scholarly journals Maintaining the Outcomes of a Successful Weight Gain Prevention Intervention in Mid-Age Women: Two Year Results from the 40-Something Randomized Control Trial

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 1100
Author(s):  
Lauren T. Williams ◽  
Clare E. Collins ◽  
Philip J. Morgan ◽  
Jenna L. Hollis
Keyword(s):  
Weight Loss ◽  
Weight Gain ◽  
Health Professional ◽  
Obesity Prevention ◽  
Controlled Trial ◽  
Life Stage ◽  
Premenopausal Women ◽  
Intervention Effects ◽  
Prevention Intervention ◽  
Percentage Body Fat

Despite the life stage of menopause being identified as a high risk for weight gain, there are few obesity prevention interventions for this target group, and no evidence on maintenance of intervention effects after intervention support is withdrawn. In the 40-Something Randomized Controlled Trial (RCT) (ACTRN12611000064909), a five-consultation health professional (dietitian and exercise physiologist) obesity prevention intervention, using motivational interviewing principles (MI) over 12 months, achieved significantly greater weight loss than a self-directed intervention (SDI) (tailored written material) in 54 non-obese (body mass index (BMI): 18.5–29.9 kg/m2), premenopausal women (44–50 years). The aim of the current paper is to report on whether the intervention effects were maintained at two years. Anthropometric, biochemical and health behavior data were collected at baseline, 12 months (end of intervention) and 24 months (end of maintenance period). Forty participants (22 = MI, 18 = SDI) who completed all measures to 12 months were invited to participate in the monitoring phase and 30 (MI = 16, SDI = 14) consented. The primary outcome of weight at 24 months was assessed using intention to treat principles (n = 54), adjusting for baseline weight. The MI group had a significantly lower weight at 24 months (64.6 kg, 95% CI: 63.2, 66.6, p = 0.015) compared with the SDI group (67.3 kg, 95% CI: 65.7, 68.8), and the secondary outcomes of percentage body fat and waist circumference were also significantly lower in the MI group. The low-intensity, health professional weight control intervention utilizing MI principles was more efficacious in maintaining a significant weight loss compared to a self-directed intervention, and both were successful in preventing obesity.

scholarly journals A cluster RCT and process evaluation evaluating the effectiveness of an optimisation intervention to promote parental engagement in a childhood obesity prevention programme: Results of the Optimising Family Engagement in HENRY (OFTEN) trial

2021 ◽  
Author(s):  
Maria Bryant ◽  
Wendy Burton ◽  
Michelle Collinson ◽  
Amanda Farrin ◽  
Jane Nixon ◽  
...  
Keyword(s):  
Childhood Obesity ◽  
Process Evaluation ◽  
Obesity Prevention ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Parental Engagement ◽  
Childhood Obesity Prevention ◽  
Prevention Intervention ◽  
The Impact ◽  
Children’S Centres

Abstract Background Low parental participation reduces the impact and sustainability of public health childhood obesity prevention programmes. Using data from a focused ethnography, we developed a multi-level, theory-based implementation optimisation intervention. The optimisation intervention aimed to support local authorities and children’s centres to adopt behaviours to promote engagement in ‘HENRY (Health Exercise Nutrition for the Really Young)’, a UK community obesity prevention intervention. Methods We evaluated the effectiveness of the optimisation intervention on programme enrolment and completion over a 12 implementation period in a cluster randomised controlled trial. We randomised 20 local government authorities (with 126 children’s centres) to HENRY plus the optimisation intervention or to HENRY alone. Primary outcomes were (1) the proportion of centres enrolling at least eight parents per programme and (2) the proportion of centres with a minimum of 75% of parents attending at least five of eight sessions per programme. Trial analyses adjusted for stratification factors (pre-randomisation implementation of HENRY, local authority size, deprivation) and allowed for cluster design. A parallel mixed-methods process evaluation used qualitative interview data and routine monitoring to explain trial results. Results Neither primary outcome differed significantly between groups; 17.8% of intervention centres and 18.0% of control centres achieved the parent enrolment target (adjusted difference -1.2%; 95%CI: -19.5%, 17.1%); 17.1% of intervention centres and 13.9% of control centres achieved the attendance target (adjusted difference 1.2%; 95%CI: -15.7%, 18.1%). Unexpectedly, the trial coincided with substantial national service restructuring, including centre closures and reduced funds. Some commissioning and management teams stopped or reduced implementation of both HENRY and the optimisation intervention due to competing demands. Thus, at follow up, HENRY programmes were delivered to approximately half the number of parents compared to baseline (n=433 vs. 881). Conclusions During a period in which services were reduced by policies outside the realm of this research, this first definitive trial found no evidence of effectiveness for an implementation optimisation intervention promoting parent engagement in an obesity prevention intervention. Trial registration: ClinicalTrials.gov Identifier: NCT02675699 registered 4th February 2016. https://clinicaltrials.gov/ct2/show/NCT02675699

scholarly journals Parents and Tots Together: Pilot randomized controlled trial of a family-based obesity prevention intervention in Canada

2015 ◽  
Vol 106 (8) ◽  
pp. e555-e562 ◽  
Author(s):  
Kathryn Walton ◽  
A. Jordan Filion ◽  
Deborah Gross ◽  
Barbara Morrongiello ◽  
Gerarda Darlington ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Obesity Prevention ◽  
Controlled Trial ◽  
Prevention Intervention ◽  
Randomized Controlled ◽  
Family Based ◽  
Pilot Randomized Controlled Trial

Abstract 3519: Modest Fat Gain Causes Endothelial Dysfunction In Lean Healthy Humans: A Randomized Blinded Controlled Trial

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Abel Romero Corral ◽  
Justo Sierra-Johnson ◽  
Marek Orban ◽  
Apoor S Gami ◽  
Fatima H Sert Kuniyoshi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Weight Loss ◽  
Body Composition ◽  
Weight Gain ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Brachial Artery ◽  
Controlled Trial ◽  
Subcutaneous Fat ◽  
Flow Mediated Dilation

Background: Endothelial dysfunction assessed by flow mediated dilation (FMD) of the brachial artery has been identified as an independent predictor of cardiovascular events. However, whether weight gain impairs endothelial function is unknown. Methods: A randomized blinded controlled-trial to assess the effects of weight gain on endothelial function. After a weight maintenance period supervised by an experience dietitian, volunteers were randomized to gain weight (4 kg) or maintain weight. We recruited lean (BMI 18.5–24.9 kg/m 2 ) healthy volunteers (no diseases, medications and non-smokers) from the community. Using ultrasound, endothelial function was measured by FMD and non-flow mediated dilation (NFMD) of the brachial artery in the early morning (6:30 a.m.). Endothelial function was measured at baseline, after fat gain at 8 weeks and after weight loss at 16 weeks for fat-gainers and at baseline and follow-up (8 weeks) for weight maintainers. Body composition techniques to measure body fat %, such as dual x-ray absorptiometry and abdominal CT scans were performed. Results: We recruited 35 fat-gainers and 8 weight maintainers. Mean age was 29 ± 6 years and 18 (42 %) were women. There were no differences in age, anthropometric and body composition measurements, blood pressure, heart rate or apnea hypopnea index at baseline between both groups. After an average gain of 4 kg, the fat-gainer group significantly increased their total, visceral and subcutaneous fat. Brachial artery FMD and NFMD remained unchanged in weight maintainers. However, it decreaed in fat-gainers (FMD=9.1 ± 3 vs. 7.6 ± 3.2, p=0.003 and NFMD=12.0 ± 4.9 vs. 10.1 ± 6.0, p=0.01), but recovered to baseline after subjects shed the gained weight (basleline vs. recovery: FMD=9.1 ± 3 vs. 9.0 ± 3, p=NS and NFMD =12.0 ± 4.9 vs.12.6 ± 5.0, p=NS). Visceral fat gain, but not subcutaneous fat gain was significantly correlated with the decrease in brachial artery FMD (rho =−0.42, p=0.004 and rho =−0.22, p=0.15, respectively). Conclusions: In lean healthy young subjects, modest weight gain results in impaired endothelial function, even in the absence of changes in blood pressure. Endothelial funcion recovers after weight loss. Viscerar rather than subcutaneous fat predicts endothelial dysfunction.

scholarly journals Genetic causal attributions for weight status and weight loss during a behavioral weight gain prevention intervention

2015 ◽  
Vol 18 (5) ◽  
pp. 476-482 ◽  
Author(s):  
Megan A. McVay ◽  
Dori M. Steinberg ◽  
Sandy Askew ◽  
Kimberly A. Kaphingst ◽  
Gary G. Bennett
Keyword(s):  
Weight Loss ◽  
Weight Gain ◽  
Weight Status ◽  
Causal Attributions ◽  
Weight Gain Prevention ◽  
Prevention Intervention

scholarly journals Weight Loss After Stroke Through an Intensive Lifestyle Intervention (Group Lifestyle Balance-Cerebrovascular Accident): Protocol for a Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Simon Driver ◽  
Chad Swank ◽  
Katherine Froehlich-Grobe ◽  
Evan McShan ◽  
Stephanie Calhoun ◽  
...  
Keyword(s):  
Weight Loss ◽  
Randomized Controlled Trial ◽  
Weight Gain ◽  
Emotional Disorders ◽  
Cerebrovascular Accident ◽  
Recurrent Stroke ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled

BACKGROUND Weight gain can be a consequence of stroke, or cerebrovascular accident (CVA), because of impaired mobility, behavioral and emotional disorders, and sensory losses. Weight gain increases the patient’s risk of recurrent stroke and chronic diseases, such as diabetes, metabolic syndrome, and pulmonary and heart disease. Approaches to weight loss in this population are lacking, although necessary because of the unique physiological and cognitive needs of persons after a stroke. Evidence shows that intensive behavioral therapy interventions that address both physical activity and diet offer the greatest potential for weight loss. The Group Lifestyle Balance (GLB) intervention is a 12-month, evidence-based weight loss program that has been used extensively with the general population; this program was modified to meet the needs of people who have had a stroke (GLB-CVA). OBJECTIVE This randomized controlled trial (RCT) aims to examine the efficacy of the GLB-CVA on weight and secondary outcomes, compared with that of a waitlist control group. METHODS This RCT will enroll and randomize 64 patients over an 18-month period. RESULTS Currently, 51 people are waitlisted, with 23 out of 51 screened and 16 out of 23 eligible. CONCLUSIONS It is anticipated that the findings from this RCT will contribute to the evidence base regarding weight loss strategies for people living with stroke. CLINICALTRIAL ClinicalTrials.gov NCT03873467; https://clinicaltrials.gov/ct2/show/NCT03873467. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/14338

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