Embree Genevieve G R, Samuel-Hodge Carmen D, Johnston Larry F, Garcia Beverly A, Gizlice Ziya, Evenson Kelly R, DeWalt Darren A, Ammerman Alice S, Keyserling Thomas C
Ambulatory Care Physician, Durham VA Medical Center, Durham, North Carolina, USA.
Department of Nutrition, Center for Health Promotion and Disease Prevention, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA; Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, North Carolina, USA.
BMJ Open Diabetes Res Care. 2017 Mar 29;5(1):e000339. doi: 10.1136/bmjdrc-2016-000339. eCollection 2017.
To examine weight change by diabetes status among participants receiving a Mediterranean-style diet, physical activity, and weight loss intervention adapted for delivery in the southeastern USA, where rates of cardiovascular disease (CVD) are disproportionately high.
The intervention included: Phase I (months 1-6), an individually tailored intervention promoting a Mediterranean-style dietary pattern and increased walking; Phase II (months 7-12), option of a 16-week weight loss intervention for those with BMI≥25 kg/m offered as 16 weekly group sessions or 5 group sessions and 10 phone calls, or a lifestyle maintenance intervention; and Phase III (months 13-24), weight loss maintenance intervention for those losing ≥8 pounds with all others receiving a lifestyle maintenance intervention. Weight change was assessed at 6, 12, and 24-month follow-up.
Baseline characteristics (n=339): mean age 56, 77% female, 65% African-American, 124 (37%) with diabetes; mean weight 103 kg for those with diabetes and 95 kg for those without. Among participants with diabetes, average weight change was -1.2 kg (95% CI -2.1 to -0.4) at 6 months (n=92), -1.5 kg (95% CI -2.9 to -0.2) at 12 months (n=96), and -3.7 kg (95% CI -5.2 to -2.1) at 24 months (n=93). Among those without diabetes, weight change was -0.4 kg (95% CI -1.4 to 0.6) at 24 months (n=154).
Participants with diabetes experienced sustained weight loss at 24-month follow-up. High-risk US populations with diabetes may experience clinically important weight loss from this type of lifestyle intervention.
NCT01433484.
在美国东南部进行一项针对心血管疾病（CVD）发病率极高地区人群的地中海式饮食、体育活动及体重减轻干预研究，观察不同糖尿病状态参与者的体重变化情况。
干预措施包括：第一阶段（第1 - 6个月），针对个人定制的干预措施，推广地中海式饮食模式并增加步行；第二阶段（第7 - 12个月），体重指数（BMI）≥25kg/m²的参与者可选择为期16周的体重减轻干预措施，形式为每周1次共16次的小组课程，或5次小组课程加10次电话指导，也可选择生活方式维持干预措施；第三阶段（第13 - 24个月），体重减轻≥8磅的参与者接受体重维持干预措施，其他所有人接受生活方式维持干预措施。在6个月、12个月和24个月的随访中评估体重变化情况。
基线特征（n = 339）：平均年龄56岁，77%为女性，65%为非裔美国人，124人（37%）患有糖尿病；糖尿病患者平均体重103kg，非糖尿病患者平均体重95kg。糖尿病患者中，6个月时平均体重变化为 - 1.2kg（95%可信区间 - 2.1至 - 0.4）（n = 92），12个月时为 - 1.5kg（95%可信区间 - 2.9至 - 0.2）（n = 96），24个月时为 - 3.7kg（95%可信区间 - 5.2至 - 2.1）（n = 93）。非糖尿病患者中，24个月时体重变化为 - 0.4kg（95%可信区间 - 1.4至0.6）（n = 154）。
糖尿病患者在24个月的随访中体重持续减轻。美国糖尿病高危人群可能通过这种生活方式干预实现具有临床意义的体重减轻。
NCT01433484。
