Kaiser Permanente Center for Health Research, Portland, OR, USA.
Int J Obes (Lond). 2012 Jan;36(1):86-92. doi: 10.1038/ijo.2011.60. Epub 2011 Mar 29.
The LIFE study is a two-phase randomized clinical trial comparing two approaches to maintaining weight loss following guided weight loss. Phase I provided a nonrandomized intensive 6-month behavioral weight loss intervention to 472 obese (body mass index 30-50) adult participants. Phase II is the randomized weight loss maintenance portion of the study. This paper focuses on Phase I measures of sleep, screen time, depression and stress.
The Phase I intervention consisted of 22 group sessions led over 26 weeks by behavioral counselors. Recommendations included reducing dietary intake by 500 calories per day, adopting the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and increasing physical exercise to at least 180 min per week. Measures reported here are sleep time, insomnia, screen time, depression and stress at entry and post-weight loss intervention follow-up.
The mean weight loss for all participants over the intensive Phase I weight loss intervention was 6.3 kg (s.d. 7.1). Sixty percent (N=285) of participants lost at least 4.5 kg (10 lbs) and were randomized into Phase II. Participants (N=472) attended a mean of 73.1% (s.d. 26.7) of sessions, completed 5.1 (s.d. 1.9) daily food records/week, and reported 195.1 min (s.d. 123.1) of exercise per week. Using logistic regression, sleep time (quadratic trend, P=0.030) and lower stress (P=0.024) at entry predicted success in the weight loss program, and lower stress predicted greater weight loss during Phase I (P=0.021). In addition, weight loss was significantly correlated with declines in stress (P=0.048) and depression (P=0.035).
Results suggest that clinicians and investigators might consider targeting sleep, depression and stress as part of a behavioral weight loss intervention.
LIFE 研究是一项两阶段随机临床试验，比较了两种方法来维持引导性减肥后的体重减轻。第一阶段为 472 名肥胖（体重指数 30-50）成年参与者提供了非随机强化 6 个月行为减肥干预。第二阶段是研究的随机减肥维持部分。本文重点介绍第一阶段的睡眠、屏幕时间、抑郁和压力测量。
第一阶段干预包括由行为顾问在 26 周内进行的 22 次小组会议。建议包括每天减少 500 卡路里的饮食摄入，采用停止高血压的饮食方法（DASH）饮食模式，并将体育锻炼增加到每周至少 180 分钟。本文报告的措施是在进入和减肥干预随访后的睡眠时间、失眠、屏幕时间、抑郁和压力。
所有参与者在强化第一阶段减肥干预期间的平均体重减轻量为 6.3 公斤（标准差 7.1）。60%（N=285）的参与者体重减轻至少 4.5 公斤（10 磅），并被随机分配到第二阶段。参与者（N=472）平均参加了 73.1%（标准差 26.7）的课程，每周完成 5.1（标准差 1.9）份日常饮食记录，并报告每周进行 195.1 分钟（标准差 123.1）的运动。使用逻辑回归，睡眠时间（二次趋势，P=0.030）和较低的压力（P=0.024）在进入时预测减肥计划的成功，较低的压力预测第一阶段的体重减轻更大（P=0.021）。此外，体重减轻与压力（P=0.048）和抑郁（P=0.035）的下降显著相关。
结果表明，临床医生和研究人员可能会考虑将睡眠、抑郁和压力作为行为减肥干预的一部分。
