Optimal Timing of Exercise Initiation Within a Lifestyle Weight Loss Program

生活方式减肥计划中开始运动的最佳时机

• 批准号: 9336877
• 负责人: VICTORIA A CATENACCI
• 金额: $ 57.96万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9336877
• 关键词: Achievement; Adherence; Adoption; Adverse event; Area; Behavior; Behavior Control; Behavior Therapy; Behavioral; Body Composition; Body Weight; Body Weight decreased; Calories; Development; Diet; Dietary Intervention; Eating Behavior; Effectiveness; Energy Intake; Exercise; Fatty acid glycerol esters; Frequencies; Future; Goals; Guidelines; Individual; Injury; Intake; Intervention; Intervention Studies; Knowledge; Life Style; Maintenance; Measures; Mediating; Modeling; National Heart, Lung, and Blood Institute; Obesity; Overweight; Perception; Physical Fitness; Physical activity; Public Health; Research; Research Activity; Research Design; Role; Testing; Thinness; Time; United States National Institutes of Health; Weight; Weight maintenance regimen; behavior change; behavioral construct; cardiorespiratory fitness; diet and exercise; evidence based guidelines; exercise adherence; exercise intervention; exercise program; improved; improved outcome; innovation; lifestyle intervention; novel strategies; obesity treatment; prevent; programs; public health relevance; randomized trial; treatment program; weight loss intervention

DESCRIPTION (provided by applicant): Despite the short-term effectiveness of lifestyle interventions for weight loss, many individuals regain a significant amount of weight within a 1 year period. Regular physical activity (PA) is one of the best predictors of sustained weight loss and current activity guidelines recommend high levels of PA to prevent weight regain after weight loss. However, most individuals do not achieve or sustain high levels of PA during typical weight loss programs in which diet and exercise interventions are initiated concurrently. Thus it is essential to evaluate novel strategies to promote adherence to high levels of PA within a lifestyle weight loss program. The optimal timing of exercise initiation within a weight loss program is an area that has not previously been studied. The overall objective of this proposal is to evaluate the extent to which an exercise intervention timed after diet-induced weight loss (rather than initiated concurrently) improves exercise adherence and facilitates long-term weight loss. Exercise initiation after weight loss may improve exercise adoption and adherence and promote long- term weight loss because: 1) exercise may be easier to perform at a lower body weight, 2) injury rates (and exercise attrition) may be reduced after weight loss and 3) it may be more effective to focus on a single behavior change at a time (rather than attempting concurrent changes in diet and exercise behaviors). For these reasons, we believe it may be more effective to initiate exercise after an initial period of diet-induced weight loss. Our overall hypothesis is that sequential delivery of diet and exercise interventions will result in improved weight loss at 18 months when compared to a traditional program in which identical diet and exercise interventions are initiated simultaneously. The study design involves an 18 month randomized trial within which obese subjects receive either standard behavioral therapy (Standard BT) or sequential behavioral therapy (Sequential BT). Standard BT will receive a traditional behavioral weight loss program where diet and exercise changes are initiated simultaneously. Sequential BT will receive a program that focuses solely on dietary changes in the initial 6 months, and then incorporates exercise in the ensuing 6 months. Both groups will be followed for 18 months to assess long-term weight loss. In Aim 1 we will assess the effect of timing of exercise initiatio on weight loss and body composition. In Aim 2 we will assess the effect of timing of exercise initiation on free living PA and cardio-respiratory fitness. In Aim 3 we will assess the effect of timing of exercise initiation on adherence to dietary weight control behaviors. In Aim 4 we will explore mechanisms (perception of exercise, exercise related injuries, and behavioral constructs related to our hypothesis) through which timing of exercise initiation may impact long-term weight loss. The approach is innovative as it focuses on determining the optimal time to begin exercise rather than evaluating a specific frequency, intensity, or duration of exercise. The proposed study is significant as it could identify a strategy that could aid in the development of more effective obesity treatment programs and help more people achieve and sustain a weight loss.

描述(由申请人提供)：尽管生活方式干预对减肥有短期效果，但许多人在一年内恢复了相当数量的体重。有规律的体力活动(PA)是持续减肥的最佳预测指标之一，目前的活动指南建议高水平的PA以防止减肥后体重回升。然而，大多数人在典型的减肥计划中无法达到或维持高水平的PA，在这些计划中，饮食和运动干预同时开始。因此，评估新的策略以促进在生活方式减肥计划中坚持高水平的PA是至关重要的。减肥计划中运动开始的最佳时机是一个以前没有研究过的领域。这项建议的总体目标是评估在饮食诱导的减肥之后进行的运动干预(而不是同时开始)在多大程度上提高了运动的依从性，并促进了长期的减肥。减肥后开始锻炼可能会提高锻炼的接受度和坚持性，并促进长期减肥，因为：1)较低体重的锻炼可能更容易进行，2)减肥后的伤害率(和运动磨耗)可能会减少，3)一次专注于单一的行为改变(而不是试图同时改变饮食和锻炼行为)可能更有效。出于这些原因，我们认为，在饮食诱导减肥的最初阶段之后开始锻炼可能会更有效。我们的总体假设是 与同时开始相同饮食和运动干预的传统计划相比，连续提供饮食和运动干预将导致18个月后体重减轻的改善。研究设计包括18个月的随机试验，肥胖者接受标准行为疗法(标准BT)或顺序行为疗法(Sequential BT)。标准BT将接受传统的行为减肥计划，同时开始改变饮食和锻炼。连续的BT将在最初的6个月里接受一个只关注饮食变化的计划，然后在接下来的6个月里加入锻炼。两组都将接受为期18个月的跟踪调查，以评估长期减肥效果。在目标1中，我们将评估运动开始时间对减肥和身体成分的影响。在目标2中，我们将评估运动开始时间对自由生活PA和心肺健康的影响。在目标3中，我们将评估运动开始时间对坚持饮食体重控制行为的影响。在目标4中，我们将探索运动开始时间可能影响长期减肥的机制(运动感知、运动相关伤害和与我们的假设相关的行为结构)。这种方法是创新的，因为它侧重于确定开始锻炼的最佳时间，而不是评估特定的锻炼频率、强度或持续时间。这个 拟议的研究具有重要意义，因为它可以确定一种策略，帮助开发更有效的肥胖治疗计划，并帮助更多的人实现并维持减肥。