Intervening on spontaneous physical activity to prevent weight regain in women

干预自发体力活动以防止女性体重反弹

• 批准号: 7933850
• 负责人: Barbara J Nicklas
• 金额: $ 15.69万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7933850
• 关键词: Adherence; Adipose tissue; Adopted; Aerobic Exercise; Age; Animal Model; Animals; Area; Back; Behavior; Behavioral; Biological; Body Weight; Body Weight decreased; Caloric Restriction; Clinical; Clinical Research; Clinical Treatment; Data; Data Collection; Data Quality; Development; Diet; Diet Monitoring; Drops; Educational Intervention; Effectiveness; Energy Metabolism; Exercise; Female; Financial compensation; Gender; Goals; Guidelines; Individual; Intervention; Lead; Life; Maintenance; Manuals; Metabolic; Methods; Monitor; NIH Program Announcements; Obesity; Online Systems; Participant; Phase; Physical activity; Pilot Projects; Prevalence; Prevention; Quality Control; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Recommendation; Recruitment Activity; Regimen; Reporting; Research; Research Design; Research Infrastructure; Rest; Role; Secondary to; Sex Characteristics; Structure; System; Testing; Training; Treatment outcome; Weight; Woman; Women' s Health; Work; arm; base; cardiovascular risk factor; design; diet and exercise; disability; energy balance; evidence base; experience; feeding; follow-up; innovation; male; men; middle age; obesity treatment; older women; prevent; programs; public health relevance; randomized trial; research study; response; sex; standard of care; stem; weight loss intervention

DESCRIPTION (provided by applicant): Recommendations for more effective long-term weight loss strategies may need to consider the role of gender differences. If, as shown in female vs. male animal models, negative energy balance resulting in weight loss results in greater compensatory reductions in energy expenditure in women compared to men, obesity treatments may need to be tailored in women to override these reductions in total energy expenditure. Our approach focuses on a behavioral strategy (self-monitoring) to eliminate the compensatory reduction in non-exercise "spontaneous" physical activity (SPA) seen in women who lose weight by means of a hypocaloric diet and structured exercise training. Our long-term research goal is to establish empirical evidence for innovative treatment options that are more effective in producing weight loss and preventing weight regain in women. The main goal of this pilot is to provide preliminary data and effect estimates to begin to test our overall hypothesis that prevention of weight loss-induced reductions in SPA will be more beneficial for long-term maintenance of weight loss in women than in men. We propose to conduct a pilot study using a 2-arm, 10-month design in 72 obese, older (55-70 yrs) men and women (n=36 per group). Participants will be randomized to a 5-month standardized weight loss intervention involving a hypocaloric diet and aerobic exercise (DIET+EX) or to the same weight loss intervention with addition of a behavioral component that targets self-monitoring (SM) of SPA (SM+DIET+EX), and then followed for another 5 months after weight loss. The specific aims of this R21 exploratory/developmental application are: Primary-To examine whether SPA self- monitoring results in less body weight regain in the follow-up phase in both men and women; Secondary-To examine whether: 1) women regain more weight than men in the follow-up phase; 2) SPA self-monitoring and gender have an effect on change in weight in the intensive weight loss phase; 3) SPA self-monitoring and gender have an effect on change in SPA in the intensive weight loss phase; 4) there is an association between SPA changes in the weight loss phase and weight regain in the follow-up phase. We anticipate that the results will lead to a larger and longer trial to definitively test our hypothesis, which could potentially provide evidence against the current standard of care (i.e., exclusive prescription of structured moderate-intensity exercise) for obesity therapy in women and may lead to sex-specific treatment guidelines. PUBLIC HEALTH RELEVANCE: Weight loss programs using caloric restriction and regular, structured exercise can lead to a reduction in physical activity performed outside of the planned exercise sessions. This study will test whether or not women reduce their spontaneous daily physical activity more than men with weight loss, and whether this reduction can be prevented by using self-monitoring, thereby slowing or preventing weight regain. Since reductions in spontaneous physical activity could potentially negate the intent of a structured exercise program for weight loss therapy, it would be important to know whether recommendations for weight loss maintenance in women should include promotion of spontaneous physical activity, rather than structured exercise, during and following a period of intensive weight loss.

描述（由申请人提供）：关于更有效的长期减肥策略的建议可能需要考虑性别差异的作用。如雌性与雄性动物模型所示，如果负能量平衡导致体重减轻，导致女性比男性能量消耗有更大的补偿性减少，那么可能需要针对女性制定肥胖治疗方案，以抵消总能量消耗的这些减少。我们的方法侧重于行为策略（自我监控），以消除通过低热量饮食和结构化运动训练减肥的女性中非运动“自发”身体活动（SPA）的补偿性减少。我们的长期研究目标是为创新治疗方案建立经验证据，使女性能够更有效地减轻体重并防止体重反弹。该试点的主要目标是提供初步数据和效果估计，以开始检验我们的总体假设，即预防减肥引起的 SPA 减少将比男性更有益于长期维持女性减肥效果。我们建议对 72 名肥胖的老年（55-70 岁）男性和女性（每组 n=36）进行一项为期 10 个月的 2 臂设计试点研究。参与者将被随机分配接受为期 5 个月的标准化减肥干预，其中包括低热量饮食和有氧运动 (DIET+EX)，或接受相同的减肥干预，并添加针对 SPA 自我监控 (SM) 的行为成分 (SM+DIET+EX)，然后在减肥后再随访 5 个月。 R21 探索性/开发性应用的具体目标是： 主要-检查 SPA 自我监测是否会导致男性和女性在后续阶段体重恢复较少；次要——检查是否：1）女性在后续阶段比男性恢复更多的体重； 2）SPA自我监测和性别对强化减肥阶段体重变化有影响； 3）SPA自我监测和性别对强化减肥阶段SPA变化有影响； 4）减肥阶段的SPA变化与后续阶段的体重反弹之间存在关联。我们预计这些结果将导致更大规模、更长时间的试验来明确检验我们的假设，这可能会为女性肥胖治疗的当前护理标准（即结构化中等强度运动的独家处方）提供证据，并可能导致针对性别的治疗指南。公共卫生相关性：使用热量限制和定期、结构化锻炼的减肥计划可能会导致计划锻炼之外的体力活动减少。这项研究将测试女性是否比减肥男性更多地减少自发的日常体力活动，以及是否可以通过自我监控来防止这种减少，从而减缓或防止体重反弹。由于自发身体活动的减少可能会否定减肥治疗的结构化锻炼计划的意图，因此了解女性维持减肥的建议是否应包括在强化减肥期间和之后促进自发身体活动而不是结构化锻炼非常重要。