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

• 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
• 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

 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.

 描述（由适用提供）：慢性疾病和与肥胖相关的慢性疾病（65岁以上）成年人强调迫切需要鉴定该人群中的肥胖症治疗，这些肥胖是基于证据的，长期有效，可能是特定年龄的。所有年龄段的最新肥胖治疗指南建议进行强化干预措施，包括行为咨询，热量限制和增加体育锻炼以实现体重减轻。但是，戒烟后的体重恢复非常普遍，尤其是在老年人中，当前推荐的持续性能进行200-300分钟/周的策略可能不那么可行且有效。导致体重恢复的关键因素是由于体重减轻而发生的能量消耗减少，这主要是由于非运动或赞助体育锻炼（SPA）的下降，这是久坐行为增加（SB）的直接结果，或坐着或坐着或倾斜的时间。 我们的飞行员数据显示，水疗中心的下降预测重量的重新升高。由于老年人在醒来的日子或容易发生的唤醒日的65-80％中，我们假设介入SB将是预防体重恢复的一种更有效的方法，而不是介入该年龄段的运动行为的常规方法。拟议的研究将测试一种新颖，可接受的，可接受的行为干预措施（无固定）的有效性，该措施的重点是增加对SB全天采用基于抗斜率的自我监控的认识。我们的试点数据表明，这种干预可能会在治疗的密集阶段改善体重减轻，并在短期（5个月）的随访阶段预防体重。这项研究的主要目的是确定将SB靶向靶向运动的常规减肥干预措施的添加是否会导致老年肥胖成年人的长期体重减轻。这将通过225个肥胖（BMI = 30-40 kg/m2）的24个月试验（65-79岁）的成年人随机分为三种治疗方法之一（n = 75），所有这些都具有饮食热量限制加上：1）适度强度有氧运动（WL+ex）; 2）介入SB（WL+Sitless）；或3）（wl+ex+坐下）。主要假设是：WL+EX+SITless的体重将比WL+EX或WL+SITless低24个月。还将检查次要结果，包括休息和体育锻炼能量消耗，SB，饮食摄入和食欲，身体成分/骨密度，身体功能，心脏代谢风险和干预过程测量值。结果将提供第一个随机，对照的试验数据，内容涉及对体重减轻的自适应热反应的关键因素的自我监测效率。对体重减轻引起的水疗中心减少的认识提高，并促进SB的行为促进以抵消这些减少的降低，可能会提供更有效，安全，非药物和可持续策略，以减轻老年人体重减轻后体重减轻后恢复体重。