Prevention of Weight Gain in Young Adults

描述(由申请人提供)： 20-35岁的年轻人体重增加速度最快，平均每年1至2磅。这种体重增加与心血管危险因素的恶化和代谢综合征患病率的增加有关。考虑到在晚年实现持续减肥的困难，防止体重增加发生在青年时期是遏制肥胖症流行的关键。该项目涉及两个相互关联的R01申请--由Miriam医院的Rena Wing博士提交的临床协调中心申请，以及由维克森林大学医学院的Mark Espeland博士提交的数据协调中心申请。该项目的目的是测试两种预防年轻人体重增加的干预措施。这两种干预措施都是基于自我调节的方法，我们已经证明，这种方法可以帮助防止最近减肥的人体重回升。这种自我调节的关键方面包括日常自我称重，使用秤上的信息来知道何时需要调整饮食和活动，改变这些行为的行为技能，以及成功防止体重增加的小补充。一种是自我调节干预，重点是在饮食和锻炼行为上做出小而一致的改变，以防止体重增加；另一种是强调饮食和锻炼行为的周期性较大改变，从而导致较小的体重减轻。这些干预措施将在一项三臂随机对照临床试验中相互比较并与对照条件进行比较。这项研究将涉及600名成年人(Miriam医院临床站点的300人和北卡罗来纳大学临床站点的300人)，年龄18-35岁，BMI在23-30之间，他们被随机分配到1)对照组；2)行为变化较小的自我调节干预；或3)行为变化较大的自我调节。参与者将在18个月内被招募，并将从随机开始跟踪，直到赠款结束，从而获得24-48个月的跟踪(平均=3年)。主要的假设是，平均计划3年的随访期间，体重增加的幅度将在三组中不同(一个先验假设是，体重增加在控制组中最大，在小变化中中等，在大变化条件下最小)。第二个假设将比较三组的体重增加比例(定义为比基线增加1磅)、心血管危险因素的变化以及过程指标(如饮食、体力活动和饮食限制)的变化。这个项目的重点是年轻人的体重增加--这是预防肥胖的关键时期--并测试基于身体8的自我调节的创新方法。这种方法显示出减少体重增加，从而改善长期心血管健康的前景。(摘要结束)

DESCRIPTION (provided by applicant): Young adults, age 20-35, experience the greatest rate of weight gain, averaging 1 to 2 pounds per year. This weight gain is associated with a worsening in cardiovascular risk factors and an increase in the prevalence of metabolic syndrome. Given the difficulties in producing sustained weight loss later in life, preventing weight gain from occurring during young adulthood is critical to curbing the obesity epidemic. This project involves two linked R01 applications--a Clinical Coordinating Center application submitted by Dr. Rena Wing, The Miriam Hospital, and a Data Coordinating Center, submitted by Dr. Mark Espeland, Wake Forest University School of Medicine. The purpose of the project is to test two interventions to prevent weight gain in young adults. Both interventions are based on a self-regulation approach that we have shown can help prevent weight regain in recent weight losers. Key aspects of this self-regulation include daily self-weighing, use of the information from the scale to know when adjustments in eating and activity are needed, behavioral skills to modify these behaviors, and small reinforcements for successful prevention of weight gain. One self-regulation intervention is focused on making small consistent changes in eating and exercise behavior to prevent weight gain; the other emphasizes periodic larger changes in eating and exercise behavior that result in small weight losses. These interventions will be compared to each other and to a control condition in a 3-armed randomized controlled clinical trial. The study will involve 600 adults (300 at the Miriam Hospital clinical site and 300 at the University of North Carolina clinical site), aged 18-35 with a BMI of 23-30, who are randomly assigned to 1) control; 2) self-regulation intervention with small behavior changes or 3) self-regulation with large behavior changes. Participants will be recruited over 18 months and will be followed from randomization until the end of the grant, resulting in 24-48 months of follow-up (mean=3 years). The primary hypothesis is that the magnitude of weight gain across an average planned follow-up of 3 years will differ among the three groups (a priori hypothesis is that weight gain will be greatest in control, intermediate in small changes, and least in the large change condition). Secondary hypotheses will compare the three groups on the proportion gaining weight (defined as > 1lb over baseline), changes in cardiovascular risk factors, and changes in the process measures (such as diet, physical activity, and dietary restraint). This project focuses on weight gain in young adults-a critical time for the prevention of obesity-and tests innovative approaches based on self-regulation of body eight. This approach shows promise for reducing weight gain and thereby improving long-term cardiovascular health. (End of Abstract)