Exploring the mechanisms of weight loss in the SHED-IT intervention for overweight men: a mediation analysis
Exploring the mechanisms of weight loss in the SHED-IT intervention for overweight men: a mediation analysis
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DOI：
10.1186/1479-5868-6-76
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发表时间：
2009-11-18
影响因子：
8.7
通讯作者：
Callister, Robin
中科院分区：
文献类型：
--
作者：
Lubans, David R.;Morgan, Philip J.;Callister, Robin
背景资料：统计中介分析可以用来改善肥胖预防和治疗方案的设计，通过确定干预措施实现其效果的可能机制。本研究的目的是在专门为超重男性设计的基于互联网的减肥计划中确定减肥的介质。自助，运动和饮食使用信息技术（SHED-IT）计划是一项为期3个月的随机对照试验（基于互联网的干预组与仅提供信息的对照组），该研究于2007年实施，对体重进行了基线和6个月的随访评估，身体活动和饮食行为。意向治疗和按协议调解分析进行了使用产品的系数test.Results：参与者（N = 65）超重和肥胖的男性学术（n = 10）和非学术（n = 27）的工作人员和学生（n = 28）从纽卡斯尔大学，澳大利亚。平均（SD）年龄= 35.9（11.1）岁，平均（SD）BMI = 30.6（2.8）。在意向治疗分析中，两组体重均减轻，但相对于对照组，干预对体重的“总效应”没有统计学显著性，tau =-0.507，p = 0.716（95%CI = -3.277至2.263）。在符合方案分析中，干预对体重具有统计学显著的“总效应”，tau =-4.487，p <0.05（95%CI = -8.208至-0.765）。在SHED-IT项目中，干预对任何假设的介质没有统计学显著影响，也没有行为变量介导的体重减轻。虽然干预组的参与者在研究期间减少了他们的脂肪摄入量，变化并不满足标准mediation.Conclusion：很少有研究研究探讨了肥胖治疗干预措施中的体重减轻的介质。虽然没有一个假设的调解人满足本研究中的调解标准，但有一些证据表明，在SHED-IT干预中，超重男性在研究期间减少了脂肪摄入量。未来的肥胖治疗和预防计划应该使用适当的统计方法来探索减肥的行为介质。
Background: Statistical mediation analysis can be used to improve the design of obesity prevention and treatment programs by identifying the possible mechanisms through which an intervention achieved its effects. The aim of this study was to identify mediators of weight loss in an Internet-based weight-loss program specifically designed for overweight men.Methods: The Self-Help, Exercise and Diet using Information Technology (SHED-IT) program was a 3-month randomized controlled trial (Internet-based intervention group vs information only control group) that was implemented in 2007 with baseline and 6-month follow-up assessment of weight, physical activity and dietary behaviors. Intention-to-treat and per-protocol mediation analyses were conducted using a product-of-coefficients test.Results: Participants (N = 65) were overweight and obese male academic (n = 10) and non-academic (n = 27) staff and students (n = 28) from the University of Newcastle, Australia. Mean (SD) age = 35.9 (11.1) years and mean (SD) BMI = 30.6 (2.8). In the intention-to-treat analysis, both groups lost weight, but relative to the control group, the intervention did not have a statistically significant 'total effect' on weight, tau = -.507, p = .716 (95% CI = -3.277 to 2.263). In the per-protocol analysis, the intervention had a statistically significant 'total effect' on weight, tau = -4.487, p < .05 (95% CI = -8.208 to -.765). The intervention did not have a statistically significant effect on any of the hypothesized mediators and none of the behavioral variables mediated weight loss in the SHED-IT program. Although participants in the intervention group reduced their fat intake over the study period, the changes did not satisfy the criteria for mediation.Conclusion: Few studies have examined the mediators of weight loss in obesity treatment interventions. While none of the hypothesized mediators satisfied the criteria for mediation in the current study, there was some evidence to suggest that overweight men in the SHED-IT intervention reduced their fat intake over the study period. Future obesity treatment and prevention programs should explore behavioral mediators of weight loss using appropriate statistical methods.