Harrington Deirdre M, Champagne Catherine M, Broyles Stephanie T, Johnson William D, Tudor-Locke Catrine, Katzmarzyk Peter T
1 Diabetes Research Centre, University of Leicester , Leicester, United Kingdom .
Metab Syndr Relat Disord. 2015 Apr;13(3):125-31. doi: 10.1089/met.2014.0112. Epub 2015 Jan 8.
Strategies to increase adherence to national dietary and physical activity (PA) guidelines to improve the health in regions such as the Lower Mississippi Delta (LMD) of the United States are needed. Here we explore the cardiometabolic responses to an education and behavior change intervention among overweight and obese adults that adapted the 2010 Dietary Guidelines (DG), with and without a PA component.
White and African American overweight and obese adults were randomized to a DG group (n=61) or a DG+PA group (n=60). Both groups received a 12-week dietary education and behavior change intervention, and the DG+PA group also received a PA education and behavior change intervention with a pedometer. Changes in individual risk factors (blood pressure, fasting glucose, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol) and a continuous cardiometabolic risk score were determined. General linear models compared mean changes between groups, adjusting for covariates.
No main effect of intervention group was found in completers (n=99) and those who engaged with ≥80% of the intervention (n=83) for individual risk factors or the continuous risk score. Pooling both groups, those with higher baseline risk factor values realized greater improvements in individual risk factors.
Adapting DG did not produce any cardiometabolic benefits, even with a PA component. Although the sample was ostensibly healthy, they were all overweight to mildly obese (body mass index of 25-34.9 kg/m(2)) and participants with higher baseline risk factor values showed more improvements. Adherence to longer-term behavior change may elicit changes in risk profile, so this should be explored.
在美国密西西比河下游三角洲（LMD）等地区，需要采取策略来提高对国家饮食和身体活动（PA）指南的依从性，以改善健康状况。在此，我们探讨超重和肥胖成年人对一项教育和行为改变干预措施的心脏代谢反应，该干预措施采用了2010年饮食指南（DG），有或没有PA成分。
白人和非裔美国超重和肥胖成年人被随机分为DG组（n = 61）或DG + PA组（n = 60）。两组均接受为期12周的饮食教育和行为改变干预，DG + PA组还接受了使用计步器的PA教育和行为改变干预。确定个体危险因素（血压、空腹血糖、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇）的变化以及连续的心脏代谢风险评分。通用线性模型比较了组间的平均变化，并对协变量进行了调整。
在完成干预的参与者（n = 99）和参与干预≥80%的参与者（n = 83）中，未发现干预组对个体危险因素或连续风险评分有主要影响。将两组合并后，基线危险因素值较高的个体在个体危险因素方面有更大改善。
即使加入PA成分，采用DG也未产生任何心脏代谢益处。尽管样本表面上健康，但他们均为超重至轻度肥胖（体重指数为25 - 34.9kg/m²），且基线危险因素值较高的参与者改善更为明显。坚持长期行为改变可能会引起风险状况的变化，因此应进行探索。
