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：
8725657
负责人：
VICTORIA A CATENACCI
金额：
$ 63.71万
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 2018-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8725657
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 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 diet and exercise evidence based guidelines fitness improved innovation lifestyle intervention novel strategies obesity treatment prevent programs public health relevance 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）：尽管生活方式干预对于减肥具有短期效果，但许多人在一年内体重明显反弹。定期体力活动 (PA) 是持续减肥的最佳预测因素之一，当前的活动指南建议进行高水平的体力活动，以防止减肥后体重反弹。然而，在同时启动饮食和运动干预的典型减肥计划中，大多数人无法达到或维持高水平的 PA。因此，有必要评估新的策略，以促进在生活方式减肥计划中坚持高水平的 PA。减肥计划中开始运动的最佳时机是一个以前没有研究过的领域。该提案的总体目标是评估在饮食诱导减肥后（而不是同时开始）进行运动干预可以在多大程度上提高运动依从性并促进长期减肥。减肥后开始运动可以提高运动的采用和坚持，并促进长期减肥，因为：1）运动在较低体重下可能更容易进行，2）减肥后受伤率（和运动损耗）可能会降低，并且3）一次专注于单一行为改变可能更有效（而不是尝试同时改变饮食和运动行为）。出于这些原因，我们认为在饮食诱导的减肥初期后开始锻炼可能更有效。我们的总体假设是与同时启动相同饮食和运动干预的传统计划相比，顺序实施饮食和运动干预将在 18 个月时改善体重减轻。研究设计涉及一项为期 18 个月的随机试验，其中肥胖受试者接受标准行为疗法 (Standard BT) 或序贯行为疗法 (Sequential BT)。标准 BT 将接受传统的行为减肥计划，其中饮食和运动改变同时启动。序贯 BT 将接受一项计划，该计划在最初 6 个月内仅关注饮食变化，然后在接下来的 6 个月中纳入锻炼。两组患者都将被跟踪 18 个月，以评估长期体重减轻情况。在目标 1 中，我们将评估运动开始时间对减肥和身体成分的影响。在目标 2 中，我们将评估运动开始时间对自由生活 PA 和心肺健康的影响。在目标 3 中，我们将评估开始运动的时间对坚持饮食体重控制行为的影响。在目标 4 中，我们将探索运动开始时间可能影响长期体重减轻的机制（对运动的感知、运动相关损伤以及与我们的假设相关的行为结构）。该方法具有创新性，因为它侧重于确定开始锻炼的最佳时间，而不是评估具体的锻炼频率、强度或持续时间。这拟议的研究意义重大，因为它可以确定一种策略，有助于制定更有效的肥胖治疗计划，并帮助更多的人实现和维持减肥。