Hawley Greer, Horwath Caroline, Gray Andrew, Bradshaw Alison, Katzer Lisa, Joyce Janine, O'Brien Sue
Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
Prev Med. 2008 Dec;47(6):593-9. doi: 10.1016/j.ypmed.2008.08.008. Epub 2008 Sep 11.
To compare three non-dieting interventions that focused on lifestyle change rather than weight loss, in terms of the sustainability of improvements in lifestyle behaviors, psychological well-being and medical symptoms at 2 years.
In Dunedin, New Zealand in 2002/2003, 225 obese/overweight women (BMI > or = 28; 25-68 years) participated in a randomised, intention-to-treat trial comparing two group programs (P1, P2) and a self-guided mail-delivered program (P3). Only P1 included intensive relaxation response training. All three non-dieting interventions involved a 10-week program, followed by an eight-month support phase. Participants completed baseline, 1-year and 2-year assessments. Outcomes included behavioral, psychological and medical symptom measures and a composite success score.
118 participants completed the 2-year follow-up. Only among P1 participants were the reductions in psychological distress and medical symptoms achieved at 1 year, also maintained at 2 years. At 2 years, P1 participants had significantly greater increases in stress management behaviors than those in P2 (p<0.05), and significantly greater success scores than those in P3 (p<0.05). In all three programs, mean weight was unchanged at 2 years.
Inclusion of relaxation response training in a healthy lifestyle program facilitates long-term maintenance of psychological and medical symptom improvements even in the absence of weight loss.
比较三种非节食干预措施，这些措施侧重于生活方式的改变而非体重减轻，评估其在两年内生活方式行为、心理健康和医学症状改善的可持续性。
2002/2003年在新西兰达尼丁，225名肥胖/超重女性（体重指数≥28；年龄25 - 68岁）参与了一项随机、意向性治疗试验，比较两个团体项目（P1、P2）和一个自我指导的邮寄项目（P3）。只有P1包括强化放松反应训练。所有三种非节食干预措施都包括一个为期10周的项目，随后是一个为期8个月的支持阶段。参与者完成了基线、1年和2年的评估。结果包括行为、心理和医学症状测量以及一个综合成功评分。
118名参与者完成了2年的随访。只有P1组的参与者在1年时实现的心理困扰和医学症状减轻在2年时仍得以维持。在2年时，P1组参与者在压力管理行为方面的增加显著大于P2组（p<0.05），且成功评分显著高于P3组（p<0.05）。在所有三个项目中，2年时平均体重均未改变。
在健康生活方式项目中纳入放松反应训练有助于即使在没有体重减轻的情况下，长期维持心理和医学症状的改善。
