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The SHED-IT Community Trial: A randomised controlled trial of Internet- and paper-based weight loss programs tailored for overweight and obese men
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Oral Abstracts
O059
O060
Can diabetes prevention programs contribute to long-term weight loss? Preliminary results from a two-year follow up of participants in the Sydney Diabetes Prevention Program
The SHED-IT Community Trial: A randomised controlled trial of Internet- and paper-based weight loss programs tailored for overweight and obese men
P. Vita 1,2,∗ , S. Colagiuri 1 , A. Gibson 1 , A. Bauman 1
P. Morgan 1,∗ , R. Callister 2 , C. Collins 2 , R. 1 1 1 Plotnikoff , M. Young , N. Berry , P. McElduff 2 , T. Burrows 2 , E. Aguiar 2 , K. Saunders 1
1 Boden
Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Australia 2 Sydney Local Health District, Australia Aim: To assess if participants who completed a 12-month lifestyle modification diabetes prevention program, reduce, increase or maintain weight two years after program is completion. Methods: Participants who completed the Sydney Diabetes Prevention Program (the ‘program’) where followed up annually for an additional two years. The program targeted 50—65-year olds at high-risk of Type 2 diabetes with a 12-month lifestyle modification program aimed at improving nutrition (decreasing total fat and saturated fat, increasing fibre), increasing physical activity and 5% weight loss (n = 1238). The mean weight loss of those who completed the program (n = 850) was 2 kg. Participants who had begun the program at least three years ago were contacted annually by computer assisted telephone interview to selfreport their diet, physical activity and weight. Results: Of the 232 participants (mean age 59.4, 68% female) eligible to be contacted the mean weight at program completion was 86.9 kg. At one year and two year follow up the response rates were 88% and 89%, respectively. The mean weight at one-year follow up was 83.1 kg (n = 183) and at two-year follow up 85.1 kg (n = 199). There were no significant differences in weight between the three time points. At the one-year follow up participants reported they were eating less fat and more fibre, however physical activity had not changed. Conclusions: Diabetes prevention programs which target individuals at high-risk of Type 2 diabetes can maintain modest weight loss. More intensive interventions may be required to increase weight loss and reduce or prevent weight gain in this population. http://dx.doi.org/10.1016/j.orcp.2012.08.061
1 Priority
Research Centre in Physical Activity and Nutrition, Faculty of Education & Arts, University of Newcastle, Australia 2 Priority Research Centre in Physical Activity and Nutrition, Faculty of Health, University of Newcastle, Australia Aim: To evaluate the efficacy of two gendertailored weight loss programs for men that required no face-to-face contact. Methods: An assessor-blinded RCT with 159 overweight/obese men (mean [SD] age = 47.5 [11.0] years; BMI = 32.7 [3.5]) randomised (stratified by BMI category) to (1) Resources (gender-tailored weight loss materials [DVD, handbooks, pedometer, tape measure]); (2) Online (Resource materials plus access to a website to monitor diet and exercise with e-feedback provided on seven occasions) or (3) wait-list control group. Outcome measures assessed at baseline, 3- and 6-month follow-up for weight (primary outcome), BMI, % body fat, waist circumference, visceral fat area, blood pressure, resting heart rate, objectively measured physical activity, dietary intake, sitting time, sleepiness, and quality of life. Results: Generalised linear mixed models analyses demonstrated significant between group differences at 6 months for weight (P < .001) in both the Online (−4.7 kg; 95% CI −6.1, −3.2; d = .96) and Resources (−3.7 kg; −4.9, −2.5; d = .83) groups compared to controls (−0.5 kg; −1.4, 0.4). Relative to the control group, intervention effects were found for BMI, % body fat, waist, systolic blood pressure, physical activity, quality of life (physical domain), alcohol risk and portion size. The only significant difference between the Online and Resources group was for waist circumference (P < .001; d = .36). A per-protocol analysis demonstrated (P < .001) Online compliers (−9.7 kg; −12.2, −7.4) lost more weight than Resource compliers (−5.9 kg; −9.0, −2.8). Conclusion: Two novel, minimal contact, gendertailored programs resulted in significant weight loss and improved health-related outcomes in community dwelling men. The nature of the
Oral Abstracts
31
programs would allow dissemination on a large scale. http://dx.doi.org/10.1016/j.orcp.2012.08.062 O061
Effectiveness of interventions using Motivational Interviewing for physical activity and dietary modification in adults: A systematic review J. Hollis 1,∗ , L. Williams 1,2 , C. Collins 1 , P. Morgan 1
Fixed energy expenditure exercise induces similar body weight and appetite responses in males and females N. King 1,∗ , P. Caudwell 2 , C. 2 Finlayson , J. Blundell 2 1 Queensland
Gibbons 2 , G.
University of Technology, Brisbane,
Australia 2 University
O062
of Leeds, UK
Aim: There is a belief that exercise is a less effective weight management tool for females than males. This study was designed to compare body composition and appetite responses to 12 weeks of supervised exercise, between males and females. Method: Overweight and obese males (n = 35) and females (n = 72) took part in 12 weeks of supervised exercise training. The energy cost of the exercise was fixed (2500 kcal/wk), both within and between subjects. Body composition (BodPod), appetite sensations (electronic visual analogue scales) and food intake (laboratory test meals) were measured at weeks 0 and 12. Results: Despite no significant difference in the total exercise-induced energy expenditure between males and females (123 ± 21 MJ and 115 ± 15 MJ, respectively), the average duration of each exercise session was longer for females than males (54 min vs 43 min). Body weight and fat mass were significantly (p < 0.05) reduced in males (−3.03 ± 3.4 kg and −3.14 ± 3.7 kg, respectively) and females (−2.28 ± 3.1 kg and −3.01 ± 3.0 kg, respectively). The differences in losses were not significant between genders. Males and females experienced similar significant increases (p < 0.001) in fasting hunger (11.0 ± 3.7 mm and 14.0 ± 2.7 mm, respectively). Changes in test meal daily energy intake was highly variable but did not significantly change in males (199 ± 2418 kJ) or females (−132 ± 1912 kJ). There was no significant gender × time interaction for changes in fasting hunger or food intake. Conclusion: When supervised, and the energy cost fixed, exercise exerted similar body weight and appetite responses in males and females. However, females had to exercise for longer. http://dx.doi.org/10.1016/j.orcp.2012.08.063
1 Australia
Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Australia 2 University of Canberra, Australia Aim: To determine the effectiveness of interventions employing Motivational Interviewing (MI) to achieve dietary and physical activity behaviour change in adults. Previous systematic reviews of MI have predominately examined long term outcomes rather than behavioural risk factors. Method: The systematic review protocol was approved by the Joanna Briggs Institute (2/8/11). Nine databases were searched up to January 2012. MI adherent studies with dietary intake or physical activity as primary outcomes were eligible for inclusion if they reported monitoring MI fidelity and compared MI intervention arm to an attention control. Studies with pregnant or breastfeeding women, participants aged <18 years or those with clinically diagnosed states, were excluded. The search yielded 1766 articles of which 123 papers were retrieved and 6 met all inclusion criteria. Two reviewers examined all retrieved articles, assessed methodological quality of included studies and performed data extraction using a standardised tool. Results: Five of the six articles were level II evidence with low-to-moderate risk of bias. Two of three articles reporting on diet found significant positive effects: one study found a significant increase in vegetables, fruit, wholegrains and/or beans servings, the other found significantly lower saturated fat intakes (ˇ = 0.23, p = 0.00). One of four articles reporting on physical activity found the MI group increased physical activity at a significantly faster rate. Conclusion: Though suggestive, there is not yet sufficient evidence to conclude that MI enhances changes in physical activity and diet above an attention control. High quality studies measuring MI fidelity and including an attention control are required. http://dx.doi.org/10.1016/j.orcp.2012.08.064
Oral Abstracts
O059
O060
Can diabetes prevention programs contribute to long-term weight loss? Preliminary results from a two-year follow up of participants in the Sydney Diabetes Prevention Program
The SHED-IT Community Trial: A randomised controlled trial of Internet- and paper-based weight loss programs tailored for overweight and obese men
P. Vita 1,2,∗ , S. Colagiuri 1 , A. Gibson 1 , A. Bauman 1
P. Morgan 1,∗ , R. Callister 2 , C. Collins 2 , R. 1 1 1 Plotnikoff , M. Young , N. Berry , P. McElduff 2 , T. Burrows 2 , E. Aguiar 2 , K. Saunders 1
1 Boden
Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Australia 2 Sydney Local Health District, Australia Aim: To assess if participants who completed a 12-month lifestyle modification diabetes prevention program, reduce, increase or maintain weight two years after program is completion. Methods: Participants who completed the Sydney Diabetes Prevention Program (the ‘program’) where followed up annually for an additional two years. The program targeted 50—65-year olds at high-risk of Type 2 diabetes with a 12-month lifestyle modification program aimed at improving nutrition (decreasing total fat and saturated fat, increasing fibre), increasing physical activity and 5% weight loss (n = 1238). The mean weight loss of those who completed the program (n = 850) was 2 kg. Participants who had begun the program at least three years ago were contacted annually by computer assisted telephone interview to selfreport their diet, physical activity and weight. Results: Of the 232 participants (mean age 59.4, 68% female) eligible to be contacted the mean weight at program completion was 86.9 kg. At one year and two year follow up the response rates were 88% and 89%, respectively. The mean weight at one-year follow up was 83.1 kg (n = 183) and at two-year follow up 85.1 kg (n = 199). There were no significant differences in weight between the three time points. At the one-year follow up participants reported they were eating less fat and more fibre, however physical activity had not changed. Conclusions: Diabetes prevention programs which target individuals at high-risk of Type 2 diabetes can maintain modest weight loss. More intensive interventions may be required to increase weight loss and reduce or prevent weight gain in this population. http://dx.doi.org/10.1016/j.orcp.2012.08.061
1 Priority
Research Centre in Physical Activity and Nutrition, Faculty of Education & Arts, University of Newcastle, Australia 2 Priority Research Centre in Physical Activity and Nutrition, Faculty of Health, University of Newcastle, Australia Aim: To evaluate the efficacy of two gendertailored weight loss programs for men that required no face-to-face contact. Methods: An assessor-blinded RCT with 159 overweight/obese men (mean [SD] age = 47.5 [11.0] years; BMI = 32.7 [3.5]) randomised (stratified by BMI category) to (1) Resources (gender-tailored weight loss materials [DVD, handbooks, pedometer, tape measure]); (2) Online (Resource materials plus access to a website to monitor diet and exercise with e-feedback provided on seven occasions) or (3) wait-list control group. Outcome measures assessed at baseline, 3- and 6-month follow-up for weight (primary outcome), BMI, % body fat, waist circumference, visceral fat area, blood pressure, resting heart rate, objectively measured physical activity, dietary intake, sitting time, sleepiness, and quality of life. Results: Generalised linear mixed models analyses demonstrated significant between group differences at 6 months for weight (P < .001) in both the Online (−4.7 kg; 95% CI −6.1, −3.2; d = .96) and Resources (−3.7 kg; −4.9, −2.5; d = .83) groups compared to controls (−0.5 kg; −1.4, 0.4). Relative to the control group, intervention effects were found for BMI, % body fat, waist, systolic blood pressure, physical activity, quality of life (physical domain), alcohol risk and portion size. The only significant difference between the Online and Resources group was for waist circumference (P < .001; d = .36). A per-protocol analysis demonstrated (P < .001) Online compliers (−9.7 kg; −12.2, −7.4) lost more weight than Resource compliers (−5.9 kg; −9.0, −2.8). Conclusion: Two novel, minimal contact, gendertailored programs resulted in significant weight loss and improved health-related outcomes in community dwelling men. The nature of the
Oral Abstracts
31
programs would allow dissemination on a large scale. http://dx.doi.org/10.1016/j.orcp.2012.08.062 O061
Effectiveness of interventions using Motivational Interviewing for physical activity and dietary modification in adults: A systematic review J. Hollis 1,∗ , L. Williams 1,2 , C. Collins 1 , P. Morgan 1
Fixed energy expenditure exercise induces similar body weight and appetite responses in males and females N. King 1,∗ , P. Caudwell 2 , C. 2 Finlayson , J. Blundell 2 1 Queensland
Gibbons 2 , G.
University of Technology, Brisbane,
Australia 2 University
O062
of Leeds, UK
Aim: There is a belief that exercise is a less effective weight management tool for females than males. This study was designed to compare body composition and appetite responses to 12 weeks of supervised exercise, between males and females. Method: Overweight and obese males (n = 35) and females (n = 72) took part in 12 weeks of supervised exercise training. The energy cost of the exercise was fixed (2500 kcal/wk), both within and between subjects. Body composition (BodPod), appetite sensations (electronic visual analogue scales) and food intake (laboratory test meals) were measured at weeks 0 and 12. Results: Despite no significant difference in the total exercise-induced energy expenditure between males and females (123 ± 21 MJ and 115 ± 15 MJ, respectively), the average duration of each exercise session was longer for females than males (54 min vs 43 min). Body weight and fat mass were significantly (p < 0.05) reduced in males (−3.03 ± 3.4 kg and −3.14 ± 3.7 kg, respectively) and females (−2.28 ± 3.1 kg and −3.01 ± 3.0 kg, respectively). The differences in losses were not significant between genders. Males and females experienced similar significant increases (p < 0.001) in fasting hunger (11.0 ± 3.7 mm and 14.0 ± 2.7 mm, respectively). Changes in test meal daily energy intake was highly variable but did not significantly change in males (199 ± 2418 kJ) or females (−132 ± 1912 kJ). There was no significant gender × time interaction for changes in fasting hunger or food intake. Conclusion: When supervised, and the energy cost fixed, exercise exerted similar body weight and appetite responses in males and females. However, females had to exercise for longer. http://dx.doi.org/10.1016/j.orcp.2012.08.063
1 Australia
Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Australia 2 University of Canberra, Australia Aim: To determine the effectiveness of interventions employing Motivational Interviewing (MI) to achieve dietary and physical activity behaviour change in adults. Previous systematic reviews of MI have predominately examined long term outcomes rather than behavioural risk factors. Method: The systematic review protocol was approved by the Joanna Briggs Institute (2/8/11). Nine databases were searched up to January 2012. MI adherent studies with dietary intake or physical activity as primary outcomes were eligible for inclusion if they reported monitoring MI fidelity and compared MI intervention arm to an attention control. Studies with pregnant or breastfeeding women, participants aged <18 years or those with clinically diagnosed states, were excluded. The search yielded 1766 articles of which 123 papers were retrieved and 6 met all inclusion criteria. Two reviewers examined all retrieved articles, assessed methodological quality of included studies and performed data extraction using a standardised tool. Results: Five of the six articles were level II evidence with low-to-moderate risk of bias. Two of three articles reporting on diet found significant positive effects: one study found a significant increase in vegetables, fruit, wholegrains and/or beans servings, the other found significantly lower saturated fat intakes (ˇ = 0.23, p = 0.00). One of four articles reporting on physical activity found the MI group increased physical activity at a significantly faster rate. Conclusion: Though suggestive, there is not yet sufficient evidence to conclude that MI enhances changes in physical activity and diet above an attention control. High quality studies measuring MI fidelity and including an attention control are required. http://dx.doi.org/10.1016/j.orcp.2012.08.064