PROFILE-BASED, INTERNET-LINKED, OBESITY PREVENTION TRIAL

肥胖症及其合并症的患病率不断增加，而先前的减肥/维持干预措施的成功有限，这表明需要新的方法来预防肥胖症。围绝经期妇女是超重和肥胖的高危人群。在此期间，生理和行为因素导致能量消耗的变化，这促进了能量过量和总脂肪和腹部脂肪的逐渐增加，通常由于瘦组织的损失而加剧。因此，我们提出开发和测试用于超重围绝经期妇女的创新的个性化体重减轻/维持计划，受频繁评估受试者的生物心理社会概况的驱动（允许及时对个人需要作出干预反应），并通过广泛使用新的通信技术（主要是互联网-CD-ROM混合包）提供，这些技术在行为和生物学研究中基本上尚未开发。为此，超重/肥胖围绝经期（45 - 55岁）女性在完成3个月的核心课程锻炼、饮食和认知行为治疗后，将随机分为干预组（n=50）和对照组（n=50）。经过3个月的计算机培训过渡（仅干预组）后，干预（15个月）将仅通过互联网进行，实验室测量除外（干预组和对照组）。将以增加体力活动（约1500千卡/周）、健康饮食和适度限制热量并提供充足营养为目标，特别强调促进自主行为。将通过网站上的问卷调查监测生物心理社会的“减肥概况”，并用于个性化干预，响应变化的需求，并评估其与体重变化的关系，并通过双能x射线吸收测定法测量组成。我们认为互联网/网站技术代表了一种潜在的低成本和有效的手段，用于提供持续的教育，鼓励和社会支持，以促进持续的行为改变和减肥/维持。

The increasing prevalence of obesity and its co-morbidities and the limited success of previous weight loss/maintenance interventions argues the need for new approaches to prevent obesity. Peri-menopausal women are t high risk to develop overweight and obesity. Around that period, physiological and behavioral factors contribute to changes in energy expenditure which promote energy surfeit and progressive gain of total and abdominal fat, often exacerbated by loss of lean tissue Thus, we propose to develop and test an innovative individualized weight loss/maintenance program for overweight peri-menopausal women, driven by frequent assessment of subjects' biopsychosocial profiles (allowing timely intervention response to individual needs), and delivered through extensive use of new communication technologies (primarily and Internet-CD-ROM hybrid package) which have been largely unexplored in behavioral and biological research. To this end, overweight/obese peri-menopausal (aged 45 to 55 years) women will be randomized to intervention (n=50) or control (n=50) after completing a 3-month core curriculum exercise, diet, and cognitive- behavior therapy. After a 3 months transition with computer training (intervention group only), intervention (15 months) will proceed via the internet only, except for laboratory measurements (intervention and control groups). Increased physical activity (approximately 1500 kcal/week), healthy eating and modest calorie restriction with adequate nutrients will be targeted, with special emphasis on promotion of self-directed behavior. Biopsychosocial "weight loss profiles" will be monitored through questionnaires on the web site and used to individualize intervention, respond to change needs, and assess their relationship with changes in body weight and composition measured by dual energy x-ray absorptiometry. We contend the internet/web site technology represents a potentially low cost and effective means for providing the continuous education, encouragement and social support to foster sustained behavior change and weight loss/maintenance.