Effects of an intensive behavioral weight loss intervention consisting of caloric restriction with or without physical activity on common carotid artery remodeling in severely obese adults

Introduction: Obesity is a primary risk factor for obstructive sleep apnea (OSA), and weight loss is a common recommendation for adults with OSA. However, we previously found that adults with OSA lost less weight than those without OSA during a 12-month behavioral weight loss intervention. The potential mechanisms underlying the blunted weight loss among those with OSA are currently unclear; however, one potential explanation may be lower adherence to the intervention and its prescribed behaviors. Purpose: These analyses examined whether measures of adherence to a behavioral weight loss intervention differed between adults with and without OSA. Methods: The sample was comprised of adults who were overweight or obese (N=114; 50.4±10.5 y, body mass index [BMI]: 34.0±4.6 kg/m 2 ; 90.4% female, 82.5% white) who participated in a 12-mo behavioral weight loss intervention study. Participants wore a home sleep testing device (ResMed ApneaLink Plus) for one night at baseline (BL), 6 mo (6M), and 12 mo (12M). Those with an apnea-hypopnea index ≥ 5 were categorized as having OSA. Adherence to the intervention was assessed by: 1) attendance at group intervention sessions over 12 mo; 2) frequency of meeting daily caloric intake goals over 12 mo; 3) objectively-measured changes from BL in physical activity (steps/day, sedentary time, moderate-vigorous physical activity [MVPA]). Linear mixed models estimated the impact of OSA on these measures of intervention adherence following adjustment for sex, age, race, marital status, smoking status, and baseline BMI, while considering participant to be a random effect. Results: About half (52%) of the participants had OSA at BL, while 41 % had OSA at 6M. Attendance at group sessions did not differ between those with and without OSA over 12 mo (74.5 vs. 75.7%; P=.72). However, adults with OSA met their caloric intake goal less frequently than those without OSA (25.2 vs. 34.8%; P=.006), and adults with OSA increased their steps/day (+378.3 vs. 1060.1; P=.047) and MVPA min/day (+2.1 vs. +6.4; P=.056) less than those without OSA. Reductions in sedentary behavior (min/day) did not differ between those with and without OSA (-7.1 vs. -9.1; P=.81). Conclusions: These data suggest that the blunted weight loss observed among adults with OSA may be at least partially attributable to lower levels of adherence to prescribed goals for caloric intake and physical activity. Additional strategies (e.g., OSA screening and treatment referral, supplemental sessions on diet and MVPA) may be needed to achieve improved adherence to the lifestyle behaviors that lead to weight loss among adults with OSA.

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12 Month Behavioral Weight Loss Intervention With Varying Doses Of Physical Activity

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000485465.46945.0e ◽

2016 ◽

Vol 48 ◽

pp. 155

Author(s):

Renee J. Rogers ◽

Erik B. Schelbert ◽

Bethany Barone Gibbs ◽

Meghan R. McGuire ◽

Seth A. Creasy ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

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Changes in Dietary Intake with Varying Doses of Physical Activity Within a Weight Loss Intervention: The Heart Health Study

Current Developments in Nutrition ◽

10.1093/cdn/nzaa066_014 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1759-1759

Author(s):

Carli Liguori ◽

Renee Rogers ◽

John Jakicic

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Dietary Intake ◽

Health Study ◽

High Dose ◽

Fat Intake ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention ◽

Successful Weight Loss

Abstract Objectives Successful weight loss interventions often require a multipronged approach. The need for interventions that incorporate both physical activity and dietary methodologies is apparent. The present study aimed to assess whether there were differential effects on dietary change within the context of a behavioral weight loss intervention that included different doses of physical activity. Methods Participants (N = 383; Age = 44.7 ± 8.2 years, BMI = 32.4 ± 3.8 kg/m2) were randomized to a reduced calorie diet (DIET, N = 127), diet plus a moderate dose of physical activity (MOD-EX, N = 129), or diet plus a high dose of physical activity (HIGH-EX, N = 127). All groups received weekly in-person intervention sessions for months 1–6, with combined in-person and telephonic sessions for months 7–12. Diet was prescribed at 1200–1800 kcal/day. MOD-EX was prescribed physical activity that progressed to 150 min/wk and HIGH-EX progressed to 250 min/wk. Physical activity, weight, and dietary intake were assessed. Dietary intake was assessed using the DHQII questionnaire. Results Retention at 12 months was 86.6% in DIET, 80.6% in MOD-EX, and 83.5% in HIGH-EX. Physical activity at 0 and 12 months was 65.4 ± 73.8 and 88.2 ± 104.3 min/wk in DIET; 68.7 ± 93.8 and 179.1 ± 125.3 min/wk in MOD-EX; and 71.5 ± 84.4 and 228.8 ± 148.3 min/wk in HIGH-EX (Group X Time P < 0.001). Weight decreased at 12 months (DIET: −9.9 ± 8.3 kg, MOD-EX: −10.8 ± 8.2 kg, HIGH-EX: −9.5 ± 7.3 kg) (P < 0.001), with no difference between groups. Energy intake decreased from baseline in all groups (6 mo: −495 ± 25.8 kcal/day, 12 mo: −502 ± 25.0 kcal/day) (P < 0.001). Percent dietary fat intake decreased (6 mo: −5.0 ± 0.4%, 12 mo: −3.8 ± 0.4%) (P < 0.001), whereas there was a non-significant increase in % carbohydrate intake (6 mo: 3.5 ± 0.4%, 12 mo: 3.0 ± 0.5%) and % protein intake (6 mo: 1.3 ± 0.2%, 12 mo: 1.0 ± 0.2%), with no difference between groups. Conclusions Weight loss was observed in all the interventions and physical activity did not enhance the weight loss that was observed. Also, the changes in diet that included reducing calories and fat intake were not impacted by the addition of physical activity. These findings have implications for interventions for weight loss in adults with obesity. Funding Sources National Institutes of Health.

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Sleep Parameters During A 12-month Behavioral Weight Loss Intervention With Varying Doses Of Physical Activity: The Heart Health Study

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000685996.30397.0a ◽

2020 ◽

Vol 52 (7S) ◽

pp. 960-960

Author(s):

Christopher E. Kline ◽

Renee J. Rogers ◽

Nalingna Yuan ◽

John M. Jakicic

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Health Study ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Heart Health ◽

Sleep Parameters ◽

Behavioral Weight Loss Intervention

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Effects of Pistachio Consumption in a Behavioral Weight Loss Intervention on Weight Change, Cardiometabolic Factors, and Dietary Intake

Nutrients ◽

10.3390/nu12072155 ◽

2020 ◽

Vol 12 (7) ◽

pp. 2155

Author(s):

Cheryl L. Rock ◽

Elizabeth Zunshine ◽

Huong Thien Nguyen ◽

Annemarie O. Perez ◽

Christine Zoumas ◽

...

Keyword(s):

Body Mass Index ◽

Weight Loss ◽

Waist Circumference ◽

Time Effect ◽

Control Group ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Obese Adults ◽

Behavioral Weight Loss Intervention ◽

Cardiometabolic Factors

Epidemiological studies have linked regular nut consumption with lower body mass index and reduced likelihood of weight gain in adulthood. Nuts can displace other foods in the diet, and thus, promote a healthier dietary pattern. The purpose of this study was to examine the effect of pistachio nut consumption in overweight/obese adults. This randomized controlled study enrolled non-diabetic overweight/obese adults (n = 100) assigned to a 4-month behavioral weight loss intervention only group (controls) or also prescribed 1.5 oz/day (42 g/day) of pistachios (pistachio group). Outcomes were change in body weight, cardiometabolic factors, and dietary intake. Percent weight change was similar in the two groups (−5.1 [0.5] (mean [SE])% in the control group and −4.9 [0.6]% in the pistachio group, and body mass index (BMI) and waist circumference were reduced in both groups (time effect p ≤ 0.05). The pistachio group (but not the control group) exhibited a significant reduction in both systolic and diastolic blood pressure (time effect p = 0.01). Plasma alpha-carotene, beta-carotene, and lutein concentrations increased significantly in the pistachio group (time effect p < 0.05). Pistachio consumption was associated with increased dietary fiber intake and decreased consumption of sweets. Regular consumption of pistachios was associated with a comparable degree of weight loss, and similar reductions in BMI and waist circumference, in overweight/obese men and women compared to controls, and favorable changes in the diet, in the context of a behavioral weight loss intervention.

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Changes in the Gut Microbiota During a Weight Loss Intervention of Daily Caloric Restriction Versus Intermittent Fasting: The DRIFT2 Randomized Clinical Trial

Current Developments in Nutrition ◽

10.1093/cdn/nzaa062_045 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1588-1588

Author(s):

Maggie Stanislawski ◽

Purevsuren Jambal ◽

Diana Ir ◽

Danielle Ostendorf ◽

Kristen Bing ◽

...

Keyword(s):

Weight Loss ◽

Waist Circumference ◽

Gut Microbiota ◽

Caloric Restriction ◽

Intermittent Fasting ◽

Microbiota Composition ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention ◽

Over Time

Abstract Objectives Intermittent fasting (IMF) is an alternative to the standard weight loss approach of daily caloric restriction (DCR). Although altered gut microbiota has been linked to obesity and may influence weight loss, it is unknown how the gut microbiota is impacted by these weight loss strategies or its association with responsiveness. In this study, we examine the gut microbial diversity and composition during an intervention of DCR versus IMF. Methods Fecal microbiota communities were profiled by 16S rRNA gene sequencing in 59 individuals with overweight and obesity (mean BMI: 33.1 (SD: 4.4) kg/m2, age: 40.7 (SD: 9.8) years; 76.3% female) undergoing a comprehensive, group-based behavioral weight loss intervention of DCR (n = 25) versus IMF (n = 34) at baseline and 3-months into the intervention. Mixed effects linear regressions, permutational ANOVA, and ANCOM were used to examine differences in gut microbiota over time and by intervention group, and regression-based methods were used to examine the association between baseline gut microbiota and percentage change in weight and waist circumference. Results Overall, participants lost 5.9 (SD: 3.7) kilograms at 3 months. Weight loss within groups is not reported, as the trial is ongoing. Alpha diversity increased in both intervention groups (P < 0.034), with no significant differences between groups (P > 0.847). Microbiota composition (beta diversity) changed significantly (R2 = 7.1%; P = 0.001) over the course of the intervention, with no significant differences between groups (P > 0.325). Numerous taxa showed changes over time with differences between groups (FDR < 0.05). Baseline gut microbiota composition significantly predicted change in waist circumference (P = 0.009) but not in weight (P = 0.172). Conclusions Our results support that a behavioral weight loss intervention of reduced energy intake impacts gut microbiota with some differences between DCR and IMF, which may provide insight into the physiological effects of these weight loss approaches. The baseline gut microbiota was significantly associated with decrease in waist circumference. These results may inform ways to target the gut microbiota before initiating weight loss in order to improve responsiveness. Funding Sources NIH NIDDK R01; AHA Innovative Project Award.

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