. Finally, in order to better understand the mechanisms beyond fasting-related changes, human studies as well as non-human models closer to human physiology may offer useful clues.KEY-MESSAGESBiochemical changes during fasting are characterised by a glucose to ketone switch, leading to a rise of ketones, advantageously used for brain energy, with consequent improved cognition.Ketones reduce appetite and help maintain effective fasting.Application of fasting patterns increases healthy life span and defences against oxidative and metabolic stresses.Today's strategies for the use of therapeutic fasting are based on different protocols, generally relying on intermittent fasting, of different duration and calorie intake.Long-term fasting, with durations between 5 and 21 days can be successfully repeated in the course of a year.
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Affiliation(s)
| | - Franziska Grundler
- Buchinger Wilhelmi Clinic, Wilhelm-Beck-Straße 27, Überlingen, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Cesare R Sirtori
- Dyslipidemia Center, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Massimiliano Ruscica
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
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27
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Relationship of objectively measured physical activity and sedentary behaviour with health-related quality of life among breast cancer survivors. Health Qual Life Outcomes 2020; 18:222. [PMID: 32650777 PMCID: PMC7350582 DOI: 10.1186/s12955-020-01478-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 07/03/2020] [Indexed: 12/14/2022] Open
Abstract
Background Lack of physical activity throughout one’s lifetime has been associated with obesity and it is also an important risk factor of breast cancer. This study aimed to determine the relationship between objectively measured physical activity and sedentary behaviour with health-related quality of life (HRQoL) among breast cancer survivors in the East Coast region of Peninsular Malaysia. Methods A cross-sectional study involving 83 breast cancer survivors was carried out in two main government referral hospitals in the region. Participants wore the ActivPAL3™ microdevice physical activity monitor for seven consecutive days. The validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ–C30) and Breast Cancer Supplementary Measure (EORTC QLQ-BR23) were used to measure their HRQoL. Multiple linear regression analysis was conducted to determine the relationship between objectively measured physical activity and sedentary behaviour with HRQoL. Results Longer time spent on moderate to vigorous physical activity (MVPA) was significantly associated with an improvement of HRQoL (p = 0.039) whereas longer time spent on sedentary behaviour significantly reduced the functioning score (p = 0.005). In addition, prolonged sedentary bouts were also significantly associated with better body image that led to improved HRQoL (p = 0.013). Conclusions The study findings suggest that an increase in the time spent on MVPA was associated with improved HRQoL while sedentary behaviour was associated with poorer HRQoL among breast cancer survivors. Thus, it is essential to displace sedentary behaviour with MVPA to improve the quality of life of breast cancer survivors.
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28
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Bilal HSM, Amin MB, Hussain J, Ali SI, Hussain S, Sadiq M, Razzaq MA, Abbas A, Choi C, Lee S. On computing critical factors based healthy behavior index for behavior assessment. Int J Med Inform 2020; 141:104181. [PMID: 32559726 DOI: 10.1016/j.ijmedinf.2020.104181] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 04/28/2020] [Accepted: 05/18/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Ubiquitous computing has supported personalized health through a vast variety of wellness and healthcare self-quantification applications over the last decade. These applications provide insights for daily life activities but unable to portray the comprehensive impact of personal habits on human health. Therefore, in order to facilitate the individuals, we have correlated the lifestyle habits in an appropriate proportion to determine the overall impact of influenced behavior on the well-being of humans. MATERIALS AND METHODS To study the combined impact of personal behaviors, we have proposed a methodology to derive the comprehensive Healthy Behavior Index (HBI) consisting of two major processes: (1) Behaviors' Weight-age Identification (BWI), and (2) Healthy Behavior Quantification and Index (HBQI) modeling. The BWI process identifies the high ranked contributing behaviors through life-expectancy based weight-age, whereas HBQI derives a mathematical model based on quantification and indexing of behavior using wellness guidelines. RESULTS The contributing behaviors are identified through text mining technique and verified by seven experts with a Kappa agreement level of 0.379. A real-world user-centric statistical evaluation is applied through User Experience Questionnaire (UEQ) method to evaluate the impact of HBI service. This HBI service is developed for the Mining Minds, a wellness management application. This study involves 103 registered participants (curious about the chronic disease) for a Korean wellness management organization. They used the HBI service over 12 weeks, the results for which were evaluated through UEQ and user feedback. The service reliability for the Cronbach's alpha coefficient greater than 0.7 was achieved using HBI service whereas the stimulation coefficient of the value 0.86 revealed significant effect. We observed an overall novelty of the value 0.88 showing the potential interest of participants. CONCLUSIONS The comprehensive HBI has demonstrated positive user experience concerning the stimulation for adapting the healthy behaviors. The HBI service is designed independently to work as a service, so any other wellness management service-enabled platform can consume it to evaluate the healthy behavior index of the person for recommendation generation, behavior indication, and behavior adaptation.
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Affiliation(s)
- Hafiz Syed Muhammad Bilal
- Department of Computer Science and Engineering, Kyung Hee University, Seocheon-dong, Giheung-gu, South Korea; National University of Sciences and Technology, Pakistan.
| | | | - Jamil Hussain
- Department of Computer Science and Engineering, Kyung Hee University, Seocheon-dong, Giheung-gu, South Korea.
| | - Syed Imran Ali
- Department of Computer Science and Engineering, Kyung Hee University, Seocheon-dong, Giheung-gu, South Korea.
| | - Shujaat Hussain
- Department of Computer Science, National University of Computer and Emerging Sciences, Islamabad, Pakistan.
| | - Muhammad Sadiq
- Department of Computer Science and Engineering, Kyung Hee University, Seocheon-dong, Giheung-gu, South Korea.
| | - Muhammad Asif Razzaq
- Department of Computer Science and Engineering, Kyung Hee University, Seocheon-dong, Giheung-gu, South Korea.
| | - Asim Abbas
- Department of Computer Science and Engineering, Kyung Hee University, Seocheon-dong, Giheung-gu, South Korea.
| | - Chunho Choi
- Korea Institute of Industrial Technology, South Korea.
| | - Sungyoung Lee
- Department of Computer Science and Engineering, Kyung Hee University, Seocheon-dong, Giheung-gu, South Korea.
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29
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Paixão C, Dias CM, Jorge R, Carraça EV, Yannakoulia M, de Zwaan M, Soini S, Hill JO, Teixeira PJ, Santos I. Successful weight loss maintenance: A systematic review of weight control registries. Obes Rev 2020; 21:e13003. [PMID: 32048787 PMCID: PMC9105823 DOI: 10.1111/obr.13003] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 12/25/2022]
Abstract
Weight loss maintenance is a major challenge for obesity treatment. Weight control registries can be useful in identifying psychological and behavioural factors that could contribute to better long-term success. The objective of this study is to describe the existing weight control registries and their participants and identify correlates of weight loss maintenance. A comprehensive search of peer-reviewed articles published until November 2018 was conducted in PubMed, Web of Science, and Scopus. Studies that reported results from weight control registries were considered. Fifty-two articles, corresponding to five registries (the United States, Portugal, Germany, Finland, and Greece), were included. Registries differed in inclusion criteria and procedures. Of 51 identified weight loss and maintenance strategies, grouped in 14 domains of the Oxford Food and Activity Behaviors taxonomy, the following were the most frequently reported: having healthy foods available at home, regular breakfast intake, increasing vegetable consumption, decreasing sugary and fatty foods, limiting certain foods, and reducing fat in meals. Increased physical activity was the most consistent positive correlate of weight loss maintenance. To our knowledge, this is the first systematic review of information about successful weight loss maintenance obtained from weight control registries. Key common influential characteristics of success were identified, which can inform future prospective studies and weight management initiatives.
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Affiliation(s)
- Catarina Paixão
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - Carlos M Dias
- Centro de Investigação em Saúde Pública (CISP), NOVA-Escola Nacional de Saúde Pública, Lisbon, Portugal.,Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Rui Jorge
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal.,Unidade de Investigação do Instituto Politécnico de Santarém, Escola Superior Agrária, Instituto Politécnico de Santarém, Santarém, Portugal
| | - Eliana V Carraça
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Sirpa Soini
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - James O Hill
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Pedro J Teixeira
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - Inês Santos
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal.,Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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30
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Sex-Specific Physical Activity Patterns Differentiate Weight Loss Maintainers From Regainers: The MedWeight Study. J Phys Act Health 2020; 17:225-229. [PMID: 31923902 DOI: 10.1123/jpah.2019-0407] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/02/2019] [Accepted: 11/07/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Although plenty of evidence indicates that weight loss maintainers are highly physically active, studies focusing on the sex-specific differences in activity levels between maintainers and regainers are scarce. The authors aimed to investigate sex-specific differences in activity patterns in a cohort of Mediterranean maintainers and regainers. METHODS Sample includes 756 participants of the MedWeight registry (60.5% women), aged 18-65 years, who lost ≥10% of their initial weight, and either maintained their loss for ≥12 months or regained it. Participants completed a series of questionnaires, including demographics and weight history. Activity levels were evaluated with the International Physical Activity Questionnaire-short version. RESULTS Maintainers of both sexes were, in total, more active than their same-sex regainers. When specific activities were considered, women maintainers spent more time walking than regainers (Padjusted = .02), whereas men maintainers spent more time in vigorous activities (Padjusted = .001) and walking than regainers (Padjusted = .001). Modest increments in activity of sex-relevant intensity were associated with increased odds for maintenance. CONCLUSIONS Maintainers attained a more active lifestyle than their same-sex regainers, involving more walking for both sexes and more vigorous activities for men. The detected differences, according to activity intensity, support that activity patterns associated with successful weight loss are distinguishable between sexes.
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Associations of Objectively Measured Physical Activity and Sleep with Weight Loss Maintenance: A Preliminary Study of Japanese Adults. Behav Sci (Basel) 2019; 10:bs10010003. [PMID: 31861449 PMCID: PMC7016799 DOI: 10.3390/bs10010003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/14/2019] [Accepted: 12/17/2019] [Indexed: 01/30/2023] Open
Abstract
Maintaining weight loss is considerably more challenging than losing weight. Most previous studies on weight loss maintenance have been conducted in Western countries and have assessed physical activity and sleep with the use of questionnaires. This preliminary study investigated the associations of objectively measured physical activity and sleep with weight loss maintenance among 25 Japanese adults who had intentionally lost ≥ 10% of their original weight. Participants wore tri-axial accelerometers on their waists and sleep monitors on their wrists for two weeks to measure their physical activity and sleep, respectively. A linear regression adjusted for sex, age, maximum weight, and time since losing weight was performed to investigate these associations. Participants had a mean body mass index of 23.4 kg/m2 and a median weight loss of 12.5%. Compared to those who maintained < 12.5% weight loss, those who maintained ≥ 12.5% weight loss slept longer (adjusted mean difference: 66.1 min/night, 95% confidence interval (CI): −14.0, 146.3 min/night, p = 0.10) and performed less moderate-to-vigorous physical activity (adjusted mean difference: −21.7 min/day, 95% CI: −58.0, 14.5 min/day, p = 0.22). Though statistical power was limited, sleep behavior may be an important modifiable factor that facilitates weight loss maintenance. Our findings can be used to establish a well-designed study to confirm this association.
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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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Abstract
One of the biggest challenges in the management of obesity is the prevention of weight regain after successful weight loss. Weight regain after weight loss has large interindividual variation. Although many factors probably contribute to this variation, we hypothesize that variability in biological responses associated with weight loss-induced shrinking of subcutaneous adipocytes has an important role. In this Review, we show that weight loss-induced variations in cellular stress, extracellular matrix remodelling, inflammatory responses, adipokine secretion and lipolysis seem to be associated with the amount of weight that is regained after successful weight loss. Weight regain could therefore, at least in part, depend on a combination of these factors. Further research on the causality of these associations could aid the development of effective strategies to prevent weight regain after successful weight loss.
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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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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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Cattivelli R, Castelnuovo G, Musetti A, Varallo G, Spatola CAM, Riboni FV, Usubini AG, Tosolin F, Manzoni GM, Capodaglio P, Rossi A, Pietrabissa G, Molinari E. ACTonHEALTH study protocol: promoting psychological flexibility with activity tracker and mHealth tools to foster healthful lifestyle for obesity and other chronic health conditions. Trials 2018; 19:659. [PMID: 30486868 PMCID: PMC6262958 DOI: 10.1186/s13063-018-2968-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 10/08/2018] [Indexed: 12/18/2022] Open
Abstract
Background Obesity and the state of being overweight are increasing steadily and becoming a global epidemic. Recent research reports 64% of the adult population as overweight in Europe and the USA. The social and economic impacts are increasing, and most of the rehabilitation programs, while effective in the short term, do not produce long-lasting results. An explanatory model from a behavioral perspective can describe the phenomena with the lack of sources of reinforcement related to healthful habits in a daily life context. Methods/design A randomized clinical trial combining single-subject studies and a four-arm group design will be conducted to compare the effect of the current standard in obesity treatment to Acceptance and Commitment Therapy (ACT) and wearable technology at different times, before starting intervention, at the end, and at follow-up visits of 3, 6, and 12 months measuring changes over time of physical activity and psychological well-being. Discussion The goal of this project, combining ACT and wearable technology, is to develop an effective intervention, efficient and sustainable, which even after discharge can provide adequate contingencies of reinforcement in the natural environment, integrating systematic measurements, continuous feedback, and individualized, values-based objectives. The intervention is aimed to provide a contingent reinforcement for healthful behaviors instead of reinforcing only the achievement of a significant weight loss. The aim of the project, combining Acceptance and Commitment Therapy and Wearable Technology, is to develop an effective, efficient and sustainable intervention able to provide a contingent reinforcement for healthy behaviors. The intervention is aimed to promote adequate healthy behaviors in the natural environment, integrating systematic measurements, continuous feedback and individualized values-based objectives, instead of reinforcing only the achievement of a significant weight loss. Trial registration ClinicalTrials.gov, NCT03351712. Registered on 24 November 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2968-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Roberto Cattivelli
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Verbania, Italy. .,Department of Psychology, Catholic University of Milan, Milan, Italy.
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Giorgia Varallo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Chiara A M Spatola
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | | | | | - Fabio Tosolin
- AARBA, Association for the Advancement of Radical Behavior Analysis, Milan, Italy
| | - Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Verbania, Italy.,Faculty of Psychology, eCampus University, Novedrate, Italy
| | - Paolo Capodaglio
- Istituto Auxologico Italiano IRCCS, Rehabilitation Unit and Research Laboratory of Biomechanics and Rehabilitation, S Giuseppe, Piancavallo, Oggebbio, Verbania, Italy
| | - Alessandro Rossi
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Verbania, Italy.,Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padova, Italy
| | - Giada Pietrabissa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Enrico Molinari
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
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Matz-Costa C, Lubben J, Lachman ME, Lee H, Choi YJ. A Pilot Randomized Trial of an Intervention to Enhance the Health-Promoting Effects of Older Adults' Activity Portfolios: The Engaged4Life Program. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2018; 61:792-816. [PMID: 30395791 PMCID: PMC6353638 DOI: 10.1080/01634372.2018.1542371] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The purpose of this study was to evaluate the feasibility and outcomes of the Engaged4Life program, an intervention to encourage inactive community-dwelling older adults to embed physical activity, cognitive activity, and social interaction into their everyday lives in contexts that are personally meaningful and natural for them. Fifteen participants were randomized to the intervention group (technology-assisted self-monitoring of daily activity via pedometers and daily tablet-based surveys; psychoeducation + goal-setting via a 3-hour workshop; and peer mentoring via phone 2×/week for 2.5 weeks) and 15 to the control (technology-assisted self-monitoring only). Recruitment was shown to be feasible and efficient, but not able to reach the target for men. Retention rate was 83% and participants manifested high adherence and engagement with the intervention. Though this pilot trial was not powered to demonstrate significant differences between groups, daily steps increased by 431 (11% increase) from baseline to Week 4 for the intervention (p < .05), but decreased by 458 for the control, for a net difference of 889 steps (p < .05). Findings were sustained at Week 8 (p < .01). In a future trial, difficulties in recruiting men, barriers due to the technology-intensive design, and the optimization of secondary outcome measures should be addressed.
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Affiliation(s)
- Christina Matz-Costa
- a School of Social Work and Center on Aging & Work , Boston College , Chestnut Hill , Massachusetts , USA
| | - James Lubben
- b School of Social Work , Boston College , Chestnut Hill , Massachusetts , USA
| | - Margie E Lachman
- c Psychology , Brandeis University , Waltham , Massachusetts , USA
| | - Haenim Lee
- d Center for Child Health and Policy , Case Western Reserve University School of Medicine , Cleveland, Ohio , Ohio , USA
| | - Yeon Jin Choi
- e Leonard School of Gerontology University of Southern California , Los Angeles, CA , California , USA
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Marzec L, Raghavan S, Banaei-Kashani F, Creasy S, Melanson EL, Lange L, Ghosh D, Rosenberg MA. Device-measured physical activity data for classification of patients with ventricular arrhythmia events: A pilot investigation. PLoS One 2018; 13:e0206153. [PMID: 30372463 PMCID: PMC6205644 DOI: 10.1371/journal.pone.0206153] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 10/07/2018] [Indexed: 12/23/2022] Open
Abstract
Low levels of physical activity are associated with increased mortality risk, especially in cardiac patients, but most studies are based on self-report. Cardiac implantable electronic devices (CIEDs) offer an opportunity to collect data for longer periods of time. However, there is limited agreement on the best approaches for quantification of activity measures due to the time series nature of the data. We examined physical activity time series data from 235 subjects with CIEDs and at least 365 days of uninterrupted measures. Summary statistics for raw daily physical activity (minutes/day), including statistical moments (e.g., mean, standard deviation, skewness, kurtosis), time series regression coefficients, frequency domain components, and forecasted predicted values, were calculated for each individual, and used to predict occurrence of ventricular tachycardia (VT) events as recorded by the device. In unsupervised analyses using principal component analysis, we found that while certain features tended to cluster near each other, most provided a reasonable spread across activity space without a large degree of redundancy. In supervised analyses, we found several features that were associated with the outcome (P < 0.05) in univariable and multivariable approaches, but few were consistent across models. Using a machine-learning approach in which the data was split into training and testing sets, and models ranging in complexity from simple univariable logistic regression to ensemble decision trees were fit, there was no improvement in classification of risk over naïve methods for any approach. Although standard approaches identified summary features of physical activity data that were correlated with risk of VT, machine-learning approaches found that none of these features provided an improvement in classification. Future studies are needed to explore and validate methods for feature extraction and machine learning in classification of VT risk based on device-measured activity.
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Affiliation(s)
- Lucas Marzec
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Division of Cardiology, Kaiser Permanente of Colorado, Lafayette, Colorado, United States of America
| | - Sridharan Raghavan
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Veterans Affairs Eastern Colorado Health Care System, Denver, Colorado, United States of America
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Farnoush Banaei-Kashani
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- College of Engineering and Applied Science, University of Colorado Denver, Denver, Colorado, United States of America
| | - Seth Creasy
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Division of Endocrinology, Diabetes, Metabolism, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Edward L. Melanson
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Division of Endocrinology, Diabetes, Metabolism, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Geriatric Research, Education, and Clinical Center, VA Eastern Colorado Health Care System, Denver, Colorado, United States of America
| | - Leslie Lange
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Debashis Ghosh
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, United States of America
| | - Michael A. Rosenberg
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Division of Cardiac Electrophysiology, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- * E-mail:
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