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

基本信息

批准号：
8921190
负责人：
VICTORIA A CATENACCI
金额：
$ 63.88万
依托单位：
UNIVERSITY OF COLORADO DENVER
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-01 至 2016-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8921190
关键词：
Achievement Adherence Adoption Adverse event Area Behavior Behavior Therapy Behavioral Body Composition Body Weight Body Weight decreased Development Diet Dietary Intervention Eating Behavior Effectiveness Energy Intake Exercise Fatty acid glycerol esters Frequencies Future Goals Guidelines Health Individual Injury Intake Intervention Knowledge Life Life Style Maintenance Measures Mediating Modeling National Heart, Lung, and Blood Institute Obesity Outcome Overweight Perception Physical Fitness Physical activity Public Health Research Research Design Role Testing Time Treatment Efficacy United States National Institutes of Health Weight Weight maintenance regimen behavior change behavioral construct diet and exercise evidence based guidelines exercise adherence fitness improved innovation lifestyle intervention novel strategies obesity treatment prevent programs randomized trial respiratory treatment program

项目摘要

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）：尽管生活方式干预措施减肥的短期有效性，但许多人在一年的时间内恢复了相当大的体重。定期体育锻炼（PA）是持续体重减轻的最佳预测因素之一，当前活动指南建议高水平的PA以防止体重减轻后重新增加体重。但是，在典型的减肥计划中，大多数人没有达到或维持高水平的PA，在这些计划中，同时启动了饮食和运动干预措施。因此，在生活方式减肥计划中评估新型策略以促进高水平PA的依从性至关重要。减肥计划中运动开始的最佳时机是以前尚未研究的领域。该提案的总体目的是评估饮食引起的体重减轻后的运动干预时间的程度（而不是同时引发）可以提高运动依从性并促进长期体重减轻。体重减轻后的运动开始可以提高运动的采用和依从性并促进长期体重减轻，因为：1）运动可能更易于以较低的体重进行，2）受伤率（和运动流失）可能会降低体重减轻和体重减轻后3）可能更有效地专注于一次行为变化（而不是尝试在饮食和运动行为方面发生同时改变）。由于这些原因，我们认为在饮食引起的体重减轻的初期后，开始运动可能更有效。我们的总体假设是与传统计划相比，饮食和运动干预措施的顺序分娩将导致18个月的体重减轻，同时开始饮食和运动干预措施。研究设计涉及一项18个月的随机试验，其中肥胖受试者接受标准行为疗法（标准BT）或顺序行为疗法（顺序BT）。标准BT将获得传统的行为减肥计划，同时启动饮食和运动的变化。顺序BT将收到一个计划，该计划仅在最初6个月内仅着眼于饮食变化，然后在随后的6个月内进行锻炼。两组将遵循18个月的时间来评估长期体重减轻。在AIM 1中，我们将评估运动时间开始对体重减轻和身体组成的影响。在AIM 2中，我们将评估运动启动时间对自由生活PA和心脏呼吸性适应性的影响。在AIM 3中，我们将评估运动开始时间对饮食体重控制行为的遵守的影响。在AIM 4中，我们将探索机制（运动感知，与我们的假设相关的行为结构的感知），通过该机制，运动的时间可能会影响长期的体重减轻。该方法具有创新性，因为它着重于确定开始锻炼的最佳时间，而不是评估特定的频率，强度或锻炼持续时间。这拟议的研究非常重要，因为它可以确定可以帮助制定更有效的肥胖治疗计划的策略，并帮助更多的人实现和维持体重减轻。