Factors associated with long-term weight loss and weight maintenance: analysis of a comprehensive workplace wellness program

Dietary and behavior changes following RDN-led corporate wellness counseling: A secondary analysis

BACKGROUND

Worksite wellness programs have the ability to activate health promotion and stimulate behavior change.

OBJECTIVE

To measure longitudinal associations between visits with a Registered Dietitian Nutritionist (RDN), as part of worksite wellness programs, on dietary and lifestyle behavior changes.

METHODS

The study sample included 1,123 employees with 77 different worksite wellness programs across the United States from March to December 2017. Hierarchical linear modeling was used to evaluate the associations of RDN visits with behavior changes.

RESULTS

The mean BMI at baseline was 33.48, indicating over half of all employees are considered obese. Employees who attended more than one visit showed an increase in whole grain consumption and corresponding weight loss (t-ratio = 2.41, p = 0.02). Age played a significant factor in the rise of systolic blood pressure; employees who attended more visits showed an increase in whole grain consumption and corresponding blood pressure (t-ratio = -2.11, p = 0.04).

CONCLUSIONS

RDNs as part of worksite wellness programs, can contribute to improvements in lifestyle behavior changes. These data highlight the need for nutrition intervention at the workplace. Research on nutrition-focused worksite wellness programs is needed to assess the long-term health outcomes related to dietary and lifestyle behavior changes.

Predictors for continued participation of employees in structured outpatient obesity intervention programmes

Background

Overweight, obesity and the conditions resulting from them have become one of the major challenges for health systems all over the world. High dropout rates are particularly common among the participants in outpatient obesity intervention programmes (OIP). Limited research has examined retention in OIP.

Methods

Based on the data of a 24-month Bundeswehr outpatient OIP with a total of 630 participants, predisposing factors (n = 30) for continued participation beyond an early stage (0–3 months) and beyond a later stage (0–6 months) were analysed by means of a logistic regression analysis. In order to correct for multiple-comparison, the p-value was adjusted (p* < 0.0017).

Results

Three hundred out of 630 participants continued to participate beyond an early stage and 205 beyond a later stage. Besides an age between 40 and 50 at the beginning of the outpatient OIP, it was possible to show that knowledge of one’s blood pressure and a positive lifestyle prior to participation in the programme (higher level of sporting activity) were predisposing factors for early dropout (>3 months) in the intervention programme.

Discussion

The possible predisposing factors examined accounted for about 35% of the variance in a rough estimate. In order to improve long-term participation in workplace outpatient OIP, the study focused on how the motivation of older people and employees with an unfavourable cardiovascular risk profile could be improved.

Effects of Obesity Management Program Provided by Occupational Health Nurse in Worksite

This study was conducted on 60 male adult technicians in the worksite to examine the impact of the obesity management program on their eating habits, exercise self-efficacy, quality of life, and body components. This was a nonrandomized pretest and posttest intervention study. The obesity management program was applied for 16 weeks on diet education, exercise, and counseling provided by the occupational health nurse in the worksite. The questionnaire for measure included the general characteristics, eating habits, exercise self-efficacy, and quality of life. Body components were measured by using the InBody 720 device. The participants who received the obesity management program showed better eating habits, a higher level of exercise self-efficacy, a higher level of quality of life, lower levels of body weight and body mass index (BMI), a smaller waist and hip circumference, and a higher level of muscle mass as compared with the preapplication.

Occupational and non-occupational factors associated with work-related injuries among construction workers in the USA

BACKGROUND

Many factors contribute to occupational injuries. However, these factors have been compartmentalized and isolated in most studies.

OBJECTIVE

To examine the relationship between work-related injuries and multiple occupational and non-occupational factors among construction workers in the USA.

METHODS

Data from the 1988-2000 National Longitudinal Survey of Youth, 1979 cohort (N = 12,686) were analyzed. Job exposures and health behaviors were examined and used as independent variables in four multivariate logistic regression models to identify associations with occupational injuries.

RESULTS

After controlling for demographic variables, occupational injuries were 18% (95% CI: 1.04-1.34) more likely in construction than in non-construction. Blue-collar occupations, job physical efforts, multiple jobs, and long working hours accounted for the escalated risk in construction. Smoking, obesity/overweight, and cocaine use significantly increased the risk of work-related injury when demographics and occupational factors were held constant.

CONCLUSIONS

Workplace injuries are better explained by simultaneously examining occupational and non-occupational characteristics.

Outcomes and utilization of a low intensity workplace weight loss program

Obesity is related to high health care costs and lost productivity in the workplace. Employers are increasingly sponsoring weight loss and wellness programs to ameliorate these costs. We evaluated weight loss outcomes, treatment utilization, and health behavior change in a low intensity phone- and web-based, employer-sponsored weight loss program. The intervention included three proactive counseling phone calls with a registered dietician and a behavioral health coach as well as a comprehensive website. At six months, one third of those who responded to the follow-up survey had lost a clinically significant amount of weight (≥5% of body weight). Clinically significant weight loss was predicted by the use of both the counseling calls and the website. When examining specific features of the web site, the weight tracking tool was the most predictive of weight loss. Health behavior changes such as eating more fruits and vegetables, increasing physical activity, and reducing stress were all predictive of clinically significant weight loss. Although limited by the low follow-up rate, this evaluation suggests that even low intensity weight loss programs can lead to clinical weight loss for a significant number of participants.

Participatory workplace interventions can reduce sedentary time for office workers--a randomised controlled trial

BACKGROUND

Occupational sedentary behaviour is an important contributor to overall sedentary risk. There is limited evidence for effective workplace interventions to reduce occupational sedentary time and increase light activity during work hours. The purpose of the study was to determine if participatory workplace interventions could reduce total sedentary time, sustained sedentary time (bouts >30 minutes), increase the frequency of breaks in sedentary time and promote light intensity activity and moderate/vigorous activity (MVPA) during work hours.

METHODS

A randomised controlled trial (ANZCTR NUMBER: ACTN12612000743864) was conducted using clerical, call centre and data processing workers (n = 62, aged 25-59 years) in 3 large government organisations in Perth, Australia. Three groups developed interventions with a participatory approach: 'Active office' (n = 19), 'Active Workstation' and promotion of incidental office activity; 'Traditional physical activity' (n = 14), pedometer challenge to increase activity between productive work time and 'Office ergonomics' (n = 29), computer workstation design and breaking up computer tasks. Accelerometer (ActiGraph GT3X, 7 days) determined sedentary time, sustained sedentary time, breaks in sedentary time, light intensity activity and MVPA on work days and during work hours were measured before and following a 12 week intervention period.

RESULTS

For all participants there was a significant reduction in sedentary time on work days (-1.6%, p = 0.006) and during work hours (-1.7%, p = 0.014) and a significant increase in number of breaks/sedentary hour on work days (0.64, p = 0.005) and during work hours (0.72, p = 0.015); there was a concurrent significant increase in light activity during work hours (1.5%, p = 0.012) and MVPA on work days (0.6%, p = 0.012).

CONCLUSIONS

This study explored novel ways to modify work practices to reduce occupational sedentary behaviour. Participatory workplace interventions can reduce sedentary time, increase the frequency of breaks and improve light activity and MVPA of office workers by using a variety of interventions.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTN12612000743864.

25-Hydroxyvitamin D Supplementation and BMI Change: A Meta-Analysis of Randomized Controlled Trials

The impact of 25-hydroxyvitamin D (25[OH]D) supplementation on weight change remains controversial. The objective of this study was to summarize the effects of 25[OH]D supplementation (cholecalciferol or ergocalciferol) on BMI change through a meta-analysis of published clinical trials. We completed a systematic review of English articles, using MEDLINE (Ovid, Pubmed) from January 1, 1998 through January 1, 2013. The articles selected focused on 25[OH]D supplementation and body mass index (BMI) in randomized controlled trials (RCT’s). The association between 25[OH]D and mean BMI change was estimated utilizing a random effects model. A total of 30 studies were reviewed and 9 were included in the meta-analysis. Total participants included 1651 adults (82.6% women and mean age 47.9 years) and mean follow-up ranged between 6 to 196 weeks and mean daily 25[OH]D dose ranged from 200 IU to 1,110 IU. Five of the 9 studies included calcium supplementation in both groups. Average baseline BMI was 30.7 and 30.4 kg/m² in the intervention and control groups, respectively. Five studies suggested a beneficial effect for 25[OH]D supplementation for BMI change whereas 3 studies showed no effect of 25[OH]D supplementation on BMI change, and one showed a non-perceptible change. Meta-analysis of BMI values at end of trial showed no statistically significant difference in BMI change by use of 25[OH]D supplementation. Based on existing published trials, oral 25[OH]D supplementation does not significantly impact BMI change.