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Caldwell AE, Gorczyca AM, Bradford AP, Nicklas JM, Montgomery RN, Smyth H, Pretzel S, Nguyen T, DeSanto K, Ernstrom C, Santoro N. Effectiveness of preconception weight loss interventions on fertility in women: a systematic review and meta-analysis. Fertil Steril 2024:S0015-0282(24)00126-2. [PMID: 38408693 DOI: 10.1016/j.fertnstert.2024.02.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/09/2024] [Accepted: 02/19/2024] [Indexed: 02/28/2024]
Abstract
IMPORTANCE Weight loss before conception is recommended for women with overweight or obesity to improve fertility outcomes, but evidence supporting this recommendation is mixed. OBJECTIVE To examine the effectiveness of weight loss interventions using lifestyle modification and/or medication in women with overweight or obesity on pregnancy, live birth, and miscarriage. DATA SOURCES An electronic search of MEDLINE, Embase, Cochrane Library, including Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature was conducted through July 6, 2022, via Wiley. STUDY SELECTION AND SYNTHESIS Randomized controlled trials examining weight loss interventions through lifestyle and/or medication in women with overweight or obesity planning pregnancy were included. Random-effects meta-analysis was conducted, reporting the risk ratio (RR) for each outcome. Subgroup analyses were conducted by intervention type, type of control group, fertility treatment, intervention length, and body mass index (BMI). MAIN OUTCOME(S) Clinical pregnancy, live birth, and miscarriage events. RESULT(S) A narrative review and meta-analysis were possible for 16 studies for pregnancy (n = 3,588), 13 for live birth (n = 3,329), and 11 for miscarriage (n = 3,248). Women randomized and exposed to a weight loss intervention were more likely to become pregnant (RR = 1.24, 95% CI 1.07-1.44; I2 = 59%) but not to have live birth (RR = 1.19, 95% CI 0.97-1.45; I2 = 69%) or miscarriage (RR = 1.17, 95% CI 0.79-1.74; I2 = 31%) compared with women in control groups. Subgroup analyses revealed women randomized to weight loss interventions lasting 12 weeks or fewer (n = 9, RR = 1.43; 95% CI 1.13-1.83) and women with a BMI ≥ 35 kg/m2 (n = 7, RR = 1.54; 95% CI, 1.18-2.02) were more likely to become pregnant compared with women in the control groups. Miscarriage was higher in intervention groups who underwent fertility treatment (n = 8, RR 1.45; 95% CI 1.07-1.96). CONCLUSION(S) Pregnancy rates were higher in women undergoing preconception weight loss interventions with no impact on live birth or miscarriage rates. Findings do not support one-size-fits-all recommendation for weight loss through lifestyle modification and/or medication in women with overweight or obesity immediately before conception to improve live birth or miscarriage outcomes.
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Affiliation(s)
- Ann E Caldwell
- Division of Endocrinology Metabolism and Diabetes, University of Colorado School of Medicine, Aurora, Colorado.
| | - Anna M Gorczyca
- Division of Physical Activity and Weight Management, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Andrew P Bradford
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado
| | - Jacinda M Nicklas
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Robert N Montgomery
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Heather Smyth
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Denver, Colorado
| | | | - Thy Nguyen
- University of Colorado School of Medicine, Aurora, Colorado
| | - Kristen DeSanto
- Strauss Health Sciences Library, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Celia Ernstrom
- University of Colorado School of Medicine, Aurora, Colorado
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado
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Caldwell AE, More KR, Chui TK, Sayer RD. Psychometric validation of four-item exercise identity and healthy-eater identity scales and applications in weight loss maintenance. Int J Behav Nutr Phys Act 2024; 21:21. [PMID: 38395833 PMCID: PMC10885534 DOI: 10.1186/s12966-024-01573-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Identifying as someone who engages in health promoting behaviors like healthy eating and exercising may be associated with sustained engagement in those behaviors, but reliable and valid instruments are needed to improve the rigor of this research. Two studies were conducted to (1) examine the psychometric properties of a four-item exerciser identity measure (4-EI) and an adapted healthy-eater identity measure (4-HEI) and (2) examine differences in identity strengths across categories of weight loss success. METHODS Data from 1,709 community dwelling adults in the International Weight Control Registry (IWCR) were used. A random half of the sample was used to assess the proposed unidimensional factor structure of the 4-EI and 4-HEI and examine convergent and discriminant validity using Spearman rank-order correlations. One-way ANOVA was used in the other random half of the sample to compare 4-EI and 4-HEI scores (-3 to + 3) across three self-defined weight loss categories ('Successful', 'Regain', and 'Unsuccessful') and those maintaining ≥ 5% weight loss for > 1 year vs. not. RESULTS Results support the unidimensional factor structure with all four items (eigenvalue scores > 2.89) as well as convergent and discriminant validity for both measures. Exercise identity was strongly correlated with self-reported physical activity (r (735) = 0.52, p <.001) and measures of autonomous motivation. Healthy eating identity was moderately correlated with cognitive restraint in eating (r (744) = 0.42, p <.001) and other measures predictive of eating behavior. 4-EI and 4-HEI are stronger in Successful (4-EI: M = 0.90, SD = 1.77; 4-HEI: M = 1.56 SD = 1.37) vs. Regain (4-EI: M=-0.18, SD = 1.68; 4-HEI: M =.57, SD = 1.48) and Unsuccessful (4-EI:M=-0.28, SD = 1.62; 4-HEI: M = 0.51, SD = 1.33) and those maintaining ≥ 5% weight loss (4-EI:M = 0.47, SD = 1.78; 4-HEI: M = 1.13, SD = 1.49) vs. not (4-EI:M=-0.27, SD = 1.66; 4-HEI: M = 0.53, SD = 1.47), p's < 0.001. CONCLUSIONS The 4-EI and 4-HEI have acceptable psychometric properties and can advance understanding of the role of identity in exercise and dietary behaviors and weight loss maintenance. TRIAL REGISTRATION The parent observational study, International Weight Control Registry (IWCR), for these sub-studies is registered in ClinicalTrials.gov (NCT04907396).
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Affiliation(s)
- Ann E Caldwell
- Division of Endocrinology, Metabolism, & Diabetes, Anschutz Health and Wellness Center, University of Colorado Anschutz School of Medicine, 12348 E. Montview Blvd, 80045, Aurora, CO, USA.
| | | | - Tsz Kiu Chui
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - R Drew Sayer
- Department of Family and Community Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Nicklas JM, Pyle L, Soares A, Leiferman JA, Bull SS, Tong S, Caldwell AE, Santoro N, Barbour LA. The Fit After Baby randomized controlled trial: An mHealth postpartum lifestyle intervention for women with elevated cardiometabolic risk. PLoS One 2024; 19:e0296244. [PMID: 38194421 PMCID: PMC10775990 DOI: 10.1371/journal.pone.0296244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 12/03/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Postpartum women with overweight/obesity and a history of adverse pregnancy outcomes are at elevated risk for cardiometabolic disease. Postpartum weight loss and lifestyle changes can decrease these risks, yet traditional face-to-face interventions often fail. We adapted the Diabetes Prevention Program into a theory-based mobile health (mHealth) program called Fit After Baby (FAB) and tested FAB in a randomized controlled trial. METHODS The FAB program provided 12 weeks of daily evidence-based content, facilitated tracking of weight, diet, and activity, and included weekly coaching and gamification with points and rewards. We randomized women at 6 weeks postpartum 2:1 to FAB or to the publicly available Text4baby (T4B) app (active control). We measured weight and administered behavioral questionnaires at 6 weeks, and 6 and 12 months postpartum, and collected app user data. RESULTS 81 eligible women participated (77% White, 2% Asian, 15% Black, with 23% Hispanic), mean baseline BMI 32±5 kg/m2 and age 31±5 years. FAB participants logged into the app a median of 51/84 (IQR 25,71) days, wore activity trackers 66/84 (IQR 43,84) days, logged weight 17 times (IQR 11,24), and did coach check-ins 5.5/12 (IQR 4,9) weeks. The COVID-19 pandemic interrupted data collection for the primary 12-month endpoint, and impacted diet, physical activity, and body weight for many participants. At 12 months postpartum women in the FAB group lost 2.8 kg [95% CI -4.2,-1.4] from baseline compared to a loss of 1.8 kg [95% CI -3.8,+0.3] in the T4B group (p = 0.42 for the difference between groups). In 60 women who reached 12 months postpartum before the onset of the COVID-19 pandemic, women randomized to FAB lost 4.3 kg [95% CI -6.0,-2.6] compared to loss in the control group of 1.3 kg [95% CI -3.7,+1.1] (p = 0.0451 for the difference between groups). CONCLUSIONS There were no significant differences between groups for postpartum weight loss for the entire study population. Among those unaffected by the COVID pandemic, women randomized to the FAB program lost significantly more weight than those randomized to the T4B program. The mHealth FAB program demonstrated a substantial level of engagement. Given the scalability and potential public health impact of the FAB program, the efficacy for decreasing cardiometabolic risk by increasing postpartum weight loss should be tested in a larger trial.
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Affiliation(s)
- Jacinda M. Nicklas
- Department of Medicine, Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Laura Pyle
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora, Colorado, United States of America
| | - Andrey Soares
- Department of Medicine, Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Jennifer A. Leiferman
- Department of Community and Behavioral Health, University of Colorado School of Public Health, Aurora, Colorado, United States of America
| | - Sheana S. Bull
- Department of Community and Behavioral Health, University of Colorado School of Public Health, Aurora, Colorado, United States of America
| | - Suhong Tong
- Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora, Colorado, United States of America
| | - Ann E. Caldwell
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility & Reproductive Sciences, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Linda A. Barbour
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
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Caldwell AE, Cummings DK, Hooper PL, Trumble BC, Gurven M, Stieglitz J, Davis HE, Kaplan H. Adolescence is characterized by more sedentary behaviour and less physical activity even among highly active forager-farmers. Proc Biol Sci 2023; 290:20231764. [PMID: 37909080 PMCID: PMC10618868 DOI: 10.1098/rspb.2023.1764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/06/2023] [Indexed: 11/02/2023] Open
Abstract
Over 80% of adolescents worldwide are insufficiently active, posing massive public health and economic challenges. Declining physical activity (PA) and sex differences in PA consistently accompany transitions from childhood to adulthood in post-industrialized populations and are attributed to psychosocial and environmental factors. An overarching evolutionary theoretical framework and data from pre-industrialized populations are lacking. This cross-sectional study tests hypotheses from life history theory, that adolescent PA is inversely related to age, but this association is mediated by Tanner stage, reflecting higher and sex-specific energetic demands for growth and reproductive maturation. Detailed measures of PA and pubertal maturation are assessed among Tsimane forager-farmers (age: 7-22 years; 50% female, n = 110). Most Tsimane sampled (71%) meet World Health Organization PA guidelines (greater than or equal to 60 min/day of moderate-to-vigorous PA). Like post-industrialized populations, sex differences and inverse age-activity associations were observed. Tanner stage significantly mediated age-activity associations. Adolescence presents difficulties to PA engagement that warrant further consideration in PA intervention approaches to improve public health.
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Affiliation(s)
- Ann E. Caldwell
- Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Paul L. Hooper
- Economic Science Institute, Chapman University, Orange, CA, USA
- Department of Anthropology, University of New Mexico, Albuquerque, NM, USA
| | - Benjamin C. Trumble
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
| | - Michael Gurven
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Jonathan Stieglitz
- Institute for Advanced Study in Toulouse, Université Toulouse 1 Capitole Toulouse, France
| | - Helen E. Davis
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
- Department of Anthropology, Harvard University, Boston, MA, USA
| | - Hillard Kaplan
- Economic Science Institute, Chapman University, Orange, CA, USA
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Seabright E, Alami S, Kraft TS, Davis H, Caldwell AE, Hooper P, McAllister L, Mulville S, Veile A, von Rueden C, Trumble B, Stieglitz J, Gurven M, Kaplan H. Correction to: 'Repercussions of patrilocal residence on mothers' social support networks among Tsimane forager-farmers' (2022) by Seabright et al.. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220537. [PMID: 36871596 PMCID: PMC9985959 DOI: 10.1098/rstb.2022.0537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 03/07/2023] Open
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Caldwell AE, Cummings DK, Hooper PL, Trumble BC, Gurven M, Stiegltz J, Davis HE, Kaplan H. Adolescence is characterized by more sedentary behavior and less physical activity even among highly active forager-farmers. medRxiv 2023:2023.03.15.23287308. [PMID: 36993728 PMCID: PMC10055571 DOI: 10.1101/2023.03.15.23287308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Over 80% of adolescents worldwide are insufficiently active, posing massive public health and economic challenges. Declining physical activity (PA) and sex differences in PA consistently accompany transitions from childhood to adulthood in post-industrialized populations and are attributed to psychosocial and environmental factors. An overarching evolutionary theoretical framework and data from pre-industrialized populations are lacking. In this cross-sectional study we test a hypothesis from life history theory, that adolescent PA reductions reflect an evolved strategy to conserve energy, given the increasing sex-specific energetic demands for growth and reproductive maturation. Detailed measures of PA and pubertal maturation are assessed among Tsimane forager-farmers (age: 7-22 yrs.; 50% female, n=110). We find that 71% of Tsimane sampled meet World Health Organization PA guidelines (≥60 minutes/day of moderate-to-vigorous PA). Consistent with post-industrialized populations, we observe sex differences and inverse age-activity associations mediated by Tanner stage. Physical inactivity in adolescence is distinct from other health risk behaviors and also not merely resulting from obesogenic environments.
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Seabright E, Alami S, Kraft TS, Davis H, Caldwell AE, Hooper P, McAllister L, Mulville S, Veile A, von Rueden C, Trumble B, Stieglitz J, Gurven M, Kaplan H. Repercussions of patrilocal residence on mothers' social support networks among Tsimane forager-farmers. Philos Trans R Soc Lond B Biol Sci 2023; 378:20210442. [PMID: 36440570 PMCID: PMC9703270 DOI: 10.1098/rstb.2021.0442] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022] Open
Abstract
While it is commonly thought that patrilocality is associated with worse outcomes for women and their children due to lower social support, few studies have examined whether the structure of female social networks covaries with post-marital residence. Here, we analyse scan sample data collected among Tsimane forager-farmers. We compare the social groups and activity partners of 181 women residing in the same community as their parents, their husband's parents, both or neither. Relative to women living closer to their in-laws, women living closer to their parents are less likely to be alone or solely in the company of their nuclear family (odds ratio (OR): 0.6, 95% CI: 0.3-0.9), and more likely to be observed with others when engaging in food processing and manufacturing of market or household goods, but not other activities. Women are slightly more likely to receive childcare support from outside the nuclear family when they live closer to their parents (OR = 1.8, 95% CI 0.8-3.9). Their social group size and their children's probability of receiving allocare decrease significantly with distance from their parents, but not their in-laws. Our findings highlight the importance of women's proximity to kin, but also indicate that patrilocality per se is not costly to Tsimane women. This article is part of the theme issue 'Cooperation among women: evolutionary and cross-cultural perspectives'.
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Affiliation(s)
- Edmond Seabright
- School of Collective Intelligence, Mohammed 6 Polytechnic University, Ben Guerir 43150, Morocco
- Department of Anthropology, University of New Mexico, Albuquerque, NM 87106, USA
| | - Sarah Alami
- School of Collective Intelligence, Mohammed 6 Polytechnic University, Ben Guerir 43150, Morocco
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA 93106, USA
| | - Thomas S. Kraft
- Department of Anthropology, University of Utah, Salt Lake City, UT 84112, USA
| | - Helen Davis
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA 01451, USA
| | - Ann E. Caldwell
- Division of Endocrinology, Metabolism and Diabetes, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO 80217, USA
| | - Paul Hooper
- Department of Anthropology, University of New Mexico, Albuquerque, NM 87106, USA
- Economic Science Institute, Chapman University, Orange, CA 92866, USA
| | - Lisa McAllister
- Department of Anthropology, Pennsylvania State University, University Park, PA 16802, USA
| | - Sarah Mulville
- Institute of Agriculture, University of Tennessee, Knoxville, TN 37996, USA
| | - Amanda Veile
- Department of Anthropology, Purdue University, West Lafayette, IN, USA
| | | | - Benjamin Trumble
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ 85287-1701, USA
| | - Jonathan Stieglitz
- Institute for Advanced Study in Toulouse, Toulouse 1 Capitol University, Toulouse 31080, France
| | - Michael Gurven
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA 93106, USA
| | - Hillard Kaplan
- Department of Anthropology, University of New Mexico, Albuquerque, NM 87106, USA
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Zaman A, Zaman A, Caldwell AE, Ostendorf DM, Pan Z, Hill EB, Rynders CA, Suboc GT, Bessesen DH, MacLean PS, Melanson EL, Thomas EA, Catenacci VA. RF24 | PSUN110 A Cross-Sectional Study Evaluating the Impact of Combined Hormonal Contraceptives on Components of Energy Balance in Pre-Menopausal Women with Overweight or Obesity. J Endocr Soc 2022. [PMCID: PMC9624749 DOI: 10.1210/jendso/bvac150.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Combined estrogen and progestin hormonal contraceptives (CHCs, including combined oral contraceptives, hormonal patches, or vaginal rings) expose women to supraphysiologic levels of reproductive hormones, which in turn suppress endogenous estrogen and progesterone. Sustained elevations of synthetic estrogen/progestin or suppression of endogenous hormones in CHC users may lead to altered dietary intake and/or patterns of physical activity (PA). Previously, we reported that CHC use was associated with higher energy intake (EI) and weight regain over 1 year after weight loss in women with overweight and obesity enrolled in a behavioral weight loss program, suggesting a potential impact of CHCs on energy balance in the weight reduced state. The aim of this secondary data analysis was to compare dietary intake and PA in weight-stable women with overweight or obesity using CHCs to non-CHC users. Methods Pre-menopausal women with overweight or obesity (n=269, age 18-55 years, BMI 27-45kg/m2) enrolled in 3 different interventional weight loss trials were categorized as CHC users (CHC, n=48) or non-CHC controls (CON, n=221). Fat mass (FM) and lean mass (LM) were measured with DXA. Self-reported dietary energy and macronutrient intake was obtained from either 3-day (n=178) or 7-day (n=91) written diet diaries and analyzed using Nutrition Data System for Research (NDSR) software. Healthy eating index (HEI) scores for diet quality were calculated in a subset (CHC=17, CON=84) of participants using variables available in NDSR output files. Additionally, average daily step counts were measured over 1 week in a subset (CHC=27, CON=143) of participants using the activPAL device. Results Age was lower in CHC users (mean±SD; CHC 35.3±9.0 vs. CON 39.4±7.6 years, p<0.01), but race and ethnicity did not differ between the two groups. After controlling for age, there were no significant differences between groups in baseline BMI (mean±SEM; CHC 34.3±0.7 vs. CON 34.8±0.3 kg/m2), weight (93.6±2.4 vs. 94.2±1.1 kg), %FM (43.3±0.6 vs. 42.7±0.3%), or %LM (54.3±0.6 vs. 54.7±0.3%). There were no significant differences between groups in EI (mean±SEM; CHC 1763.7±78.1 vs. CON 1768.8±36.7 kcal); proportions of fat (36.7±0.9 vs. 36.9±0.4%), carbohydrate (43.9±1.1 vs. 44.3±0.5%), and protein intake (17.7±0.6 vs. 17.3±0.3%); or HEI scores (58.3±2.9 vs. 56.8±1.3). There was a trend for lower daily step count in CHC users (mean±SEM; CHC 5978±460 vs. CON 6913±197 steps/day, p=0.07). Conclusion Daily steps tended to be lower in CHC users compared to controls, while differences in self-reported dietary intake were not observed. Future studies that are done in larger samples over a greater range of BMI and with more detailed measures of PA timed to the menstrual cycle are needed to explore the extent to which CHC use may impact energy balance in women. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m., Sunday, June 12, 2022 1:06 p.m. - 1:11 p.m.
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Ostendorf DM, Caldwell AE, Zaman A, Pan Z, Bing K, Wayland LT, Creasy SA, Bessesen DH, MacLean P, Melanson EL, Catenacci VA. Comparison of weight loss induced by daily caloric restriction versus intermittent fasting (DRIFT) in individuals with obesity: study protocol for a 52-week randomized clinical trial. Trials 2022; 23:718. [PMID: 36038881 PMCID: PMC9421629 DOI: 10.1186/s13063-022-06523-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/06/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The standard of care for treating overweight and obesity is daily caloric restriction (DCR). While this approach produces modest weight loss, adherence to DCR declines over time and weight regain is common. Intermittent fasting (IMF) is an alternative dietary strategy for reducing energy intake (EI) that involves >60% energy restriction on 2-3 days per week, or on alternate days, with habitual intake on fed days. While numerous studies have evaluated IMF as a weight loss strategy, there are several limitations including lack of a standard-of-care DCR control, failure to provide guideline-based behavioral support, and failure to rigorously evaluate dietary and PA adherence using objective measures. To date, only three longer-term (52-week) trials have evaluated IMF as a weight loss strategy. None of these longer-duration studies reported significant differences between IMF and DCR in changes in weight. However, each of these studies has limitations that prohibit drawing generalizable conclusions about the relative long-term efficacy of IMF vs. DCR for obesity treatment. METHODS The Daily Caloric Restriction vs. Intermittent Fasting Trial (DRIFT) is a two-arm, 52-week block randomized (1:1) clinical weight loss trial. The two intervention arms (DCR and IMF) are designed to prescribe an equivalent average weekly energy deficit from baseline weight maintenance energy requirements. Both DCR and IMF will be provided guideline-based behavioral support and a PA prescription. The primary outcome is change in body weight at 52 weeks. Secondary outcomes include changes in body composition (dual-energy x-ray absorptiometry (DXA)), metabolic parameters, total daily energy expenditure (TDEE, doubly labeled water (DLW)), EI (DLW intake-balance method, 7-day diet diaries), and patterns of physical activity (PA, activPAL device). DISCUSSION Although DCR leads to modest weight loss success in the short-term, there is wide inter-individual variability in weight loss and poor long-term weight loss maintenance. Evidence-based dietary approaches to energy restriction that are effective long-term are needed to provide a range of evidence-based options to individuals seeking weight loss. The DRIFT study will evaluate the long-term effectiveness of IMF vs. DCR on changes in objectively measured weight, EI, and PA, when these approaches are delivered using guideline-based behavioral support and PA prescriptions.
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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
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Ann E. Caldwell
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Adnin Zaman
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Zhaoxing Pan
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Kristen Bing
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Liza T. Wayland
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Seth A. Creasy
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Daniel H. Bessesen
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Paul MacLean
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Edward L. Melanson
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical Center, Denver, CO USA
| | - Victoria A. Catenacci
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
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10
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Zaman A, Sloggett KJ, Caldwell AE, Catenacci V, Cornier MA, Grau L, Vetter C, Rynders C, Thomas E. The effects of the COVID-19 pandemic on weight loss in participants in a behavioral weight-loss intervention. Obesity (Silver Spring) 2022; 30:1015-1026. [PMID: 35118814 PMCID: PMC9050831 DOI: 10.1002/oby.23399] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/27/2022] [Accepted: 01/30/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aimed to assess the effects of the COVID-19 pandemic on weight loss, physical activity, and sleep in adults with overweight or obesity participating in a 39-week weight-loss intervention. METHODS Participants (n = 81, 85% female, mean [SD] age 38.0 [7.8] years, BMI 34.1 [5.7] kg/m2 ) were enrolled in 3 separate cohorts. Cohorts 1 and 2 were studied prior to the pandemic (pre-COVID cohorts). Cohort 3 (COVID cohort) transitioned to a virtual intervention at week 6, when "stay-at-home" orders were implemented in Colorado. Weight was assessed at baseline, week 12, and week 39 with clinic scales before the pandemic and home scales during the pandemic. Diet was assessed with Likert scales at weeks 4, 8, and 12. Physical activity and sleep were assessed at baseline and week 12 with actigraphy. RESULTS Participants in the COVID cohort reported greater dietary adherence (p = 0.004) and lost more weight than those in the pre-COVID cohorts at week 12 (-7.7 [3.3] kg vs. -3.7 [3.0] kg, p < 0.001) and week 39 (-8.5 [4.4] kg vs. -2.8 [4.6] kg, p < 0.001). Energy intake did not differ between cohorts (p = 0.51). The COVID cohort increased both sedentary time while awake and time in bed at night. CONCLUSIONS Although the pandemic caused disruptions for the COVID cohort, participants still achieved weight loss with continued behavioral support.
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Affiliation(s)
- Adnin Zaman
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health & Wellness Center at the University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Kelsey Jones Sloggett
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health & Wellness Center at the University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ann E. Caldwell
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health & Wellness Center at the University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Victoria Catenacci
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health & Wellness Center at the University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Marc-Andre Cornier
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health & Wellness Center at the University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Rocky Mountain Regional Veterans Administration, Aurora, Colorado, USA
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Laura Grau
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Céline Vetter
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Corey Rynders
- Division of Geriatric Medicine, Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Kinesiology, School of Education and Human Development, University of Virginia, Charlottesville, Virginia, USA
- Division of Endocrinology and Metabolism, School of Education Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Elizabeth Thomas
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health & Wellness Center at the University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Rocky Mountain Regional Veterans Administration, Aurora, Colorado, USA
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11
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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12
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Caldwell AE, Thomas EA, Rynders C, Holliman BD, Perreira C, Ostendorf DM, Catenacci VA. Improving lifestyle obesity treatment during the COVID-19 pandemic and beyond: New challenges for weight management. Obes Sci Pract 2022; 8:32-44. [PMID: 34540266 PMCID: PMC8441901 DOI: 10.1002/osp4.540] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 12/12/2022] Open
Abstract
Objective The COVID-19 pandemic has resulted in significant changes to daily life and many health-related behaviors. The objective of this study was to examine how the stay-at-home/safer-at-home mandates issued in Colorado (March 2020-May 2020) impacted lifestyle behaviors and mental health among individuals with overweight or obesity participating in two separate behavioral weight loss trials (n = 82). Methods Questionnaires were used to collect qualitative and quantitative data on challenges to weight loss presented by the COVID-19 pandemic, including changes in dietary intake, physical activity, sedentary behavior, and mental health during the stay-at-home/safer-at-home mandates. Results Using a convergent mixed method approach integrating qualitative and quantitative data, the greatest challenge experienced by participants was increased stress and anxiety, which led to more unhealthy behaviors. The majority perceived it to be harder to adhere to the prescribed diet (81%) and recommended physical activity (68%); however, self-reported exercise on weekdays increased significantly and 92% of participants lost weight or maintained weight within ±1% 5-6 weeks following the stay-at-home mandate. Conclusion Study results suggest that obesity treatment programs should consider and attempt to address the burden of stress and anxiety stemming from the COVID-19 pandemic and other sources due to the negative effects they can have on weight management and associated behaviors.
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Affiliation(s)
- Ann E. Caldwell
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Division of EndocrinologyMetabolism, and DiabetesDepartment of MedicineUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Elizabeth A. Thomas
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Division of EndocrinologyMetabolism, and DiabetesDepartment of MedicineUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Rocky Mountain Regional Veterans Affairs Medical CenterAuroraCOUSA
| | - Corey Rynders
- Division of Geriatric MedicineDepartment of MedicineUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Eastern Colorado Veterans Affairs Geriatric Research, Educationand Clinical CenterDenverCOUSA
| | - Brooke Dorsey Holliman
- Department of Family MedicineUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS)Children's Hospital ColoradoUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Cathryn Perreira
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS)Children's Hospital ColoradoUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Danielle M. Ostendorf
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Division of EndocrinologyMetabolism, and DiabetesDepartment of MedicineUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Victoria A. Catenacci
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Division of EndocrinologyMetabolism, and DiabetesDepartment of MedicineUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
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13
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Roberts SB, Das SK, Sayer RD, Caldwell AE, Wyatt HR, Mehta TS, Gorczyca AM, Oslund JL, Peters JC, Friedman JE, Chiu CY, Greenway FL, Donnelly JE, Dao MC, Cuevas AG, Affuso O, Wilkinson LL, Thomas D, Al-Ozairi E, Yannakoulia M, Khazrai YM, Manalac RJ, Bachiashvili V, Hill JO. Technical report: an online international weight control registry to inform precision approaches to healthy weight management. Int J Obes (Lond) 2022; 46:1728-1733. [PMID: 35710944 PMCID: PMC9201790 DOI: 10.1038/s41366-022-01158-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 05/18/2022] [Accepted: 05/24/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Personalizing approaches to prevention and treatment of obesity will be a crucial aspect of precision health initiatives. However, in considering individual susceptibility to obesity, much remains to be learned about how to support healthy weight management in different population subgroups, environments and geographical locations. SUBJECTS/METHODS The International Weight Control Registry (IWCR) has been launched to facilitate a deeper and broader understanding of the spectrum of factors contributing to success and challenges in weight loss and weight loss maintenance in individuals and across population groups. The IWCR registry aims to recruit, enroll and follow a diverse cohort of adults with varying rates of success in weight management. Data collection methods include questionnaires of demographic variables, weight history, and behavioral, cultural, economic, psychological, and environmental domains. A subset of participants will provide objective measures of physical activity, weight, and body composition along with detailed reports of dietary intake. Lastly, participants will be able to provide qualitative information in an unstructured format on additional topics they feel are relevant, and environmental data will be obtained from public sources based on participant zip code. CONCLUSIONS The IWCR will be a resource for researchers to inform improvements in interventions for weight loss and weight loss maintenance in different countries, and to examine environmental and policy-level factors that affect weight management in different population groups. This large scale, multi-level approach aims to inform efforts to reduce the prevalence of obesity worldwide and its associated comorbidities and economic impacts. TRIAL REGISTRATION NCT04907396 (clinicaltrials.gov) sponsor SB Roberts; Tufts University IRB #13075.
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Affiliation(s)
- Susan B. Roberts
- grid.429997.80000 0004 1936 7531Energy Metabolism, Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA 02111 USA
| | - Sai Krupa Das
- grid.429997.80000 0004 1936 7531Energy Metabolism, Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA 02111 USA
| | - R. Drew Sayer
- grid.265892.20000000106344187Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Ann E. Caldwell
- grid.430503.10000 0001 0703 675XDivision of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, Aurora, CO 80045 USA
| | - Holly R. Wyatt
- grid.265892.20000000106344187Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Tapan S. Mehta
- grid.265892.20000000106344187Department of Family and Community Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233 USA
| | - Anna M. Gorczyca
- grid.412016.00000 0001 2177 6375Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160 USA
| | - Jennifer L. Oslund
- grid.429997.80000 0004 1936 7531Energy Metabolism, Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA 02111 USA
| | - John C. Peters
- grid.430503.10000 0001 0703 675XDivision of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, Aurora, CO 80045 USA
| | - James E. Friedman
- grid.265892.20000000106344187Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Chia-Ying Chiu
- grid.265892.20000000106344187Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233 USA
| | - Frank L. Greenway
- grid.410428.b0000 0001 0665 5823Clinical Trials Unit, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808 USA
| | - Joseph E. Donnelly
- grid.412016.00000 0001 2177 6375Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160 USA
| | - Maria Carlota Dao
- grid.167436.10000 0001 2192 7145Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH 03824 USA
| | - Adolfo G. Cuevas
- grid.429997.80000 0004 1936 7531Department of Community Health, Tufts University, Medford, MA 02155 USA
| | - Olivia Affuso
- grid.265892.20000000106344187Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35233 USA
| | - Larrell L. Wilkinson
- grid.265892.20000000106344187Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL 35233 USA
| | - Diana Thomas
- grid.419884.80000 0001 2287 2270Department of Mathematical Sciences, United States Military Academy, West Point, NY 10996 USA
| | - Ebaa Al-Ozairi
- grid.452356.30000 0004 0518 1285Clinical Research Unit, Dasman Diabetes Institute, 15462 Kuwait City, Kuwait
| | - Mary Yannakoulia
- grid.15823.3d0000 0004 0622 2843Department of Nutrition and Dietetics, Harokopio University, El. Venizelou 70, 176 71 Kallithea, Greece
| | - Yeganeh M. Khazrai
- grid.9657.d0000 0004 1757 5329Department of Food Science and Human Nutrition, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128 Roma, RM Italy
| | - Raoul J. Manalac
- grid.64337.350000 0001 0662 7451Bariatric & Metabolic Institute, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA USA
| | - Vasil Bachiashvili
- grid.265892.20000000106344187Department of Family and Community Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233 USA
| | - James O. Hill
- grid.265892.20000000106344187Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
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14
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Ostendorf DM, Blankenship JM, Grau L, Arbet J, Mitchell NS, Creasy SA, Caldwell AE, Melanson EL, Phelan S, Bessesen DH, Catenacci VA. Predictors of long-term weight loss trajectories during a behavioral weight loss intervention: An exploratory analysis. Obes Sci Pract 2021; 7:569-582. [PMID: 34631135 PMCID: PMC8488452 DOI: 10.1002/osp4.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/30/2021] [Accepted: 05/08/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Substantial interindividual variability in response to behavioral weight loss interventions remains a critical challenge in obesity treatment. An improved understanding of the complex factors that contribute to this variability may improve obesity treatment outcomes. OBJECTIVE To identify weight change trajectories during a behavioral weight loss intervention and to explore differences between trajectory groups in sociodemographic, biologic, behavioral, and psychosocial factors. METHODS Adults (n = 170, 40 ± 9 years, BMI 34 ± 4 kg/m2, 84% female) participated in an 18-month behavioral weight loss intervention. Weight was measured at 0, 3, 6, 9, 12, 15, 18, and 24 months. Among participants with at least two weights after baseline (n = 140), clusters of longitudinal trajectories of changes in weight were identified using a latent class growth mixture model. The association between baseline factors or changes in factors over time and trajectory group was examined. RESULTS Two weight change trajectories were identified: "weight regainers" (n = 91) and "weight loss maintainers" (n = 49). Black participants (90%, 19/21) were more likely than non-Black participants to be regainers versus maintainers (p < 0.01). Maintainers demonstrated greater increases in device-measured physical activity, autonomous motivation for exercise, diet self-efficacy, cognitive restraint, and engagement in weight management behaviors and greater reductions in barriers for exercise, disinhibition, and depressive symptoms over 24 months versus regainers (p < 0.05). CONCLUSION Maintainers and regainers appear to be distinct trajectories that are associated with specific sociodemographic, behavioral, and psychosocial factors. Study results suggest potential targets for more tailored, multifaceted interventions to improve obesity treatment outcomes.
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Affiliation(s)
- Danielle M. Ostendorf
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Department of MedicineDivision of Endocrinology, Metabolism, and DiabetesUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Jennifer M. Blankenship
- Department of MedicineDivision of Endocrinology, Metabolism, and DiabetesUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Laura Grau
- Department of Biostatistics and InformaticsColorado School of Public HealthUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Jaron Arbet
- Department of Biostatistics and InformaticsColorado School of Public HealthUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Nia S. Mitchell
- Department of MedicineDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Seth A. Creasy
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Department of MedicineDivision of Endocrinology, Metabolism, and DiabetesUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Ann E. Caldwell
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Department of MedicineDivision of Endocrinology, Metabolism, and DiabetesUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Edward L. Melanson
- Department of MedicineDivision of Endocrinology, Metabolism, and DiabetesUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Department of MedicineDivision of Geriatric MedicineUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical CenterDenverColoradoUSA
| | - Suzanne Phelan
- Department of Kinesiology & Public HealthCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUSA
| | - Daniel H. Bessesen
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Department of MedicineDivision of Endocrinology, Metabolism, and DiabetesUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Victoria A. Catenacci
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Department of MedicineDivision of Endocrinology, Metabolism, and DiabetesUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
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15
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Cardel MI, Pavela G, Janicke D, Huo T, Miller D, Lee AM, Gurka MJ, Dhurandhar E, Peters JC, Caldwell AE, Krause E, Fernandez A, Allison DB. Experimentally Manipulated Low Social Status and Food Insecurity Alter Eating Behavior Among Adolescents: A Randomized Controlled Trial. Obesity (Silver Spring) 2020; 28:2010-2019. [PMID: 33150744 PMCID: PMC7653825 DOI: 10.1002/oby.23002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/05/2020] [Accepted: 05/27/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This randomized trial experimentally manipulated social status to assess effects on acute eating behavior and 24-hour energy balance. METHODS Participants (n = 133 Hispanics; age 15-21 years; 60.2% females) were randomized to low social status ("LOW") or high social status ("HIGH") conditions in a rigged game of Monopoly (Hasbro, Inc.). Acute energy intake in a lunchtime meal was measured by food scales. Twenty-four-hour energy balance was assessed via summation of resting metabolic rate (metabolic cart), physical activity energy expenditure (accelerometer), thermic effect of food, and subtraction of twenty-four-hour energy intake (food diary). RESULTS In the total sample, no significant differences were observed by study condition at lunchtime. LOW females consumed a greater percent of lunchtime daily energy needs (37.5%) relative to HIGH females (34.3%); however, this difference was not statistically significant (P = 0.291). In males, however, LOW consumed significantly less (36.5%) of their daily energy needs relative to HIGH males (45.8%; P = 0.001). For 24-hour energy balance, sex differences were nearly significant (P = 0.057; LOW females: surplus +200 kcal; HIGH males: surplus +445 kcal). Food-insecure individuals consumed a nearly significant greater lunchtime percent daily energy than those with food security (40.7% vs. 36.3%; P = 0.0797). CONCLUSIONS The data demonstrate differential acute and 24-hour eating behavior responses between Hispanic male and female adolescents in experimentally manipulated conditions of low social status.
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Affiliation(s)
- Michelle I. Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida, 2004 Mowry Road, PO Box 100177, Gainesville, FL, 32610
| | - Greg Pavela
- Department of Health Behavior, University of Alabama at Birmingham, 227K Ryals Public Health Building, 1665 University Boulevard, Birmingham, AL, 35294
| | - David Janicke
- Department of Clinical and Health Psychology, University of Florida, PO Box 100165, Gainesville, FL, 32610
| | - Tianyao Huo
- Department of Health Outcomes and Biomedical Informatics, University of Florida, 2004 Mowry Road, PO Box 100177, Gainesville, FL, 32610
| | - Darci Miller
- Department of Health Outcomes and Biomedical Informatics, University of Florida, 2004 Mowry Road, PO Box 100177, Gainesville, FL, 32610
| | - Alexandra M. Lee
- Department of Health Outcomes and Biomedical Informatics, University of Florida, 2004 Mowry Road, PO Box 100177, Gainesville, FL, 32610
| | - Matthew J. Gurka
- Department of Health Outcomes and Biomedical Informatics, University of Florida, 2004 Mowry Road, PO Box 100177, Gainesville, FL, 32610
| | - Emily Dhurandhar
- Department of Kinesiology and Sport Management, Texas Tech University, Box 43011, 2500 Broadway, Lubbock, TX, 79409
| | - John C. Peters
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Denver, Anschutz Health and Wellness Center, PO Box 6511-MS 8106, 12801 East 17 Ave, RC1 South RM 7103, Aurora, CO, 80045
| | - Ann E. Caldwell
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Denver, Anschutz Health and Wellness Center, PO Box 6511-MS 8106, 12801 East 17 Ave, RC1 South RM 7103, Aurora, CO, 80045
| | - Eric Krause
- Department of Pharmacodynamics, University of Florida, PO Box 100487, Gainesville, FL, 32610
| | - Alicia Fernandez
- Department of Medicine, University of California San Francisco, 1001 Potrero Ave, Rm. 1307, UCSF Box 1364, San Francisco, CA, 94110
| | - David B. Allison
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University-Bloomington, 1025 East 7 Street, Suite 111, Bloomington, IN, 47405
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16
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Caldwell AE, Zaman A, Ostendorf DM, Pan Z, Swanson BB, Phelan S, Wyatt HR, Bessesen DH, Melanson EL, Catenacci VA. Impact of Combined Hormonal Contraceptive Use on Weight Loss: A Secondary Analysis of a Behavioral Weight-Loss Trial. Obesity (Silver Spring) 2020; 28:1040-1049. [PMID: 32441474 PMCID: PMC7556729 DOI: 10.1002/oby.22787] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/24/2020] [Accepted: 02/27/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This study aimed to perform a preliminary investigation of the impact of combined hormonal contraceptive (CHC) use on weight loss during an 18-month behavioral weight-loss trial. METHODS Adults (n = 170; 18-55 years; BMI 27-42 kg/m2 ) received a weight-loss intervention that included a reduced-calorie diet, a progressive exercise prescription, and group-based behavioral support. Premenopausal women (n = 110) were classified as CHC users (CHC, n = 17) or non-CHC users (non-CHC, n = 93). Changes in weight were examined within groups using a linear mixed model, adjusted for age and randomized group assignment. RESULTS At 6 M, weight was reduced from baseline in both CHC (mean, -6.7 kg; 95% CI: -9.8 to -3.7 kg) and non-CHC (-9.1 kg; -9.1 to -6.4 kg). Between 6 and 18 M, CHC regained weight (4.9 kg; 0.9 to 8.9 kg), while weight remained relatively unchanged in non-CHC (-0.1 kg; -1.8 to 1.6 kg). At 18 M, weight was relatively unchanged from baseline in CHC (-1.8 kg; -7.3 to 3.6 kg) and was reduced from baseline in non-CHC (-7.9 kg; -10.2 to -5.5 kg). CONCLUSIONS In this secondary data analysis, CHC use was associated with weight regain after initial weight loss. Prospective studies are needed to further understand the extent to which CHC use influences weight loss and maintenance.
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Affiliation(s)
- Ann E Caldwell
- Anschutz Health and Wellness Center, Department of Medicine, 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
| | - Adnin Zaman
- Anschutz Health and Wellness Center, Department of Medicine, 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
| | - Danielle M Ostendorf
- Anschutz Health and Wellness Center, Department of Medicine, 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
| | - Zhaoxing Pan
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Bryan B Swanson
- Department of Chemistry and Biochemistry, Colorado College, Colorado Springs, Colorado, USA
| | - Suzanne Phelan
- Kinesiology and Public Health Department, California Polytechnic State University, San Luis Obispo, California, USA
| | - Holly R Wyatt
- Anschutz Health and Wellness Center, Department of Medicine, 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
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Daniel H Bessesen
- Anschutz Health and Wellness Center, Department of Medicine, 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
| | - Edward L Melanson
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Geriatric Research, Education, and Clinical Center, Eastern Colorado Veterans Affairs Medical Center, Denver, Colorado, USA
| | - Victoria A Catenacci
- Anschutz Health and Wellness Center, Department of Medicine, 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
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Catenacci VA, Ostendorf DM, Pan Z, Bing K, Wayland LT, Seyoum E, Stauffer BL, Phelan S, Creasy SA, Caldwell AE, Wyatt HR, Bessesen DH, Melanson EL. The Impact of Timing of Exercise Initiation on Weight Loss: An 18-Month Randomized Clinical Trial. Obesity (Silver Spring) 2019; 27:1828-1838. [PMID: 31565869 PMCID: PMC6832769 DOI: 10.1002/oby.22624] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/25/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to evaluate the impact of timing of exercise initiation on weight loss within a behavioral weight loss program. METHODS Adults with overweight or obesity (N = 170; age 18-55 years; BMI 25-42 kg/m2 ; 83.5% women) were enrolled in an 18-month behavioral weight loss program consisting of a reduced-calorie diet, exercise, and group-based support. The standard group (STD) received a supervised exercise program (progressing to 300 min/wk of moderate-intensity aerobic exercise) during months 0 to 6. The sequential group (SEQ) was asked to refrain from changing exercise during months 0 to 6 and received the supervised exercise program during months 7 to 12. On completion of supervised exercise, both groups were instructed to continue 300 min/wk of moderate-intensity exercise for the study duration. RESULTS At 6 months, the STD group exhibited greater reductions in body weight (-8.7 ± 0.7 kg) compared with the SEQ group (-6.9 ± 0.6 kg; P = 0.047). Between 6 and 18 months, the STD group regained more weight (2.5 ± 0.8 kg vs. 0.0 ± 0.8 kg; P = 0.02). At 18 months, there were no between-group differences in changes in weight (STD: -6.9 ± 1.2 kg; SEQ: -7.9 ± 1.2 kg), fat mass, lean mass, physical activity, or attrition. CONCLUSIONS Both immediate and delayed exercise initiation within a behavioral weight loss program resulted in clinically meaningful weight loss at 18 months. Thus, timing of exercise initiation can be personalized based on patient preference.
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Affiliation(s)
- Victoria A. Catenacci
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Danielle M. Ostendorf
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Zhaoxing Pan
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kristen Bing
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Liza T. Wayland
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Emmanuel Seyoum
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Brian L. Stauffer
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Suzanne Phelan
- California Polytechnic State University, San Luis Obispo CA
| | - Seth A. Creasy
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Ann E. Caldwell
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Holly R. Wyatt
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Daniel H. Bessesen
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Edward L. Melanson
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical Center, Denver, CO, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Ostendorf DM, Melanson EL, Caldwell AE, Creasy SA, Pan Z, MacLean PS, Wyatt HR, Hill JO, Catenacci VA. No consistent evidence of a disproportionately low resting energy expenditure in long-term successful weight-loss maintainers. Am J Clin Nutr 2018; 108:658-666. [PMID: 30321282 PMCID: PMC6186213 DOI: 10.1093/ajcn/nqy179] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 07/06/2018] [Indexed: 12/20/2022] Open
Abstract
Background Evidence in humans is equivocal in regards to whether resting energy expenditure (REE) decreases to a greater extent than predicted for the loss of body mass with weight loss, and whether this disproportionate decrease in REE persists with weight-loss maintenance. Objectives We aimed to1) determine if a lower-than-predicted REE is present in a sample of successful weight-loss maintainers (WLMs) and 2) determine if amount of weight loss or duration of weight-loss maintenance are correlated with a lower-than-predicted REE in WLMs. Design Participants (18-65 y old) were recruited in 3 groups: WLMs (maintaining ≥13.6 kg weight loss for ≥1 y, n = 34), normal-weight controls [NCs, body mass index (BMI; in kg/m2) similar to current BMI of WLMs, n = 35], and controls with overweight/obesity (OCs, BMI similar to pre-weight-loss maximum BMI of WLMs, n = 33). REE was measured (REEm) with indirect calorimetry. Predicted REE (REEp) was determined via 1) a best-fit linear regression developed with the use of REEm, age, sex, fat-free mass, and fat mass from our control groups and 2) three standard predictive equations. Results REEm in WLMs was accurately predicted by equations developed from NCs and OCs (±1%) and by 3 standard predictive equations (±3%). In WLMs, individual differences between REEm and REEp ranged from -257 to +163 kcal/d. A lower REEm compared with REEp was correlated with amount of weight lost (r = 0.36, P < 0.05) but was not correlated with duration of weight-loss maintenance (r = 0.04, P = 0.81). Conclusions We found no consistent evidence of a significantly lower REE than predicted in a sample of long-term WLMs based on predictive equations developed from NCs and OCs as well as 3 standard predictive equations. Results suggest that sustained weight loss may not always result in a substantial, disproportionately low REE. This trial was registered at clinicaltrials.gov as NCT03422380.
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Affiliation(s)
- Danielle M Ostendorf
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO,Anschutz Health and Wellness Center, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO,Address correspondence to DMO (e-mail: )
| | - Edward L Melanson
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO,Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO,Eastern Colorado VA Geriatric Research, Education, and Clinical Center, Denver, CO
| | - Ann E Caldwell
- Anschutz Health and Wellness Center, Department of Medicine, 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
| | - Zhaoxing Pan
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Paul S MacLean
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Holly R Wyatt
- Anschutz Health and Wellness Center, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO,Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - James O Hill
- Anschutz Health and Wellness Center, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Victoria A Catenacci
- Anschutz Health and Wellness Center, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO,Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
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20
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Caldwell AE, Masters KS, Peters JC, Bryan AD, Grigsby J, Hooker SA, Wyatt HR, Hill JO. Harnessing centred identity transformation to reduce executive function burden for maintenance of health behaviour change: the Maintain IT model. Health Psychol Rev 2018; 12:231-253. [PMID: 29402182 PMCID: PMC6124500 DOI: 10.1080/17437199.2018.1437551] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 02/02/2018] [Indexed: 01/12/2023]
Abstract
The inability to produce sustainable lifestyle modifications (e.g., physical activity, healthy diet) remains a major barrier to reducing morbidity and mortality from prevalent, preventable conditions. The objective of this paper is to present a model that builds on and extends foundational theory and research to suggest novel approaches that may help to produce lasting behaviour change. The model aims to integrate factors not typically examined together in order to elucidate potential processes underlying a shift from behaviour initiation to long-term maintenance. The central premise of the Maintain IT model builds on approaches demonstrating that in-tact executive function (EF) is critical for health behaviour initiation, for more complex behaviours beyond initiation, and in unsupportive environments and circumstances, but successful recruitment of EF is effortful and prone to error. Enduring changes are more likely if the underlying cognitive processes can become less effortful (non-conscious, automatic). The Maintain IT model posits that a centred identity transformation is one path leading to less effortful processing and facilitating successful recruitment of EF when necessary over the long term, increasing the sustainability of health behaviour change. A conceptual overview of the literature supporting the utility of this integrative model, future directions, and anticipated challenges are presented.
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Affiliation(s)
- Ann E. Caldwell
- Colorado Nutrition Obesity Research Center, University of Colorado, Anschutz Medical Campus
| | - Kevin S. Masters
- Colorado Nutrition Obesity Research Center, University of Colorado, Anschutz Medical Campus
- Department of Psychology, University of Colorado, Denver
| | - John C. Peters
- Colorado Nutrition Obesity Research Center, University of Colorado, Anschutz Medical Campus
- Department of Medicine, University of Colorado, Anschutz Medical Campus
| | - Angela D. Bryan
- Department of Psychology and Neuroscience, University of Colorado, Boulder
| | - Jim Grigsby
- Department of Psychology, University of Colorado, Denver
- Department of Medicine, University of Colorado, Anschutz Medical Campus
| | | | - Holly R. Wyatt
- Colorado Nutrition Obesity Research Center, University of Colorado, Anschutz Medical Campus
- Department of Medicine, University of Colorado, Anschutz Medical Campus
| | - James O. Hill
- Colorado Nutrition Obesity Research Center, University of Colorado, Anschutz Medical Campus
- Department of Medicine, University of Colorado, Anschutz Medical Campus
- Department of Pediatrics, University of Colorado, Anschutz Medical Campus
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21
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Caldwell AE, Sayer RD. Evolutionary considerations on social status, eating behavior, and obesity. Appetite 2018; 132:238-248. [PMID: 30078673 DOI: 10.1016/j.appet.2018.07.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/16/2018] [Accepted: 07/26/2018] [Indexed: 12/31/2022]
Abstract
Lower socioeconomic status (SES) is consistently related to higher obesity risk, especially in women living in developed countries such as the United States and Western Europe. Prevailing theories to describe this relationship have focused primarily on proximate level factors such as the generally poorer food environment (e.g. relative lack of healthy food options and higher concentrations of fast food restaurants) found in lower vs. higher SES neighborhoods and the higher financial costs associated with purchasing healthy, nutrient-dense foods compared to unhealthy, energy-dense foods. These factors are hypothesized to preclude the purchase of these foods by lower SES individuals. Unfortunately, public health interventions aimed at improving the food environment of lower SES communities and to provide financial resources for purchasing healthy foods have had limited success in reducing overall energy intake and body weight. Some evidence suggests these interventions may even exacerbate obesity. More recent hypotheses have shifted the focus to ultimate (or adaptive) factors that view increased energy intake and accrual of body fat among individuals of lower social status as adaptive strategies to protect against potential prolonged food scarcity. The purpose of this review is integrate past research at the proximate and ultimate levels with a consideration of how social status and SES during development (in utero through adolescence) may moderate the relationships between social status, eating behavior, and obesity. Utilizing an evolutionary framework that incorporates life history theory can lead to more integrative and thorough interpretations of past research and allow researchers to better elucidate the complex set of environmental, physiological, psychological, and behavioral factors that influence obesity risk among individuals of lower social status.
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Affiliation(s)
- Ann E Caldwell
- University of Colorado Anschutz Medical Campus, University of Colorado, Anschutz Health and Wellness Center, USA; University of Colorado Anschutz Medical Campus, Division of Endocrinology, Metabolism, and Diabetes, USA.
| | - R Drew Sayer
- University of Colorado Anschutz Medical Campus, University of Colorado, Anschutz Health and Wellness Center, USA; University of Colorado Anschutz Medical Campus, Division of Endocrinology, Metabolism, and Diabetes, USA
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Caldwell AE. La Malinconia: final movement of Beethoven's Quartet Op. 18, No. 6--a musical account of manic depressive states. Woman Physician 1972; 27:241-8. [PMID: 11633598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Caldwell AE. La Malinconia: final movement of Beethoven's Quartet Op. 18, No. 6--a musical account of manic depressive states. J Am Med Womens Assoc (1972) 1972; 27:241-8. [PMID: 4337931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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24
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Caldwell AE. The history of psychopharmacology; its relation to anesthesiology. Dis Nerv Syst 1967; 28:816-20. [PMID: 4864389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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