Reducing Obesity at the Workplace: A Randomized Trial

描述(由申请人提供)： 降低人口肥胖率是2010年健康人目标之一，在预防和扭转超重和肥胖方面，所有年龄段都需要提高警惕。在个人层面上，影响体重的行为因素包括导致卡路里摄入量过高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。从人口的角度来看，超重的流行与多种影响有关，包括社会、行为、文化和环境因素以及遗传和生理因素。对于大多数超重的人来说，恢复能量摄入和支出之间的平衡是困难的，因此在人口层面上越来越重视预防肥胖症。这项研究的长期目标是防止肥胖率在人群中进一步上升。 在工作年龄的成年人中，一天中的大部分时间都在工作场所度过，这表明在工作场所层面的干预可能为这一年龄段的成功提供机会。我们建议开发和测试一种具有简单信息的综合干预措施，将饮食摄入量的变化与能量消耗的变化结合起来，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48个工作地点并将其随机分配到为期两年的干预措施中，在此期间，我们将：建立一个结合增加日常体力活动和定期、有组织的锻炼的体力活动干预；建立一个将促进较低卡路里摄入量的饮食干预；增加工作地点获得健康食品和体育活动的机会。我们的主要目标是在工作场所的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项横断面调查，比较干预工地和对照工地身体质量指数的变化。使用生物标记物和健康测量的额外评估将在部分员工中进行。我们的团队在现场干预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。我们期待这个项目将为理解肥胖预防做出重要贡献。

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.