Reducing Obesity at the Workplace: A Randomized Trial

描述（由申请人提供）： 降低人口中肥胖症的流行率是“2010年健康人”的目标之一，所有年龄组都需要提高警惕，预防和扭转超重和肥胖。 在个人层面上，影响体重的行为因素包括导致卡路里摄入过量的饮食选择和导致卡路里消耗减少的体育活动模式。 随着时间的推移，两者之间的平衡会导致体重增加。 在人口基础上，超重的流行与无数的影响有关，包括社会，行为，文化和环境因素以及遗传和生理因素。 对于大多数超重的个体来说，恢复能量摄入和消耗之间的平衡是困难的，因此越来越强调在人群水平上预防肥胖。 这项研究的长期目标是防止人口中肥胖率的进一步增加。 在工作年龄的成年人中，一天的大部分时间都在工作场所度过，这表明在工作场所一级采取的干预措施可能为这一年龄组的成功提供机会。 我们建议开发和测试一个综合的干预措施，简单的信息，将整合饮食摄入量的变化与能量消耗的变化，同时修改结构和环境因素，以促进社会支持和行为改变的机会。 我们将招募并随机分配48个工作场所进行为期两年的干预，其中我们将：建立一个身体活动干预措施，将增加日常身体活动和定期，有组织的锻炼相结合;建立一个饮食干预措施，促进降低卡路里摄入量;增加工作场所获得健康食品和身体活动的机会。 我们的主要目的是在一项随机对照试验中评估干预措施在降低或维持体重指数方面的有效性。我们将在基线和随访时使用两个横断面调查比较干预与对照工地的体重指数变化。 将在一部分员工中使用生物标志物和健康指标进行额外评估。 我们的团队在工作场所层面的干预措施方面拥有丰富的经验，并在肥胖预防方面拥有丰富的专业知识。 我们预计，该项目将产生重要的贡献，了解肥胖预防。

DESCRIPTION (provided by applicant): Reducing the prevalence of obesity in the population is one of the Healthy People 2010 goals, and increased vigilance is required in all age groups in preventing and reversing overweight and obesity. On an individual level, behavioral factors that influence body weight include eating choices leading to excess calorie intake and physical activity patterns leading to diminished calorie expenditure. A balance between the two over time leads to increased weight. On a population basis, the prevalence of overweight is associated with a myriad of influences, including social, behavioral, cultural, and environmental factors as well as genetic and physiological factors. For a majority of overweight individuals, restoring a balance between energy intake and expenditure is difficult, and therefore there is an increasing emphasis on preventing obesity on a population level. The long-term goal of this research is to prevent further increase in rates of obesity in the population. In the adult population of working age, a majority of the day is spent in the worksite, suggesting that interventions at the worksite level may offer the opportunity for success in this age group. We propose to develop and test a comprehensive intervention with simple messages that will integrate changes in dietary intake with changes in energy expenditure, while simultaneously modifying structural and environmental factors to promote social support and opportunities for behavioral change. We will recruit and randomize 48 worksites to a two year intervention in which we will: build a physical activity intervention combining increased daily physical activity and regular, structured exercise; build a dietary intervention that will promote lower calorie intake; increase worksite access to both healthy foods and physical activity. Our primary aim is to evaluate the effectiveness of the intervention in reducing or maintaining body mass index in a randomized controlled trial of worksites. We will compare changes in body mass index in intervention versus control worksites using two cross-sectional surveys at baseline and follow-up. Additional assessments using biomarkers and fitness measures will be performed in a subset of employees. Our team has considerable experience with interventions at the worksite level and substantial expertise in obesity prevention. We anticipate that this project will yield important contributions to the understanding of obesity prevention.