Home vs Center-Based Weight Loss & Exercise in Menopause

家庭减肥与中心减肥

• 批准号: 7162176
• 负责人: KAREN E DENNIS
• 金额: $ 33.21万
• 依托单位: UNIVERSITY OF CENTRAL FLORIDA
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-04-01 至 2009-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7162176
• 关键词: Adult; Age-Years; Aging; Automobile Driving; Behavior; Behavioral; Body Composition; Body Weight; Body Weight decreased; Body fat; Body mass index; Candidate Disease Gene; Cardiovascular Diseases; Caring; Cities; Class; Client; Cognition; Daily; Data; Diet Modification; Discipline; Discipline of Nursing; Disease; Drops; Eating; Economic Inflation; Emotions; Energy Metabolism; Enrollment; Epidemic; Evaluation; Exercise; Family; Genes; Genetic Predisposition to Disease; Genotype; Health; Health Promotion; Healthcare; Healthcare Systems; Heritability; Home environment; Hour; Human; Individual; Intervention; Intervention Studies; Life; Life Style; Maintenance; Medical center; Menopause; Metabolic; Metabolic Diseases; Methods; Modeling; Modification; Morbidity - disease rate; Multivariate Analysis; Numbers; Nurses; Obesity; Office Visits; Outcome; Outpatients; Overweight; Physical activity; Postmenopause; Postpartum Women; Predisposition; Prevalence; Primary Health Care; Psychosocial Factor; Purpose; Randomized; Research; Risk Factors; Schedule; Site; Social support; Source; Techniques; Telephone; Time; Translating; Variant; Walking; Week; Weight; Woman; Work; base; cardiovascular disorder risk; cognitive change; desire; diet and exercise; follow-up; health care delivery; innovation; insulin sensitivity; men; mortality; nursing intervention; nutrition; obesity treatment; prevent; programs; response; sedentary; social; trafficking; weight gain prevention; weight loss intervention

Multi-faceted obesity treatment demonstrates the best weight loss (WL) outcomes, yet the most effective site and method for treatment delivery and follow-up remain elusive. Compounding the persistent treatment enigmas, aging in women is associated with an increasingly sedentary lifestyle that reduces total daily energy expenditure, predisposing to obesity. Moreover, candidate genes that contribute to the heritability of body weight and body fat distribution also may influence the response to WL treatment. In a nation with an unrelenting epidemic of obesity, the need for treatment far exceeds the capacity of the health care system to provide care on an individual basis. The purpose of this study is to: 1) assess the effects of a multi-faceted HOME- versus CENTER-based WL program on WL, CVD risk factors, and psychosocial factors; 2) determine whether a multi-faceted HOME- or CENTER-based approach more effectively leads to sustained treatment enrollment; and 3) retrospectively determine whether women with one or more variants in selected obesity-energy expenditure or insulin-sensitivity candidate genes have different outcomes post-treatment and/or at follow-up than women without a genetic predisposition. Overweight or obese (BMI 25-40 kg/hm 2) women (n=100) at least one year postmenopausal but ___65 years of age will be randomized to receive CENTER- or HOME-based interventions for WL that include low intensity exercise (walking). All women will receive 2 weeks of orientation to CENTER or HOME programs onsite and have baseline data collected before 6-month CENTER or HOME-based programs begin. Evaluation will be in a stable diet and exercise status post-intervention, and again after 6 months maintenance at CENTER or HOME. Multivariate analyses will be used to reduce error inflation from multiple comparisons, or Bonferonni corrections will be used when multivariate analyses are not possible. With its health promotion emphasis, nursing is an ideal discipline to conduct and translate research-based, lifestyle-modification WL interventions into practice. WL interventions that postmenopausal women will accept and sustain are essential for promoting health and preventing disease during this period of major vulnerability in their lives.

多方面的肥胖治疗证明了最好的减肥（WL）结果，但最有效的 用于治疗递送和随访部位和方法仍然难以捉摸。混合持久性 治疗之谜，女性的衰老与越来越多的久坐不动的生活方式有关， 每日能量消耗，易患肥胖症。此外，有助于基因表达的候选基因 体重和体脂分布的遗传率也可能影响WL治疗的反应。在 作为一个肥胖症持续流行的国家，对治疗的需求远远超过了医疗机构的能力。 卫生保健系统为个人提供保健。本研究的目的是：1）评估 多方面的家庭与中心WL计划对WL、CVD风险因素和 心理社会因素; 2）确定多方面的家庭或中心为基础的方法更多 有效地导致持续的治疗登记;和3）回顾性地确定是否有 在选定的肥胖能量消耗或胰岛素敏感性候选基因中的一种或多种变体具有 治疗后和/或随访结果与无遗传倾向的女性不同。 超重或肥胖（BMI 25-40 kg/hm 2）女性（n=100）绝经后至少1年，但 将随机分配1岁的患者接受基于中心或家庭的WL干预，包括 低强度运动（步行）。所有女性将接受为期2周的中心或家庭指导 在6个月的中心或家庭计划之前收集基线数据 开始。评估将在干预后饮食和运动状态稳定的情况下进行，并在6个月后再次进行 在中心或家中进行维护。多变量分析将用于减少误差膨胀， 当多变量分析不可能时，将使用多重比较或Bonferonni校正。 以其健康促进的重点，护理是一个理想的学科进行和翻译的研究为基础， 改变生活方式的WL干预措施付诸实践。绝经后妇女将 接受和维持是促进健康和预防疾病的关键，在这一重大时期， 生活中的脆弱性。