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Walc A, Latimer-Cheung AE, Day AG, Brennan AM, Hill JO, Ross R. A small change approach on adiposity, lean mass and bone mineral density in adults with overweight and obesity: A randomized controlled trial. Clin Obes 2023:e12587. [PMID: 36853069 DOI: 10.1111/cob.12587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/18/2022] [Accepted: 01/26/2023] [Indexed: 03/01/2023]
Abstract
We sought to determine whether small changes in physical activity and diet could prevent adverse changes in body composition over 2 years in adults with overweight and obesity. Previously inactive adults (N = 289) were included in a secondary analysis of data derived from a 3-year, single-centre, two-arm, longitudinal randomized controlled trial. Participants were randomized to a small change approach (N = 144, body mass index: 32.4 ± 4.2 [mean ± standard deviation], age: 52.3 ±. 10.6 years) or usual care (N = 145, body mass index: 32.4 ± 4.2, age: 53.1 ± 10.6 years). Small change approach participants were counselled to make small changes in diet and physical activity, while usual care participants were asked to maintain their usual lifestyle. Adiposity, lean mass and bone mineral density were measured by dual-x-ray absorptiometry. The change in total adiposity was significantly greater in the small change approach group than usual care at 6 and 12 months but did not remain significant at 24 months (mean change [standard error] -0.8 [0.4] vs. -0.7 [0.4] kg; difference 0.6, 95% confidence interval [CI] -1.2 to 1.1). Changes in visceral fat were significantly greater in the small change approach than usual care at 6 and 12 months but did not remain significant at 24 months (-0.04 [0.03] vs. 0.02 [0.03] kg; difference 0.06, 95% CI: -1.5 to 0.3). Changes in lean mass or bone mineral density were not significantly different between groups at any time point (all p > 0.1). The small change approach did not prevent gains in adiposity or losses in lean mass compared to usual care at 2 years in adults with overweight or obesity. No difference from baseline in adiposity, lean mass or bone mineral density was observed in either arm of the trial.
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Affiliation(s)
- Azalea Walc
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Amy E Latimer-Cheung
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Andrew G Day
- Clinical Evaluation Research Unit, Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Andrea M Brennan
- AdventHealth Orlando, Translational Research Institute, Orlando, Florida, USA
| | - James O Hill
- Department of Nutritional Sciences, University of Alabama at Birmingham, South Birmingham, Alabama, USA
| | - Robert Ross
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
- Division of Endocrinology and Metabolism, Department of Medicine, Queen's University, Kingston, Ontario, Canada
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Hayes JF, Schumacher LM, Lanoye A, LaRose JG, Tate DF, Espeland MA, Gorin AA, Lewis CE, Jelalian E, Wing RR. Persistent, High Levels of Social Jetlag Predict Poor Weight Outcomes in a Weight Gain Prevention Study for Young adults. J Behav Med 2022; 45:794-803. [PMID: 35841487 DOI: 10.1007/s10865-022-00339-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 06/20/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Social jetlag (SJL), the discrepancy in sleep timing between weekdays and weekends, is associated with higher BMI and cardiometabolic risk and is common in young adults. We examined whether chronic SJL impacts weight gain in young adults participating in a weight gain prevention trial. METHODS Young adults (n = 599, age 18-35; BMI: 21.0-30.9 kg/m2) completed assessments at 0, 4, 12, and 24 months. Multilevel mixed growth models were used to examine (1) associations between demographics and longitudinal SJL and (2) longitudinal SJL as a predictor of weight change and cardiometabolic outcomes. SJL was assessed as a continuous and clinically-significant dichotomous (< vs. ≥2 h) variable. RESULTS 38% of participants had clinically-significant SJL at ≥ 1 timepoints (Baseline M ± SD = 1.3±0.89). Younger (b=-0.05, p < 0.001), female (b = 0.18, p = 0.037) and Black (compared to White, b = 0.23, p = 0.045) participants were more likely to have greater SJL. Individuals with high SJL (≥ 2 h; between-person effect) were more likely to have greater weight gain over 2 years (b = 0.05, p = 0.028). High SJL did not affect the rate of change in waist circumference or cardiometabolic markers over time. CONCLUSIONS High SJL is associated with greater weight gain over time. Reducing SJL may positively impact weight status in young adults.
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Affiliation(s)
- Jacqueline F Hayes
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. .,Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA.
| | - Leah M Schumacher
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA
| | - Autumn Lanoye
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.,Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Deborah F Tate
- Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Mark A Espeland
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Amy A Gorin
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Cora E Lewis
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Elissa Jelalian
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA
| | - Rena R Wing
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA
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Jia J, Levy DE, McCurley JL, Anderson E, Gelsomin ED, Porneala B, Thorndike AN. Health Literacy, Numeracy, and Health Promotion: A Secondary Analysis of the Choosewell 365 Workplace Trial. Am J Prev Med 2022; 63:93-101. [PMID: 35282955 PMCID: PMC9232847 DOI: 10.1016/j.amepre.2021.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Health literacy and numeracy are linked to obesity and dietary behaviors. This study investigates whether the effect of a workplace behavioral intervention to prevent weight gain and improve diet differed by employee health literacy and numeracy. METHODS ChooseWell 365 was an RCT of hospital employees testing a 12-month intervention using nudges and feedback to promote healthier choices, building on existing cafeteria traffic light labels (e.g., green=healthy, red=unhealthy). Health literacy and numeracy were measured with the Newest Vital Sign (range=0-6) and General Numeracy Scale (range=0-3). Mixed-effects linear models examined if intervention effects on cafeteria purchases, diet quality (Healthy Eating Index 2015, range=0-100), and weight change over 24 months differed by higher versus lower health literacy or numeracy. Data were collected in 2016-2020 and analyzed in 2020-2021. RESULTS In 12 months, 510 participants completed the Newest Vital Sign and General Numerancy Scale; 36.7% had Newest Vital Sign<6 (lower health literacy) and 31.6% had General Numerancy Scale<2 (lower numeracy). Intervention participants increased healthy purchases over 24 months compared with controls in both higher and lower health literacy and numeracy groups. At 12 months, Healthy Eating Index 2015 scores increased in intervention versus control participants with lower health literacy (5.5 points, 95% CI=1.51, 9.54) but not in those with higher health literacy (p-interaction=0.040). BMI did not differ by health literacy or numeracy. CONCLUSIONS A behavioral intervention improved cafeteria food choices of hospital employees of varying health literacy and numeracy levels and improved diet quality among employees with lower health literacy, suggesting this group also improved food choices outside of work.
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Affiliation(s)
- Jenny Jia
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Douglas E Levy
- Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Jessica L McCurley
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Emma Anderson
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Emily D Gelsomin
- Department of Nutrition and Food Services, Massachusetts General Hospital, Boston, Massachusetts
| | - Bianca Porneala
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Anne N Thorndike
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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Mobile health plus community health worker support for weight management among public housing residents (Path to Health): A randomized controlled trial protocol. Contemp Clin Trials 2022; 119:106836. [PMID: 35724842 PMCID: PMC9673759 DOI: 10.1016/j.cct.2022.106836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 05/04/2022] [Accepted: 06/13/2022] [Indexed: 11/21/2022]
Abstract
Interventions delivered by mobile devices (mHealth interventions) have the potential to increase access to weight management treatment in low-income populations. However, little prior research has examined effects of mHealth programming plus phone-based community health worker (CHW) support for weight management among public housing residents. For our intervention, we first interacted with a community advisory board to collect feedback on proposed intervention components. Transcripts from 5 advisory board meetings were coded and qualitative data was organized into themes. We used these data to inform our ongoing trial, in which public housing residents are randomized to one of three different groups: phone text messaging and digital self-weighing (mHealth only); mHealth intervention plus CHW behavioral phone counseling (mHealth+CHW); or assessment only to evaluate their differential effects on weight loss at 6- and 12-month follow-up. We will examine changes in diet and physical activity behaviors as well as potential mediating and moderating factors. Results of this trial could provide support for technology-based weight management interventions which may have greater potential for scalability and long-term dissemination than face-to-face programming. Clinical Trial Registration Number: NCT04852042.
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Graham HE, Madigan CD, Daley AJ. Is a small change approach for weight management effective? A systematic review and meta-analysis of randomized controlled trials. Obes Rev 2022; 23:e13357. [PMID: 34580993 DOI: 10.1111/obr.13357] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/16/2021] [Accepted: 08/16/2021] [Indexed: 01/09/2023]
Abstract
Traditional weight management interventions typically involve people making large changes to their energy intake and/or expenditure and can be effective in the short term, but weight regain is common. An alternative strategy is a small change approach, which asks people to make small(er) changes to their diet and/or physical activity behaviors (e.g., 100-kcal reduction or increases of 1000 steps/day). This approach may lead to sustained weight management because such energy-deficit goals are easier for people to integrate into their lives and then maintain. This systematic review and meta-analysis of randomized and quasi-randomized controlled trials assessed the effectiveness of a small change approach for weight management; 21 trials were included. In weight gain prevention trials with adults, the mean difference in weight change between groups was -0.7 kg (95% CI -1.0 to -0.4, 95% PI -1.1 to -0.3) at program-end and -0.9 kg (95% CI -1.5 to -0.3, 95% PI -3.1 to 1.3) at last follow-up, favoring small change interventions. A small change approach was not effective for weight loss. Only 2/21 trials had a low risk of bias. Initial evidence supports the effectiveness of a small change approach for weight gain prevention but not weight loss. Further high-quality trials with longer follow-up are required.
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Affiliation(s)
- Henrietta Emily Graham
- The Centre for Lifestyle Medicine and Behaviour (CLIMB), School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Claire Deborah Madigan
- The Centre for Lifestyle Medicine and Behaviour (CLIMB), School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Amanda Jane Daley
- The Centre for Lifestyle Medicine and Behaviour (CLIMB), School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Napolitano MA, Whiteley JA, Mavredes M, Tjaden AH, Simmens S, Hayman LL, Faro J, Winston G, Malin S, DiPietro L. Effect of tailoring on weight loss among young adults receiving digital interventions: an 18 month randomized controlled trial. Transl Behav Med 2021; 11:970-980. [PMID: 33739422 DOI: 10.1093/tbm/ibab017] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Weight loss outcomes among young adults in technology-based programs have been equivocal. The purpose of this study was to deliver digital weight loss treatments to young adults and examine the 6, 12, and 18 month effects on weight loss. Young adults with overweight/obesity (N = 459; 23.3 ± 4.4 years) were recruited from two university sites and randomly assigned to receive through Facebook and text messaging either personalized (TAILORED; n = 150) or generic (TARGETED; n = 152) weight loss information, messages, and feedback or general healthy body content (e.g., body image, sleep; CONTROL; n = 157). The study was powered to detect a 2.1-kg difference at all time points with the primary outcome being 18 months. There was no overall effect of treatment group on 6, 12, or 18 month weight loss (ps = NS). However, at 6 months, those in TAILORED who were highly engaged (completing >66%) lost more weight compared to CONTROL (-2.32 kg [95% confidence intervals: -3.90, -0.74]; p = .004), with the trend continuing at 12 months. A significant baseline body mass index (BMI) by treatment group interaction (p = .004) was observed at 6 months. Among participants in the lowest baseline BMI category (25-27.5 kg/m2), those in TAILORED lost 2.27 kg (-3.86, -0.68) more, and those in TARGETED lost 1.72 kg (-3.16, -0.29) more than CONTROL after adjusting for covariates. Among participants with a BMI between 27.5 and 30 kg/m2, those in TAILORED lost 2.20 kg (-3.90, -0.51) more than participants in TARGETED. Results did not persist over time with no treatment interaction at 12 or 18 months. Initial body weight should be considered when recommending weight loss treatments for young adults. More intensive interventions or stepped care approaches may be needed for young adults with obesity.
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Affiliation(s)
- Melissa A Napolitano
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 3rd Floor, Washington, DC 20052, USA.,Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 2nd Floor, Washington, DC 20052, USA
| | - Jessica A Whiteley
- College of Nursing and Health Sciences, The University of Massachusetts at Boston, Boston, MA 02125, USA
| | - Meghan Mavredes
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 3rd Floor, Washington, DC 20052, USA
| | - Ashley Hogan Tjaden
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Samuel Simmens
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Laura L Hayman
- College of Nursing and Health Sciences, The University of Massachusetts at Boston, Boston, MA 02125, USA
| | - Jamie Faro
- Department of Population and Quantitative Health Sciences, The University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Ginger Winston
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 3rd Floor, Washington, DC 20052, USA.,Medical Faculty Associates, The George Washington University, Washington, DC 20052, USA
| | - Steven Malin
- Departments of Kinesiology and Division of Endocrinology, Metabolism and Nutrition, Rutgers University, New Brunswick, NJ 08901, USA
| | - Loretta DiPietro
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 2nd Floor, Washington, DC 20052, USA
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Nezami BT, Valle CG, Nulty AK, Espeland M, Wing RR, Tate DF. Predictors and Outcomes of Digital Weighing and Activity Tracking Lapses Among Young Adults During Weight Gain Prevention. Obesity (Silver Spring) 2021; 29:698-705. [PMID: 33759388 PMCID: PMC7995618 DOI: 10.1002/oby.23123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/22/2020] [Accepted: 12/29/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Self-monitoring is critical for weight management, but little is known about lapses in the use of digital self-monitoring. The objectives of this study were to examine whether lapses in self-weighing and wearing activity trackers are associated with weight and activity outcomes and to identify objective predictors of lapses. METHODS Participants (N = 160, BMI = 25.5 ± 3.3 kg/m2 , 33.1 ± 4.6 years old) were drawn from a sample of young adults in the Study of Novel Approaches to Prevention-Extension (SNAP-E) weight gain prevention trial. Analyses evaluated associations between weighing and tracker lapses and changes in weight and steps/day during the first 90 days after receiving a smart scale and activity tracker. RESULTS On average, participants self-weighed 49.6% of days and wore activity trackers 75.2% of days. Every 1-day increase in a weighing lapse was associated with a 0.06-lb gain. Lapses in tracker wear were not associated with changes in steps/day or weight between wear days. Weight gain predicted a higher likelihood of starting a lapse in weighing and tracker wear, whereas lower steps predicted a higher likelihood of a tracker lapse. CONCLUSIONS Weight gain may discourage adherence to self-monitoring. Future research could examine just-in-time supports to anticipate and reduce the frequency or length of self-monitoring lapses.
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Affiliation(s)
- Brooke T. Nezami
- Department of Nutrition, University of North Carolina at
Chapel Hill, Chapel Hill, NC, USA
| | - Carmina G. Valle
- Department of Nutrition, University of North Carolina at
Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North
Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alison K. Nulty
- Department of Anthropology, University of North Carolina at
Chapel Hill, Chapel Hill, NC, USA
| | - Mark Espeland
- Division of Gerontology and Geriatric Medicine, Wake Forest
School of Medicine, Winston-Salem, NC, USA
| | - Rena R. Wing
- Department of Psychiatry and Human Behavior, Alpert Medical
School of Brown University, Miriam Hospital, Providence, RI, USA
| | - Deborah F. Tate
- Department of Nutrition, University of North Carolina at
Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North
Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health Behavior, University of North Carolina
at Chapel Hill, Chapel Hill, NC, USA
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8
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Fields SD, Tung E. Patient-Focused Selection of PrEP Medication for Individuals at Risk of HIV: A Narrative Review. Infect Dis Ther 2021; 10:165-186. [PMID: 33569743 PMCID: PMC7875561 DOI: 10.1007/s40121-020-00384-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 12/23/2022] Open
Abstract
Pre-exposure prophylaxis (PrEP) medication is a key component of the HIV prevention strategy in the US, which has been demonstrated to be highly effective in preventing HIV acquisition among individuals at risk. Two PrEP medications are currently approved: emtricitabine/tenofovir disoproxil fumarate (Truvada®; F/TDF) was approved by the US Food and Drug Administration in 2012, followed by emtricitabine/tenofovir alafenamide (Descovy®; F/TAF) in 2019. An ongoing randomized, double-blind, Phase 3 study (DISCOVER) demonstrated that F/TAF had non-inferior efficacy to F/TDF. While both medications have been found to be efficacious and well tolerated, several studies have identified that important differences exist with regards to pharmacokinetics, bone and renal safety profiles, and other factors. In this narrative review, we conducted a comprehensive evaluation of the populations at risk of HIV who may also be affected by, or at risk of, bone or renal conditions. We reviewed the safety profiles of F/TDF and F/TAF to develop an evidence-based algorithm for selecting the appropriate PrEP medication, based on biological, behavioral, and health characteristics of an individual at risk of HIV, and considered how the choice of PrEP medication may or may not compound safety concerns for these individuals. We identified that the introduction of F/TAF provides a valuable alternative to F/TDF, allowing the personalization of PrEP. F/TAF may be the preferred medication for cisgender men and transgender women at risk of HIV infection who are predisposed to, or already have, bone or renal conditions. While the approval of F/TAF is the first step in personalization of PrEP, additional options are still warranted to help accommodate the wide spectrum of individuals at risk of HIV with different lifestyles, medical histories, preferences, and requirements.
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Affiliation(s)
- Sheldon D Fields
- The Pennsylvania State University, College of Nursing, University Park, PA, USA.
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Wing RR, Espeland MA, Tate DF, Perdue LH, Bahnson J, Polzien K, Robichaud EF, LaRose JG, Gorin AA, Lewis CE, Jelalian E. Changes in Cardiovascular Risk Factors Over 6 Years in Young Adults in a Randomized Trial of Weight Gain Prevention. Obesity (Silver Spring) 2020; 28:2323-2330. [PMID: 33230964 PMCID: PMC7687606 DOI: 10.1002/oby.23003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/10/2020] [Accepted: 07/21/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aimed to determine the impact of weight gain prevention interventions on changes in cardiovascular risk factors over 6 years. METHODS The Study of Novel Approaches to Weight Gain Prevention (SNAP) randomized 599 participants (ages 18-35; 46% with BMI 21-25; 54% with BMI 25-30) to Large Changes (produce buffer by losing 5-10 pounds initially), Small Changes (daily small changes in intake and activity) or Control and followed 355 participants with ongoing intervention and assessments through 6 years. RESULTS There were no significant differences among interventions for changes in weight or cardiovascular disease (CVD) risk factors from baseline to 6 years. However, 44% of participants gained ≥5%, and only 14% lost ≥5% over 6 years. Weight changes, from baseline to year 6, were significantly associated with changes in risk factors, especially insulin and high-density lipoprotein cholesterol. Earlier weight changes (e.g., weight cycling) had no beneficial or adverse effect on changes in CVD risk factors at 6 years, independent of 6-year weight changes. CONCLUSIONS Despite participation in a weight gain prevention trial, almost half of these young adults gained ≥5% or more over 6 years, with significant worsening in CVD risk factors. Greater attention to long-term weight gain prevention in young adults is needed.
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Affiliation(s)
- Rena R. Wing
- Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, Rhode Island
| | | | - Deborah F. Tate
- Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill
| | | | - Judy Bahnson
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kristen Polzien
- Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill
| | - Erica Ferguson Robichaud
- Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, Rhode Island
| | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine Richmond
| | - Amy A. Gorin
- Department of Psychological Sciences, University of Connecticut, Storrs
| | - Cora E. Lewis
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham
| | - Elissa Jelalian
- Alpert Medical School of Brown University, Miriam Hospital, Weight Control and Diabetes Research Center, Providence, Rhode Island
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