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

基本信息

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
项目类别：
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&apos 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

项目摘要

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）：有关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。如果如女性动物模型所示，与男性相比，女性的能量消耗会导致负重减少的负能量平衡，则可能需要在女性中量身定制肥胖治疗，以覆盖总能量消耗中的这些减少。我们的方法侧重于一种行为策略（自我监控），以消除通过低温饮食和结构化运动训练的女性中的非运动“自发”体育锻炼（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，这些证据在减轻体重和防止女性体重恢复方面更有效。该试点的主要目的是提供初步的数据和效果估计，以开始检验我们的总体假设，即预防减肥诱导的水疗中心减少的水疗中心的长期维持女性的体重减轻将比男性更有益。我们建议在72个肥胖，年龄较大（55 - 70年）的男女（每组n = 36）中使用2臂，10个月的设计进行试点研究。参与者将被随机分为5个月的标准化减肥干预措施，涉及低温饮食和有氧运动（Diet+EX）或相同的减肥干预措施，并添加针对SPA自我监测（SM+Diet+EX）的行为成分，然后在体重减轻后再进行5个月。该R21探索性/发育应用的具体目的是：主要检查水疗自我监测是否会导致男性和女性的随访阶段减轻体重；次要检查：1）在后续阶段，女性是否比男性重新增加体重； 2）在密集减肥阶段，水疗自我监控和性别对体重的变化有影响； 3）在密集减肥阶段，水疗中心的自我监控和性别对水疗中心的变化有影响； 4）在随访阶段，体重减轻阶段的水疗变化与体重恢复之间存在关联。我们预计结果将导致更大且更长的试验，以确切地检验我们的假设，这可能会根据当前的护理标准（即，结构性中强度运动的独家处方）对妇女的肥胖治疗提供证据，并可能导致性别特定治疗指南。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导致在计划的运动课程之外进行的体育锻炼。这项研究将测试女性是否比体重减轻的男性减少自发的每日体育锻炼，以及是否可以通过使用自我监控来预防这种减少，从而减慢或预防体重恢复。由于自发体育锻炼的减少可能会否定体重减轻疗法的结构化运动计划的意图，因此重要的是要知道女性减肥的建议是否应包括促进自发的体育锻炼，而不是结构化锻炼，而不是在大量体重减轻期间进行结构化运动。