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Intervening on sedentary behavior to prevent weight regain in older adults

干预久坐行为以防止老年人体重反弹

基本信息

批准号：
9273330
负责人：
Barbara J Nicklas
金额：
$ 61.61万
依托单位：
WAKE FOREST UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-05-15 至 2021-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9273330
关键词：
Accelerometer Activities of Daily Living Address Adult Aerobic Exercise Aftercare Age Awareness Behavior Behavior Therapy Behavioral Biological Adaptation Body Composition Body Weight Body Weight decreased Bone Density Caloric Restriction Chronic Disease Clinical Cognitive Counseling Data Desire for food Diet Dietary intake Eating Elderly Energy Intake Energy Metabolism Exercise Goals Guidelines Health Individual Intake Intervention Lead Life Style Light Maintenance Measures Mediating Methods Monitor Obesity Outcome Participant Pattern Performance Persons Phase Physical Function Physical activity Population Predictive Factor Prevalence Process Measure Randomized Randomized Controlled Trials Recommendation Reporting Research Rest Science Self Efficacy Structure Time Treatment Efficacy United States National Institutes of Health Weight Weight Gain Wing Withholding Treatment age group arm awake base cardiometabolic risk design diet and exercise efficacy testing evidence base exercise intensity fitness follow-up improved intervention effect lifestyle intervention novel obesity treatment prevent public health relevance recidivism response secondary outcome sedentary lifestyle social total energy expenditure treatment effect weight loss intervention working group

项目摘要

DESCRIPTION (provided by applicant): Chronic disease and decreased mobility associated with obesity in older (65+ yrs) adults emphasize the urgent need to identify obesity treatments in this population that are evidenced-based, effective in the long-term, and perhaps age-specific. The latest obesity treatment guidelines for all ages recommend an intensive intervention involving behavioral counseling, caloric restriction, and increased physical activity to achieve weight loss. However weight regain after treatment cessation is very common, especially in older adults in whom the currently recommended strategy of continued performance of high-volume structured exercise of 200-300 min/wk may be less feasible and effective. A key factor contributing to weight regain is the decrease in energy expenditure that occurs in response to weight loss, due mainly to a decline in non-exercise or spontaneous physical activity (SPA) that is the direct result of an increase in sedentary behavior (SB), or time spent sitting or reclining. Our pilot data show that decreases in SPA predict magnitude of weight regain. Since older adults spend 65-80% of their waking day sitting or prone, we hypothesize that intervening on SB will be a more effective method for preventing weight regain than the conventional approach of intervening on exercise behavior in this age group. The proposed research will test the efficacy of a novel, acceptable, behavioral intervention (SitLess) that focuses on increased awareness of SB employing inclinometer-based self-monitoring throughout the day. Our pilot data show that this intervention may improve weight loss during the intensive phase of treatment and prevents weight regain during a short (5-month) follow-up phase. The primary aim of this study is to determine whether addition of this intervention that targets SB to a conventional weight loss intervention that targets exercise results in lower long-term reduction in weight in older, obese adults. This will be accomplished with a 24-month trial in 225 obese (BMI=30-40 kg/m2) older (65-79 yrs) adults randomized to one of three treatments (n=75), all with dietary caloric restriction plus either: 1) moderate-intensity aerobic exercise (WL+EX); 2) intervening on SB (WL+SitLess); or 3) (WL+EX+SitLess). The primary hypothesis is that: WL+EX+SitLess will have lower 24-month body weight than either WL+EX or WL+SitLess. Secondary outcomes, including resting and physical activity energy expenditure, SB, dietary intake and appetite, body composition/bone density, physical function, cardiometabolic risk and intervention process measures, will also be examined. The results will provide the first randomized, controlled trial data on the efficacy of self-monitoring of a key contributor to the adaptive thermogenic response to weight loss. Increasing awareness of weight loss-induced reductions in SPA, and behavioral promotion of decreasing SB to counteract these reductions, may provide for a more effective, safe, non- pharmacologic, and sustainable strategy to reduce weight regain after weight loss in older adults.